DAFI48-151 2 MAY 2022 15
Chapter 3
HEAT STRESS PROGRAM ELEMENTS
3.1. Heat Illnesses. Heat illnesses are interrelated and include some degree of elevated body
temperature which may be complicated by deficits of body water. Heat illnesses include heat
stroke, heat syncope, heat exhaustion, heat cramps, hyponatremia, heat rash, rhabdomyolysis, and
other similar type issues.
3.2. Critical Elements of a Heat-Related Illness Prevention Program. According to National
Institute for Occupational Safety and Health (NIOSH), Criteria for a Recommended Standard:
Occupational Exposure to Heat and Hot Environments, there are four critical elements of a heat-
related illness prevention program: (1) Acclimatization Program; (2) Training Program; (3) Heat
Alert Program and (4) Medical Monitoring Program. Furthermore, and from a Joint Force Health
Protection warfighting perspective, commanders at all levels employ these critical elements in
preparation for and during Chemical, Biological, Radiological, and Nuclear (CBRN) operations
that require personnel to wear Mission Oriented Protective Posture (MOPP) and Individual
Protective Equipment. In effect, these combined elements are a critical enabling capability that
support overarching CBRN survivability and mission continuation. Furthermore, more details
regarding thermal stress while wearing MOPP is documented in Air Force Tactics, Techniques
and Procedures (AFTTP) 3-2.46, Multi-Service Tactics, Techniques, and Procedures for
Chemical, Biological, Radiological, and Nuclear Passive Defense.
3.3. Acclimatization Program. An effective acclimatization program will reduce the impact
heat stress will have on the core body temperature of the worker. NIOSH recommends gradually
acclimating the worker to his or her new environment by increasing the time of exposure each day
over a 7 to 14 day period. The time to acclimatize varies by worker based on individual risk
factors. Workplace supervisors shall consult Bioenvironmental Engineering for assistance
developing an acclimatization plan. (T-3) Bioenvironmental Engineering may refer to NIOSH’s
Criteria for a Recommended Standard: Occupational Exposure to Heat and Hot Environments
when assisting supervisors to develop acclimatization plans. Additionally, adequate hydration
following heat exposure is required for acclimatization, equal to or greater than volume of sweat
lost. It is known that a physically fit individual will acclimatize in half the time of a worker who
is not physically fit. Also, acclimatized workers who are not exposed to heat stress for a week or
more will need to re-acclimatize to the hot environment, typically completed in two or three days.
3.4. Training Program.
3.4.1. A heat stress training program ensures supervisors and workers are prepared to work
safely in hot environments.
3.4.2. Employee Heat Stress Training. Employee training shall include information about
acclimatizing, proper hydrating/fluid intake, recognizing and reporting heat-related illness
symptoms, giving appropriate first aid, proper care and use of heat-protective clothing, added
heat load caused by exertion/clothing/personal protective equipment, other factors that affect
heat tolerance (e.g., medications, alcohol, obesity, relevant health conditions such as sickle cell
trait status, etc.), and how to ensure weather data (i.e., WBGT) is part of the process for making
work/rest cycle decisions. (T-1)