Heat Illness Prevention Training Guide 

Acknowledgments: 

This Heat Illness Prevention Training Guide was adapted from materials developed by the Labor 

Occupational Health Program (LOHP), University of California, Berkeley. These materials are 

part of the Worker Occupational Safety and Health Training and Education Program 

(WOSHTEP), which is administered by the Commission on Health and Safety and Workers’ 

Compensation in the Department of Industrial Relations through interagency agreements with 

LOHP and the Labor Occupational Safety and Health Program (LOSH) at the University of 

California, Los Angeles (UCLA).

Some of these materials were adapted from Heat Hazards in Agriculture – a Guide for 

Employers to Carry Out Tailgate Training for Workers, developed by The Division of 

Occupational Safety and Health, better known as Cal/OSHA and Labor Occupational Health 

Program (LOHP). 

For additional information on acknowledgments and technical contributors, please see: 

http://www.dir.ca.gov/chswc/reports/CHSWC_HeatAgriculturEnglish.pdf

For More Information:

U.S. Department of Labor 

Occupational Safety and Health Administration

1-800-321-OSHA (6742) 

TTY 1-877-889-5627 

www.osha.gov

Users are encouraged to photocopy or adapt this information as needed 

for not-for-profit training purposes. 

Please acknowledge CalOSHA and LOHP for producing the materials. 

Heat Illness Prevention Training Guide – i

Table of Contents 

Introduction ......................................................................................................................1 

The Heat Illness Prevention Training Guide ....................................................................4 

Training Session #1: Health Effects of Heat .................................................................6 

Training Session #2: How to Respond to Symptoms ................................................. 11 

Training Session #3: Preventing Heat Exhaustion ..................................................... 13 

Additional Resources ..................................................................................................... 17 

Daily Checklist ............................................................................................................ 18 

OSHA Fact Sheets and Posters ................................................................................. 19 

For Use in Training ..................................................................................................... 30 

Rogelio’s Story ....................................................................................................... 31 

Diagram #1. Preventing Heat Illness ...................................................................... 32 

Diagram #2. Health Effects of Heat ........................................................................ 33 

Heat Illness Prevention Training Guide – 1

Introduction 

The past few summers have shown that the risk of heat illness from high 

temperatures is one of the most serious challenges to the safety and health of 

workers. 

This training guide will help you plan how to prevent heat illness among your crew 

and provide training to your workers. The training guide includes the following 

tools for the supervisor or crew leader to use: 

 Complete instructions for teaching workers about heat hazards. (pages 4-16)

 Additional resources: 

o A daily checklist to make sure all appropriate precautions are in place 

each workday. (page 18)

o OSHA Heat Safety Fact Sheet, in English and Spanish, that reviews 

some of the key information about heat illness. (pages 19-23)

o Easy-to-read OSHA posters, in English and Spanish, for the worksite 

and the community that you can copy and distribute to workers. 

(pages 24-29)

The training is designed to be: 

 Short — it’s 45 minutes long, but if you’d prefer you can carry it out in 

three 15-minute sessions as meetings before the work shift or during “shade 

breaks.” 

 Participatory — for workers to be able to ask questions and have some 

discussion, which increases the likelihood they will remember the 

information. 

 Easy to follow — so a supervisor or crew leader can lead the training. 
Heat Illness Prevention Training Guide – 2

Why is it important to prevent heat illness?

 Heat illness can be a matter of life and death. Workers die from heat stroke 

every summer and every death is preventable. 

 When heat stroke doesn’t kill immediately, it can shut down major body 

organs causing acute heart, liver, kidney and muscle damage, nervous 

system problems, and blood disorders. 

 Having a serious injury or death occur at work affects everyone at a 

worksite. 

 Workers suffering from heat exhaustion are at greater risk for accidents, 

since they are less alert and can be confused. 
Heat Illness Prevention Training Guide – 3

The Training 

Providing short training sessions can be a very efficient way to reach workers with 

health and safety information. Like all training, making sure you are effective in 

communicating the information takes preparation and a real desire to involve your 

crew in health and safety. In this guide, you will find some advice for trainers that 

can help encourage discussion and enable workers to be active players in keeping 

the job safe. 

Follow these three steps to prepare for and carry out the training: 

1. Read and become familiar with the Heat Illness Prevention Training Guide

(beginning on page 4). 

2. Hold the training. 

3. Obtain feedback. To conclude the training, you may want to ask the crew for 

feedback. Did they understand the material? Was it well presented? Was it 

helpful and relevant to their particular type of work? 
Heat Illness Prevention Training Guide – 4

The Heat Illness Prevention Training Guide 

How to use this guide: 

The training guide is written so that you can easily follow it. It is divided into 

three 15-minute sessions: 

Session 1: Health effects of heat 

Session 2: How to respond to symptoms 

Session 3: Preventing heat illness 

To provide this training, you will be leading a discussion in which you ask 

questions and encourage participation. 

How the guide is formatted: 

The training guide will lead you through the training. It includes instructions for 

you as the trainer as well as questions you can ask to lead a discussion. 

 Most of the training guide is made up of the questions and comments that 

you as the trainer will be reading out loud, or saying once you get to know 

the material and are comfortable with it. A talking head icon (y) is used to 

show where you will be speaking. 

 Instructions to the trainer are numbered and written in bold italics. You do 

not need to read these out loud. 

 The answers to questions are provided in Wait for the 

crew to give answers based on what they know, and then add any missing 

points or clarify any information if needed.

shaded boxes.
Heat Illness Prevention Training Guide – 5

To prepare to teach the training sessions: 

1. Spend about 15 minutes becoming familiar with this Heat Illness Prevention 

Training Guide. Read it over and make sure you understand all the 

information. 

2. Fill in the blanks in the training guide. Adding these details helps make sure 

that the safety meeting deals with actual conditions on your own job site. 

3. There are three drawings you will use in the sessions. They are on pages 31-

33 and you can hold them up to show the crew as you teach. Or you may 

want to make copies of them ahead of time. 

Advice for Trainers 

Safety meetings work best if the whole crew actively participates. This makes it 

more interesting and more likely that people will remember the information 

you’ve provided. Here are some ways to encourage everyone to get involved: 

 Ask questions instead of simply giving them all the information. After you 

ask a question, wait a short time to let people think. Then call on volunteers 

to answer. After workers have provided their answers, use the information in 

the answer boxes to add any points the crew missed. 

 Ask about personal experience. This can help the group see how the topic is 

relevant to them. You could ask: Has anyone experienced any problems with 

heat, such as heat cramps? What happened? What did you do to recover? 

 Limit the amount of time any one person can talk. If a crew member is 

talking too much, invite someone else to speak. 

 Never make fun of anyone, or put anyone down, especially for asking 

questions. 

 Don’t fake it. If you don’t know the answer to a question, don’t guess or 

fake the answer. Write the question down and promise to get back to them. 

 Stick to the topic. If the crew’s questions and comments move too far from 

the topic, tell them that their concerns can be addressed later, either privately 

or in another safety meeting. 
Heat Illness Prevention Training Guide – 6

Training Session #1: Health Effects of Heat 

1. Introduce the topic by saying something like this: 

y Today we are going to talk about how heat can affect you and what 

symptoms you should watch out for. Heat exhaustion can often affect you 

before you even realize it, so it’s important to be very aware of the signs. 

2. Ask the crew these questions: 

(Wait for their answers and then use the shaded answer boxes to add any information they missed.) 

y Just like we can’t let a car engine overheat or it shuts down, we don’t want 

your body to get too hot. Let’s start by talking about heat — where does 

the heat come from that causes our bodies to overheat? 

y Working outdoors, especially in hot and humid weather, being in the sun, 

and doing hard physical work is something we have to take seriously. 

What are some of the signs you may notice if your body is getting too hot? 

(Time: 15 minutes) 

· Hot weather 

· Humid weather 

· Sun – you absorb more heat if you are in the sun 

· Heat our bodies generate when we are physically 

active and doing hard work 

· Headache, dizziness, or fainting 

· Weakness and wet skin 

· Irritability or confusion 

· Thirst, nausea, or vomiting 
Heat Illness Prevention Training Guide – 7

y These are the early signs that you need to cool off, rest, and drink water to 

let your body recover. If you don’t, you could develop some of the more 

serious effects of heat. 

3. Show the crew Diagram #1, Preventing Heat Illness, on page 32. Review the 

following points: 

y Working outdoors is hard work and you will feel sweaty and tired. 

Workers need to drink water, take shade breaks, and rest to prevent heat 

problems (point to A in the diagram). 

Then, if you feel better, you can go back to work (point to B), but you 

should still drink water frequently and take another break when you need 

to. If you don’t feel better, talk to your supervisor right away. 

4. Show the crew Diagram #2, Health Effects of Heat, on page 33. Review the 

following points:

y This diagram will help us understand what happens when you are affected 

by heat. 

If you are working in the heat, especially if you’re not drinking enough 

water or taking enough breaks, you may get heat exhaustion (point to C).

 You may get a headache, experience dizziness, or faint. 

 You could get weak or have wet skin. 

 You may become irritable or confused. 

 You may be thirsty, nauseous, or vomit. People react differently, so you 

may have just a few of these symptoms, or most of them. 

 If you start to feel confused, or if you vomit or become faint, you may 

be having a more serious response. 

Workers may also develop what is called heat stroke (point to D).

 At this point, you may be confused, unable to think clearly, pass out, 

collapse, or have seizures (fits). 
Heat Illness Prevention Training Guide – 8

 You may stop sweating. Sweating is the main way our bodies cool off 

— so not sweating is a very serious emergency. 

There have been cases where workers have seemed fine at lunch and a couple of 

hours later were found having seizures or unconscious. It can happen quickly. The 

best way to protect ourselves is to prevent heat exhaustion — by drinking plenty of 

water, taking breaks, and resting to cool off. (Point to A on Diagram #1.) 

Weakness, headache, and wet skin Weakness, headache, and wet skin

D) may be confused, 

unable to think 

clearly, pass out, 

collapse, or have 

seizures (fits), may 

stop sweating 

C) may have 

headache, 

dizziness, or 

fainting, 

weakness and 

wet skin, irritability 

or confusion, 

thirst, nausea, or 

vomiting
Heat Illness Prevention Training Guide – 9

5. Ask the crew these questions: 

(Wait for their answers and then use the shaded answer boxes to add any information they missed.) 

y To review, what are some of the signs that you are developing heat 

exhaustion? 

y What are some of the signs of heat stroke? 

· Headache 

· Dizziness or fainting 

· Weakness 

· Wet skin 

· Irritability 

· Thirst 

· Nausea or vomiting 

· WARNING: If you feel FAINT, CONFUSED, or 

if you VOMIT – you need help FAST! 

· May be confused 

· May be unable to think clearly 

· May pass out 

· May collapse 

· May have seizures (fits) 

· May stop sweating 
Heat Illness Prevention Training Guide – 10

y Heat illness can affect us all, but some people are at greater risk. What do 

you think would put a person at greater risk? 

6. Stress the following points: 

y Not being used to working in heat is a big problem. Most of the people 

who died from heat stroke in the past few years were in their first few days 

on the job or were working during a heat wave. If you haven’t worked in 

hot weather for a week or more, your body needs time to adjust. You need 

to take more breaks and not do too much strenuous work during your first 

weeks on the job. 

Some health conditions can put you at greater risk of heat illness. These 

include diabetes, kidney and heart problems, pregnancy, and being 

overweight. If you have these, it would be good to talk to your doctor 

about the work you do and ask whether there are any special precautions 

you need to take. 

7. To conclude, ask if anyone has questions, then close by saying: 

y Next time, we are going to talk about how you should respond if you or 

your co-workers are feeling any of these symptoms. 

· You aren’t used to working in heat or doing heavy 

work. 

· You are new to working outdoors. 

· You are not physically fit or are overweight. 

· You drink alcohol or take drugs (illegal drugs or 

prescription medicine). 

· You wear heavy, dark, or tight clothing, or use 

personal protective equipment. 

· You had some early heat-related symptoms the day 

before. 
Heat Illness Prevention Training Guide – 11

Training Session #2: How to Respond to Symptoms 

1. Introduce the topic by saying something like this: 

y Last time, we talked about the symptoms you may get if you have heat 

exhaustion or the very serious condition called heat stroke. Today we are 

going to talk about what you should do if you or your co-workers are 

having these symptoms. 

2. Ask the crew these questions: 

(Wait for their answers and then use the shaded answer boxes to add any information they missed.) 

y Let’s say there is a worker in our crew who has signs of heat exhaustion: 

she is very sweaty, weak, and has a headache. What do you think you 

should do? 

3. Add the following points: 

y Be prepared to describe the symptoms and know how to describe our 

location to the emergency personnel so they can find us quickly. 

Don’t wait because heat exhaustion can quickly become more dangerous.

(Time: 15 minutes) 

1. Notify the supervisor. She needs medical help. 

2. Move the person to a cooler place to rest in the 

shade. Don’t leave her alone. 

3. Little by little, give her water. 

4. Loosen her clothing. 

5. Help cool the person. Fan her, put ice packs on her 

groin and underarms, or soak her clothing with 

cool water.
Heat Illness Prevention Training Guide – 12

Be alert to unusual behavior: if your co-workers seem confused, or are 

sitting by themselves or walking around aimlessly, ask them if they’re 

okay. If they seem to be acting strangely, they may have heat stroke. 

Contact the supervisor. 

4. For the next activity pick one of the workers to be a person who has heat 

exhaustion, and explain: 

(Make sure the crew acts out what they would do, instead of just telling you. Add any points they miss 

from the shaded box below.) 

y Now to review how we would respond, you are going to practice what you 

should do if someone is having symptoms of heat exhaustion. 

Let’s say you are working with (fill in name) and you notice he is very 

sweaty and confused, and he looks disoriented and can’t seem to 

concentrate on his work. Show me what you would do. 

5. To conclude, ask if anyone has questions, then close by saying: 

y Now we have learned how we would respond if someone developed heat 

exhaustion, but the best strategy is always prevention. Next time, we are 

going to talk about how to prevent heat exhaustion. 

1. Call the supervisor and asks for medical help.

2. Move the person to a cooler place to rest in the 

shade. Stay with the person. 

3. Give the person water as long as he/she is not 

losing consciousness or vomiting. 

4. Loosen the person’s clothing. 

5. Help cool the person. Fan the person, put ice packs 

on the person’s groin and underarms, or soak the 

person’s clothing with cool water. 
Heat Illness Prevention Training Guide – 13

Training Session #3: Preventing Heat Exhaustion 

1. Introduce the topic by saying something like this: 

y While heat exhaustion is very dangerous, it is also preventable. Today we 

are going to review what we have learned so far and talk about what we 

can do to protect ourselves from heat. There are three simple words: water, 

rest, shade. Heat illness can be prevented: Drink water often, even if you 

aren’t thirsty; rest in the shade to cool down; report heat symptoms early; 

know what to do in an emergency.

2. Show the crew the drawing of Rogelio on page 31. Read the following story 

out loud: 

y Rogelio is a new member of a crew that is picking melons in the fields. On 

his second day, he works hard for long periods without a break. In the early 

afternoon his co-worker, Julio, looks over and sees that Rogelio is 

sweating profusely and is acting 

strangely. Julio asks Rogelio 

what’s going on, and Rogelio 

says he has a slight headache and 

feels dizzy.

Julio realizes Rogelio needs help 

and calls the crew leader. 

Together they give him water 

and help him sit down. Julio 

stays with him while the crew 

leader calls 911 for medical help. 

Rogelio recovers, but can’t work 

for a few days. Later, he says he 

had wanted to show he could 

work hard, and he didn’t drink 

much water because he didn’t 

feel thirsty.

(Time: 15 minutes) 
Heat Illness Prevention Training Guide – 14

3. Ask the crew these questions: 

(Wait for their answers and then use the shaded answer boxes to add any information they missed.) 

y How do you know Rogelio may be suffering from heat exhaustion? 

y What went well in this case to address heat exhaustion? 

y What went wrong? 

· He is sweating, weak, has a headache, and feels 

dizzy. 

· Julio called the crew leader. 

· They gave Rogelio water. 

· They called 911. 

· They helped him sit down to rest. 

· Julio was watching out for his co-worker. He 

stayed with Rogelio while the crew leader made 

the call. 

· Rogelio wasn’t used to working in the heat. He 

should have had less intense work until he got used 

to working in the heat. 

· They had not made sure Rogelio got adequate 

breaks. 

· Rogelio hadn’t drunk water. You shouldn’t wait 

until you are thirsty to drink. 

· They didn’t take Rogelio to shade. 

· Rogelio wanted to prove he could work hard — he 

didn’t report symptoms as soon as he felt them. 
Heat Illness Prevention Training Guide – 15

y So what can we learn from this – what are the important steps to prevent 

heat exhaustion? 

4. Add the following points: 

y It is recommended that each person drink water often. 

 It’s better to drink small amounts frequently, as opposed to larger 

amounts less often. 

 Drink even if you don’t feel thirsty. 

 Avoid drinks like sodas or coffee that have caffeine, or alcoholic drinks 

– these drinks dehydrate you and can make it more dangerous to work 

in the heat. Also avoid sports drinks as these contain too much sugar. 

 People worry that if they drink a lot of water, they’ll have to go to the 

bathroom more often. In fact, you’ll mostly sweat it off. 

 When you’re not at work, still drink plenty of water to help your body 

recover from the workday. 

 During a heat wave, it is recommended to provide more frequent 

breaks.

· Rogelio wasn’t used to working in the heat. He 

should have had less intense work until he got used 

to working in the heat. 

· They had not made sure Rogelio got adequate 

breaks. 

· Rogelio hadn’t drunk water. You shouldn’t wait 

until you are thirsty to drink. 

· They didn’t take Rogelio to shade. 

· Rogelio wanted to prove he could work hard – he 

didn’t report symptoms as soon as he felt them. 
Heat Illness Prevention Training Guide – 16

 Pair off and watch your co-worker for signs of heat exhaustion. Remind 

your buddy to drink water or take a break. Talk to your buddy during 

the work shift to make sure everything is okay. Sometimes people with 

heat exhaustion get disoriented and think they are okay. If you suspect a 

problem, keep checking on your co-worker or tell a supervisor. 

 Sometimes people say they are more protected by dark-colored, heavier 

clothing. This will only make you hotter. Wear light-colored 

lightweight cotton clothing. 

5. Explain to the crew: 

y There are also ways to prevent heat exhaustion that have to do with how 

the work is done. At our site we will: (check those that apply to your site)

 Schedule our work to do the more strenuous tasks during cooler times 

of the day. 

 Start work earlier and end earlier. 

 Add more scheduled breaks. 

 Other: _________________________________________________ 

6. Ask the crew this question: 

y What other suggestions do you have for what we can do on this job site to 

prevent heat exhaustion? 

(Give the crew a few minutes to come up with suggestions. Make a plan for implementing 

good ideas.) 

7. To conclude, ask if anyone has questions and remind workers of the following 

four points: 

y 1) Drink water often; 2) Rest in the shade; 3) Report 

heat symptoms early; 4) Know what to do in an 

emergency.
Heat Illness Prevention Training Guide – 17

Additional Resources 
Heat Illness Prevention Training Guide – 18

Daily Checklist 

Daily Checklist ;

This is a helpful guide that you may 

choose to use before each workday. 

Checklist ;

Water 

Is there plenty of fresh, cool drinking water 

located as close as possible to the workers? 

Are water coolers refilled throughout the day? 

Shade Is there shade available for breaks and if workers 

need to recover? 

Training

Do workers know the: 

Common signs and symptoms of heat illness? 

Proper precautions to prevent heat illness? 

Importance of acclimatization? 

Importance of drinking water frequently (even 

when they are not thirsty)? 

Steps to take if someone is having symptoms? 

Emergencies

Does everyone know who to notify if there is an 

emergency? 

Can workers explain their location if they need to 

call an ambulance? 

Does everyone know who will provide first aid? 

Worker 

Reminders

Drink water often 

Rest in the shade 

Report heat symptoms early 

Know what to do in an emergency 
Heat Illness Prevention Training Guide – 19

OSHA Fact Sheets and Posters 

OSHA Publications attached are: 

 OSHA Heat Safety Fact Sheet, Publication #3422; English 

 OSHA Heat Safety Fact Sheet, Publication #3423; Spanish 

 OSHA Heat Illness Worksite Poster, Publication #3431; English 

 OSHA Heat Illness Worksite Poster, Publication #3432; Spanish 

 OSHA Heat Illness Community Poster, Publication #3435; English 

 OSHA Heat Illness Community Poster, Publication #3436; Spanish 
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For Use in Training 
Heat Illness Prevention Training Guide – 31

 Story 
Heat Illness Prevention Training Guide – 32

Diagram #1. Preventing Heat Illness 

Weakness, headache, 

and wet skin 
Heat Illness Prevention Training Guide – 33 

#2. Health Effects of Heat 

D) may be confused, 

unable to think clearly, 

pass out, collapse, or 

have seizures (fits), 

may stop sweating 

C) may have headache, 

dizziness, or fainting, 

weakness and wet skin, 

irritability or confusion, 

thirst, nausea, or vomiting 

Weakness, headache, 

and wet skin