Finally, it's time to truly protect our workers.

MedTech Outlook | Thursday, September 23, 2021

In Oregon’s Willamette Valley, just southwest of Portland, Sebastian Francisco Perezwas found unresponsive in late June after working on a crew moving irrigation lines for a large nursery. Sebastian, who was 38 years old, had arrived in the U.S. from Guatemala shortly before his death. When the workers broke for their noon meal and realized Sebastian was not among them, a search party discovered his body alone, in the fields. That day, the temperature in the Willamette Valleywas above 115 degrees Fahrenheit.

Three Junes ago, in 2018, Miguel Angel Guzman Chavez was picking tomatoes in Georgia, having arrived from Mexico just a few days prior. Miguel, who was 24 years old,collapsed in the field from heat stroke – a condition that led to his full cardiac arrest. Fewer than two hours later, at the Colquitt Regional Medical Center in Moultrie, Miguel died. The temperature in southwest Georgia that day was 95 degrees.

In May 2008, Maria Isabel Vasquez Jimenez was tying grape vines on a vineyard near Stockton, California. With no breaks allowed and a 10-minute walk to the nearest water cooler, Mariacollapsed from heat exhaustion and was taken to a nearby hospital. After two days in a coma, Maria died. It was only during this time that her fiancé, Florentino Bautista, learned Maria was two months pregnant. The temperature in California’s Central Valley that day was over 95 degrees Fahrenheit, and upon arrival at the hospital, Maria’s body temperature reached 108 degrees.

In light of this unspeakable – and completely unnecessary – loss of life (as well as many others, well-documented by NPRhere), it’s time we admit we’ve done a woefully inadequate job of preventing heat injury and illness. In the 12 years since Maria’s death, almost nothing changed to protect our workers from heat injuries and illnesses. Although California passed the nation’s strictest heat laws in the countrythree years prior, in 2005, there were still three heat-related deaths in the state the following year, and California inspectors found that most employers were violating heat rules requiring that workers receive adequate breaks, shade, and access to water. As noted by NPR and Columbia Journalism Investigations, at least384 workers have died from environmental heat exposure in the decade since Maria’s death. Between 1992 and 2016, almost70,000 workers suffered serious heat injuries nationally; 783 of them lost their lives to heat-related illness.

Our temperatures have increased dramatically in the last 100 years, with the National Oceanic and Atmospheric Administration (NOAA) recently declaring July of 2021 theEarth’s hottest month on record. With200 million Americans under heat advisories across the country, the story now is less about individual anomalies around the globe and more about the consistent, pervasive warming of the entire planet. As the United Nations ominously noted on August 9,the past 50 years have seen the fastest temperature increases in at least 2,000 years. Two new studies, released by Lancet last month, find a74% rise in deaths caused by high temperatures, with a “strong scientific argument that the health dimensions of heat can no longer be overlooked.”

Public Citizen reports that130 million workers lack protection from heat injury and illness, including construction workers, oil field laborers, and fire fighters, in addition to farm workers like Sebastian, Miguel, and Maria. And while some laborers, at least in Oregon, have the option to start working earlier and stop midday, their economic need as well as a “band of brothers” mentality often prevents them from stopping work when they should.

The true tragedy of heat illness is the fact that it is almost always entirely preventable. Often caused by poorheat acclimatization, a phenomenon that occurs when new workers haven't fully adapted to higher temperatures, migrant workers are especially susceptible to this risk. It typically takes a full two weeks for new workers to acclimatize to a new environment, a simple preventative measure that may have saved both Sebastian and Miguel.

Heat susceptibility also increases with age, with those of us over age 35 being far less equipped to handle high temperatures. Gender is also a factor (women handle the heat better than men), as are pre-existing health conditions, and other medical factors such as prescription medications. Consider the age, gender, health conditions, and geographic locations of Sebastian, Miguel, and Maria, and it’s clear that one size does not fit all when it comes to heat injuries.

Furthermore, the number of heat wave days per summer has not only gone up substantially since 1960, but high heat days are also more sporadic throughout the year. Maria died in May, on a day that was unusually hot for that season, even in Central California -- one example of how heat illness is not just a broad, seasonal risk for workplaces, but a specific, daily, and personal risk for each individual worker. And while new regulations could help impact the trend of heat-related deaths overall, employers are still likely to miss individual instances of heat injury and illness in the workforce.

Finally, regulatory efforts are underway: this week, the President announced new efforts to establish new safety standards with OSHA for addressing the problem. California, Minnesota, and Washington have state guidelines. Oregon’s OSHA agency is working onnew rules to keep outdoor workers safe during extreme heat in response to Sebastian’s death, and Public Citizen isworking diligently to enact the Asuncion Valdivia Heat Illness and Fatality Prevent Act. Countries and cities across the globe are creating Chief Heat Officer positions, beginning with Miami’s first CHO appointment worldwide in May and most recently in Athens, whose temperatures this summer have risen above 111 degrees Fahrenheit and toppled records in the ancient city.

While we haven’t come far in terms of workplace regulation or the political will to change our laws, it’s fair to say our overall concern for the worker is starting to improve. Most work site safety managers care about their workers and are pleading with their own industries to step forward and take better care of them.

Many employers, in fact, are implementing sophisticated technology that helps them track individual worker biometrics, to ensure key physiological indicators don’t elevate to dangerous levels.Wearable sensors that show core body temperature, heart rate, and other physiological markers are critical tools in preventing heat injury and illness, and death: a simple armband device can alert both the worker and supervisor if an individual’s core body temperature rises above acceptable levels, and the worker can hydrate and seek shade (or be encouraged to do so) before the heat illness becomes too severe.

For example, if a rigger on an offshore oil platform experiences an increased core body temperature, his supervisor on land can alert him to take a break and move to shade. If the heart rate of a public works flagger spikes, she can move herself to safety and hydrate. And if a 17-year-old vineyard worker expecting her first child begins to feel overheated and weak, perhaps someone can help her find water and seek shelter from the oppressive heat.

These innovations weren’t here in time to save Sebastian, Miguel, and Maria. But as two new Lancet studies report what many of us already know – that heat-related injuries and illnesses can all too easily kill – let’s work to produce technology that saves many more workers now and in the future. In the absence of regulations and political will, maybe wearable tech can bring science to the forefront of worker safety and reduce the unnecessary loss of human life due to heat injury and illness.