does this control the business or the people?

This is another example of regulation in search of a problem.  As a small auto repair/ gas station owner we do not need more costly, ineffective, burdensome regulations that will harm our businesses.  In the summer it gets hot. Due to COVID we now meet a great number of our customers outside in the parking lot. We repair tires, head lights and wipers while people wait ... outside. We road test vehicles. We maintain our grass, plant flowers and decorate to make the neighborhood beautiful.  When people have trouble with the gas pumps we our employees help them. We pump gas for our handicapped & elderly customers. All of these activities would be prohibited or limited to 15 minutes per hour which is not a sustainable business model. This is extremely short sighted and nonsensical example of beauracratic overreach and should be opposed by every business and politician in the state.  Scott 

Why do I need more regulation in my business. We are proud of our employees the work they do and the skill they do it with. I don't need the government imposing regulations to reduce productivity raise costs and hinder my business. We go to great lengths to care for each and every employee. It seems to me that you are concerned with burdening and creating hardship. Government oversight is useless. Use your time to help my business

Many of the concerns that have been stated are already being addressed by businesses in this field. We have air conditioned areas (snackshops or showrooms) that employees can cool off if they feel they need to. Water is of course readily available. We have commercial fans in our service bays to aid in ventilation. 

This is not an industry where employees can realistically take 15 minute breaks every hour because often times they are working on complex repairs that require extended periods of concentration and focus to complete. You will directly be hurting the compensation of employees who have trained over years (sometimes decades) to be in a position to maximize their time and skillset. 

Some of the suggestions seem predicated on unfair assumptions about soda usage, alcohol, caffeine, and obesity. Those are private matters and it is unfair to shift the burden on the employer to address these aspects of an employees' lifestyle. 

Lastly, this past year has been one of the most challenging times for small businesses. For those of us that made it through this incredibly stressful time, we respectfully but firmly ask that you please do not make it even harder to survive going forward. More restrictions and regulations are not needed, especially right now. 

this an over reach violation of employee and employer 

As a restaurant owner, why do I feel like this is aimed at construction type jobs and that we are going to be caught up as collateral damage? Over reaching legislation that isn't worded well will have unintended consequences for our industry. I will not speak for the other industries that may be affected, but would like to see something written that protects or even exempts us from this legislation. I cannot time each minute that a server is on the patio as opposed to being in the dining room and would need to, if I am reading this correctly.

Thank you for your leadership on creating the emergency COVID-19 standard. Please develop strong standards/regulations for addressing heat illness to protect farmworkers and other at-risk workers. The regulation should outline standards for access to water, breaks, training and air-conditioning in employer provided housing.  Thank you for consideration of protecting the people who make our food available to us.

The following message was developed by VICPP and having lived on a farm, and understanding the physical burden of farm labor I totally agree with the need for regulation and work standards

Thank you for your consideration  Sheila Kryston

Thank you for your leadership on creating the emergency COVID-19 standard. Please develop strong standards/regulations for addressing heat illness to protect farmworkers and other at-risk workers. The regulation should outline standards for access to water, breaks, training and air-conditioning in employer provided housing.

Just as you drafted and approved the Emergency OSHA Standard for COVID-19, now please develop strong standards and regulations for addressing conditions to prevent heat-related illnesses to protect workers, such as farmworkers, landscapers, constructions workers, and indoor workers who labor in excessively hot conditions.  The standards should address access to water, breaks, training and air conditioning in employer-provided housing.  

If society wants the services of these essential workers, we need to provide humane standards and regulations for them.

Thank you.

Thank you for your leadership on creating the emergency COVID-19 standard. Please develop strong standards/regulations for addressing heat illness to protect farmworkers and other at-risk workers. The regulation should outline standards for access to water, breaks, training and air-conditioning in employer provided housing.

Thank you for your leadership on creating the emergency COVID-19 standard. Please develop strong standards/regulations for addressing heat illness to protect farmworkers and other at-risk workers. The regulation should outline standards for access to water, breaks, training and air-conditioning in employer provided housing.

I appreciate your leadership on creating the emergency COVID-19 standard. Please develop strong standards/regulations for addressing heat illness to protect farmworkers and other at-risk workers. The regulation should outline standards for access to water, breaks, training and air-conditioning in employer provided housing. I remember working over 20 years in the air-conditioned office of a local company with a large manufacturing area, and on hot summer days in the mid to upper 90s, the factory was a furnace. I never understood how the people who worked in that area could survive working for hours like that. Just walking through it briefly left me feeling very tired, lethargic and uncomfortable. It certainly was not a healthy situation.

Thank you for your leadership on creating the emergency COVID-19 standard. Please develop strong standards/regulations for addressing heat illness to protect farmworkers and other at-risk workers. The regulation should outline standards for access to water, breaks, training and air-conditioning in employer provided housing.

Please develop strong standards/regulations for addressing heat illness to protect farmworkers & other at-risk workers.  The regulation should outline standards for access to water,  breaks, training & air conditioning in employer provided housing.  I would also reccomend having access to sunscreen SPF 50 or higher, insect repellants, & a simple graphics fact sheet like the CDC's on how to spot heat stroke & heat exhaustion to post in various locations, in Spanish as well.  I saw the inside of the old Kroger Bakery before it closed, when it was located on 5th St., Roanoke, VA back in the late 70s/early 80s  by an employee who said his job was "throwing pans", & was told due to bread needing to rise, no AC was allowed.  Even the few windows were blacked out.  I didn't ask if they were sealed up, so those types of workers need standards/regulations as well.  

Please follow through with guidelines to protect workers, especially those who work outside, from heat illness by being sure they get plenty of water and time breaks from the heat. Thank you.

I have worked in extreme heat when I was younger and know how it can impact you.

Thank you for your leadership on creating the emergency COVID-19 standard. Please develop strong standards/regulations for addressing heat illness to protect farmworkers and other at-risk workers. The regulation should outline standards for access to water, breaks, training and air-conditioning in employer provided housing.

Thank you for your leadership on creating the emergency COVID-19 standard.

Please develop strong standards/regulations for addressing heat illness to protect farmworkers and any other at-risk workers.

This regulation should outline standards for access to water, breaks, training, and air-conditioning in employer provided housing.

I see this as a basic right of workers.

Thank you in advance for your serious consideration. 

Thank you for your leadership on creating the emergency COVID-19 standard. Please develop strong standards/regulations for addressing heat illness to protect farmworkers and other at-risk workers. The regulation should outline standards for access to water, breaks, training and air-conditioning provided by the employer.

P.S.Years ago I worker in California with the United Farm Workers.  At 5 a,m, it  was allready so hot I could scarcely breathe.

Dear Board Members,

Thank you for your leadership on creating the emergency COVID-19 standard. Please develop strong standards/regulations for addressing heat illness to protect farmworkers and other at-risk workers. The regulation should outline standards for access to water, breaks, training and air-conditioning in employer provided housing.

This would demonstrate your humanity to all workers in Virginia. Thank you!

Thank you for your leadership on creating the emergency COVID-19 standard. Please develop strong standards/regulations for addressing heat illness to protect farmworkers and other at-risk workers. The regulation should outline standards for access to water, breaks, training and air-conditioning in employer provided housing.

Please always remember that it was not the wealthy people that kept our country running during the pandemic, it was those essential workers like construction, water, gas and farmers that kept us going.  They deserve adequate support to continue their jobs.

Thank you for all of your leadership protecting our workers. I'm writing to ask your support for another set of protections. We desperately need a strong set of standards and regulations to protect farmworkers, landscapers, contractors, and other at-risk workers from heat illness. The regulation should outline standards for access to water, breaks, training and air-conditioning in employer provided housing.

Thank you for your leadership on creating the emergency COVID-19 standard. Please develop strong standards/regulations for addressing heat illness to protect farmworkers and other at-risk workers. The regulation should outline standards for access to water, breaks, training and air-conditioning in employer provided housing.

I am also concerned about other climate related conditions, some workers must work in cold conditions, for long periods increasing their exposure to crippling arthritis.

As mother of 2 sons who were required to work through COVID, but NOT given protection in their work with the public through enforcement by their employers requiring physical protection of distance or masks.  Both had to use unpaid time to receive the vaccination and juggle child care and home schooling.  

It is time to think of emplyment as part of LIFE and structure work to allow employees to be real people in a community.

Thank you for your attention to the welfare of all people.

Thank you for your leadership on creating the emergency COVID-19 standard. Please develop strong standards/regulations for addressing heat illness to protect farmworkers and other at-risk workers. The regulation should outline standards for access to water, breaks, training and air-conditioning in employer provided housing.

I am grateful to know that you created the emergency COVID-19 standard.  I would also be very grateful if you were to develop strong standards/regulations for addressing heat illness to protect farmworkers and other at-risk workers. The regulation should outline standards for access to water, breaks, training and air-conditioning in employer provided housing. If professional soccer games can build in water breaks for athletes during especially hot weather, surely the state government can mandate that employers take such sensible measures to prevent illness--and even death--from elevated temperatures.

Thank you for considering the adoption of work rules that will help protect agricultural workers and those working in unsafe indoor commercial settings.  

Please develop strong standards/regulations for addressing heat illness to protect farmworkers and other at-risk workers. The regulation should outline standards for access to water, breaks, shaded cooling stations, training, and air-conditioning in employer-provided housing.

Sincerely,

Rea Howarth

PS: Thank you for your leadership on creating the emergency COVID-19 standard.

Thank you for your leadership on creating the emergency COVID-19 standard. Please develop strong standards/regulations for addressing heat illness to protect farmworkers and other at-risk workers. The regulations should, at a minimum, outline standards for access to water, breaks, training and air-conditioning in employer provided housing. As the effects of climate change continue to contribute to a warming world, these regulations are more critical than ever.

Sirs/Madams,

Thank you for your leadership in creating the emergency COVID-19 standard. This is a request that you please develop strong standards and regulations for addressing heat illness to protect farmworkers and other at-risk workers. The regulations should outline standards for access to ater, breaks, training, and air-conditioning in employer provided housing.

Thank you.

Addie N. Peterson

On behalf of Celanese Corporation (“Celanese”), we are submitting comments in response to the Virginia Department of Labor and Industry’s Safety and Health Codes Board (“Board’s”) Notice of Intended Regulatory Action (“NOIRA”) to adopt a regulation on Heat Illness Prevention. Celanese is deeply committed to the safety of its workers and particularly concerned with worker health, safety, and well-being during hot days in Virginia. Celanese therefore supports workplace safety policies that ensure feasible action, which are based on sound science, and are not unnecessarily complex or difficult to implement. With that said, Celanese supports the Board’s proposal to provide a standard on heat illness prevention, but does have concerns over the intended scope, feasibility, complexity, and ambiguities in the proposed regulatory language.

• The proposed Heat Illness Prevention Standard does not have a clear scope.

The Board’s rulemaking documents convey that it is considering a “comprehensive regulation to address employee exposure to heat illness hazards during indoor and outdoor work activities in all industries under the jurisdiction of the Virginia State Plan for occupational safety and health.” But the NOIRA and associated documents focus on heat illness issues associated with mainly outdoor work. To avoid confusion, the Board should ensure any regulation on heat illness prevention identifies the scope and application of the requirements. This can be accomplished through adding a “scope” or “applicability” section directly in the regulation text. As indoor and outdoor environments also pose different potential exposure to heat illness hazards, the Board should ensure the regulation clarifies when preventive measures may differ for indoor or outdoor environments. That said, because multiple definitions could impose unnecessarily burdensome obligations on employers or create confusion, the Board should ensure the scope and application of the regulation does not lead to employers having to develop or implement different “plans” or “programs” to manage heat illness issues.

• The proposed Heat Illness Prevention Standard should be based on sound scientific information and data.

The Board’s rulemaking documents convey that the regulation will be set up to achieve the highest degree of health and safety protection for employees, while still heeding the latest available scientific data. In evaluating preventive measures that will be required by the standard, we urge you to rely on the best available scientific evidence on identification and prevention of heat illnesses. This approach would ensure both the most effective methods for identifying potential heat illness and appropriateness of controls. The Board should specifically consider information, data, and recommendations from the National Institute for Occupational Safety and Health, as well as research and data collected in public health studies and research.

• The proposed Heat Illness Prevention Standard requirements for written programs and controls should be flexible enough to accommodate incorporation into employers’ already established programs or health and safety initiatives, without requiring new or separate program efforts.

Employers balance many competing regulatory compliance obligations, including the need for many programs, plans, policies, and procedures under federal, state, and local laws. The Board should therefore implement a regulation that achieves its goal of protecting worker health and safety while still being flexible enough to avoid imposing new or added obligations on employers to complete unnecessary duplication of effort purely administrative steps. Employers should, for example, be able to incorporate heat illness hazard identification processes and controls into their current health and safety programs and initiatives without having to develop separate or unique “programs” or written “plans.” In addition, because the procedure for assessing heat hazards is more like a “process” than a plan, employers should be able to use their current hazard identification processes to identify, evaluate, and respond to heat illness hazards, rather than developing a new set of procedures or operations to deal specifically with heat illnesses.

• The proposed Heat Illness Prevention Standard should not unreasonably expand employers’ obligations to control of employees’ personal health and medical conditions, or require employers to make fit-for-duty determinations.

The Board’s rulemaking documents contemplate specific rules for managing heat illness, including potential management of employees’ personal risk factors that could contribute to heat illness and some considerations for return to work following an employee’s exhibition of heat illness symptoms. While employers need to be aware of the personal risk factors that can contribute to heat illness as well as the signs and symptoms of heat illness to ensure identification of heat illness occurrence and appropriate emergency response—any Heat Illness Standard adopted should not put employers in a position to act as a medical professional or advisor to employees. Employers should, as a result, not be responsible for managing their employees’ personal health or medical conditions, counseling employees on personal risk factors, or deciding on when an employee should return to work following symptoms of heat illness. Rather, employers should only be responsible for educating workers on the risk factors that can contribute to heat illnesses and injuries, including personal risk factors, identifying potential heat illness symptoms, and ensuring appropriate emergency response. Further, employers should be able to rely on designated medical or healthcare professionals to determine when it is safe to bring an employee back to work rather than rely on the employee’s statements or assertions of ability to return following a heat illness incident.

• The proposed Heat Illness Prevention Standard should sufficiently direct employers on identification of heat illness hazards, occurrence of heat illness, and selection of appropriate controls, including engineering controls and personal protective equipment.

As the proposed Heat Illness Prevention Standard has applicability to diverse operations, the Board should ensure regulation text sufficiently details steps, analytical processes, and measures to identify and evaluate heat illness hazards. This would include detailed enough instructions to employers on measures for evaluating temperatures and relative humidity; temperatures and factors at which engineering controls are required, if feasible; and options for employers to use alternative controls like personal protective equipment (“PPE”). The regulation text should also have flexibility for employers in evaluating and responding to heat illness hazards so as to address their specific work operations and needs. For example, some employers may be able to use engineering controls, such as outside cooling units for some fixed outdoor environments, but be unable to use outside cooling units for mobile or constantly shifting outdoor work. Employers should also be allowed to follow recommendations on engineering controls, administrative controls, and required PPE from local public health authorities or employees’ personal medical providers.

In addition, the  Heat Illness Prevention Standard should identify appropriate methods for responding to and managing heat-related emergencies. More specifically, the standard should be clear on heat illness symptoms, when there has been a heat-related emergency, and the expected level of emergency response. To avoid confusion and also align with industry best practices, we recommend that the Board use federal OSHA’s guidance for “Preparing for and Responding to Heat-Related Emergencies,” which has a chart for employers to use advising on when a worker may be experiencing heat stroke, exhaustion, cramps, rash, or a medical emergency and directs on the appropriate emergency response, in development of the standard. See https://www.osha.gov/heat/heat-index/heat-emergencies. The standard should also detail objective steps employers should follow when removing or bringing an employee back to work that are not based on an employee’s singular symptoms or consideration for the surrounding circumstances. Employers should not, for example, need to treat all potential symptoms of heat illness, such as vomiting or fatigue, as a heat illness case requiring emergency treatment or medical clearance for the employees to return to work. Rather, employers should be able to use the evidence reasonably and readily available along with present circumstances to take appropriate action to remove employees from work where necessary, ensure appropriate first aid or medical response as detailed in federal OSHA’s guidance, and return the employees to work.

• The Board should ensure that employers are given time to comply with new requirements.

The Board’s rulemaking documents convey the potential for a complex standard and regulations with many new regulatory compliance, including considerations for a written plan, development of new procedures, establishment of new or differing engineering controls, and extensive training for management and employees. It will take time for employers to review their compliance obligations under the standard, develop responsive programs, implement new or added controls, and develop and implement training. The Board should also know that training for an employer is unlikely to be as easy as developing a single PowerPoint presentation and rolling out to an entire employee population at a single time. Employers may, in fact, need to develop many training materials (e.g., supervisor level training, affected employee training, training for specific hazards and controls, and awareness training) and roll out in phases or to multiple shifts and departments. The Board should therefore ensure employers have clear and adequate notice of the new requirements as well as time to implement (i.e., minimum of 90 days).

We appreciate the opportunity to provide this input and your thoughtful and serious consideration to our input and recommendations. To discuss this subject more, please contact me at your convenience.

Heat is a rising threat to workers in Virginia, placing them at risk of illness or even death. Nationally, between 1992 and 2016, at least 783 workers died of heat stress and 69,374 workers were seriously injured.¹ Statistics have shown that farmworkers are twenty (20) times more likely than workers in other industries to die of heat illness.²  These numbers are most likely severe underestimates for a variety of factors. In Virginia, men accounted for 70% of visits to emergency departments and urgent care centers for heat-related illnesses during July heat events of 2019 and 2020. About 70% of those visits were in people 20-60 years old³ and it reasonable to assume that a percentage of these visits were work-related.  This is supported by research done by the Science Museum of Virginia and the Virginia Office of Emergency Medical Services demonstrating that over 14% of summertime heat-related illnesses responded to by ambulance in Richmond from 2016-2018 were work-related. With rising temperatures associated with climate change, it is increasingly important to protect workers from heat with common sense regulations including access to water, training, breaks in cool areas and emergency preparedness plans. 

1. 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), https://citizenvox.org/wp-content/uploads/2018/07/180717_Petition-to-OSHA-on-Heat-Stress-Signed_FINAL.pdf (last accessed June 2, 2021).
2. Center for Disease Control, Morbidity and Mortality Weekly Report, Heat Related Deaths Among Crop Workers -United States, 1992-2006 (June 20, 2008), https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5724a1.htm (last accessed June 3, 2021).
3. https://www.vdh.virginia.gov/surveillance-and-investigation/syndromic-surveillance/weather-surveillance/ (last accessed June 3, 2021)

This is a great idea. Va. does experience very hot/humid weather during certain times of the year.  The people who have to work outside in the heat and elderly who might not have air conditioning suffer. Let us acknowledge the situation and do something about it.

Avoid medications that produce adverse effects while in sun.

Stay hydrated--drink plenty of water.

Wear light-weight, loose fitting clothing; wear sunglasses to protect eyes; wear wide-brim hats.

Take frequent breaks when experiencing adverse reaction to the sun.

Have supervisors provide cooling stations placed at various locations.

Thank you for your leadership on creating the emergency COVID-19 standard. Please develop strong standards/regulations for addressing heat illness to protect farmworkers and other at-risk workers. The regulation should outline standards for access to water, breaks, training and air-conditioning in employer provided housing.

Thank you for your leadership on creating the emergency COVID-19 standard. Please develop strong standards/regulations for addressing heat illness to protect farmworkers and other at-risk workers. The regulation should outline standards for access to water, breaks, training and air-conditioning in employer provided housing.

Thank you. 

Emily

Thank you for your leadership on creating the emergency COVID-19 standard. Please develop strong standards/regulations for addressing heat illness to protect farmworkers and other at-risk workers. The regulation should outline standards for access to water, breaks, training and air-conditioning in employer provided housing.

Excessive heat is a serious health threat for farmers and others who must toil in our hot/humid environment. Please develop strong standards to protect these workers. These need to address access to water, breaks, training and employer provided housing. We are counting on you to help improve these conditions. Thank you. 

Thank you for your leadership on creating the emergency COVID-19 standard. Please develop strong standards/regulations for addressing heat illness to protect farmworkers and other at-risk workers. The regulation should outline standards for access to water, breaks, training and air-conditioning in employer provided housing.

Thank you for your leadership on creating the emergency COVID-19 standard. Please develop strong standards/regulations for addressing heat illness to protect farmworkers, landscapers, day laborers, and other at-risk workers. The regulation should outline standards for access to water and shade, breaks, training, and air-conditioning in employer provided housing. You and I wouldn’t subject ourselves to the dangers of heat illness, and others shouldn’t have to either. Heat illness kills thousands of people each year.  Please take action to enact proven measures to protect vulnerable workers. Thank you. 

As you did for the Covid-19 standards, please create strong standards addressing heat stress/illness so we can protect our 'outside' workers in our hot, humid summers.  These standards need to address access to work breaks, water, training, and cooling.    Thanks    

Thank you for your leadership on creating the emergency COVID-19 standard. Please develop strong standards/regulations for addressing heat illness to protect farm workers and other at-risk workers. The regulation should outline standards for access to water, breaks, training and air-conditioning in employer provided housing. 

Dear Mr. Withrow:

AIHA, headquartered in Virginia and representing more than 200 occupational and environmental health and safety professionals in the Commonwealth strongly supports Virginia’s intent to develop and adopt a standard “to reduce/eliminate employee injuries, illnesses, and fatalities due to exposure to excessive heat at indoor and outdoor places of work.”[1] Each year, hundreds of workers die and thousands more suffer injuries from occupational exposure to heat illness.[2]^,[3] Despite this, neither the U.S. Occupational Safety and Health Administration (OSHA) nor the Virginia Occupational Safety and Health (VOSH) program have a standard that specifically addresses heat stress. Action is urgently needed to help prevent more fatalities and injuries.

AIHA recommends the following components be detailed in the standard:

• Reference to established and recognized alert/exposure limits
• Provisions for personal protective equipment, rest, water, and shade
• Reference to surveillance and medical testing
• Administrative controls such as training and the posting of heat stress warning notices
• Provisions for whistleblower protections

Conclusion and Next Steps

AIHA looks forward to working with VOSH on this rulemaking and other actions to help protect all workers from occupational hazards. If you have any questions on these comments or other matters, please contact Mark Ames at mames@aiha.org or (703) 846-0730.

Sincerely,

John Mulhausen, Ph.D., CIH, CSP, FAIHA

President

AIHA

About AIHA

AIHA is the association for scientists and professionals committed to preserving and ensuring occupational and environmental health and safety in the workplace and community. Founded in 1939, we support our members with our expertise, networks, comprehensive education programs, and other products and services that help them maintain the highest professional and competency standards. More than half of AIHA's nearly 8,500 members are Certified Industrial Hygienists and many hold other professional designations. AIHA serves as a resource for those employed across the public and private sectors as well as to the communities in which they work. For more information, please visit www.aiha.org.

I am concerned at how the proposed regulations could inadvertently affect our restuarants that have outdoor dining. Though our servers do go onto the patio they are also frequently inside. It seems like this legislation could be put out broadly in a way that would be difficult for our managment to track and comply. We really just want to follow the rules, so please make sure that the rules makes sense for any businesses affected. 

Thank you for your leadership on creating the emergency COVID-19 standard. Please develop strong standards/regulations for addressing heat illness to protect farmworkers and other at-risk workers. The regulation should outline standards for access to water, breaks, training and air-conditioning in employer provided housing.

The Commonwealth of Virginia should enact heat protection regulations for outdoor workers.

There are a number of types of workers who are at risk for heat-related illness - agricultural workers, construction workers, landscape workers and others who are required to be outside for long periods of time.

Heat related illness can be very serious requiring hospitalization and, occasionally leading to death. Some of the more serious complication of heat related illness include muscle destruction and kidney damage.

The Bureau of Labor Statistics reported for the years of 2015 and 2016 there were 100 nonfatal injuries and illnesses and 6 fatalities in Virginia for workers caused by heat injuries but it is recognized that this number is under reported. The Virginia Department of Health data indicate that hundreds of Virginians are seen in emergency rooms every summer. Not all of these visits will be from workers; nevertheless, worker heat protection should be a priority for the Commonwealth.

It is very encouraging to see that Virginia is moving to join three other states to protect our workers from the dangers of extreme heat.  The text of the NOIRA very completely outlines the medical conditions, from heat rash to the potentially fatal heat stroke, that can impact the Commonwealth’s workers.

Two California cases illustrate the danger of extreme heat on workers.

• A 17 y/o woman was tying grape vines at a farm in May of 2008 when the temperature soared above 95 degrees. The nearest water cooler was a 10-minute walk away and the break given to workers did not allow them time to go and get water and then return. She collapsed from the extreme heat and on arrival at the hospital she was in a coma and her body temperature topped 108 degrees. She died two days later.

• A 53 y/o gentleman came to America in July of 2004 to join his son working in the fields.  5 days later, after a 10-hour workday picking grapes in the 105 degree sun, he collapsed from heatstroke. The crew’s supervisor did not recognize the signs of heat stroke and told his son to drive his father home. In the car his father began foaming at the mouth and then went limp. The son immediately headed to the closest hospital. By the time they reached their destination his father had died.

Very simple measures from scheduled water breaks, close access to water and shade, and training of both workers and supervisors in recognizing the signs and symptoms of heat illness can protect our workers.  Let us take these steps to prevent Virginia from experiencing cases such as those described above.  

Bob Kitchen, MD

Virginia Clinicians for Climate Action

It is my understanding that the Virginia Safety and Health Codes Board intends to develop a standard to help protect workers who are at risk of heat illnesses such as heat exhaustion and heat stroke.  I write to applaud your efforts and to respectfully suggest such a standard should provide workers with easy access to drinking water and air conditioning; frequent breaks; and significant training regarding working in hot conditions.

It's no secret that a southern state like Virginia is hot in the summer; on many days dangerously so.  Climate change promises to exacerbate this situation for workers whose occupation requires them to work outdoors.  I ask the Board to develop a strong standard that will protect Virginia's workers.

Respectfully submitted,

Bruce Burton

Alexandria, VA

I am concerned about the effects of rising temperatures on the health of Virginians. The risk of heat illness is particularly high for those working in extreme heat. I support the development of strong standards for heat illness as a method to protect the health of outdoor workers by requiring access to water, breaks in cool areas and training of workers and supervisors in recognizing and treating heat illness.

A study of Emergency Room admissions to the UVA Health System showed that heat waves increase ALL categories of illnesses, not just the illnesses directly related to overheating.

Climate change increasingly makes heat waves last longer, be more intense, and cause more serious health effects.

Please enact the proposed mandatory protections from heat illnesses for outdoor workers in Virginia.  The Golden Rule clearly applies to this increasingly important situation:  "Do unto others as you would have them do to you".

According to research conducted by Andreas D Flouris and colleagues at the University of Thessaly, nearly one third of the world’s populations is regularly exposed to conditions that exceed human thermoregulatory capacity, which can lead to dramatic increases in illness and death.¹ Although this information can be difficult to digest, measurable action must be made in Virginia to ensure the health of its society. Workers can be at high risk of heat stress in a myriad of environments, including both indoor and outdoor settings. Anytime workers are exposed to hot temperatures, and especially when they are performing strenuous tasks in these conditions, excessive heat must be a key consideration.² Flouris and colleagues results demonstrated that individuals working in heat stress conditions were roughly four times more likely to experience heat strain throughout of after their shifts when compared to individuals working in thermoneutral conditions.¹ They also have a higher prevalence of acute kidney injury, a serious condition that can lead to chronic kidney disease. Illnesses influenced by heat stress, like chronic kidney disease, can carry with them substantial socioeconomic burdens and public health outcomes.^1&3

1.  Flouris, Andreas D., Petros C. Dinas, Leonidas G. Ioannou, Lars Nybo, George Havenith, Glen P. Kenny, and Tord Kjellstrom. "Workers' health and productivity under occupational heat strain: a systematic review and meta-analysis." The Lancet Planetary Health 2, no. 12 (2018): e521-e531.
2.  Brenda Jacklitsch et al., Dept. of Health and Human Serv., Criteria For A Recommend Standard: Occupational Exposure to Heat and Hot Environments 33 (2016), https://www.cdc.gov/niosh/docs/2016-106/pdfs/2016-106.pdf (last accessed June 2, 2021).  
3. Lameire, Norbert H., Arvind Bagga, Dinna Cruz, Jan De Maeseneer, Zoltan Endre, John A. Kellum, Kathleen D. Liu et al. "Acute kidney injury: an increasing global concern." The Lancet 382, no. 9887 (2013): 170-179.

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),  https://thehill.com/opinion/energy-environment/461126-killer-climate-extreme-heat-kills-more-americans-than-any-other (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), https://www.cdc.gov/niosh/docs/2016-106/pdfs/2016-106.pdf (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), https://www.citizen.org/wp-content/uploads/petition-for-a-heat-standard-090111.pdf (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), https://www.ilo.org/wcmsp5/groups/public/—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), https://citizenvox.org/wp-content/uploads/2018/07/180717_Petition-to-OSHA-on-Heat-Stress-Signed_FINAL.pdf (last accessed June 2, 2021).

[6] Centers for Disease Control and Prevention, Heat Stress – Heat Related Illness, https://www.cdc.gov/niosh/topics/heatstress/heatrelillness.html (last 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.