Heat Injury and Illness Prevention Program Survey

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* 1. How many Full Time Employees (FTEs) do your company employ?

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* 2. What is your company’s primary line of business? (check all that apply)

Construction

Maintenance

Operations

Combination

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* 3. Does your company have a written heat illness prevention program?

Yes

No

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* 4. Does your company have a process for monitoring the temperature of the work environment for excessive heat?

Yes

No

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* 5. Does your company have a method for monitoring employee health while working in high heat environments?

Yes

No

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* 6. Does your company train its employees on prevention of heat related illness?

Yes

No

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* 7. Does your company currently have an acclimatization process for employees exposed to high heat?

Yes

No

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* 8. Is the identification of heat related hazards included in your company’s Job Hazard Analysis process?

Yes

No

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* 9. What safety controls does your company apply to manage heat stress in the workplace?

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* 10. How many heat related injuries/fatalities has your company experienced in the past 5 years?

None

1-5

5-10

>10