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Why are workers in the U.S. still dying from heat exhaustion?

Extreme heat is a public health crisis that disproportionately affects low-income communities, minorities and seniors, labor advocates say.

As a brutal heat wave rips across the country, thousands of workers who toil outdoors face risks of heat stress, with no specific federal standard that covers working in hot environments.

Climate scientists and labor advocates are pressing individual states to enhance their worker protections, while federal lawmakers consider two new bills that would create measures such as paid breaks in cool spaces, access to water and limitations on time workers are exposed to heat as temperatures hike to daily record levels.

“Extreme heat is a public health crisis and a lot of social and economic inequities come with it,” said Oscar Londoño, executive director of WeCount!, a Homestead, Florida-based immigrant worker advocacy organization. “We see heat disproportionately impacts low-income communities, minorities and seniors,” he said.

Workers exposed to extreme heat are particularly vulnerable to illness. Between 1992 and 2017, heat stress injuries killed 815 U.S. workers and seriously injured more than 70,000, according to the Occupational Safety and Health Administration.

Overall, more than 65,000 people visit the emergency room for heat-related stress a year and about 700 die from heat, according to the Centers for Disease Control and Prevention. The majority of these cases are concentrated in Florida, where heat drove more than 6,800 people to the emergency room in 2019, a 35 percent increase from 2010, when heat resulted in roughly 5,000 ER visits, according to data from the CDC.

In 2012, the Occupational Safety and Health Administration denied a petition submitted by a consumer advocacy group called Public Citizen calling on the agency to set a heat standard in 2012. A second petition from the group is still sitting with the agency. OSHA issued a request earlier this month for information on heat illness as it considers a possible new rule.

"This and the other activities outlined in the Spring 2021 regulatory agenda emphasize OSHA’s renewed commitment to workplace safety and health," the Department of Labor told NBC News in an emailed statement.

While heat affects workers across a range of industries, U.S. farmworkers are 20 times more likely to die from illnesses related to heat stress than workers overall, the CDC said. As temperatures rise, this figure is estimated to grow. Farmworkers labor through about 21 unsafe working days every growing season when the heat index reaches 84 degrees, according to a March 2020 analysis by researchers with the University of Washington. But by the end of the century, the study estimates, U.S. farmworkers will work an average of 62 days in unsafe conditions.

“Heat illness affects workers in our nation’s fields, warehouses and factories, and climate change is making the problem more severe every year,” said U.S. Rep. Bobby Scott, D-Va., who introduced a bill in March that would require OSHA to create an enforceable standard to protect workers from heat. “This legislation will require OSHA to issue a heat standard on a much faster track than the normal OSHA regulatory process. Workers deserve no less,” he said.

All workers are covered by OSHA’s “general clause” protections, which require employers to keep workplaces “free from recognized hazards,” including heat. But without a specific standard, workers have no recourse to address heat exposure, said Rachel Licker, a senior climate scientist with the nonprofit organization Union of Concerned Scientists.

“It’s a regulation and those aren’t necessarily welcome,” she said, referring to businesses. “But our perspective is that it shouldn’t be regarded as another regulation, because it is affording basic protections.”

Allison Crittenden, director of congressional relations with the American Farm Bureau Federation, told NBC News in an emailed statement that farmers prioritize worker safety, including access to water, frequent breaks as temperatures rise and monitoring for illness.

“America’s farmers adhere to local, state and federal workforce safety rules and they strive to create a safe and productive environment for all of their employees," she said. "We are concerned with approaches to heat illness protection that take a one-size fits all approach and do not consider individual health needs and regional differences in weather.”

The country’s agricultural industry amounts to a $136 billion market, according to the U.S. Department of Agriculture. Largely dominated by several states, including California, Oregon, Washington and Florida, just three have passed state laws that specifically address heat-related worker protections.

Florida has failed to pass two bills introduced in the state Senate over the last two years. Some employers have dragged their feet on improving farm conditions for workers voluntarily, Londoño said. Now, the organization is pushing for a countywide standard that would require employers in Miami-Dade County to provide access to water and shade during extreme heat.

Image: Jose Delgado.
Jose Delgado, a 72-year-old farmworker in Florida, says he does not have access to water or shade at work. When he becomes too hot, he crawls under his truck for a brief break from the sun.Erick Sanchez

Jose Delgado, a 72-year-old farmworker based in Homestead, told NBC News that a rule is long overdue. A few years ago during a month of working sweet potato fields during scorching temperatures, he collapsed on his way to cash his check at the bank. He said he had been feeling sick but dragged himself to work every day with a large water bottle because he needed to work. The day he collapsed, the doctors in the emergency room told him he had kidney failure and if he had waited even five minutes longer to get medical attention, he could have died.

“I still am afraid for my life because of the heat and I still need to work,” said Delgado, who is undocumented and earns between $100 and $300 a week as a contract farmworker. “I don't receive any kind of health benefits and I’ve been paying taxes since the 1990s. It becomes difficult because I do believe I deserve benefits.”

He still doesn’t have access to water or shade. When he becomes too hot, he crawls under his truck for a brief break from the sun.

“We are the workers that put food on the table and we suffer through the heat,” he said. “We deserve a pay that is fair and reasonable, and consciousness that we’re putting our lives at risk.”