Admire Stewart takes a deep breath and sits still while a breeze hits her face. Her gallon-sized water bottle is by her side.

“Right now I have a migraine because of the heat yesterday and I have heat hives,” she says as she points to the bumps on her arms. She’s trained herself not to scratch them, which only makes them worse.

Stewart works inside Ellicott Hall, one of the unairconditioned dormitories on University of Maryland’s College Park campus.

President Joe Biden introduced an occupational standard for workers laboring in extreme heat, but it could take years to take effect. Meanwhile, states like California, Colorado, Minnesota, Oregon and Washington have passed protections as workers toil in extreme temperatures.

Maryland is set to finalize its heat standard later this summer, making it the first state to do so on the East Coast.

When students leave for the summer, Stewart is one of dozens of housekeepers who clean every inch of the building – doing laundry, waxing floors, and pushing a vacuum through student bedrooms.

When she spoke to a reporter in early June, she said temperatures in the building had already swelled close to ninety degrees.

“I really didn’t finish my assignment yet because I’ve been really slowing myself down a little bit [more] than usual,” she said.

Stewart feels generally supported by her employer to take the measures she needs to keep herself from getting too sick– like slowing down, stopping for water, or just leaving work undone until the worst part of the heat passes.

But many are not so lucky.

Thirty-six U.S. workers died from heat sickness in 2021, the last complete year in which the Bureau of Labor Statistics provided data. That number has grown throughout the last decade and according to independentinvestigations, those are likely undercounts.

In the decade from 2011-2020 there were 34,000 work-related heat injuries and illnesses severe enough that workers had to take time away from the job. It’s likely those numbers are undercounts too, according to the federal Occupational Safety and Health Administration (OSHA) because states have varying definitions for heat sickness and most data comes from self-reporting.

State Delegate Lorig Charkoudian, a Democrat, proposed the bill to create Maryland’s heat standard back in 2020.

“We are facing serious impacts from climate change, and it plays out in many ways, harming usually, the most vulnerable communities first,” Charkoudian said.

Occupational safety experts say Maryland is poised to enact one of the most comprehensive standards.

Under the rules, employers will have to post protections in workers’ native languages and provide acclimatization periods so workers can get adjusted to the heat. Workplaces will have to have a written heat safety plan for any work done when the heat index, including humidity, is at 80 degrees or above. That goes for indoor and outdoor work. Additional protocols, like paid mandatory cooled and shaded breaks every two hours, are triggered when temperatures reach ninety degrees.

The incoming standards have received pushback from some industry groups.

Steve Sohasky, who advises construction companies with Creative Risk Management Solutions, says the standard is too extreme and that workers and companies can regulate themselves.

“If people need breaks, they take breaks, you know, we have that flexibility in the job,” Sohasky said after a stakeholder meeting with the Maryland Department of Labor.

Construction workers make up about 6% of the workforce, but according to a National Institute of Health study account for over one-third of yearly heat deaths. Workers of color and immigrants tend to work jobs with the most risk of heat sickness.

Adele Abrams, a labor attorney based in Maryland, says the dangers of working in the heat shouldn’t be minimized.

“I represent employers but I’m not going to sugarcoat this: people die from heat illness. I have had fatality cases I have handled where I know weather conditions were a contributing factor in causing the death of the worker,” she said.

Industry advocates have expressed concerns about the feasibility of setting up cooling and shading stations, especially in jobs where crews are constantly moving. But Abrams says some solutions require planning and creativity. Low-cost options include letting crews sit in a truck with the AC on or setting up a cooling trailer.

Abrams expressed concerns about the patchwork of state protections going into effect as the federal government slowly moves to set its own standards.

“How many times can [employers] reinvent the wheel and re-do their programs?” Abrams said. “This was part of what was making employers crazy back when the COVID regulations were in place…it seemed like every other month we were having to retool it because new information was available or old information was found not to be accurate.”

Anastasia Christman, a policy analyst from the National Employment Law Project, says Congress is notoriously slow in updating laws for the Occupational Safety and Health Administration, or OSHA.

“The public comment period can be made very long, the cost-benefit analysis is very difficult in the case of OSHA, because how do you count the value of injuries that won’t happen? You’re having to sort of count something negative,” Christman said.

Meanwhile, states like Texas and Florida have made it illegal for municipalities to pass their own heat ordinances.

Christman points out that heat, which can cause tiredness or confusion, can be the underlying cause of other incidents like forklift collisions or car accidents on the commute home.

“I think it will be very interesting to see whether or not we see not only a decrease in straight up heat illness, but also a decrease in all these other kinds of injuries. And if in fact, the workplace just starts to become exponentially safer,” she said.

If a federal standard goes into effect, experts say enforcement will still be a challenge. OSHA has fewer than 2,000 inspectors responsible for nearly eight million worksites.