Add heat death to the list of challenges on the first few days on the job.
During 2012-2013 there were 20 cases of work-related heat illness or fatality cited for federal enforcement, according to a review by the Occupational Safety and Health Administration reported in the CDC's Morbidity and Mortality Report on Aug 8.
Thirteen of the 20 workers died. Nine deaths occurred on the first 3 days of the job.
Four workers died on their first day. They ranged in age from 36 to 60 years and were collecting waste, roofing, laying pipe, and doing ship repair.
Failure to support acclimatization was the most common deficiency and the factor most clearly associated with death, said Sheila Arbury, RN, MPH, and colleagues.
Many employers had no heat illness prevention program. Among workplaces with such programs, many lacked program elements such as water management, shaded rest areas, work-rest cycles, and acclimatization protocols.
Most of the affected employees worked outdoors or indoors with a local heat source, and all performed heavy or moderate work.
All cases occurred on days with a heat index in the range of 84.0°F to 105.7°F, although those working in direct sunlight might have experienced a index up to 15.0°F higher than reported.
"Employers must ensure that all workers acclimatize to hot environments by gradually increasing duration of work in the hot environment," authors wrote.
The authors reiterated guidelines for new workers and all workers returning from an absence of more than a week: Begin with 20% of the usual duration of work in the hot environment on the first day and increase incrementally by no more than 20% each subsequent day.
For experienced workers during a rapid change to excessively hot weather: Begin on the first day with 50% of the usual duration of work, 60% on the second day, 80% on the third, and 100% on the fourth.
The author disclosed no relevant relationships with industry.