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One or more of the following control measures can be used to help control heat stress and are mandatory if any site worker has a heart rate (measured immediately prior to rest period) in excess of 110 beats per minute: • A work regimen that will provide adequate rest periods for cooling down will be established, as requited. • Cooling devices such as vortex tubes or cooling vests should be used when personnel must wear impermeable clothing in conditions of extreme heat. • Employees should be instructed to monitor themselves and coworkers for signs of heat stress and to take additional breaks as necessary. • A shaded rest area must be provided. All breaks should take place in the shaded rest area. • Employees shall not be assigned to other tasks during breaks. • Employees shall remove impermeable garments during rest periods. This includes white Tyvek-type garments. �. The signs of heat stress disorders are given below. Heat Cramps. Heat cramps are caused by heavy sweating and inadequate electrolyte replacement. Signs and symptoms include muscle spasms and pain in the hands, feet and abdomen. i Heat Exhaustion. Heat exhaustion occurs from increased stress on various body organs. ■ Signs and symptoms include: • Pale, cool , moist skin; • Heavy sweating; ' Dizziness, nausea; and/or • Fainting. Heat Stroke. Heat stroke is the most serious form of heat stress and should always be treated as a medical emergency. The body's temperature regulation system fails, and the body temperature rapidly rises to critical levels. Immediate action must be taken to cool the body before serious injury or death occurs. Signs and symptoms of heat stroke include: • Red, hot unusually dry skin; • Lack of, or reduced perspiration; • Nausea.; • Dizziness and confusion; M71054)9-94/usTA44X164 4-8 1