Juan Jose Soriano, a 44-year-old father of five children, worked for several hours in humid 100 degree-plus (38C) weather before telling his crew leader that he did not feel well. Soriano was given some water and was driven back to the workers’ housing area and left alone to rest.

About 45 minutes later he was discovered unconscious outside. Soriano was pronounced dead from heat stroke at a local hospital. His core body temperature was 108 F (42 C), well above normal body temperature of 98.6 F (37 C).

A National Institute for Occupational Safety and Health (NIOSH) investigation noted that workers at the tobacco farm toiled for exceptionally long hours. They were allowed a one-hour mid-morning break, where they were offered soda and crackers. A one-hour lunch break was their last break of the day.

Workers took their breaks in a shaded area, where soda, sports drinks and water were always available. Although worker housing met all the housing requirements of the Migrant Housing Act of North Carolina, the accommodation was not air-conditioned, nor were fans provided.

Although the farmer had distributed a Spanish-language safety/health booklet that included information on heat illness and heat stroke, he did not require workers to read it. He also didn’t discuss heat illness with his workers.

Workers who are showing symptoms of heat exhaustion, including heavy sweating, paleness, fatigue, weakness, dizziness, headache, nausea/vomiting, fainting, excessive thirst, dry mouth and dark yellow urine need to be treated and watched – not left alone to rest.

Their clothing should be loosened or removed and they should be splashed with cool water. They should also be given sips of cool water. If the symptoms do not improve, medical assistance must be provided. Symptoms of potentially fatal heat stroke include red, hot and dry skin, no sweating, rapid and strong pulse, throbbing headache, dizziness, nausea, incoherent speech, confusion, aggressive behavior, convulsions and unconsciousness.

Heat stroke victims need to be cooled with a hose or in a tub of cold water before professional medical help arrives. It simply isn’t enough to provide water and remove the worker to shade.

Although the tobacco farm workers could drink as much soda, water or sports drink as they wanted, they were not told that they needed to drink it frequently to stay hydrated. No one supervised their fluid intake.

“In this incident, the worker complained of not feeling well, but instead of receiving medical attention, he was left alone to rest,” states the NIOSH investigation report. “Heat stroke is a life-threatening illness, and medical care must be administered immediately to prevent permanent disability or death.”