Heat-related illnesses are preventable; here’s how – The Health Care Blog

By PHIYEN NGUYEN & KRISTINA CARVALHO

As we enjoy the crisp air of fall, a harsh reality remains: our planet is heating up. With more frequent and intense heat waves, 57.5 million Americans are living in areas with dangerously hot summer conditions, yet many states remain unprepared for the heat crisis already unfolding.

Impact of Heat on Health

Extreme heat poses a growing health threat, causing more deaths in recent years in the United States than any other weather-related event. Heat-related illnesses (HRIs), such as heat exhaustion and heat stroke, are on the rise, particularly among the elderly, children, outdoor workers, and individuals with certain preexisting medical conditions.

Not all communities are affected equally. Low-income neighborhoods and communities of color, often situated in urban “heat islands,” face greater exposure and have less access to cooling resources.  Moreover, extreme heat worsens air pollution and spreads disease-carrying insects, exacerbating health risks.

Without stronger protections, HRIs will continue to escalate, especially among populations who are already at increased health risks. Heat standards are a key part of the solution.

What are Heat Standards?

Heat standards are regulations that protect workers from excessive heat by requiring breaks, water access, and emergency procedures to prevent HRIs. Yet few states have heat standards in place.

In 2005, California was the first state to implement a mandatory HRI prevention standard requiring water, shade structures, and rest breaks for outdoor workplaces when temperatures exceed 80°F. Employers are also required to educate their workers about HRIs and have additional precautions in place when the temperatures exceed 95°F. A few months ago, California even expanded protections to include indoor workplaces when it is over 82°F inside.

Washington, Colorado, and Oregon followed suit with similar policies, though without indoor regulations. On the other hand, Minnesota’s heat standard only applies to indoor workspaces. But it’s unique in that it also applies to care facilities such as nursing homes and daycares, protecting the elderly and young children. Lastly, Maryland just passed a heat standard that applies to all outdoor and indoor workers across all industries.

All other states, including warm ones like Arizona, have no established heat standards. Texas and Florida have even tried to prevent their cities and towns from mandating that employers provide heat protections like water breaks.

Heat Standards Work!

Although formal studies are limited, there’s enough observational data to suggest that heat standards are effective at keeping people safe and healthy.

For example, California saw a 30% decrease in reported HRIs following implementation of its heat standard in 2005. Similarly, HRI-related medical visits in Oregon dropped by 75% in the year after the state enacted its standard. What’s more, that was in spite of having more days with temperatures above 80°F as well.

In short, HRIs are preventable. And they’re also cost-effective.

HRIs have been known to increase health care costs and may even hurt business productivity. By minimizing heat-related absenteeism, implementing heat standards can prevent potential losses up to $200 billion by the year 2030.

Toward National Heat Standards

Now that its clear heat standards are effective – we just need more of them.

To protect against HRIs, the Occupational Safety and Health Administration (OSHA) already encourages workplaces to develop safety guidelines that include rest breaks, shade, and hydration. OSHA has also proposed a mandatory national heat standard that would cover all outdoor and indoor work settings in industries such as construction, maritime, and agriculture. If enacted, it would require employers to develop plans to identify and mitigate heat hazards in their workplace. But OSHA’s proposal is not in effect yet; that’ll require action by the President.

However, a significant oversight in all this is that current heat standards focus mainly on workplace exposure, neglecting many vulnerable communities. The elderly, who often have health issues or use medications that impair their cooling, and children, whose bodies heat up faster, are left without direct protections. They are at the mercy of local action in their communities.

And many communities have already taken action! Multi-pronged, community-based heat action plans, local guidance that is not mandated, but strongly encouraged, are also highly effective at reducing HRIs. This is especially true among older adults and those with chronic conditions. Common strategies in heat action plans include establishing cooling centers, distributing water bottles and fans, and creating energy assistance programs (which help families pay for cooling systems and weatherization in their homes).

Without comprehensive heat standards at the federal or state level, workers – along with a variety of vulnerable communities (e.g., children, elderly, low income individuals) — will continue to face heightened risk for HRIs.

As extreme heat becomes the norm, the absence of effective heat standards at the national level and in most states is alarming. Certain communities are a great risk: implementing heat safety measures is essential for safeguarding our health and future.

PhiYen Nguyen, MPP, is a policy analyst at the Partnered Evidence-based Policy Resource Center with Boston University School of Public Health. Kristina Carvalho, MSW is a policy analyst with Boston University School of Public Health