{"id":1543,"date":"2024-10-28T09:00:00","date_gmt":"2024-10-28T09:00:00","guid":{"rendered":"https:\/\/medical-article.com\/?p=1543"},"modified":"2024-10-28T09:00:00","modified_gmt":"2024-10-28T09:00:00","slug":"how-a-proposed-federal-heat-rule-might-have-saved-these-workers-lives","status":"publish","type":"post","link":"https:\/\/medical-article.com\/?p=1543","title":{"rendered":"How a Proposed Federal Heat Rule Might Have Saved These Workers\u2019 Lives"},"content":{"rendered":"<p>On a sweltering afternoon in July 2020, Belinda Ramones got a call that her brother was in the hospital. The call was from a woman at the Florida landscaping business that he had joined that week, the Davey Tree Expert Co., Ramones said. By the time she arrived, she said, \u201cMy brother was swollen up from hands to toes.\u201d<\/p>\n<p>Two days later, her brother, Jose Leandro-Barrera, died at age 45 with acute kidney failure caused by heatstroke, according to a report from the Hillsborough County medical examiner. His temperature in the ambulance had been 108 F, said the report.<\/p>\n<p>It described the circumstances preceding his death, as recorded by a nurse. At the jobsite, Leandro-Barrera had advised his supervisor that he was not feeling well, and the supervisor told him to sit in a vehicle until he felt better. While there, he \u201curinated himself, had seizure like activity\u201d and became unresponsive.<\/p>\n<p>\u201cEmployee suffers from heat exhaustion while doing landscaping,\u201d said <a href=\"https:\/\/www.osha.gov\/ords\/imis\/establishment.inspection_detail?id=1483327.015\">an investigation<\/a> into the incident from the Occupational Safety and Health Administration. The agency issued a $9,639 fine to the Davey Tree Expert Co. The company did not respond to requests for comment.<\/p>\n<p>Without national regulations on preventing heat-related illness and death, OSHA has difficulty, in general, protecting workers before it\u2019s too late, said Paloma Renter\u00eda, a Department of Labor spokesperson.<\/p>\n<p>Laborers have suffered as summers have grown <a href=\"https:\/\/www.nasa.gov\/earth\/nasa-finds-summer-2024-hottest-to-date\/\">progressively hotter<\/a> with climate change. But health policy and occupational health researchers say that worker deaths are not inevitable. Employers can save lives by providing ample water and breaks and building in time for new workers to adjust to extreme heat.<\/p>\n<p>This is the logic behind proposed national rules that President Joe Biden set in motion in 2021, aiming to protect an estimated 36 million workers exposed to extreme heat. The Bureau of Labor Statistics counts about 480 worker deaths from heat exposure each year, on average. But these are \u201cvast underestimates,\u201d <a href=\"https:\/\/www.federalregister.gov\/documents\/2024\/08\/30\/2024-14824\/heat-injury-and-illness-prevention-in-outdoor-and-indoor-work-settings#:~:text=Evidence%20suggests%20that,for%20incidence%20rates).\">according to OSHA<\/a>, because heat stress is an underlying factor often unaccounted for in medical records.<\/p>\n<p>The advocacy organization <a href=\"https:\/\/www.citizen.org\/article\/boiling-point\/\">Public Citizen estimates<\/a> that as many as 2,000 U.S. workers die of heat annually, based on extrapolations from heat injury data.<\/p>\n<p>Both estimates are upsetting, said Linda McCauley, dean of the nursing school at Emory University and an occupational health researcher. \u201cNo one should go to work expecting that they might die,\u201d she said.<\/p>\n<p>The proposed rules \u2014 a heat standard from OSHA \u2014 reaches a milestone Dec. 30, when the <a href=\"https:\/\/federalregister.gov\/d\/2024-14824\">public comment period<\/a> closes. But it\u2019s unlikely to be finalized before Biden leaves office.<\/p>\n<p>Vice President Kamala Harris would likely carry the heat rules forward if she wins the presidency next month, said Jordan Barab, who was OSHA\u2019s deputy assistant secretary during the Obama administration. She advanced heat regulations in California in 2020.<\/p>\n<p>Should Donald Trump win, the rules would stall, Barab predicts. In general, Republicans have opposed workplace safety regulations over the <a href=\"https:\/\/kffhealthnews.org\/news\/article\/workers-pay-price-congress-employers-debate-osha-heat-standard\/\">past 20 years<\/a>, saying they are costly to businesses and consumers. And during the first Trump administration, the number of OSHA inspectors tasked with monitoring workplace safety hit an all-time low across the agency\u2019s 48-year history. Workplace inspections regarding heat stress dropped by half on Trump\u2019s watch, according to an analysis by the <a href=\"https:\/\/www.nelp.org\/workplace-fatalities-rising-trump-osha-enforcement-declines\/\">National Employment Law Project.<\/a><\/p>\n<p>OSHA\u2019s rules would require employers to provide ample, cool drinking water, and shade or air conditioning for breaks, when temperatures exceed 80 degrees. Above 90 degrees, employers would need to provide paid 15-minute breaks every two hours.<\/p>\n<p>Two additional aspects of the standard confront overlooked problems that contribute to heat deaths at work. More than <a href=\"https:\/\/blog.dol.gov\/2024\/09\/03\/8-things-to-know-about-oshas-proposed-heat-rule\">70% of workers<\/a> who die of heat do so within their first week on the job. And delayed medical care is a common theme.<\/p>\n<p>\u201cWe need to stop telling people who complain of being about to pass out to go sit in the car or take a break,\u201d McCauley said. \u201cRest breaks are needed to prevent the problem, but once someone has symptoms, they need help fast.\u201d<\/p>\n<p>The proposed rules require employers to allow new workers time to acclimate to high temperatures and to institute protocols, like a buddy system, so that workers get rapid medical care as soon as they show signs of heat illness, like dizziness, confusion, and cramps.<\/p>\n<p>By the time an emergency medical team arrived to help one laborer in July 2021, he had stopped breathing, according to one Department of Labor <a href=\"https:\/\/www.osha.gov\/news\/newsreleases\/region4\/01192022\">press release<\/a>. A supervisor at the ecological restoration company EarthBalance had seen him earlier that day, it said, and he was \u201csweating heavily, his hands were trembling, and he seemed confused,\u201d He rested. \u201cOnly 30 minutes later, the supervisor returned to the man finding him unresponsive.\u201d<\/p>\n<p>That evening, Gilberto Macario-Gimenez died at the hospital, said a medical examiner case report. It noted \u201cthe decedent had overheated\u201d and attributed his death to heart disease and hypertension. Heat can exacerbate those conditions.<\/p>\n<p>OSHA investigated the situation. It fined EarthBalance $9,216, <a href=\"https:\/\/www.dol.gov\/sites\/dolgov\/files\/OPA\/newsreleases\/2022\/01\/OSHA20212116.pdf\">finding that<\/a> \u201cthe employer failed to ensure that a person adequately trained to provide first aid to employees [was] working in an area where there was no infirmary.\u201d<\/p>\n<p>EarthBalance did not respond to requests for comment.<\/p>\n<p>OSHA has received at least 12,980 comments on its proposals posted to the federal register. One woman <a href=\"https:\/\/www.regulations.gov\/comment\/OSHA-2021-0009-7975\">wrote about her cousin<\/a> who died while clearing shrubs for a rancher in Texas when temperatures exceeded 100 degrees: \u201cHe was only 34. There was no water or rest breaks.\u201d<\/p>\n<p>After the comment period ends in December, OSHA will hold a public hearing, incorporate changes, and finalize the rule. If Harris is president, Barab said, the agency may finish the process by 2026. For the rule to work, Congress would need to <a href=\"https:\/\/fas.org\/publication\/osha-extreme-heat-rule-investment\">fund OSHA<\/a> adequately, so that it can hire staffers to teach employers how to implement the standards, and enough investigators to enforce them.<\/p>\n<p>Several industry groups have opposed the standard. The Associated General Contractors of America called it \u201cunnecessary, unworkable, and impractical.\u201d A single set of rules isn\u2019t fair when climates and jobs vary widely, in addition to workers\u2019 abilities to tolerate heat, the group wrote in an <a href=\"https:\/\/nclc.agc.org\/wp-content\/uploads\/sites\/15\/2019\/09\/National-Heat-Standard.pdf\">online statement<\/a>.<\/p>\n<p>Some Republican lawmakers have called the rule government overreach. Rick Roth, a Republican Florida state representative, <a href=\"https:\/\/www.youtube.com\/watch?v=MKHMCqKptEg\">told Al Jazeera<\/a> that workers are pushing for paid breaks because they \u201cdon\u2019t want to work so hard.\u201d If they didn\u2019t feel safe, they could change jobs. \u201cGo work for somebody else,\u201d he said.<\/p>\n<p>Critics also say that the regulations will cost employers. But a <a href=\"https:\/\/ucla.app.box.com\/s\/14m6pj1algt7rwb8ihq4lyqjhm2ueejj\">UCLA analysis<\/a> of workers\u2019 compensation claims in California suggests that a national heat standard saves money overall. The study estimated the cost of heat-related injuries between $750 million and $1.25 billion a year in California alone, including medical bills, lost wages, and disability claims.<\/p>\n<p>Because six states have varying sets of rules to reduce heat-related illness \u2014 California, Colorado, Maryland, Minnesota, Oregon, and Washington \u2014 researchers and union representatives have been able to see where policies need strengthening. One issue with enforcement is that OSHA largely relies on employees to report hazards. <a href=\"https:\/\/journals.lww.com\/joem\/fulltext\/2021\/06000\/are_cal_osha_regulations_protecting_farmworkers_in.13.aspx\">One study found<\/a> that just 14% of nearly 600 farmworkers surveyed in California knew about acclimatization and how much water they needed when temperatures were high.<\/p>\n<p>Although Florida doesn\u2019t have specific heat regulations, Dominique O\u2019Connor of the Farmworker Association of Florida said the biggest obstacle in ensuring occupational safety is that workers are afraid of getting fired for filing a complaint with OSHA.<\/p>\n<p>This is especially true for farmworkers with H-2A visas, which permit noncitizens to fill temporary jobs. Because these workers depend on their employers not only to remain in the country but often for transportation and housing, retaliation from employers would be life-altering. \u201cThis summer we talked with H-2A workers who were only given dirty water on the job,\u201d she said. \u201cThey were told to just pretend it was coffee.\u201d<\/p>\n<p>Leaders in several Republican-led states are likely to push back against the federal standard if it\u2019s issued. Last April, Florida Gov. Ron DeSantis approved legislation that blocks local governments from requiring employers to offer workers water and shade when temperatures rise.<\/p>\n<p>And the Supreme Court\u2019s decision to overturn the \u201cChevron doctrine\u201d this year may embolden employers to challenge OSHA\u2019s ability to enforce the rules. For decades, the Chevron doctrine had required courts to defer to expertise at regulatory agencies when interpreting regulations, but the high court\u2019s ruling ended that. \u201cWe are in uncharted territory,\u201d Barab said.<\/p>\n<p><em>Jeremy Young, senior producer at Fault Lines on Al Jazeera English, contributed to this report.<\/em><\/p>\n<p><a href=\"https:\/\/kffhealthnews.org\/about-us\">KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about <a href=\"https:\/\/www.kff.org\/about-us\/\">KFF<\/a>.<\/p>\n<h3>USE OUR CONTENT<\/h3>\n<p>This story can be republished for free (<a href=\"https:\/\/kffhealthnews.org\/news\/article\/racist-policies-black-health-south-carolina\/view\/republish\/\">details<\/a>).<\/p>","protected":false},"excerpt":{"rendered":"<p>On a sweltering afternoon in July 2020, Belinda Ramones got a call that her brother was in the hospital. The call was from a woman at the Florida landscaping business that he had joined that week, the Davey Tree Expert Co., Ramones said. By the time she arrived, she said, \u201cMy brother was swollen up&#8230;<\/p>\n","protected":false},"author":0,"featured_media":1544,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-1543","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articles"],"_links":{"self":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/1543"}],"collection":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1543"}],"version-history":[{"count":0,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/posts\/1543\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=\/wp\/v2\/media\/1544"}],"wp:attachment":[{"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1543"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1543"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medical-article.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1543"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}