Heat illness still a problem despite progress

By Joy Hepp
California Health Report

Arcenio Lopez hasn’t been a farm worker since 2003, but the Oaxaca, Mexico native still remembers what it feels like to work a full day under the California sun.

“Your boss is telling you to hurry up,” says Lopez, who spent a year picking strawberries near Oxnard. “Second, you have this pressure. You feel if you don’t move faster you won’t make a good check. You hurry a lot. You think if you drink too much water your body is going to be heavy and you won’t be able to [fill] more boxes.”

Lopez, who is now administrative director for Mixteco/Indigena Community Organizing Project in Oxnard (MICOP), says he was not prepared for the dangers associated with working eight hours or more under direct sunlight. Although deaths related to heat illness have decreased dramatically across the state – from 12 in 2005 to four suspected cases pending medical determination in 2012 – the danger for workers is still very real, particularly during heat waves and during a worker’s first week on the job. Even if heat stroke doesn’t lead to death it can shut down and/or damage major organs and it is particularly difficult to diagnose during urgent care.

“When I was a farm worker I never heard about heat illness …or my rights as a worker,” Lopez says.

If Lopez were working in an outdoor industry in California today, he likely would see billboards in Spanish or hear radio ads in his native Mixteco language with slogans like “A wise man looks for shade.” or “If you want to last, don’t forget to drink water.” Or, he may have learned from a co-worker that his employer is required by law to provide adequate protection from the heat.

MICOP is one of more than 100 organizations in a grassroots network across the state that are working with the California Occupational Safety and Health Administration (Cal/OSHA) and the University of California to help educate workers in the agriculture, construction and landscaping industries both about the dangers of heat-related illness and about their rights as workers.

The issue of heat-related illness came to the forefront among California labor activists and officials in 2005 when record-breaking heat led to 12 farm worker deaths. The State of California issued emergency heat regulations, which were made permanent in 2006. The Heat Illness Prevention Standard — developed by Cal/OSHA — was the first of its kind in the United States and has since been adopted by its Federal counterpart; it calls for employee and supervisor training, fresh water provided at work sights, access to adequate shade for rest and recovery periods and written documentation on site that provides information about the regulations.

After the regulations were passed, the next essential task became educating California’s diverse population of outdoor workers and their employers. Despite initial efforts to get the word out, “it became pretty clear the more outreach was done that we weren’t reaching quite as deep into the base,” says Erika Mendoza of California’s Department of Industrial Relations, Cal/OSHA’s parent organization.

When Cal/OSHA received a government mandate to create a targeted outreach campaign regarding heat-related illnesses in 2009 they enlisted the help of UC Berkeley’s Labor Occupational Health Program (LOHP) to create educational materials and a multimedia communication plan including billboards, radio ads and a comprehensive website that was launched in 2010.

Train the Trainer

At the heart of these educational efforts are “Train the Trainer” workshops in which representatives from LOHP along with UCLA’s Labor Occupational Safety and Health Program (LOSH), and UC Davis’ Western Center for Agricultural Health and Safety (WCAHS) train representatives from schools, advocacy organizations, cultural centers, churches and health centers who in turn reached out to thousands outdoor workers in their respective communities.

“They tend to be the trusted resources and the go-to places, so we have done a lot of outreach to engage those organizations in the campaign,” says Erika Monterroza of the Department of Industrial Relations. “One of the goals of the campaign has been to create a community norm that starts to see this as a public health issue.”

Lopez says he’s seen a growing awareness among his clients.

“I’ve been seeing people being more conscious about this,” he says. Workers realize “it’s not a game. It’s something real.”
According to UC Berkeley’s Labor Occupational Health Program, the train the trainer workshops in addition to direct worker outreach reach 6-8,000 workers per year. For a worker who may be on the job site 10-12 hours a day, 6-7 days a week, this type of peer-to-peer education can be a needed lifeline.

“I think people really appreciate the information,” says Norma Ventura, a community worker with California Rural Legal Assistance who has participated in the Train the Trainer education efforts. “They’re not told they have the right to shade, or that the employer is responsible for following a certain procedure. They don’t get that information anywhere else.”

In 2006 Cal/OSHA found only 32 percent of inspected work sites to be in compliance with the new regulations. In 2011 of 753 heat enforcement inspections, 76 percent of employers were found to be compliant. However, Ventura says that many of her clients – who work in seven Central California counties – report that the workplace culture is often slow to change.

“We’re out there telling farm workers what the law says and they tell us how it doesn’t work that well all the time,” she says. Her clients tell her they worry that, “If we’re feeling sick and we say something, then we’re not going to get called back to work the next day or the next season.”

Both Ventura and Lopez report that dangers often arise for clients whose pay is based upon the amount they harvest each day, or on a “per piece” basis. Many of these workers worry that stopping to take a break in the shade or drink a glass of water would only serve to slow them down, thus taking away from their bottom line.

“They don’t really have that freedom to drink water, they just have this pressure,” Ventura says.
LOHP Progam Coordinator Suzanne Terran says one of the goals of the Train the Trainer workshops and employer outreach is to make heat illness prevention the norm in all outdoor workplaces.

“It’s about creating this culture in the workplace where everybody is doing it,” she says. “We’ve heard examples of where the crew leader blows a whistle and everyone takes their quick water break. It should be accessible and that’s been part of what’s been emphasized so they can in fact drink it without it becoming a big task.”

Over the past week the California legislature passed a trio of bills that would affect outdoor workers. AB 1313 calls for overtime wages, AB 2676 would make it a crime punishable by a fine and/or jail time for employers who don’t uphold heat standards, and AB 2346 would allow workers to sue their employers directly if they don’t provide adequate water and shade. When reached for comment, a Cal/OSHA representative said the agency does not comment on pending legislation. However, Cal/OSHA Heat Illness Prevention coordinator William Kreycia says educational outreach efforts will continue no matter the legislative outcome.

“Heat illness prevention will continue through 2012 into 2013 and as long as heat presents a hazard to the workers of the state of California,” he says.

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