FIQ (Fédération Interprofessionnelle de la santé du Québec)

Discomfort and heat stress are serious issues that healthcare professionals must face in many workplaces. The health crisis has had major impacts: depleted teams, heavier workload, multiple personal protective equipment (PPE), etc. This new reality inevitably adds its own set of additional difficulties in a context of heat.

Hereafter is a series of ways for minimizing the risks and discomforts associated with the heat in your workplaces. The best way to implement these ways is in the collective action of the healthcare professionals themselves. Don’t hesitate to contact your union team to assist you and in acting collectively.

Pandemic context

Aerosol transmission of SARS-CoV-2 is well documented. During the summer, it is common practice to open windows to allow natural ventilation when the outside temperature is cooler than the inside temperature. However, it is recommended to always verify first with the infection prevention and control service (IPC) whether this type of practice can pose specific risks given the air currents generated and the aerosol transmission of the virus. A similar check should be made before installing fans, air conditioners or dehumidifiers.

Additional personal protective equipment heightens the dangers of thermal stress. Wearing an extra layer of clothing reduces the human body’s capacity to regulate its temperature. Moreover, wearing PPEs for extended periods can complicate hydration. In this context, the FIQ believes that it is the employer’s responsibility to plan an organization of work ensuring the healthcare professionals’ safety. The latter can increase the number of breaks, give the time needed to hydrate and reduce the workload.

What employers should plan on

The process of identifying and reducing occupational health and safety risks is always done in a sequence from elimination at source to individual measures. The process of addressing the risks associated with heat is no exception.

At the source:

  • In accordance with ICP rules, where possible, air-condition the workplace or a section of it (central air-conditioning, portable air-conditioner, fan).
  • Provide means to limit the entry of sunlight in the workplace and leave windows closed when the outside temperature is higher than the inside temperature.
  • Limit the use of devices or equipment emitting heat.

Administrative measures:

  • Carry out a joint exercise of thinking about organizing work so that it is safe to work in the heat.
  • Take the necessary steps to raise awareness and provide training on the risks associated with the heat, on the symptoms associated with heat stroke and strategies to eliminate or reduce these risks.
  • Provide a cool, airy place to take breaks in a relaxing, cool environment.
  • Review organization of work to be able to take mini-breaks and extra breaks when it is very hot. According to a survey conducted by the ASSTSAS, 83% of institutions surveyed would deploy work-relief measures.
  • Review organization of work to reduce the work pace and intensity. For example, by keeping the most demanding tasks for cooler periods or by improving the composition of work teams (e.g.: adding healthcare professionals to cover breaks or adding auxiliary staff). According to a survey conducted by the ASSTSAS, 83% of institutions surveyed claim to implement a lighter workload.
  • Access to fresh water all the time and organize the work to be able to hydrate as often as needed. This is a touchy issue, especially in the context of a work overload (lack of time to hydrate) and wearing PPEs.
  • Properly train on PPEs to enable safe hydration without self-contamination.

Individual measures:

  • Make cooling PPEs available (cooling headband or collar). These PPEs should be for personal use and not shared between healthcare professionals.
  • Accommodate the healthcare professionals more vulnerable to the heat because of a specific medical or personal situation. These personal factors may be taking certain medications, previous heat stroke, working overtime (OT or MOT), certain physical or medical conditions, etc.
  • Evaluate the possibility of deploying alternative strategies to reduce the discomfort of N95 masks which can be aggravated by heat. For example, adding self-adhesive lines under the mask (if they do not compromise the watertightness) or using hydrating creams may also be considered.
What you should plan on
  • Drink 250 ml of fresh water every 20 minutes. More if you meet the criteria set out in the charte proposée par la CNESST. Never more than 1.5 liters of water per hour.
  • Favour light and fresh meals.
  • Discuss with your colleagues and contact your union team if the employer does not take the discomfort or thermal stress seriously. Help the employer and your union team to identify the risks and ways to minimize them.
  • Immediately inform an employer representative, then stop working in the event of symptoms of heat stroke: lack of perspiration, skin hot and dry, incoherent speech, loss of balance, drowsiness, nausea, loss of consciousness, convulsion. If you observe these symptoms in a colleague, inform your immediate superior immediately.


  • The CNESST proposes a method for measuring the heat in a workplace and adapting the work to the hazard. According to the level of heat and intensity of the work, a certain frequency of hydration and rest is proposed. The measurement of heat and determination of the actions to be taken must take into account:
    • The relative humidity. The rate of relative humidity in a healthcare building should generally be between 30 to 60%;
  • The personal protective equipment worn. Waterproof or sweaty equipment increases thermal stress (gown, gloves mask, visor);
    • The exertion. General rule, working while sitting or standing and performing light activities (e.g.: taking vital signs) is considered light work. Working in a fast-paced standing position with more demanding tasks (e.g.: personal care or mobilizing the patient) is work of medium intensity.
  • When you work in an environment that reaches a certain temperature, you must apply the CNESST recommendations, and the employer must allow you to do so. Talk to your union team as soon as there is a problem.
  • To apply the CNESST heat scale, the temperature must be taken:
    • With a thermometer and a hygrometer;
    • Jointly with the union when taking the measurement;
    • At a frequency agreed with the union;
    • And the results must be recorded in a register.

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