We all have plenty of reminders to hydrate “often and early” up on the roof in June, but how many of us really “think to drink” in the winter? According to some medical authorities, our bodies are almost 75 percent water, with about the same salinity as the North Atlantic. A healthy body can lose as much as 3 to 6 liters (up to 12 pounds) of water per day, summer or winter, depending on work tasks and environmental conditions. Amazingly, just the water vapor that we normally exhale can fill more than a one liter soda bottle every day.
Our brains may send us clear signals that we’re thirsty in June, but in February we might be less inclined to toss back a bottle of water as often as we should. Therefore, we need to be aware of a few telltale signs that can indicate the onset of dehydration.
- Thirst. Thirst is a conscious urge to drink fluids. A slight 1 to 2 liter body fluid loss will usually initiate this brain signal. Loss of 4 liters is critical. For reasons mostly unexplained by medical science, a fluid loss of at least 1.5 to 3 liters is required in cold weather to create the same level of “thirst” urges experienced in warm weather. Therefore, despite how thirsty we think we are, we must remain vigilant and establish a regular schedule to hydrate during winter work.
- Urination. Everyone’s bladder is a different size, but if you don’t feel the urge to empty your bladder all day, it may be a sign of impending dehydration. Urine should be light yellow and “gin-clear.” Urine darker than normal indicates the kidneys are running low on filtrating-dilution fluids and the victim may be approaching moderate dehydration. Serious damage to internal organs and physiological functions can happen quickly and lead to extreme dehydration.
- Feeling dried out. All of your external mucous membranes will tend to be drier. Dried, cracked lips and nose seem to come with winter, but they’re also sure signs you’re becoming dehydrated. Internal organs such as the stomach and intestines and fluid-filled joints tend to replace blood plasma losses from their own resources, causing indigestion and cramps. As the central nervous system fluids drop in volume, mild to severe headaches may result. Diarrhea is an obvious and sometimes serious cause of dehydration, possibly requiring medical attention. If the pinched-up skin on the back of the hand tends to return more slowly, it can indicate possible systemic dehydration.
- Total blood volume. Your blood will tend to lose fluid (plasma) and become more sluggish, leading to a slightly rapid or weak pulse. Squeezing the tips of the fingers will turn them pale and their pink color will only return slowly. In severe dehydration, the capacity of the red blood cells to efficiently absorb oxygen into the body and release carbon dioxide may diminish. This leads to rapid, deep breathing to replace oxygen and extreme muscle fatigue due to carbolic acid buildup in the tissues.
- Cold. Dehydration can exacerbate many other debilitating conditions, such as hypothermia, frostbite and suspension trauma. Low blood volume means that less metabolic heat will be distributed around the body during cold weather. When the brain detects this negative thermal condition it will “sacrifice” blood flow to those areas farthest from the core organs — the heart, lungs and brain — which are located in the upper chest and head. Death by freezing is faster when dehydrated.
- Behavioral changes. Dehydration, like low blood sugar and hypothermia, can cause an initial, overall drowsy feeling. Moderate dehydration results in mental lethargy and irritability. While not all grumpy roofers are dehydrated, all dehydrated ones eventually become grumpy. In advanced cases, it can cause the victim to become totally disorientated and possibly go into physical shock (rapid, erratic pulse, rapid breathing, pale skin and possible death).
The procedures most emergency medical professionals recommend to rehydrate the victim is based on the WIWU Principle — water ingested versus water used. We should carefully monitor and replace our fluid losses as time progresses, and not all at once when symptoms suddenly become apparent (and possibly insurmountable). Unfortunately with dehydration, once the symptoms are finally recognized we may already be in the moderate to severe stages where debilitation is to be expected. Even the capability to discern a problem or the effort required to abate it becomes more than we can handle by ourselves. The inevitable lost-work downtime and medical assistance necessitated at that point makes prevention your best option.
Dehydration for winter workers is often a cumulative process, as symptoms indicating low bodily fluids can proliferate overnight (with a few beers after work) and carry into the next work shift if not identified and corrected promptly. We may realize we should take on more fluids, but we often don’t know how much, how fast, or what kind. The following bullet list may prove helpful to develop your company’s rehydration plan:
- Start with a 30-minute hydration period prior to a physically stressful day of work. You could combine your crew’s morning stretch and warm-up exercises with a 16 ounce bottle of water. Starting with a “full tank” may require you to get hydrating the day before a big job even starts. Everyone’s absorption rate will differ. The higher your body fat index and the older you are, the slower your rate of absorption.
- Camelback packs allow the wearer to take sips all day long through a tube to keep fluids up. Filling it with warm water and insulating both the pack and the tube will prevent the contents from freezing.
- Monitor your intake and output regularly. Check the color and quantity of your urine. Adjust your intake accordingly. The kidneys can process up to 15 liters of fluid a day, so results can be analyzed and rehydration determined quickly.
- Although unlikely in most circumstances, Hyper-hydration (or water intoxication) is caused by drinking too much water in too short a time. It can result in serious organ damage (kidneys) and possible death (intercellular brain swelling). The International Sports Medicine Institute recommends hydrating with 1/2to 2/3of an ounce of water for every pound of body weight every day. For a 190-pound worker, this could amount to 3-4 quarts by the end of the shift.
- Adjust your lifestyle a little. Eat more foods with high water content. The more fruits and vegetables you eat every day, the less water you’ll be required to regularly replace.
- Drink an extra large glass of water before bed to replace the loss anticipated while you sleep (as much as a liter).
- Have a thermos full of hot chicken soup or tomato soup for lunch. It’s a great way to give your mid-day hydration a boost. If you’re going to have a few brews after work, ask the bartender for a large glass of water as a chaser.
- When filling water bottles before winter work, use hot or warm water in a few for use later in the day. Luke warm water is more quickly assimilated and easier to drink than ice water in February. Keep a bottle under your jacket or vest to prevent freezing.
- Avoid caffeine. It’s a notorious diuretic, causing frequent urination. Beyond your two “eye-opener” cups of java on the way to work, avoid drinking coffee during the day.
- Never take salt tablets. A pinch of salt in your drink may help to retain fluids and promote the “thirst urge” to drink more. Too much salt is detrimental, as it will cause the body to demand more water to counterbalance the sodium-ion reaction.
- Tap water is a cheap hydrator, but electrolyte replacement drinks are good as well. Despite their costs, flavored “sports drinks” may replace depleted electrolytes (sodium, potassium) and provide a refreshing energy boost in the afternoon.
- Dress in layers. Strip and reapply as necessary to prevent an unnecessary buildup of body heat under your clothing. When possible, avoid wearing heavy insulation like goose down with a “wicking” fabric beneath; this will only promote sweating out fluids you can’t afford to lose.
Normally, an adult should consume “eight eights” (or eight glasses of 8-ounce volume) each day. However, when physically working hard, go ahead and drink more fluids diligently, but always continue hydration well after the task is done. Remember: the ingestion rate should match absorption rate, even while you’re sleeping. The “quarter-liter per quarter” hour is a good rule-of-thumb for construction workers in the winter. That works out to be about 32 ounces every hour.
As with almost anything important, it’s always easier to talk about it than do it. Get in the habit of sending a case of water bottles to the job every day, all year round, and train employees to access it regularly. OSHA clearly lists a number of mandatory potable water requirements in Section 1926.51-Sanitation.