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Heat-Related Illness

Can you explain OSHA’s involvement in heat-related illness?

Heat-stress continues to be a concern of the Occupational Safety and Health Administration, and the agency has recently entered a preliminary rulemaking stage. OSHA published an Advance Notice of Proposed Rulemaking, “Heat Injury and Illness Prevention in Outdoor and Indoor Settings.” The document provided extensive background on the issue and requested public comment. The information that was sought includes “nature and extent of hazardous heat in the workplace and interventions and controls to prevent heat-related injury and illness, including measuring heat exposures, strategies to reduce it, personal protective equipment and other controls, and worker training and engagement.”


The ANPRM is broken into five categories: Background; Existing Heat Illness Prevention Efforts; Key Issues in Occupational Heat-Related Illness; Costs, Impacts and Benefits; and References. The notice starts with the statement that “heat is the leading cause of death among all weather-related phenomena.” It then states that “excessive heat exacerbates existing health problems like asthma, kidney failure and heart disease, and can cause heat stroke and even death if not treated properly and promptly. Workers in both outdoor and indoor work settings without adequate climate-controlled environments are at risk of hazardous heat exposure.” The document cites statistics that support the need for implementing a course of action to mitigate heat-related stress.


Construction is seen as a leading industry with a high rate of heat-related mortality, but geography also plays an important role in heat-related illness. Texas and California led the nation in 2015 in the number of nonfatal injuries with days away from work. Looking at the demographics and worker population, Southern states have the highest rate of workplace fatality.


OSHA follows a very precise procedure in its rulemaking process. In a recent presentation meant as an update on the subject The OSHA Directorate of Standards and Guidance outlined seven stages in the OSHA rulemaking process. Heat Illness is still in the first stage, which is considered preliminary activities. The next stage is developing the actual rule. Publication of the final rule occurs in the sixth stage. Stage seven is listed as “post promulgation activities.” Time to completion will be measured in multiple months.


There are some preventive measures that are already in place. OSHA initiated a campaign on heat illness prevention in 2011. Their succinct message is water, rest, shade. In that regard, it is the employer’s responsibility to provide the three items mentioned above and to acclimatize returning workers to working while exposed to heat. The employers should plan for emergency situations and monitor for symptoms of illness. Fact sheets and a website source are available for more information.


The National Institute for Occupational Safety and Health has published some recommendations regarding heat stress. These recommendations include introducing engineering controls, work practice activities and training.


Three states already have standards in place for heat exposure: California, Minnesota and Washington. In California, temperatures in excess of 80o F trigger specific requirements regarding water and shade. Other requirements include training and planning. The Minnesota standard is specific to indoor temperatures, while Washington’s is specific to outdoor temperatures.


The General Duty Clause is already in existence within the Occupational Safety and Health Act of 1970. This clause has been interpreted to mean that the employer has the legal obligation to provide a workplace that is free of conditions that can lead to death or physical injury. This includes heat-related hazards.


Other standards are already in place that are related to heat stress. These include PPE standards, recordkeeping regulations, sanitation and medical services and first aid standards. There are also many letters of interpretation that relate to this topic.


Questions that are being asked during this public comment period provide a glimpse of where the rule is headed. They center around heat exposure metrics, contributions to heat stress, existing employer-heat prevention programs, engineering and administration controls, acclimatization, monitoring activities and training activities.


The Construction Industry Safety Coalition, of which AWCI is a member, has been monitoring this issue for some time. CISC drafted a letter in 2019 where they cited their concerns, and also submitted a letter within the January 2022 public comment period.


It would be advisable for the contractor who wants to stay ahead of the final rulemaking process to review what is currently in place in California, Minnesota and Washington as well as OSHA and NIOSH, monitor this particular rulemaking process. Research engineering controls, and develop heat-related training programs. Fact sheets are available to learn more on the subject, and remember: water, rest, shade.

Robert Grupe is AWCI’s director of technical services. Send your questions to, or call him directly at (703) 538.1611.

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