A maintenance worker pushes a refuse cart in the sun, Friday, Aug. 25, 2023, in Las Vegas. AP RENO, Nevada — Santos Brizuela spent more than two decades laboring outdoors, persisting despite a bout of heatstroke while cutting sugarcane in Mexico and chronic laryngitis from repeated exposure to the hot sun while on various other jobs. But last summer, while on a construction crew in Las Vegas, he reached his breaking point. Exposure to the sun made his head ache immediately. He lost much of his appetite.

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