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Zhao C, Huang Y, Cheng Y, Zhang R, Wang Y, Tong S, He J, Guo J, Xia F, Li Y, Yao X. Association between heatwaves and risk and economic burden of injury related hospitalizations in China. ENVIRONMENTAL RESEARCH 2024:119509. [PMID: 38945512 DOI: 10.1016/j.envres.2024.119509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 06/26/2024] [Accepted: 06/28/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND Public health is greatly affected by heatwaves, especially as a result of climate change. It is unclear whether heatwaves affect injury hospitalization, especially as developing countries facing the impact of climate change. OBJECTIVES To assess the impact of heatwaves on injury-related hospitalization and the economic burden. METHODS The daily hospitalizations and meteorological data from 2014 to 2019 were collected from 23 study sites in 11 meteorological geographic zones in China. We conducted a two-stage time series analysis based on a time-stratified case-crossover design, combined with DLNM to assess the association between heatwaves and daily injury hospitalization, and to further assess the regional and national economic losses resulting from hospitalization by calculating excess hospitalization costs (direct economic losses) and labor losses (indirect economic losses). To determine the vulnerable groups and areas, we also carried out stratified analyses by age, sex, and region. RESULTS We found that 6.542% (95%CI: 3.939%, 9.008 %) of injury hospitalization were attributable to heatwaves during warm season (May to September) from 2014-2019. Approximately 361,447 injury hospitalizations were attributed to heatwaves each year in China, leading to an excess economic loss of 5.173 (95%CI: 3.104, 7.196) billion CNY, of which 3.114 (95%CI: 1.454, 4.720) billion CNY for males and 4.785 (95%CI: 3.203, 6.321) billion CNY for people aged 15-64 years. The attributable fraction (AF) of injury hospitalizations due to heatwaves was the highest in the plateau mountain climate zone, followed by the subtropical monsoon climate zone and the temperate monsoon climate zone. CONCLUSIONS Heatwaves significantly increase the disease and economic burden of injury hospitalizations, and vary across populations and regions. Our findings implicate the necessity for targeted measures, including raising public awareness, improving healthcare infrastructure, and developing climate resilience policies, to reduce the threat of heatwaves to vulnerable populations and the associated disease and economic burden.
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Affiliation(s)
- Cheng Zhao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Yushu Huang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China; Department of Big Data in Health Science School of Public Health, and Center of Clinical Big Data and Analytics of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Yibin Cheng
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Rui Zhang
- Chinese Center for Disease Control and Prevention, Beijing 102206, China
| | - Yu Wang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Shilu Tong
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China; School of Public Health, Institute of Environment and Population Health, Anhui Medical University, Hefei 230032, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Jiang He
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Jia Guo
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Fan Xia
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China
| | - Yonghong Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China.
| | - Xiaoyuan Yao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China.
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Brink N, Lakhoo DP, Solarin I, Maimela G, von Dadelszen P, Norris S, Chersich MF. Impacts of heat exposure in utero on long-term health and social outcomes: a systematic review. BMC Pregnancy Childbirth 2024; 24:344. [PMID: 38704541 PMCID: PMC11069224 DOI: 10.1186/s12884-024-06512-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 04/11/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Climate change, particularly global warming, is amongst the greatest threats to human health. While short-term effects of heat exposure in pregnancy, such as preterm birth, are well documented, long-term effects have received less attention. This review aims to systematically assess evidence on the long-term impacts on the foetus of heat exposure in utero. METHODS A search was conducted in August 2019 and updated in April 2023 in MEDLINE(PubMed). We included studies on the relationship of environmental heat exposure during pregnancy and any long-term outcomes. Risk of bias was assessed using tools developed by the Joanna-Briggs Institute, and the evidence was appraised using the GRADE approach. Synthesis without Meta-Analysis (SWiM) guidelines were used. RESULTS Eighteen thousand six hundred twenty one records were screened, with 29 studies included across six outcome groups. Studies were mostly conducted in high-income countries (n = 16/25), in cooler climates. All studies were observational, with 17 cohort, 5 case-control and 8 cross-sectional studies. The timeline of the data is from 1913 to 2019, and individuals ranged in age from neonates to adults, and the elderly. Increasing heat exposure during pregnancy was associated with decreased earnings and lower educational attainment (n = 4/6), as well as worsened cardiovascular (n = 3/6), respiratory (n = 3/3), psychiatric (n = 7/12) and anthropometric (n = 2/2) outcomes, possibly culminating in increased overall mortality (n = 2/3). The effect on female infants was greater than on males in 8 of 9 studies differentiating by sex. The quality of evidence was low in respiratory and longevity outcome groups to very low in all others. CONCLUSIONS Increasing heat exposure was associated with a multitude of detrimental outcomes across diverse body systems. The biological pathways involved are yet to be elucidated, but could include epigenetic and developmental perturbations, through interactions with the placenta and inflammation. This highlights the need for further research into the long-term effects of heat exposure, biological pathways, and possible adaptation strategies in studies, particularly in neglected regions. Heat exposure in-utero has the potential to compound existing health and social inequalities. Poor study design of the included studies constrains the conclusions of this review, with heterogenous exposure measures and outcomes rendering comparisons across contexts/studies difficult. TRIAL REGISTRATION PROSPERO CRD 42019140136.
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Affiliation(s)
- Nicholas Brink
- Climate and Health Directorate, Wits RHI, University of the Witwatersrand, Johannesburg, South Africa.
| | - Darshnika P Lakhoo
- Climate and Health Directorate, Wits RHI, University of the Witwatersrand, Johannesburg, South Africa
| | - Ijeoma Solarin
- Climate and Health Directorate, Wits RHI, University of the Witwatersrand, Johannesburg, South Africa
| | - Gloria Maimela
- Climate and Health Directorate, Wits RHI, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Shane Norris
- MRC Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Matthew F Chersich
- Climate and Health Directorate, Wits RHI, University of the Witwatersrand, Johannesburg, South Africa
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Zhou L, Liu C, He C, Lei J, Zhu Y, Gao Y, Xuan J, Kan H, Chen R. Quantification of the Heat-Related Risk and Burden of Hospitalizations for Cause-Specific Injuries and Contribution of Human-Induced Climate Change: A Time-Stratified Case-Crossover Study in China. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:57005. [PMID: 38752990 PMCID: PMC11098006 DOI: 10.1289/ehp14057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 04/07/2024] [Accepted: 04/26/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Although ambient temperature has been linked with injury incidence, there have been few nationwide studies to quantify the temperature-related risk and burden of cause-specific injury hospitalizations. Additionally, the impact of human-induced climate change to injury burden remains unknown. OBJECTIVES Our objectives are to examine the associations between ambient temperature and injury hospitalizations from various causes and to quantify the contribution of human-induced warming to the heat-related burden. METHODS We collected injury hospitalization data from a nationwide hospital-based registry in China during 2000-2019. Using a time-stratified case-crossover design, we investigated the associations between daily mean temperature (°C) and cause-specific injury hospitalizations. We also quantified the burden of heat-related injuries under the scenarios with and without anthropogenic forcing, using the Detection and Attribution Model Intercomparison Project to assess the contribution of human-induced warming. RESULTS Our study included a total of 988,087 patients with hospitalization records for injuries. Overall, compared to the temperature at minimum risk of hospitalization (- 12.1 ° C ), the relative risk of hospitalization at extreme hot temperature (30.8°C, 97.5th percentile) was 1.18 [95% confidence interval (CI): 1.14, 1.22], with an approximately linear association between temperature and hospitalization. Vulnerability to heat-related injuries was more pronounced among males, young (< 18 years of age) or middle-aged (45-64 years of age) individuals, and those living in the North. The heat-related attributable fraction increased from 23.2% in the 2000s to 23.6% in the 2010s, with a corresponding increase in the contribution of human-induced change over time. In the 2010s, the heat-related attributable fractions for specific causes of injury ranged from 12.4% to 54.4%, with human-induced change accounting for 6.7% to 10.6% of the burden. DISCUSSION This nationwide study presents new evidence of significant associations between temperature and cause-specific injury hospitalizations in China and highlights the increasing contribution of human-induced warming to the injury burden. https://doi.org/10.1289/EHP14057.
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Affiliation(s)
- Lu Zhou
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
| | - Cong Liu
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
| | - Cheng He
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
- Institute of Epidemiology, Helmholtz Zentrum München—German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Jian Lei
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
| | - Yixiang Zhu
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
| | - Ya Gao
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
| | - Jianwei Xuan
- Health Economic Research Institute, School of Pharmacy, Sun Yat-Sen University, Guangzhou, China
| | - Haidong Kan
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
- National Center for Children’s Health, Children’s Hospital of Fudan University, Shanghai, China
| | - Renjie Chen
- Shanghai Institute of Infectious Disease and Biosecurity, School of Public Health, Fudan University, Shanghai, China
- School of Public Health, Hengyang Medical School, University of South China, Hengyang, Hunan, China
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Bernhardt JM, Amiri A. Application of the socioecological model to mitigate risks of heat illness. Nurs Outlook 2024; 72:102150. [PMID: 38442464 DOI: 10.1016/j.outlook.2024.102150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/08/2024] [Accepted: 02/11/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND The socio-ecological model (SEM) is a widely used framework that can be applied to heat-related illness (HRI) in the context of multiple influencing factors that exist in society. Leaders and policymakers must intervene to mitigate the deleterious effects of climate change on those at risk. PURPOSE The purpose is to introduce the SEM as a framework to address the complex factors contributing to the impact of excess heat. METHODS Conceived through the SEM, the compounding and cumulative impact of excess heat resulting in HRI is operationalized. DISCUSSION The SEM provides a structure for understanding the complex nature of climate change and HRI and proposed interventions. The prevention of HRI is dependent on actions, related to practice, education, research, and advocacy across multiple levels of the SEM. The SEM has the potential to target HRI at all levels of society to reduce the harm of excess heat.
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Affiliation(s)
- Jean M Bernhardt
- School of Nursing, MGH Institute of Health Professions, Charlestown, MA.
| | - Azita Amiri
- College of Nursing, The University of Alabama Huntsville, Huntsville, AL
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5
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Tetzlaff EJ, Cassan C, Goulet N, Gorman M, Hogya B, Kenny GP. "Breaking down in tears, soaked in sweat, and sick from the heat": Media-based composite narratives of first responders working during the 2021 Heat Dome. Am J Ind Med 2024; 67:442-452. [PMID: 38460501 DOI: 10.1002/ajim.23576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 01/15/2024] [Accepted: 02/19/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND During the summer of 2021, a deadly, unprecedented multiday Heat Dome engulfed western Canada. As a result of this extreme heat event (EHE), emergency dispatchers received an unparalleled increase in incoming 911 calls for ambulance, police, and fire (as first responders) services to attend to hundreds of heat-vulnerable community members succumbing to the heat. With 103 all-time heat records broken during this EHE and indoor temperatures of nearly 40°C, the first responders attending these calls faced extensive job demands and highly challenging operating conditions. Initial investigations have explored the health system-level impacts; however, little has been done to explore the impact on the first responders themselves. Therefore, this study aimed to improve our understanding of EHEs' impacts on the operational capabilities and health of first responders, specifically police, fire, ambulance, and dispatch services. METHODS A systematized review and content analysis of media articles published on the 2021 Heat Dome in Canada was conducted (n = 2909), and four media-based composite narratives were developed highlighting police, fire, ambulance, and dispatch services. The Job Demands-Resources (JD-R) model was applied as a theoretical framework for occupational burnout. RESULTS The media-based composite narratives highlighted that first responders faced record-breaking call volumes, increased mental-health-related claims, and exhaustive heat-related physiological stress. Using the JD-R model as a theoretical framework for occupational burnout, we identified three measures of stressful job demand: work overload (e.g., the surge in call volume, firefighters responding to medical emergencies), emotional demands (e.g., severe medical emergencies, sudden deaths, unresponsive patients, distraught family members), and physical demands (e.g., resuscitation in personal protective equipment, heat-related illness). CONCLUSION The experiences described underscore the importance of supporting first responders during work in extreme heat conditions. These findings have important implications for addressing rising rates of burnout during and following public health crises, such as EHEs, a problem that is increasingly being recognized as a threat to the Canadian public healthcare system.
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Affiliation(s)
- Emily J Tetzlaff
- Human and Environmental Physiology Research Unit, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Heat Division, Climate Change and Innovation Bureau, Healthy Environments and Consumer Safety Branch, Safe Environments Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Casey Cassan
- Human and Environmental Physiology Research Unit, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Nicholas Goulet
- Human and Environmental Physiology Research Unit, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Heat Division, Climate Change and Innovation Bureau, Healthy Environments and Consumer Safety Branch, Safe Environments Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Melissa Gorman
- Heat Division, Climate Change and Innovation Bureau, Healthy Environments and Consumer Safety Branch, Safe Environments Directorate, Health Canada, Ottawa, Ontario, Canada
| | - Brooks Hogya
- BC Emergency Health Services, Provincial Health Services Authority, Vancouver, British Columbia, Canada
| | - Glen P Kenny
- Human and Environmental Physiology Research Unit, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
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Bernard TE, Wolf ST, Kenney WL. A Novel Conceptual Model for Human Heat Tolerance. Exerc Sport Sci Rev 2024; 52:39-46. [PMID: 38294236 PMCID: PMC10963138 DOI: 10.1249/jes.0000000000000332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
Human "heat tolerance" has no accepted definition or physiological underpinnings; rather, it is almost always discussed in relative or comparative terms. We propose to use environmental limits to heat balance accounting for metabolic rate and clothing, that is, the environments for which heat stress becomes uncompensable for a specified metabolic rate and clothing, as a novel metric for quantifying heat tolerance.
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Affiliation(s)
- Thomas E. Bernard
- College of Public Health, University of South Florida, Tampa, FL 33612
| | - S. Tony Wolf
- Department of Kinesiology, University of Georgia, Athens, GA 30602
| | - W. Larry Kenney
- Department of Kinesiology and Integrative and Biomedical Physiology Program, The Pennsylvania State University, University Park, PA 16802
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Abarca Nava GJ, Pebley AR. Racial, Ethnic, and Immigrant Generational Disparities in Physically Strenuous and Hazardous Work Conditions. J Immigr Minor Health 2024; 26:268-277. [PMID: 37906400 PMCID: PMC10937783 DOI: 10.1007/s10903-023-01552-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2023] [Indexed: 11/02/2023]
Abstract
Despite the importance of work in adult life, research on the social determinants of health often ignores its effects. We examine race/ethnic, immigrant generational, and gender differentials in exposure to work conditions associated with poor health outcomes, using a nationally-representative sample of adults. On average, Latino 1st generation workers are more exposed to strenuous and hazardous work conditions than other workers, even after adjusting for sociodemographic differences. Exposure is lower for 2nd and 3rd generation Latinos. In contrast, Asian 1st generation men often have the lowest exposure levels of all groups and Asian 2nd and 3rd generation men have higher levels of exposure than the first generation, primarily due to intergenerational differences in education. Asian 1st generation women have higher exposures than those in the 2nd or 3rd generation. These results illustrate the importance of considering work conditions in research and policy related to the social determinants of health.
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Affiliation(s)
- Gabino J Abarca Nava
- Fielding School of Public Health and California Center for Population Research, University of California, Los Angeles (UCLA), Los Angeles, CA, USA
| | - Anne R Pebley
- Fielding School of Public Health and California Center for Population Research, University of California, Los Angeles (UCLA), Los Angeles, CA, USA.
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Deshayes TA, Hsouna H, Braham MAA, Arvisais D, Pageaux B, Ouellet C, Jay O, Maso FD, Begon M, Saidi A, Gendron P, Gagnon D. Work-rest regimens for work in hot environments: A scoping review. Am J Ind Med 2024; 67:304-320. [PMID: 38345435 DOI: 10.1002/ajim.23569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/08/2024] [Accepted: 01/23/2024] [Indexed: 03/16/2024]
Abstract
BACKGROUND To limit exposures to occupational heat stress, leading occupational health and safety organizations recommend work-rest regimens to prevent core temperature from exceeding 38°C or increasing by ≥1°C. This scoping review aims to map existing knowledge of the effects of work-rest regimens in hot environments and to propose recommendations for future research based on identified gaps. METHODS We performed a search of 10 databases to retrieve studies focused on work-rest regimens under hot conditions. RESULTS Forty-nine articles were included, of which 35 were experimental studies. Most studies were conducted in laboratory settings, in North America (71%), on healthy young adults, with 94% of the 642 participants being males. Most studies (66%) employed a protocol duration ≤240 min (222 ± 162 min, range: 37-660) and the time-weighted average wet-bulb globe temperature was 27 ± 4°C (range: 18-34). The work-rest regimens implemented were those proposed by the American Conference of Governmental and Industrial Hygiene (20%), National Institute of Occupational Safety and Health (11%), or the Australian Army (3%). The remaining studies (66%) did not mention how the work-rest regimens were derived. Most studies (89%) focused on physical tasks only. Most studies (94%) reported core temperature, whereas only 22% reported physical and/or mental performance outcomes, respectively. Of the 35 experimental studies included, 77% indicated that core temperature exceeded 38°C. CONCLUSIONS Although work-rest regimens are widely used, few studies have investigated their physiological effectiveness. These studies were mainly short in duration, involved mostly healthy young males, and rarely considered the effect of work-rest regimens beyond heat strain during physical exertion.
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Affiliation(s)
- Thomas A Deshayes
- Montreal Heart Institute, Montréal, Québec, Canada
- École de kinésiologie et des sciences de l'activité physique (EKSAP), Faculté de médecine, Université de Montréal, Montréal, Québec, Canada
| | - Hsen Hsouna
- Montreal Heart Institute, Montréal, Québec, Canada
- École de kinésiologie et des sciences de l'activité physique (EKSAP), Faculté de médecine, Université de Montréal, Montréal, Québec, Canada
| | - Mounir A A Braham
- Département des sciences de l'activité physique, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
- Département d'anatomie, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Denis Arvisais
- Bibliothèque des sciences de la santé, Université de Montréal, Montréal, Québec, Canada
| | - Benjamin Pageaux
- École de kinésiologie et des sciences de l'activité physique (EKSAP), Faculté de médecine, Université de Montréal, Montréal, Québec, Canada
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, Québec, Canada
- Centre interdisciplinaire de recherche sur le cerveau et l'apprentissage (CIRCA), Montréal, Québec, Canada
| | - Capucine Ouellet
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montréal, Québec, Canada
| | - Ollie Jay
- Heat and Health Research Incubator, University of Sydney, Sydney, New South Wales, Australia
| | - Fabien D Maso
- École de kinésiologie et des sciences de l'activité physique (EKSAP), Faculté de médecine, Université de Montréal, Montréal, Québec, Canada
- Centre interdisciplinaire de recherche sur le cerveau et l'apprentissage (CIRCA), Montréal, Québec, Canada
| | - Mickael Begon
- École de kinésiologie et des sciences de l'activité physique (EKSAP), Faculté de médecine, Université de Montréal, Montréal, Québec, Canada
- Centre de recherche du CHU Sainte-Justine, Montréal, Québec, Canada
| | - Alireza Saidi
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montréal, Québec, Canada
| | - Philippe Gendron
- Département des sciences de l'activité physique, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Daniel Gagnon
- Montreal Heart Institute, Montréal, Québec, Canada
- École de kinésiologie et des sciences de l'activité physique (EKSAP), Faculté de médecine, Université de Montréal, Montréal, Québec, Canada
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Banerjee S, Goswami K. Whether occupational injuries of the industrial workers can be prevented: an analysis from the slums of West Bengal-India? Int J Inj Contr Saf Promot 2024; 31:48-60. [PMID: 37740694 DOI: 10.1080/17457300.2023.2258511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 09/10/2023] [Indexed: 09/25/2023]
Abstract
A lack of research exists concerning the heterogeneity of the occupational injuries of slum dwellers across industries which has a close link with health expenditure and hence livelihood. It necessitates analysing their occupational injuries and associated out-of-pocket health expenditures. Multi-stage random sampling is used to collect the primary data and the logit model is used for data analyses. Permanent non-fatal injuries in the civil-mechanical industries and temporary non-fatal injuries in textile industries are common. The share of health expenditure of the injured workers seeking medical consultations remains 59% of their average monthly income. Average monthly income, parental occupation, types of industry, job security, risk intensity, and salary basis are significant estimates of occupational injuries. The differences in the nature and extent of the occupational injuries of the workers across industries in the light of the socio-demographic and working environment context provide significant insight into the policy implications.
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Affiliation(s)
- Shashwati Banerjee
- Department of Humanities and Social Sciences, Indian Institute of Engineering Science and Technology Shibpur, Shibpur, India
| | - Kishor Goswami
- Department of Humanities and Social Sciences, Indian Institute of Technology Kharagpur, Kharagpur, India
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10
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N SVSC, Xu Z. Heat and health of occupational workers: a short summary of literature. J Occup Health 2024; 66:uiae018. [PMID: 38604180 PMCID: PMC11131018 DOI: 10.1093/joccuh/uiae018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/02/2024] [Accepted: 03/21/2024] [Indexed: 04/13/2024] Open
Abstract
Globally, occupational workers suffer various health impacts due to extreme heat. In this short review, we examine the literature discussing health impacts of heat on occupational workers, and then discuss certain individual and institutional measures needed to address the problem. Though the available literature in the recent decade discusses health impacts of heat on workers as various heat-related illnesses, we found very few studies examining how occupational workers suffer from issues concerning cardiovascular health, neurological health, respiratory health, and mental health. In this regard, we highlight the need for more studies to examine how occupational workers exposed to extreme heat conditions suffer from fatal health issues like cardiovascular attack, brain stroke, and other ailments impacting vital organs of the body. Occupational workers across the world should be made aware of measures to protect themselves from extreme heat. Further, countries should develop occupational heat safety guidelines with statutory effect.
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Affiliation(s)
- Sai Venkata Sarath Chandra N
- School of Medicine and Dentistry, Parklands Drive, Southport, Gold Coast Campus, Griffith University, QLD 4222, Australia
| | - Zhiwei Xu
- School of Medicine and Dentistry, Parklands Drive, Southport, Gold Coast Campus, Griffith University, QLD 4222, Australia
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Jahangiri H, Zamanian Z, Daneshmandi H, Seif M, Jamshidi H. Investigating the short-term effects of using full-body hospital personal protective equipment and changes in physical workload intensity on human physiological and cognitive performance. ERGONOMICS 2023; 66:1295-1309. [PMID: 36343173 DOI: 10.1080/00140139.2022.2145375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 11/01/2022] [Indexed: 06/16/2023]
Abstract
The present study investigated the short-term effects of using Personal Protective Equipment (PPE) and physical workload intensity on human physiological and cognitive performance among 21 males and 19 females. PPE1 consisted of a medical coverall and surgical mask, while PPE2 consisted of impermeable full-body coverall, shoe covers, latex gloves, N95 mask, and face shield. Objective assessments were heart rate, energy expenditure, core body temperature, clothing microclimate temperature and humidity, and cognitive performance were the continuous performance test and N-Back test. Subjective assessments included thermal sensation, perceived fatigue/skin wetness/clothing moisture. Using PPE2 and increased workload intensity significantly increased the values of all physiological parameters and the subjective ratings of fatigue, thermal sensation, skin wetness, and clothing moisture. Moreover, the participants' cognitive performance was not affected by the type of PPE.Practitioner summary: Healthcare workers are at the highest risk in the fight against pandemics. Therefore, these people are required to use personal protective equipment. Using this equipment may have difficulties. The results show physiological strain and higher subjective ratings associated with using full-body hospital PPE and increased physical workload.
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Affiliation(s)
- Hamid Jahangiri
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Zamanian
- Department of Ergonomics, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hadi Daneshmandi
- Research Center for Health Sciences, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mozhgan Seif
- Non-Communicable Diseases Research Center, Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamid Jamshidi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
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12
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Tetzlaff EJ, Goulet N, Gorman M, Ioannou LG, Kenny GP. Working under the 2021 Heat Dome: A Content Analysis of Occupational Impacts Mentioned in the Canadian Media. Healthcare (Basel) 2023; 11:2423. [PMID: 37685459 PMCID: PMC10487058 DOI: 10.3390/healthcare11172423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
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.
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Affiliation(s)
- Emily J. Tetzlaff
- Human and Environmental Physiology Research Unit, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, 125 University Private, Ottawa, ON K1N 6N5, Canada; (E.J.T.)
- Climate Change and Innovation Bureau, Healthy Environments and Consumer Safety Branch, Safe Environments Directorate, Health Canada, 269 Laurier Avenue West, Ottawa, ON K1A 0K9, Canada;
| | - Nicholas Goulet
- Human and Environmental Physiology Research Unit, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, 125 University Private, Ottawa, ON K1N 6N5, Canada; (E.J.T.)
- Climate Change and Innovation Bureau, Healthy Environments and Consumer Safety Branch, Safe Environments Directorate, Health Canada, 269 Laurier Avenue West, Ottawa, ON K1A 0K9, Canada;
- Behavioural and Metabolic Research Unit, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, 200 Lees Avenue, Ottawa, ON K1N 6N5, Canada
| | - Melissa Gorman
- Climate Change and Innovation Bureau, Healthy Environments and Consumer Safety Branch, Safe Environments Directorate, Health Canada, 269 Laurier Avenue West, Ottawa, ON K1A 0K9, Canada;
| | - Leonidas G. Ioannou
- Department of Automatics, Biocybernetics and Robotics, Jožef Stefan Institute, 1000 Ljubljana, Slovenia;
| | - Glen P. Kenny
- Human and Environmental Physiology Research Unit, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, 125 University Private, Ottawa, ON K1N 6N5, Canada; (E.J.T.)
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON K1Y 4E9, Canada
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13
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De Sario M, de'Donato FK, Bonafede M, Marinaccio A, Levi M, Ariani F, Morabito M, Michelozzi P. Occupational heat stress, heat-related effects and the related social and economic loss: a scoping literature review. Front Public Health 2023; 11:1173553. [PMID: 37601227 PMCID: PMC10434255 DOI: 10.3389/fpubh.2023.1173553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 06/01/2023] [Indexed: 08/22/2023] Open
Abstract
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.
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Affiliation(s)
- Manuela De Sario
- Department of Epidemiology Lazio Regional Health Service, Rome, Italy
| | | | - Michela Bonafede
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | - Alessandro Marinaccio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | - Miriam Levi
- Epidemiology Unit, Department of Prevention, Central Tuscany Local Health Authority, Florence, Italy
| | - Filippo Ariani
- Regional Centre for the Analysis of Data on Occupational and Work-Related Injuries and Diseases, Central Tuscany Local Health Authority, Florence, Italy
| | - Marco Morabito
- Institute of Bioeconomy, National Research Council (IBE-CNR), Florence, Italy
| | - Paola Michelozzi
- Department of Epidemiology Lazio Regional Health Service, Rome, Italy
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14
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Wohlgemuth K, Sekiguchi Y, Mota J. Overexertion and heat stress in the fire service: a new conceptual framework. Am J Ind Med 2023; 66:705-709. [PMID: 37062940 DOI: 10.1002/ajim.23482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/03/2023] [Accepted: 04/05/2023] [Indexed: 04/18/2023]
Abstract
From the year 2000, the United States Fire Administration (USFA) has been recording all line-of-duty deaths in the fire service. Stress or overexertion caused 1096 out of 2598 total line-of-duty deaths in the United States from 2000 to 2021. Those deaths due to stress or overexertion were further classified as myocardial infarction (90%), cerebrovascular accident (6.8%), other (2.6%), and heat exhaustion (0.6%). Environmental heat exposure is a concern in firefighting, as firefighters work in extreme conditions, such as high ambient temperatures, while wearing protective clothing. Heat stress is not only hazardous to the cardiovascular system, but may accentuate muscle fatigue and overexertion. In addition, overexertion itself is related to increased incidence of musculoskeletal injuries, usually to the lower extremities. Further, there is a strong physiological mechanistic link to suggest that the increased occupational heat exposure and thermoregulatory strain firefighters experience may be a stressor that increases the risk of injuries. This commentary hopes to show the need for further research on the effects of occupational exposures and physiological strain in the fire service.
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Affiliation(s)
- Kealey Wohlgemuth
- Neuromuscular and Occupational Performance Laboratory, Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas, USA
| | - Yasuki Sekiguchi
- Sports Performance Lab, Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas, USA
| | - Jacob Mota
- Neuromuscular and Occupational Performance Laboratory, Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas, USA
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15
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Alahmad B, Al-Hemoud A, Al-Bouwarthan M, Khraishah H, Kamel M, Akrouf Q, Wegman DH, Bernstein AS, Koutrakis P. Extreme heat and work injuries in Kuwait's hot summers. Occup Environ Med 2023; 80:347-352. [PMID: 37068948 DOI: 10.1136/oemed-2022-108697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 03/27/2023] [Indexed: 04/19/2023]
Abstract
BACKGROUND Hot, desert Gulf countries are host to millions of migrant workers doing outdoor jobs such as construction and hospitality. The Gulf countries apply a summertime ban on midday work to protect workers from extreme heat, although without clear evidence of effectiveness. We assessed the risk of occupational injuries associated with extreme hot temperatures during the summertime ban on midday work in Kuwait. METHODS We collected daily occupational injuries in the summer months that are reported to the Ministry of Health's Occupational Health Department for 5 years from 2015 to 2019. We fitted generalised additive models with a quasi-Poisson distribution in a time series design. A 7-day moving average of daily temperature was modelled with penalised splines adjusted for relative humidity, time trend and day of the week. RESULTS During the summertime ban, the daily average temperature was 39.4°C (±1.8°C). There were 7.2, 7.6 and 9.4 reported injuries per day in the summer months of June, July and August, respectively. Compared with the 10th percentile of summer temperatures in Kuwait (37.0°C), the average day with a temperature of 39.4°C increased the relative risk of injury to 1.44 (95% CI 1.34 to 1.53). Similarly, temperatures of 40°C and 41°C were associated with relative risks of 1.48 (95% CI 1.39 to 1.59) and 1.44 (95% CI 1.27 to 1.63), respectively. At the 90th percentile (42°C), the risks levelled off (relative risk 1.21; 95% CI 0.93 to 1.57). CONCLUSION We found substantial increases in the risk of occupational injury from extremely hot temperatures despite the ban on midday work policy in Kuwait. 'Calendar-based' regulations may be inadequate to provide occupational heat protections, especially for migrant workers.
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Affiliation(s)
- Barrak Alahmad
- Environmental Health Department, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
- Department of Environmental and Occupational Health, College of Public Health, Kuwait University, Kuwait City, Kuwait
- Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Ali Al-Hemoud
- Environment and Life Sciences Research Center, Kuwait Institute for Scientific Research, Safat, Kuwait
| | - Mohammed Al-Bouwarthan
- Department of Environmental Health, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Haitham Khraishah
- Division of Cardiovascular Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Mohamed Kamel
- Occupational Health Administration, Ministry of Health, Kuwait City, Kuwait
| | - Qassem Akrouf
- Occupational Health Administration, Ministry of Health, Kuwait City, Kuwait
| | - David H Wegman
- Environmental Health Department, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
- Department of Public Health, College of Health Sciences, University of Massachusetts Lowell, Lowell, Massachusetts, USA
- La Isla Network, District of Columbia, Washington, DC, USA
| | - Aaron S Bernstein
- Center for Climate, Health and the Global Environment, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Pediatrics, Harvard University, Cambridge, Massachusetts, USA
| | - Petros Koutrakis
- Environmental Health Department, T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
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16
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Morrissey MC, Langan SP, Brewer GJ, Struder JF, Navarro JS, Nye MN, Casa DJ. Limitations associated with thermoregulation and cardiovascular research assessing laborers performing work in the heat. Am J Ind Med 2023; 66:267-280. [PMID: 36748881 DOI: 10.1002/ajim.23462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 12/13/2022] [Accepted: 01/10/2023] [Indexed: 02/08/2023]
Abstract
PURPOSE To quantify the current literature and limitations associated with research examining thermoregulatory and cardiovascular strain in laborers working in the heat. METHODS PubMed, SCOPUS, and SPORTDiscus were searched for terms related to the cardiovascular system, heat stress, and physical work. Qualifying studies included adult participants (18-65 years old), a labor-intensive environment or exercise protocol simulating a labor environment, a minimum duration of 120 min of physical work, and environmental heat stress (ambient temperature ≥26.0°C and ≥30% relative humidity). Studies included at least one of the following outcomes: pre- and peak physical work, core temperature, heart rate (HR), systolic blood pressure, diastolic blood pressure, HR variability, and rate pressure product. RESULTS Twenty-one out of 1559 potential studies qualified from our search. There was a total of 598 participants (mean = 28 ± 50 participants per study, range = 4-238 participants per study), which included 51 females (8.5%) and 547 males (91.5%). Of the participants, 3.8% had cardiovascular risk factors (diabetes: n = 10; hypertension: n = 13) and 96.2% were characterized as "healthy". Fifty-seven percent of the included studies were performed in a laboratory setting. CONCLUSIONS Studies were predominantly in men (91.5%), laboratory settings (57%), and "healthy" individuals (96.2%). To advance equity in protection against occupational heat stress and better inform future heat safety recommendations to protect all workers, future studies must focus on addressing these limitations. Employers, supervisors, and other safety stakeholders should consider these limitations while implementing current heat safety recommendations.
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Affiliation(s)
| | - Sean P Langan
- Korey Stringer Institute, University of Connecticut, Storrs, Connecticut, USA
| | - Gabrielle J Brewer
- Korey Stringer Institute, University of Connecticut, Storrs, Connecticut, USA
| | - Jeb F Struder
- Korey Stringer Institute, University of Connecticut, Storrs, Connecticut, USA
| | - John S Navarro
- Korey Stringer Institute, University of Connecticut, Storrs, Connecticut, USA
| | - Megan N Nye
- Korey Stringer Institute, University of Connecticut, Storrs, Connecticut, USA
| | - Douglas J Casa
- Korey Stringer Institute, University of Connecticut, Storrs, Connecticut, USA
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Marrone M, Buongiorno L, Caricato P, Pititto F, De Luca BP, Angeletti C, Sebastiani G, Cascardi E, Ingravallo G, Stellacci A, Cazzato G. Heat Stroke in the Work Environment: Case Report of an Underestimated Phenomenon. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4028. [PMID: 36901039 PMCID: PMC10001472 DOI: 10.3390/ijerph20054028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/10/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
Average global temperatures continue to trend upward, and this phenomenon is part of the more complex climate change taking place on our planet over the past century. Human health is directly affected by environmental conditions, not only because of communicable diseases that are clearly affected by climate, but also because of the relationship between rising temperatures and increased morbidity for psychiatric diseases. As global temperatures and the number of extreme days increase, so does the risk associated with all those acute illnesses related to these factors. For example, there is a correlation between out-of-hospital cardiac arrest and heat. Then, there are pathologies that recognize excessive heat as the main etiological agent. This is the case with so-called "heat stroke", a form of hyperthermia accompanied by a systemic inflammatory response, which causes multi-organ dysfunction and sometimes death. Starting with a case that came to their attention of a young man in good general health who died while working unloading fruit crates from a truck, the authors wanted to express some thoughts on the need to adapt the world of work, including work-specific hazards, in order to protect the worker exposed to this "new risk" and develop multidisciplinary adaptation strategies that incorporate climatology, indoor/building environments, energy use, regulatory perfection of work and human thermal comfort.
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Affiliation(s)
- Maricla Marrone
- Section of Legal Medicine, Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Luigi Buongiorno
- Section of Legal Medicine, Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Pierluigi Caricato
- Section of Legal Medicine, Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Fortunato Pititto
- Section of Legal Medicine, Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Benedetta Pia De Luca
- Section of Legal Medicine, Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Carlo Angeletti
- Section of Legal Medicine, Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Gabriele Sebastiani
- Section of Legal Medicine, Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Eliano Cascardi
- Department of Medical Sciences, University of Turin, 10124 Turin, Italy
- Pathology Unit, FPO-IRCCS Candiolo Cancer Institute, 10060 Candiolo, Italy
| | - Giuseppe Ingravallo
- Section of Molecular Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Alessandra Stellacci
- Section of Legal Medicine, Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Gerardo Cazzato
- Section of Molecular Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70124 Bari, Italy
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18
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Di Blasi C, Marinaccio A, Gariazzo C, Taiano L, Bonafede M, Leva A, Morabito M, Michelozzi P, de’ Donato FK. Effects of Temperatures and Heatwaves on Occupational Injuries in the Agricultural Sector in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2781. [PMID: 36833478 PMCID: PMC9957348 DOI: 10.3390/ijerph20042781] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/30/2023] [Accepted: 02/02/2023] [Indexed: 05/12/2023]
Abstract
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.
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Affiliation(s)
- Chiara Di Blasi
- Department of Epidemiology Lazio Regional Health Service, ASL ROMA 1, 00147 Rome, Italy
| | - Alessandro Marinaccio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers’ Compensation Authority (INAIL), 00143 Rome, Italy
| | - Claudio Gariazzo
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers’ Compensation Authority (INAIL), 00143 Rome, Italy
| | - Luca Taiano
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers’ Compensation Authority (INAIL), 00143 Rome, Italy
| | - Michela Bonafede
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers’ Compensation Authority (INAIL), 00143 Rome, Italy
| | - Antonio Leva
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers’ Compensation Authority (INAIL), 00143 Rome, Italy
| | - Marco Morabito
- Institute of Bioeconomy, National Research Council (IBE-CNR), 50019 Florence, Italy
| | - Paola Michelozzi
- Department of Epidemiology Lazio Regional Health Service, ASL ROMA 1, 00147 Rome, Italy
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19
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Dally M, Suresh K, Van Dyke M, James KA, Bauer AK, Krisher L, Newman LS. Occurrence of Occupational Injuries and Within Day Changes in Wet Bulb Temperature Among Sugarcane Harvesters. J Agromedicine 2023; 28:523-531. [PMID: 36650099 DOI: 10.1080/1059924x.2023.2169425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
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.
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Affiliation(s)
- Miranda Dally
- Center for Health, Work & Environment, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Department of Environmental & Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Krithika Suresh
- Department of Biostatistics & Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Mike Van Dyke
- Center for Health, Work & Environment, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Department of Environmental & Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Katherine A James
- Center for Health, Work & Environment, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Department of Environmental & Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Alison K Bauer
- Department of Environmental & Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Lyndsay Krisher
- Center for Health, Work & Environment, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Department of Environmental & Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Lee S Newman
- Center for Health, Work & Environment, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Department of Environmental & Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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20
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Basagaña X, de la Peña-Ramirez C. Ambient temperature and risk of motor vehicle crashes: A countrywide analysis in Spain. ENVIRONMENTAL RESEARCH 2023; 216:114599. [PMID: 36270536 DOI: 10.1016/j.envres.2022.114599] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/11/2022] [Accepted: 10/12/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Some studies have documented that cold or hot ambient temperatures increase the risk of motor vehicle crashes. However, the number of existing studies is still limited, especially for the effects of cold. OBJECTIVES To estimate the relationship between ambient temperatures and risk of motor vehicle crashes in Spain, and to estimate the same association when restricting to those crashes with driver performance-associated factors (namely distraction, fatigue, sleepiness or disease). METHODS We used data for the period 1993-2013. We conducted a time series analysis controlling for seasonality and trends and using the distributed lag nonlinear model framework to estimate nonlinear and delayed effects of up to 7 days. Analyses were conducted at the province level and combined using multivariate meta-analysis. RESULTS The study included 1,908,460 motor vehicle crashes, 37% of them with associated driver performance factors. The overall analysis showed that the risk of crashes increased almost linearly with temperature. The estimates of the cumulative effect of lags 0-7 when comparing the 99th percentile and the first percentile of temperature produced a relative risk (RR) of 1.15 (95% confidence interval (CI): 1.11, 1.20). The estimates were slightly higher when analyses were restricted to crashes with driver performance-associated factors (RR: 1.23, 95% CI: 1.17, 1.30). In some provinces that reached temperatures below 0 °C, an increased risk with cold temperatures was also observed. An added effect of both cold spell and heat wave periods was found only in the analysis of crashes with driver performance-associated factors (cold spells, RR: 1.029, 95% CI: 1.005, 1.053; heat waves, RR: 1.020, 95% CI: 1.002, 1.039). CONCLUSIONS The increase of temperature increased the risk of motor vehicle crashes in Spain. Measures aimed at reducing the influence of heat on the risk of motor vehicle crashes can have important benefits for public health.
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Affiliation(s)
- Xavier Basagaña
- ISGlobal, 08003, Barcelona, Spain; Universitat Pompeu Fabra (UPF), 08003, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), 28029, Madrid, Spain.
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21
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Utzet M, Ayala-Garcia A, Benavides FG, Basagaña X. Extreme temperatures and sickness absence in the Mediterranean province of Barcelona: An occupational health issue. Front Public Health 2023; 11:1129027. [PMID: 36891341 PMCID: PMC9986628 DOI: 10.3389/fpubh.2023.1129027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 01/31/2023] [Indexed: 02/22/2023] Open
Abstract
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.
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Affiliation(s)
- Mireia Utzet
- Center for Research in Occupational Health (CiSAL), Universitat Pompeu Fabra, Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Center for Biomedical Research Network (CIBER) of Epidemiology and Public Health, Madrid, Spain
| | - Amaya Ayala-Garcia
- Center for Research in Occupational Health (CiSAL), Universitat Pompeu Fabra, Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Center for Biomedical Research Network (CIBER) of Epidemiology and Public Health, Madrid, Spain
| | - Fernando G Benavides
- Center for Research in Occupational Health (CiSAL), Universitat Pompeu Fabra, Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Center for Biomedical Research Network (CIBER) of Epidemiology and Public Health, Madrid, Spain
| | - Xavier Basagaña
- Center for Biomedical Research Network (CIBER) of Epidemiology and Public Health, Madrid, Spain.,Institute for Global Health (ISGlobal), Barcelona, Spain.,Departament de Medicina i Ciències de la Vida, Universitat Pompeu Fabra, Barcelona, Spain
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22
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High Temperature and Its Association With Work-Related Injuries by Employment Status in South Korea, 2017-2018. J Occup Environ Med 2022; 64:e690-e694. [PMID: 35941745 DOI: 10.1097/jom.0000000000002667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE This study aimed to determine the association between maximum daily temperature and work-related injuries according to employment status in South Korea. METHODS Data on workers' compensation claims and daily maximum temperature between May 20 and September 10, 2017-2018, were collected and analyzed. The absolute temperature risk effect (ATR) was evaluated by comparing the risk effect at 2 temperatures (30°C vs 33°C) across all communities using 2-stage time-series analysis. RESULTS The association between high temperatures and work-related injuries was statistically significant in the construction sector (ATR, 1.129; 95% confidence interval [CI], 1.010-1.261). In addition, the findings of this study also demonstrated a higher risk effect among nonpermanent workers (ATR, 1.109; 95% CI, 1.013-1.214) at 33°C versus 30°C when compared with permanent workers (ATR, 0.963; 95% CI, 0.891-1.041). CONCLUSIONS This study found a significant association between high temperatures and work-related injuries among nonpermanent workers in South Korea.
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23
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Ferrari GN, Leal GCL, Thom de Souza RC, Galdamez EVC. Impact of climate change on occupational health and safety: A review of methodological approaches. Work 2022; 74:485-499. [PMID: 36314181 DOI: 10.3233/wor-211303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
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.
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Affiliation(s)
- Guilherme Neto Ferrari
- Postgraduate Program in Production Engineering, Production Engineering Department, State University of Maringá, Maringá, PR, Brazil
| | - Gislaine Camila Lapasini Leal
- Postgraduate Program in Production Engineering, Production Engineering Department, State University of Maringá, Maringá, PR, Brazil
| | | | - Edwin Vladimir Cardoza Galdamez
- Postgraduate Program in Production Engineering, Production Engineering Department, State University of Maringá, Maringá, PR, Brazil
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24
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Martinez GS, Kendrovski V, Salazar MA, de'Donato F, Boeckmann M. Heat-health action planning in the WHO European Region: Status and policy implications. ENVIRONMENTAL RESEARCH 2022; 214:113709. [PMID: 35779622 DOI: 10.1016/j.envres.2022.113709] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 06/12/2022] [Accepted: 06/14/2022] [Indexed: 06/15/2023]
Abstract
Adverse health effects from extreme heat remain a major risk, especially in a changing climate. Several European countries have implemented heat health action plans (HHAPs) to prevent ill health and excess mortality from heat. This paper assesses the state of implementation of HHAPs in the WHO European Region and discusses barriers and successes since the early 2000s. The results are based on a web-based survey among 53 member states on the current national and federal HHAPs in place. Guided by the eight core elements of HHAPs as outlined by the WHO Regional Office for Europe guidance from 2008, we analyzed which elements were fully or partially implemented and which areas of improvement countries identified. HHAP adaptations to account for COVID-19 were sought via literature search and expert consultations. 27 member states provided information, of which 17 countries reported having a HHAP. Five out of eight core elements, namely agreement on a lead body, accurate and timely alert systems, heat-related health information plans, strategies to reduce health exposure, and care for vulnerable groups, were at least partially implemented in all 17 plans. Alert systems were implemented most often at 94%. The least often implemented items were real-time surveillance, long-term urban planning, and preparedness of health and social systems. Five countries had published COVID-19 guidance online. Our findings suggest a progressive improvement in the development and rollout of HHAPs overall and awareness of vulnerable population groups in WHO/Europe, while integration of HHAPs into long-term climate change and health planning remains a challenge.
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Affiliation(s)
| | - Vladimir Kendrovski
- European Centre for Environment and Health, WHO Regional Office for Europe, Bonn, Germany.
| | | | - Francesca de'Donato
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Via C. Colombo 112, Rome, Italy.
| | - Melanie Boeckmann
- University of Bremen, Faculty 11 Human and Health Sciences, Mary-Somerville-Str.3, 28359, Bremen, Germany.
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25
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Chavez Santos E, Spector JT, Egbert J, Krenz J, Sampson PD, Palmández P, Torres E, Blancas M, Carmona J, Jung J, Flunker JC. The effect of the participatory heat education and awareness tools (HEAT) intervention on agricultural worker physiological heat strain: results from a parallel, comparison, group randomized study. BMC Public Health 2022; 22:1746. [PMID: 36104813 PMCID: PMC9476265 DOI: 10.1186/s12889-022-14144-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 09/06/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Farmworkers are at risk of heat-related illness (HRI). We sought to: 1) evaluate the effectiveness of farmworker Spanish/English participatory heat education and a supervisor decision-support mobile application (HEAT intervention) on physiological heat strain; and 2) describe factors associated with HRI symptoms reporting. METHODS We conducted a parallel, comparison group intervention study from May-September of 2019 in Central/Eastern Washington State, USA. We used convenience sampling to recruit adult outdoor farmworkers and allocated participating crews to intervention (n = 37 participants) and alternative-training comparison (n = 38 participants) groups. We measured heat strain monthly using heart rate and estimated core body temperature to compute the maximum work-shift physiological strain index (PSImax) and assessed self-reported HRI symptoms using a weekly survey. Multivariable linear mixed effects models were used to assess associations of the HEAT intervention with PSImax, and bivariate mixed models were used to describe factors associated with HRI symptoms reported (0, 1, 2+ symptoms), with random effects for workers. RESULTS We observed larger decreases in PSImax in the intervention versus comparison group for higher work exertion levels (categorized as low, low/medium-low, and high effort), after adjustment for maximum work-shift ambient Heat Index (HImax), but this was not statistically significant (interaction - 0.91 for high versus low/medium-low effort, t = - 1.60, p = 0.11). We observed a higher PSImax with high versus low/medium-low effort (main effect 1.96, t = 3.81, p < 0.001) and a lower PSImax with older age (- 0.03, t = - 2.95, p = 0.004), after covariate adjustment. There was no clear relationship between PSImax and the number of HRI symptoms reported. Reporting more symptoms was associated with older age, higher HImax, 10+ years agricultural work, not being an H-2A guest worker, and walking > 3 min to get to the toilet at work. CONCLUSIONS Effort level should be addressed in heat management plans, for example through work/rest cycles, rotation, and pacing, in addition to education and other factors that influence heat stress. Both symptoms and indicators of physiological heat strain should be monitored, if possible, during periods of high heat stress to increase the sensitivity of early HRI detection and prevention. Structural barriers to HRI prevention must also be addressed. TRIAL REGISTRATION ClinicalTrials.gov Registration Number: NCT04234802 , date first posted 21/01/2020.
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Affiliation(s)
- Erica Chavez Santos
- grid.34477.330000000122986657Department of Health Systems and Population Health, University of Washington, Seattle, WA USA
| | - June T. Spector
- grid.34477.330000000122986657Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Seattle, WA 98105 USA ,grid.34477.330000000122986657Department of Medicine, University of Washington, 4225 Roosevelt Way NE, Seattle, WA 98105 USA
| | - Jared Egbert
- grid.34477.330000000122986657Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Seattle, WA 98105 USA ,grid.416237.50000 0004 0418 9357Department of Preventive Medicine, Madigan Army Medical Center, Joint Base Lewis-McChord, Seattle, WA USA
| | - Jennifer Krenz
- grid.34477.330000000122986657Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Seattle, WA 98105 USA
| | - Paul D. Sampson
- grid.34477.330000000122986657Department of Statistics, University of Washington, Seattle, WA USA
| | - Pablo Palmández
- grid.34477.330000000122986657Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Seattle, WA 98105 USA
| | - Elizabeth Torres
- Northwest Communities Education Center/Radio KDNA, Granger, WA USA
| | - Maria Blancas
- grid.34477.330000000122986657Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Seattle, WA 98105 USA
| | - Jose Carmona
- grid.34477.330000000122986657Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Seattle, WA 98105 USA
| | - Jihoon Jung
- grid.34477.330000000122986657Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Seattle, WA 98105 USA
| | - John C. Flunker
- grid.34477.330000000122986657Department of Environmental and Occupational Health Sciences, University of Washington, 4225 Roosevelt Way NE, Seattle, WA 98105 USA
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26
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Flunker JC, Zuidema C, Jung J, Kasner E, Cohen M, Seto E, Austin E, Spector JT. Potential Impacts of Different Occupational Outdoor Heat Exposure Thresholds among Washington State Crop and Construction Workers and Implications for Other Jurisdictions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11583. [PMID: 36141863 PMCID: PMC9517246 DOI: 10.3390/ijerph191811583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 09/05/2022] [Accepted: 09/08/2022] [Indexed: 06/10/2023]
Abstract
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.
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Affiliation(s)
- John C. Flunker
- Department of Environmental and Occupational Health Sciences, Hans Rosling Center for Population Health, University of Washington, Seattle, WA 98195, USA
| | - Christopher Zuidema
- Department of Environmental and Occupational Health Sciences, Hans Rosling Center for Population Health, University of Washington, Seattle, WA 98195, USA
| | - Jihoon Jung
- Department of Environmental and Occupational Health Sciences, Hans Rosling Center for Population Health, University of Washington, Seattle, WA 98195, USA
| | - Edward Kasner
- Department of Environmental and Occupational Health Sciences, Hans Rosling Center for Population Health, University of Washington, Seattle, WA 98195, USA
| | - Martin Cohen
- Department of Environmental and Occupational Health Sciences, Hans Rosling Center for Population Health, University of Washington, Seattle, WA 98195, USA
| | - Edmund Seto
- Department of Environmental and Occupational Health Sciences, Hans Rosling Center for Population Health, University of Washington, Seattle, WA 98195, USA
| | - Elena Austin
- Department of Environmental and Occupational Health Sciences, Hans Rosling Center for Population Health, University of Washington, Seattle, WA 98195, USA
| | - June T. Spector
- Department of Environmental and Occupational Health Sciences, Hans Rosling Center for Population Health, University of Washington, Seattle, WA 98195, USA
- Safety & Health Assessment and Research for Prevention (SHARP) Program, Washington State Department of Labor and Industries, Olympia, WA 98504, USA
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27
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Hess HW, Tarr ML, Baker TB, Hostler D, Schlader ZJ. Ad libitum drinking prevents dehydration during physical work in the heat when adhering to occupational heat stress recommendations. Temperature (Austin) 2022; 9:292-302. [PMID: 36211944 PMCID: PMC9542357 DOI: 10.1080/23328940.2022.2094160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/21/2022] [Accepted: 06/22/2022] [Indexed: 10/17/2022] Open
Abstract
Government entities issue recommendations that aim to maintain core temperature below 38.0°C and prevent dehydration [>2% body mass loss] in unacclimated workers exposed to heat. Hydration recommendations suggest drinking 237 mL of a cool sport drink every 15-20 min. This is based on the premise that ad libitum drinking results in dehydration due to inadequate fluid replacement, but this has never been examined in the background of recommendation compliant work in the heat. Therefore, we tested the hypothesis that ad libitum drinking results in >2% body mass loss during heat stress recommendation compliant work. Ten subjects completed four trials consisting of 4 hours of exposure to wet bulb globe temperatures (WBGT) of 24.1 ± 0.3°C (A), 26.6 ± 0.2°C (B), 28.5 ± 0.2°C (C), 29.3 ± 0.6°C (D). Subjects walked on a treadmill and work-rest ratios were prescribed as a function of WBGT [work:rest per hour - A: 60:0, B: 45:15, C: 30:30, D: 15:45] and were provided 237 mL of a cool sport drink every 15 min to drink ad libitum. Mean core temperature was higher in Trial A (37.8 ± 0.4°C; p = 0.03) and Trial B (37.6 ± 0.3°C; p = 0.01) versus Trial D (37.3 ± 0.3°C) but did not differ between the other trials (p ≥ 0.20). Body mass loss (A: -0.9 ± 0.7%, B: -0.7 ± 0.5%, C: -0.3 ± 0.5%, D: -0.4 ± 0.6%) was greater in Trial A compared to Trial D (p = 0.04) and was different from 2% body mass loss in all trials (p ≤ 0.01). Ad libitum drinking during recommendation compliant work in the heat rarely resulted in dehydration. Registered Clinical Trial (NCT04767347).
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Affiliation(s)
- Hayden W. Hess
- Department of Kinesiology, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Macie L. Tarr
- Department of Kinesiology, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Tyler B. Baker
- Department of Kinesiology, School of Public Health, Indiana University, Bloomington, IN, USA
| | - David Hostler
- Center for Research and Education in Special Environments, Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY, USA
| | - Zachary J. Schlader
- Department of Kinesiology, School of Public Health, Indiana University, Bloomington, IN, USA
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Lee SY, Lung SCC, Chiu PG, Wang WC, Tsai IC, Lin TH. Northern Hemisphere Urban Heat Stress and Associated Labor Hour Hazard from ERA5 Reanalysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138163. [PMID: 35805822 PMCID: PMC9266236 DOI: 10.3390/ijerph19138163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 06/14/2022] [Accepted: 06/30/2022] [Indexed: 11/16/2022]
Abstract
Increasing surface air temperature is a fundamental characteristic of a warming world. Rising temperatures have potential impacts on human health through heat stress. One heat stress metric is the wet-bulb globe temperature, which takes into consideration the effects of radiation, humidity, and wind speed. It also has broad health and environmental implications. This study presents wet-bulb globe temperatures calculated from the fifth-generation European Centre for Medium-Range Weather Forecasts atmospheric reanalysis and combines it with health guidelines to assess heat stress variability and the potential for reduction in labor hours over the past decade on both the continental and urban scale. Compared to 2010–2014, there was a general increase in heat stress during the period from 2015 to 2019 throughout the northern hemisphere, with the largest warming found in tropical regions, especially in the northern part of the Indian Peninsula. On the urban scale, our results suggest that heat stress might have led to a reduction in labor hours by up to ~20% in some Asian cities subject to work–rest regulations. Extremes in heat stress can be explained by changes in radiation and circulation. The resultant threat is highest in developing countries in tropical areas where workers often have limited legal protection and healthcare. The effect of heat stress exposure is therefore a collective challenge with environmental, economic, and social implications.
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Affiliation(s)
- Shih-Yu Lee
- Research Center for Environmental Changes, Academia Sinica, Taipei 11529, Taiwan; (S.-C.C.L.); (W.-C.W.); (I.-C.T.)
- Correspondence:
| | - Shih-Chun Candice Lung
- Research Center for Environmental Changes, Academia Sinica, Taipei 11529, Taiwan; (S.-C.C.L.); (W.-C.W.); (I.-C.T.)
| | - Ping-Gin Chiu
- Geophysical Institute, University of Bergen, 5020 Bergen, Norway;
| | - Wen-Cheng Wang
- Research Center for Environmental Changes, Academia Sinica, Taipei 11529, Taiwan; (S.-C.C.L.); (W.-C.W.); (I.-C.T.)
| | - I-Chun Tsai
- Research Center for Environmental Changes, Academia Sinica, Taipei 11529, Taiwan; (S.-C.C.L.); (W.-C.W.); (I.-C.T.)
| | - Thung-Hong Lin
- Institute of Sociology, Academia Sinica, Taipei 11529, Taiwan;
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Workers and Climate Change: The Need for Academic–Industry Partnerships to Improve Agricultural Worker Health, Safety, and Wellbeing. SUSTAINABILITY 2022. [DOI: 10.3390/su14116717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Climate change will have negative consequences for human health worldwide. Agricultural workers are especially vulnerable to the health consequences of climate change. This communication demonstrates how a Total Worker Health® approach is utilized to protect Guatemalan agricultural workers from the negative health effects of climate change. DrPH researchers work alongside local partners to develop, implement, and evaluate climate adaptation strategies and other interventions to improve agricultural worker health, safety, and wellbeing. Training in public health ethics, communications, and leadership gives DrPH researchers the tools to help create successful academic–industry partnerships that increase local capacity and have sustainable public health impact.
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Lee J, Lee YH, Choi WJ, Ham S, Kang SK, Yoon JH, Yoon MJ, Kang MY, Lee W. Heat exposure and workers' health: a systematic review. REVIEWS ON ENVIRONMENTAL HEALTH 2022; 37:45-59. [PMID: 33752272 DOI: 10.1515/reveh-2020-0158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/08/2021] [Indexed: 06/12/2023]
Abstract
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.
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Affiliation(s)
- Junhyeong Lee
- Department of Occupational and Environmental Medicine, Gil Medical Center, Incheon, Republic of Korea
| | - Yong Ho Lee
- Department of Occupational and Environmental Medicine, Gil Medical Center, Incheon, Republic of Korea
| | - Won-Jun Choi
- Department of Occupational and Environmental Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Seunghon Ham
- Department of Occupational and Environmental Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Seong-Kyu Kang
- Department of Occupational and Environmental Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Jin-Ha Yoon
- The Institute for Occupational Health, Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Min Joo Yoon
- Jungbu Area Epidemiologic Investigation Team, Occupational Safety and Health Research Institute, Korea Occupational Safety & Health Agency, Incheon, Republic of Korea
| | - Mo-Yeol Kang
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Wanhyung Lee
- Department of Occupational and Environmental Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
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Association between outdoor temperature and achilles tendon repair: A 14-years nationwide population-based cohort study. PLoS One 2022; 17:e0265041. [PMID: 35302994 PMCID: PMC8932609 DOI: 10.1371/journal.pone.0265041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 02/22/2022] [Indexed: 11/28/2022] Open
Abstract
The incidence of achilles tendon rupture varies by gender, age, and seasonal variation. However, there has been no study as yet linking achilles tendon rupture to daily fluctuations in outdoor temperature. The purpose of this study was to investigate the association between outdoor temperature and achilles tendon rupture using a Korea Meteorological Administration database and a Korean National Health Insurance Service-National Sample Cohort database. Between 2002 and 2015, all instances of achilles tendon repair were retrieved from the National Health Insurance Service-National Sample Cohort database to examine sociodemographic factors, specifically sex, age, residential area, and income level. Minimum age requirement was 20 years. Outdoor temperatures recorded at 16 observation points in South Korea were also acquired from the Korea Meteorological Administration data center for analysis. Overall, 850 (0.119%) of 713,456 individuals in the National Health Insurance Service-National Sample Cohort database underwent achilles tendon repair between 2002 and 2015. Yearly procedural totals increased with advancing age, peaking at ages 30–39 years (14.6 per 100,000 persons) and declining thereafter. Minimum, median, and maximum outdoor temperatures were associated with achilles tendon repair (p<0.05), as did household income. In multivariate logistic regression analysis, outdoor temperatures, sex, age, and household income emerged as factors significantly associated with achilles tendon repair. Outcomes of this study confirm an association between incidence of achilles tendon repair and outdoor temperature, the latter denoting a novel index and likely surrogate measure of vigorous physical activity afforded by warmer weather.
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32
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Stephens D, Brearley M, Vermeulen L. Heat Health Management in a Quarantine and Isolation Facility in the Tropics. Prehosp Disaster Med 2022; 37:1-6. [PMID: 35225212 PMCID: PMC8948486 DOI: 10.1017/s1049023x22000255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/01/2021] [Accepted: 12/08/2021] [Indexed: 11/10/2022]
Abstract
INTRODUCTION The Howard Springs Quarantine Facility (HSQF) is located in tropical Northern Australia and has 875 blocks of four rooms (3,500 rooms in total) spread over 67 hectares. The HSQF requires a large outdoor workforce walking outdoor pathways to provide individual care in the ambient climate. The personal protective equipment (PPE) required for the safety of quarantine workers varies between workgroups and limits body heat dissipation that anecdotally contributes to excessive sweating, which combined with heat stress symptoms of fatigue, headache, and irritability, likely increases the risk of workplace injuries including infection control breaches. STUDY OBJECTIVE The purpose of this study was the description of qualitative and quantitative assessment for HSQF workers exposed to tropical environmental conditions and provision of evidenced-based strategies to mitigate the risk of heat stress in an outdoor quarantine and isolation workforce. METHODS The study comprised two components - a cross-sectional physiological monitoring study of 18 workers (eight males/ten females; means: 41.4 years; 1.69m; 80.6kg) during a single shift in November 2020 and a subjective heat health survey completed by participants on a minimum of four occasions across the wet season/summer period from November 2020 through February 2021. The physiological monitoring included continuous core temperature monitoring and assessment of fluid balance. RESULTS The mean apparent temperature across first-half and second-half of the shift was 34.7°C (SD = 0.8) and 35.6°C (SD = 1.9), respectively. Across the work shift (mean duration 10.1 hours), the mean core temperature of participants was 37.3°C (SD = 0.2) with a range of 37.0°C - 37.7°C. The mean maximal core temperature of participants was 37.7°C (SD = 0.3). In the survey, for the workforce in full PPE, 57% reported feeling moderately, severely, or unbearably hot compared to 49% of those in non-contact PPE, and the level of fatigue was reported as moderate to severe in just over 25% of the workforce in both groups. CONCLUSION Heat stress is a significant risk in outdoor workers in the tropics and is amplified in the coronavirus disease 2019 (COVID-19) frontline workforce required to wear PPE in outdoor settings. A heat health program aimed at mitigating risk, including workplace education, limiting exposure times, encouraging hydration, buddy system, active cooling, and monitoring, is recommended to limit PPE breaches and other workplace injuries in this workforce.
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Affiliation(s)
- Dianne Stephens
- National Critical Care and Trauma Response Centre, Darwin, Northern Territory, Australia
| | - Matt Brearley
- National Critical Care and Trauma Response Centre, Darwin, Northern Territory, Australia
| | - Lisa Vermeulen
- Northern Territory Department of Health, Centre for National Resilience, Casuarina, Northern Territory, Australia
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Zeppetello LRV, Cook-Patton SC, Parsons LA, Wolff NH, Kroeger T, Battisti DS, Bettles J, Spector JT, Balakumar A, Masuda YJ. Consistent cooling benefits of silvopasture in the tropics. Nat Commun 2022; 13:708. [PMID: 35121752 PMCID: PMC8816911 DOI: 10.1038/s41467-022-28388-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 01/21/2022] [Indexed: 12/30/2022] Open
Abstract
Agroforestry systems have the potential to sequester carbon and offer numerous benefits to rural communities, but their capacity to offer valuable cooling services has not been quantified on continental scales. Here, we find that trees in pasturelands (“silvopasture”) across Latin America and Africa can offer substantial cooling benefits. These cooling benefits increase linearly by −0.32 °C to −2.4 °C per 10 metric tons of woody carbon per hectare, and importantly do not depend on the spatial extent of the silvopasture systems. Thus, even smallholders can reap important cooling services from intensifying their silvopasture practices. We then map where realistic (but ambitious) silvopasture expansion could counteract a substantial fraction of the local projected warming in 2050 due to climate change. Our findings indicate where and to what extent silvopasture systems can counteract local temperature increases from global climate change and help vulnerable communities adapt to a warming world. A new study shows that tropical silvopasture systems can provide significant cooling services for local communities, and identifies where these silvopasture systems can most effectively counteract global climate change to help communities adapt to warming.
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Egbert J, Krenz J, Sampson PD, Jung J, Calkins M, Zhang K, Palmández P, Faestel P, Spector JT. Accuracy of an estimated core temperature algorithm for agricultural workers. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2022; 77:809-818. [PMID: 35114899 PMCID: PMC9346099 DOI: 10.1080/19338244.2022.2033672] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
There is a substantial burden of occupational health effects from heat exposure. We sought to assess the accuracy of estimated core body temperature (CBTest) derived from an algorithm that uses sequential heart rate and initializing CBT,1 compared with gastrointestinal temperature measured using more invasive ingestible sensors (CBTgi), among outdoor agricultural workers. We analyzed CBTest and CBTgi data from Washington State, USA, pear and apple harvesters collected across one work shift in 2015 (13,413 observations, 35 participants) using Bland Altman methods. The mean (standard deviation, range) CBTgi was 37.7 (0.4, 36.5-39.4)°C. Overall CBT bias (limits of agreement) was -0.14 (±0.76)°C. Biases ranged from -0.006 to -0.75 °C. The algorithm, which does not require the use of ingestible sensors, may be a practical tool in research among groups of workers for evaluating the effectiveness of interventions to prevent adverse occupational heat health effects.
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Affiliation(s)
- Jared Egbert
- Department of Preventive Medicine, Madigan Army Medical Center, Joint Base Lewis-McChord, WA, USA
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Jennifer Krenz
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Paul D. Sampson
- Department of Statistics, University of Washington, Seattle, WA, USA
| | - Jihoon Jung
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Miriam Calkins
- Division of Field Studies and Engineering - Field Research Branch, National Institute for Occupational Safety & Health, Centers for Disease Control and Prevention, Cincinnati, OH, USA
| | - Kai Zhang
- Department of Environmental Health Sciences, University of Albany, State University of New York, Albany, NY, USA
| | - Pablo Palmández
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Paul Faestel
- Department of Preventive Medicine, Madigan Army Medical Center, Joint Base Lewis-McChord, WA, USA
| | - June T. Spector
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
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Increased labor losses and decreased adaptation potential in a warmer world. Nat Commun 2021; 12:7286. [PMID: 34907184 PMCID: PMC8671389 DOI: 10.1038/s41467-021-27328-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 11/08/2021] [Indexed: 02/06/2023] Open
Abstract
Working in hot and potentially humid conditions creates health and well-being risks that will increase as the planet warms. It has been proposed that workers could adapt to increasing temperatures by moving labor from midday to cooler hours. Here, we use reanalysis data to show that in the current climate approximately 30% of global heavy labor losses in the workday could be recovered by moving labor from the hottest hours of the day. However, we show that this particular workshift adaptation potential is lost at a rate of about 2% per degree of global warming as early morning heat exposure rises to unsafe levels for continuous work, with worker productivity losses accelerating under higher warming levels. These findings emphasize the importance of finding alternative adaptation mechanisms to keep workers safe, as well as the importance of limiting global warming. Outdoor workers may need to adapt to warming by moving labor from midday to cooler hours. Here the authors find this adaptation strategy loses efficacy under additional climate change due to increased heat exposure in the coolest hours of the day.
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Girard O, Gaoua N, Grantham J, Knez W, Walsh A, Racinais S. Effects of living and working in a hot environment on cognitive function in a quiet and temperature-controlled room: An oil and gas industry study. Temperature (Austin) 2021; 8:372-380. [PMID: 34901319 DOI: 10.1080/23328940.2021.1959289] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
We investigate the effects of seasonal heat stress on cognitive function in outdoor workers. Thirty-nine workers from an oil and gas industry in the Middle-East volunteered for cognitive testing before (5.30 to 7.00 am) and after (3.30 to 5.00 pm) their daily work-shift in hot (August - average daily temperature: ~41°C) and temperate (January - average daily temperature: ~22°C) seasons. While physical activity was reduced in hot compared to temperate season (average normalized acceleration: 96 ± 33 vs. 112 ± 31 × 10-3 g; -12.5 ± 4.7%; P = 0.010), the average core temperature during the work-shift was higher in the hot season (37.4 ± 0.2 vs. 37.2 ± 0.2°C; P = 0.002). Peak core temperature was 38.0 ± 0.1°C and 37.8 ± 0.1°C in hot and temperate seasons, respectively. Cognitive performance did not differ between seasons for tests of recognition memory (P = 0.169), working memory (P = 0.797) and executive function (P = 0.145), independent of testing time. Whereas there was no significant main effect of testing time for tests of recognition memory (P = 0.503) and working memory (P = 0.849), the number of problems solved on the first choice for the executive function test was lower in the afternoon than the morning (-9.2 ± 5.3%; P = 0.039). There was no season × testing time interaction for any cognitive tests (P ≥ 0.145). In the absence of hyperthermia, living and working in a hot environment does not alter cognitive function in oil and gas industry workers tested in a quiet and temperature-controlled room, with reduced clothing encumbrance (relative to work). Conclusions should not be extrapolated to more stressful situations (i.e., thermal stressor present, pronounced dehydration, noise).
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Affiliation(s)
- Olivier Girard
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Crawley, Western Australia, Australia.,Research and Scientific Support Department, Aspetar Orthopaedic and Sport Medicine Hospital, Doha, Qatar
| | - Nadia Gaoua
- Research and Scientific Support Department, Aspetar Orthopaedic and Sport Medicine Hospital, Doha, Qatar.,Sport and Exercise Science Research Centre (SESRC), London South Bank University, London, UK
| | - Justin Grantham
- Research and Scientific Support Department, Aspetar Orthopaedic and Sport Medicine Hospital, Doha, Qatar.,RelatePerform, Relate Perform Ltd, Hong Kong
| | - Wade Knez
- Research and Scientific Support Department, Aspetar Orthopaedic and Sport Medicine Hospital, Doha, Qatar
| | - Andrew Walsh
- Research and Scientific Support Department, Aspetar Orthopaedic and Sport Medicine Hospital, Doha, Qatar.,Brisbane Lions Football Club, Brisbane, Queensland, Australia
| | - Sebastien Racinais
- Research and Scientific Support Department, Aspetar Orthopaedic and Sport Medicine Hospital, Doha, Qatar
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Merchant RK, Grundstein A, Yeargin S, Emerson D. Exertional heat illnesses in marching band artists: a case series. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2021; 65:2181-2188. [PMID: 34424411 DOI: 10.1007/s00484-021-02183-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/29/2021] [Accepted: 08/10/2021] [Indexed: 06/13/2023]
Abstract
Marching band (MB) artists frequently spend many hours engaged in outdoor physical activity. Anecdotal evidence and small studies have indicated that MB artists do experience heat-related health problems. Yet, unlike athletes, military personnel, or workers, there is very little research on heat-related hazards among this unique population. Here, we seek to understand the incidence and circumstances under which exertional heat illnesses (EHIs) occur among MB artists over a 31-year period (1990-2020) across the USA. Using an on-line news dataset, we identified 34 separate events and at least 393 total EHIs. Heat syncope (~ 55%) and heat exhaustion (~ 44%) comprised the majority of EHIs, although a small number of exertional heat stroke cases were also reported. EHIs were reported in all types of MB activities with ~ 32% during rehearsal, ~ 29% during parades, ~ 21% during competition, and ~ 15% during a performance. Also, the vast majority of events occurred with high school (~ 88%) marching bands. Finally, EHIs overwhelmingly occurred when the weather was unusually hot by local conditions. In light of these findings, we emphasize the need for MB specific heat polices that incorporate weather-based activity modification, acclimatization, education about EHIs, and access to on-site medical professionals.
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Affiliation(s)
- Rashawn K Merchant
- Department of Agricultural and Applied Economics, University of Georgia, Athens, GA, 30602, USA
| | - Andrew Grundstein
- Department of Geography, University of Georgia, Athens, GA, 30602, USA.
| | - Susan Yeargin
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Dawn Emerson
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, School of Health Professions, University of Kansas Medical Center, Kansas City, KS, 66160, USA
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Wolff NH, Zeppetello LRV, Parsons LA, Aggraeni I, Battisti DS, Ebi KL, Game ET, Kroeger T, Masuda YJ, Spector JT. The effect of deforestation and climate change on all-cause mortality and unsafe work conditions due to heat exposure in Berau, Indonesia: a modelling study. Lancet Planet Health 2021; 5:e882-e892. [PMID: 34774222 DOI: 10.1016/s2542-5196(21)00279-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 09/19/2021] [Accepted: 09/28/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Previous studies focusing on urban, industrialised regions have found that excess heat exposure can increase all-cause mortality, heat-related illnesses, and occupational injuries. However, little research has examined how deforestation and climate change can adversely affect work conditions and population health in low latitude, industrialising countries. METHODS For this modelling study we used data at 1 km2 resolution to compare forest cover and temperature conditions in the Berau regency, Indonesia, between 2002 and 2018. We used spatially explicit satellite, climate model, and population data to estimate the effects of global warming, between 2002 and 2018 and after applying 1·0°C, 1·5°C, and 2·0°C of global warming to 2018 temperatures, on all-cause mortality and unsafe work conditions in the Berau regency, Indonesia. FINDINGS Between 2002 and 2018, 4375 km2 of forested land in Berau was cleared, corresponding to approximately 17% of the entire regency. Deforestation increased mean daily maximum temperatures by 0·95°C (95% CI 0·97-0·92; p<0·0001). Mean daily temperatures increased by a population-weighted 0·86°C, accounting for an estimated 7·3-8·5% of all-cause mortality (or 101-118 additional deaths per year) in 2018. Unsafe work time increased by 0·31 h per day (95% CI 0·30-0·32; p<0·0001) in deforested areas compared to 0·03 h per day (0·03-0·04; p<0·0001) in areas that maintained forest cover. With 2·0°C of additional future global warming, relative to 2018, deforested areas could experience an estimated 17-20% increase in all-cause mortality (corresponding to an additional 236-282 deaths per year) and up to 5 h of unsafe work per day. INTERPRETATION Heat exposure from deforestation and climate change has already started affecting populations in low latitude, industrialising countries, and future global warming indicates substantial health impacts in these regions. Further research should examine how deforestation is currently affecting the health and wellbeing of local communities. FUNDING University of Washington Population Health Initiative. TRANSLATION For the Bahasa translation of the abstract see Supplementary Materials section.
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Affiliation(s)
| | | | - Luke A Parsons
- Nicholas School of the Environment, Duke University, Durham, NC, USA
| | - Ike Aggraeni
- Faculty of Public Health, Mulawarman University, Samarinda, Indonesia
| | - David S Battisti
- Department of Atmospheric Sciences, University of Washington, Seattle, WA, USA
| | - Kristie L Ebi
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA; Department of Global Health, University of Washington, Seattle, WA, USA
| | | | | | - Yuta J Masuda
- Global Science, The Nature Conservancy, Arlington, VA, USA.
| | - June T Spector
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA; Department of Medicine, University of Washington, Seattle, WA, USA
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Carlson SA, Whitfield GP, Davis RT, Peterson EL, Fulton JE, Berrigan D. Associations between Perceptions and Measures of Weather and Walking, United States-2015. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8398. [PMID: 34444148 PMCID: PMC8392542 DOI: 10.3390/ijerph18168398] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Weather can be a barrier to walking. Understanding how perceptions of weather as a barrier and measured temperature are associated with walking can inform monitoring and promotion strategies. The objective of this study is to examine the association between perceptions of weather as a barrier to walking and measured weather with the volume of leisure and transportation walking. METHODS The 2015 National Health Interview Survey (NHIS) assessed participation in and volume of walking (transportation, leisure) in the past week and frequency of reporting weather as a barrier to walking. Data were collected over the entire year. In 2019, we merged month-specific temperature data from the PRISM climate group with individual NHIS records. We examined associations using logistic (participation) and linear regression models (volume). RESULTS Participation in walking increased as frequency of reporting weather as a barrier to walking decreased, from 'almost always' (transportation: 23%, leisure: 42%) to 'a little of the time' (transportation: 40%, leisure: 67%). Among adults reporting walking, walking volume increased as frequency of reporting weather as a barrier decreased from 'almost always' (transportation: 51 min/week, leisure: 64 min/week) to 'never' (transportation: 69 min/week, leisure: 98 min/week). Month-specific temperature was significantly associated with leisure walking with lower participation at the lowest and highest temperature quintiles, although the strength of the association differed by frequency of reporting weather as a barrier. CONCLUSIONS In general, prevalence and volume of leisure and transportation walking decreased as the perception of weather as a barrier increased. Low and high temperature conditions were also associated with leisure walking participation, particularly among adults with increased perceptions of weather as a barrier. Our findings highlight the importance of including strategies to help adults overcome perceived and actual weather-related barriers in walking promotion efforts.
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Affiliation(s)
- Susan A. Carlson
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (S.A.C.); (G.P.W.); (E.L.P.); (J.E.F.)
| | - Geoffrey P. Whitfield
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (S.A.C.); (G.P.W.); (E.L.P.); (J.E.F.)
| | - Ryan T. Davis
- Geospatial Research, Analysis, and Services Program, Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry, Atlanta, GA 30341, USA;
| | - Erin L. Peterson
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (S.A.C.); (G.P.W.); (E.L.P.); (J.E.F.)
| | - Janet E. Fulton
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA; (S.A.C.); (G.P.W.); (E.L.P.); (J.E.F.)
| | - David Berrigan
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD 20892, USA
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Morrissey MC, Casa DJ, Brewer GJ, Adams WM, Hosokawa Y, Benjamin CL, Grundstein AJ, Hostler D, McDermott BP, McQuerry ML, Stearns RL, Filep EM, DeGroot DW, Fulcher J, Flouris AD, Huggins RA, Jacklitsch BL, Jardine JF, Lopez RM, McCarthy RB, Pitisladis Y, Pryor RR, Schlader ZJ, Smith CJ, Smith DL, Spector JT, Vanos JK, Williams WJ, Vargas NT, Yeargin SW. Heat Safety in the Workplace: Modified Delphi Consensus to Establish Strategies and Resources to Protect the US Workers. GEOHEALTH 2021; 5:e2021GH000443. [PMID: 34471788 PMCID: PMC8388206 DOI: 10.1029/2021gh000443] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/08/2021] [Accepted: 06/11/2021] [Indexed: 06/04/2023]
Abstract
The purpose of this consensus document was to develop feasible, evidence-based occupational heat safety recommendations to protect the US workers that experience heat stress. Heat safety recommendations were created to protect worker health and to avoid productivity losses associated with occupational heat stress. Recommendations were tailored to be utilized by safety managers, industrial hygienists, and the employers who bear responsibility for implementing heat safety plans. An interdisciplinary roundtable comprised of 51 experts was assembled to create a narrative review summarizing current data and gaps in knowledge within eight heat safety topics: (a) heat hygiene, (b) hydration, (c) heat acclimatization, (d) environmental monitoring, (e) physiological monitoring, (f) body cooling, (g) textiles and personal protective gear, and (h) emergency action plan implementation. The consensus-based recommendations for each topic were created using the Delphi method and evaluated based on scientific evidence, feasibility, and clarity. The current document presents 40 occupational heat safety recommendations across all eight topics. Establishing these recommendations will help organizations and employers create effective heat safety plans for their workplaces, address factors that limit the implementation of heat safety best-practices and protect worker health and productivity.
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Affiliation(s)
- Margaret C. Morrissey
- Department of KinesiologyKorey Stringer InstituteUniversity of ConnecticutMansfieldCTUSA
| | - Douglas J. Casa
- Department of KinesiologyKorey Stringer InstituteUniversity of ConnecticutMansfieldCTUSA
| | - Gabrielle J. Brewer
- Department of KinesiologyKorey Stringer InstituteUniversity of ConnecticutMansfieldCTUSA
| | - William M. Adams
- Department of KinesiologyUniversity of North Carolina at GreensboroGreensboroNCUSA
| | - Yuri Hosokawa
- Faculty of Sports SciencesWaseda UniversitySaitamaJapan
| | | | | | - David Hostler
- Department of Exercise and Nutrition SciencesCenter for Research and Education in Special EnvironmentsBuffaloNYUSA
| | - Brendon P. McDermott
- Department of Health, Human Performance and RecreationUniversity of ArkansasFayettevilleARUSA
| | | | - Rebecca L. Stearns
- Department of KinesiologyKorey Stringer InstituteUniversity of ConnecticutMansfieldCTUSA
| | - Erica M. Filep
- Department of KinesiologyKorey Stringer InstituteUniversity of ConnecticutMansfieldCTUSA
| | - David W. DeGroot
- Fort Benning Heat CenterMartin Army Community HospitalFort BenningGAUSA
| | | | - Andreas D. Flouris
- Department of Exercise ScienceFAME LaboratoryUniversity of ThessalyTrikalaGreece
| | - Robert A. Huggins
- Department of KinesiologyKorey Stringer InstituteUniversity of ConnecticutMansfieldCTUSA
| | | | - John F. Jardine
- Department of KinesiologyKorey Stringer InstituteUniversity of ConnecticutMansfieldCTUSA
| | - Rebecca M. Lopez
- School of Physical Therapy & Rehabilitation SciencesMorsani College of MedicineUniversity of South FloridaTampaFLUSA
| | | | - Yannis Pitisladis
- Collaborating Centre of Sports MedicineUniversity of BrightonBrightonUK
| | - Riana R. Pryor
- Department of Exercise and Nutrition SciencesCenter for Research and Education in Special EnvironmentsBuffaloNYUSA
| | - Zachary J. Schlader
- Department of KinesiologySchool of Public HealthIndiana UniversityBloomingtonIAUSA
| | - Caroline J. Smith
- Department of Health and Exercise ScienceAppalachian State UniversityBooneNCUSA
| | - Denise L. Smith
- Department of Health and Human Physiological SciencesFirst Responder Health and Safety LaboratorySkidmore CollegeSaratoga SpringsNYUSA
| | - June T. Spector
- Department of Environmental and Occupational Health SciencesSchool of Public HealthUniversity of WashingtonSeattleWAUSA
| | | | - W. Jon Williams
- Centers for Disease Control and Prevention (CDC)National Personal Protective Technology Laboratory (NPPTL)National Institute for Occupational Safety and Health (NIOSH)PittsburghPAUSA
| | - Nicole T. Vargas
- Faculty of Health SciencesUniversity of SydneySydneyNSWAustralia
| | - Susan W. Yeargin
- Department of Exercise ScienceArnold School of Public HealthUniversity of South CarolinaColumbiaSCUSA
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Krenz J, Santos EC, Torres E, Palmández P, Carmona J, Blancas M, Marquez D, Sampson P, Spector JT. The multi-level heat education and awareness tools [HEAT] intervention study for farmworkers: Rationale and methods. Contemp Clin Trials Commun 2021; 22:100795. [PMID: 34169175 PMCID: PMC8209069 DOI: 10.1016/j.conctc.2021.100795] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 05/24/2021] [Accepted: 06/03/2021] [Indexed: 11/29/2022] Open
Abstract
Background The burden of adverse health effects from heat exposure is substantial, and outdoor workers who perform heavy physical work are at high risk. Though heat prevention interventions have been developed, studies have not yet systematically evaluated the effectiveness of approaches that address risk factors at multiple levels. Objective We sought to test the effectiveness of a multi-level heat prevention approach (heat education and awareness tools [HEAT]), which includes participatory training for outdoor agricultural workers that addresses individual and community factors and a heat awareness mobile application for agricultural supervisors that supports decisions about workplace heat prevention, in the Northwest United States. Design We designed the HEAT study as a parallel, comparison, randomized group intervention study that recruited workers and supervisors from agricultural workplaces. In intervention arm crews, workers received HEAT training, and supervisors received the HEAT awareness application. In comparison arm crews, workers were offered non-HEAT training. Primary outcomes were worker physiological heat strain and heat-related illness (HRI) symptoms. In both worker groups, we assessed HRI symptoms approximately weekly, and heat strain physiological monitoring was conducted at worksites approximately monthly, from June through August. Discussion To our knowledge, this is the first study to evaluate the effectiveness of a multi-level heat prevention intervention on physiological heat strain and HRI symptoms for outdoor agricultural workers. Trial registration ClinicalTrials.gov Registration Number: NCT04234802;
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Affiliation(s)
- Jennifer Krenz
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | | | - Elizabeth Torres
- Northwest Communities Education Center/Radio KDNA, Granger, WA, USA
| | - Pablo Palmández
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Jose Carmona
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Maria Blancas
- College of the Environment, University of Washington, Seattle, WA, USA
| | - Diana Marquez
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Paul Sampson
- Department of Statistics, University of Washington, Seattle, WA, USA
| | - June T Spector
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA.,Department of Medicine, University of Washington, Seattle, WA, USA
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Borg MA, Xiang J, Anikeeva O, Pisaniello D, Hansen A, Zander K, Dear K, Sim MR, Bi P. Occupational heat stress and economic burden: A review of global evidence. ENVIRONMENTAL RESEARCH 2021; 195:110781. [PMID: 33516686 DOI: 10.1016/j.envres.2021.110781] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 11/22/2020] [Accepted: 01/19/2021] [Indexed: 05/14/2023]
Abstract
BACKGROUND The adverse effects of heat on workers' health and work productivity are well documented. However, the resultant economic consequences and productivity loss are less understood. This review aims to summarize the retrospective and potential future economic burden of workplace heat exposure in the context of climate change. METHODS Literature was searched from database inception to October 2020 using Embase, PubMed, and Scopus. Articles were limited to original human studies investigating costs from occupational heat stress in English. RESULTS Twenty studies met criteria for inclusion. Eighteen studies estimated costs secondary to heat-induced labor productivity loss. Predicted global costs from lost worktime, in US$, were 280 billion in 1995, 311 billion in 2010 (≈0.5% of GDP), 2.4-2.5 trillion in 2030 (>1% of GDP) and up to 4.0% of GDP by 2100. Three studies estimated heat-related healthcare expenses from occupational injuries with averaged annual costs (US$) exceeding 1 million in Spain, 1 million in Guangzhou, China and 250,000 in Adelaide, Australia. Low- and middle-income countries and countries with warmer climates had greater losses as a proportion of GDP. Greater costs per worker were observed in outdoor industries, medium-sized businesses, amongst males, and workers aged 25-44 years. CONCLUSIONS The estimated global economic burden of occupational heat stress is substantial. Climate change adaptation and mitigation strategies should be implemented to likely minimize future costs. Further research exploring the relationship between occupational heat stress and related expenses from lost productivity, decreased work efficiency and healthcare, and costs stratified by demographic factors, is warranted. Key messages. The estimated retrospective and future economic burden from occupational heat stress is large. Responding to climate change is crucial to minimize this burden. Analyzing heat-attributable occupational costs may guide the development of workplace heat management policies and practices as part of global warming strategies.
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Affiliation(s)
- Matthew A Borg
- School of Public Health, University of Adelaide, 57 North Terrace, Adelaide, SA, 5000, Australia.
| | - Jianjun Xiang
- School of Public Health, University of Adelaide, 57 North Terrace, Adelaide, SA, 5000, Australia.
| | - Olga Anikeeva
- School of Public Health, University of Adelaide, 57 North Terrace, Adelaide, SA, 5000, Australia.
| | - Dino Pisaniello
- School of Public Health, University of Adelaide, 57 North Terrace, Adelaide, SA, 5000, Australia.
| | - Alana Hansen
- School of Public Health, University of Adelaide, 57 North Terrace, Adelaide, SA, 5000, Australia.
| | - Kerstin Zander
- Northern Institute, Charles Darwin University, Darwin, NT, 0909, Australia.
| | - Keith Dear
- School of Public Health, University of Adelaide, 57 North Terrace, Adelaide, SA, 5000, Australia.
| | - Malcolm R Sim
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventative Medicine, The Alfred Centre, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
| | - Peng Bi
- School of Public Health, University of Adelaide, 57 North Terrace, Adelaide, SA, 5000, Australia.
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Masuda YJ, Garg T, Anggraeni I, Ebi K, Krenz J, Game ET, Wolff NH, Spector JT. Warming from tropical deforestation reduces worker productivity in rural communities. Nat Commun 2021; 12:1601. [PMID: 33707454 PMCID: PMC7952402 DOI: 10.1038/s41467-021-21779-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 01/22/2021] [Indexed: 12/01/2022] Open
Abstract
The accelerating loss of tropical forests in the 21st century has eliminated cooling services provided by trees in low latitude countries. Cooling services can protect rural communities and outdoor workers with little adaptive capacity from adverse heat exposure, which is expected to increase with climate change. Yet little is still known about whether cooling services can mitigate negative impacts of heat on labor productivity among rural outdoor workers. Through a field experiment in Indonesia, we show that worker productivity was 8.22% lower in deforested relative to forested settings, where wet bulb globe temperatures were, on average, 2.84 °C higher in deforested settings. We demonstrate that productivity losses are driven by behavioral adaptations in the form of increased number of work breaks, and provide evidence that suggests breaks are in part driven by awareness of heat effects on work. Our results indicate that the cooling services from forests have the potential for increasing resilience and adaptive capacity to local warming. It is expected that tropical deforestation and related increases in heat exposure have negative impacts on labour productivity, but the size of the effect is not well known. Here, the authors show that deforestation reduces productivity by 8.22% in rural Indonesia and causes behavioural adaptation responses like more work breaks.
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Affiliation(s)
- Yuta J Masuda
- Global Science, The Nature Conservancy, Arlington, TX, USA.
| | - Teevrat Garg
- School of Global Policy and Strategy, University of California, San Diego, La Jolla, CA, USA. .,Center for Effective Global Action (CEGA), Berkeley, CA, USA. .,Institute for the Study of Labor (IZA), Bonn, Germany.
| | - Ike Anggraeni
- Faculty of Public Health, Mulawarman University, Samarinda, Indonesia
| | - Kristie Ebi
- Department of Global Health, University of Washington, Washington, USA.,Department of Environmental and Occupational Health Sciences, University of Washington, Washington, USA
| | - Jennifer Krenz
- Department of Environmental and Occupational Health Sciences, University of Washington, Washington, USA
| | - Edward T Game
- Global Science, The Nature Conservancy, Arlington, TX, USA
| | | | - June T Spector
- Department of Environmental and Occupational Health Sciences, University of Washington, Washington, USA
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Fatima SH, Rothmore P, Giles LC, Varghese BM, Bi P. Extreme heat and occupational injuries in different climate zones: A systematic review and meta-analysis of epidemiological evidence. ENVIRONMENT INTERNATIONAL 2021; 148:106384. [PMID: 33472088 DOI: 10.1016/j.envint.2021.106384] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 12/09/2020] [Accepted: 01/05/2021] [Indexed: 05/14/2023]
Abstract
BACKGROUND The link between heat exposure and adverse health outcomes in workers is well documented and a growing body of epidemiological evidence from various countries suggests that extreme heat may also contribute to increased risk of occupational injuries (OI). Previously, there have been no comparative reviews assessing the risk of OI due to extreme heat within a wide range of global climate zones. The present review therefore aims to summarise the existing epidemiological evidence on the impact of extreme heat (hot temperatures and heatwaves (HW)) on OI in different climate zones and to assess the individual risk factors associated with workers and workplace that contribute to heat-associated OI risks. METHODS A systematic review of published peer-reviewed articles that assessed the effects of extreme heat on OI among non-military workers was undertaken using three databases (PubMed, Embase and Scopus) without temporal or geographical limits from database inception until July 2020. Extreme heat exposure was assessed in terms of hot temperatures and HW periods. For hot temperatures, the effect estimates were converted to relative risks (RR) associated with 1 °C increase in temperature above reference values, while for HW, effect estimates were RR comparing heatwave with non-heatwave periods. The patterns of heat associated OI risk were investigated in different climate zones (according to Köppen Geiger classification) based on the study locations and were estimated using random-effects meta-analysis models. Subgroup analyses according to workers' characteristics (e.g. gender, age group, experience), nature of work (e.g. physical demands, location of work i.e. indoor/outdoor) and workplace characteristics (e.g. industries, business size) were also conducted. RESULTS A total of 24 studies published between 2005 and 2020 were included in the review. Among these, 22 studies met the eligibility criteria, representing almost 22 million OI across six countries (Australia, Canada, China, Italy, Spain, and USA) and were included in the meta-analysis. The pooled results suggested that the overall risk of OI increased by 1% (RR 1.010, 95% CI: 1.009-1.011) for 1 °C increase in temperature above reference values and 17.4% (RR 1.174, 95% CI: 1.057-1.291) during HW. Among different climate zones, the highest risk of OI during hot temperatures was identified in Humid Subtropical Climates (RR 1.017, 95% CI: 1.014-1.020) followed by Oceanic (RR 1.010, 95% CI: 1.008-1.012) and Hot Mediterranean Climates (RR 1.009, 95% CI: 1.008-1.011). Similarly, Oceanic (RR 1.218, 95% CI: 1.093-1.343) and Humid Subtropical Climates (RR 1.213, 95% CI: 0.995-1.431) had the highest risk of OI during HW periods. No studies assessing the risk of OI in Tropical regions were found. The effects of hot temperatures on the risk of OI were acute with a lag effect of 1-2 days in all climate zones. Young workers (age < 35 years), male workers and workers in agriculture, forestry or fishing, construction and manufacturing industries were at high risk of OI during hot temperatures. Further young workers (age < 35 years), male workers and those working in electricity, gas and water and manufacturing industries were found to be at high risk of OI during HW. CONCLUSIONS This review strengthens the evidence on the risk of heat-associated OI in different climate zones. The risk of OI associated with extreme heat is not evenly distributed and is dependent on underlying climatic conditions, workers' attributes, the nature of work and workplace characteristics. The differences in the risk of OI across different climate zones and worker subgroups warrant further investigation along with the development of climate and work-specific intervention strategies.
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Affiliation(s)
| | - Paul Rothmore
- School of Allied Health Science and Practice, The University of Adelaide, Australia
| | - Lynne C Giles
- School of Public Health, The University of Adelaide, Australia
| | | | - Peng Bi
- School of Public Health, The University of Adelaide, Australia.
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Pedersen KM, Busch Isaksen TM, Baker MG, Seixas N, Errett NA. Climate Change Impacts and Workforce Development Needs in Federal Region X: A Qualitative Study of Occupational Health and Safety Professionals' Perceptions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041513. [PMID: 33562700 PMCID: PMC7915234 DOI: 10.3390/ijerph18041513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 01/29/2021] [Accepted: 02/01/2021] [Indexed: 11/16/2022]
Abstract
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.
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Affiliation(s)
- Katherine M. Pedersen
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA 98105, USA; (K.M.P); (T.M.B.I.); (M.G.B.); (N.S.)
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA 98195, USA
- Department of Urban Design and Planning, College of Built Environments, University of Washington, Seattle, WA 98195, USA
| | - Tania M. Busch Isaksen
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA 98105, USA; (K.M.P); (T.M.B.I.); (M.G.B.); (N.S.)
| | - Marissa G. Baker
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA 98105, USA; (K.M.P); (T.M.B.I.); (M.G.B.); (N.S.)
| | - Noah Seixas
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA 98105, USA; (K.M.P); (T.M.B.I.); (M.G.B.); (N.S.)
| | - Nicole A. Errett
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA 98105, USA; (K.M.P); (T.M.B.I.); (M.G.B.); (N.S.)
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA 98195, USA
- Correspondence:
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46
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Fenske RA, Pinkerton KE. Climate Change and the Amplification of Agricultural Worker Health Risks. J Agromedicine 2021; 26:15-17. [PMID: 33487144 DOI: 10.1080/1059924x.2021.1849211] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Richard A Fenske
- Pacific Northwest Agricultural Safety and Health Center, Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA,
| | - Kent E Pinkerton
- Western Center for Agricultural Health and Safety, University of California, Davis, CA, USA
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Kakamu T, Endo S, Hidaka T, Masuishi Y, Kasuga H, Fukushima T. Heat-related illness risk and associated personal and environmental factors of construction workers during work in summer. Sci Rep 2021; 11:1119. [PMID: 33441683 PMCID: PMC7806839 DOI: 10.1038/s41598-020-79876-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 12/14/2020] [Indexed: 11/30/2022] Open
Abstract
Heat-related illness (HRI) is a common occupational injury, especially in construction workers. To explore the factors related to HRI risk in construction workers under hot outdoor working conditions, we surveyed vital and environmental data of construction workers in the summer season. Sixty-one workers joined the study and the total number of days when their vital data during working hours and environmental data were recorded was 1165. Heart rate with high-risk HRI was determined using the following formula: 180 − 0.65 × age. As a result of the logistic regression analysis, age, working area, maximum skin temperature, and heart rate immediately after warming up were significantly positively related, and experience of construction was significantly negatively related to heart rate with high-risk HRI. Heart rate immediately after warming up may indicate morning fatigue due to reasons such as insufficient sleep, too much alcohol intake the night before, and sickness. Asking morning conditions may lead to the prevention of HRI. For occupational risk management, monitoring of environmental and personal conditions is required.
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Affiliation(s)
- Takeyasu Kakamu
- Department of Hygiene and Preventive Medicine, Fukushima Medical University, Fukushima City, 1 Hikarigaoka, Fukushima, 960-1295, Japan.
| | - Shota Endo
- Department of Hygiene and Preventive Medicine, Fukushima Medical University, Fukushima City, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Tomoo Hidaka
- Department of Hygiene and Preventive Medicine, Fukushima Medical University, Fukushima City, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Yusuke Masuishi
- Department of Hygiene and Preventive Medicine, Fukushima Medical University, Fukushima City, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Hideaki Kasuga
- Department of Hygiene and Preventive Medicine, Fukushima Medical University, Fukushima City, 1 Hikarigaoka, Fukushima, 960-1295, Japan
| | - Tetsuhito Fukushima
- Department of Hygiene and Preventive Medicine, Fukushima Medical University, Fukushima City, 1 Hikarigaoka, Fukushima, 960-1295, Japan
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Foster J, Hodder SG, Goodwin J, Havenith G. Occupational Heat Stress and Practical Cooling Solutions for Healthcare and Industry Workers During the COVID-19 Pandemic. Ann Work Expo Health 2020; 64:915-922. [PMID: 32955080 PMCID: PMC7543286 DOI: 10.1093/annweh/wxaa082] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/06/2020] [Accepted: 07/29/2020] [Indexed: 12/16/2022] Open
Abstract
Treatment and management of severe acute respiratory syndrome coronavirus-2, which causes coronavirus disease (COVID-19), requires increased adoption of personal protective equipment (PPE) to be worn by workers in healthcare and industry. In warm occupational settings, the added burden of PPE threatens worker health and productivity, a major lesson learned during the West-African Ebola outbreak which ultimately constrained disease control. In this paper, we comment on the link between COVID-19 PPE and occupational heat strain, cooling solutions available to mitigate occupational heat stress, and practical considerations surrounding their effectiveness and feasibility. While the choice of cooling solution depends on the context of the work and what is practical, mitigating occupational heat stress benefits workers in the healthcare and industrial sectors during the COVID-19 disease outbreak.
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Affiliation(s)
- Josh Foster
- Environmental Ergonomics Research Centre, Loughborough University, Design School, Loughborough, UK
| | - Simon G Hodder
- Environmental Ergonomics Research Centre, Loughborough University, Design School, Loughborough, UK
| | - James Goodwin
- Environmental Ergonomics Research Centre, Loughborough University, Design School, Loughborough, UK
| | - George Havenith
- Environmental Ergonomics Research Centre, Loughborough University, Design School, Loughborough, UK
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Dally M, Butler-Dawson J, Sorensen CJ, Van Dyke M, James KA, Krisher L, Jaramillo D, Newman LS. Wet Bulb Globe Temperature and Recorded Occupational Injury Rates among Sugarcane Harvesters in Southwest Guatemala. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218195. [PMID: 33171945 PMCID: PMC7664243 DOI: 10.3390/ijerph17218195] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/27/2020] [Accepted: 11/03/2020] [Indexed: 12/13/2022]
Abstract
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.
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Affiliation(s)
- Miranda Dally
- Center for Health, Work & Environment, Department of Environmental and Occupational Health, and Colorado Consortium for Climate Change & Health, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119 HSC, Aurora, CO 80045, USA; (J.B.-D.); (C.J.S.); (M.V.D.); (K.A.J.); (L.K.); (D.J.); (L.S.N.)
- Correspondence: ; Tel.: +1-303-724-2463
| | - Jaime Butler-Dawson
- Center for Health, Work & Environment, Department of Environmental and Occupational Health, and Colorado Consortium for Climate Change & Health, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119 HSC, Aurora, CO 80045, USA; (J.B.-D.); (C.J.S.); (M.V.D.); (K.A.J.); (L.K.); (D.J.); (L.S.N.)
| | - Cecilia J. Sorensen
- Center for Health, Work & Environment, Department of Environmental and Occupational Health, and Colorado Consortium for Climate Change & Health, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119 HSC, Aurora, CO 80045, USA; (J.B.-D.); (C.J.S.); (M.V.D.); (K.A.J.); (L.K.); (D.J.); (L.S.N.)
- Department of Medicine, School of Medicine, University of Colorado, Anschutz Medical Campus, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119 HSC, Aurora, CO 80045, USA
| | - Mike Van Dyke
- Center for Health, Work & Environment, Department of Environmental and Occupational Health, and Colorado Consortium for Climate Change & Health, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119 HSC, Aurora, CO 80045, USA; (J.B.-D.); (C.J.S.); (M.V.D.); (K.A.J.); (L.K.); (D.J.); (L.S.N.)
| | - Katherine A. James
- Center for Health, Work & Environment, Department of Environmental and Occupational Health, and Colorado Consortium for Climate Change & Health, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119 HSC, Aurora, CO 80045, USA; (J.B.-D.); (C.J.S.); (M.V.D.); (K.A.J.); (L.K.); (D.J.); (L.S.N.)
| | - Lyndsay Krisher
- Center for Health, Work & Environment, Department of Environmental and Occupational Health, and Colorado Consortium for Climate Change & Health, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119 HSC, Aurora, CO 80045, USA; (J.B.-D.); (C.J.S.); (M.V.D.); (K.A.J.); (L.K.); (D.J.); (L.S.N.)
| | - Diana Jaramillo
- Center for Health, Work & Environment, Department of Environmental and Occupational Health, and Colorado Consortium for Climate Change & Health, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119 HSC, Aurora, CO 80045, USA; (J.B.-D.); (C.J.S.); (M.V.D.); (K.A.J.); (L.K.); (D.J.); (L.S.N.)
| | - Lee S. Newman
- Center for Health, Work & Environment, Department of Environmental and Occupational Health, and Colorado Consortium for Climate Change & Health, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119 HSC, Aurora, CO 80045, USA; (J.B.-D.); (C.J.S.); (M.V.D.); (K.A.J.); (L.K.); (D.J.); (L.S.N.)
- Department of Medicine, School of Medicine, University of Colorado, Anschutz Medical Campus, 13001 E. 17th Pl., 3rd Floor, Mail Stop B119 HSC, Aurora, CO 80045, USA
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Tigchelaar M, Battisti DS, Spector JT. Work Adaptations Insufficient to Address Growing Heat Risk for U.S. Agricultural Workers. ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2020; 15:094035. [PMID: 33133229 PMCID: PMC7594196 DOI: 10.1088/1748-9326/ab86f4] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
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.
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Affiliation(s)
- Michelle Tigchelaar
- Department of Atmospheric Sciences, University of Washington, Seattle, WA
- now at: Center for Ocean Solutions, Stanford University, Palo Alto, CA
| | - David S. Battisti
- Department of Atmospheric Sciences, University of Washington, Seattle, WA
| | - June T. Spector
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA
- Department of Medicine, University of Washington, Seattle, WA
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