title: Heat illness and death among workers - United States, 2012-2013.
abstract: Exposure to heat and hot environments puts workers at risk for heat stress, which can result in heat illnesses and death. This report describes findings from a review of 2012‒2013 Occupational Safety and Health Administration (OSHA) federal enforcement cases (i.e., inspections) resulting in citations under paragraph 5(a)(1), the "general duty clause" of the Occupational Safety and Health Act of 1970. That clause requires that each employer "furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees". Because OSHA has not issued a heat standard, it must use 5(a)(1) citations in cases of heat illness or death to enforce employers' obligations to provide a safe and healthy workplace. During the 2-year period reviewed, 20 cases of heat illness or death were cited for federal enforcement under paragraph 5(a)(1) among 18 private employers and two federal agencies. In 13 cases, a worker died from heat exposure, and in seven cases, two or more employees experienced symptoms of heat illness. Most of the affected employees worked outdoors, and all performed heavy or moderate work, as defined by the American Conference of Governmental Industrial Hygienists. Nine of the deaths occurred in the first 3 days of working on the job, four of them occurring on the worker's first day. Heat illness prevention programs at these workplaces were found to be incomplete or absent, and no provision was made for the acclimatization of new workers. Acclimatization is the result of beneficial physiologic adaptations (e.g., increased sweating efficiency and stabilization of circulation) that occur after gradually increased exposure to heat or a hot environment. Whenever a potential exists for workers to be exposed to heat or hot environments, employers should implement heat illness prevention programs (including acclimatization requirements) at their workplaces.
authors.forename: Sheila
authors.initials: S
authors.lastname: Arbury
authors.forename: Brenda
authors.initials: B
authors.lastname: Jacklitsch
authors.forename: Opeyemi
authors.initials: O
authors.lastname: Farquah
authors.forename: Michael
authors.initials: M
authors.lastname: Hodgson
authors.forename: Glenn
authors.initials: G
authors.lastname: Lamson
authors.forename: Heather
authors.initials: H
authors.lastname: Martin
authors.forename: Audrey
authors.initials: A
authors.lastname: Profitt
mesh_terms: D000328:Adult; D000368:Aged; D004651:Employment / Q000706:statistics & numerical data; D018882:Heat Stress Disorders / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology* / Q000401:mortality; D014481:United States / Q000453:epidemiology; D014489:United States Occupational Safety and Health Administration
references.citation: MMWR Morb Mortal Wkly Rep. 2008 Jun 20;57(24):649-53
references.pmid: 18566563
references.citation: J Community Health. 2012 Apr;37(2):495-500
references.pmid: 21882040
references.citation: PLoS One. 2013 May 29;8(5):e62596
references.pmid: 23734174
references.citation: Ann Epidemiol. 2014 Apr;24(4):254-9
references.pmid: 24507952