The Daily - Lives, Livelihoods, and the High Cost of Heat

Episode Date: August 10, 2023

This summer, unrelenting heat waves have taken a devastating toll in many parts of the world, putting this year on track to be the hottest ever recorded.Coral Davenport, who covers energy and environmental policy for The Times, and Dana Smith, a reporter for the Well section, discuss what it means to live in this new normal, an era in which extreme heat threatens our way of life.Guest: Coral Davenport, an energy and environmental policy correspondent for The New York Times.Dana G. Smith, a reporter for the Well section of The New York Times.Background reading: Heat is costing the U.S. economy billions in lost productivity.Here’s what extreme heat does to your body.For more information on today’s episode, visit nytimes.com/thedaily. Transcripts of each episode will be made available by the next workday. 

From The New York Times, I'm Sabrina Tavernisi, and this is The Daily. This summer, an unrelenting heat wave has taken a devastating toll and has put this year on track to be the hottest ever recorded. Today, my colleagues Coral Davenport and Dana Smith on what it means to live in this new normal, where extreme heat now threatens our way of life and even our very lives. It's Thursday, August 10th. Coral, welcome back to the show. I am so happy to be back with you guys. So, Coral, you cover climate change and climate policy for The Times.

And, of course, this summer there's been this intense heat wave going on for weeks and weeks, soaring ER visits, even some deaths. You set out to understand something kind of different about the extreme heat, its economic cost. Tell me about that. So yeah, I'm kind of obsessed with being able to put price tags on the cost of climate change to the economy, to people's pocketbooks. What is the effect of heat on how much work gets done in the United States, on worker productivity, on how much work is lost, on how much pay is lost? You know, I sort of feel like I'm a climate economic detective. And Coral, why were you obsessed by this question? Well, you know, I think that a lot of people,

when they hear about climate change, it's just this giant existential threat. And it's sort of hard to wrap your head around, and it's sort of hard to wrap your head around what to do about it. But when it's explained in terms of something that absolutely everyone understands, which is dollars and cents and a specific cost. If you are an employer and you understand that extreme heat caused by climate change is actually costing you worker hours or increasing the amount of workers comp that you have to pay, or if you are a worker and you understand that it's lowering your payroll or that you just can't do your job as well. In so many ways, I think this makes it very or that you just can't do your job as well.

In so many ways, I think this makes it very tangible and specific. Anything you can put a price tag on, I think Americans understand more clearly. Okay, so you went out to do this economic detective work with the effects of climate change. What did you find? So first, Sabrina, I'm going to tell you what I thought I would find. Okay. Which is something that I think a lot of, you know, readers of the New York Times and listeners to the Daily would expect, which is like, of course, when it's hot, people work less.

But the workers who are affected are outdoor workers. I mean, that's obvious, right? Right. Mailmen, construction workers. Farm workers. Right. Yes. And, you know, medical researchers have known for years that when people or workers are exposed to heat, they make more mistakes, they think less clearly, they work more slowly, they have more injuries.

So I really thought this was going to be a story focused on outdoor workers. And that was my original pitch, showing like construction workers are working less and they're having more job injuries. And what I found is that there's a lot of new economic data showing that heat does hurt outdoor workers. It's lowering outdoor worker productivity. But the bigger effect on the economy in the United States is actually on indoor workers. It is affecting so much more of the indoor economy than we really understood. And Coral, why is that? It's kind of surprising, right? You really do think of farm workers and construction workers. In my mind, people inside really wouldn't be affected as much. So why is the bigger impact with indoor workers? Right. So a couple of reasons. One simple one is that

in the United States, there are far, far, far more indoor workers. So even if not as many of them are being as affected by heat, the U.S. is not fundamentally an agricultural economy. We are much more in indoor. We are an industrial economy. So that makes sense. But the number two is there's so many more indoor workers are exposed to extreme heat, particularly now as we are having more extreme heat than I understood. One big example that was very surprising to me, many, many, many factories in the United States are not air conditioned. Interesting. And there's a couple of reasons for that.

A lot of factories were built 30, 40 years ago at a time when the climate was different, you know, in areas like Ohio or Michigan or, you know, parts of the country where you wouldn't necessarily need air conditioning in a factory. And, you know, maybe workers would have to gut it out for like a week each summer when, you know, you'd have a week of hot temperatures, but it wouldn't be typical to have days and days or weeks and weeks or, you know, many, many days with temperatures over 85 or 90 degrees. Now that that is happening inside of those factories, workers are consistently experiencing days where they are regularly working in conditions over 90 and 100 degrees. And I'm talking about Michigan, Ohio, Oklahoma, Kansas, you know, parts of the country where workers are going to work, they're working indoors, and they're really, really hot. work, they're working indoors, and they're really, really hot. Wow. Interesting. Coral, I want to talk about the workplaces and what the actual effect has been on workers. But before we get to

that, can you tell me what the total effect is to the economy, like in actual dollars? Like, what are we looking at here? Sure. So there's studies on this. One study shows that right now in the United States, as a direct result of heat, the U.S. is losing about two and a half billion hours of work per year. Wow. That translates, a study found, into about $100 billion of economic loss per year and projects that that would go up to about $500 billion a year by the middle of the century. So there's, you know, a pretty clear price tag. And I should say that the economists who work on these numbers, it's new to be putting these price tags. And they say, if anything, these are probably undercounts, underestimates of what this price tag of loss is. So $100 billion going up to $500 billion in loss, that's pretty dramatic. I mean, that is a chunk of change,

even in context of federal budgets and, you know, big ticket items like that. So let's dig into this. What's causing this economic hit associated with extreme heat? Like, what's that number made up of? Sure. To just be sort of really like dollars and cents, employer, corporate about it, those dollar losses are about specifically the loss of worker productivity. That means that humans don't function well in heat. When they are hot, they work more slowly, they make more mistakes, they need to take more breaks.

And something that is new now is that researchers have been able to quantify how much less they work when they're exposed to certain amounts of heat. So there's a new study that shows when workers are working in 90-degree heat, their productivity drops 25%. 25%. And when they are exposed to heat of over 100 degrees, their productivity drops 70%. Whoa. So you're only really working at like 30% capacity when it's 100 degrees?

Yes, exactly. I mean, it's kind of amazing that they're actually able to put a price tag on it. What are some examples of what we mean when we talk about productivity going down, like from the lives of workers? Sure. So I talked to a lot of workers for this story, people who work in different kinds of indoor and outdoor environments. And it's pretty simple. You know, the workers who are getting hot, they're getting exhausted or sick. So they need more breaks. They need more time off. In some cases, when the heat is too much, the work just doesn't get done

at all. It gets postponed. When they get dizzy or can't think clearly, there are more accidents, there are more mistakes. And so there's less work getting done, less hours being completed, more breaks, more time off, and more mistakes. And I talked to factory managers. I talked to people who work in warehouses who say, in some cases, we just need to let people leave work early. Or, you know, we can tell if people have heat exhaustion that they should not come back to work for a day or two. All of that is what responsible employers should be doing. It also means that less work gets done. Right. Like we're not meant to work in that kind of heat, right? Exactly. And the thing is, too, I mean, the effects go beyond productivity, go beyond lost working hours.

I talked to workers in a meatpacking plant in Kansas who talked about how this is a part of the country that's experiencing so much more heat than usual. The workers inside this plant are getting exposed to so much more heat, and they describe goggles fogging up, not being able to see clearly. And when that consistently happens, a lot of these workers said, you know, there's a huge risk for food contamination, for meat contamination. When we're so hot and we can't even see to do our jobs, you know, one of the workers specifically described we're working with carcasses and manure, flecks of manure could get in the meat. If you can't see what you're doing and you're so hot, you can't think straight. Something else I heard from a lot of factories, a lot of plants is much higher turnover,

much higher percentages of people leaving, and fewer people wanting to take the jobs where they would be exposed to heat. Interesting. So given the cost in terms of productivity, which I assume, you know, companies understand and are kind of trying to think about. Not to mention, of course, basic human decency, having AC when it's 100 degrees. Why have employers been allowing their facilities to get so hot? So again, one of the sort of big eye-opening moments for me in reporting this story was specifically discovering how many factories and sort of indoor industrial facilities in the United States are not air conditioned. Again, in part because many of them are decades old, built in places and at times where we did not consistently experience so much extreme heat. So it wasn't necessary. And then now

it is wildly expensive to install cooling units in gigantic industrial facilities. I'm talking hundreds of millions of dollars. And so for this story, we did talk to a school bus manufacturing plant in Tulsa. And this is a place that makes most of the yellow school buses we see in the U.S., where the workers were consistently working at over 90 degrees, and they decided to go ahead and install a $100 million cooling system. But that's a really hard check to write, I think, for a lot of companies, especially if you're not sort of a gigantic national company. Right. Like if you're a tiny mom and pop business, the expense might just be too much to bear.

Exactly. And so I think this is genuinely a set of costs that employers have to look at, are looking at across the country. They're saying, you know, on one side, we're losing worker productivity. We're losing worker hours. I'm paying more workers comp. We're having to close on super hot days. All of that is like a really clear loss on one side of the ledger. On the other side is, well, you know, do I invest $100 million on indoor cooling or do I just take the hit in productivity?

But can employers just do that? Like ignore what heat is doing to their workers? Like, aren't there rules about that? So right now, OSHA, which is the federal agency that regulates workplace safety and has many, many rules in place for time limits on work and for safety and for exposure to all kinds of hazardous conditions. OSHA right now, there's no federal regulation that protects workers from exposure to heat or compels employers to protect their workers from heat exposure. There are seven states currently that have some kind of state-level regulation, but nothing in place at the national level. Right. Are authorities trying to make some? I mean, given our new heat reality? Yes. So the Biden administration has directed OSHA to begin the process of crafting new federal regulations on heat and worker exposure. This is very new, this process. It could take as long as 10 years. This is another thing I was surprised to learn when I did this reporting is just how long it can actually take to write

national workplace safety regulations. The expectation is, you know, what OSHA is working on is expected to set some kind of heat standards. You know, workers who are working over a certain temperature or exposed to certain temperatures for a certain amount of time must be given breaks, must be given water.

Indoor workplaces where workers are exposed to heat may need to install air conditioning. That's sort of the expected standard that we're likely to see from this, but that could be years away. And in the meantime, there are a lot of business groups that are coming out and saying, hey, we don't want to see this. This could be too expensive. We can figure this out ourselves. This is burdensome government regulation. Right. But, I mean, given our new heat reality, presumably something has to change. Well, I mean, it's changing already, right? Workers are already suffering. We're already taking the economic hit. Someone who I interviewed

in reporting this story was a former senior official at OSHA who said, this is going to cost a lot no matter what. Either employers are going to have to incorporate these new costs, you know, installing, cooling, giving a lot more breaks, all the other costs that they will have to pay to protect their workers in the new world of heat, and it's going to cost them a lot. And if they don't pay it, then we're going to see workers die. Coral, thank you. It was great to be with you, Sabrina. After the break, what extreme heat actually does to the body? We'll be right back.

There is no end in sight to a dangerous heat wave around 100 million Americans under excessive heat alerts this morning. In El Paso, Texas, temperatures have hit 100 for 43 straight days, while Phoenix, Arizona has seen a scorching 110 degrees for nearly 30 days in a row. Heat may have led to the death of a local man in Death Valley. The 71-year-old from Los Angeles collapsed outside a restroom yesterday when the temperature was 121 degrees. And we've learned a letter carrier died Tuesday while walking his route in Dallas. Texas inmates are dying in sweltering prisons. At least nine inmates have died since the

relentless heat wave has gripped Texas. As of July 11th, 12 people have died due to heat, with 55 additional deaths. New numbers released by Maricopa County reveal so far this year, 25 people have died from our relentless heat. Now tracking 39 heat-related deaths this summer, with more than 300 cases still waiting on confirmation. The medical examiner is telling Arizona's family we are on track to have a record summer for deadly heat. Dana, welcome to the show. Thanks so much for having me. So Dana, we just heard from our colleague Coral Davenport about the economic effects of heat. And of course, that has everything to do with how heat affects people and their bodies. And I think everybody has a kind of basic understanding that heat can be bad, but I don't think people really understand how, like the science of it, like what actually happens to our bodies in extreme heat. So tell me about that. about that? Yeah, I think a lot of people think of heat as an annoyance. I grew up in North Carolina where it is famously hot and humid in the summers, and it's kind of a pain, but you don't think that it's deadly. But I think what is a real surprise for people is that heat is actually the number

one cause of death when it comes to extreme weather events. So it really is a very serious thing that we have to account for, especially now with a warming planet. The number one cause of weather-related death, like more than hurricanes or floods? Yes, that's right. It is the number one cause of death due to weather-related events is heat. Well, that's kind of amazing. So let's unpack it. What actually happens to people's bodies when they're exposed to extreme heat? So the body has two main ways to cool itself down. I think the first one we're all familiar with, which is sweat. So our sweat glands on our skin start to produce sweat. And the goal is that that sweat evaporates off the body. And when it does, it cools the area underneath.

Okay. That's, you're right, pretty known. So what's the other one? So the really cool part is the second aspect of the body's cooling mechanism, which is that it starts to increase blood flow. So when it does that, the body is pushing more blood that normally circulates around your internal organs, and now it's redirecting that blood out to the surface of the skin. And that helps partly because the body can actually dissipate heat out through the skin, so it just releases heat into the atmosphere. But the really crazy part is that when the sweat evaporates off your skin and cools the area underneath, it's actually also cooling that blood that is now closer to the surface. And that cooler blood can

recirculate back to your internal organs and cool them down. Got it. Okay. So organs get hot. Blood takes the heat away from those organs to the surface of your skin. It has contact with the air, which is cooler, and cools you down. Exactly. So there's a really cool kind of two-step process with that sweat evaporation, then cooling the blood underneath the skin, and then hopefully cooling down the internal organs as it recirculates back through the body. Got it. Okay, so enter extreme heat. So what happens when it gets hotter outside? So these two processes work really well in most conditions, but they do start to fail when it gets too hot or too humid.

So you have to think of your body and the environment kind of on a gradient in terms of temperature and moisture. So when your skin temperature, which is normally about 95 degrees Fahrenheit, is hotter than the air outside, your skin can actually release heat out into the environment. But when the air temperature is hotter than your skin, your skin starts to gain heat from the environment and you can no longer cool down that way through the increased blood flow. Okay. The same happens with humidity. cool down that way through the increased blood flow. The same happens with humidity. If it's too humid outside, if there's too much moisture in the air, the water on your skin, the sweat on your skin can't evaporate.

And so it just sits there or pulls off. So again, that cooling mechanism is lost. Got it. So it's all about this gradient, basically. All of these processes in your body are interacting with the atmosphere around your body, what's going on in the air. And if it's too humid, can't sweat. If it's too hot, your body's going to take in heat as opposed to give it off. So that's a problem for the body. Exactly. So what exactly happens inside your body when it gets too

hot and humid? Right. So because of that increased circulation, the heart is really the most important organ when it comes to cooling down your body. So the heart is having to pump harder and faster. So your heart rate increases because it's trying to push blood further out. So out to the very surface of your skin. So it's working a lot harder. But at the same time, blood pressure can start to drop because there's not really an increased amount of blood volume. You're just pushing the same amount of blood to a wider surface area. So the heart is working harder, but your blood pressure is dropping. Because that blood is trying to get all over the body instead of just in one area around the organs.

Therefore, the pressure is weaker and weaker the further out it gets. That's exactly right. Yes. And a drop in blood pressure is actually one of the most common causes of injury because someone might stand up if they've been sitting and they don't have enough blood going up to their head and then they can feel dizzy or faint. So these are often really early signs that someone is really struggling from the heat is low blood pressure, dizziness, and potentially even fainting. Okay, so your body's working extra hard to increase your circulation and this is taxing your heart. Exactly. And in older people or people who have a pre-existing condition, especially one

related to the heart, this can actually turn fatal. This is how heat can kill them in the end, is by really taxing their heart. But in young, healthy people, this isn't as much of a problem. The heart is pretty resilient. The body is pretty resilient. And eventually, the increase in core temperature will plateau. But if the temperatures are really extreme, 100 degrees and more, if someone is working out or working in the heat, then problems can start to arise. And scientists think that's generally when the internal temperature of the body reaches about 100 to 103 degrees. And what exactly is heat exhaustion, Dana? I hear it a lot and feel like myself, I have experienced it, but what's going on scientifically in the body? Yeah, so it's a real general sense of fatigue. Also, your muscles might start not to function very well. And scientists think that this is actually a protective signal from the brain. So your brain is actually telling your body to stop working, to sit down, to get somewhere shaded and cool so that it can try to cool itself off.

Interesting. So it makes you tired so that you do that. Exactly. That is a really protective mechanism to try to prevent the next stage in the process, which is heat stroke, which can be deadly. Okay, so tell me about heat stroke. What is that? So normally the body is really good at trying to prevent your body from heating up too fast. But if those mechanisms start to fail, so say that you're in really extreme conditions, maybe you're a worker and you have on heavy work equipment so that your sweat can't evaporate out into the environment, or if you're working hard or exercising and you're generating internal heat

as well as gaining it from the outside, then your internal temperature can continue to rise even past the point of heat exhaustion. And that's when things get really dangerous. And what happens then? So scientists think about 104 degrees is generally the cutoff for heat stroke. And at that point, you can start to have multi-organ failure. Okay, multi-organ failure. Okay, multi-organ failure. So which organs are we talking about?

So the organs that are most immediately and dangerously affected are the heart, which we've talked about a little bit, and then also the kidneys, the gut, and the brain. Okay, so heart, kidneys, gut, brain. So start with the heart. So I talked about this a little bit, but the heart is pumping harder and harder and harder. So your heart rate is increasing, your blood pressure is dropping. And what happens when your blood pressure drops

is that blood can't circulate to everywhere that it needs to go. And so your organs slowly start to become deprived of oxygen, and that includes your heart. So it can even look like a heart attack where your heart was actually starved of oxygen because it just wasn't able to pump enough blood to the organs, including to itself. Okay, so that's the heart. What about the kidneys? The kidneys is really interesting because the brain actually sends a signal to the body that it should stop sending as much blood to the kidneys as it starts to get dehydrated. So a quick refresher, you know, your kidneys are what are cleaning your blood,

and then the waste gets excreted as urine. But that means that you're going to be losing a little bit of liquid. So if you're dehydrated, your body wants to preserve as much liquid as it possibly can. And so blood stops being pushed as much to the kidneys so that you don't lose any as urine. But as a result, your kidneys are then also starved of oxygen and those cells can start to suffer and die. Interesting. Got it. So body is just trying to preserve liquid any way it can, but the effect of that is that oxygen stops flowing to the kidneys. Exactly. And your kidneys can survive for a little bit of time with reduced blood flow

and reduced oxygen, but if that gets prolonged, you can start to have kidney failure. Okay. And you said also, Dana, the gut. So how is my gut affected? Okay, and you said also, Dana, the gut. So how is my gut affected? The gut is another area that blood is diverted from pretty quickly, and as a result, also has less oxygen going there. And when that happens, the gut can start to fail and break down a little bit, and you can start to have what we know as leaky gut. So the bacteria that's in your gut can actually start to travel out into the bloodstream,

causing inflammation and in really extreme and long-term situations, sepsis. Sepsis from heat? That's kind of crazy. Exactly. One of the emergency room physicians I spoke with said that sepsis is not a common cause of death when it comes to heat, normally because your other organs fail faster, frankly, but it is something that can occur. Okay, so your heart is working over time, kidneys aren't getting enough oxygen, gut is leaking, so full-on multi-organ failure, as you're saying. Yes, and not only the heart, the kidneys, and the gut, but also your brain.

And when the brain is affected affected things are getting really bad so heat stroke by definition means that the brain is being affected you know you think stroke you think brain and so the reduced blood flow the lack of oxygen the increased temperature are affecting your brain just like every other organ. So what is really kind of perverse about heat stroke is that the body's internal thermometer is located in a part of the brain called the hypothalamus. And if that starts to dysfunction or malfunction, then your body can actually stop cooling itself down. So oftentimes when people have really extreme heat stroke, they stop sweating. Their skin might feel cool and clammy. You know, they are no longer trying to cool their body down,

even though their internal temperature is continuing to rise. temperature is continuing to rise. So basically, kind of like the instinct to sweat and to have the body deal with this natural emergency state has gone. It's the brain is off kilter. Exactly. It started to fail. So people also start to have dizziness, confusion, delirium. You're just no longer responding to your external environment, and that can really be deadly. So what's the fastest way to cool somebody off and save somebody if they get into this dangerous situation? It's an ice bath. It sounds really simple, but it actually is the fastest way to cool down your internal temperature and try to prevent organ failure. So this is even what they use in emergency rooms is kind of a glorified ice bath. And you can also do this in your home.

But is that not too been a fair amount of research on this and there's a greater risk of heat than there is of a kind of temperature change shock to your body. So really the most important thing you can do is to cool someone down as fast as possible and an ice bath is the way. Okay, so ice bath. Got it. I will remember that. Got it. I will remember that. Now, Dana, you mentioned earlier that people with heart conditions can be particularly susceptible to the dangers of extreme heat, which you just laid out in pretty frightening terms. I'm wondering, are there other people or groups who are really vulnerable? I think this is really fascinating. An earlier article I wrote during the summer heat

waves looked at how elderly people are really uniquely vulnerable to heat. And that's because both of our two cooling mechanisms, the sweating and the increased blood flow, are hampered in a lot of older adults. So older adults just don't sweat very much. You know, their sweat glands produce less sweat than they used to. And so that really important way to cool yourself down is just really not as available to you. And then a lot of older adults, partly just because of age and partly because of pre-existing conditions, have decreased blood flow. So again, the heart is just not as able to push as much blood to the surface of the skin as happens in younger adults. Now, the good news is that older adults who are physically fit,

they do still maintain these cooling mechanisms better than unfit older adults. So exercise is almost always the most important thing you can do for yourself health-wise, and it's the same when it comes to extreme heat. Dana, I think one of the things we're actually realizing is that this extreme heat is here to stay, right? This is our new climate reality. And we'll have plenty more summers like this. So in many ways, this is our new normal. So I guess I'm wondering, is there any way to adapt to this? There is some research that the human body can adapt to heat.

And that is mostly in extreme athletes. human body can adapt to heat. And that is mostly in extreme athletes. So athletes who are doing, you know, long endurance training in high temperatures. And what scientists see is that they actually start these cooling mechanisms faster. So they start to sweat at lower temperatures. They have increased blood flow at lower temperatures. They also are more cardiovascularly fit. So their heart is just able to withstand the stress of that increased blood flow and heart rate for longer. Interesting. You know, I was a reporter in Baghdad in Iraq for a number of years, and it was a time when I was doing a lot of running. And we had this strip we would run on, and it was, you know, 120 degrees at 8 p.m. And I remember

doing that run and just feeling like, you know, my body was so taxed, but I got good at it. And then coming back to New York and running in Central Park and thinking, oh my God, this is easy. It was so much easier to run in a normal temperature than to run at 120, but I did get used to the 120. Exactly. So the body is remarkable and it actually can adapt to these extreme temperatures, but that is not realistic, frankly, for most people, especially, again, older adults and people with pre-existing conditions who are the most at risk for heat. So while it is possible, it's really not the best strategy that we should just think that biologically we can adapt to these extreme temperatures.

I think we just really have to respect the heat and take it seriously. And I think that we're going to have to continue to adapt our behaviors and our lifestyles going forward as we deal with hotter and hotter temperatures. So that means air conditioning, cooling centers, dehydration, and doing those really practical behavioral ways to cool yourself down in these hot, hot climates. So just being smart about heat is really essential and can be life-saving. Dana, thank you. Thank you. We'll be right back.

Here's what else you should know today. Fast-moving wildfires killed 36 people on the island of Maui in Hawaii in the past two days, as gusty winds were amplified by Hurricane Dora, hundreds of miles to the south. Some residents survived by swimming into the ocean, where they were later rescued by the U.S. Coast Guard. The fires burned much of the historic town of Lahaina, Hawaii's royal capital. They had been largely contained by Wednesday night. And President Biden escalated his confrontation with China by signing an executive order that bans American investments in key technology industries. The order will prohibit venture capital and private equity firms from pumping money into Chinese efforts to develop semiconductors and other microelectronics, quantum computers,

and certain artificial intelligence applications. American officials stress that the move was tailored to guard national security, but China is likely to see it as part of a wider campaign to contain its rise. Today's episode was produced by Diana Nguyen, Carlos Prieto, and Summer Tamad, with help from Nina Feldman and Sydney Harper.

It was edited by Devin Taylor, with help from Paige Cowett. Contains original music by Alicia Baitube, Marian Lozano, and Rowan Nemisto, and was engineered by Alyssa Moxley. Our theme music is by Jim Brunberg and Ben Landsberg of Wonderly. That's it for The Daily. I'm Sabrina Tavernisi. See you tomorrow.