If a roofer gets dizzy from the heat and falls to their death, the fall is going to be listed as a cause of death, not the heat. A trucker missing the back-up beep on a heavy vehicle, because they have a heat induced headache, will get listed as a vehicular accident, not heat-related. The death of an undocumented farmworker from lack of water will likely never be listed.
So, statistics that the Bureau of Labor Statistics have on environmental heat deaths — 436 from 2011-2021 — and on serious injuries from heat — more than 70,000 workers from 1992 to 2017 — are undercounts.
While OSHA (Occupational Safety and Health Administration) has published some suggestions from the National Institute for Occupational Safety and Health (NIOSH) on how to deal with workplace heat stress, it has not created rules which would be legally enforceable mandates specifying breaks, access to shade and water, health monitoring and acclimatization — the process of gradually building tolerance to heat.