On a sweltering afternoon in July 2020, Belinda Ramones received a call that her brother was in the hospital. The call came from a woman at the Hillsborough County landscaping company he had joined that week, the Davey Tree Expert Co., Ramones said. By the time she arrived, she said: “My brother was swollen from his hands to his toes. »

Two days later, his brother, Jose Leandro-Barrera, died at age 45 of acute kidney failure caused by heatstroke, according to a report from the Hillsborough County medical examiner. His body temperature in the ambulance was 108 degrees, according to the report.

It described the circumstances leading up to his death, as recorded by a nurse. At the job site, Leandro-Barrera informed 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 “urinated himself, had seizure-like activity” and became unresponsive.

“Employee suffers from heat exhaustion while doing landscaping,” said an investigation on the incident from the Occupational Safety and Health Administration. The agency fined Davey Tree Expert Co $9,639. The company did not respond to requests for comment.

Without national regulations on preventing heat-related illnesses and deaths, OSHA has difficulty, in general, protecting workers before it is too late, said Paloma Rentería, a spokeswoman for the Department of Health. Work.

Workers suffered as summers lengthened gradually warmer with climate change. But health policy and occupational health researchers say worker deaths are not inevitable. Employers can save lives by providing sufficient water and breaks and allowing time for new workers to adjust to extreme heat.

That’s the logic behind President Joe Biden’s proposed national rules in 2021, aimed at protecting an estimated 36 million workers exposed to extreme heat. The Bureau of Labor Statistics averages about 480 worker deaths due to heat exposure each year. But these are “large underestimates”. according to OSHAbecause heat stress is an underlying factor often overlooked in medical records.

The defense organization Estimates of public citizens that up to 2,000 American workers die each year from heat, based on extrapolations from heat injury data.

Both estimates are shocking, said Linda McCauley, dean of Emory University’s nursing school and an occupational health researcher. “No one should go to work expecting to die,” she said.

The proposed rules – an OSHA heat standard – reach an important milestone on Dec. 30, when the public comment period farm. But it is unlikely to be finalized before Biden leaves office.

Vice President Kamala Harris would likely enforce the heat rules if she wins the presidency next month, said Jordan Barab, who was OSHA’s deputy assistant secretary during the Obama administration. She advanced thermal regulations in California in 2020.

If Donald Trump won, the rules would stagnate, Barab predicted. In general, Republicans have opposed workplace safety regulations in recent years. last 20 yearssaying they are costly to businesses and consumers. And under the first Trump administration, the number of OSHA inspectors charged with monitoring workplace safety reached an all-time high in the agency’s 48-year history. Workplace inspections for heat stress have fallen by half under Trump’s leadership, according to an analysis by the National labor law project.

OSHA rules would require employers to provide sufficient fresh drinking water and shade or air conditioning during breaks when temperatures exceed 80 degrees. Above 90 degrees, employers should provide 15-minute paid breaks every two hours.

Two other aspects of the standard address overlooked issues that contribute to workplace heat deaths. More than 70% of workers those who die from heat do so during their first week on the job. And the delay in medical care is a common theme.

“We need to stop telling people who complain about being about to pass out to go sit in the car or take a break,” McCauley said. “Breaks are necessary to prevent the problem, but once a person shows symptoms, they need help quickly.”

The proposed rules require employers to give new workers time to acclimate to high temperatures and establish protocols, such as a buddy system, so that workers receive prompt medical care as soon as they show signs of illness due to heat, such as dizziness, confusion and cramps.

By the time an emergency medical team arrived to help a worker in the Apalachicola National Forest in the Panhandle in July 2021, he had stopped breathing, according to a labor department. press release.

His team leader at EarthBalance, an ecological restoration company based in Sarasota County, had seen the worker earlier in the day, the agency said, and he was “sweating profusely, his hands were shaking and he appeared confused.” . “Only 30 minutes later, the supervisor returned to the man and found him unconscious.”

That evening, Gilberto Macario-Gimenez, 42, died at the hospital, according to a medical examiner’s report. He noted that “the deceased had overheated” and attributed his death to heart disease and hypertension. Heat can make these conditions worse.

OSHA investigated the situation. It fined EarthBalance $9,216, find that “the employer failed to ensure that a person sufficiently trained to provide first aid to employees (worked) in an area where there was no infirmary. »

EarthBalance did not respond to requests for comment.

OSHA received at least 12,980 comments on its proposals published in the Federal Register. A woman wrote about her cousin who died while clearing brush for a rancher in Texas when temperatures exceeded 100 degrees: “He was only 34 years old. There was no water or breaks. »

After the comment period ends in December, OSHA will hold a public hearing, incorporate the changes, and finalize the rule. If Harris is president, Barab said, the agency could complete the process by 2026. For the rule to work, Congress will have to fund OSHA adequately, so it can hire staff to teach employers how to implement the standards and enough investigators to enforce them.

Several industry groups opposed the standard. The Associated General Contractors of America called it “unnecessary, impractical and impractical.” A single set of rules is not fair when climates and jobs vary widely, in addition to workers’ ability to tolerate heat, the group wrote in a statement. online statement.

Some Republican lawmakers called the rule government overreach. State Rep. Rick Roth, R-West Palm Beach, told Al Jazeera that workers are demanding paid breaks because they “don’t want to work so hard.” If they didn’t feel safe, they could change jobs. “Go work for someone else.”

Alfredo De Lara

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Fault Lines/Al Jazeera English for KFF Health News

Critics also say the regulations will cost employers. But one UCLA Analysis Workers’ compensation claims in California suggest that a national heating standard saves money overall. The study estimates the cost of heat-related injuries at $750 million to $1.25 billion annually in California alone, including medical bills, lost wages and disability claims.

Because six states have different sets of rules for reducing heat-related illnesses — California, Colorado, Maryland, Minnesota, Oregon and Washington — researchers and union representatives were able to see where policies need to be strengthened. One of the problems with enforcement is that OSHA relies largely on employees to report hazards. A study found that only 14 percent of the nearly 600 farmworkers surveyed in California knew about acclimatization and how much water they needed when temperatures were high.

Although Florida does not have specific heat regulations, Dominique O’Connor of the Farmworker Association of Florida said the biggest barrier to workplace safety is that workers are afraid of being fired if they are they file a complaint with OSHA.

This is especially true for agricultural workers on H-2A visas, which allow noncitizens to take temporary jobs. Since these workers depend on their employers not only to stay in the country, but also often for their transportation and housing, retaliation from employers could be life-changing. “This summer, we spoke with H-2A workers who were getting nothing but dirty water on the job,” she said. “We told them to pretend it was coffee.”

Leaders in several Republican-led states will likely oppose the federal standard if it is released. Last April, Gov. Ron DeSantis approved legislation that prevents local governments from requiring employers to provide workers with water and shade when temperatures rise.

And the Supreme Court’s decision to overturn the “Chevron doctrine” this year could encourage employers to challenge OSHA’s ability to enforce the rules. For decades, the Chevron doctrine required courts to defer to the expertise of regulatory agencies when interpreting regulations, but the high court’s decision ended that. “We are in uncharted territory,” Barab said.

Jeremy Young, senior producer at Fault Lines on Al Jazeera English, contributed to this report.

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