Understanding and preventing farm employee heat-related illness

Heat-related illnesses can occur indoors or outdoors and during any season of the year.

person on ladder picking apples from a tree
Michigan apple harvest employee climbing ladder. Photo credit: Zachariah Rutledge

Every year, thousands of workers in the United States become sick from occupational heat exposure, and dozens of people die from heat-related illnesses. Most of these cases occur within the first few days of working in warm or hot environments because the human body needs time to acclimate and build tolerance to the heat. Heat-related illnesses can occur indoors or outdoors and during any season of the year. 

Farm work typically involves repetitious physical tasks, which are often strenuous in nature. Farm employees who perform physical labor in high temperature environments are at increased risk of heat-related health dangers. Heat-related illnesses differ in terms of their severity and symptoms, which may include heat rash, sunburn, heat cramps, dizziness and fainting. Heat-related muscle breakdown, called rhabdomyolysis or “rhabdo,” heat exhaustion and heat stroke are very serious illnesses that can be fatal.

Farmers and farm employees who understand the symptoms of heat-related illnesses and provide first aid in a timely manner can reduce the chance of symptoms worsening and help prevent employee fatalities. Diagnosis of specific heat-related illnesses is difficult, and some employees may experience multiple heat-related illnesses at the same time. The Occupational Safety and Health Administration (OSHA)  recommends immediately administering first aid to employees who are suffering from heat-related symptoms instead of trying to diagnose which illness the employee has.  When in doubt, assist in cooling the employee down and call 911. OSHA also recommends following these first aid principles to help employees who are experiencing symptoms of heat-related illness:

  • Take the affected employee to a cooler area, such as in the shade or air conditioning.
  • Cool the employee immediately:
    • Immerse the employee in cold water or an ice bath. Create an ice bath by placing all of the available ice into a large container with water. Ice baths are the best method to cool workers rapidly in an emergency.
    • Remove outer layers of clothing, especially heavy protective clothing.
    • Place ice or cold wet towels on the head, neck, abdomen, armpits and groin.
    • Use fans to circulate air around the worker.
  • Never leave an employee with heat-related illness alone. The illness can rapidly become worse. Stay with the employee.
  • When in doubt, call 911!

Details about certain types of severe heat-related illnesses, their common symptoms, and more OSHA-recommended first aid tips are listed below.

Types of Heat Illnesses and Their Symptoms

Heat Stroke: Heat stroke occurs when a person’s temperature regulating system fails, and their body temperature rises above 104 degrees Fahrenheit. Signs of heat stroke include confusion, slurred speech, seizures, and loss of consciousness. Workers experiencing heat stroke may stop sweating. Heat stroke is a medical emergency that can result in death.

What to do if an employee shows signs of heat stroke:

  1. Call 911 immediately.
  2. While waiting for medical help to arrive:
    1. Move the person to a shady, cool area.
    2. Remove as much clothing as possible.
    3. Wet the worker with cool water and circulate air to speed cooling.
    4. Place cold wet cloths, wet towels, or ice all over the person’s body or soak the person’s clothing with cold water.

Heat-Related Muscle Breakdown (Rhabdomyolysis): Heat-related muscle breakdown, commonly referred to as “rhabdo,” results from a combination of dehydration and overheating. Heat is a catalyst for muscle breakdown, which causes certain muscle components such as potassium to leak into the blood stream. Normally, the kidneys remove these components from the blood, and they are released during urination. However, when a person has not had enough fluids, the kidneys cannot dispose of this waste, which can lead to kidney failure and death. Symptoms of rhabdo include extremely sore and weak muscles, muscle swelling and dark urine.

What to do if an employee shows signs of rhabdo:

  1. Arrange for the employee to receive medical attention right away. If rhabdo is treated early, most employees are able to return to work within a few days.
  2. Take the employee to a cooler location.
  3. Give the employee fluids to drink.
  4. Allow the employee to rest.

Heat Exhaustion: Heat exhaustion occurs when a person’s body temperature rises above 100.4 degrees Fahrenheit, and they experience one or more of the following symptoms: heavy sweating, thirst, irritability, dizziness, headaches, nausea, weakness or confusion.  While heat exhaustion is generally not life threatening, it can lead to heat stroke if not treated.

What do to if an employee shows signs of heat exhaustion:

  1. Remove the employee from the hot area.
  2. Give the employee cold water to drink and encourage them to take frequent sips.
  3. Place cold compresses on the employee’s head, face and neck or have the person wash their head, face and neck in cold water.
  4. OSHA recommends taking the employee to a medical clinic or emergency room for medical evaluation or treatment.

Helping Prevent Heat-Related Illnesses Before They Occur

Your Responsibilities as an Agricultural Employer

Agricultural employers must abide by OSHA’s Field Sanitation Standards, which require agricultural establishments with 11 or more hand laborers in any field on any given day to provide cool potable drinking water to workers in the field at no cost. Drinking containers must be covered and regularly cleaned. Employers also have to provide enough drinking water for all employees in locations that are readily accessible to all employees. Employers must provide single-use cups or drinking fountains. Employers are responsible for notifying each employee where the water is located.

What Else Can You Do to Protect Your Employees?

Employers can help reduce their employees’ risk of experiencing heat-related health problems by taking some of the following actions:

While you may not be able to fully prevent employees from experiencing heat-related illnesses, understanding what the symptoms are and what to do if an employee experiences them can help you promote a safer work environment and possibly save a life.

Additional Resources

OHSA Guidance on Heat-Related Illness

Heat Exposure

General Heat Education

Plan for Heat Exposure

Heat Exposure: Water - Rest - Shade

OSHA-NIOSH Heat Safety Tool

Michigan Occupational Safety and Health Administration Heat-Illness Prevention Program

MSU Extension News Articles

Reducing heat stress for you and your employees

Avoid heat related illness while enjoying the summer weather

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