Virginia Regulatory Town Hall
Department of Labor and Industry
Safety and Health Codes Board
Heat Illness Prevention Standard [16 VAC 25 ‑ 210]
Action NOIRA on Heat Illness Prevention
Comment Period Ended on 6/9/2021
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6/9/21  7:03 am
Commenter: Yohance Whitaker

Heat Stress Conditions

There is no comprehensive federal or Virginia standard protecting workers against heat stress.  Without protections, Virginia’s workers are at risk of severe illness or death.  Heat kills more Americans than any other weather-related hazard.[1]  Heat illnesses occur when the total heat load exceeds what the body can handle while maintaining normal functions.[2]  Workers are at risk of heat stress in both outdoor work and indoor work, particularly when engaged in strenuous activities or with inadequate air conditioning.[3]  Even when heat illness is not a problem, productivity can suffer.[4]  Between 1992 and 2016, at least 783 workers died of heat stress and 69,374 workers were seriously injured.[5] 


There are various types of heat illness.[6]  Heat syncope occurs when someone has been standing for a long time or gets up suddenly having been sitting or lying down; it causes symptoms like dizziness or fainting.[7]  Heat rash, from excessive sweating, causes pimples and/or blisters.[8]  Heat cramps are caused by sweating when the person’s salt levels get too low; symptoms include cramps and spasms in muscles.[9]  Rhabdomyolysis occurs with prolonged physical activity and causes rapid degradation of muscle tissues and acute injury to the kidneys.[10]  Heat exhaustion occurs when the body has lost excessive amounts of water and salt.[11]  Symptoms include “headache, nausea, dizziness, weakness, irritability, thirst, heavy sweating, elevated body temperature, or decreased urination.”[12]  When not treated properly and quickly enough, heat exhaustion can lead to heat stroke, at which point the body can no longer produce sweat or control the internal temperature.[13]  Heat stroke symptoms include “confusion, slurred speech, hot and dry skin or profuse sweating, seizures, and loss of consciousness (coma),” as well as death.[14]


Although data shows high numbers of injuries and deaths from heat stress, these numbers are likely substantially lower than the true numbers.[15]  First, the data comes from Form 300 Logs, which are not required for employers not covered by OSHA and only require reporting if the injury or illness is sufficiently severe.[16]  Form 300 Logs are notoriously incomplete as employers underreport to avoid liability.[17]  Medical providers have also reported that employers have asked them to provide only enough treatment to not reach the reporting threshold.[18]  Employees underreport fearing retaliation and because of employer-sponsored incentive programs where workers get rewards for lack of injuries.[19]  Undocumented workers are especially afraid of reporting, fearing deportation.[20]  Workers may also not report because they cannot afford to miss work.[21]  Heat stress symptoms can be mistaken for symptoms of other illnesses, causing misdiagnoses.  Finally, heat stress makes workers more prone to accidents, which may be attributed as the sole cause of injury or death.[22]  All in all, millions of workers are at risk.


[1] Georges C. Benjamin, Killer Climate: More Americans Are Dying From Extreme Heat, The Hill (Sep. 12, 2019), (last accessed June 2, 2021).

[2] Brenda Jacklitsch et al., Dept. of Health and Human Serv., Criteria For A Recommend Standard: Occupational Exposure to Heat and Hot Environments 1 (2016), (last accessed June 2, 2021). 

[3] Id. at v; Letter from Sammy Almashat, M.D., M.P.H., Staff Researcher, Public Citizen’s Health Research Group et al., to Hon. Dr. David Michaels, Ph.D, M.P.H., Asst. Sec. of Labor for Occupational Safety and Health, Dept. of Labor 21 (Sep. 1, 2011), (last accessed June 2, 2021).

[4] International Labour Organization, Working on a Warmer Planet: The Impact of Heat Stress on Labour Productivity and Decent Work 18 (2019),—dgreports/—dcomm/—publ/documents/publication/wcms_711919.pdf (last accessed June 2, 2021).

[5] Letter from Sidney Wolfe, M.D., Founder and Senior Advisor, Public Citizen’s Health Research Group, to Loren Sweatt, Acting Asst. Sec. of Labor for Occupational Safety and Health, Dept. of Labor 8-9 (July 17, 2018), (last accessed June 2, 2021).

[6] Centers for Disease Control and Prevention, Heat Stress – Heat Related Illness, accessed June 2, 2021).

[7] Wolfe, supra note 5, at 7.

[8] Centers for Disease Control and Prevention, supra note 6.

[9] Id.

[10] Wolfe, supra note 5, at 7.

[11] Centers for Disease Control and Prevention, supra note 6.

[12] Wolfe, supra note 5, at 8.

[13] Id.

[14] Id.; Centers for Disease Control and Prevention, supra note 6.

[15] Wolfe, supra note 5, at 10.

[16] Id. at 10-11.

[17] Id. at 11.

[18] Id.

[19] Id.

[20] Id. at 11-12.

[21] Id. at 12.

[22] Id.

CommentID: 98998