HEAT DANGER

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To Amadeo DiRocco, the owner of DiRocco Masonry and Construction, Aug. 7 of last year was supposed to be a simple day on the job.

Although his business is usually a one-man operation, DiRocco occasionally hires manual laborers for the day — in this case, Sean J. Conley, 30 — to unload, stack and clean bricks outside a nursing home in East Providence.

Aug. 7, 2018, however, was unusually hot. It was the third day of the summer’s first heat wave and temperatures were expected to hit 97 degrees. The National Weather Service had issued heat advisories for all of southern New England. By 2 p.m., six hours into Conley’s workday, the heat index had climbed to 96.5 degrees. By around 2:15, he had collapsed from the heat.

The day is described in a violation citation against DiRocco Masonry obtained via public records request from the Providence office of the Occupational Safety and Health Administration, which investigated Conley’s death: “[Conley] became disoriented and collapsed in the afternoon, and arrived at the hospital with a core temperature of 110.6 degrees F, and died as a result of hyperthermia.”

Finding that DiRocco had failed to take adequate precautions to minimize the threat from extreme heat, OSHA cited him for a “serious” violation and a fine of $3,978 (as well as an additional fine of $2,842 for failing to report the fatality to OSHA within eight hours).

Conley’s death, to labor safety advocates like James Celenza, executive director of the Rhode Island Committee on Occupational Safety and Health, serves as a call to better protect Rhode Island laborers from dangerously high temperatures. Furthermore, the case reveals how current OSHA standards — which don’t explicitly mention heat — often leave employers uncertain as to what responsibilities they have in preventing heat illnesses.

And as a warming climate drives Rhode Island temperatures higher, some experts say the urgency to pass legislation that protects workers will become more intense.

“We’re only going to face more problems down the road,” Celenza said.

While Conley is the only Rhode Island worker recorded by OSHA to have died directly from extreme heat in recent years, his case exemplifies the broader threat of heat-related illnesses. In addition to possibly-fatal heat stress, the dangers of heat include other illnesses, such as heat rashes, heat cramps and heat exhaustion.

These risks apply not just to outdoor laborers but also to workers in places such as kitchens and warehouses. For example, on July 1, 2018, a food service worker at Brown University suffered a serious heat illness while working in a dining-hall kitchen, and was hospitalized for several days after experiencing a heat-related seizure, The Nation reported.

Extreme temperatures also affect the workplace in more subtle and indirect ways, Celenza said. He links high temperatures to lower worker productivity and confusion, as well as to issues such as teacher absenteeism. “Even in schools,” workplaces not normally associated with high-risk heat, “teachers have reported being in classrooms that feel like ovens,” Celenza said.

Data obtained from the Rhode Island Department of Labor and Training shows 63 workers who suffered from heat-related injuries since 2015, with 18 occurring in 2018 and 11 so far in 2019.

But these numbers don’t represent the full scope of the issue, said Gregory Wellenius, a professor of public health at Brown University who has published numerous studies on the health effects of extreme heat in Rhode Island. The injuries recorded by the DLT are a “fraction” of the actual effects, Wellenius said, because they only include cases where the cause of injury is directly linked to extreme heat. Other injuries that may have been exacerbated by extreme heat, or injuries caused by heat-driven exhaustion and confusion, wouldn’t be tallied.

“We think we are underreporting the occupational danger of extreme heat,” Wellenius said.

Wellenius and his colleagues have also found that many people treated for heat illnesses in Rhode Island were younger men — suggesting to the researchers that many of them were outdoor workers. While many consider children and the elderly to be most at-risk from extreme heat, Wellenius said, outdoor workers, who don’t have the choice of being in air conditioning, are particularly vulnerable.

In fact, the average age of the workers who have suffered from heat-related illnesses recorded by the DLT was 35. Two-thirds of them were male.

Celenza has led local efforts to alert workers to this hazard and instill standards that will protect workers, both at the local and national level.

To educate workers of the risk, he has led “Heat Stress: Hazards and Prevention” workshops this summer, educating workers that heat stress can occur even when temperatures don’t reach all-time highs. “It’s not just really super hot days,” he said, pointing to a study that found that even temperatures in the 80s can be fatal if proper precautions are not taken.

Celenza’s organization also sends out hazard alerts before hot days to raise awareness of “Heat’s Hidden Hazards” and provide basic steps to avoid overheating. The dangers of extreme heat for workers have also been the focus of a summer-long communications campaign aired by the Rhode Island Department of Health, an agency spokesman said. Citing research done by Wellenius, the Health Department campaign has been targeting men and boys between 15 and 40 years old.

To protect workers from heat illness, these groups recommend precautions such as paid breaks in cool areas, easy access to hydration, and training for employees on heat-stress illness and prevention.

In Conley’s case, the OSHA violation cited DiRocco for not taking these precautions to create a worksite free from the recognized hazard of extreme heat. According to the report, DiRocco, who was not on site at the time Conley collapsed, had no written health and safety plan and had not conducted any training on heat-stress prevention.

OSHA recommended DiRocco create an acclimatization plan for new workers unaccustomed to working in hot conditions, train employees about heat-related illnesses, and reschedule work during cooler hours of the day. While Conley was just a short-term employee, temporary workers receive the same protections, as do all other covered workers.

DiRocco’s attorney, Michael St. Pierre, said DiRocco maintained a safe workplace, providing a cooler of water and allowing workers to cool off in his air-conditioned truck. (The OSHA report described the provision of water as “in dispute.”)

Most other details, including details about Conley’s medical history and information about his death from the Rhode Island medical examiner, were redacted from the report. Conley’s mother, Donna M. Skinner, of Pawtucket, who filed a petition against DiRocco Masonry in Workers’ Compensation Court, declined to comment through her attorney.

The report also quotes St. Pierre saying that “Sean Conley would have to take some self-accountability for his death.” Asked about this statement, St. Pierre said, “You’ve got to take responsibility to go take a drink. I don’t know how else to put it. When I’m thirsty, I drink water.”

Celenza, however, said that confusion is one of the most common side effects of heat stroke. “It’s a cascading series of events — feeling woozy, forgetting simple things, getting nauseous” — that leads workers to stop themselves from getting help, Celenza said.

The federal Occupational Health and Safety Administration considers the conditions Conley was working under on the day of his death — performing strenuous labor in direct sunlight with the heat index above 91 degrees — as high-risk.

Furthermore, for workers like Conley who are on their first few days of work, OSHA recommends taking steps to help become acclimatized to working outdoors in the heat. In fact, OSHA advises that new workers starting work during hot weather should begin with only 20% of the workload on the first day.

These OSHA recommendations, Celenza said, must be formalized into a specific heat-illness standard to better protect workers. Celenza and the Rhode Island Committee on Occupational Safety and Health have joined a national campaign, led by the advocacy group Public Citizen, pushing for more strict legal standards for how employers must protect their workers from heat.

Currently, citations for extreme heat injuries and deaths can only be filed against employers for violating what’s called the “general duty” clause. This clause requires workplaces remain “free from recognized hazards that are causing or are likely to cause death or serious physical harm to employees.”

But, Celenza said, the general clause is too weak to address heat illnesses — and it just got even weaker. In a February 2019 case with details similar to Conley’s, OSHA cited Sturgill Roofing in Dayton, Ohio, for violating the general duty clause in a case involving extreme heat. But upon appeal, the Occupational Safety and Health Review Commission vacated the violations.

“While practical considerations may have led OSHA, over the years, to rely on the general duty clause in lieu of setting standards, the provision seems to have increasingly become more of a ‘gotcha’ and ‘catch all’ for the agency to utilize, which as a practical matter often leaves employers confused as to what is required of them,” the commission wrote in the 2-1 decision.

Celenza said the Sturgill decision made citing employers for heat violations more difficult. “It sends a chill through the entire OSHA apparatus,” Celenza said. “The fines become harder to justify because of the uncertainty of the legal understanding of the general duty clause.”

The proposed national legislation would force OSHA to require employers to develop heat-illness prevention plans for their workplaces. The plans would require employers to provide paid breaks in cool areas and include heat acclimatization plans. Celenza said he expects the legislation will pass the House of Representatives but hit difficulties in the Republican-controlled Senate.

Three states have their own heat standards, although Celenza said it hasn’t been pursued in Rhode Island. “There is no statewide legislation in the mix,” he said. “A federal mandate is much preferable from the perspective of enforcement.”

Asked about the potential legislation, Greater Providence Chamber of Commerce president Laurie White said the chamber has not studied any particular bill. If state action is proposed, she said, the chamber would gather input from employers as well as the building trade unions. “We will want to be mindful of language around compliance, uniformity and alignment with other states’ approaches,” White said.

Wellenius made clear that increasing temperatures from climate change are making these risks to workers more severe.

“The climate in Rhode Island has already warmed substantially,” Wellenius said. The number of days with heat indexes above 80 degrees — when the risk of heat illnesses can become serious, according to Celenza — has increased by two and a half weeks since 1960.

These temperatures threaten the health of not just outdoor workers but all vulnerable populations, such as young children, the elderly, and those living in hot urban areas, Wellenius said. “This is the face of climate change,” Wellenius said. “This is why climate change is important to the health of Rhode Islanders.”

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Guidelines for employers whose workers perform strenuous labor, work in direct sunshine or wear heavy clothing.  

Heat index less than 91°

Moderate Risk

-Alert workers to anticipated heat index

-Review heat-related illness signs and symptoms

-Provide adequate amounts of cool water

Heat index 91°-103°

High Risk

-Have a person on site who is well-informed about heat-related illness

-Establish and enforce work/rest schedules

Heat index 103°-115°

Very High to Extreme Risk

-Reschedule all nonessential outdoor work

-Be extra vigilant in monitoring workers

Heat index greater than 115°

Extreme Risk

-Strenuous work should not be conducted.

Source: Occupational Safety and Health Administration