Heat kills...and it doesn’t have to be that way

Worse than hurricanes
    Heat is one of the most dangerous types of weather, typically killing more people annually in the U.S. than hurricanes, tornadoes or flooding.
    The Bureau of Labor Statistics (BLS) lists 436 workplace deaths between 2011 and 2021 due to exposure to high heat in the workplace, or roughly 40 a year. Since most of those occurred in the summer that’s well over a death a week on the job for workers exposed to heat during the hottest months. BLS statistics on serious injuries from heat — more than 70,000 workers from 1992 to 2017 — are undercounts.
    Here’s why: If a roofer gets dizzy from the heat and falls to their death, the fall is going to be listed as a cause of death, not the heat. A trucker missing the back-up beep on a heavy vehicle because they have a heat-induced headache, will get listed as a vehicular accident, not heat-related. The death of an undocumented farmworker from lack of water will likely never be listed.

Resources abound
    It doesn’t have to be this tragic — both indoors and outdoors when temperatures reach dangerous, extreme levels. Preventive measures are easily found all over the Internet this summer. Go to www.osha.gov today. First thing you see, posted in a large banner stretching across the homepage: “Heat hazards can be anywhere, no matter what state you live in.” One click away is a list of every OSHA area office. Every office provides heat stress prevention material. A second button takes you to OSHA’s Hazard Alert: “Extreme Heat Can Be Deadly to Workers.” Scroll down the page and you find a long list of resources, including:
    • Heat Illness Illustrated Fact Sheet
    • Heat Illness: Prevent Heat Illness at Work Brochure
    • Heat Illness: Prevent Heat Illness at Work Poster
    • Heat Illness Prevention: Don’t Wait… Hydrate Sticker
    Ways to protect yourself and coworkers are basic and should be easy to practice, according to OSHA guidelines:
    • Ease into work. Nearly three out of four fatalities from heat illness happen during the first week of work, according to OSHA. New and returning workers need to build tolerance to heat, aka acclimation. OSHA suggests (certainly does not mandate, there is no federal heat illness prevention standard) following the 20 percent rule. On the first day, work no more than 20 percent of the shift’s duration at full intensity in the heat. Increase the duration of time at full intensity by no more than 20 percent a day until workers are acclimated to toiling in the heat.
    • Drink at least one cup of water every 20 minutes
    • Take rest breaks
    • Find shade or a cool area
    • Wear a hat and light-colored, loose-fitting and breathable clothing if possible
    • Monitor yourself and coworkers for signs of heat illness (abnormal thinking, slurred speech, seizures, loss of consciousness, headaches, nausea, weakness or dizziness, heavy sweating, hot and dry skin, elevated body temperatures, thirst, decreased urine output)

Reality intervenes
    Heat prevention practices, in reality, are not always easily practiced, if attempted at all. Workers at high risk of heat illness cut a mighty broad swath across the economy. They include employees in construction, warehouses, bakeries, food preparation, farming, firefighting, delivery services – including mail carriers, utilities, oil and gas, landscaping, mining, factories, boiler rooms and many other workplaces.
    Productivity goals and quotas, always an obstacle to safety and health, can push indoor and outdoor workers into danger zones in high heat conditions. Most employers, especially big brand corporations, will deny any use of quotas or, heaven forbid, placing production over safety. But let’s get real, they are a fact of business life.
    Many employees are never subject to medical exams that could expose underlying conditions that increase risks in hot temperatures. These include high blood pressure; arthritis; autoimmune conditions; migraines; mental health diseases; respiratory illnesses such as asthma and chronic obstructive pulmonary disease; heart disease; diabetes; chronic kidney disease; and poor blood circulation. Individuals who are overweight or obese, pregnant, or advanced in years are also at risk — no medical check-ups are necessary.
    Wearing loose-fitting, light-colored clothing and floppy wide-brimmed hats are not the PPE of choice for firefighters, construction workers, emergency responders, miners and many factory workers. Thick gloves, heavy boots, hard hats, respirators, fall protection equipment and some chemical-resistant clothing can add weight — and more exertion — that can potentially cause risks to increase in hot temperatures.
    A rhetorical question: how many small contractors, landscapers, farms and many businesses are going to slow down the pace of work to follow the 20 percent rule and gradually over days acclimate new workers to high heat? Many of these workers are immigrants, legal or illegal, earning low salaries and in too many cases are considered disposable and easily replaceable.
    Another reality that butts against heat illness prevention measures: Migrants working as farmhands, builders and delivery workers are often not guaranteed measures such as water and shade breaks because they are considered expendable. And they are less likely to complain about the absence of heat prevention practices for fear of losing their jobs, visas, and possibly being deported.
    “To be blunt about it, the people most impacted by heat are not the kind of voting demographic that gets any politician nervous,” says Jeff Goodell, author of “The Heat Will Kill You First: Life and Death on a Scorched Planet” in an article published this summer in The Guardian, a newspaper based in the United Kingdom.

How much will standards help?
    Will mandatory heat illness prevention standards, both at the state and federal level, prove to be lifesavers? It will take years to find out. An OSHA heat standard proposal is being pushed by the Biden administration to be issued this year. But this is only the first step in a standards-setting process that usually take five to eight or more years. A handful of states have or are considering heat standards (Oregon, Washington, California -- standard still under review, Minnesota, Maryland, Nevada and Colorado – for agricultural workers only -- are among them). Interestingly, or ironically, none of the hot weather sunbelt states have heat standards.
    Dr. David Berry, a heat illness prevention expert, told ISHN that the best antidote for heat-related illnesses and deaths is for a business to have a robust safety culture with values and sustainable practices that lay the foundation for preventing unnecessary heat-related injuries, illnesses and fatalities. Without such a foundation, heat prevention tactics such as offered by OSHA and many other organizations will be implemented to varying degrees. And in some cases, not at all – whether there are standards in place or not.
    How robust is your safety and health culture? Have you downloaded resources from osha.gov and many other safety and health associations, insurance companies, consulting services, PPE vendors and healthcare websites? Do you have a working heat illness prevention program? Heat kills, but the knowledge, practices and resources are readily accessible to prevent these tragedies.