On August 1, 2006, a 44-year-old Hispanic migrant farm worker (the victim) died after succumbing to heat stroke while working in a tobacco field on a farm in North Carolina. The victim arrived on the farm from Mexico on July 21, 2006. On July 24 he was assigned to work in the tobacco fields, where he worked for the next week. On August 1, 2006, he started work at 7 a.m., had a short break between 9 and 10 a.m. that included soda and crackers, and ate lunch between noon and 1 p.m. The weather was hot and humid with a heat index (a measure of the combined effects of high temperatures and high humidity on the body) between 100 and 110. He had been working in a tobacco field when around 3 p.m. he complained to the crew leader that he was not feeling well. The victim drank some water and was driven back to the workers' housing and left alone to rest. At approximately 3:45 p.m. the victim was found unconscious on the steps of the house. Emergency medical service (EMS) personnel were immediately called and responded within five minutes. The victim was transported to the hospital where his core body temperature was recorded at 108º F and he was pronounced dead. NIOSH investigators determined that to help prevent similar occurrences agricultural employers should: 1. develop, implement, and enforce a comprehensive safety and health program which includes standard operating procedures for prevention of heat-related illnesses; 2. train supervisors and employees on how to prevent, recognize, and treat heat illness, using a language and literacy level that workers can understand; 3. establish a hydration program which provides adequate potable water (or other appropriate hydrating fluid) for each employee and which encourages workers to drink at regular intervals; 4. monitor environmental conditions and develop work/rest schedules to accommodate high heat and humidity; 5. provide an appropriate acclimatization program for new workers to a hot environment, workers who have not been on the job for over a week, and experienced workers during a rapid change to excessively hot weather; and, 6. provide prompt medical attention to workers who show signs or symptoms of heat illness.