Heatwave – incoming
On August 8, 2023, a Fresno-area farmworker died harvesting tomatillos in 100-degree weather, reported the Desert Sun. The 59-year-old father of two girls breathed his last among the plants he watered.
“Farm workers work outside in the fields eight hours a day with a 30-minute break,” said Dr. Sharon Okonkwo-Holmes, Family Medicine Physician, Kaiser Permanente Southern California at an August 29 Ethnic Media Services briefing. When our bodies encounter heat, and sweat is not enough to cool the body, blood rushes to the surface of the skin to maintain the internal temperature. The body needs the blood to circulate in the head and the heart. This shunting of the blood away from vital organs spells trouble.
“We have to keep body temperature between 96 to 99 or the proteins in the body stop working. If the proteins stop working, the heart can’t keep up. We get symptoms of heat exhaustion: fatigue, tiredness, disorientation, cramps in the extremities, etc. Ignoring these, warning systems results in coma, seizures, and even death,” said the doctor.
The farmworker did not ignore these signs, say his co-workers. He did approach the supervisor but was sent back to work.
Symptoms of heat exhaustion
Symptoms of heat exhaustion are swelling in the lower extremities like calves, ankles, and feet, a high pulse, heart beating fast, elevated blood pressure, and reduced kidney function. “Kidneys get dehydrated,” said Dr. Okonkwo-Holmes.
“When people get hot, they say I’m just going to go lay down. When they lay down, they lose consciousness, and death and dying occur,” warned Dr. Okonkwo-Holmes.
The farmworker collapsed with heat. Workers told Rangel that he may have died in the fields prior to being transported to the hospital, reported the Desert Sun. Heat-related deaths are recorded as heart failure, strokes, or respiratory failure, according to a 2021 Los Angeles Times investigation. Therefore heat as a killer is historically undercounted in California.
Farmworkers and heat-related illnesses
Farmworkers, who are mostly foreign-born and undocumented, are at a unique disadvantage from heat-related illnesses, said Counter. “Because of their immigration status, many workers often don’t complain about poor working conditions, such as lack of air conditioning or access to water, that complicate the risk of extreme heat.”
High temperatures disproportionately affect farmworkers: The Centers for Disease Control and Prevention has found they died at a rate nearly 20 times that of all U.S. workers. Although 21 states reported heat-related deaths among crop workers, California, Florida, and North Carolina accounted for 57% of all deaths.
This death places a spotlight on California because it is one of the few states with an outdoor heat standard that is supposed to protect farm workers. If the heat reaches 95 degrees, workers must get a rest period of at least 10 minutes every two hours, with additional breaks if the shift goes beyond eight hours. The state often is cited as an example by lawmakers pushing for tougher federal workplace standards — although California still does not have heat rules for indoor workplaces.
No shade for those who need it most
A February study on California farmworker health and safety by the UC Merced Community and Labor Center found that only a third of farm laborers could recognize the symptoms of a heat-related illness. Only half of the roughly 1,500 farmworkers surveyed said their employers always provide shade mandated by California law when it hits 80 degrees, while a quarter said their employers never or rarely provide the required shade.
Farmworkers, as well as the rest of California, must be informed of the dangers of heat.
Hotter temperatures increase workplace injuries significantly.
A 2021 study of California by The Washington Center for Equitable Growth study on temperature and workplace safety estimates hot temperatures have caused at least 360,000 workplace injuries in California from 2001 to 2018, or about 20,000 injuries a year. There is an increase of 10 to 15% in same-day injuries on a day when temperatures soar above 100 degrees. The study says injuries hit low-wage workers hardest. Recovering from a heat-related injury or illness costs the average worker $35,000, including health care and long-term wage impact. The effects persist in both outdoor and indoor settings.
“Older adults usually don’t get very thirsty. They need to stay on top of their hydration schedule. Add lime, lemon, cucumber, whatever is necessary to stay hydrated,” said Dr Okonkwo-Holmes who sees many patients come through her clinic confused by these symptoms. Patients on diuretics or water pills need to adjust their medications.
Educating people is very critical, she feels. Those who are active outdoors are more likely to get sick or even die.
Informing workers about heat risks and their legal rights with culturally and linguistically appropriate messaging on the risk and severity of these heat waves must be done in a culturally and linguistically appropriate way.
Nights are getting hotter
The current heat wave is different from the ones California has faced in the past, said Braden Kay, Program Manager of the new Extreme Heat and Community Resilience program in the Governor’s Office of Planning and Research. The program aims to apprise cities, counties, and nonprofits across California to become more resilient to extreme heat in the long term and provide short-term relief efforts.
“90-degree weather now sometimes occurs as early as March and as late as November. It stays hot for longer hours in the day.,” said Kay at the Ethnic News Media briefing. “The hours in which it is hot are increasing. Our bodies are not acclimatized to it,” he said. “It’s a huge difference.”
“One of the biggest health concerns we have is around nighttime temperatures. For people who don’t have air conditioning or access to cooling infrastructure, those nighttime temperatures have potentially a more deadly impact.”
Combating heat
Heat deaths start happening when the daily temps remain at 90 degrees for days, and continue into the nights. Cooling stations close by 7 p.m. and it’s still more than 110 degrees. Libraries or other public buildings close as well.
“To combat heat we must change the way we live and make investments in long-term infrastructure improvements,” said Kay, who previously worked in Phoenix, Arizona, which last month recorded more than 30 consecutive days of 110-degrees-or-higher temperatures.“In a lot of ways, Arizona is the future that California will be facing,” he said.
Farmworkers working indoors and outdoors must plan for heat resilience in the face of the oncoming onslaught of heat. “Not just today, not just this summer, not just next summer, but for decades to come.”
Ritu Marwah reported on undocumented farmworkers while participating in the USC Annenberg Center for Health Journalism ‘s 2023 California Health Equity Impact Fund.