Heat-related fatalities in North Carolina.

We used medical examiner's records to identify heat-related fatalities (N=161) that occurred during the period January 1, 1977, to December 31, 2001, in North Carolina. Estimates of the population at risk were derived from US census data. Annual fatality rates increased with increases in average summer temperature and with the number of days per year at 90 degrees F or higher. Of the occupational heat-related fatalities (n=40), 45% occurred among farm laborers, many of whom died unnoticed and without medical attention.