Working in hot weather

Working in hot weather when temperatures in the workplace can be significantly elevated, can be uncomfortable. It can increase the likelihood of accidents and injuries, have an adverse effect on your health and impact patient safety, particularly where nursing staff are dehydrated or experiencing heat stress.

Heat and raised summer temperatures

There is no legal maximum temperature for workplaces, however the Workplace (Health, Safety and Welfare) Regulations require employers to provide a reasonable indoor temperature in the workplace.

Under the Management of Health and Safety at Work Regulations, employers must:

assess the risks of working in high temperatures to nursing staff
put suitable controls in place to protect them from adverse effects.

As heat is a hazard, workplace temperature should be factored into activity/ area risk assessments for nursing staff, including those working in the community. In addition, heat/ increased temperatures should be considered in individual risk assessments for nursing staff with health conditions which may be exacerbated by heat. Heat should also be considered in pregnancy risk assessments.

Employers should consult with nursing staff and trade union representatives on the proposed measures to manage workplace temperatures.

Potential risks of increased workplace temperatures

The main risks include:

not drinking enough cool liquids (dehydration)
overheating - which is a risk for people who already have certain health conditions including problems with their heart or breathing
heat exhaustion and heatstroke.

Risk	Signs and symptoms
Dehydration: not drinking enough liquids	feeling thirsty dark yellow and strong smelling urine urinating less often that usual feeling dizzy or lightheaded feeling tired a dry mouth, lips and tongue sunken eyes headache.
Heat exhaustion symptoms: heat exhaustion occurs when the body overheats and cannot cool down. If action is not taken to cool down, heat exhaustion can lead to heatstroke.	tiredness headache dizziness and confusion loss of appetite and feeling sick excessive sweating and skin becoming pale and clammy or getting a heat rash, but a change in skin colour can be harder to see on brown and black skin cramps in the arms, legs and stomach fast breathing or pulse a high temperature of 38C or above being very thirsty weakness feeling faint. If someone is showing signs of heat exhaustion, they need to be cooled down and given fluids.
Heatstroke: this is where the body is no longer able to cool down and body temperature becomes dangerously high.	confusion lack of co-ordination fast heartbeat fast breathing or shortness of breath hot skin which does not sweat seizures. Heatstroke is a medical emergency.

Sun exposure

Nursing staff who work outside, even for short periods of time, are at risk of sunburn and skin damage caused by ultraviolet (UV) rays in sunlight.

Nursing staff are unlikely to work outdoors for prolonged periods of time but may be involved in supporting groups on trips and community nurses travel to patient/ service users’ homes.

Nursing staff involved in work outdoors should cover as much skin as possible, use a minimum of SPF15 factor sunscreen on any exposed skin and try to stay in the shade wherever possible. Anyone with fair/ freckled skin that doesn’t tan or burns easily, has red or fair hair and light-coloured eyes, or has a large number of moles should consider additional measures including wearing a hat that covers the ears and back of the neck.

Personal Protective Equipment (PPE)

Nursing staff who are required to wear PPE including respiratory protection, eye protection, aprons etc. are at risk of increased body temperature when working in high temperatures. Employers should review the risk assessment for the activity that requires PPE and implement additional measures, such as ensuring PPE is only worn for the task requiring it, discarding single use PPE when taking breaks, taking breaks more frequently and wearing lighter, loose fitting uniforms.

Weather forecasts and health alerts

In England the MET office, in partnership with the UK Health Security Agency, operates the Heat-health Alert Service from June to September each year. The service forewarns of periods of high temperatures, which may affect the health of the public, using a green to red colour warning system. Red being the most serious, indicating a significant risk to life.

Devolved nations have their own threshold action levels and members living or working in those locations should refer to the advice issued by the devolved administrations:

Actions employers should take to identify and manage risks to staff

Employers must take action to assess the risk to staff working in hot weather. This should include:

undertaking risk assessments for tasks, activities and/or a working area taking into consideration hot weather/ increased workplace temperatures in line with weather forecasts and relevant alerts.
consulting with staff and Trade Union Reps on the control measures for managing heat/ increased workplace temperatures.
ensuring that business continuity and emergency preparedness plans are in place for periods of extreme heat e.g. in line with amber/ red alerts (England).
undertaking individual risk assessments for staff with health conditions (including those experiencing difficulties with menopause) who are adversely affected by heat/ temperature in line with weather forecasts and relevant warnings.
making use of the RCN health ability passports to support specific adjustments required when temperatures rise (in line with controls identified in the individual risk assessment).
ensuring that pregnancy risk assessments identify heat/ workplace temperature as a hazard for consideration and are reviewed in line with weather forecasts and relevant warnings.
ensuring mechanical ventilation systems including air conditioning, cooling and HVAC systems are inspected and maintained in line with manufacturer requirements, and where required statutory periodic tests and examinations are completed every 14 months as a minimum.

Control measures to protect staff

Employers must ensure they implement suitable control measures to protect staff during hot weather. Examples include:

installing thermometers in work areas to monitor the temperature
installing blinds or a reflective film on windows to reduce direct sunlight
ensuring there is good ventilation in the workplace to keep it cool either by using:
- natural ventilation – opening doors/ windows to allow in fresh air,
- mechanical ventilation which supplies fresh/ cool/ purified air to working areas
positioning workstations away from direct sunlight or sources of heat
insulating heat sources properly e.g. placing insulating materials around hot plant and pipes
encouraging staff to take increased breaks to rest
providing staff with easy access to cool drinking water and information on staying hydrated
providing cool rest areas for staff to take their breaks
selecting uniforms made from loose breathable fabrics
considering whether there is any flexibility in staff being able to wear alternative clothing/ uniform during extreme heat
where staff are required to wear PPE, considering:
- whether the tasks/ activity need to take place
- where tasks need to continue, introducing flexible working patterns e.g. reducing amount of time spent undertaking tasks in PPE
- increasing the frequency of breaks
- single use PPE which is changed regularly
- providing additional uniform and opportunities to change uniform
introducing flexible working patterns e.g. rotating staff, moving staff to work in cooler areas of a building
providing staff, particularly those who work night shifts, with advice and support on getting good quality sleep in hot weather/ increased temperatures
training staff to recognise the signs of heat exhaustion/ dehydration
informing staff to report any incidents relating to heat/ raised workplace temperatures through the employer incident reporting system.

Additional specific concerns for nurses working in a peripatetic/community role

Community nurses may need additional controls and employers should consider:

developing and implementing plans to consider the way that work is organised during very hot temperatures/ amber and red alerts (England) e.g. reducing the need to travel during the hottest part of the day between 11am-3pm
risk assessments to assess the risk of damage/ overheating of medical equipment and supplies transported in vehicles during hot weather/ increased temperatures
risk assessments to assess the risk of carrying equipment/ supplies during hot weather and how this can be managed to reduce strenuous tasks/ activitiesrisk assessments that consider the risk of fire from items left in a vehicle when unattended e.g. prescription sunglasses
information and guidance for staff on:
- working in hot weather
- parking vehicles in shaded areas where possible
- wearing high factor sunscreen
- asking service users/ patients to open windows, where possible, during their visit
providing staff with reflective windscreen covers to reduce sunlight/ glare into the vehicle when parked
managing work to ensure staff are able to take increased frequent breaks to rest
establishing methods for staff to access cool drinking water e.g. provide reusable water bottles
providing access to cool rest areas for breaks
considering alternative ways of working when extremely high temperatures are forecast e.g. remote work
ensuring staff are provided with information on how to keep cool and stay hydrated.

Raising concerns

If you have concerns you can:

contact your RCN Representative and ask for their help and support
contact us for further support and advice.

If you don’t have an RCN Representative in your workplace, you can ask your line manager/ employer some questions about how heat in the workplace is being managed.

Have you thought about becoming an RCN Safety Representative?

If you are an RCN member and a registered nurse, nursing associate or nursing support worker in employment, you can apply to become an RCN representative.

Becoming an RCN Safety rep gives you the chance to make a real difference to your patients, colleagues and even the future of nursing.

RCN safety reps understand and champion safe working practice and environments. They help members understand what they should expect and how to identify where standards fall short, leaving them at risk.

Safety reps build strong relationships in their workplace and understand how to influence for change. They connect with members to find out what matters to them, provide support to get those issues heard and win changes that make a difference.

You will be provided with a structured and supported learning pathway and will have access to support from the learning and development team, your local Regional Officers and the Health Safety and Wellbeing team.