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Juan Peña, 28, has worked in the fields since childhood, often exposing his body to extreme heat like the wave that hit the Midwest last week.

The heat can cause such deep pain in his whole body that he just wants to lie down, he said. It sucks his desire to work, as his body tells him he can't take another hot day on the job. On those days, his only motivation to get out of bed is to earn dollars to send to his 10-month-old baby in Mexico.

Farmworkers, such as Peña and the crew he leads in Iowa, are unprotected against heat-related illnesses. They are 35 times more likely to die from heat exposure than workers in other sectors, according to the National Institutes of Health, and the absence of a federal heat regulation that guarantees their safety and life — when scientists have warned that global warming will continue — increases that risk.

In a six-year period, 121 workers lost their lives due to exposure to severe heat. One-fifth of these fatalities were individuals employed in the agricultural sector, according to an Investigate Midwest analysis of Occupational Safety and Health Administration data.

One such case involved a Nebraska farmworker who suffered heat stroke alone and died on a farm in the early summer of 2018. A search party found his body the next day.

In early July 2020, a worker detasseling corn in Indiana felt dizzy after working for about five hours. His coworkers provided him shade and fluids before going back to work. The farmworker was found lying on the floor of the company bus about 10 minutes later. He was pronounced dead at the hospital due to cardiac arrest.

"As a physician, I believe that these deaths are almost completely preventable," said Bill Kinsey, a physician and professor at the University of Wisconsin-Madison. "Until we determine as a society the importance of a human right for people to work in healthy situations, we are going to see continued illness and death in this population."

Peña works in fields in Texas and Iowa. This summer, he's overseen five Mexican seasonal workers picking vegetables and fruits in eastern Iowa. With its high humidity and heat, Iowa's climate causes the boys, as he affectionately refers to them, to end their day completely wet, as if they had taken "a shower with their clothes on," he said. They work up to 65 or 70 hours a week to meet their contractual obligations.

"I'm lucky because my bosses are considerate (when it's hot)," he said in Spanish, recalling that he managed to endure temperatures as high as 105 degrees in Texas. "I've had bosses who, if they see you resting for a few minutes under a tree to recover yourself, think you're wasting your time and send you home without pay."

Some of his friends have been less fortunate and got fired for taking a brief rest, he said.

The fatalities don't tell the whole story of heat illnesses and deaths, according to health experts, academics and advocacy groups.

"There is a massive undercount," said Elizabeth Strater, director of strategic campaigns for United Farm Workers.

She said it is common for an autopsy to list heart attack as the cause of death even when it's brought on by heat stroke.

The scope of the problem also is obscured by the nature of the population, Strater said. Farmworkers move a lot and live in isolated areas. About half are undocumented. "Everything to do with farmworkers is particularly difficult because we don't know," she said.

An estimated 2.4 million people work on farms and ranches nationwide, according to the U.S. Department of Agriculture's census of agriculture. This population, mostly Latino, is roughly equal to the population of Chicago.

A possible federal standard

Although employers generally are responsible for ensuring a safe working environment that protects employees' well-being and lives, no federal regulation stipulates a specific temperature threshold that mandates protective measures.

Nearly four in 10 farmworkers are unwilling to file a complaint against their employer for noncompliance, mostly out of fear of retaliation or losing their job, according to survey data of California farmworkers conducted by researchers at the University of California Merced Community and Labor Center.

Four states have adopted outdoor workplace heat-stress standards. None is in the Midwest. California was the first to implement such standards, followed by Oregon, Washington, and Colorado.

This leaves protecting agricultural workers from heat stress at the discretion of their employers in most states.

OSHA has been working on a heat-stress rule since 2021 that will require employers to provide adequate water and rest breaks for outdoor workers, as well as medical services and training to treat the signs and symptoms of heat-related illnesses. However, issuing new safety standards can take from 15 months to 19 years, according to a U.S. Government Accountability Office report.

OSHA officials would not comment on the pending federal heat standard.

Last year, the Asuncion Valdivia Heat Stress Injury, Illness, and Death Prevention Act, which would force OSHA to issue a heat standard much faster than the normal process, failed to advance through Congress.

The bill was named in honor of Asuncion Valdivia, who died in 2004 after picking grapes for 10 hours in 105-degree heat. Valdivia collapsed unconscious and, instead of calling an ambulance, his employer told his son to take his father home. On the way home, he died of heat stroke at 53.

A group of Democratic lawmakers reintroduced the bill last month.

"There is definitely a political decision to be made by members of Congress, in both the House and the Senate, because they have the power to pass legislation to tell OSHA to issue a standard more quickly," said Mayra Reiter, project director of occupational safety and health at the advocacy group Farmworker Justice.

Reiter added that the legislation also would help shield that standard from future legal challenges.

The summer of 2023 has broken records for heat.

In response, President Joe Biden announced new measures to protect workers — including a hazard alert notifying employers and employees of ways to stay safe from extreme heat — as well as steps to improve weather forecasting and make drinking water more accessible.

But farmworker advocacy groups are calling on the administration to speed up OSHA's issuance of a rule protecting workers. They are also pushing for the 2023 farm bill to include farmworker heat protections.

"Farmer organizations and many other worker advocacy groups are hoping that there'll be a federal regulation," Reiter said, "because, going state by state, we have seen that there isn't that urgency to develop these rules."

Long way to a new rule

Creating a new rule to protect workers from heat must overcome several hurdles, from bureaucratic procedures to lobbying industries, including the agricultural industry.

"OSHA is uniquely slow," said Jordan Barab, who served as OSHA's deputy assistant secretary of labor during the Obama administration.

He said the 1970 act that created OSHA imposes many requirements on the rulemaking process. The agency has to determine the current problem and whether the new standard will reduce risk. OSHA also must ensure the new standard is economically, technically and technologically feasible in all industries.

The road to regulations to protect workers from the heat also has to overcome industry lobbying, including big agricultural and construction groups. One group that has expressed hesitancy to new federal rules is the American Farm Bureau Federation, which has spent on average about $2.3 million on lobbying in the past two years, according to OpenSecrets.

"Considering the variances in agricultural work and climate, (the Farm Bureau) questions whether the department can develop additional heat illness regulations without imposing new, onerous burdens on farmers and ranchers that will lead to economic losses," said Sam Kieffer, the vice president for public policy at the farm bureau, in a statement.

Vulnerable populations

​​To make a living, Javier Salinas fills 32 sacks of apples each day in Missouri. His daily quota is one ton or about 3,200 apples. His wife used to walk 10 miles a day to harvest fruits and vegetables when she worked in the field.

He said when he gets too hot, he sits in the shade to drink water but feels pressured to keep working because he's paid by how much he harvests.

Strater, with Farmworker Justice, believes the way farmworkers are paid is a main obstacle that must be overcome to ensure their safety.

Kinsey, the University of Wisconsin professor and the director of a mobile clinic, said the demographic has a higher incidence of diabetes, hypertension and chronic kidney disease.

"Climate stress," he said, "has introduced an additional layer of complexity to these existing challenges."

Seasonal visa workers are especially vulnerable because they depend completely on whoever hires them for their job, housing and food.

"You're going to endure as much as you can with the hopes of continuing to provide for your family," Strater said.

In Tama County, Iowa, Dave Hinegardner owns a small farm called Hinegardner's Orchard, where he grows apples, strawberries, corn and soybeans. He sells his crop to supermarkets, farmers' markets, schools, and colleges.

The farmworkers are immigrants from Latin America who reside in the surrounding area, and some of them have been working on his farm for decades. One of the measures he takes during the summer to avoid risks to his workers is to change work schedules to avoid the hottest part of the day.

"I think they do a much better job when they're treated with respect and taken good care of," he said.

This story is a product of Harvest Public Media, Investigate Midwest and the Mississippi River Basin Ag & Water Desk as part of the series A Changing Basin.