Extreme heat events directly impact worker health and cause additional cascading and transitional workplace impacts. However, current investigations on these impacts often rely on specific datasets (e.g., compensation claims, hospitalizations). Thus, to continue to work towards preventing and mitigating the occupational risks posed by extreme heat events, this study aimed to explore the occupational impacts of the 2021 Heat Dome in Canada using a qualitative content analysis method on a news-based dataset. A systematized review of news articles published before, during, and after the 2021 Heat Dome was conducted on academic (n = 8) and news (n = 5) databases, along with targeted grey literature. Two researchers qualitatively coded the articles in NVivo for occupational impacts or references mentioned within the articles. Overall, 52 different occupations were identified as being impacted by the 2021 Heat Dome. Impacts were diverse and ranged from work cancellations or delays to work modifications and reports of heat-related illnesses. The 2021 Heat Dome impacted the health and safety of many occupational groups and provided new insights into the expanding impacts that extreme heat events can have on the Canadian workforce. With climate projections showing a growing trend of more hot days and intense heat waves in Canada, addressing these concerns should be a critical priority.
Workers, particularly outdoor workers, are among the populations most disproportionately affected by climate-related hazards. However, scientific research and control actions to comprehensively address these hazards are notably absent. To assess this absence, a seven-category framework was developed in 2009 to characterize the scientific literature published from 1988-2008. Using this framework, a second assessment examined the literature published through 2014, and the current one examines literature from 2014-2021. The objectives were to present literature that updates the framework and related topics and increases awareness of the role of climate change in occupational safety and health. In general, there is substantial literature on worker hazards related to ambient temperatures, biological hazards, and extreme weather but less on air pollution, ultraviolet radiation, industrial transitions, and the built environment. There is growing literature on mental health and health equity issues related to climate change, but much more research is needed. The socioeconomic impacts of climate change also require more research. This study illustrates that workers are experiencing increased morbidity and mortality related to climate change. In all areas of climate-related worker risk, including geoengineering, research is needed on the causality and prevalence of hazards, along with surveillance to identify, and interventions for hazard prevention and control.
Some impacts of climate change that are expected to affect the American workforce are rising temperatures, greater prevalence of wildland fires, increase in Lyme disease, and exposure to insecticides. The purpose of this study was to assess how fatal and non-fatal occupational injuries due to environmental heat, forest/brush fires, Lyme disease, and exposure to insecticides have changed over time in the United States and if there were any significant relationships between national occupational injury/illness data and national temperature trends. METHODS: Linear regression models assessed fatal and non-fatal injuries/illnesses since 1992 by both the frequency of incidents and the proportion of total incidents and the effects of national average temperatures. RESULTS: There were significant increases in occupational fatalities and illnesses due to exposure to environmental heat and national average annual temperatures were predictive of heat exposure fatalities and illnesses. CONCLUSION: Heat exposure is an occupational hazard that must be managed carefully in the coming years. Organizations will need to take more aggressive heat exposure control measures as temperatures continue to rise and remain hotter for longer periods during the year. While not currently showing increasing trends on a national scale, the prevalence of occupational incidents due to forest/brush fires, Lyme disease, and insecticides should be monitored as the United States experiences more of the projected impacts of climate change.
BACKGROUND: Northern Finland, like the rest of the Arctic, has experienced increases in mean annual temperature, the number of winter rains, the number of thaw-freeze days, the number of extremely warm weather events, and a shortened snow season. These changes have produced numerous problems for reindeer herders whose livelihoods rely on a healthy ecosystem with predictable weather patterns. METHODS: We performed a scoping literature review to assess how climate change induced extreme weather has negatively impacted reindeer herding as well as the health and wellbeing of reindeer herders. RESULTS: Late snow cover negatively impacts reindeer herding through a more widely dispersed herd that increases the work to gather reindeer, leads to reduced calf weight, and results in less meat for sale. This increased labor, especially in extreme cold conditions, can also negatively impact reindeer herder health. Icing due to thaw-freeze and rain-on-snow events makes it impossible for reindeer to dig through the snow to access lichens, increasing the need for reindeer herders to keep the herd in winter enclosures and provide supplemental feed. CONCLUSION: Climate change induced weather events such as late snow cover and icing increase reindeer herder efforts and expenses, put their livelihood at risk, and put their health at risk.
To assess the population health impact of high temperatures on workplace health and safety by estimating the burden of heat-attributable occupational injury in Australia. Retrospective observational study; estimation of burden of occupational injury in Australia attributable to high temperatures during 2014-19, based on Safe Work Australia (work-related traumatic injury fatalities and workers’ compensation databases) and Australian Institute of Health and Welfare data (Australian Burden of Disease Study and National Hospital Morbidity databases), and a meta-analysis of climate zone-specific risk data. Burden of heat-attributable occupational injuries as disability-adjusted life years (DALYs), comprising the numbers of years of life lived with disability (YLDs) and years of life lost (YLLs), nationally, by Köppen-Geiger climate zone, and by state and territory. During 2014-19, an estimated 42 884 years of healthy life were lost to occupational injury, comprising 39 485 YLLs (92.1%) and 3399 YLDs (7.9%), at a rate of 0.80 DALYs per 1000 workers per year. A total of 967 occupational injury-related DALYs were attributable to heat (2.3% of occupational injury-related DALYs), comprising 890 YLLs (92%) and 77 YLDs (8%). By climate zone, the heat-attributable proportion was largest in the tropical Am (12 DALYs; 3.5%) and Aw zones (34 DALYs; 3.5%); by state and territory, the proportion was largest in New South Wales and Queensland (each 2.9%), which also included the largest numbers of heat-attributable occupational injury-related DALYs (NSW: 379 DALYs, 39% of national total; Queensland: 308 DALYs; 32%). An estimated 2.3% of the occupational injury burden in Australia is attributable to high ambient temperatures. To prevent this burden increasing with global warming, adaptive measures and industry-based policies are needed to safeguard workplace health and safety, particularly in heat-exposed industries, such as agriculture, transport, and construction.
Heat stress is a harmful physical hazard in many occupational settings. However, consequences of occupational heat exposure among workers in a sugarcane factory in Ethiopia are not well characterized. This study aimed to assess the level of occupational heat exposure-related symptoms and contributing factors. In this cross-sectional study, five workstations were selected for temperature measurement. Heat stress levels were measured using a wet-bulb globe temperature index meter. A stratified random sampling technique was used to select 1,524 participants. Heat-related symptoms were assessed using validated questionnaires. The level of occupational heat exposure was 72.4% (95% CI: 70.2%-74.8%), while 71.6% (95% CI: 69.3%-74.9%) of participants experienced at least one symptom related to heat stress. The most common heat-related symptoms were swelling of hands and feet (78%), severe thirst (77.8%) and dry mouth (77.4%). The identified risk factors were a lack of reflective shields (AOR: 2.20, 95% CI: 1.53, 3.17), not-enclosed extreme heat sources (AOR: 1.76, 95% CI: 1.23, 2.51), a lack of access to shade (AOR: 9.62, 95% CI: 6.20, 14.92), and inappropriate protective clothing provision (AOR: 1.58, 95% CI: 1.27, 2.71). The burden of occupational heat exposure and heat-induced symptoms was high. Lack of reflective shields, the absence of enclosed extreme heat sources, a lack of access to shade, and inappropriate protective clothing provision were considerable attributes of heat stress. Therefore, the use of mechanical solutions to stop heat emissions at their sources and the key factors identified were areas for future intervention.
Due to climate change crisis, the risk of occupational heat stress for agricultural workers has recently increased. The temporal and spatial biometeorological conditions in different climatic regions of Slovenia during summer were analyzed using the Universal Thermal Climate Index (UTCI), and additionally the water loss index (SW) and the accepted level of physical activity (MHR). Term values of air temperature, relative air humidity, wind speed at 10 m and cloud cover at 14:00 CEST were used as input for the BioKlima 2.6 software package and were retrieved from the Slovenian Environment Agency for the summer months in the period 2000-2021. The rise in the average UTCI values was shown to be positive and statistically significant for summer (0.7 degrees C/decade) as well as for all three months, the highest being for June (0.9 degrees C/decade). The percentage of summer days during 2000-2021 that were under strong or very strong heat stress varied widely by location, ranging from one-third to more than one-half. Average monthly UTCI values at 14:00 CEST were the highest in July, reaching 30 degrees C in a submediterranean climate, Crnomelj is the only station with this average higher than 32 degrees C. Daily highest UTCI value was 47 degrees C (Crnomelj). It was shown that conditions in the middle of a hot summer day are not suitable for moderate or severe agricultural workloads.
Natural disasters, including floods, earthquakes, and hurricanes, result in devastating consequences at the individual and community levels. To date, much of the research reflecting the consequences of natural disasters focuses heavily on victims, with little attention paid to the personnel responding to such disasters. We conducted a systematic review of the challenges faced by military, medical and public safety personnel supporting natural disaster relief operations. Specifically, we report on the current evidence reflecting challenges faced, as well as positive outcomes experienced by military, medical and public safety personnel following deployment to natural disasters. The review included 382 studies. A large proportion of the studies documented experiences of medical workers, followed by volunteers from humanitarian organizations and military personnel. The most frequently reported challenges across the studies were structural (i.e., interactions with the infrastructure or structural institutions), followed by resource limitations, psychological, physical, and social challenges. Over 60% of the articles reviewed documented positive or transformative outcomes following engagement in relief work (e.g., the provision of additional resources, support, and training), as well as self-growth and fulfillment. The current results emphasize the importance of pre-deployment training to better prepare relief workers to manage expected challenges, as well as post-deployment supportive services to mitigate adverse outcomes and support relief workers’ well-being.
BACKGROUND: Heat exposures occur in many occupations. Heat has been linked to key carcinogenic processes, however, evidence for associations with cancer risk is sparse. We examined potential associations between occupational heat exposure and prostate cancer risk in a multi-country study. METHODS: We analysed a large, pooled dataset of 3142 histologically confirmed prostate cancer cases and 3512 frequency-matched controls from three countries: Canada, France, and Spain. Three exposure indices: ever exposure, lifetime cumulative exposure and duration of exposure, were developed using the Finnish Job-Exposure Matrix, FINJEM, applied to the lifetime occupational history of participants. We estimated odds ratios (ORs) and 95% confidence intervals (CIs), using conditional logistic regression models stratified by 5-year age groups and study, adjusting for potential confounders. Potential interactions with exposure to other occupational agents were also explored. RESULTS: Overall, we found no association for ever occupational heat exposure (OR 0.97; 95% CI 0.87, 1.09), nor in the highest categories of lifetime cumulative exposure (OR 1.04; 95% CI 0.89, 1.23) or duration (OR 1.03; 95% CI 0.88, 1.22). When using only the Spanish case-control study and a Spanish Job Exposure Matrix (JEM), some weakly elevated ORs were observed. CONCLUSIONS: Findings from this study provide no clear evidence for an association between occupational heat exposure and prostate cancer risk.
INTRODUCTION: While there is consistent evidence on the effects of heat on workers’ health and safety, the evidence on the resulting social and economic impacts is still limited. A scoping literature review was carried out to update the knowledge about social and economic impacts related to workplace heat exposure. METHODS: The literature search was conducted in two bibliographic databases (Web of Science and PubMed), to select publications from 2010 to April 2022. RESULTS: A total of 89 studies were included in the qualitative synthesis (32 field studies, 8 studies estimating healthcare-related costs, and 49 economic studies). Overall, consistent evidence of the socioeconomic impacts of heat exposure in the workplace emerges. Actual productivity losses at the global level are nearly 10% and are expected to increase up to 30-40% under the worst climate change scenario by the end of the century. Vulnerable regions are mainly low-latitude and low- and middle-income countries with a greater proportion of outdoor workers but include also areas from developed countries such as southern Europe. The most affected sectors are agriculture and construction. There is limited evidence regarding the role of cooling measures and changes in the work/rest schedule in mitigating heat-related productivity loss. CONCLUSION: The available evidence highlights the need for strengthening prevention efforts to enhance workers’ awareness and resilience toward occupational heat exposure, particularly in low- and middle-income countries but also in some areas of developed countries where an increase in frequency and intensity of heat waves is expected under future climate change scenarios.
Insufficient heat acclimatization is a risk factor for heat-related illness (HRI) morbidity, particularly during periods of sudden temperature increase. We sought to characterize heat exposure on days before, and days of, occupational HRIs. A total of 1241 Washington State workers’ compensation State Fund HRI claims from 2006 to 2021 were linked with modeled parameter-elevation regressions on independent slopes model (PRISM) meteorological data. We determined location-specific maximum temperatures (T(max,PRISM) ) on the day of illness (DOI) and prior days, and whether the T(max,PRISM) was ≥10.0°F (~5.6°C) higher than the average of past 5 days (“sudden increase”) for each HRI claim. Claims occurring on days with ≥10 HRI claims (“clusters”) were compared with “non-cluster” claims using t tests and χ(2) tests. RESULTS: Seventy-six percent of analyzed HRI claims occurred on days with a T(max,PRISM) ≥ 80°F. Claims occurring on “cluster” days, compared to “non-cluster” days, had both a significantly higher mean DOI T(max,PRISM) (99.3°F vs. 85.8°F [37.4°C vs. 29.9°C], t(148) = -18, p < 0.001) and a higher proportion of "sudden increase" claims (80.2% vs. 24.3%, χ(2) [1] = 132.9, p < 0.001). Compared to "cluster" days, HRI claims occurring during the 2021 Pacific Northwest "heat dome" had a similar increased trajectory of mean T(max,PRISM) on the days before the DOI, but with higher mean T(max,PRISM.) Occupational HRI risk assessments should consider both current temperatures and changes in temperatures relative to prior days. Heat prevention programs should include provisions to address acclimatization and, when increases in temperature occur too quickly to allow for sufficient acclimatization, additional precautions.
OBJECTIVE: Climate change has implications for human health worldwide, with workers in outdoor occupations in low- to middle-income countries shouldering the burden of increasing average temperatures and more frequent extreme heat days. An overlooked aspect of the human health impact is the relationship between heat exposure and increased risk of occupational injury. In this study, we examined the association between occupational injury occurrence and changes in outdoor temperatures through the workday among a cohort of Guatemalan sugarcane harvesters. METHODS: Occupational injuries recorded for the 2014/2015 to 2017/2018 harvest seasons were collected from a large agribusiness employing male sugarcane harvesters in Southwest Guatemala. Wet Bulb Globe Temperature (WBGT) for the same period was collected from the El Balsamo weather station. We used a logistic mixed effects model to examine the association between injury occurrence and (1) the average WBGT during the hour injury was recorded, (2) the average WBGT during the hour prior to the injury being recorded, and (3) the change in the hourly average WBGT prior to the injury being recorded. RESULTS: There were 155 injuries recorded during the study period. Injuries were recorded most often between 14:00 and 16:00 (n = 62, 40%) followed by 8:00 and 10:00 (n = 56, 36%). There were significant differences in the average hourly WBGT and the hour in which injuries were recorded (p-value <.001). There were no observable associations between average hourly WBGT (OR: 1.00, 95%CI: 0.94, 1.05; p-value: 0.87), lagged average hourly WBGT (OR: 1.01, 95%CI: 0.97, 1.05; p-value: 0.71), or change in average hourly WBGT (OR: 0.96, 95%CI: 0.89, 1.04; p-value: 0.35) and recorded occupational injury. CONCLUSIONS: This is the first study that has examined how changes in WBGT throughout the day are related to occupational injury among agricultural workers. Although this study did not demonstrate an association, there is a need for future research to examine how various measurements of WBGT exposure are related to occupational injury in agricultural worker populations.
Respiratory diseases of infectious, allergic, neoplastic or degenerative origin are due to the interaction of environmental and occupational risk factors, individual susceptibility and other co-factors and comorbidities. Asthma and other respiratory pathologies can be worsened by climate change and exposure to other agents in occupational environments.PubMed and Scopus, and several websites on public and occupational health were queried to find publications and documents on work-related respiratory diseases, asthma, rhinitis, chronic obstructive pulmonary disease (COPD), pneumoconiosis and allergic alveolitis in association with climate change. Most of the retrieved articles concerned asthma (75 in Scopus), while the other topics were less frequently covered in the scientific literature, with a maximum of 29 papers for rhinitis and 23 for COPD. The most important terms highlighted by the word clouds were ‘health’, ‘air’, ‘pollution’, and, only for asthma and rhinitis, ‘pollen’ and ‘allergic/allergy’. Website data on public and occupational health, and climate change were reported. Assessment and management of respiratory diseases that recognise occupational exposures should be improved, and more research into integrated approaches should be favoured. Health surveillance practices for workers exposed to agents that cause respiratory diseases should be implemented. The development of biomarkers of exposure, effect and susceptibility needs further study.
Introduction: Mass mortality events (MMEs) involve the sudden death of thousands to millions of fish. MMEs are a serious problem in marine finfish aquaculture globally and may become more common with climate change. They can entail significant asset losses; pose compliance threats to environmental and animal health, and occupational health and safety obligations; and may undermine social license to operate. MMEs may be defined as major accidents in that they require rapid mobilization of workers, vessels and other supports and working under pressure to a) investigate the extent and cause of the die-off; b) remove, transport, and dispose of dead finfish; and c) adjust farm design and practices to reduce future risk. As with other such events, MMEs have the potential to cause injury or fatalities to persons, damage to cages and vessels and also substantially reduce the welfare or number of fish. Still, no existing research has explored the potential aquaculture occupational health and safety (AOHS) hazards and risks associated with responding to MMEs.Materials and methods: An international AOHS research team performed a desktop exercise using information on definitions of MMEs, incident reports, legal and regulatory guidance and documentation and media coverage to generate five country profiles (Canada, Chile, Ireland, Norway, Scotland) of potential AOHS hazards and risks associated with MMEs. Country profile findings were synthesized and incorporated into a multi-disciplinary, expert elicitation risk assessment process to identify causes and consequences of MMEs.Results: Findings indicate variability in MME definitions, requirements for event reporting and AOHS-related contingency planning across countries. To highlight key hazards and potential pathways between MME -prevention planning, monitoring and response and AOHS risks a preliminary bow-tie risk analysis is conduct-ed. Bow-tie risk analysis is a graphical tool to illustrate an accident scenario, with accident causes on one side of the tie and consequences on the other. These findings are also relevant for AOHS in general.Conclusions: AOHS concerns need to be fully and effectively integrated into broader risk assessments and sur-veillance systems to prevent MMEs and reduce their consequences in marine finfish aquaculture.
The intensity and frequency of wildfires is increasing globally. The systematic review of the current evidence on long-term impacts of non-occupational wildfire exposure on human health has not been performed yet. To provide a systematic review and identify potential knowledge gaps in the current evidence of long-term impacts of non-occupational exposure to wildfire smoke and/or wildfire impacts on human health. We conducted a systematic search of the literature via MEDLINE, Embase and Scopus from the database inception to July 05, 2022. References from the included studies and relevant reviews were also considered. The Newcastle-Ottawa Scale (NOS) and a validated quality assessment framework were used to evaluate the quality of observational studies. Study results were synthesized descriptively. A total of 36 studies were included in our systematic review. Most studies were from developed countries (11 in Australia, 9 in Canada, 7 in the United States). Studies predominantly focused on mental health (21 studies, 58.33%), while evidence on long-term impacts of wildfire exposure on health outcomes other than mental health is limited. Current evidence indicated that long-term impacts of non-occupational wildfire exposure were associated with mortality (COVID-19 mortality, cardiovascular disease mortality and acute myocardial disease mortality), morbidity (mainly respiratory diseases), mental health disorders (mainly posttraumatic stress disorder), shorter height of children, reduced lung function and poorer general health status. However, no significant associations were observed for long-term impacts of wildfire exposure on child mortality and respiratory hospitalizations. The population-based high-quality evidence with quantitative analysis on this topic is still limited. Future well-designed studies considering extensive wildfire smoke air pollutants (e.g., particulate matter, ozone, nitrogen oxides) and estimating risk coefficient values for extensive health outcomes (e.g., mortality, morbidity) are warranted to fill current knowledge gaps.
Increased risk of occupational injuries and illnesses (OI) is associated with ambient temperature. However, most studies have reported the average impacts within cities, states, or provinces at broader scales. METHODS: We assessed the intra-urban risk of OI associated with ambient temperature in three Australian cities at statistical area level 3 (SA3). We collected daily workers’ compensation claims data and gridded meteorological data from July 1, 2005, to June 30, 2018. Heat index was used as the primary temperature metric. We performed a two-stage time series analysis: we generated location-specific estimates using Distributed Lag Non-Linear Models (DLNM) and estimated the cumulative effects with multivariate meta-analysis. The risk was estimated at moderate heat (90th percentile) and extreme heat (99th percentile). Subgroup analyses were conducted to identify vulnerable groups of workers. Further, the OI risk in the future was estimated for two projected periods: 2016-2045 and 2036-2065. RESULTS: The cumulative risk of OI was 3.4% in Greater Brisbane, 9.5% in Greater Melbourne, and 8.9% in Greater Sydney at extreme heat. The western inland regions in Greater Brisbane (17.4%) and Greater Sydney (32.3%) had higher risk of OI for younger workers, workers in outdoor and indoor industries, and workers reporting injury claims. The urbanized SA3 regions posed a higher risk (19.3%) for workers in Greater Melbourne. The regions were generally at high risk for young workers and illness-related claims. The projected risk of OI increased with time in climate change scenarios. CONCLUSIONS: This study provides a comprehensive spatial profile of OI risk associated with hot weather conditions across three cities in Australia. Risk assessment at the intra-urban level revealed strong spatial patterns in OI risk distribution due to heat exposure. These findings provide much-needed scientific evidence for work, health, and safety regulators, industries, unions, and workers to design and implement location-specific preventative measures.
The quality of health services in flood disaster conditions still needs to get better attention because health workers carry out actions in this condition that are not yet effective. It was closely related to the quality of preparedness of these health workers. It can reflect whether there was an integration of health workers’ knowledge, attitude, and preparedness in dealing with flood disasters.The study used a mixed method consisting of a quantitative design with a correlation test and a qualitative design with interviews. The quantitative design study involved a total population of 22 health workers, and the qualitative design involved 8 participants who are representatives of each profession. Analysis used univariate analysis and bivariate analysis with Fisher’s exact test. Knowledge and preparedness of health workers to face flood disasters were still not good and not ready when com pared to attitudes.Knowledge relates to preparing the health workers to face flood disasters with p 0.009, and a study with a qualitative design using eight participants who are representatives of each profession. Health workers dealing with flood disasters have not fully integrated knowledge, attitudes, and preparedness. We need to improve aspects of behavior that are still not optimal.
There has been an insurgence of allergic respiratory diseases such as asthma and rhinitis in industrialized countries in the last few decades as a result of the interaction between air pollutants and pollen, which has become a global and dramatic health problem. Air pollutants such as nitrogen dioxide, sulfur dioxide, ozone, and carbon dioxide affect the physical, chemical and biological properties of pollen such as the pollen content, production, and allergenicity, exacerbating symptoms in vulnerable subjects. When investigating these interactions and their effects, the environmental impact of climate change, weather variables and urbanization should be taken into account as well as the pollen species, type of pollutant, conditions of exposure, and individual susceptibility. Up to 25% of asthma adult cases are work-related, because several categories of workers in different sectors are exposed to aeroallergens and outdoor air pollutants. Thus, in this study, we evaluated the significant impacts of occupational allergies on worker’s health and quality of life. In summary, to assess the effect of interactions between air pollutants and pollen on public and occupational health, all the factors that play a role in this context will be investigated, including environmental factors, individual susceptibility in relation to pollen species, type of pollutants, and conditions of exposure.
Heatwaves, which are defined as prolonged periods of time when the weather is much hotter than usual, have been always serious threats to the occupational health and productivity of workers. To reduce the risk of occupational health hazards during heatwaves, various heat protection methods have been developed and applied. One of the proposed methods is to apply personal cooling onto a certain local body part of the worker, like one’s neck or one’s torso, using thermoelectric coolers. Several commercial solutions of this type are already available in the market, but a rigorous analysis of the effects of local cooling of body parts is not yet widely available. In this study, we use a human thermal behavior model, i.e., the FIALA-FE model, to assess the effectiveness of such a personal local cooling device under heatwaves. A whole-body thermal comfort index, i.e., predicted mean vote (PMV), and a local thermal sensation index, i.e., Zhang’s local thermal comfort index, are calculated under local cooling conditions of various body parts and compared to those without any cooling to assess the effectiveness of such a local cooling strategy. Our result shows that the local cooling strategy may provide only limited protection against extreme thermal conditions like heatwaves, suggesting that basic measures for the protection of workers including assured access to drinking water, frequent rest breaks, reduction of working hours, and suspension of work must remain as the primary means for protecting workers during heatwaves.
Increases in population exposure to humid heat extremes in agriculturally-dependent areas of the world highlights the importance of understanding how the location and timing of humid heat extremes intersects with labor-intensive agricultural activities. Agricultural workers are acutely vulnerable to heat-related health and productivity impacts as a result of the outdoor and physical nature of their work and by compounding socio-economic factors. Here, we identify the regions, crops, and seasons when agricultural workers experience the highest hazard from extreme humid heat. Using daily maximum wet-bulb temperature data, and region-specific agricultural calendars and cropland area for 12 crops, we quantify the number of extreme humid heat days during the planting and harvesting seasons for each crop between 1979-2019. We find that rice, an extremely labor-intensive crop, and maize croplands experienced the greatest exposure to dangerous humid heat (integrating cropland area exposed to >27 degrees C wet-bulb temperatures), with 2001-2019 mean rice and maize cropland exposure increasing 1.8 and 1.9 times the 1979-2000 mean exposure, respectively. Crops in socio-economically vulnerable regions, including Southeast Asia, equatorial South America, the Indo-Gangetic Basin, coastal Mexico, and the northern coast of the Gulf of Guinea, experience the most frequent exposure to these extremes, in certain areas exceeding 60 extreme humid heat days per year when crops are being cultivated. They also experience higher trends relative to other world regions, with certain areas exceeding a 15 day per decade increase in extreme humid heat days. Our crop and location-specific analysis of extreme humid heat hazards during labor-intensive agricultural seasons can inform the design of policies and efforts to reduce the adverse health and productivity impacts on this vulnerable population that is crucial to the global food system.
Work accidents result in consequences to the employment of the population and increasing public spendings. Caused by workplace and work activity characteristics, occupational accidents may also derive from ergonomics and comfort issues. Heat stress is a discomfort factor that affects workers when exposed to temperatures above the body limits, resulting in exhaustion, dizziness, reduced cognitive performance and, eventually, injuries and accidents. Under the current climate change scenario characterized by increase of temperature projections all around the world, the heat stress issue becomes even more significant. However, in Brazil, this topic is yet little explored, especially regarding the investigation of historical data on occupational accidents considering the climatic variables. This paper aims at filling a part of this gap by presenting a new database that unifies a work accident database -recording from 2006 to 2019 -with meteorological data of the place and time of the accident. We investigate the relationship between these two datasets through the application of Multiple Correspondence Analysis (MCA) in the R Software. Our results show some association between accident variables and heat stress variables. We identify some of the more critical workers’ characteristics in this context and the most exposed regions of Brazil. Our database allows the continuity and expansion of this type of research in Brazil, and the MCA results point to a positive association between the occurrence of accidents with climatic variables. It may pave a new path for research that can detail and deepen the discussion on the behavior of these variables.
The transportation industry employs a wide range of workers, from truck drivers to construction workers operating in active traffic zones. Workers are constantly exposed to unfavorable temperatures that affect their physical and mental health, making it important for them to have longer and more frequent rest periods to recover. Therefore, the objective of this study is to investigate the various factors that contribute to the need for longer breaks when working in cold temperatures. To achieve this objective, a comprehensive questionnaire survey was developed and distributed online to workers in the construction industry. Total responses gathered from the survey distribution were 100 responses. The survey data was used to develop a predictive logistic regression model. The results revealed that dexterity, ineffective cold protective clothing, and the lack of a sufficient cold protection plan are significant indicators that contribute to the need for workers for longer breaks. However, other factors, such as worker age, gender, fatigue, and mental stress, were not significant enough to contribute to the need for extended breaks. The results also indicated that reduced exposure to cold weather with sufficient protective clothing can help in improving their performance in cold temperatures. The outcomes from this study will help employers in construction industry to develop an efficient cold weather work-rest regime, as they understand the various health challenges construction workers experience in cold temperatures, as well as the factors that contribute to their need for extended recovery periods.
Thailand is a tropical developing country which has a serious increase in health risk due to hot weather exposure among outdoor workers. OBJECTIVES: The aims of this study were to compare the factors related to environmental heat exposure in three different seasons, and to assess the relationship between environmental heat and dehydration status in each season among farmworkers in Nakhon Ratchasima, Thailand. METHODS: A semi-longitudinal study was carried out in 22 male farmworkers throughout a year of farming. The primary data were collected in farmworkers for socio-demographic information, clinical assessments, and heat-related illnesses. RESULTS: Average of environmental heat index (Median, SD) were severe in summer (WBGT=38.1, 2.8°C), rainy season (WBGT=36.1, 2.1°C), and winter (WBGT=31.5, 2.7°C). Average urine Sp. Gr. in summer, rainy season, and winter were 1.022, 1.020, and 1.018 respectively. The third sentence should be corrected as follows: The Friedman analysis revealed a statistically significant difference between the three different seasons in WBGT (wet bulb globe temperature), body temperature, heart rate (P<0.01), and respiratory rate (P<0.05). There was a statistically significant difference between the three different seasons for skin rash/itching, dizziness, muscle cramp dyspnea (P<0.05), and weakness (P<0.01). Wilcoxon signed-ranks analysis found a significant difference in the medians of the paired sets of urine Sp. Gr. values between baseline and summer (P<0.05). Spearman's rank correlation coefficient did not find a relationship between WBGT and urine Sp. Gr. in the three different seasons. CONCLUSIONS: This study demonstrated that farmworkers had exposure to environmental heat stress which was expressed through physical changes. Therefore, there is a need for either interventions or guidelines to prevent dehydration for outdoor workers in this region.
Forestry workers play a crucial role in implementing forest management programs, but their outdoor work exposes them to rising temperatures caused by global climate change, which poses potential health risks related to heat. This study specifically investigates the relationship between knowledge of heat-related issues, risk perception, and precautionary behavior among Indonesian forestry workers and paddy farmers in response to the escalating workplace heat exposure. Developing effective precautionary behavior is essential for preventing heat-related health disorders and promoting health protection programs. To investigate the association of the latent variables comprehensively, structured interviews were conducted with two occupational groups of outdoor workers, comprising 210 forestry workers and 215 paddy farmers. The findings indicate that increasing knowledge about heat-related issues promotes precautionary behavior, and risk perception acts as a mediator between knowledge and behavior. Additionally, the study highlights that the emotion of “dread” intensifies the perceived risk and predicts positive behavior changes. To enhance heat-related knowledge, exploring the potential use of a “fear” tone is important. In conclusion, comprehensive strategies should be implemented to promote precautionary behavior among forestry workers, particularly manual laborers, who are more vulnerable compared to farmers.
There is growing attention on occupational heat stress in Central America, as workers in this region are affected by a unique form of chronic kidney disease. Previous studies have examined wet bulb globe temperatures and estimated metabolic rates to assess heat stress, but there are limited data characterizing heat strain among these workers. OBJECTIVE: The aims were to characterize heat stress and heat strain and examine whether job task, break duration, hydration practices, and kidney function were associated with heat strain. METHODS: We used data from the MesoAmerican Nephropathy Occupational Study, a cohort of 569 outdoor workers in El Salvador and Nicaragua who underwent workplace exposure monitoring, including continuous measurement of core body temperature (T(c)), heart rate (HR), physical activity, and wet bulb globe temperature (WBGT), over the course of three days in January 2018 – May 2018. Participants represented five industries: sugarcane, corn, plantain, brickmaking, and construction. RESULTS: Median WBGTs were relatively high (>27 °C) at most sites, particularly when work shifts spanned the afternoon hours (e.g., 29.2 °C among plantain workers). Sugarcane workers, especially cane cutters in both countries and Nicaraguan agrichemical applicators, had the highest estimated metabolic rates (medians: 299-318 kcal/hr). Most workers spent little time on break (<10% of the shift), as determined by physical activity data. Overall, sugarcane workers-particularly those in Nicaragua-experienced the highest T(c) and HR values. However, a few workers in other industries reached high T(c) (>39 °C) as well. Impaired kidney function (estimated glomerular filtration rate <90 mL/min/1.73 m(2)) was associated with higher T(c) and HR values, even after adjustment. SIGNIFICANCE: This is the largest study to-date examining heat stress and strain among outdoor workers in Central America. Workers at sugar companies regularly experienced T(c) > 38°C (76.9% of monitored person-days at Nicaraguan companies; 46.5% at Salvadoran companies). Workers with impaired kidney function had higher measures of T(c) and HR. IMPACT STATEMENT: This study examined levels of occupational heat stress and heat strain experienced among outdoor workers in five industries in El Salvador and Nicaragua. We characterized heat stress using wet bulb globe temperatures and estimated metabolic rate and heat strain using core body temperature and heart rate. Sugarcane workers, particularly cane cutters and Nicaraguan agrichemical applicators, performed more strenuous work and experienced greater levels of heat strain. Impaired kidney function was associated with higher heart rates and core body temperatures.
Since the advent of coronavirus disease 2019 (COVID-19), healthcare workers (HCWs) wearing personal protective equipment (PPE) has become a common phenomenon. COVID-19 outbreaks overlap with heat waves, and healthcare workers must unfortunately wear PPE during hot weather and experience excessive heat stress. Healthcare workers are at risk of developing heat-related health problems during hot periods in South China. The investigation of thermal response to heat stress among HCWs when they do not wear PPE and when they finish work wearing PPE, and the impact of PPE use on HCWs’ physical health were conducted. The field survey were conducted in Guangzhou, including 11 districts. In this survey, HCWs were invited to answer a questionnaire about their heat perception in the thermal environment around them. Most HCWs experienced discomfort in their back, head, face, etc., and nearly 80% of HCWs experienced “profuse sweating.” Up to 96.81% of HCWs felt “hot” or “very hot.” The air temperature had a significant impact on thermal comfort. Healthcare workers’ whole thermal sensation and local thermal sensation were increased significantly by wearing PPE and their thermal sensation vote (TSV) tended towards “very hot.” The adaptive ability of the healthcare workers would decreased while wearing PPE. In addition, the accept range of the air temperature (T (a)) were determined in this investigation. Graphical Abstract.
Increasing heatwave frequency due to climate change threatens outdoor workers’ health. We aimed to assess the on-site heat strain level of outdoor workers using wearable sensors and identify the factors for consideration in developing individual-based heat adaptation strategies. Seven road construction workers were recruited and asked to wear necklace-form temperature loggers and smartwatches monitoring heart rate (HR). The questionnaire was delivered daily to ask about their psychological comfort level during work. Workers were exposed to up to 5.4 degrees C higher temperature than the official air temperature, indicating that the national heatwave alarm does not reflect on-site heat conditions. Based on the measured HR data, heat strain levels were defined. When HR exceeded the level of “180-age,” we assumed extreme heat strain occurred, which requires immediate cessation of work. When HR exceeded 40% of the individual heart rate reserve (the difference between the maximum and resting HR), we assumed high heat strain occurred, indicating a stressed condition. High heat strain occurred in all workers on 9 of the 13 monitored days, whereas the official heatwave alarms were issued only on four dates. Additionally, three workers experienced extreme heat strain on two dates. The main factor for workers experiencing extreme heat strain was age. Comparing the heat strain levels from HR with the survey results, we found that the older workers considered their condition comfortable even under extreme and high heat strain. Thus, an individual sensor-based early-warning system is needed to prevent heat strain not perceived by outdoor workers. The findings emphasize the need for a personalized adaptation strategy for heatwaves and will be a baseline for developing a new work manual that mainstreams climate change impacts.
OBJECTIVES: This study aims to assess the association between daily temperature and sickness absence episodes in the Mediterranean province of Barcelona between 2012 and 2015, according to sociodemographic and occupational characteristics. METHODS: Ecological study of a sample of salaried workers affiliated to the Spanish social security, resident in Barcelona province between 2012 and 2015. The association between daily mean temperature and risk of new sickness absence episodes was estimated with distributed lag non-linear models. The lag effect up to 1 week was considered. Analyses were repeated separately by sex, age groups, occupational category, economic sector and medical diagnosis groups of sickness absence. RESULTS: The study included 42,744 salaried workers and 97,166 episodes of sickness absence. The risk of sickness absence increased significantly between 2 and 6 days after the cold day. For hot days there was no association with risk of sickness absence. Women, young, non-manual and workers in the service sector had a higher risk of sickness absence on cold days. The effect of cold on sickness absence was significant for respiratory system diseases (RR: 2.16; 95%CI: 1.68-2.79) and infectious diseases (RR: 1.31; 95%CI: 1.04-1.66). CONCLUSION: Low temperatures increase the risk of having a new episode of sickness absence, especially due to respiratory and infectious diseases. Vulnerable groups were identified. These results suggest the importance of working in indoor and possibly poorly ventilated spaces in the spread of diseases that eventually lead to an episode of sickness absence. It is necessary to develop specific prevention plans for cold situations.
During summer heat waves, road workers are easily exposed to heat stress and faced with a high risk of thermal diseases and death, and thus preventive measures are required for their safety at the work site. To prepare response measures, it is necessary to estimate workers’ perceived temperature (PT) according to exposure time, road environment, clothing type, and work intensity. This study aimed to examine radiation (short-wave radiation and long-wave radiation) and other meteorological factors (temperature, humidity, and wind) in an actual highway work environment in summer and to estimate PT using the observation data. Analysis of radiation and meteorological factors on the road according to pavement type and weather revealed that more heat was released from asphalt than from concrete. Regression model analysis indicated that compared with young workers (aged 25-30 years), older workers (aged >= 60 years) showed a rapid increase in PT as the temperature increased. The temperatures that people actually feel on concrete and asphalt roads in heat wave conditions can be predicted using the PT values calculated by the regression models. Our findings can serve as a basis for measures to prevent workers from thermal diseases at actual road work sites.
The effects of heat on health have been well documented, while less is known about the effects among agricultural workers. Our aim is to estimate the effects and impacts of heat on occupational injuries in the agricultural sector in Italy. Occupational injuries in the agricultural sector from the Italian national workers’ compensation authority (INAIL) and daily mean air temperatures from Copernicus ERA5-land for a five-year period (2014-2018) were considered. Distributed lag non-linear models (DLNM) were used to estimate the relative risk and attributable injuries for increases in daily mean air temperatures between the 75th and 99th percentile and during heatwaves. Analyses were stratified by age, professional qualification, and severity of injury. A total of 150,422 agricultural injuries were considered and the overall relative risk of injury for exposure to high temperatures was 1.13 (95% CI: 1.08; 1.18). A higher risk was observed among younger workers (15-34 years) (1.23 95% CI: 1.14; 1.34) and occasional workers (1.25 95% CI: 1.03; 1.52). A total of 2050 heat-attributable injuries were estimated in the study period. Workers engaged in outdoor and labour-intensive activities in the agricultural sector are at greater risk of injury and these results can help target prevention actions for climate change adaptation.
The use of short message service (SMS) text messaging technology has grown in popularity over the last twenty years, but there is limited data on the design and feasibility of campaigns to reduce work-related injury, particularly among rural workers, non-native English speakers, and illiterate or low-literacy populations. Although there is a critical need for tech equity or ‘TechQuity’ interventions that reduce injury and enhance the wellbeing of under-reached communities, the barriers and benefits to implementation must be empirically and systematically examined. Thus, our team used D&I science to design and implement an 18-week texting campaign for under-reached workers with a higher-than-average risk of fatal and non-fatal injury. The experimental project was conducted with English-, Spanish-, and Vietnamese-speaking commercial fishermen in the Gulf of Mexico to test the design and feasibility, and messaging focused on preventing injury from slips, trips, and falls, as well as hurricane preparedness. The ubiquity of mobile devices and the previous success of texting campaigns made this a promising approach for enhancing health and preventing injury among an under-reached population. However, the perceived benefits were not without their barriers. The lessons learned included the difficulty of navigating federal regulations regarding limits for special characters, enrolling migratory participants, and navigating areas with limited cellular service or populations with limited accessibility to technology. We conclude with short- and long-term suggestions for future technology interventions for under-reached worker populations, including ethical and policy regulations.
Exposure to heat is a recognized occupational risk factor. Deaths and accidents at work caused by high temperatures are underestimated. With the aim of detecting and monitoring heat-related illnesses and injuries, a prototype database of occupational events attributable to critical thermal conditions reported in Italian newspapers was created. Information was analyzed from national and local online newspapers using a web application. The analysis was conducted from May to September during the three-year period 2020-2022. Articles concerning 35 occupational heat-related illnesses and injuries were selected; 57.1% of the events were reported in 2022, and 31.4% of total accidents occurred in the month of July 2022, when the Universal Thermal Climate Index daily mean values corresponded to “moderate heat stress” (51.0%) and “strong heat stress” (49.0%). Fatal heat-related illnesses were the most frequent conditions described. In most cases, workers had been involved in outdoor activities in the construction sector. A comprehensive report was created by compiling all relevant newspaper articles to enhance awareness of this issue among relevant stakeholders and promote heat-risk prevention strategies in the current context where heatwaves are becoming increasingly frequent, intense and long-lasting.
Introduction: Climate change and hot processes in the workplaces has led to an increase in the effects of heat stress on employed people, which has become a major concern, especially in tropical and subtropical countries. Early detection of biomarkers in induction of heat stress-related DNA damage can be used in the identification and evaluation of health and safety, including occupational health professionals, as well as to prevent serious diseases caused by heat stress in various occupations with the nature of hot processes or to help different warm seasons of the year. Therefore, this review study was conducted to identify diagnostic biomarkers heat stress induced- DNA damage in occupational exposure. Material and Methods: Databases such as PubMed, Scopus, Google Scholar, and Web of Science were systematically searched to meet the study’s goals. Moreover, references to relevant publications were examined. Finally, suitable articles were selected and analyzed using the inclusion (studies on different occupations, different biomarkers in hot work environments, all articles published without time limit until the end of April 2022 , and English and Persian language) and exclusion criteria.Results: The results of search in databases showed that 9234 articles were found in the initial search. After removing duplicate and unrelated articles, 2209 eligible articles were selected. Based on abstract full-text screening, 7166 studies were excluded, and based on abstract full-text screening, 21 studies were not accessible. Finally, seven articles were selected to be reviewed. The evidence showed that diagnostic biomarkers included the measurement of 8-hydroxy-2-deoxyguanosine (8-OHdG), micronuclei semen quality, heat shock proteins (HSP70), and leukocytes were extracted to heat stress induced- DNA damage in occupational exposure. Conclusion: Based on a review of studies, biomarkers identified are suitable for heat stress induced- DNA damage as a result of occupational exposure to extremely high heat climate conditions. Understanding and identifying appropriate biomarkers in inducing DNA damage can help health and safety professionals determine the amount and magnitude of heat stress responses in occupational exposure to different temperatures and take appropriate measures and interventions to control and reduce the hazard effects of thermal stress. This study can also be considered as a preliminary study for research in the future.
Objective: The purpose of this work is to carry out a descriptive analysis of occupational accidents and to evaluate the relationship between heatwaves and work accidents in Spain’s three most populated provinces: Madrid, Barcelona and Valencia.Methods: Daily data of work accidents (including for each case: gender, age, date, length of time in the position, type of work, place of accident and duration of medical leave) was collected. A heatwave was defined when daily mean temperatures above the threshold (95th percentile) of the climatological period (1990-2021) were recorded for at least three consecutive days. To estimate the association between daily workplace accidents and heatwave events, we applied a Generalized Additive Model combined with a Distributed Lag Non-linear Model with a quasi-Poisson distribution.Results: The average annual accident rate was 33.2 work accidents/100,000 employees in Madrid, 35.8 work accidents/100,000 employees in Barcelona and 31.8 work accidents/100,000 employees in Valencia. The total accident rates followed a downward trend between 2005 and 2021. The difference in work accident rates between sex decreased over the studied period (p < 0.005). In the first month of work, the highest casualty rate occurs among construction workers in Madrid and Barcelona, and in primary sector workers in Valencia. Work accidents tend to increase during heatwaves. The highest risk was recorded when considering a cumulative lagged effect of 3 days in Madrid and Barcelona and 5 days in Valencia.Conclusions: Since work accidents increase during heatwaves, risk prevention services and public administrations must take special measures to prevent them.
BACKGROUND: Specialized occupational health and safety (OHS) issues are covered at the EU level through detailed legislation and guidelines. Unfortunately, this does not extend to occupational heat stress, not only in Greece but also (with few exceptions) internationally. One possible explanation could be the difficulty in accurately identifying the dangerous conditions, as many environmental and individualized elements are involved, and hundreds of “thermal stress indicators” are available. Another explanation could be the difficulty in adequately measuring hazardous conditions for workers affected more (i.e., outdoor and high intensity) since the biological protection framework is based on the human body’s internal temperature. METHODS: The Wet Bulb Globe Temperature (WBGT) has been proposed as the most efficacious thermal stress indicator. Since 2021, the Hellenic National Meteorological Service has provided 48-h WBGT forecast predictions to serve as a first level of alert. Real-time measurements and 48-h forecasts of WBGT are also available through a smartphone application. Additionally, as revealed when developing the occupational heat stress legislation in Cyprus and Qatar, crucial first steps are identifying the specific characteristics of worker exposure and the tripartite collaboration between employers, workers, and the State. RESULTS: Evaluating the simplified WBGT forecasted values and the smartphone application estimates proved well-established. The sound scientific basis can be effectively combined with administrative measures based on the EU OHS legislative experience to produce practical solutions. CONCLUSIONS: As the climate crisis exacerbates, worker productivity and well-being will decline, underscoring the urgent need for an integrated protection framework. Such a framework is proposed here.
INTRODUCTION: The costs of global warming are substantial. These include expenses from occupational illnesses and injuries (OIIs), which have been associated with increases during heatwaves. This study estimated retrospective and projected future heatwave-attributable OIIs and their costs in Australia. MATERIALS AND METHODS: Climate and workers’ compensation claims data were extracted from seven Australian capital cities representing OIIs from July 2005 to June 2018. Heatwaves were defined using the Excess Heat Factor. OIIs and associated costs were estimated separately per city and pooled to derive national estimates. Results were projected to 2030 (2016-2045) and 2050 (2036-2065). RESULTS: The risk of OIIs and associated costs increased during heatwaves, with the risk increasing during severe and particularly extreme heatwaves. Of all OIIs, 0.13% (95% empirical confidence interval [eCI]: 0.11-0.16%) were heatwave-attributable, equivalent to 120 (95%eCI:70-181) OIIs annually. 0.25% of costs were heatwave-attributable (95%eCI: 0.18-0.34%), equal to $AU4.3 (95%eCI: 1.4-7.4) million annually. Estimates of heatwave-attributable OIIs by 2050, under Representative Concentration Pathway [RCP]4.5 and RCP8.5, were 0.17% (95%eCI: 0.10-0.27%) and 0.23% (95%eCI: 0.13-0.37%), respectively. National costs estimates for 2030 under RCP4.5 and RCP8.5 were 0.13% (95%eCI: 0.27-0.46%) and 0.04% (95%eCI: 0.66-0.60), respectively. These estimates for extreme heatwaves were 0.04% (95%eCI: 0.02-0.06%) and 0.04% (95%eCI: 0.01-0.07), respectively. Cost-AFs in 2050 were, under RCP4.5, 0.127% (95%eCI: 0.27-0.46) for all heatwaves and 0.04% (95%eCI: 0.01-0.09%) for extreme heatwaves. Attributable fractions were approximately similar to baseline when assuming theoretical climate adaptation. DISCUSSION: Heatwaves represent notable and preventable portions of preventable OIIs and economic burden. OIIs are likely to increase in the future, and costs during extreme heatwaves in 2030. Workplace and public health policies aimed at heat adaptation can reduce heat-attributable morbidity and costs.
The impact of climate change on the physical environment, ecosystems, and human societies is increasingly recognized as the most important global challenge. Climate change may alter, among others, the thermal environment, the occurrence of extreme weather events, and the human exposure to physical, chemical, and biological pollutants, thus affecting human health with several potential outcomes. The impact of climate change on occupational health and safety has been receiving increasing attention in last years. In the European Union, the health and safety of workers is under the rule of Directive 89/391 and its daughters. In a changing climate, compliance with all requirements of the existing EU regulation entails an additional effort to implement preventive and protective measures. A central role in workers’ health protection is played by proper workers’ information and training, which is partly in charge of the occupational physicians. This paper provides a basic proposal on topics related to climate change to update workers’ information and training and to integrate the curricula of occupational physicians. Importantly, suitable information and training may contribute to promoting workers’ health and to implement adaptation measures, which are part of the individual, societal, and global responses to climate change.
Global heating is subjecting more of the planet to longer periods of higher heat stress categories commonly employed to determine safe work durations. This study compared predicted worker heat strain and labour capacity for a recent normal climate (1986-2005) and under commonly applied climate scenarios for the 2041-2080 period for selected Australian locations. Recently published heat indices for northern (Darwin, Townsville, and Tom Price) and south-eastern coastal and inland Australia locations (Griffith, Port Macquarie, and Clare) under four projected climate scenarios, comprising two representative concentration pathways (RCPs), RCP4.5 and RCP8.5, and two time periods, 2041-2060 and 2061-2080, were used. Safe work durations, before the threshold for core temperature (38.0 °C) or sweat loss (5% body mass) are attained, were then estimated for each scenario using the predicted heat strain model (ISO7933). The modelled time to threshold core temperature varied with location, climate scenario, and metabolic rate. Relative to the baseline (1986-2005), safe work durations (labour capacity) were reduced by >50% in Port Macquarie and Griffith and by 20-50% in northern Australia. Reaching the sweat loss limit restricted safe work durations in Clare and Griffith. Projected future climatic conditions will adversely impact the predicted heat strain and labour capacity of outdoor workers in Australia. Risk management strategies must adapt to warming conditions to protect outdoor workers from the deleterious effects of heat.
At present, climate change is considered a considerable future threat due to its possible catastrophic impacts on humans, their properties, and also the environment. Therefore, most people and organizations have paid attention to this area. Thus, special consideration should be given to building operations, as buildings and building operations are capable of being impacted by various negative consequences of climate change. As facade-maintenance workers experience considerable climate change impacts as they perform their work for prolonged hours, at height, on the exterior of buildings, this study focuses on identifying the impacts of climate change on facade-access methods and facade-maintenance workers. Thus, in this study, a qualitative research approach was undertaken with an interview research design. A comprehensive literature review was conducted along with 12 semi-structured expert interviews selected through judgmental sampling. Software-aided thematic content analysis was carried out to analyze the collected data. The findings indicated that climate change could have significant impacts on building operations, as the attention paid to climate change adaptation by building operations is negligible in various countries, especially in developing countries. A significant impact was identified on facade-maintenance workers and facade-access methods caused by climate change, creating various risk factors for their occupational health and safety. Furthermore, the research methods that have been applied in this study are also capable of expanding to address various other probable operations. Accordingly, this research is exploring a new field of study that should be given more consideration by researchers due to its significant importance in scenarios that are experienced worldwide.
The informal economy is crucial for making cities function, and it provides the main means of income for a significant proportion of all workers globally. At the same time, informal workers are extremely vulnerable to the effects of climate change, with higher temperatures and more intense weather events causing direct physical harm and contributing to ill-health. This paper analyzes research from three cities in India and Zimbabwe (Indore, Harare, and Masvingo) to describe the vulnerability of informal workers in several sectors. It highlights the ways in which the direct impacts of climate change are compounded by other factors, including low-quality living conditions and the absence of provision for Occupational Health and Safety (OHS). Informal workers in the three cities have adopted a range of responses to reduce risk, and there are some recent inclusive engagements with local officials to enhance living and working conditions. However, key interventions such as expanding access to social protection (which has important potential to foster climate resilience) often fail to reach the most vulnerable urban informal workers. We conclude with recommendations and an agenda for more equitable policy and practice that can support multiple benefits for informal workers’ health, livelihoods, and climate resilience in urban areas.
Climate change may be the most pressing existential threat to human health and wellbeing in the twenty first century. In this paper, the authors provide context and critique on barriers to climate action in the United States and other high-income countries, including the profit-driven approach to health, consumerism, and the climate change countermovement. The reciprocal connections between occupational engagement and climate damage are examined from a lens of collective and irresponsible occupations and subsequent accountability. The authors propose the United Nations’ Sustainable Development Goals as a basis for recommendations occupational therapy practitioners could implement within the priorities of adaptation, mitigation, and resilience.
Climate protection is a global public good. The related mitigation policies implemented by a single country could have little effect on climate change issue such that there could be no net gains for society. However, those measures might create winners and losers among individuals. We investigate the citizens’ support for different pro-climate policies in EU countries, by considering the degree of heterogeneity in their attitudes towards climate issues using a cluster analysis. We also exploit the extent to which carbon intensity and green skills requirement of jobs contribute to supporting climate policies. Our results suggest that individuals’ occupational exposure does matter: people in emission-intensive activities tend to be against stringent climate measures, whereas people in jobs that require high levels of green skills are in favour of them.
OBJECTIVE: This study describes the characteristics of workers experiencing occupational heat-related injuries/illnesses in the United States and explores the associations between states’ average annual temperatures and heat-related injury/illness rates. METHODS: The number and rate of occupational environmental heat injuries/illnesses were calculated according to age group, gender, race/ethnicity, occupation group, and state from 2011 to 2019. RESULTS: Injury/illness rates were higher among Black and Hispanic workers. Workers in farming, fishing, and forestry; installation, maintenance, and repair; and construction/extraction occupations had the highest rates. There was a positive correlation between states’ average annual temperatures and heat-related injury/illness rates. DISCUSSION: There are demographic and occupational disparities in occupational environmental heat-related injuries/illnesses in the United States and a correlation between these injuries/illnesses and state average annual temperatures. There is a need for policies and other interventions to protect workers from occupational environmental heat injuries/illnesses.
OBJECTIVE: Heat exposure and heat stress/strain is a concern for many workers. There is increasing interest in potential chronic health effects of occupational heat exposure, including cancer risk. We examined potential associations of occupational heat exposure and colorectal cancer (CRC) risk in a large Spanish multi-case–control study. METHODS: We analyzed data on 1198 histologically confirmed CRC cases and 2690 frequency-matched controls. The Spanish job-exposure matrix, MatEmEsp, was used to assign heat exposure estimates to the lifetime occupations of participants. Three exposure indices were assessed: ever versus never exposed, cumulative exposure and duration (years). We estimated odds ratios (OR) and 95% confidence intervals (CI) using unconditional logistic regression adjusting for potential confounders. RESULTS: Overall, there was no association of ever, compared with never, occupational heat exposure and CRC (OR 1.09, 95% CI 0.92-1.29). There were also no associations observed according to categories of cumulative exposure or duration, and there was no evidence for a trend. There was no clear association of ever occupational heat exposure and CRC in analysis conducted among either men or women when analyzed separately. Positive associations were observed among women in the highest categories of cumulative exposure (OR 1.81, 95% CI 1.09-3.03) and duration (OR 2.89, 95% CI 1.50-5.59) as well as some evidence for a trend (P<0.05). CONCLUSION: Overall, this study provides no clear evidence for an association between occupational heat exposure and CRC.
The Arab region has witnessed different biological hazards, including cholera, yellow fever, and the COVID-19 pandemic. In addition, changes in rainfall and increased vegetation cover led to locust outbreaks in Tunisia, Libya, Morocco, and Saudi Arabia. This problem still exists and affects more than 20 countries and concerns indicate food shortages and food insecurity for more than 20 million people. OBJECTIVE: This study aimed to detect mental health problems related to climate change in the Arab world. METHODS: A cross-sectional descriptive survey was applied to determine the prevalence of mental health problems related to climate change (MHPCC). A random sample consisted of 1080 participants (523 male and 557 female), residents in 18 Arab countries; their ages ranged from 25 to 60 years. The Mental Health Problems related to Climate Change Questionnaire (MHPCCQ) was completed online. RESULTS: The results indicated average levels of MHPCC prevalence. The results also revealed no significant statistical differences in the MHPCC due to gender, educational class, and marital status except in climate anxiety; there were statistical differences in favor of married subgroup individuals. At the same time, there are statistically significant differences in the MHPCC due to the residing country variable in favor of Syria, Yemen, Algeria, Libya, and Oman regarding fears, anxiety, alienation, and somatic symptoms. In addition, Tunisia, Bahrain, Sudan, and Iraq were higher in climate depression than the other countries. CONCLUSION: The findings shed light on the prevalence of MHPCC in the Arab world and oblige mental health system workers, including policymakers, mental health providers, and departments of psychology in Arab universities, to take urgent action to assess and develop the system for mental health to manage the risks of extreme climate change on the human mental health.
The increasing number of extremely hot days globally has made outdoor workers more vulnerable to heat-related illnesses such as heat syncope, heat exhaustion, heat edema, and heat stress. The objective of this article is to identify and analyze the challenges experienced by construction workers who work in extremely hot weather conditions for extended periods of time. To achieve this objective, a questionnaire was developed and distributed through the online platform QuestionPro. The 100 responses that were collected were analyzed using the Kruskal-Wallis test, and analyses were performed based on physiological indicators such as heart rate and blood pressure and personal indicators such as climate acclimatization and clothing comfort. The results of the analyses revealed that challenges such as physical fatigue, dehydration, excessive sweating, inability to concentrate, and frequent mood fluctuations were unique to individuals based on their acclimatization level, heart rate, and blood pressure. Optimized work-rest hours, the provision of adequate time for workers to acclimate to extreme conditions, and adoption of technologies such as cooling vests and continuous monitoring of workers’ physical parameters are some of the strategies that can be used to protect workers from heat-related health hazards. The article also briefly discusses the practices and regulations that are currently in effect to protect construction workers who are exposed to prolonged hot weather conditions. The findings presented in this article will help professionals in the construction sector effectively manage and safeguard workers’ health in extreme hot weather conditions.
This study highlights the profile of rural workers with schistosomiasis mansoni, an endemic disease acquired during their work activities in flooded areas in the Baixada Maranhense. In order to analyze the social security and labor legislation used to grant benefits and the causal link that establishes the relationship between the work situation and the onset of the disease, we performed a bibliographical research on the topic and a documentary research on the formal legal plan of social security. This study addresses the need to recognize this relationship in endemic regions in order to improve what is proposed by the List of Work-Related Diseases.
Occupational heat exposure is associated with substantial morbidity and mortality among outdoor workers. We sought to descriptively evaluate spatiotemporal variability in heat threshold exceedances and describe potential impacts of these exposures for crop and construction workers. We also present general considerations for approaching heat policy-relevant analyses. We analyzed county-level 2011-2020 monthly employment (Bureau of Labor Statistics Quarterly Census of Employment and Wages) and environmental exposure (Parameter-elevation Relationships on Independent Slopes Model (PRISM)) data for Washington State (WA), USA, crop (North American Industry Classification System (NAICS) 111 and 1151) and construction (NAICS 23) sectors. Days exceeding maximum daily temperature thresholds, averaged per county, were linked with employment estimates to generate employment days of exceedances. We found spatiotemporal variability in WA temperature threshold exceedances and crop and construction employment. Maximum temperature exceedances peaked in July and August and were most numerous in Central WA counties. Counties with high employment and/or high numbers of threshold exceedance days, led by Yakima and King Counties, experienced the greatest total employment days of exceedances. Crop employment contributed to the largest proportion of total state-wide employment days of exceedances with Central WA counties experiencing the greatest potential workforce burden of exposure. Considerations from this analysis can help inform decision-making regarding thresholds, timing of provisions for heat rules, and tailoring of best practices in different industries and areas.
Increased risk of occupational injuries and illnesses (OI) is associated with hot ambient temperatures. However, the existing evidence of risk estimation is limited to large regions at the city or provincial scales. For effective and localized occupational health risk management, spatio-temporal analysis should be carried out at the intra-city level to identify high-risk areas within cities. This study examined the exposure-response relationship between ambient temperatures and OI at the intra-city scale in Greater Adelaide, Australia. Vulnerable groups of workers, in terms of workers’ characteristics, the nature of their work, and workplace characteristics were identified. Further, the projected risk of OI was quantified in various climate change scenarios. The temperature-OI association was estimated using a time-series study design combined with Distributed Lag Non-linear Models. Daily workers’ compensation claims (2005-2018) were merged with 5 km gridded meteorological data of maximum temperature (°C) at Statistical Area Level 3 in Greater Adelaide. Region-wise subgroup analyses were conducted to identify vulnerable groups of workers. Future projections (2006-2100) were conducted using downscaled climate projections and the risk was quantified using log-linear extrapolation. The analyses were performed in R 4.1.0. The overall OI risk was 16.7% (95%CI: 10.8-23.0) at moderate heat (90th percentile) and increased to 25.0% (95%CI: 16.4-34.2) at extreme heat (99th percentile). Northern Adelaide had a higher risk of OI for all types of workers at moderate heat, while western regions had a high risk for indoor industries. Southern and eastern regions had a higher OI risk for males, older workers, and outdoor industries at extreme heat. The projected risk of OI is estimated to increase from 20.8% (95%CI: -0.2-46.3) in 2010s to 22.9% (95%CI: -8.0-64.1) by 2050s. Spatio-temporal risk assessment at the intra-city scale can help us identify high-risk areas, where targeted interventions can be efficiently employed to reduce the socio-economic burden of OI.
OBJECTIVE: More patients are reaching end-stage kidney disease without evident cause. This study aims to explore occupational risk factors associated with hemodialysis. METHODS: A multicenter matched case-control study included dialysis patients and age, sex, and diabetes-matched controls (normal kidney function). Conditional logistic regression analysis assessed occupational factors associated with dialysis. RESULTS: Two hundred thirty eight hemodialysis patients and 238 controls were included. History of occupational heat exposure (odds ratio [OR] = 1.93; 95% confidence interval [CI]: 1.24 to 3.00), working as a cook (OR = 12; 95% CI: 1.56 to 92.29), as construction worker (OR = 10; 95% CI: 1.28 to 78.12) were associated with higher risk of dialysis. These results were significant in men and in those with kidney disease of unknown etiology. CONCLUSIONS: Occupational heat exposure was found to be associated with hemodialysis. This is an important step for future development of preventive strategies in high-risk professions.
The present comprehensive review (i) summarizes the current knowledge on the impacts of occupational heat stress on outdoor workers, (ii) provides a historical background on this issue, (iii) presents a meta-analysis of published data, (iv) explores inter-individual and intra-individual factors, (v) discusses the available heat mitigation strategies, (vi) estimates physical work capacity, labour productivity, and metabolic rate for the year 2030, and (vii) provides an overview of existing policy and legal frameworks on occupational heat exposure. Meta-analytic findings from 38 field studies that involved monitoring 2,409 outdoor workers across 41 jobs in 21 countries suggest that occupational heat stress increases the core (r = 0.44) and skin (r = 0.44) temperatures, as well as the heart rate (r = 0.38) and urine specific gravity (r = 0.13) of outdoor workers (all p < 0.05). Moreover, it diminishes the capacity of outdoor workers for manual labour (r = -0.82; p < 0.001) and is responsible for more than two thirds of the reduction in their metabolic rate. Importantly, our analysis shows that physical work capacity is projected to be highly affected by the ongoing anthropogenic global warming. Nevertheless, the metabolic rate and, therefore, labour productivity are projected to remain at levels higher than the workers' physical work capacity, indicating that people will continue to work more intensely than they should to meet their financial obligations for food and shelter. In this respect, complementary measures targeting self-pacing, hydration, work-rest regimes, ventilated garments, and mechanization can be adopted to protect outdoor workers.
Unsustainable lifestyles contribute to global greenhouse gas emissions and climate change. The growing recognition of this negative impact on the earth’s ecosystems and human health and well-being compels occupational therapy practitioners to address environmental sustainability issues. Western contextual factors present obstacles to the adoption of ecologically beneficial practices in occupational therapy. Resolving these ethical challenges through the use of multiple epistemologies may yield novel solutions and usher in the adoption of ecologically sustainable occupational therapy in the United States. In this column, I explore some of the contextual factors that influence occupational therapy theory and practice as they relate to ecological sustainability. I also briefly discuss some non-Western cultural perspectives, challenges to integrating ecological ethics into occupational therapy practice in the United States, and ways individual occupational therapy practitioners and state and national organizations can begin to address this issue.
Climate change is considered one of the top health threats in the United States. This research sought to (1) to understand the perceptions of occupational health and safety (OHS) professionals regarding the impacts of climate-related hazards on OHS in Region X, and (2) to explore the ideas of these OHS professionals regarding the content of future training programs that would better prepare OHS professionals to identify and mitigate climate-related hazards in Region X. Key informant (KI) interviews with 17 OHS professionals familiar with the climate-related hazards and impacts to OHS in Region X were coded and thematically analyzed. Climate hazards, social and economic impacts from climate-related hazards, and sector-specific worker and workplace impacts from climate-related hazards were described as having interacting relationships that influenced worker health and safety impacts. KIs further described how workplace controls could be used to mitigate OHS impacts of climate-related hazards, and how training of the OHS workforce could influence the ability to successfully implement such controls. Our findings suggest that OHS impacts are sector-specific, influenced by social and economic factors, and can be mitigated through workplace controls designed and implemented by a trained OHS workforce. The findings from this work should inform future educational and training programming and additional research and translation activities in the region, while our approach can inform other regions as they develop regionally specific OHS climate change training and programming.
INTRODUCTION: The purpose of this study was to evaluate heat stress occurring in wildfire management activities with variable environmental conditions. METHODS: Direct observation and real-time wireless physiological monitoring allowed for weather and physiological metrics, including heart rate, core temperature (T(c)), skin temperature, and physiological strain index (PSI), of male (n=193) and female (n=28) wildland firefighters (WLFFs) to be recorded during wildfire management activities. Accelerometry data were used to categorize intensity level of activity. RESULTS: Ambient temperature and relative humidity values were used to compute the heat index (HI; n=3891 h) and divided into quartiles (Q1: 13.3-25.1°C; Q2: 25.2-26.4°C; Q3: 26.5-28.9°C; Q4: 29.0-49.1°C). Activity levels remained relatively constant across all HI quartiles. The percentage of time spent performing moderate/vigorous activities was lowest during the hotter Q4 (Q1: 3%; Q2: 2%; Q3: 2%; Q4: 1%). Heart rate, T(c), PSI, and skin temperature associations with HI varied by resource type. Sixty-one percent of WLFFs (n=134) experienced a T(c) ≥38.0°C, and 50% of WLFFs (n=111) experienced a PSI ≥6.0. CONCLUSIONS: Heat stress was prevalent as WLFFs performed job tasks of varying intensities in all ambient conditions. Spontaneous bouts of arduous labor, duration of work shifts, and other occupation characteristics present the possibility for substantial durations of hyperthermia, although no heat-related injuries occurred in this study. Despite chronic exposure to rugged sloped terrain, load carriage, and environmental conditions, self-regulation and individual attention to managing work:rest appears to be the primary management strategy in mitigating excessive accumulation of body heat in this occupation.
Uncompensable heat from wildland firefighter personal protective equipment decreases the physiological tolerance while exercising in the heat. Our previous work demonstrated that the standard wildland firefighter helmet significantly increases both perceived and actual head heat. This study compared heat accumulation under simulated working conditions while wearing a standard non-vented helmet versus a vented helmet. Ten male subjects randomly completed two trials separated by a 2-week washout. Subjects walked 180 min (5.6 km h−1, 5% grade) in a heat chamber (35°C, 30% relative humidity) broken into three segments of 50 min of exercise and 10 min rest, followed by a work capacity test to exhaustion. Each trial measured the physiological strain index, perceived head heat, helmet temperature and relative humidity, rating of perceived exertion and heart rate. At the end of the 3-h trial heart rate, physiological strain, perceived exertion, helmet temperature and humidity showed the main effects of time (P < 0.05) but were not different between trials. Work capacity was significantly greater in the vented trial (P = 0.001). End-trial strain and heart rate were significantly related to work performed (r = –0.8, P < 0.001). Elevated work, trends for changes in perceived exertion, helmet microenvironment and perceived head heat suggest greater heat dissipation and comfort with the vented helmet.
Climate change has increased the exposure risk of workers to occupational health risk factors and diseases. This study aims to investigate the impacts of climate change on the occupational health indicators at the workplaces in Iran. This study was conducted during 2021 in three climatic regions of Iran. Required data was collected from Health Deputies of Medical Universities and Iran Meteorological Organization. Stepwise linear regression model used for data analysis and predictions were done based on three scenarios of SSP1-2.6, SSP3-7.0, and SSP5-8.5 during the period of 2021-2100. This indicated 2.6 and 2.9 times higher percentage of workers who were exposed to heat stress and Ultra Violet (UV) radiation, respectively, in the provinces understudy. This study suggests a holistic approach to address potential impacts of climate change on workers’ health and safety that would benefit in making decisions on climate-related planning and developing the adaptation strategies at workplaces.
BACKGROUND: The working population is exposed daily to unavoidable climatic conditions due to their occupational settings. Effects of the weather such as rain, heat, and air pollution may increase the risk of diseases, injuries, accidents, and even death during labor. OBJECTIVE: This paper aims to summarize the impacts of climate change on workers’ health, safety and performance, identifying the risks, affected workplaces and the range of methodological approaches used to assess this problem. METHODS: A thorough systematic mapping was conducted in seven scientific international databases: Emerald, IEEE Xplore, Science Direct, Scielo, Scopus, SpringerLink, and Web of Science. Three research questions guided the extraction process resulting in 170 articles regarding the impacts of climate change on occupational health and safety. RESULTS: We found an accentuated trend in observational studies applying primary and secondary data collection. Many studies focused on the association between rising temperatures and occupational hazards, mainly in outdoor work settings such as agriculture. The variation of temperature was the most investigated impact of climate change. CONCLUSIONS: We established a knowledge base on how to explore the impacts of climate change on workers’ well-being and health. Researchers and policymakers benefit from this review, which explores the suitable methods found in the literature and highlights the most recurring risks and their consequences to occupational health and safety.
OBJECTIVES: Due to accelerating wildland fire activity, there is mounting urgency to understand, prevent, and mitigate the occupational health impacts associated with wildland fire suppression. The objectives of this review of academic and grey literature were to: 1. Identify the impact of occupational exposure to wildland fires on physical, mental, and emotional health; and 2. Examine the characteristics and effectiveness of prevention, mitigation, or management strategies studied to reduce negative health outcomes associated with occupational exposure to wildland fire. METHODS: Following established scoping review methods, academic literature as well as government and industry reports were identified by searching seven academic databases and through a targeted grey literature search. 4679 articles were screened using pre-determined eligibility criteria. Data on study characteristics, health outcomes assessed, prevention or mitigation strategies studied, and main findings were extracted from each included document. The results of this scoping review are presented using descriptive tables and a narrative summary to organize key findings. RESULTS: The final sample was comprised of 100 articles: 76 research articles and 24 grey literature reports. Grey literature focused on acute injuries and fatalities. Health outcomes reported in academic studies focused on respiratory health (n = 14), mental health (n = 16), and inflammation and oxidative stress (n = 12). The identified studies evaluated short-term outcomes measuring changes across a single shift or wildland fire season. Most research was conducted with wildland firefighters and excluded personnel such as aviation crews, contract crews, and incident management teams. Five articles reported direct study of mitigation strategies, focusing on the potential usage of masks, advanced hygiene protocols to reduce exposure, fluid intake to manage hydration and core temperature, and glutamine supplementation to reduce fatigue. CONCLUSIONS: While broad in scope, the evidence base linking wildland fire exposure to any one health outcome is limited. The lack of long-term evidence on changes in health status or morbidity is a clear evidence gap and there is a need to prioritize research on the mental and physical health impact of occupational exposure to wildland fire.
Global climate change exposes workers to increased air temperature, polluted air, and ultraviolet radiation due to ozone depletion, increased extreme weather events, and evolving patterns of vector-borne diseases. These climate change hazards are causing acute and chronic health problems to workers. The occupational distribution of the population is the most vulnerable to the negative impacts of climate change worldwide. Climate change-related adverse health hazards to the general population is getting evident around the globe. A limited focus has been made on developing a relationship between climate change and related occupational health hazards. This policy paper aims to guide health officials and policymakers to develop a climate change mitigation policy for the occupational distribution of the population. Absolute magnitude determination of climate changerelated health risks is essential to developing projecting models and predicting future hazards and risks. These models will help us to estimate climate change and environmental exposure, susceptibility of the exposed population, and capacity of public health practice and services to reduce climate change impact. Adaptation policies in international, national, and local occupational settings are required to acclimatize the workers and mitigate climate change-related adverse effects.
In Portugal, forest fires are responsible for disasters that tend to be repeated annually, leading to dramatic consequences, such as those that have occurred in 2017, with the destruction of hundreds of houses and the deaths of dozens of people. Firefighters who are exposed to these potentially traumatic events are considered a high-risk group for the development of stress-related disorders. The aim of this study was to monitor the progress of two firefighters with symptoms of post-traumatic stress disorder (PTSD) treated through dynamic psychotherapy (DP) and to assess the feasibility of implementing this intervention within fire departments. A female firefighter and a male firefighter, with similar sociodemographic characteristics and PTSD symptom severity, were selected to verify the treatment applicability for both genders. The symptomatology changes were assessed through a set of instruments (PHQ-15, PCL-5, BSI, DASS, and CALPAS-P) applied every three months over 15 months (including pre-treatment, treatment period, and post-treatment). DP seemed to be an effective treatment for PTSD symptoms, with patients showing a state of increasing improvement even after the end of treatment. The acceptability to firefighters, the treatment adherence, the therapeutic alliance, and the reduction in PTSD symptoms suggest feasibility for implementing this intervention inside the Portuguese fire departments.
Tasks performed by search and rescue (SAR) teams can be physically demanding. SAR organizations are faced with mounting challenges due to increased participation in recreation in remote locations and more frequent extreme weather. We sought to describe the physiological response and the methods for data collection during helicopter emergency medical service (HEMS) winch rescue from remote wilderness in extreme heat. A flight paramedic sustained 81% of maximum heart rate (VO₂ ~44.8 mL/kg/min) for ~10 minutes at a rate of perceived exertion of 19/20, and a relative heart rate of 77.5% in 37.1°C. Maximal acceptable work time for this task was calculated at 37.7 minutes. Our data collection methods were feasible, and the data captured demonstrated the level of physiological strain that may be encountered during HEMS SAR operations in austere environments and hot climate. It is essential that SAR teams that perform physically demanding tasks use a scientific approach to adapt and evolve. This is necessary to ensure personnel are appropriately selected, trained, and equipped to respond in an era of increasing demand and extreme environments.
Heart failure is a major contributor to healthcare expenditures. Many clinical risk factors for the development and exacerbation of heart failure had been reported, including diabetes, renal dysfunction, and respiratory disease. In addition to these clinical parameters, the effects of social factors, such as occupation or lifestyle, and environmental factors may have a great impact on disease development and progression of heart failure. However, the current understanding of social and environmental factors as contributors to the clinical course of heart failure is insufficient. To present the knowledge of these factors to date, this comprehensive review of the literature sought to identify the major contributors to heart failure within this context. Social factors for the risk of heart failure included occupation and lifestyle, specifically in terms of the effects of specific occupations, occupational exposure to toxicities, work style, and sleep deprivation. Socioeconomic factors focused on income and education level, social status, the neighborhood environment, and marital status. Environmental factors included traffic and noise, air pollution, and other climate factors. In addition, psychological stress and behavior traits were investigated. The development of heart failure may be closely related to these factors; therefore, these data should be summarized for the context to improve their effects on patients with heart failure. The present study reviews the literature to summarize these influences.
INTRODUCTION: Climate change plays an important role in the geographic spread of zoonotic diseases. Knowing which populations are at risk of contracting these diseases is critical to informing public health policies and practices. In Québec, 14 zoonoses have been identified as important for public health to guide the climate change adaptation efforts of decision-makers and researchers. A great deal has been learned about these diseases in recent years, but information on at-risk workplaces remains incomplete. The objective of this study is to paint a portrait of the occupations and sectors of economic activity at risk for the acquisition of these zoonoses. METHODS: A rapid review of the scientific literature was conducted. Databases on the Ovid and EBSCO research platforms were searched for articles published between 1995 and 2018, in English and French, on 14 zoonoses (campylobacteriosis, cryptosporidiosis, verocytotoxigenic Escherichia coli, giardiasis, listeriosis, salmonellosis, Eastern equine encephalitis, Lyme disease, West Nile virus, food botulism, Q fever, avian and swine influenza, rabies, hantavirus pulmonary syndrome) and occupational health. The literature search retrieved 12,558 articles and, after elimination of duplicates, 6,838 articles were evaluated based on the title and the abstract. Eligible articles had to address both concepts of the research issue (prioritized zoonoses and worker health). Of the 621 articles deemed eligible, 110 were selected following their full reading. RESULTS: Of the diseases under study, enteric zoonoses were the most frequently reported. Agriculture, including veterinary services, public administration services and medical and social services were the sectors most frequently identified in the literature. CONCLUSION: The results of our study will support public health authorities and decision-makers in targeting those sectors and occupations that are particularly at risk for the acquisition of zoonoses. Doing so will ultimately optimize the public health practices of those responsible for the health of workers.
Male fertility and semen quality have declined over recent decades. Among other causes, exposure to environmental and occupational pollution has been linked to adverse reproductive outcomes, but effects on male semen quality are still uncertain. Therefore, the aim of the present study was to conduct a systematic review and meta-analysis to assess current evidence regarding the impact of exposure to tobacco smoke and environmental and occupational pollution on sperm quality in humans. In the meta-analysis, 22 studies are included showing that environmental and occupational pollutants may affect sperm count, volume, concentration, motility, vitality and sperm DNA, and chromatin integrity. All included articles reported significant alterations in at least one of the outcomes studied in association with at least one of the pollutants studied. Considering that sperm quality can be considered a proxy for general health and that pollutants have a dramatic impact on climate change, it would be strongly recommended to better understand the role of pollutants on human, animal, and planetary health.
OBJECTIVES: Several studies on the health effects of heat exposure on workers have been reported; however, only few studies have summarized the overall and systematic health effects of heat exposure on workers. This study aims to review the scientific reports on the health status of workers exposed to high temperatures in the workplace. METHODS: We reviewed literature from databases such as PubMed and Google Scholar, using Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines to identify studies that address health effects of heat exposure among workers. RESULTS: In total, 459 articles were identified, and finally, 47 articles were selected. Various health effects of heat exposure on workers have been reported, such as heat-related diseases, deaths, accidents or injuries, effects on the urinary system, reproductive system, and on the psychological system. CONCLUSIONS: Our review suggests that many workers are vulnerable to heat exposure, and this has a health effect on workers.
INTRODUCTION: The future of work is characterized by changes that could disrupt all aspects of the nature and availability of work. Our study aims to understand how the future of work could result in conditions, which contribute to vulnerability for different groups of workers. METHODS: A horizon scan was conducted to systematically identify and synthesize diverse sources of evidence, including academic and gray literature and resources shared over social media. Evidence was synthesized, and trend categories were developed through iterative discussions among the research team. RESULTS: Nine trend categories were uncovered, which included the digital transformation of the economy, artificial intelligence (AI)/machine learning-enhanced automation, AI-enabled human resource management systems, skill requirements for the future of work; globalization 4.0, climate change and the green economy, Gen Zs and the work environment; populism and the future of work, and external shocks to accelerate the changing nature of work. The scan highlighted that some groups of workers may be more likely to experience conditions that contribute to vulnerability, including greater exposure to job displacement or wage depression. The future of work could also create opportunities for labor market engagement. CONCLUSION: The future of work represents an emerging public health concern. Exclusion from the future of work has the potential to widen existing social and health inequities. Thus, tailored supports that are resilient to changes in the nature and availability of work are required for workers facing vulnerability.
Background: Environmental health is a growing area of knowledge, continually increasing and updating the body of evidence linking the environment to human health. Aim: This study summarizes the epidemiological evidence on environmental risk factors from meta-analyses through an umbrella review. Methods: An umbrella review was conducted on meta-analyses of cohort, case-control, case-crossover, and time-series studies that evaluated the associations between environmental risk factors and health outcomes defined as incidence, prevalence, and mortality. The specific search strategy was designed in PubMed using free text and Medical Subject Headings (MeSH) terms related to risk factors, environment, health outcomes, observational studies, and meta-analysis. The search was limited to English, Spanish, and French published articles and studies on humans. The search was conducted on September 20, 2020. Risk factors were defined as any attribute, characteristic, or exposure of an individual that increases the likelihood of developing a disease or death. The environment was defined as the external elements and conditions that surround, influence, and affect a human organism or population’s life and development. The environment definition included the physical environment such as nature, built environment, or pollution, but not the social environment. We excluded occupational exposures, microorganisms, water, sanitation and hygiene (WASH), behavioral risk factors, and no-natural disasters. Results: This umbrella review found 197 associations among 69 environmental exposures and 83 diseases and death causes reported in 103 publications. The environmental factors found in this review were air pollution, environmental tobacco smoke, heavy metals, chemicals, ambient temperature, noise, radiation, and urban residential surroundings. Among these, we identified 65 environmental exposures defined as risk factors and 4 environmental protective factors. In terms of study design, 57 included cohort and/or case-control studies, and 46 included time-series and/or case-crossover studies. In terms of the study population, 21 included children, and the rest included adult population and both sexes. In this review, the largest body of evidence was found in air pollution (91 associations among 14 air pollution definitions and 34 diseases and mortality diagnoses), followed by environmental tobacco smoke with 24 associations. Chemicals (including pesticides) were the third larger group of environmental exposures found among the meta-analyses included, with 19 associations. Conclusion: Environmental exposures are an important health determinant. This review provides an overview of an evolving research area and should be used as a complementary tool to understand the connections between the environment and human health. The evidence presented by this review should help to design public health interventions and the implementation of health in all policies approach aiming to improve populational health.
Wildland firefighters work on wildfire incidents all over the United States and perform arduous work under extreme work conditions, including exposure to smoke. Wildland fire smoke is a mixture of hazardous air pollutants. For assessing wildland firefighter exposure to smoke, most studies measured carbon monoixde (CO) and particulate matter and reported changes in lung health by measured lung function, airway responsiveness, and respiratory symptoms across individual work shifts and single fire seasons. All fire personnel should understand the hazards of smoke and develop ways to mitigate exposure to smoke.
In this era, grand challenges lies in biodiversity loss, climate change, and global noncommunicable diseases signify that planet and humanity are in crisis. Scholarly evidence from human and animal kingdom suggest that there is an optimism in planetary health which can provide a unique and novel concept where efforts toward survival and remediation can be made. With accurate navigation, the current challenges can be mitigated leading to a new reality, one in which the core value is the well-being of all. This paper discusses the drivers of planetary health and the role of community health workers (CHWs) in making health-care system more resilient that can produce multiple benefits to community and overall planetary health. A web-based international database such as Google, Google Scholar, SCOPUS/MEDLINE/PubMed, and JSTOR was searched relevant to a planetary health framework. The study findings suggest that CHWs can offer health care interventions through environmental health cobenefits across the spectrum of health effects of climate change cause and effects. These actions have been divided into four major categories (i. health care promotion and prevention, ii. health care strengthening, iii. advocacy, and iv. education and research) that CHWs perform through a variety of roles and functions they are engaged in protecting planetary health. CHWs contribute toward achieving sustainable development goals such as planetary health and focus on environment sustainability and well-being of entire mankind.
The humanity is currently facing the COVID-19 pandemic challenge, the largest global health emergency after the Second World War. During summer months, many countries in the northern hemisphere will also have to counteract an imminent seasonal phenomenon, the management of extreme heat events. The novelty this year concerns that the world population will have to deal with a new situation that foresees the application of specific measures, including adjunctive personal protective equipment (i.e. facemasks and gloves), in order to reduce the potential transmission of the SARS-CoV-2 virus. These measures should help to decrease the risk of the infection transmission but will also represent an aggravating factor to counteract the heat effects on the population health both at occupational and environmental level. The use of a specific heat health warning system with personalized information based on individual, behavioural and environmental characteristics represents a necessary strategy to help a fast adaptation of the population at a time where the priority is to live avoiding SARS-CoV-2 infection.
PURPOSE: Millions of workers exposed to the outdoor environment are extremely susceptible to extreme heat. Although several articles analyzed heat-related illnesses, injuries, fatalities at the country level, few investigated regional and state statistics especially for OSHA Region 4 and the state of Alabama, U.S, which we explored in this study. METHODS: We studied the number of heat-days over 90 °F (32.2 °C) heat-index within our study area, analyzed heat-related injury and illnesses to calculate their incidence rate during 2015 to 2019, observed the nature of such incidents, their monthly occurrence, and incidence trend over average air temperature. We conducted a comparative analysis of heat-related fatalities between construction and all industries. The existing heat regulations by OSHA and some state agencies have also been summarized. RESULTS: We observed the highest mean, maximum heat-days and injury-illness rate in the south and southeast part of Region 4; increase in incidence rate from 0.03 in 2017 to 0.28 per 10,000 employees in 2018 for the contiguous U.S; highest injury-illness rate (HIR) in OSHA Region 1, 4 and 6; highest HIR in Lee, Montgomery, Mobile and Madison counties of Alabama; 34.7% (construction) and 31.3% (all industries) of all cases experiencing nonclassifiable heat-light effects; high fatalities in construction industry with a trend of 1 death/5 years; increased mortality in all occupations with 1 death/2.4 years. We also proposed a Heat-Stress Index (HSI) as a routine heat-stress measure on jobsite. CONCLUSION: The findings from this research and the proposed index can help in understanding heat-related risk at a regional level and implementing workplace interventions.
Extreme heat is an increasing climate threat, most pronounced in urban areas where poor populations are at particular risk. We analyzed heat impacts and vulnerabilities of 1027 outdoor workers who participated in a KAP survey in Hanoi, Vietnam in 2018, and the influence of their mitigation actions, their knowledge of heat-risks, and access to early warnings. We grouped respondents by their main income (vendors, builders, shippers, others, multiple jobs, and non-working) and analyzed their reported heat-health impacts, taking into consideration socioeconomics, knowledge of heat impacts and preventive measures, actions taken, access to air-conditioning, drinking amounts and use of weather forecasts. We applied linear and logistic regression analyses using R. Construction workers were younger and had less knowledge of heat-health impacts, but also reported fewer symptoms. Older females were more likely to report symptoms and visit a doctor. Access to air-conditioning in the bedroom depended on age and house ownership, but did not influence heat impacts as cooling was too expensive. Respondents who knew more heat exhaustion symptoms were more likely to report impacts (p < 0.01) or consult a doctor (p < 0.05). Similarly, those who checked weather updates were more likely to report heat impacts (p < 0.01) and experienced about 0.6 more symptoms (p < 0.01). Even though occupation type did not explain heat illness, builders knew considerably less (40%; p < 0.05) about heat than other groups but were twice as likely to consult a doctor than street vendors (p < 0.01). Knowledge of preventive actions and taking these actions both correlated positively with reporting of heat-health symptoms, while drinking water did not reduce these symptoms (p < 0.01). Child carers and homeowners experienced income losses in heatwaves (p < 0.01). The differences support directed actions, such as dissemination of educational materials and weather forecasts for construction workers. The Red Cross assisted all groups with cooling tents, provision of drinks and health advice.
BACKGROUND: Mechanisms linking occupational heat exposure with chronic diseases have been proposed. However, evidence on occupational heat exposure and cancer risk is limited. METHODS: We evaluated occupational heat exposure and female breast cancer risk in a large Spanish case-control study. We enrolled 1,738 breast cancer cases and 1,910 frequency-matched population controls. A Spanish job-exposure matrix, MatEmEsp, was used to assign estimates of the proportion of workers exposed (P ? 25% for at least 1 year) and work time with heat stress (wet bulb globe temperature ISO 7243) for each occupation. We used three exposure indices: ever versus never exposed, lifetime cumulative exposure, and duration of exposure (years). We estimated ORs and 95% confidence intervals (CI), applying a lag period of 5 years and adjusting for potential confounders. RESULTS: Ever occupational heat exposure was associated with a moderate but statistically significant higher risk of breast cancer (OR 1.22; 95% CI, 1.01-1.46), with significant trends across categories of lifetime cumulative exposure and duration (P (trend) = 0.01 and 0.03, respectively). Stronger associations were found for hormone receptor-positive disease (OR ever exposure = 1.38; 95% CI, 1.12-1.67). We found no confounding effects from multiple other common occupational exposures; however, results attenuated with adjustment for occupational detergent exposure. CONCLUSIONS: This study provides some evidence of an association between occupational heat exposure and female breast cancer risk. IMPACT: Our results contribute substantially to the scientific literature. Further investigations are needed considering multiple occupational exposures.
The health of smallholder farmers is crucial for ensuring food and nutritional security for two billion people. However, their health is in jeopardy for several reasons including challenges from climate change impacts. Using a narrative literature review supported by field observations and informal interviews with key informants in India, Bangladesh and Malawi, this paper identifies and discusses the health impacts of climate change under four categories: (i) communicable diseases, (ii) non-communicable diseases, (iii) mental health, and (iv) occupational health, safety and other health issues. The health impacts of climate change on smallholder farmers will hamper the realization of many of the United Nations’ Sustainable Development Goals, and a series of recommendations are made to regional and country governments to address the increasing health impacts of accelerating climate change among smallholder farmers.
The lack of empirical evidence on the effect of heat exposure on the health and safety, productivity, psychological behaviour and social well-being outcomes of small- and large-scale mining workers in Africa has derailed concrete policy directions and interventions. An explanatory cross-sectional survey involving 320 small- and large-scale mining workers was used to assess this research gap. A path analysis was used to model health and safety, productivity, psychological behaviour and social well-being as a function of heat exposure, mediated and moderated by adaptation strategies and barriers, while controlling for age, gender, level of education, years of working experience and workplace environment. Significant direct adverse effects of heat exposure on mining workers’ health and safety, productivity and psychological behaviour outcomes were found. Using a pick-a-point approach, significant difference was found in simple slopes (SS) for heat exposure on adaptation strategies at medium level of barriers and a trend toward significance at the high level of barriers. Except for health and safety outcomes, there were significant conditional indirect effects of heat exposure on the performance outcomes at the medium and high levels of barriers to adaptation strategies. However, there was no evidence of mediated-moderation for heat exposure and health and safety, productivity, psychological behaviour and social well-being outcomes. We have provided empirical evidence to establish heat exposure effect on key performance outcomes of mining workers to initiate and guide the formulation of heat exposure management policies.
Many occupational settings located outdoors in direct sun, such as open cut mining, pose a health, safety, and productivity risk to workers because of their increased exposure to heat. This issue is exacerbated by climate change effects, the physical nature of the work, the requirement to work extended shifts and the need to wear protective clothing which restricts evaporative cooling. Though Ghana has a rapidly expanding mining sector with a large workforce, there appears to be no study that has assessed the magnitude and risk of heat exposure on mining workers and its potential impact on this workforce. Questionnaires and temperature data loggers were used to assess the risk and extent of heat exposure in the working and living environments of Ghanaian miners. The variation in heat exposure risk factors across workers’ gender, education level, workload, work hours, physical work exertion and proximity to heat sources is significant (p<0.05). Mining workers are vulnerable to the hazards of heat exposure which can endanger their health and safety, productive capacity, social well-being, adaptive capacity and resilience. An evaluation of indoor and outdoor Wet Bulb Globe Temperature (WBGT) in the working and living environment showed that mining workers can be exposed to relatively high thermal load, thus raising their heat stress risk. Adequate adaptation policies and heat exposure management for workers are imperative to reduce heat stress risk, and improve productive capacity and the social health of mining workers.
In this study the authors examined how maternal health workers (MHWs) perceive the health risks of extreme heat exposure to pregnant women and fetuses. The authors conducted interviews with 12 MHWs (including midwives and doulas) in El Paso, Texas. Using qualitative analysis, the researchers identified numerous themes. Although heat was not communicated as a major health risk, participants expressed some concern with growing heat exposure and communicated standard protective measures. While all participants were familiar with some heat illness symptoms, they were generally unaware of their clients’ vulnerability. MHWs’ minimal heat-risk knowledge leaves pregnant women and developing fetuses at risk of preventable harm.
Rapid, detrimental climate change and environmental degradation pose real threats to the health, environment, social, economic and technological wellbeing of society (HESET). It has become even more imperative that the health workforce (public health and medical healthcare as well as auxiliary and support workers) be ‘climate-environment’ competent to fulfil their role in managing the environmental public health risks and impacts as climate and environment inevitably continue to change. We developed a broad six-domain competency framework consisting of (1) climate and environment sciences, (2) drivers of climate change (3) evidence, projections and assessments (4) iterative risk management (5) mitigation, adaptation and health co-benefits and (6) collective strategies-harnessing international/regional/local agreements and frameworks. The framework can be used by health/medical trainers to design cross-sectoral sub-competencies and learning content for training health workers to function at local, regional and global levels. Reaching, maintaining and improving the different levels of competency, the health workforce will be increasingly invaluable partners in intra- as well as inter-sectoral responses to climate and environmental risks and impacts.
BACKGROUND: During the period 2001 to 2016, the maximum temperatures in Thailand rose from 38-41(o)C to 42-44(o)C. The current occupational heat exposure standard of Thailand issued in 2006 is based on wet bulb globe temperature (WBGT) defined for three workload levels without a work-rest regimen. This study examined whether the present standard still protects most workers. METHODS: The sample comprised 168 heat acclimatized workers (90 in construction sites, 78 in foundries). Heart rate and auditory canal temperature were recorded continuously for 2 hours. Workplace WBGT, relative humidity, and wind velocity were monitored, and the participants’ workloads were estimated. Heat-related symptoms and signs were collected by a questionnaire. RESULTS: Only 55% of the participants worked in workplaces complying with the heat standard. Of them, 79% had auditory canal temperature ? 38.5(o)C, compared with only 58% in noncompliant workplaces. 18% and 43% of the workers in compliant and noncompliant workplaces, respectively, had symptoms from heat stress, the trend being similar across all workload levels. An increase of one degree (C) in WBGT was associated with a 1.85-fold increase (95% confidence interval: 1.44-2.48) in odds for having symptoms. CONCLUSION: Compliance with the current occupational heat standard protects 4/5 of the workers, whereas noncompliance reduces this proportion to one half. The reasons for noncompliance include the gaps and ambiguities in the law. The law should specify work/rest schedules; outdoor work should be identified as an occupational heat hazard; and the staff should include occupational personnel to manage heat stress in establishments involving heat exposure.
Despite the relevance of road crashes and their impact on social and health care costs, the effects of extreme temperatures on road crashes risk have been scarcely investigated, particularly for those occurring in occupational activities. A nationwide epidemiological study was carried out to estimate the risk of general indistinct and work-related road crashes related with extreme temperatures and to identify crash and occupation parameters mostly involved. Data about road crashes, resulting in death or injury, occurring during years 2013-2015 in Italy, were collected from the National Institute of Statistics, for general indistinct road crashes, and from the compensation claim applications registered by the national workers’ compensation authority, for work-related ones. Time series of hourly temperature were derived from the results provided by the meteorological model WRF applied at a national domain with 5 km resolution. To consider the different spatial-temporal characteristics of the two road crashes archives, the association with extreme temperatures was estimated by means of a case-crossover time-stratified approach using conditional logistic regression analysis, and a time-series analysis, using over-dispersed Poisson generalized linear regression model, for general indistinct and work-related datasets respectively. The analyses were controlled for other covariates and confounding variables (including precipitation). Non-linearity and lag effects were considered by using a distributed lag non-linear model. Relative risks were calculated for increment from 75th to 99th percentiles (hot) and from 25 to first percentile (cold) of temperature. Results for general indistinct crashes show a positive association with hot temperature (RR = 1.12, 95 % CI: 1.09-1.16) and a negative one for cold (RR = 0.93, 95 % CI: 0.91-0.96), while for work-related crashes a positive association was found for both hot and cold (RR = 1.06 (95 % CI: 1.01-1.11) and RR = 1.10 (95 % CI: 1.05-1.16). The use of motorcycles, the location of accident (urban vs out of town), presence of crossroads, as well as occupational factors like the use of a vehicle on duty were all found to produce higher risks of road crashes during extreme temperatures. Mitigation and prevention measures are needed to limit social and health care costs.
Occupational heat stress directly hampers physical work capacity (PWC), with large economic consequences for industries and regions vulnerable to global warming. Accurately quantifying PWC is essential for forecasting impacts of different climate change scenarios, but the current state of knowledge is limited, leading to potential underestimations in mild heat, and overestimations in extreme heat. We therefore developed advanced empirical equations for PWC based on 338 work sessions in climatic chambers (low air movement, no solar radiation) spanning mild to extreme heat stress. Equations for PWC are available based on air temperature and humidity, for a suite of heat stress assessment metrics, and mean skin temperature. Our models are highly sensitive to mild heat and to our knowledge are the first to include empirical data across the full range of warm and hot environments possible with future climate change across the world. Using wet bulb globe temperature (WBGT) as an example, we noted 10% reductions in PWC at mild heat stress (WBGT = 18°C) and reductions of 78% in the most extreme conditions (WBGT = 40°C). Of the different heat stress indices available, the heat index was the best predictor of group level PWC (R(2) = 0.96) but can only be applied in shaded conditions. The skin temperature, but not internal/core temperature, was a strong predictor of PWC (R(2) = 0.88), thermal sensation (R(2) = 0.84), and thermal comfort (R(2) = 0.73). The models presented apply to occupational workloads and can be used in climate projection models to predict economic and social consequences of climate change.
BACKGROUND: As the global climate changes in response to anthropogenic greenhouse gas emissions, weather and temperature are expected to become increasingly variable. Although heat sensitivity is a recognized clinical feature of multiple sclerosis (MS), a chronic demyelinating disorder of the central nervous system, few studies have examined the implications of climate change for patients with this disease. METHODS AND FINDINGS: We conducted a retrospective cohort study of individuals with MS ages 18-64 years in a nationwide United States patient-level commercial and Medicare Advantage claims database from 2003 to 2017. We defined anomalously warm weather as any month in which local average temperatures exceeded the long-term average by ?1.5°C. We estimated the association between anomalously warm weather and MS-related inpatient, outpatient, and emergency department visits using generalized log-linear models. From 75,395,334 individuals, we identified 106,225 with MS. The majority were women (76.6%) aged 36-55 years (59.0%). Anomalously warm weather was associated with increased risk for emergency department visits (risk ratio [RR] = 1.043, 95% CI: 1.025-1.063) and inpatient visits (RR = 1.032, 95% CI: 1.010-1.054). There was limited evidence of an association between anomalously warm weather and MS-related outpatient visits (RR = 1.010, 95% CI: 1.005-1.015). Estimates were similar for men and women, strongest among older individuals, and exhibited substantial variation by season, region, and climate zone. Limitations of the present study include the absence of key individual-level measures of socioeconomic position (i.e., race/ethnicity, occupational status, and housing quality) that may determine where individuals live-and therefore the extent of their exposure to anomalously warm weather-as well as their propensity to seek treatment for neurologic symptoms. CONCLUSIONS: Our findings suggest that as global temperatures rise, individuals with MS may represent a particularly susceptible subpopulation, a finding with implications for both healthcare providers and systems.
BACKGROUND: As global temperatures rise, increasing numbers of individuals will work in hot environments. Interventions to protect their health are critical, as are reliable methods to measure the physiological strain experienced from heat exposure. The physiological strain index (PSI) is a measure of heat strain that relies on heart rate and core temperature but is challenging to calculate in a real-world occupational setting. METHODS: We modified the PSI for use in field settings where resting temperature and heart rate are not available and used the modified physiological strain index (mPSI) to describe risk factors for high heat strain (mPSI???7) experienced by agricultural workers in Florida during the summers of 2015 through 2017. mPSI was calculated for 221 workers, yielding 465 days of data. RESULTS: A higher heat index (??=?0.185; 95% CI: 0.064, 0.307) and higher levels of physical activity at work (0.033; 95% CI: 0.017, 0.050) were associated with a higher maximum mPSI. More years worked in US agriculture (-0.041; 95% CI: -0.061, -0.020) were protective against a higher maximum mPSI. Out of 23 workdays that a participant experienced a maximum mPSI???7,?22 were also classified as strained by at least one other measure of high heat strain (core temperature [Tc] >38.5°C, sustained heart rate >(180?-?age), and mean heart rate?>?115?bpm). CONCLUSIONS: This study provides critical information on risk factors for elevated heat strain for agricultural workers and suggests a practical approach for using PSI in field-based settings.
The over one million agricultural workers in the United States (U.S.) are amongst the populations most vulnerable to the health impacts of extreme heat. Climate change will further increase this vulnerability. Here we estimate the magnitude and spatial patterns of the growing heat exposure and health risk faced by U.S. crop workers and assess the effect of workplace adaptations on mitigating that risk. We find that the average number of days spent working in unsafe conditions will double by mid-century, and, without mitigation, triple by the end of it. Increases in rest time and the availability of climate-controlled recovery areas can eliminate this risk but could affect farm productivity, farm worker earnings, and/or labor costs much more than alternative measures. Safeguarding the health and well-being of U.S. crop workers will therefore require systemic change beyond the worker and workplace level.
As global temperatures continue to rise it is imperative to understand the adverse effects this will pose to workers laboring outdoors. The purpose of this study was to investigate the relationship between increases in wet bulb globe temperature (WBGT) and risk of occupational injury or dehydration among agricultural workers. We used data collected by an agribusiness in Southwest Guatemala over the course of four harvest seasons and Poisson generalized linear modelling for this analysis. Our analyses suggest a 3% increase in recorded injury risk with each degree increase in daily average WBGT above 30 °C (95% CI: -6%, 14%). Additionally, these data suggest that the relationship between WBGT and injury risk is non-linear with an additional 4% acceleration in risk for every degree increase in WBGT above 30 °C (95% CI: 0%, 8%). No relationship was found between daily average WBGT and risk of dehydration. Our results indicate that agricultural workers are at an increased risk of occupational injury in humid and hot environments and that businesses need to plan and adapt to increasing global temperatures by implementing and evaluating effective occupational safety and health programs to protect the health, safety, and well-being of their workers.
Epidemiological evidence has shown an association between exposure to high temperatures and occupational injuries, an issue gaining importance with environmental change. The aim of this study was to better understand contributing risk factors and preventive actions based on personal experiences. Interviews were conducted with 21 workers from five Australian states using a critical phenomenological approach to capture the lived experiences of participants, whilst exploring contextual factors that surround these experiences. Two case studies are presented: a cerebrovascular injury and injuries among seasonal horticulture workers. Other accounts of heat-related injuries and heat stress are also presented. Risk factors were classified as individual, interpersonal and organizational. In terms of prevention, participants recommended greater awareness of heat risks and peer-support for co-workers. Adding value to current evidence, we have provided new insights into the etiology of the health consequences of workplace heat exposure with workers identifying a range of influencing factors, prevention measures and adaptation strategies. Underpinning the importance of these are future climate change scenarios, suggesting that extended hot seasons will lead to increasing numbers of workers at risk of heat-stress and associated occupational injuries.
Emergency managers (EMs) and Emergency Social Services Directors (ESSDs) are essential service providers who fulfill critical roles in disaster risk reduction. Despite being positioned throughout all levels of government, and in the private sector, EMs and ESSDs fulfill roles which occur largely behind the scenes. The purpose of this phenomenological study was to explore the roles of EMs and ESSDs from different regions across Canada. Specifically, we wanted to understand their perceptions of barriers, vulnerabilities and capabilities within the context of their roles. EMs (n = 15) and ESSDs (n = 6) from six Canadian provinces participated in semi-structured telephone interviews. Through content analysis, five themes and one model were generated from the data: 1) Emergency management is not synonymous with first response, 2) Unrealistic expectations for a “side-of-desk” role, 3) Minding the gap between academia and practice with a ‘whole-society’ approach, 4) Personal preparedness tends to be weak, 5) Behind the scenes roles can have mental health implications. We present a model, based on these themes, which makes explicit the occupational risks that EMs and ESSDs may encounter in carrying out the skills, tasks, and roles of their jobs. Identification of occupational risks is a first step towards reducing vulnerabilities and supporting capability. This is particularly relevant in our current society as increased demands placed on these professionals coincides with the increasing frequency and severity of natural disasters due to climate change and the emergence of the world wide COVID-19 pandemic.
BACKGROUND: Scrub typhus is a major cause of acute febrile illness in the tropics and is endemic over large areas of the Asia Pacific region. The national and global burden of scrub typhus remains unclear due to limited data and difficulties surrounding diagnosis. METHODOLOGY/PRINCIPAL FINDINGS: Scrub typhus reporting data from 2003-2018 were collected from the Thai national disease surveillance system. Additional information including the district, sub-district and village of residence, population, geographical, meteorological and satellite imagery data were also collected for Chiangrai, the province with the highest number of reported cases from 2003-2018. From 2003-2018, 103,345 cases of scrub typhus were reported with the number of reported cases increasing substantially over the observed period. There were more men than women, with agricultural workers the main occupational group affected. The majority of cases occurred in the 15-64 year old age group (72,144/99,543, 72%). Disease burden was greatest in the northern region, accounting for 53% of the total reported cases per year (mean). In the northern region, five provinces-Chiangrai, Chiangmai, Tak, Nan and Mae Hong Son-accounted for 84% (46,927/55,872) of the total cases from the northern region or 45% (46,927/103,345) of cases nationally. The majority of cases occurred from June to November but seasonality was less marked in the southern region. In Chiangrai province, elevation, rainfall, temperature, population size, habitat complexity and diversity of land cover contributed to scrub typhus incidence. INTERPRETATION: The burden of scrub typhus in Thailand is high with disease incidence rising significantly over the last two decades. However, disease burden is not uniform with northern provinces particularly affected. Agricultural activity along with geographical, meteorological and land cover factors are likely to contribute to disease incidence. Our report, along with existing epidemiological data, suggests that scrub typhus is the most clinically important rickettsial disease globally.
Occupational heat stress has an important negative impact on the well-being, health and productivity of workers and should; therefore, be recognized as a public health issue in Europe. There is no comprehensive heat health warning system in Slovenia combining public health measures with meteorological forecasts. The aim of this research was to provide insight into the development of such a system in Slovenia, turning the communication from the current meteoalarm into a broader system that has more information for different social groups. To achieve this goal, the following steps were used: Analysis of summer temperatures and issued meteoalarms, a survey of the general knowledge about heat among the public, organization and management of two stakeholder symposia, and a final survey on workers’ opinions on heat stress and measures, supplemented by interviews with employers. Summer average daily temperature distributions in Slovenia changed during the investigated period (1961-2019) and the mean values increased over time by 2-3 °C. Additionally, the number of days with fulfilled yellow (potentially dangerous) and especially orange (dangerous) meteoalarm conditions increased significantly after 1990. The survey of the general public about heat stress and warnings showed that efforts to raise awareness of heat issues need to be intensified and that public health measures should effectively target vulnerable groups. Stakeholder symposia and further surveys have shown that awareness and understanding of the negative effects of heat stress on health and productivity are still quite low, so effective ways of disseminating information to different sectors while striking the best balance between efficiency, feasibility and economic cost have to be found.
BACKGROUND: Outdoor workers are at risk of prolonged and high solar ultraviolet radiation (UVR) exposure, which is known to cause skin cancer. The objectives of this study were to characterize the UVR exposure levels of outdoor workers in Alberta, Canada, and to investigate what factors may contribute to their exposure. METHODS: This study collected objective solar UVR measurements from outdoor workers primarily in Alberta during the summer of 2019. Workers were recruited via the management or health and safety teams from building trade unions and employers. Calibrated, electronic UVR dosimeters were worn by workers on their hardhats, wrists, or lapels for five working days. Data on workers’ demographics, jobs, sun protection behaviors, and personal risk factors were collected using questionnaires, and meteorological data for each sampling day were noted. Mean daily exposure measured as the standard erythemal dose (SED) was calculated and compared to the international occupational exposure limit guideline (1.3 SED). Marginal models were developed to evaluate potential determinants of occupational solar UVR exposure. RESULTS: In total, 883 measurements were collected from 179 workers. On average, workerswere exposed to 1.93 SED (range: 0.03-16.63 SED) per day. Just under half of workers (45%) were exposed to levels exceeding the international exposure limit guideline. In the bivariate analyses, landscape and maintenance workers, as well as trade and recreation workers, had the highest levels of exposure (average: 2.64 and 1.84 SED, respectively). Regional variations were observed, with the “other” cities/regions (outside of Edmonton and Calgary) experiencing the highest average levels (2.60 SED). Workers who placed the dosimeters on their hardhats experienced higher levels compared to the other groups. Exposure was highest on sunny and mixed days. Education, trade, city, dosimeter placement, forecast, hair colour, and number of hours outside were included in the final exposure model, of which trade, dosimeter placement, forecast, and number of hours outside at work were statistically significant. CONCLUSIONS: Exposure to elevated solar UVR levels is common among outdoor workers in Alberta. The study findings can help inform future monitoring studies and exposure reduction initiatives aimed at protecting workers.
BACKGROUND: As climate change increases global temperatures, heat-related morbidity and mortality are projected to rise. Outdoor workers and those who perform exertional tasks are particularly susceptible to heat-related illness (HRI). Using workers’ compensation data, we aimed to describe rates of occupational HRI in California and identify demographic and occupational risk factors to inform prevention efforts. METHODS: We identified HRI cases during 2000-2017 in the California Workers’ Compensation Information System (WCIS) using International Classification of Diseases Ninth and Tenth Revision codes, WCIS nature and cause of injury codes, and HRI keywords. We assigned industry and occupation codes using the NIOSH Industry and Occupation Computerized Coding System (NIOCCS). We calculated HRI rates by sex, age group, year, county, industry, and occupation, and estimated confidence intervals using generalized linear models. RESULTS: We identified 15,996 HRI cases during 2000-2017 (6.0 cases/100,000 workers). Workers aged 16-24 years had the highest HRI rate (7.6) among age groups, and men (8.1) had a higher rate than women (3.5). Industry sectors with the highest HRI rates were Agriculture, Farming, Fishing, and Forestry (38.6), and Public Administration (35.3). Occupational groups with the highest HRI rates were Protective Services (56.6) and Farming, Fishing, and Forestry (36.6). Firefighters had the highest HRI rate (389.6) among individual occupations. CONCLUSIONS: Workers in certain demographic and occupational groups are particularly susceptible to HRI. Additional prevention efforts, including outreach and enforcement targeting high-risk groups, are needed to reduce occupational HRI. Workers’ compensation data can provide timely information about temporal trends and risk factors for HRI.
Saudi Arabia (SA) is one of the hottest countries in the world. This study was conducted to assess the impact of summer heat stress in Southeastern SA on short-term kidney injury (KI) among building construction workers and to identify relevant risk factors. Measurements of urinary albumin-creatinine ratio (ACR), height, weight, hydration, symptoms, daily work and behavioral factors were collected in June and September of 2016 from a cohort of construction workers (n = 65) in Al-Ahsa Province, SA. KI was defined as ACR ?30 mg/g. Multivariate linear regression analysis was used to assess factors related to cross-summer changes in ACR. A significant increase in ACR occurred among most workers over the study period; incidence of KI was 18%. Risk factors associated with an increased ACR included dehydration, short sleep, and obesity. The findings suggest that exposure to summer heat may lead to the development of KI among construction workers in this region. Adequate hydration and promotion of healthy habits among workers may help reduce the risk of KI. A reduction in work hours may be the most effective intervention because this action can reduce heat exposure and improve sleep quality.
Infectious diseases are emerging and re-emerging due to climate change. Understanding how climate variability affects the transmission of infectious diseases is important for both researchers and the general public. Yet, the widespread knowledge of the general public on this matter is unknown, and quantitative research is still lacking. A survey was designed to assess the knowledge and perception of 1) infectious diseases, 2) climate change and 3) the effect of climate change on infectious diseases. Participants were recruited via convenience sampling, and an anonymous cross-sectional survey with informed consent was distributed to each participant. Descriptive and inferential analyses were performed primarily focusing on the occupational background as well as nationality of participants. A total of 458 individuals participated in this study, and most participants were originally from Myanmar, the Netherlands, Spain, United Kingdom and the United States. Almost half (44%) had a background in natural sciences and had a higher level of knowledge on infectious diseases compared to participants with non-science background (mean score of 12.5 and 11.2 out of 20, respectively). The knowledge of the effect of climate change on infectious diseases was also significantly different between participants with and without a background in natural sciences (13.1 and 11.8 out of 20, respectively). The level of knowledge on various topics was highly correlated with nationality but not associated with age. The general population demonstrated a high awareness and strong knowledge of climate change regardless of their background in natural sciences. This study exposes a knowledge gap in the general public regarding the effect of climate change on infectious diseases, and highlights that different levels of knowledge are observed in groups with differing occupations and nationalities. These results may help to develop awareness interventions for the general public.
Rising temperature and heat stress risks in the changing climate scenario might potentially affect workers globally, especially the ones with strenuous workload in tropical settings. We used a cross-sectional study design to profile the heat exposures of similar to 1900 workers from eight industrial sectors using a QuesTemp Wet Bulb Globe Temperature (WBGT) monitor, quantified select heat-strain indicators viz., rise in Core Body Temperature, Sweat Rate, and Urine Specific Gravity and evaluated the perceived health impacts of heat stress using a structured questionnaire. Heat exposures (average WBGT: 30.1 +/- 2.6 degrees C) exceeded the Threshold Limit Value for 67% workers and was positively associated with the rise in Core Body Temperature >1 degrees C in 13% and elevated Urine Specific Gravity >1.020 in 9% workers. Heat-related health concerns were reported by 86% workers, and the heat-exposed workers had 2.3 times higher odds of adverse health outcomes compared to unexposed workers (p < 0.0001). Exposure to higher WBGT and adverse renal health among salt-pan workers were significantly associated (p = 0.004), and steel workers had 9% prevalence of kidney stones. Evidence presented clearly points to heat stress as a health and productivity risk factor that could have long-term and irreversible health impacts. In-depth assessments are urgently needed to develop scientifically sound preventative interventions and protective labor policies to avert the adverse occupational health and productivity consequences for millions of workers globally, thereby aiding poverty reduction.
Climate Change and malnutrition are two global phenomena that affect millions of population groups. The Philippines is considered one of the most vulnerable countries for extreme natural events and at the same time has a high prevalence of underweight (19.0%) and stunting (28.8%) in 2019 among under five children. The nutritionally vulnerable groups are children, pregnant and lactating women, and elderly. These groups are also greatly affected by climate change-related events then the malnutrition situation is exacerbated. The local nutrition workers are the frontline workers who plan, implement, and monitor nutrition programs. Mainstreaming climate change in the local nutrition planning processes will be facilitated if nutrition workers are knowledgeable. This study aimed to determine the current knowledge, attitudes and practices of nutrition workers and perceptions on how to mainstream climate change in the nutrition sector’s local planning system. A survey was conducted among local nutrition workers. Ninety-five percent of nutrition workers were highly knowledgeable, 86% were with high level of attitudes and 50% were exhibiting moderate level of practices related to climate change. The gaps can be narrowed by capacity building and possibly this can lead to mainstreaming climate change in the local nutrition planning process.
Introduction: Hot weather poses occupational health and safety concerns for people working in hot environments. It is known that work-related injuries increase during hot weather, yet there is an incomplete understanding of the underlying factors. Methods: A national online survey was conducted in Australia among health and safety representatives (HSRs) to better understand factors contributing to heat-related injuries in workplaces. Risk factors and preventive measures associated with reported injuries were identified using log-poisson regression models. Results: In total, 222 HSRs completed the survey. Overall, 43% reported that injuries or incidents caused by hot/very humid weather occur sometimes or often in their workplace. Factors found to be associated with reported heat-related injuries included ‘the wearing of personal protective equipment (PPE)’ which can hinder the loss of body heat, and ‘inadequate resources and facilities’. ‘Piece-rate workers’ and ‘new workers’ were identified as being at high risk. The most frequently adopted preventive measures for outdoor and indoor workers were the provision of PPE (despite some identified issues) and access to cool drinking water. HSRs reported that less injuries occurred in hot weather among outdoor workers if work was rescheduled to cooler times and shade was provided; and in indoor environments where there was adequate ventilation, heat sources were shielded and workers were able to self-pace. Conclusion: Organisational issues, workplace hazards, personal factors and preventive measures, are all determinants of heat-related injuries in Australian workplaces. Wider adoption of identified prevention measures could reduce the incidence of heat-related injuries in outdoor and indoor workplaces.
Susceptibility to heat illness during physically demanding work in hot environments is greater on the second of two consecutive workdays. While it has been demonstrated that heat storage is exacerbated on the second compared to first workday in older workers (50-65?yr), the effects on heart rate variability (HRV), an established surrogate of cardiac autonomic modulation, remain unclear. This study evaluated HRV in older workers on the day following prolonged work in the heat. Electrocardiogram was recorded in nine older (53-64?yr) males at rest, during three 30-min bouts of semi-recumbent cycling at fixed rates of metabolic heat production (150, 200, 250?W/m(2)), each separated by 15-min recovery. Experiments were conducted in hot-dry conditions (40?°C, 20% relative humidity), immediately prior to (Day 1), and on the day following (Day 2), a prolonged work simulation (?7.5?hr) involving moderate intensity intermittent exercise in hot-dry conditions (38?°C, 34% relative humidity). Core temperature, as well as time, frequency, and nonlinear HRV indices were derived for analysis during rest, the final 5-min of exercise at the highest heat production and recovery. The change in core temperature at the end of work (mean?±SD) was significantly greater on Day 2 (1.0?°C?±0.3) relative to Day 1 (0.8?°C?±0.2; p?0.01). Heart rate, however, did not significantly differ between days 1 and 2 at rest (Day 1, 59 ±11 bpm; Day 2, 62 ±13 bpm), during exercise (Day 1, 113 ±21?bpm; Day 2, 114 ±18?bpm ) and at the end of recovery (Day 1, 75 ±16?bpm; Day 2, 76 ±12?bpm). Likewise, there were no significant differences in any HRV indices derived from time, frequency, and nonlinear domains (all p?>?0.05). Prolonged work in the heat did not modulate next-day heart rhythms, as reflected by HRV, despite augmented core temperature. While HRV can reflect physiological aspects of cardiac autonomic stressors, these findings indicate it does not provide a means to identify exacerbated heat strain in older workers over consecutive work shifts in the heat.
BACKGROUND: The Threshold Limit Values (TLV) of the American Conference of Governmental and Industrial Hygienists indicate the levels of heat stress that all workers may be repeatedly exposed to without adverse health effects. In this study, we evaluated heart rate variability (HRV) during moderate-to-heavy work performed continuously or according to different TLV work-rest (WR) allocations in healthy physically active older workers. METHODS: Nine healthy older (58?±?5?years) males performed three different 120-minute conditions in accordance with TLV guidelines for moderate-to-heavy intensity work (360?W fixed rate of heat production) in different wet-bulb globe temperatures (WBGT): continuous cycling at 28°C WBGT (CON), as well as intermitted work performed at WR of 3:1 in 29°C WBGT (WR3:1), and at WR of 1:1 at 30°C (WR1:1). Rectal temperature and HRV (3-lead electrocardiogram [ECG]) were assessed throughout. RESULTS: Coefficient of Variation, Poincaré SD2, and Shannon Entropy were decreased during the CON compared with the WR3:1 when core temperature exceeded 38°C and after 1?hour of continuous work (P?.05). Also, 4 of the 12 HRV indices studied were reduced at CON compared with WR1:1 after 2?hours of accumulated work time (P?.05). Participants worked longer before core temperature reached 38°C during the WR1:1 and the WR3:1, compared with CON (P?.05). CONCLUSIONS: Incorporating breaks during moderate-to-heavy work in the heat for older adults can reduce autonomic stress and prolong the work performed at safe core temperature levels. The TLV WR1:1 provides increased cardiac protection for older workers, as compared with the CON and the WR3:1.
The effect of tropical deforestation on heat exposure and subsequent human health outcomes remains understudied, especially among an increasingly vulnerable population-healthy, adult subsistence workers in rural industrializing tropical countries. We report on a field experiment that estimated the short-term effects of heat exposure from deforestation on cognitive performance. We randomly assigned rural, adult subsistence workers in East Kalimantan, Indonesia to deforested or forested settings, and standard or high incentive piece rate payments. Participants worked in forested or deforested settings for up to 90 min, where ambient and black globe temperatures in deforested areas were, on average, 2.1 degrees C and 10 degrees C higher. After completing the experimental task, participants were asked to take a validated general cognitive assessment test (CAT) and episodic memory test (EMT). We found participants in deforested settings had statistically significant lower scores on both CAT and EMT. Effects were largely driven by heat effects on male participants and those working after noon. Our results highlight how heat exposure from tropical deforestation may lead to declines in cognitive performance even in favorable work settings. Policymakers should consider how land use planning that takes into account the cooling services of trees can play a significant role in increasing resilience to heat from climate and land use change in the tropics.
BACKGROUND: Heat related illness (HRI) places a significant burden on the health and safety of working populations and its impacts will likely increase with climate change. The aim of this study was to characterize the demographic and occupational characteristics of Washington workers who suffered from HRI from 2006 to 2017 using workers’ compensation claims data. METHODS: We used Washington workers’ compensation data linked to weather station data to identify cases of work-related HRI. We utilized Occupational Injury and Illness Classification System codes, International Classification of Diseases 9/10 codes, and medical review to identify accepted and rejected Washington State (WA) workers’ compensation claims for HRI from 2006 to 2017. We estimated rates of HRI by industry and evaluated patterns by ambient temperature. RESULTS: We detected 918 confirmed Washington workers’ compensation HRI claims from 2006 to 2017, 654 were accepted and 264 were rejected. Public Administration had the highest third quarter rate (131.3 per 100?000 full time employees [FTE]), followed by Agriculture, Forestry, Fishing, and Hunting (102.6 per 100?000 FTE). The median maximum daytime temperature was below the Washington heat rule threshold for 45% of the accepted HRI claims. Latinos were estimated to be overrepresented in HRI cases. CONCLUSION: The WA heat rule threshold may not be adequately protecting workers and racial disparities are present in occupational HRI. Employers should take additional precautions to prevent HRI depending on the intensity of heat exposure. States without heat rules and with large industry sectors disproportionately affected by HRI should consider regulations to protect outdoor workers in the face of more frequent and extreme heat waves.
The need for healthcare workers (HCWs) to wear personal protective equipment (PPE) during the coronavirus disease 2019 (COVID-19) pandemic heightens their risk of thermal stress. We assessed the knowledge, attitudes, and practices of HCWs from India and Singapore regarding PPE usage and heat stress when performing treatment and care activities. One hundred sixty-five HCWs from India (n = 110) and Singapore (n = 55) participated in a survey. Thirty-seven HCWs from Singapore provided thermal comfort ratings before and after ice slurry ingestion. Differences in responses between India and Singapore HCWs were compared. A p-value cut-off of 0.05 depicted statistical significance. Median wet-bulb globe temperature was higher in India (30.2 °C (interquartile range [IQR] 29.1-31.8 °C)) than in Singapore (22.0 °C (IQR 18.8-24.8 °C)) (p < 0.001). Respondents from both countries reported thirst (n = 144, 87%), excessive sweating (n = 145, 88%), exhaustion (n = 128, 78%), and desire to go to comfort zones (n = 136, 84%). In Singapore, reports of air-conditioning at worksites (n = 34, 62%), dedicated rest area availability (n = 55, 100%), and PPE removal during breaks (n = 54, 98.2%) were higher than in India (n = 27, 25%; n = 46, 42%; and n = 66, 60%, respectively) (p < 0.001). Median thermal comfort rating improved from 2 (IQR 1-2) to 0 (IQR 0-1) after ice slurry ingestion in Singapore (p < 0.001). HCWs are cognizant of the effects of heat stress but might not adopt best practices due to various constraints. Thermal stress management is better in Singapore than in India. Ice slurry ingestion is shown to be practical and effective in promoting thermal comfort. Adverse effects of heat stress on productivity and judgment of HCWs warrant further investigation.
Currently, occupational heat exposure is usually measured using environmental variables such as the wet bulb globe temperature index. The costs of heat stress monitoring include the acquisition of specialized equipment and the recruitment of trained personnel. In rapidly changing environments, such as outdoor settings, these assessments must be conducted on a daily basis. The wet bulb globe temperature index has been criticized as a measure of heat stress for its failure to account for individual differences in susceptibility to heat stress, age, body mass index, physical fitness, clothing, illnesses and use of alcohol or drugs. The objective of this study was to assess the relationship between heart rate and body temperature in heat-exposed workers to determine whether heart rate can be used to monitor and prevent heat stress and physiological strain. This study was based on previous literature as well as physiological and environmental data collected from 10 individuals engaged in heavy physical labor. Heart rate, which has been recommended by the American Conference of Governmental Industrial Hygienists (ACGIH) as a possible measure of heat stress, follows a similar trend to body temperature with a slight temporal delay. Heart rate monitors with alarm systems could be developed to notify workers when to slow down their activities or take a break for thermal recovery, thereby contributing to the prevention of heat-related illness.
Prolonged or intense exposure to heat can lead to a range of health effects. This study investigated heat exposure and heat-related symptoms which sugarcane workers (90 sugarcane cutters and 93 factory workers) experienced during a harvesting season in Thailand. During the hottest month of harvesting season, wet bulb globe temperature was collected in the work environment, and workloads observed, to assess heat stress. Urine samples for dehydration test, blood pressure, heart rate, and body temperature were measured pre- and post-shift to measure heat strain. Fluid intake and heat-related symptoms which subjects had experienced during the harvesting season were gathered via interviews at the end of the season. From the results, sugarcane cutters showed high risk for heat stress and strain, unlike factory workers who had low risk based on the American Conference of Governmental Industrial Hygiene (ACGIH) threshold limit values (TLVs) for heat stress. Dehydration was observed among sugarcane cutters and significant physiological changes including heart rate, body temperature, and systolic blood pressure occurred across the work shift. Significantly more sugarcane cutters reported experiencing heat-related symptoms including weakness/fatigue, heavy sweating, headache, rash, muscle cramp, dry mouth, dizziness, fever, dry/cracking skin, and swelling, compared to sugarcane factory workers. We conclude that the heat stress experienced by sugarcane cutters working in extremely hot environments, with high workloads, is associated with acute health effects. Preventive and control measures for heat stress are needed to reduce the risk of heat strain.
An energy supply dominated by the use of fossil fuels causes both climate change and air pollution, which have negative impacts on human capital via both health and productivity. In addition, different people are affected differently because of factors such as age, gender and education level. To enhance the understanding of the benefits of low carbon transition from the labor supply perspective and help to identify strategies of collaborative control for CO2 and local air pollutants in China, an integrated assessment model linking the air quality module and the health impact module with a disaggregated labor sector computable general equilibrium (CGE) economic system is developed and applied in this study. Results show some key findings. First, renewable energy development and carbon capture and storage (CCS) technologies will contribute significantly to GDP in terms of their impact on air quality improvement by 0.99% and 0.54%, respectively, in 2050. Second, due to differences in labor composition, air pollution has, and will continue to have, the greatest impact on sectors with a higher proportion of male and lower-educated workers – such as the coal sector, and it will have the least impact on sectors with a higher proportion of female and higher-educated workers – such as the public administration sector. Third, the different impacts of sector output will increase economic inequality.
Climate change has caused an increased occurrence of heat waves. As a result of rising temperatures, implications for health and the environment have been more frequently reported. Outdoor labour activities deserve special attention, as is the case with agricultural and construction workers exposed to extreme weather conditions, including intense heat. This paper presents an overview of heat stress conditions in Brazil from 1961 to 2010. It also presents computer-simulated projections of heat stress conditions up to the late 21st century. The proposed climate analysis drew on historical weather data obtained from national weather stations and on reanalysis data, in addition to future projections with the ETA (regarding the model’s unique vertical coordinate) regional forecast model. The projections took into consideration two Representative Concentration Pathways (RCP)-the 4.5 and 8.5 climate scenarios, namely, moderate and high emissions scenarios, respectively. Heat stress was inferred based on the wet-bulb globe temperature (WBGT) index. The results of this climate analysis show that Brazilian outdoor workers have been exposed to an increasing level of heat stress. These results suggest that future changes in the regional climate may increase the probability of heat stress situations in the next decades, with expectations of WBGT values greater than those observed in the baseline period (1961-1990). In terms of spatial distribution, the Brazilian western and northern regions experienced more critical heat stress conditions with higher WBGT values. As a response to the increased frequency trends of hot periods in tropical areas, urgent measures should be taken to review public policies in Brazil. Such policies should include actions towards better working conditions, technological development to improve outdoor labour activities, and employment legislation reviews to mitigate heat impacts on occupational health.
BACKGROUND: Adverse health effects among agricultural workers due to chronic heat exposure have been characterized in the literature as not only due to high ambient temperatures but also due to intensive manual labor in hot and humid conditions. The aim of this study was to use biomonitoring equipment to examine the effectiveness of selected cooling devices at preventing agricultural workers from exceeding the core body temperature threshold of 38.0°C (Tc38) and attenuating heat-related illness symptoms. METHODS: A convenience sample of 84 agricultural workers in Florida was randomized to one of four groups: (a) no intervention, clothing as usual; (b) cooling bandana; (c) cooling vest; and (d) both the cooling bandana and cooling vest. Biomonitoring equipment worn by the participants included core body temperature monitor and an accelerometer to capture physical activity. FINDINGS: A total of 78 agricultural workers completed one intervention workday trial. Compared with the control group, the bandana group had lower odds of exceeding Tc38 (odds ratio [OR] = 0.7, 90% confidence interval [CI] = [0.2, 3.2]) and the vest group had higher odds of exceeding Tc38 (OR = 1.8, 90% CI = [0.4, 7.9]). The simultaneous use of cooling vest and bandana showed an effect little different from the control group (OR = 1.3, 90% CI = [0.3, 5.6]). CONCLUSION/APPLICATION TO PRACTICE: This is the first field-based study to examine cooling intervention among agricultural workers in the United States using biomonitoring equipment. This study found that using a bandana while working in a hot agricultural environment has the potential to be protective against exceeding the recommended Tc38 threshold.