On Monday, Sept. 30, Maryland became the first state in the eastern U.S. to implement a heat standard for workers. The standard applies to both indoor and outdoor work and kicks in when the “heat index” (a combination of air temperature and humidity) equals or exceeds 80 degrees Fahrenheit. The standard requires employers to provide shaded areas to exposed employees as close to the work area as practicable and at least 32 ounces of drinking water per hour at no cost to the employee, as well as to encourage workers to take rest breaks as needed to prevent heat-related illness. Special procedures will go into effect when the heat index rises above 90 degrees Fahrenheit, including a mandate for a minimum rest period of 10 minutes for every two hours worked when the heat index is above 90 degrees and below 100 degrees, and a mandate for a minimum rest period of 15 minutes for every hour worked when employees are exposed to a heat index above 100 degrees. An employer may be exempted from providing these rest breaks if “alternate cooling and control measures” are implemented, which are defined as “engineering, work practice, administrative or other controls to manage heat, including job rotation, mechanical ventilation systems, misting equipment, cooling vests, air-cooled or water-cooled garments, and access to recreational water.” Employers are further required to set up training programs for employees and supervisors so that they can recognize the symptoms of heat stress, know how to communicate and can handle medical emergencies.