Alvin Scott made a habit of covering the shifts of fellow solid waste workers who were struck down by summer heat.

The former Department of Public Works employee said he watched people suffer strokes, fainting, vomiting and severe dehydration — all to survive a day of tossing trash in the back of a truck.

In Scott’s six years picking up waste for the Eastern Sanitation Yard on Bowleys Lane, he said he could not recall his employer providing water or time for breaks on hot days. So when he heard last Friday that 36-year-old Ronald Silver II died of heatstroke while picking up waste along an afternoon route, Scott was not surprised.

“It’s one of those jobs where they don’t care about you out there,” said Scott, who said he left DPW in 2019 due to an injury. “You pass out and they would go get another man.”

This year, more than 1,000 Marylanders have sought medical assistance for heat-related illness. Emergency room and urgent care visits for heatstroke, heat exhaustion and hyperthermia are the highest recorded in the last five years, according to the health department.

Yet, since 2019, the Maryland agency responsible for investigating unsafe work environments initiated only 32 inspections into employers reported for heat stress-related issues, according to data obtained by The Baltimore Banner.

The absence of inspections does not mean employees spent the last five years unaffected by heat exposure, said Devki Virk, commissioner of Maryland’s Division of Labor and Industry, which oversees the state’s Occupational Safety and Health agency (MOSH). It only means they have not received a report, she said.

The Department of Labor was unable to provide numbers on how many reports of heat-related concerns MOSH has received since 2019. Reports are submitted from a wide variety of sources, from federal partners to phone calls and emails, Virk said.

Employers are only required to report incidents that violate safety standards to MOSH. But until this summer, Maryland had not proposed rules identifying the heat-related hazards likely to harm workers.

Multiple experts say the lack of safety enforcement by the state agency stems from years of neglect under former Gov. Larry Hogan’s administration. When Gov. Wes Moore inherited the agency in 2023, about 28% of staff positions had been left vacant. While Moore’s administration tried to rebuild — reducing vacancies, raising penalties on employers violating workers’ safety and pushing standards on workforce heat protection — the agency remains strapped for resources.

Stuart Katzenberg, director of growth and collective bargaining for AFSCME Council 3, called the lack of MOSH inspections “terribly disappointing.” His group, along with city council members and Moore, have called for an investigation into the death of Silver. Baltimore Mayor Brandon Scott on Wednesday acknowledged problems within DPW and promised to hold those responsible for harming employees to account.

Katzenberg described MOSH under Hogan as “hollowed out.” The former governor created an eight-year barrier to implementing heat protections, Katzenberg said. In Hogan’s first year in office, the number of formal complaints investigated by MOSH dropped from 106 to 92. That number later dipped to levels lower than those under previous Gov. Martin O’Malley or Moore, falling to 72 in 2019 and diving another 29% the following year, according to state budget plans.

Michael Ricci, a representative for Hogan, said the administration deeply appreciated the work of employees who helped navigate turnover in the agency resulting from the pandemic. He cited a report issued by the state agency that showed MOSH meeting the majority of their inspection enforcement goals and their fatality inspection goals.

There are five fewer safety compliance officers and three fewer inspectors than needed to match the standards set by the federal Occupational Safety and Health Administration agency, according to a federal review of MOSH. The review also discovered staff failed to respond to complaints of serious safety violations filed using Maryland’s online reporting forum between October 2022 though September 2023.

Attracting workers and retaining them have been chronic issues, said Jamie Mangrum, a spokeswoman for the state Department of Labor. She did not comment on how the vacancies are affecting MOSH’s ability to investigate employers.

Only one of the 32 heat-related inspections carried out by MOSH since 2019 involved waste management, with the majority targeting food service industries, according to Department of Labor data.

A bill passing through the state legislature aims to set an enforceable heat standard, as do rules published in the state register last week. The proposed changes set a baseline for what employers must provide to protect workers, including at least 32 ounces of water per day at no cost, access to shaded rest areas and at least ten minute breaks every two hours spent working in temperatures over 90 degreest.

The rules will go through a 30-day comment period, which then leaves commissioner Virk 16 days to revise them before they are adopted.

The rules also give employers options for meeting the new benchmarks. Acclimatization plans to help workers adapt to the temperature can either be a mix of cooling measures or a gradual rise in their time spent in heat. Health care professionals and labor advocates participated in drafting the minimum requirements to keep sites cool, and give both inspectors and workers a standard barometer on what qualifies as a safety violation, Virk said.

The Maryland rules as currently stated are more aggressive than the heat standards proposed by the OSHA in recent weeks, according to Debbie Berkowitz, a now retired senior policy advisor and chief of staff for the Occupational Safety and Health Administration. It will hopefully be finalized faster, she said, as the federal proposals are likely years away from being implemented.

“I’m sad we didn’t have this standard already because maybe [Silver’s] death would have been prevented,” Berkowitz said.

Despite efforts to improve safety, workers are doubtful that conditions will change. Two recent reports by the Baltimore inspector general revealed dilapidated water fountains, bathrooms and air conditioners within Public Works facilities, including the former workplaces of both Silver and Scott.

Scott said he tried to report the issues he saw to supervisors more than once. It’s unclear to him whether changes were made.

The Department of Public Works did not respond to requests for comment.

Looking back, Scott said he got out of the yard relatively unscathed, with one injury from falling off a truck. On hot days, he still remembers the older men inside the Bowleys Lane locker room, dizzy from the heat. He wonders if they will ever find a way to cool down.