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• Avoid entering areas infested with poisonous plants. • Immediately wash any areas that come into contact with poisonous plants. Use PPE when there is possibility of contact with poisonous plants. 5.1.31 Heat Stress Observe CB&I Procedure CMS-710-01-PR-0600. In addition, observe the following general procedures and practices regarding heat stress: • Increase number of rest breaks and/or rotate workers in shorter work shifts. • Watch for signs and symptoms of heat exhaustion and fatigue. • During hot months,plan work for early morning or evening. • Use ice vests when necessary. Rest in cool,dry areas. 5.1.31.1 Signs, Symptoms, and Treatment Adverse climatic conditions are important considerations in planning and conducting site operations. High ambient temperature can result in health effects ranging from transient heat fatigue, physical discomfort, reduced efficiency, personal illness, increased accident probability, etc., to serious illness or death. Heat stress is of particular concern when chemical protective garments are worn since they prevent evaporative body cooling. Wearing personal protective equipment places employees at considerable risk of developing heat stress. Heat stress is caused by a number of interacting factors, including environmental conditions, clothing, workload, and the individual characteristics of the worker. Because heat stress is probably one of the most common(and potentially serious)illnesses,regular monitoring and other preventive precautions are vital. Heat Rash. Heat rash can be caused by continuous exposure to hot and humid air and skin abrasion from sweat soaked clothing. The condition is characterized by a localized red skin rash and reduced sweating. Aside from being a nuisance, the ability to tolerate heat is reduced. To treat, Keep skin hygienically clean and allow it to dry thoroughly after using chemical protective clothing. Heat Cramps. Heat cramps are caused by profuse perspiration with inadequate electrolytic fluid replacement. This often robs the larger muscle groups (stomach and quadriceps)of blood which can cause painful muscle spasms and pain in the extremities and abdomen. To treat, remove employee to a cool place and give sips of water or an electrolytic drink. Watch for signs of heat exhaustion or stroke. Heat Exhaustion. Heat exhaustion is a mild form of shock caused by increased stress on various organs to meet increased demand to cool the body. Onset is gradual and symptoms should subside within one hour. It symptoms include weak pulse; shallow breathing; pale, cool, moist skin; profuse sweating; dizziness; fatigue. To treat, remove employee to a cool place and remove as much clothing as possible. Give sips of water or electrolytic solution and fan the person continuously to remove heat by convection. Do not allow the affected per-son to become chilled—treat for shock if necessary. Heat Stroke. Heat stroke is the most severe form of heat stress; the body must be cooled immediately to prevent severe injury and/or death. This is a medical emergency! Symptoms include red, hot, dry skin; body temperature of 105- Fahrenheit or higher; no perspiration; nausea; dizziness and confusion; strong, rapid pulse. Since heat stroke is a true medical emergency, transport the victim to a medical facility immediately. Prior to transport, remove as much clothing as possible and wrap the victim in a sheet soaked with water. Fan vigorously while transporting to help reduce body temperature. Apply cold packs, 5-17