Eighteen of the last 19 summers were the hottest on record. Those rising temperatures mean a rising risk of heat-related illnesses and deaths.

The three-year average of workplace deaths caused by heat has doubled since the early 1990s, Secretary of Labor Marty Walsh said in April when announcing a new Occupational Safety and Health Administration (OSHA) National Emphasis Program to concentrate on heat-related workplace inspections.

Workers suffer more than 3,500 injuries and illnesses related to heat each year and “extreme heat hazards aren’t limited to outdoor occupations, the seasons or geography,” Walsh said.

“From farm workers in California to construction workers in Texas and warehouse workers in Pennsylvania, heat illness — exacerbated by our climate’s rising temperatures — presents a growing hazard for millions of workers.”

National Emphasis Programs are temporary programs that focus OSHA’s resources on particular hazards and high-hazard industries. This NEP went into effect in April and will remain in effect for three years unless canceled or extended. Long-term, the administration is working to establish a heat illness prevention rule.

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From OSHA: Working in outdoor and indoor heat environments

Through the new NEP, OSHA will initiate inspections in more than 70 high-risk industries in indoor and outdoor work settings when the National Weather Service has issued a heat warning or advisory for a local area. On days when the heat index is 80 degrees Fahrenheit or higher, OSHA said inspectors “will engage in outreach and technical assistance to help stakeholders keep workers safe on the job. Inspectors will look for and address heat hazards during inspections, regardless of whether the industry is targeted in the NEP.”

Under OSHA law, employers are responsible for providing workplaces free of known safety hazards, including extreme heat. Any employer with workers exposed to high temperatures should establish a complete heat illness prevention program to:

• Provide workers with water, rest and shade.
• Allow new or returning workers to gradually increase workloads and take more frequent breaks as they acclimatize or build a tolerance for working in the heat.
• Plan for emergencies and train workers on prevention.
• Monitor workers for signs of illness.

In Inyo County, Calif., which includes Death Valley — the lowest, hottest and driest portion of the North American continent — Risk Management & Loss Prevention Manager Aaron Holmberg is prepared.

Death Valley is national park land, but Inyo County employees work in areas where “it’s over 100 degrees,” he said. “I’m proud that we’ve never had a heat-related illness or injury.”

California has its own state OSHA program, which meets or exceeds federal OSHA requirements, Holmberg said. “Fed OSHA is pretty much modeled after what California has done.” Washington and Minnesota also have specific laws governing occupational heat exposure.

“We start training well before it starts getting hot,” he said. “The things we do make a lot of sense —start the day super early and end early or take a long break before the day reaches its peak. Or finish that part of the day indoors.”

He added that he finds CAL OSHA training materials “quite helpful” for outdoor workers because they include lots of simple graphic depictions of heat-related problems and treatment instead of long blocks of words. 

Last fall, OSHA published an Advance Notice of Proposed Rulemaking to initiate the rulemaking process toward a federal heat standard. The agency planned a public stakeholder meeting May 3 to discuss ongoing activities to protect workers from heat-related hazards, including its Heat Illness Prevention Campaign, compliance assistance activities and enforcement efforts.

Protect against heat stroke

The National Institute for Occupational Safety and Health (NIOSH) website warns about the dangers of heat exhaustion and heat stroke. 

Heat exhaustion is the body’s response to an excessive loss of water and salt, usually through excessive sweating. Not surprisingly, workers most prone to heat exhaustion are those who are elderly, have high blood pressure and those working in a hot environment.

According to NIOSH, symptoms of heat exhaustion include headache, nausea, dizziness, weakness, irritability, thirst, heavy sweating, elevated body temperature and decreased urine output.

NIOSH recommends the following steps to treat a worker with heat exhaustion:

• Take worker to a clinic or emergency room for medical evaluation and treatment.
• If medical care is unavailable, call 911.
• Someone should stay with the worker until help arrives.
• Remove worker from hot area and give liquids to drink.
• Remove unnecessary clothing, including shoes and socks.
• Cool the worker with cold compresses or have the worker wash head, face and neck with cold water.
• Encourage frequent sips of cool water.

Heat stroke is the most serious heat-related illness, according to NIOSH. Heat stroke can cause death or permanent disability if emergency treatment is not given.

Heat stroke occurs when the body becomes unable to control its temperature: The body’s temperature rises rapidly, the sweating mechanism fails, and the body is unable to cool down. When heat stroke occurs, the body temperature can rise to 106 degrees Fahrenheit or higher within 10 to 15 minutes.

Symptoms of heat stroke include: Confusion, altered mental status, slurred speech; loss of consciousness (coma); hot, dry skin or profuse sweating; seizures and very high body temperature.

NIOSH recommends the following steps to treat a worker with heat stroke:

• Call 911 for emergency medical care.
• Stay with worker until emergency medical services arrive.
• Move the worker to a shaded, cool area and remove outer clothing.
• Cool the worker quickly with a cold water or ice bath if possible; wet the skin, place cold wet cloths on skin or soak clothing with cool water.
• Circulate the air around the worker to speed cooling.
• Place cold wet cloths or ice on head, neck, armpits and groin; or soak the clothing with cool water.