I have my doubts.

Joe Paduda

Despite all the chest beating about worker safety and injury worker advocacy, few “industry leaders” have acknowledged a very serious issue: the failure to aggressively address heat risk.

We now know, from extremely well-done research, that smart, well-implemented regulations can save workers’ lives. California led the way on protections for workers, and its leadership likely saved dozens of lives.

This is from research just published in the latest HealthAffairs:

California and its neighboring states experienced similar death rate spikes during the heat waves of 2005 and 2006, demonstrating comparable vulnerability to extreme heat events … After the implementation of California’s 2015 revised heat standard, death rates followed very different trajectories, with California’s death rate increasing much less than the death rate in its neighboring states. 

The HealthAffairs piece followed a detailed analysis of all 2023 injuries reported to OSHA. It found that increasing heat increases all injuries in all occupations, especially in states without heat protection rules.

The odds of work injury increased non-linearly with a rising heat index … Our results were consistent across nearly all industry sectors, including those that are predominantly indoors. Using a heat index of 80°F as reference, odds ratios (OR) of injuries at or above 90°F, 100°F and 110°F were 1.03 (95% confidence intervals [CI]: 1.02, 1.04), 1.10 (1.07, 1.13) and 1.20 (1.13, 1.26), respectively. At a heat index of 110°F or higher, the odds increased by 22% in states without occupational heat rules … versus 9% in states with rules (OR=1.09; 0.84, 1.41), suggesting a protective effect, although confidence intervals overlapped. Overall, we estimate 1.18% … of all injuries were attributable to heat exposure on days exceeding a heat index of 70°F.

The Trump administration appears to have dropped efforts to implement OSHA standards for heat protection; the regs, which went through a far too lengthy development and approval process, have not moved since Trump’s inauguration. (Note that the Trump administration also gutted NIOSH, in the process eliminating work on PFAS exposure risk, firefighter protections, cancer risk for health care workers and mining safety.)

What does this mean for you? 

You don’t care about worker safety and worker health if you don’t actively support heat protections for all workers.

Joseph Paduda is the principal of Health Strategy Associates, a consulting firm focused on improving medical management programs in workers’ compensation. This column is republished with his permission from his Managed Care Matters blog.