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Heatstroke, Heat Exhaustion, and Workers’ Compensation Claims

In the summer in North Carolina and Virginia, it be can quite hot if you’re working outside. The temperature during the day is often in the 80s and 90s. Sometimes, the temperature even crossed the 100-degree threshold. Some of the jobs that may cause heatstroke during the hot summer months include landscaping, agricultural work, delivery services, and construction work. Even inside work can become unbearable if the air-conditioning isn’t running 24/7. But failing to take proper precautions can result in serious injury or even death.

What is heatstroke?

According to the Mayo Clinic, heatstroke occurs when your body overheats – usually due to “prolonged exposure to or physical exertion in high temperatures. The most serious form of heat injury, heatstroke, can occur if your body temperature rises to 104 F (40 C) or higher.” Heatstroke generally requires immediate medical attention – usually at a local emergency room. If heatstroke isn’t treated properly, a worker can suffer damage to his/her heart, brain, kidneys, and muscle, and even death. The more treatment is delayed, the more serious the complications may be. In some cases, a worker may die due to heat stroke. Even without heatstroke, a worker can suffer heat exhaustion, which, while not quite as severe as heatstroke, can prove just as dangerous and deadly. For heat exhaustion, you do not need to hit that body temperature of 104 degrees F, and oftentimes, heat exhaustion can lead to heat stroke. We recently represented a worker who tragically died as a result of heat exhaustion.

What work causes heatstroke?

The Occupational Safety and Health Administration states that millions of American workers risk heatstroke every year. Thousands of people become ill due to occupational heat exposure. For many employees, the risk of heat stroke is most severe during:

“The first few days of working in warm or hot environments because the body needs to build a tolerance to the heat gradually over time. The process of building tolerance is called heat acclimatization. Lack of acclimatization represents a major risk factor for fatal outcomes.”

In our recent case mentioned above, the deceased worker had just begun a job as a roofer on two of the hottest days of the year to date. Previously, he had been working on a job that did not require him to be outside all day. The first day on the job, he was sweating profusely, red and began vomiting, all signs of heat exhaustion. He had to go home early.

On the second day, he returned to another roofing job, only to suffer the same symptoms. Unfortunately, he did not make it past the second day. The heat killed him and he tragically died upon arrival in the ER.

One of the things the investigation in that case revealed is that the employer had failed to acclimatize our client to heavy exposure to heat on a roofing job. They just threw him into the job, and his body simply was not used to that level of heat exposure. Tragically, that mistake proved fatal.

Some of the risk factors for heatstroke or heat-related illness include physical activity, warm or hot weather, lack of acclimatization, and wearing clothing that keeps in body heat. Heatstroke can occur indoors as well as outdoors and in seasons other than summer. OSHA states that the following jobs have a high risk of heat exposure.

Outdoor work

  • Agriculture
  • Construction – especially, road, roofing, and other outdoor work
  • Construction – roofing work
  • Landscaping
  • Mail and package delivery
  • Oil and gas well operations

Indoor work

  • Bakeries, kitchens, and laundries (sources with indoor heat-generating appliances
  • Electrical utilities (particularly boiler rooms)
  • Fire Service
  • Iron and steel mills and foundries
  • Manufacturing with hot local heat sources, like furnaces (e.g., paper products or concrete)
  • Warehousing

“During heat waves, workers may experience a combination of two kinds of heat-related illness.

  • “Exertional heat illness results primarily from exertion (metabolic heat generated by muscle activity in the body).”
  • “Environmental heat illness is attributed primarily to ambient conditions, including heat and relative humidity, and is related to heat waves and death in the elderly, urban heat islands, and hot motor vehicles.”

What are the symptoms of Heat Exhaustion?

The Mayo clinic lists several:

  • Cool, moist skin with goose bumps when in the heat
  • Heavy sweating
  • Faintness
  • Dizziness
  • Fatigue
  • Weak, rapid pulse
  • Low blood pressure upon standing
  • Muscle cramps
  • Nausea
  • Headache

What are the symptoms of Heatstroke?

The Mayo Clinic lists the following heatstroke symptoms:

  • High body temperature. A core body temperature of 104 F (40 C) or higher, obtained with a rectal thermometer, is the main sign of heatstroke.
  • Altered mental state or behavior. Confusion, agitation, slurred speech, irritability, delirium, seizures, and coma can all result from heatstroke.
  • Alteration in sweating. In heatstroke brought on by hot weather, your skin will feel hot and dry to the touch. However, in heatstroke brought on by strenuous exercise, your skin may feel dry or slightly moist.
  • Nausea and vomiting. You may feel sick to your stomach or vomit.
  • Flushed skin. Your skin may turn red as your body temperature increases.
  • Rapid breathing. Your breathing may become rapid and shallow.
  • Racing heart rate. Your pulse may significantly increase because heat stress places a tremendous burden on your heart to help cool your body.
  • Headache. Your head may throb.

The risk factors for heat stroke include:

  • Being an older worker
  • Sudden exposure to hot weather
  • A lack of air-conditioning
  • Exertion in hot weather
  • Certain medications

What preventive measures can be used to treat heatstroke?

Some of the steps workers can take to reduce the risk of heat stroke, according to the Mayo Clinic, include:

  • Wearing lightweight and loose-fitting clothing that allows or body to cool properly.
  • Wear a wide-brimmed hat and use a broad-spectrum sunscreen with an SPF of 15 or more to help protect against sunburn.
  • Stay hydrated. Drink lots of fluids to help your body sweat and keep a normal temperature.
  • Understand your medications. Some medications can affect your ability to stay hydrated and dissipate heat.
  • Don’t leave anyone in a hot car.
  • Get acclimated – as we discussed above. Some workers may need several days or even weeks to get acclimated to hot weather work.
  • Use smart schedules. More strenuous work should be done when the weather is cooler – such as early in the morning.
  • Take breaks. During breaks, stay in the shade or where there is air-conditioning.
  • Check the signs. If you feel dizzy, have muscle cramps, or notice any of the other symptoms of heat stroke – drink plenty of fluids, stop working, and seek medical help if your health does not improve.

What are the treatments for heatstroke?

Your physician will normally work to cool your body and to prevent damage to your brain and vital organs. Treatments may include:

  • Water immersion. “A bath of cold or ice water has been proved to be the most effective way of quickly lowering your core body temperature. The quicker you can receive cold water immersion, the less risk of death and organ damage.”
  • Use evaporation cooling techniques. Here, “cool water is misted on your body while warm air is fanned over you, causing the water to evaporate and cool your skin.”
  • Pack you with ice and cooling blankets. Another method is to wrap you in a special cooling blanket and apply ice packs to your groin, neck, back, and armpits to lower your temperature.

If the treatments make a worker shiver, the physician may prescribe a muscle relaxant, such as a benzodiazepine.

The diagnosis of heat stroke may include diagnostic tests – mostly to rule out other conditions – such as blood tests, urine tests, X-rays, and tests of muscle function. Other types of heat injuries include heat exhaustion, heat cramps, and heat rash.

Risk of Employment in VA. It is to be remembered, however, that one of the main considerations in any heat stroke case is that particularly in Virginia, you are dealing with the issue of Risk of Employment. So that means that the conditions faced by the worker must be characteristic of the workplace and typically those conditions must be extraordinary as compared with members of the general public. In other words, if the injured or heat-stroked worker is subject to the same conditions as everyone else in the public, there may be no risk peculiar to the employment, and hence, no case.

So for example, if it’s 80 degrees out, and even non-acclimatized workers should be suffering no ill effects from that level of heat, and the injured worker suffers a heat stroke, that may be a very difficult case to prove due to risk of employment. But, if that worker was required to be exposed to heat such as riding in a truck, even in that level of heat, with no air conditioning and no working windows, emptying hundreds of trash containers all day, that would very likely be a risk of employment that could lead to heat stroke.

Pre-Existing or Confounding Conditions. Another issue that is often brought up in heat stroke cases is the contribution of pre-existing conditions and issues to the cause of death. For instance, if the injured worker had drunk alcohol prior to suffering heat stroke, besides the issue of intoxication, that could be a confounding factor making it difficult for doctor to say that the injury or death resulted from heat exposure, and not the alcohol consumption. Or, for example, if the injured worker had a long history of heart disease or a previous stroke, this could also make it more difficult to prove the death or injury was caused by heat exposure instead of the pre-existing heart issues.

At Joe Miller Law Ltd., our North Carolina and Virginia workers’ compensation attorney has been fighting for injured and ill workers for more than 30 years. He understands the unique challenges involved in filing heat-related workers’ compensation claims. To assert your rights to work injury benefits, call attorney Joe Miller, Esq., at 888-667-8295 or fill out my online contact form to schedule an appointment.

Joe Miller Law Ltd. is now using remote services for clients who are more comfortable speaking to use from their residences. To use our remote services, please look at our New Electronic Case Review.

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