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Heat-Related Deaths Among Crop Workers --- United States, 1992--2006
Workers employed in outdoor occupations such as farming are exposed to hot and humid environments that put them at risk for heat-related illness or death. This report describes one such death and summarizes heat-related fatalities among crop production workers in the United States during 1992--2006. During this 15-year period,423 workers in agricultural and nonagricultural industries were reported to have died from exposure to environmental heat; 68 (16%) of these workers were engaged in crop production or support activities for crop production. The heat-related average annual death rate for these crop workers was 0.39 per 100,000 workers, compared with 0.02 for all U.S. civilian workers. Data aggregated into 5-yearperiods indicated that heat-related death rates among crop workers might be increasing; however, trend analysis did not indicate a statistically significant increase. Prevention of heat-related deaths among crop workers requires educating employers and workers on the hazards of working in hot environments, including recognition of heat-related illness symptoms, and implementing appropriate heatstress management measures. Information for the illustrative case described in this report was collected by the Agricultural Safety and Health Bureau of the North Carolina Department of Labor. For the nationwide analysis, fatality data were obtained from the Bureau of Labor Statistics (BLS) Census of Fatal Occupational Injuries (CFOI) (1).* A heat-related death was identified in CFOI as an exposureto environmental heat (BLS Occupational Injury and Illness Classification System [OIICS] event/exposure code 321), with the nature of injury attributed to effects of heat and light (OIICS nature code 072). A crop worker death was indicated where the industry in which the decedent worked was crop production or support activities for crop production.† Fatality rates were calculated as an averageannualized rate per 100,000 workers

during the 15-year study period for civilian noninstitutionalized workers aged >15 years. The numerator was the total of all fatalities during the 15-year period; the denominator was the total of the annual average worker population during the same period. Estimates of the number of workers employed were derived from the U.S. Current Population Survey (CPS)(2).§ To examine trends in fatality rates during the study period, data were aggregated in 5-year periods because the numbers of fatalities for several individual years in the study period were too low to meet BLS publishing criteria. Poisson regression was used to estimate confidence intervals for these aggregate rates. Case Report In mid- July 2005, a male Hispanic worker with an H-2A work visa(i.e., a temporary, nonimmigrant foreign worker hired under contract to perform farm work) aged 56 years was hand-harvesting ripe tobacco leaves on a North Carolina farm. He had arrived from Mexico 4 days earlier and was on his third day on the job. The man began work at approximately 6:00 a.m. and took a short mid-morning break and a 90-minute lunch break. At approximately 2:45 p.m., the employer'sson observed the man working slowly and reportedly instructed him to rest, but the man continued working. Shortly thereafter, the man's coworkers noticed that he appeared confused. Although the man was combative, his coworkers carried him to the shade and tried unsuccessfully to get him to drink water. At approximately 3:50 p.m., coworkers notified the employer of the man's condition. At 4:25p.m., the man was taken by ambulance to an emergency department, where his core body temperature was recorded at 108°F (42°C) and, despite treatment, he died. The cause of death was heat stroke. On the day of the incident, the local high temperature was approximately 93°F (34°C) with 44% relative humidity and clear skies. The heat index was in the range of 86°--101°F (30°--38°C) at mid-morning and...
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