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"This work is an important example of how infectious diseases are influenced by climate conditions," said the lead author of a new report.
Scientists at the University of California noticed that cases of Valley fever, a respiratory infection that is spread only through the inhalation of fungal spores, only peaked in certain parts of the state in recent years—and when they set out to discover why, they found that drought may play a major role in rising cases of the disease.
In a study published in The Lancet Regional Health - Americas on Tuesday, the researchers explained that increased droughts in the state have created conditions for a growing number of people to inhale coccidioides spores, which thrive in soil and can be inhaled through dust.
The scientists analyzed cases of Valley fever from 2000-22, and found that cases have risen dramatically since the turn of the century—particularly from 2014-18 and again from 2018-22, two periods when reported cases tripled.
Cases of the seasonal illness have long been known to occur mostly between September and November, but the researchers found "there were certain years during which few or no counties had a seasonal peak in Valley fever cases," said lead author Alexandra Heaney, an assistant professor at the UC San Diego Herbert Wertheim School of Public Health and Human Longevity Science. "This made us wonder what was driving these differences in seasonality between years, and based on the timing we observed, we hypothesized that drought might be playing a role."
"Even though droughts appear to decrease Valley fever cases in the short term, the net effect is an increase in cases over time, particularly as we experience more frequent and severe droughts due to climate change."
During periods of drought, seasonal peaks of Valley fever were less severe, according to the study. It was after the dry periods, when heavy rains returned, that cases spiked.
The researchers suggested that the return of rainy weather could allow the heat-resistant coccidioides fungus to proliferate because of the newly moist soil and the influx of nutrients. Another hypothesis was that droughts cause a decline in the population of rodents that host the fungus.
"Because dead rodents are thought to be an important source of nutrients for the fungus, it may be able to survive and spread more easily in drought conditions," reported UC San Diego Today.
"This work is an important example of how infectious diseases are influenced by climate conditions," Heaney said. "Even though droughts appear to decrease Valley fever cases in the short term, the net effect is an increase in cases over time, particularly as we experience more frequent and severe droughts due to climate change."
The study comes a month after a music festival in the state's Central Valley was linked to 14 cases of Valley fever, which can cause joint pain and fatigue as well as respiratory symptoms and can spread to the bones or brain in rare, potentially fatal cases.
People who work outside, including farmworkers and construction workers, are most at risk for breathing in the fungus.
The scientists called for more thorough monitoring of the fungus, which can be difficult to detect and whose symptoms are often confused for other respiratory illnesses. They also called for people in the state to wear face coverings when coming into contact with soil and dust and to minimize time outdoors, if possible, during dry and dusty periods.
Heaney said the team is next looking at climate dynamics related to Valley fever in Arizona, where about two-thirds of cases occur in the United States.
"Understanding where, when, and in what conditions Valley fever is most prevalent is critical for public health officials, physicians, and the public to take precautions during periods of increased risk," said Heaney.
Knowing the true human toll resulting from soaring temperatures might help jolt the nation into action on climate change sooner and lessen the mitigation and resilience we will need.
Extreme heat and wildfire smoke should of course be defined as major disasters by the Federal Emergency Management Agency. According to the National Weather Service, heat kills more people in this nation than hurricanes, tornadoes, floods, and lightning combined. The Washington Post reported that extreme heat killed at least 28 people across the nation in the past week.
Yet, despite several requests from states over the years, most recently California during a 2022 “heat dome” and wildfires, no White House has ever approved a disaster declaration for heat or smoke.
Some states outright ignore the dangers in the name of greed. Over the last 13 months, Texas and Florida have enacted laws that block localities from issuing heat protection rules for workers. Nationally, the Biden administration proposed on July 2 new rules to protect workers from heat. But the U.S. Chamber of Commerce and a host of construction and agricultural lobbying groups have opposed the prospect of rules for months and are sure to oppose them in the courts.
It is clear that the opposition is willing to risk sacrificing lower-wage construction and farm workers to the sun’s brutality as executives count the cash in air conditioned offices. Farm workers make an average $13.59 an hour. Hispanic construction laborers make $15.34 an hour, well below the $25-an-hour living wage for a family of four in the Massachusetts Institute of Technology’s Living Wage Calculator. Farm workers respectively have 35 times and 12 times higher risk of heat-related injuries than in all other industries.
Making the latest case for disaster declarations is a consortium of 31 environmental, public health, labor, and justice groups, led by the Center for Biological Diversity. In a June 17 petition to FEMA, the groups warned that the record-breaking heat and fire disasters we are already experiencing are likely only the beginning. The world’s nations, particularly the top burners of fossil fuels such as the United States, have yet to unify to prevent uncontrolled global warming.
“These may be the coolest days and the cleanest air of the 21st century,” the petition said, “and it is already unbearably hot and unsafe for too many Americans.”
The petitioners hope that disaster declarations can unlock federal funds for short-term relief such as cooling centers, water supplies, emergency air conditioning and air filtration systems, and financial assistance for evacuations. Declarations could also lead to money for long-term, proactive mitigation, such as renewable energy storage and microgrids to withstand utility blackouts, and retrofitting of homes and buildings to be more energy efficient and weatherized.
That is vitally important for disadvantaged families who are more likely to live on shadeless, asphalt and concrete “heat islands.” Such communities are often already overburdened with pollution associated with fossil fuel burning and proximity to polluting industries. The petition called extreme heat a “harm multiplier” for these communities because of poor housing stock, difficulty in paying utility bills, and pre-existing poorer health.
In making their case, the 31 environmental groups cite data from the Intergovernmental Panel on Climate Change, projecting that financial cost of extreme heat in the United States will explode fivefold to half a trillion dollars a year by 2050.
There is something else that would make their case even stronger: Data on people. The federal government is woefully behind university researchers in calculating the current and future mortality of heat and smoke.
It should be just as much an emergency for the government to tell us the toll of heat and wildfire smoke. Especially since the government itself says “most heat-related deaths are preventable.”
Property damage from tornadoes, hurricanes, and floods is easy to visualize and leaves the costs of emergency assistance and repair without much question. Because of the nation’s overall wealth, which gives us relatively sturdier dwellings and stronger rebuilds, deaths from those weather disasters are a fraction of the fatalities suffered in lesser resourced parts of the world. For instance, while Hurricane Katrina took 1,400 lives in the US in 2005, Cyclone Nargis in the Bay of Bengal made landfall in Myanmar in 2008 and killed 140,000 people—100 times more people than Katrina.
People perishing by heat or smoke one by one in the privacy of their homes or in the sterility of hospitals is relatively invisible. An analysis of heat deaths by the Cincinnati Enquirer found that about half of heat deaths happen at home, often to people who lack air conditioning, are elderly with pre-existing medical conditions, or who are socially isolated.
The petition by environmental groups points to the current invisibility of heat deaths. It cites federal data saying there were 2,300 deaths last year where heat was listed as a factor on death certificates. That by itself was a record in nearly a half-century of such record keeping. But left as is, that toll would seem to pale next to last year’s nearly 43,000 car fatalities, nearly 43,000 gun-related deaths, or 107,000 drug overdose deaths.
The number of heat deaths is assuredly far more. Heat is often not listed on death certificates as a contributing factor to the final cause of death, such as kidney failure, organ failure, and heart attack. There is no uniform protocol tying together how the federal government, the 50 states, or the nation’s 3,000 counties calculate heat-related deaths.
University scientists and health and safety groups are filling in the gaps as best they can.
In 2020, a study in the journal Environmental Epidemiology determined that 5,600 deaths a year were attributable to heat from 1997 to 2006, eight times higher than federal figures. In 2022, researchers at the University of Pennsylvania and the Philadelphia Veterans Administration Medical Center calculated that the number of people who died from heat-related causes between 2008 and 2017 was two to three times higher than federal figures. The Penn and Philadelphia VA researchers also found that extreme heat days were associated with “significantly higher” cardiovascular mortality among adults.
This spring, Texas A&M climate scientists Andrew Dessler and Jangho Lee told the Associated Press that last year’s real national annual heat death toll may be 11,000, nearly five times higher than the 2,300 cited by the government.
In the work world, the federal Bureau of Labor Statistics says 43 workers died in 2022 from heat. But reports by Public Citizen, the most recent being in May of this year, estimate that as many as 2,000 workers a year (46 times more) die from heat and another 170,000 are injuries triggered by heat, such as becoming dizzy and falling off a roof.
But the injury might simply be listed as a fall without mention of heat. Public Citizen says government figures are “decidedly unreliable” and “notoriously problematic” because they are based on self-reporting surveys of employers and “less than half of employers even maintain the required records.”
No matter what number you’re looking at, all of them are likely to soar much higher without concerted global action on climate change. Without a drastic and immediate cut in fossil fuel emissions, the planet is currently staring at a 5-degree Fahrenheit rise in temperatures this century, with the U.S. being the world’s biggest historical contributor to global warming gases.
According to a study published last year by Lee and Dessler in the journal GeoHealth, the US suffered an average of 36,444 deaths a year from extreme temperatures a quarter century ago, with most of those deaths being cold-related. With a rise of 5 degrees Fahrenheit, that number could explode to 200,000 a year this century, driven significantly by shifts of heat mortality to Northern cities. Among the cities with the highest projected temperature increases are Minneapolis, Milwaukee, and Muskegon, Minnesota.
Parallel to that, and arguably worse, there is virtually no federal data on the fatal impacts of wildfire smoke. The National Oceanic and Atmospheric Administration (NOAA) lists a mere 535 deaths directly from wildfires over the last 45 years in its list of “Billion-Dollar Weather and Climate Disasters.” But there are likely thousands more from the smoke, which is associated with cardiovascular, ischemic heart disease, digestive, endocrine, diabetes, mental, and chronic kidney disease mortality.
Such smoke is not covered by the Clean Air Act, and there is growing evidence that it is eroding decades of gains in the nation’s air quality under the act. A new study by researchers at UCLA found that the fine particulate matter (known as PM2.5) in wildfire smoke that easily passes into the lungs and spreads throughout the body, contributed to the premature deaths of more than 50,000 people in California from 2008 to 2018, with an economic impact of between $432 billion and $456 billion.
Another study this spring by the National Bureau of Economic Research found that 16,000 people a year died from smoke PM2.5 across the US from 2011 to 2020. That study found that elevated long-term smoke concentrations “increase mortality rates at both low and high concentrations.” Wildfire smoke, as the nation found out last year with its orange-brown skies that dulled the sun into a moon-like disk, spreads for so many thousands of miles from its source that the study projects a “large mortality burden not only in regions where large fires occur but also in populous regions with low smoke concentrations (e.g., the eastern US).”
Juan Aguilera, a physician researcher at the University of Texas School of Public Health in El Paso, found that wildfire smoke stresses immune systems and triggers inflammation. He told National Public Radio that living in a wildfire-prone area is “something equivalent to smoking like one pack a day, or 10 packs a week.”
Today’s 16,000 deaths a year from wildfire smoke could grow to nearly 28,000 by mid-century under a high warming scenario and take a cumulative 700,000 lives by 2055, according to the National Bureau of Economic Research.
“Our research suggests that the health cost of climate-driven wildfire smoke could be among the most important and costly consequences of a warming climate in the US,” NBER scientists said.
That concern is bolstered by a new study by Australian researchers who found that the number of extreme wildfires has doubled since 2003, with the last seven years including six of the most extreme. Lead author Calum Cunningham told the New York Times last month, “That we’ve detected such a big increase over such a short period of time makes the findings even more shocking. We’re seeing the manifestations of a warming and drying climate before our very eyes in these extreme fires.”
Adaptation could cut into the mortality risk, but it alone is likely not enough, given how Lee and Dessler noted in their study: “Many adaptive responses (e.g., installing air conditioning, improved health care, better urban planning) are too expensive for poorer individuals or communities, so adaptation will necessarily require society to pay for much of the adaptation. This would represent a huge transfer of wealth from richer to poorer members of our society, a dicey proposition in today’s political environment.”
Even better, of course, would be a serious drive toward net-zero greenhouse gas emissions. The International Energy Agency says no new gas, oil or coal investment is necessary as renewables, energy efficiency and electrification already can deliver the vast majority of emissions reductions.
Though all heat-related disaster declaration requests to FEMA thus far have been denied, agency spokesperson Daniel Llargues told National Public Radio that “there’s nothing specific” in federal law that precludes such a declaration. “If a circumstance did occur where an extreme heat incident exceeded state and local capacity, an emergency or major disaster declaration request submission could be considered,” Llargues said in an email.
And the White House can make a disaster declaration regardless of FEMA’s recommendation. In May, President Biden overruled a FEMA denial of a major disaster declaration so parts of Massachusetts could get federal aid to recover from severe storms and flooding last September.
The process of FEMA better understanding a “circumstance” where extreme heat and wildfire smoke constitutes a disaster starts with a better understanding of the danger. Some parts of the government are trying to mine the data, such as the National Institute of Health’s Heat Information System.
Extreme heat and wildfire smoke also offers FEMA a fresh chance to create new paradigms of aid, to avoid inequities seen in other disasters. Current FEMA storm funding often maintains systemic racism, putting communities with more white residents and higher property values back on their feet, while low-income people and communities of color, historically hemmed into lower property values by redlining, are left on their knees.
As Politico wrote in 2022, FEMA grants to help richer families raise homes above flood levels “have helped turn dozens of wealthy or overwhelmingly white areas into enclaves of climate resilience. The communities are seeing rising property values and economic stability, while much of the nation faces devastating effects of rising seas and intensifying floods.”
One can only imagine the results if the same mentality is ultimately applied to communities marooned on “heat islands.” Seniors and Black adults are at disproportionate risk of cardiovascular deaths from extreme heat according to a Penn study last year. A 2022 Penn study warned, “As extreme heat events increase, the burden of cardiovascular mortality may continue to increase and the disparities between demographic subgroups may widen.”
The same can be said for those lower-wage farmworkers, construction workers and other industries where heat is a major risk. Often, the workers in those industries are disproportionately of color and immigrants. Other trades where heat is a high risk include landscaping, and indoor jobs in warehouses, restaurant kitchens, mills, and doing maintenance.
And let’s not forget public school teachers and staff, as huge percentages of the nation’s public school buildings are not equipped for the rising heat.
There are scientists, including UCS’s Juan Declet-Barreto, who have long called for standard methodology to more accurately determine whether excess deaths originated with heat or smoke exposure. Last year, Ashley Ward, the director of Duke University’s Heat Policy Innovation Lab, wrote in STAT that we need much better and uniformed coding for external causes of injuries and incentives for health systems to apply the codes for cases involving extreme heat. Without uniform coding, the public is left to weigh the emerging body of studies that have different estimations and may “add to the incorrect assumption that there is a lack of scientific consensus.”
Seconding the call for data collection is the Federation of American Scientists. Among its major list of recommendations is a “whole-of-government strategy to address extreme heat.” The federation said that true mortality counts are “essential to enhancing the benefit-cost analysis for heat mitigation and resilience.”
But having heat- and smoke-related mortality data is more than that. Knowing the true toll might help jolt the nation into action on climate change sooner and lessen the mitigation and resilience we will need. One only need think back to the peak of the COVID-19 pandemic and how critical data was to devise public health policy. Currently, the federal data on extreme heat and wildfire smoke itself constitutes a major disaster.
The administration has established that "every worker in America has the right to shade, water, and rest while working in temperatures that could kill them," a labor leader said.
Labor advocates celebrated on Tuesday following the Biden administration's announcement of a proposed rule to protect workers from extreme heat—the first national workplace heat safety standard.
The Occupational Safety and Health Administration (OSHA), an agency within the U.S. Department of Labor, published the rule, which the administration says would protect about 36 million indoor and outdoor employees from heat-related injuries and illnesses. It follows similar regulations that five states have approved in recent years.
Labor groups said the rule was the result of decades of advocacy by farmworkers and others subjected to extreme heat, who tend to be working-class people of color or immigrants. The movement was galvanized by heat-related deaths in workplaces around the country.
"This is a bittersweet moment for farmworkers," United Farm Workers president Teresa Romero said in a statement. "Every significant heat safety regulation at the state, and now federal, level was written in the blood of farmworkers."
"Today, the federal government put itself on the right side of history by seeking, for the first time, to establish the precedent that every worker in America has the right to shade, water, and rest while working in temperatures that could kill them," Romero added.
Juley Fulcher, a worker health and safety advocate at Public Citizen, an advocacy group that first called for a federal workplace heat protection standard in 2011, said in a statement that the OSHA rule was a "monumental victory for those who toil in the summer heat."
President Joe Biden has and will continue to protect workers. This President continues to show us where his priorities lie.
Thank you for prioritizing workers' right to safe working conditions, @POTUS. https://t.co/D4YMvWgIml
— Machinists Union (@MachinistsUnion) July 2, 2024
The focus on protection from heat comes as millions of Americans are under heat advisories this week and fossil-fuel driven climate change causes record-setting temperatures month after month.
The OSHA regulation, which will be the subject of written comments and a public hearing before being finalized, requires worker access to clean drinking water, indoor or shaded areas, rest breaks, and heat-related training. The regulation contains tiers so that certain protections kick in at a heat index of 80°F and still more at 90°F. The rule mandates an acclimatization process for new employees, as they are especially at risk in high temperatures.
The rule would also substantially increase the penalties that employers might pay in the case of heat-related employee injuries, according toThe Guardian.
Bill McGuire, a climate scientist at University College London, wrote on social media that the new rule was "absolutely vital" but warned that "working outside will not be possible at all in the extreme summer temperatures that coming years will bring."
The federal rule comes amid a push by labor and environmental groups to establish more workplace protections against extreme heat. Rep. Greg Casar (D-Texas) helped organize a "thirst strike" with unions and civil society groups on the U.S. Capitol steps last July. Responding to bottom-up pressure, California, Colorado, Oregon, Minnesota, and Washington have passed workplace heat safety standards in recent years.
Industry groups have lobbied against the rules, with remarkable success in states such as Florida and Texas, both of which have gone as far as passing laws that prohibit local authorities from mandating heat protections for outdoor workers. The Texas law was ruled unconstitutional by a state district court judge last year.
The new federal rule comes as a part of a larger administration effort to address the extreme heat that Americans are increasingly facing. An OSHA program that began in 2022 has conducted more than 5,000 heat-related inspections in workplaces with the most heat exposure, according to a Labor Department statement.
Separately on Tuesday, the Department of Homeland Security and the Federal Emergency Management Agency (FEMA) announced a set of 656 projects aimed at preparing for extreme heat and other weather disasters, at a total cost of nearly $1 billion.
Jean Su, energy justice director at the Center for Biological Diversity, said in an emailed statement that the project funding "only scratches the surface of the nation's enormous need for tools to combat extreme heat" and pushed for FEMA to classify extreme heat and wildlife smoke events as "major disasters," which would unlock much more key funding.
Su did praise OSHA's "landmark rule" and called for an "urgent, government-wide game plan to tackle catastrophic extreme heat."