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As weather starts to cool in much of the country, the heat-baked cement and sweaty afternoons from this summer fade from collective memory. But activists and labor groups representing outdoor workers haven’t forgotten. They are pushing lawmakers and regulators to keep facing the heat.

On Tuesday, the Miami-Dade Board of County Commissioners will take a final vote on a proposed heat standard to protect outdoor workers. If approved, it will be the first comprehensive local heat standard for outdoor workers in the country, going beyond requiring rest breaks and giving local officials regulatory teeth in a realm that lacks real oversight.

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Miami-Dade is the latest local push to protect agricultural and construction workers, two high-risk groups among employees affected by hot temperatures. But the effort comes as more and more people are becoming aware of — and stressed by — extreme heat, which causes more deaths every year in the U.S. than any other weather-related event. An estimated 1,300 Americans die from extreme heat each year. By 2050, that number could be closer to 60,000.

Without a federal heat standard for employers, states and local governments are left to grapple on their own with a pressing public health issue. Extreme heat exposure has been linked to spikes in cardiovascular deaths. But even when people don’t die from heat illness and heat stroke, they can suffer other health consequences, like impaired kidney function.

“We used to really think if you had heat stroke, that was a terrible thing and you could die from it — the death rate was something like 40% — but if you recovered from it, that’s fine. There’s no problem,” said Rosemary Sokas, a professor of human science and of family medicine at Georgetown University School of Health. (Symptoms of heat stroke include: a body temperature above 103 degrees Fahrenheit; red, hot, and dry skin; a fast pulse; headache; nausea; dizziness; or confusion.) That thinking has changed.

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A growing pile of research warns of how heat stroke can worsen health for decades afterward, potentially increasing the risk of stroke, cardiovascular disease, and end-stage kidney disease. Some studies suggest heat stroke could cause neurological dysfunction or even decrease a person’s life expectancy.

In the shorter term, hot days also increase the odds of being injured at work. And heat can cause flare-ups of multiple chronic health conditions, from migraine to rosacea, lupus, rheumatoid arthritis, chronic obstructive pulmonary disease, asthma, chronic kidney disease, hypertension, type 2 diabetes, cardiovascular disease, and more.

Yet even as the science becomes clearer, the politics are sticky. In Texas, local rest break laws are being challenged in court by state lawmakers who wish to strip local governments of regulatory authority. On the federal level, Congress has stopped short of expediting a federal rule for protecting workers from heat. And although the Biden administration asked the Occupational Safety and Health Administration to develop a a heat standard, the process could take nearly a decade.

Millions of outdoor workers are left to work in increasingly extreme conditions in the meantime.

The ‘It’s so hot!’ campaign

From May to September, almost all Americans got heat alerts from the National Weather Service, according to a report from the advocacy group Public Citizen, which is pushing for a federal heat standard.

For workers exposed to the elements, those extra hot weeks equal a heightened risk of heat-related illness. Miami-Dade’s outdoor workers, which number about 327,000, already endure far more days above 80 degrees Fahrenheit than the national average. And yet they have no promise of rest breaks, shade, or other protections from extreme heat.

That’s why, in 2018, advocacy group WeCount! pitched a statewide heat bill to lawmakers in Tallahassee. Such legislation wasn’t unheard of: States like California, Washington, Oregon and Minnesota all have a heat standard. And Florida was the state with the most heat-related hospitalizations. But the bill died in committee over four legislative sessions.

From that bill’s ashes, “¡Qué Calor!” (rough translation: “It’s so hot!”) emerged as a localized campaign for heat protections. And in July, on a 90-degree day, Miami-Dade county commissioners unanimously agreed to consider a local standard for outdoor workers. At a public hearing, dozens of community members, including local physicians, turned out in support.

Nov. 7 is the final hurdle. If commissioners approve the standard, it could be the strongest local heat rule in the country, said Oscar Londoño, co-executive director of WeCount!.

The proposal would require employers to have heat safety programs in place, including acclimatization practices to gradually — and safely — condition workers to the heat and workload (many heat-related deaths occur during the first week of work). The standard would also require employers to have first aid and emergency procedures, and give workers 10-minute water and rest breaks in the shade every two hours on very hot days.

But the real bite behind the Miami rule would be the creation of an enforcement arm at the county level. Employers who violate the standard would face financial penalties, possible suspension of county contracts and permits, requirements for extra training and inspections in the event of repeat offenses, and their violations listed in a public database.

Crucially, workers would also gain the right to sue employers if they are retaliated against for exercising their workplace safety rights.

Faltering federal steps

Workers in the U.S. are entitled to a safe working environment, a right given to them by the Occupational Safety and Health Act of 1970. OSHA was created by that same legislation to oversee worker safety and minimize workplace hazards, like lead and asbestos. But the agency hasn’t acted on heat, even though groups including the Centers for Disease Control and Prevention’s National Institute of Occupational Safety and Health have pleaded for a standard since 1972.

It’s partly a numbers problem. There are about 1,850 inspectors for about 130 million workers across the country, which is the equivalent of one compliance officer for every 70,000 workers.

But OSHA is also a “battered agency” whose hands are often tied by stiff opposition from politicians and special interest groups, including agriculture and construction industry associations, said Sokas, who twice directed OSHA’s Office of Occupational Medicine. “OSHA has been fighting its entire existence for every single thing it gets out the door, every single standard.”

In the 1980s, an early OSHA standard for workplace exposure to benzene, an industrial chemical often used in crude oil, wound up in front of the Supreme Court. The court told OSHA that any regulation the agency made had to demonstrate that, through an average working lifetime, the hazard was associated with a “material impairment to health, which meant serious illness or death, at the risk level of one in 1,000,” Sokas said. That’s compared to the Environmental Protection Agency, which can issue regulations for environmental exposures at a much lower threshold.

When it comes to agriculture, OSHA is also bound by a congressional “agriculture rider” that prevents it from regulating small farms.

Even with the Biden administration’s request for a heat standard, which came in 2021 after decades of advocacy, the agency has to complete dozens of steps before releasing a new regulation. “If it makes it out in the next two years, I will be thrilled to pieces but shocked at the same time,” Sokas said. And if Biden isn’t reelected, heat could fall off the priority list altogether under another administration.

Juley Fulcher, a worker health and safety advocate at Public Citizen who has been pushing for a federal heat standard, praised OSHA’s commitment but predicted, “Once the rule is released, the very day that it happens, there will be lawsuits filed,” she said.

Local laws to protect workers from heat are a stopgap measure in the meantime, she said – “better than nothing.”

Business and political blowback

In Miami, the possible heat standard has already gotten pushback from big employers who see it as an onerous proposition. Others might take issue with the fiscal demands — if passed, enforcing the law would require creating a new county office of workplace health and safety, which would cost taxpayers money. And the rule could also get political blowback from higher up, at the state level, just as in Texas.

In June, during Texas’ second hottest summer on record, Gov. Greg Abbott signed a bill into law that barred cities and counties from passing stricter regulations than the state’s. In doing so, Abbott effectively overturned numerous local rules, including some ordinances major cities had made years before to protect outdoor workers.

Austin passed a rest break law in 2010. A few years later, the death of Roendy Granillo, a 25-year-old construction worker who developed heatstroke while working on a home near Dallas, led to the creation of a rest break ordinance there in 2015. The laws were basic, requiring short water breaks every few hours, but they were still challenged — and now, they’re in legal limbo.

After House Bill 2127 was signed into law, several cities filed lawsuits, arguing the bill was unconstitutional and overly broad. And although a district judge declared the “Death Star” bill unconstitutional, it still went into effect on Sept. 1. The state appealed the ruling, and the legal fight is expected to make its way to the all-Republican Texas Supreme Court.

Advocates like David Chincanchan, policy director of the Workers Defense Project, are calling on the state to create its own heat standard, especially if the impetus behind HB2127 was to fix regulatory inconsistency. So far, the state has ignored those pleas, but Chincanchan said he’s heard from state legislators about expanding heat and water break rules to other parts of Texas (the state leads the nation in heat-related deaths on the job, according to CDC data).

Florida organizers hope the inroads they’ve made over almost a decade will shield them from a similar outcome. And having a heat rule in Miami-Dade, a politically powerful and populous county in Florida, could embolden other municipalities to take action, too, Londoño said.

“We can push back against state governments that try to overreach and undermine local democracy by negating protections that have been voted on by elected officials and that protect hundreds of thousands if not millions of workers,” he said.

The long path to change

It has often taken tragic deaths to spur action on heat. Migrant worker María Isavel Vásquez Jiménez was 17 years old and pregnant — and on her second day of work — when she collapsed and died of heat stroke. She had been picking grapes in scorching heat in Northern California.

Four years earlier, in 2004, Asunción Valdivia collapsed in an eerily similar fashion. He died of heat stroke at the age of 53, five days after he’d migrated to the U.S. to be with family.

Valdivia’s name is now on legislation that would request an interim heat standard from OSHA, and let the agency jump over some bureaucratic hurdles. But Congress hasn’t acted so far. Republicans are hesitant to approve any new business regulation, Fulcher said. But Public Citizen is working to build up co-sponsorship, and might try to pin the Valdivia Act to the reauthorization of the farm bill, which regulates agriculture programs and ran out on Sept. 30.

If the Valdivia Act passed by the end of 2023, Fulcher said, it could clear a path for OSHA to release an interim heat standard to protect workers before the boiling summer months arrive.

STAT’s coverage of chronic health issues is supported by a grant from Bloomberg Philanthropies. Our financial supporters are not involved in any decisions about our journalism.

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