Climate change and occupational safety and health: establishing a preliminary framework

Climate Change and Occupational Heat Strain Among Women Workers: A Systematic Review

Climate change increases heat stress exposure and occupational heat strain in tropical and subtropical regions with generally hot-humid climate conditions. The present systematic review was conducted to assess the effect of climate change on occupational heat strain among women workers. In this study, three main databases (PubMed, Scopus, and Web of Science) were searched to find relevant literature on climate change and its effects using subject headings and appropriate MeSh terms. This article has been written according to the PRISMA checklist. A total of 6,176 studies were identified for screening and 13 studies were eligible for data extraction. Scientific evidence reveals that there is an imprecise but positive relationship between climate change and occupational heat strain regarding women workers. Some complications associated with occupational heat strain among women workers include fatigue, discomfort, dehydration, reduced brain function, and loss of concentration. Climate change can lead to an increase in the occurrence of heat-related illnesses and the levels of injury risk. In addition, its adverse health effects on women workers are mentioned. This systematic study identifies key priorities for action to better characterize and understand how occupational heat strain among women workers may be associated with climate change events. Strong evidence indicates that climate change will continue to cause occupational heat strain among women workers. It is essential to implement preventive measures considering multidisciplinary strategies to reduce the adverse effects of climate change on women workers health in hot weather settings. This can limit the health risks and negative effects of climate change.

Risk factors for heat-related illness resulting in death or hospitalization in the oil and gas extraction industry

Many oil and gas extraction (OGE) activities occur in high-heat environments, resulting in a significant risk of heat-related illness among outdoor workers in this industry. This report highlights cases of occupational heat-related illness that resulted in death and identifies common risk factors for heat-related fatalities and hospitalizations among OGE workers. Two databases maintained by the National Institute for Occupational Safety and Health (NIOSH) and the Occupational Safety and Health Administration (OSHA) were reviewed to identify heat-related fatalities, hospitalizations, and associated risk factors among OGE workers. Nine fatalities and associated risk factors were identified during 2014-2019 from NIOSH's Fatalities in Oil and Gas Extraction (FOG) Database. Risk factors identified included those commonly associated with heat-related fatalities: new workers not acclimatized to heat, inadequate heat stress training, and underlying hypertension or cardiovascular disease. Of particular note, substance use was identified as a significant risk factor as more than half of the fatalities included a positive postmortem test for amphetamines or methamphetamines. Fifty heat-related hospitalizations were identified from OSHA's Severe Injury Report Database during January 2015-May 2021. Heat stress has been and will continue to be an important cause of fatality and adverse health effects in OGE as hot outdoor working conditions become more common and extreme. More emphasis on heat stress training, acclimatization regimens, medical screening, and implementation of workplace-supportive recovery programs may reduce heat-related fatalities and injuries in this industry.

Climate Change: The Ultimate Determinant of Health

Climate change ubiquitously influences social determinants of health via various pathways. Disproportionately burdening communities who have contributed the least to greenhouse gas (GHG) emissions and benefitted the least from economic benefits obtained through high-emission activities that cause climate change, climate justice must be centered in any discussion of health equity. This article will explore how climate change contributes to health disparities in vulnerable populations, why this is a justice issue for primary care to address, and what we can do to promote equity, resilience, and adaption in our current economic system while mitigating GHG emissions, leveraging the health sector.

Comparison of women's heat risk profiles among those working in indoor and outdoor sectors

Rising temperatures and heat events may affect workers, especially women, by increasing the risk of Heat Related Illnesses (HRIs). We conducted a cross-sectional study among 903 women in outdoor and indoor sectors. We measured Wet Bulb Globe Temperature (WBGT) and physiological Heat Strain Indicators (HSI), as well as self-reported symptoms of HRIs using a HOTHAPS questionnaire. Multivariate Logistic Regression models were used to compare the heat risks. WBGT exposures were high in both the outdoor (Avg. WBGT = 28.8 °C ± 2.4 °C) and indoor (Avg. WBGT = 28.7 °C ± 3.5 °C) sectors. Outdoor Women Workers (OWW) reported higher HRI symptoms (94%vs.81%), and heat exposures were positively correlated with HRIs (AOR: 3.7; 95%CI: 2.4-6.1). OWW showed a 1.5-fold higher risk of measured HSI above safe limits (95%CI: 1.1-2.1) and a 2.1-fold higher risk of urogenital issues (95%CI: 2.1-3.8) than Indoor Women Workers (IWW). Due to direct sun exposure, intensive labor, and a lack of welfare facilities, OWW has a higher HRI risk.

Impacts of Climate Change on Work Health and Safety in Australia: A Scoping Literature Review

This scoping review explores the extant literature on climate change impacts on Workplace Health and Safety (WHS) in Australia. It maps the coverage of climate hazards, occupations at risk, and health and socio-economic impacts with the aim of identifying climate change impacts on WHS in Australia and associated knowledge gaps. We used a scoping review approach to identify and investigate 41 scholarly works at the nexus between climate change and WHS in Australia. Thematic template analysis and the NVivo software helped us identify and structure the main themes and systematically document the analysis process. The review highlighted a research focus on the impacts on WHS of heat and extreme weather events resulting from climate change. Agriculture and construction emerged as the most examined occupations, emphasising climate-related diseases and productivity loss. Other climate-related hazards, occupations, and health and socio-economic impacts were largely overlooked in the included research literature. The analysis revealed there is scope for further research relating to climate change impacts on occupational hazards (e.g., air pollution), occupations (e.g., indoor settings at risk), worker health (e.g., injuries), and socio-economic impacts (e.g., change in social practice). Furthermore, the results highlight that the main themes (hazards, occupations, health, and productivity) are interconnected, and the impacts of climate change can be 'cascading', adding complexity and severity. Hence, it is important to look at WHS as a multifaceted phenomenon in a holistic way to understand the risks and support required.

Work as a social determinant of health in high-income countries: past, present, and future

This paper, the first in a three-part Series on work and health, provides a narrative review of research into work as a social determinant of health over the past 25 years, the key emerging challenges in this field, and the implications of these challenges for future research. By use of a conceptual framework for work as a social determinant of health, we identified six emerging challenges: (1) the influence of technology on the nature of work in high-income countries, culminating in the sudden shift to telework during the COVID-19 pandemic; (2) the intersectionality of work with gender, sexual orientation, age, race, ethnicity, migrant status, and socioeconomic status as codeterminants of health disparities; (3) the arrival in many Organisation for Economic Co-operation and Development countries of large migrant labour workforces, who are often subject to adverse working conditions and social exclusion; (4) the development of precarious employment as a feature of many national labour markets; (5) the phenomenon of working long and irregular hours with potential health consequences; and (6) the looming threat of climate change's effects on work. We conclude that profound changes in the nature and availability of work over the past few decades have led to widespread new psychosocial and physical exposures that are associated with adverse health outcomes and contribute to increasing disparities in health. These new exposures at work will require novel and creative methods of data collection for monitoring of their potential health impacts to protect the workforce, and for new research into better means of occupational health promotion and protection. There is also an urgent need for a better integration of occupational health within public health, medicine, the life sciences, and the social sciences, with the work environment explicitly conceptualised as a major social determinant of health.

Work accidents, climate change and COVID-19

The effects brought by climate change and the pandemic upon worker health and wellbeing are varied and necessitate the identification and implementation of improved strategic interventions. This review aims, firstly, to assess how climate change affects occupational accidents, focusing on the impacts of extreme air temperatures and natural disasters; and, secondly, to analyze the role of the pandemic in this context. Our results show that the manifestations of climate change affect workers physically while on the job, psychologically, and by modifying the work environment and conditions; all these factors can cause stress, in turn increasing the risk of suffering a work accident. There is no consensus on the impact of the COVID-19 pandemic on work accidents; however, an increase in adverse mental effects on workers in contact with the public (specifically in healthcare) has been described. It has also been shown that this strain affects the risk of suffering an accident. During the pandemic, many people began to work remotely, and what initially appeared to be a provisional situation has been made permanent or semi-permanent in some positions and companies. However, we found no studies evaluating the working conditions of those who telework. In relation to the combined impact of climate change and the pandemic on occupational health, only publications focusing on the synergistic effect of heat due to the obligation to wear COVID-19-specific PPE, either outdoors or in poorly acclimatized indoor environments, were found. It is essential that preventive services establish new measures, train workers, and determine new priorities for adapting working conditions to these altered circumstances.

Updated assessment of occupational safety and health hazards of climate change

Workers, particularly outdoor workers, are among the populations most disproportionately affected by climate-related hazards. However, scientific research and control actions to comprehensively address these hazards are notably absent. To assess this absence, a seven-category framework was developed in 2009 to characterize the scientific literature published from 1988-2008. Using this framework, a second assessment examined the literature published through 2014, and the current one examines literature from 2014-2021. The objectives were to present literature that updates the framework and related topics and increases awareness of the role of climate change in occupational safety and health. In general, there is substantial literature on worker hazards related to ambient temperatures, biological hazards, and extreme weather but less on air pollution, ultraviolet radiation, industrial transitions, and the built environment. There is growing literature on mental health and health equity issues related to climate change, but much more research is needed. The socioeconomic impacts of climate change also require more research. This study illustrates that workers are experiencing increased morbidity and mortality related to climate change. In all areas of climate-related worker risk, including geoengineering, research is needed on the causality and prevalence of hazards, along with surveillance to identify, and interventions for hazard prevention and control.

Expanding the Focus of Occupational Safety and Health: Lessons from a Series of Linked Scientific Meetings

There is widespread recognition that the world of work is changing, and agreement is growing that the occupational safety and health (OSH) field must change to contribute to the protection of workers now and in the future. Discourse on the evolution of OSH has been active for many decades, but formalized support of an expanded focus for OSH has greatly increased over the past 20 years. Development of approaches such as the National Institute for Occupational Safety and Health (NIOSH)'s Total Worker Health® concept and the World Health Organization (WHO)'s Healthy Workplace Framework are concrete examples of how OSH can incorporate a new focus with a wider view. In 2019, NIOSH initiated a multi-year effort to explore an expanded focus for OSH. This paper is a report on the outputs of a three-year cooperative agreement between NIOSH and The University of Texas School of Public Health, which led to subject matter expert workshops in 2020 and an international conference of global interest groups in 2021. This article traces the background of these meetings and identifies and assesses the lessons learned. It also reviews ten thematic topics that emerged from the meetings: worker health inequalities; training new OSH professionals; future OSH research and practice; tools to measure well-being of workers; psychosocial hazards and adverse mental health effects; skilling, upskilling and improving job quality; socioeconomic influences; climate change; COVID-19 pandemic influences; and strategic foresight. Cross-cutting these themes is the need for systems and transdisciplinary thinking and operationalization of the concept of well-being to prepare the OSH field for the work of the future.

Impact of climate change on occupational health and safety: A review of methodological approaches

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.

Towards real-time thermal stress prediction systems for workers

Exposure to extreme temperatures in workplaces implies serious physical hazards to workers. In addition, a poorly acclimatized worker can have reduced performance and alertness. It may therefore be more vulnerable to the risk of accidents and injuries. Due to the incompatibility of standards and regulations with some work environments and a lack of thermal exchange in many personal protective equipment, heat stress remains among the most common physical risks in many industrial sectors. Furthermore, conventional methods of measuring physiological parameters in order to calculate personal thermophysiological constraints are not practical to use during work tasks. However, the emergence of wearable technologies can contribute to real-time measurement of body temperature and the biometric signals needed to assess thermophysiological constraints while actively working. Thus, the present study was carried out in order to scrutinize the current knowledge of these types of technologies by analyzing the available systems and the advances made in previous studies, as well as to discuss the efforts required to develop devices for the prevention of the occurrence of heat stress in real time.

Occupational Safety and Health Staging Framework for Decent Work

The 2030 United Nations Goal 8 for sustainable development focuses on decent work. There is utility in identifying the occupational safety and health aspects of Goal 8, as they pertain to the four pillars of decent work: job creation, social protection, rights of workers, and social dialogue. A workgroup of the International Commission on Occupational Health and collaborators addressed the issue of decent work and occupational safety and health (OSH) with the objective of elaborating a framework for guidance for practitioners, researchers, employers, workers, and authorities. This article presents that framework, which is based on an examination of the literature and the perspectives of the workgroup. The framework encompasses the intersection of the pillars of decent (employment creation, social protection, rights of workers, and social dialogue) work with new and emerging hazards and risks related to various selected determinants: new technologies and new forms of work; demographics (aging and gender); globalization; informal work; migration; pandemics; and OSH policies and climate change. The OSH field will need an expanded focus to address the future of decent work. This focus should incorporate the needs of workers and workforces in terms of their well-being. The framework identifies a starting point for the OSH community to begin to promote decent work.

Outdoor ambient temperatures and occupational injuries and illnesses: Are there risk differences in various regions within a city?

Increased risk of occupational injuries and illnesses (OI) is associated with hot ambient temperatures. However, the existing evidence of risk estimation is limited to large regions at the city or provincial scales. For effective and localized occupational health risk management, spatio-temporal analysis should be carried out at the intra-city level to identify high-risk areas within cities. This study examined the exposure-response relationship between ambient temperatures and OI at the intra-city scale in Greater Adelaide, Australia. Vulnerable groups of workers, in terms of workers' characteristics, the nature of their work, and workplace characteristics were identified. Further, the projected risk of OI was quantified in various climate change scenarios. The temperature-OI association was estimated using a time-series study design combined with Distributed Lag Non-linear Models. Daily workers' compensation claims (2005-2018) were merged with 5 km gridded meteorological data of maximum temperature (°C) at Statistical Area Level 3 in Greater Adelaide. Region-wise subgroup analyses were conducted to identify vulnerable groups of workers. Future projections (2006-2100) were conducted using downscaled climate projections and the risk was quantified using log-linear extrapolation. The analyses were performed in R 4.1.0. The overall OI risk was 16.7% (95%CI: 10.8-23.0) at moderate heat (90th percentile) and increased to 25.0% (95%CI: 16.4-34.2) at extreme heat (99th percentile). Northern Adelaide had a higher risk of OI for all types of workers at moderate heat, while western regions had a high risk for indoor industries. Southern and eastern regions had a higher OI risk for males, older workers, and outdoor industries at extreme heat. The projected risk of OI is estimated to increase from 20.8% (95%CI: -0.2-46.3) in 2010s to 22.9% (95%CI: -8.0-64.1) by 2050s. Spatio-temporal risk assessment at the intra-city scale can help us identify high-risk areas, where targeted interventions can be efficiently employed to reduce the socio-economic burden of OI.

Workers and Climate Change: The Need for Academic–Industry Partnerships to Improve Agricultural Worker Health, Safety, and Wellbeing

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.

A Review of Construction Workforce Health Challenges and Strategies in Extreme Weather Conditions

AbstractConstruction sites continue to operate despite inclement weather, exposing workers to unpleasant working circumstances that can lead to various physical and mental health challenges. A thorough literature review yielded 21 challenges for hot weather conditions such as heat stroke, kidney disease, heat cramps, anxiety, depression and 20 challenges for cold weather conditions like asthma, frostbite, Musculo-Skeletal disorders, hallucination. Workers vulnerable to hot and cold weather based on demographic characteristics were identified. The study also provides 27 strategies to address the challenges experienced in hot and cold weather conditions. Some of these include ensuring that workers stay hydrated, scheduling sufficient rest periods, and allowing workers to self-pace. The results of this study will help construction decision-makers and project managers understand the difficulties faced by a field workforce who labors in extreme working conditions on construction sites and will facilitate adoption of strategies that can prevent weather-related physical and mental health problems.

Occupational heat strain in outdoor workers: A comprehensive review and meta-analysis

The present comprehensive review (i) summarizes the current knowledge on the impacts of occupational heat stress on outdoor workers, (ii) provides a historical background on this issue, (iii) presents a meta-analysis of published data, (iv) explores inter-individual and intra-individual factors, (v) discusses the available heat mitigation strategies, (vi) estimates physical work capacity, labour productivity, and metabolic rate for the year 2030, and (vii) provides an overview of existing policy and legal frameworks on occupational heat exposure. Meta-analytic findings from 38 field studies that involved monitoring 2,409 outdoor workers across 41 jobs in 21 countries suggest that occupational heat stress increases the core (r = 0.44) and skin (r = 0.44) temperatures, as well as the heart rate (r = 0.38) and urine specific gravity (r = 0.13) of outdoor workers (all p < 0.05). Moreover, it diminishes the capacity of outdoor workers for manual labour (r = -0.82; p < 0.001) and is responsible for more than two thirds of the reduction in their metabolic rate. Importantly, our analysis shows that physical work capacity is projected to be highly affected by the ongoing anthropogenic global warming. Nevertheless, the metabolic rate and, therefore, labour productivity are projected to remain at levels higher than the workers' physical work capacity, indicating that people will continue to work more intensely than they should to meet their financial obligations for food and shelter. In this respect, complementary measures targeting self-pacing, hydration, work-rest regimes, ventilated garments, and mechanization can be adopted to protect outdoor workers.

Potential impacts of Washington State's wildfire worker protection rule on construction workers

Driven by climate change, wildfires are increasing in frequency, duration, and intensity across the Western United States. Outdoor workers are being exposed to increasing wildfire-related particulate matter and smoke. Recognizing this emerging risk, Washington adopted an emergency rule and is presently engaged in creating a permanent rule to protect outdoor workers from wildfire smoke exposure. While there are growing bodies of literature on the exposure to and health effects of wildfire smoke in the general public and wildland firefighters, there is a gap in knowledge about wildfire smoke exposure among outdoor workers generally and construction workers specifically-a large category of outdoor workers in Washington totaling 200,000 people. Several data sources were linked in this study-including state-collected employment data and national ambient air quality data-to gain insight into the risk of PM2.5 exposure among construction workers and evaluate the impacts of different air quality thresholds that would have triggered a new Washington emergency wildfire smoke rule aimed at protecting workers from high PM2.5 exposure. Results indicate the number of poor air quality days has increased in August and September in recent years. Over the last decade, these months with the greatest potential for particulate matter exposure coincided with an annual peak in construction employment that was typically 9.4-42.7% larger across Washington counties (one county was 75.8%). Lastly, the 'encouraged' threshold of the Washington emergency rule (20.5 μg m-3) would have resulted in 5.5 times more days subject to the wildfire rule on average across all Washington counties compared to its 'required' threshold (55.5 μg m-3), and in 2020, the rule could have created demand for 1.35 million N-95 filtering facepiece respirators among construction workers. These results have important implications for both employers and policy makers as rules are developed. The potential policy implications of wildfire smoke exposure, exposure control strategies, and data gaps that would improve understanding of construction worker exposure to wildfire smoke are also discussed.

Modeling and investigating the effect of parasol installation on solar radiant temperature reduction using COMSOL Multiphysics

Objectives. Occupational activities in open spaces can experience excessive heat exposure caused by sunlight and other artificial sources in these professional environments can be one of the current and future challenges of occupational safety and health due to increasing global warming. Use of lightweight portable parasols is the first available control measure to reduce the radiation emitted by the sun in outdoor workplaces, which has been used for a long time. Methods. Due to the lack of study and results on the effect of using parasols in scientific literature, this modeling study was conducted to investigate the effect of sunshade installation on radiant temperature reduction of the sun in outdoor work using COMSOL Multiphysics version 5.5. Results. In general, six different shapes of portable parasols in different positions were modeled and the average radiant temperature reduction effectiveness (TRE) was about 30% in the presence of different parasols. The designed conical, simple and pyramidal sunshades showed the most effectiveness, respectively. Conclusions. The results show that changing variables such as the axis, installation height and shape is more effective for improving parasol efficiency to reduce the radiant temperature below it.

Knowledge, Attitudes, and Practices on Tick-Borne Encephalitis Virus and Tick-Borne Diseases within Professionally Tick-Exposed Persons, Health Care Workers, and General Population in Serbia: A Questionnaire-Based Study

This study assessed the level of knowledge, attitudes, and practices (KAP) regarding tick-borne encephalitis virus (TBEV) and tick-borne diseases (TBDs) among different groups of people in Serbia. Professionally tick-exposed persons (PTEPs), health care workers (HCWs), and the general population (GP) were subjected to an anonymous, voluntary, online questionnaire using Microsoft Forms. A total of 663 questionnaire responses were collected (February–March 2021), while 642 were included in the analysis. The significant difference in knowledge in TBDs existed between GP and PTEPs, and HCWs (p < 0.001). The perception of risk-to-tick exposure and TBDs was generally high (42.4 (95% CI: 33.6–51.2) within GP, 44.9 (95% CI: 35.8–53.9) within PTEPs and 46.2 (95% CI: 38.0–54.5) within HCWs), while fear was low (13.7 (95% CI: 7.9–19.5) within GP, 12.6 (95% CI: 7.3–19.9) within PTEPs, and 13.5 (95% CI: 7.4–19.5) within HCWs). Protective practices differed across groups (F (2639) = 12.920, p < 0.001, η² = 0.039), with both PTEPs (t = 3.621, Cohen d = 0.332, p < 0.001) and HCWs (t = 4.644, Cohen d = 0.468, p < 0.001) adhering to more protective practices than the GP, without differences between PTEPs and HCWs (t = 1.256, Cohen d = 0.137, p = 0.421). Further education about TBDs in Serbia is required and critical points were identified in this study.

Integrated Underground Mining Hazard Assessment, Management, Environmental Monitoring, and Policy Control in Pakistan

This study focused on the significance of underground mining in Pakistan, resulting in the employment of operational staff to undertake the primary tasks of this sector, such as explosions, rock excavation, mineral research, mining-supporting walls, and mine compactivity. Occupational accidents and illnesses arise due to the activities mentioned above because the working circumstances are not optimal. The decision-matrix risk-assessment (DMRA) approach, in which incidents are evaluated according to their severity and probability, was also utilized to improve working conditions, including public health and environment protection. To assess the risks and to select which actions should continue in the same manner, we highlighted hazards that need control measures and, as the last option, those that must be stopped. By taking into account the results of the study, corrective actions were proposed that can help avoid the occurrence of the presented accidents through applying occupational safety and health regulations issued by the Department of Minerals and Mines, which is a governmental entity responsible for both the issuing and the compliance to those regulations. The current study also outlined the requirements that must be reported under mining-related laws.

Advanced Functional Materials for Intelligent Thermoregulation in Personal Protective Equipment

The exposure to extreme temperatures in workplaces involves physical hazards for workers. A poorly acclimated worker may have lower performance and vigilance and therefore may be more exposed to accidents and injuries. Due to the incompatibility of the existing standards implemented in some workplaces and the lack of thermoregulation in many types of protective equipment that are commonly fabricated using various types of polymeric materials, thermal stress remains one of the most frequent physical hazards in many work sectors. However, many of these problems can be overcome with the use of smart textile technologies that enable intelligent thermoregulation in personal protective equipment. Being based on conductive and functional polymeric materials, smart textiles can detect many external stimuli and react to them. Interconnected sensors and actuators that interact and react to existing risks can provide the wearer with increased safety, protection, and comfort. Thus, the skills of smart protective equipment can contribute to the reduction of errors and the number and severity of accidents in the workplace and thus promote improved performance, efficiency, and productivity. This review provides an overview and opinions of authors on the current state of knowledge on these types of technologies by reviewing and discussing the state of the art of commercially available systems and the advances made in previous research works.

Heat exposure effect on Ghanaian mining workers: A mediated-moderation approach

The lack of empirical evidence on the effect of heat exposure on the health and safety, productivity, psychological behaviour and social well-being outcomes of small- and large-scale mining workers in Africa has derailed concrete policy directions and interventions. An explanatory cross-sectional survey involving 320 small- and large-scale mining workers was used to assess this research gap. A path analysis was used to model health and safety, productivity, psychological behaviour and social well-being as a function of heat exposure, mediated and moderated by adaptation strategies and barriers, while controlling for age, gender, level of education, years of working experience and workplace environment. Significant direct adverse effects of heat exposure on mining workers' health and safety, productivity and psychological behaviour outcomes were found. Using a pick-a-point approach, significant difference was found in simple slopes (SS) for heat exposure on adaptation strategies at medium level of barriers and a trend toward significance at the high level of barriers. Except for health and safety outcomes, there were significant conditional indirect effects of heat exposure on the performance outcomes at the medium and high levels of barriers to adaptation strategies. However, there was no evidence of mediated-moderation for heat exposure and health and safety, productivity, psychological behaviour and social well-being outcomes. We have provided empirical evidence to establish heat exposure effect on key performance outcomes of mining workers to initiate and guide the formulation of heat exposure management policies.

Effects of climate change on combined labour productivity and supply: an empirical, multi-model study

BACKGROUND

Although effects on labour is one of the most tangible and attributable climate impact, our quantification of these effects is insufficient and based on weak methodologies. Partly, this gap is due to the inability to resolve different impact channels, such as changes in time allocation (labour supply) and slowdown of work (labour productivity). Explicitly resolving those in a multi-model inter-comparison framework can help to improve estimates of the effects of climate change on labour effectiveness.

METHODS

In this empirical, multi-model study, we used a large collection of micro-survey data aggregated to subnational regions across the world to estimate new, robust global and regional temperature and wet-bulb globe temperature exposure-response functions (ERFs) for labour supply. We then assessed the uncertainty in existing labour productivity response functions and derived an augmented mean function. Finally, we combined these two dimensions of labour into a single compound metric (effective labour effects). This combined measure allowed us to estimate the effect of future climate change on both the number of hours worked and on the productivity of workers during their working hours under 1·5°C, 2·0°C, and 3·0°C of global warming. We separately analysed low-exposure (indoors or outdoors in the shade) and high-exposure (outdoor in the sun) sectors.

FINDINGS

We found differentiated empirical regional and sectoral ERF's for labour supply. Current climate conditions already negatively affect labour effectiveness, particularly in tropical countries. Future climate change will reduce global total labour in the low-exposure sectors by 18 percentage points (range -48·8 to 5·3) under a scenario of 3·0°C warming (24·8 percentage points in the high-exposure sectors). The reductions will be 25·9 percentage points (-48·8 to 2·7) in Africa, 18·6 percentage points (-33·6 to 5·3) in Asia, and 10·4 percentage points (-35·0 to 2·6) in the Americas in the low-exposure sectors. These regional effects are projected to be substantially higher for labour outdoors in full sunlight compared with indoors (or outdoors in the shade) with the average reductions in total labour projected to be 32·8 percentage points (-66·3 to 1·6) in Africa, 25·0 percentage points (-66·3 to 7·0) in Asia, and 16·7 percentage points (-45·5 to 4·4) in the Americas.

INTERPRETATION

Both labour supply and productivity are projected to decrease under future climate change in most parts of the world, and particularly in tropical regions. Parts of sub-Saharan Africa, south Asia, and southeast Asia are at highest risk under future warming scenarios. The heterogeneous regional response functions suggest that it is necessary to move away from one-size-fits-all response functions to investigate the climate effect on labour. Our findings imply income and distributional consequences in terms of increased inequality and poverty, especially in low-income countries, where the labour effects are projected to be high.

FUNDING

COST (European Cooperation in Science and Technology).

Construct validity and invariance assessment of the social impacts of occupational heat stress scale (SIOHSS) among Ghanaian mining workers

Heat exposure studies over the last decade have shown little attention in assessing and reporting the psychometric properties of the various scales used to measure impacts of occupational heat stress on workers. A descriptive cross-sectional survey including 320 small- and large-scale mining workers was employed to assess the construct validity of the social impacts of occupational heat stress scale (SIOHSS) in the Western Region of Ghana in 2017. A confirmatory factor analysis (CFA) and invariance analysis were carried out using AMOS version 25 and statistical product and service solutions (SPSS) version 26 to examine the model fit and establish consistency correspondingly across multiple groups (gender, age, working hours, type of mining and workplace setting). Empirically, our results depicted that effects on health and safety, behavioural, productivity and social well-being were each found to be reliable, with Cronbach's α of 0.722, 0.807, 0.852 and 0.900 respectively. Though there were issues of insufficient discriminant validity as some average variance extract (AVE) were smaller than the corresponding maximum shared variance (MSV), the CFA showed good model fit indices (CFI = 0.856, GFI = 0.890, TLI = 0.863, SRMR = 0.08, RMSEA = 0.08). Also, the model was variant for all constrained aspects of the structural model indicating a requirement for an adaptation of the instrument across groups. The good to moderate internal consistency and construct validity of the SIOHSS is adequate evidence for the confidence required for its reliability and accuracy in measuring the social impacts of occupational heat stress on workers.

Climate Change Impacts and Workforce Development Needs in Federal Region X: A Qualitative Study of Occupational Health and Safety Professionals' Perceptions

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.

A Field Evaluation of Construction Workers' Activity, Hydration Status, and Heat Strain in the Extreme Summer Heat of Saudi Arabia

OBJECTIVES

Assess the impact of summer heat exposure (June-September) on residential construction workers in Al-Ahsa, Saudi Arabia by evaluating (i) heart rate (HR) responses, hydration status, and physical workload among workers in indoor and outdoor construction settings, (ii) factors related to physiological responses to work in hot conditions, and (iii) how well wet-bulb globe temperature-based occupational exposure limits (WBGTOELs) predict measures of heat strain.

METHODS

Twenty-three construction workers (plasterers, tilers, and laborers) contributed 260 person-days of monitoring. Workload energy expenditure, HR, fluid intake, and pre- and postshift urine specific gravity (USG) were measured. Indoor and outdoor heat exposures (WBGT) were measured continuously and a WBGTOEL was calculated. The effects of heat exposure and workload on heart rate reserve (HRR), a measure of cardiovascular strain, were examined with linear mixed models. A metric called 'heat stress exceedance' (HSE) was constructed to summarize whether the environmental heat exposure (WBGT) exceeded the heat stress exposure limit (WBGTOEL). The sensitivity and specificity of the HSE as a predictor of cardiovascular strain (HRR ≥30%) were determined.

RESULTS

The WBGTOEL was exceeded frequently, on 63 person-days indoors (44%) and 91(78%) outdoors. High-risk HRR occurred on 26 and 36 person-days indoors and outdoors, respectively. The HSE metric showed higher sensitivity for HRR ≥30% outdoors (89%) than indoors (58%) and greater specificity indoors (59%) than outdoors (27%). Workload intensity was generally moderate, with light intensity work more common outdoors. The ability to self-pace work was associated with a lower frequency of HRR ≥30%. USG concentrations indicated that workers began and ended their shifts dehydrated (USG ≥1.020).

CONCLUSIONS

Construction work where WBGTOEL is commonly exceeded poses health risks. The ability of workers to self-pace may help reduce risks.

Identification, Classification, and Prioritization of Effective Factors in Producing Thermal Strain in Men at Workplaces using Fuzzy AHP Technique

Background:

Various factors can affect thermal strain at workplaces. To prevent heat illnesses due to the heat strain, one must identify and prioritize these factors. Therefore, the present study was aimed to determine the relative importance of the effective factors in producing thermal strain in men at workplaces using fuzzy AHP technique.

Materials and Methods:

This qualitative practical study was performed in 2019. Effective factors in producing heat strain were identified by a literature review. Then, an expert panel reviewed the identified factors and omitted some of them. Further, the balance theory of job design was applied to classify the heat strain factors. Later, these factors were categorized into six groups, including environmental, personal, job, clothing, administrative, and lifestyle elements. In the end, the fuzzy analytical hierarchy technique was used for prioritizing the elements and factors involved in each of them.

Results:

Based on the results, the environmental element had the highest relative weight and priority (0.178). Other priorities were assigned to the job element (0.171), clothing element (0.171), personal element (0.169), administrative element (0.169), and lifestyle element (0.142), respectively.

Conclusion:

In general, the results showed that environmental factors are the most effective ones in producing heat strain. The results of the present study can be helpful in controlling the thermal strain.

The nexus between social impacts and adaptation strategies of workers to occupational heat stress: a conceptual framework

Adverse effects of occupational heat stress in the context of the changing climate on working populations are subtle but considerably harmful. However, social dimensions and impacts of climate change-related occupational heat concerns on workers' safety and health, productivity and well-being are often overlooked or relegated as minor issues in social impact analyses of occupational heat exposure due to climate change. This paper offers a conceptual framework based on an appraisal and synthesis of the literature on social impacts of climate change-related occupational heat exposure on workers' safety and health, productivity and social welfare and the quest to localise and achieve sustainable development goals. A sustained global, national, institutional and individual collaborative involvement and financial support for research, improved adaptation and social protection strategies, predominantly in the developing world, where a large number of people work outdoors, can reduce heat exposure and boost the resilience and adaptive capacity of workers to facilitate efforts to achieve sustainable development goals.

Impacts of Climate Change on Outdoor Workers and their Safety: Some Research Priorities

The literature on the potential impacts of climate change on the health of outdoor workers has received limited attention as a whole, and in sub-Saharan African countries in particular. Yet, substantial numbers of workers are experiencing the health effects of elevated temperature, in combination with changes in precipitation patterns, climate extremes and the effects of air pollution, which have a potential impact on their safety and wellbeing. With increased temperatures within urban settlements and frequent heats waves, there has been a sudden rise in the occurrence of heat-related illness leading to higher levels of mortality, as well as other adverse health impacts. This paper discusses the impacts of extreme heat exposure and health concerns among outdoor workers, and the resultant impacts on their productivity and occupational safety in tropical developing countries with a focus on Sub-Saharan Africa, where there is a dearth of such studies. Aside from the direct effects caused by extreme heat exposure, other indirect health hazards associated with increasing heat among this group includes exposures to hazardous chemicals and other vector-borne diseases. In addition, reduced work capacity in heat-exposed jobs will continue to rise and hinder economic and social development in such countries. There is an urgent need for further studies around the health and economic impacts of climate change in the workplace, especially in tropical developing countries, which may guide the implementation of the measures needed to address the problem.

Perceptions of climate change and occupational heat stress risks and adaptation strategies of mining workers in Ghana

Heavy physical workload for long hours coupled with increasing workplace heat exposure due to rising temperatures stemming from climate change, especially where there are inadequate prevention and control policies, adversely affect workers' health and safety, productive capacity and social well-being. However, variations in workers' concerns and awareness of occupational heat stress and climate change risks impede the effectiveness of heat stress management. A mixed method approach was used to assess climate change perceptions and occupational heat stress risks and adaptation strategies of Ghanaian mining workers. Questionnaires and focus group discussions were used to collect data from 320 respondents. Quantitative and qualitative approaches were used for data analysis. Workers' climate change risk perception, as confirmed by trends in climate data, was reasonable, but concerns about climate change effects and workplace heat exposure risks varied significantly across types of mining activity (p < 0.001). Workers experienced heat-related morbidities, but the variation in heat-related morbidity experiences across the type of mining activity was not significant. However, the type of heat-related morbidities experienced by workers differed across the type of mining activity (p < 0.001). Workers' awareness of occupational heat stress prevention and control was adequate. The disparities in workers' awareness and use of the prevention and control measures significantly differed across the type of mining activity (p < 0.001). Occupational heat stress prevention activities should focus on workers, and a concerted effort must be made to promote workers' adaptive capacity and inform policy decisions.

Occupational exposure to blood and body fluids and associated factors among health care workers at the University of Gondar Hospital, Northwest Ethiopia

Background

Occupational exposure to blood and body fluids (BBFs) is a serious concern for health care workers (HCWs) and presents a major risk factor for transmission of infectious diseases such as hepatitis B virus (HBV), hepatitis C virus, and human immune deficiency virus. The main objective of this study was to assess the magnitudes of occupational exposure of blood and body fluids and associated factors among health workers at the University of Gondar Hospital.

Methods

An institution-based cross-sectional study was conducted from 1 February to 31 May 2017 at the University of Gondar Hospital. A total of 282 health care workers were selected by simple random sampling technique. Descriptive data was presented as absolute number with percentage, and multivariate analysis was used to assess the statistical association between associated factors and occupational exposure to BBFs. A P value of < 0.05 was considered as statistical significant.

Result

A total of 282 HCWs participated with the mean (±SD) age of 30.51 ± 5.86 year. Of the total, 58.5% (165) and 42.2% (119) of the study participants had been exposed to BBFs splash and needlestick injury (NSI) in their lifetime, respectively. However, 39.0% (110) and 20.6% (58) of the HCWs were exposed to splash and NSI in the past 1 year, respectively. Not wearing eye goggle, lack of training on infection prevention, taking of HBV vaccination, and recapping of used needle were risk factors associated with BBFs splash exposure, whereas taking HBV vaccination and recapping of used needle were associated risk factors with NSI exposure.

Conclusion

This study showed a high percentage of occupational exposure to blood and body fluids among health care workers. Not wearing eye goggle, HBV vaccine status, and recapping needles were found to be independent predictors of occupational exposure to BBFs among HCWs. Therefore, relevant stakeholders need to formulate strategies to create a favorable working environment and increase their adherence to universal precautions.

Evaluation of the impact of heat stress on the occurrence of occupational injuries: Meta-analysis of observational studies

BACKGROUND

Growing evidence indicates that the exposure to high heat levels in the workplace results in health problems in workers. A meta-analysis was carried out to summarize the epidemiological evidence of the effects of heat exposure on the risk of occupational injuries.

METHODS

A search strategy was conducted to retrieve studies on the effects of climate change on occupational injury risk. Among the 406 identified, 5 time-series and 3 case-crossover studies were selected for meta-analysis.

RESULTS

Pooled risk estimates for time-series and case-crossover studies combined, and then separated, were 1.005 (95%CI: 1.001-1009), 1.002 (95%CI: 0.998-1.005), and 1.014 (95%CI: 1.012-1.017), respectively. Subgroup analyses found increased risks (not statistically significant) for male gender, age <25 years and agriculture.

CONCLUSIONS

The present findings can orient further research to assess the effects of heat at workplace and consequently to establish better health policies for managing such exposure in at-risk regions.

The effects of ambient temperatures on the risk of work-related injuries and illnesses: Evidence from Adelaide, Australia 2003-2013

BACKGROUND

The thermal environment can directly affect workers' occupational health and safety, and act as a contributing factor to injury or illness. However, the literature addressing risks posed by varying temperatures on work-related injuries and illnesses is limited.

OBJECTIVES

To examine the occupational injury and illness risk profiles for hot and cold conditions.

METHODS

Daily numbers of workers' compensation claims in Adelaide, South Australia from 2003 to 2013 (n = 224,631) were sourced together with daily weather data. The impacts of maximum daily temperature on the risk of work-related injuries and illnesses was assessed using a time-stratified case-crossover study design combined with a distributed lag non-linear model.

RESULTS

The minimum number of workers' compensation claims occurred when the maximum daily temperature was 25 °C. Compared with this optimal temperature, extremely hot temperatures (99th percentile) were associated with an increase in overall claims (RR: 1.30, 95%CI: 1.18-1.44) whereas a non-significant increase was observed with extremely cold temperatures (1st percentile, RR: 1.10 (95%CI: 0.99-1.21). Heat exposure had an acute effect on workers' injuries whereas cold conditions resulted in delayed effects. Moderate temperatures were associated with a greater injury burden than extreme temperatures.

CONCLUSION

Days of very high temperatures were associated with the greatest risks of occupational injuries; whereas moderate temperatures, which occur more commonly, have the greatest burden. These findings suggest that the broader range of thermal conditions should be considered in workplace injury and illness prevention strategies.

Climate change and occupational heat stress risks and adaptation strategies of mining workers: Perspectives of supervisors and other stakeholders in Ghana

Increasing air temperatures as a result of climate change are worsening the impact of heat exposure on working populations, including mining workers, who are at risk of suffering heat-related illnesses, injury and death. However, inadequate awareness of climate change-related occupational heat stress risks and adaptation strategies have been shown to render occupational heat stress management ineffective. A concurrent mixed-methods approach was used to assess the perceptions of climate change and occupational heat stress risks and adaptation strategies of mining workers among supervisory personnel and other stakeholders in Ghana. Questionnaires and interviews were used to elicit data from 19 respondents. Data were processed and interpreted using descriptive statistics, chi-square and Fisher's exact tests, and thematic analysis. Supervisors' climate change risks perception was adequate, and their concern about workplace heat exposure risks was moderate. Mining workers' occupational heat stress risks experiences were linked to heat-related illness and minor injuries. Mining workers' adaptation strategies included water intake, use of cooling mechanisms, work-break practices, and clothing use. The related differences in job experience in the distribution of climate change risk perception and occupational heat stress risk experiences, and the difference in educational attainment in the distribution of adaptation strategies of occupational heat stress were significant (p < 0.05). Hence, an effective workplace heat management policy requires adequate understanding of occupational heat stress risks and adaptation policies and continued education and training for mining workers.

Priority focus areas for a sub-national response to climate change and health: A South African provincial case study

INTRODUCTION

The intersection of health and climate change is often absent or under-represented in sub-national government strategies. This analysis of the literature, using a new methodological framework, highlights priority focus areas for a sub-national government response to health and climate change, using the Western Cape (WC) province of South Africa as a case study.

METHODS

A methodological framework was created to conduct a review of priority focus areas relevant for sub-national governments. The framework encompassed the establishment of a Project Steering Group consisting of relevant, sub-national stakeholders (e.g. provincial officials, public and environmental health specialists and academics); an analysis of local climatic projections as well as an analysis of global, national and sub-national health risk factors and impacts.

RESULTS

Globally, the discussion of health and climate change adaptation strategies in sub-national, or provincial government is often limited. For the case study presented, multiple health risk factors were identified. WC climatic projections include a warmer and potentially drier future with an increased frequency and intensity of extreme weather events. WC government priority focus areas requiring further research on health risk factors include: population migration and environmental refugees, land use change, violence and human conflict and vulnerable groups. WC government priority focus areas for further research on health impacts include: mental ill-health, non-communicable diseases, injuries, poisonings (e.g. pesticides), food and nutrition insecurity-related diseases, water- and food-borne diseases and reproductive health. These areas are currently under-addressed, or not addressed at all, in the current provincial climate change strategy.

CONCLUSIONS

Sub-national government adaptation strategies often display limited discussion on the health and climate change intersect. The methodological framework presented in this case study can be globally utilized by other sub-national governments for decision-making and development of climate change and health adaptation strategies. Additionally, due to the broad range of sectoral issues identified, a primary recommendation from this study is that sub-national governments internationally should consider a "health and climate change in all policies" approach when developing adaptation and mitigation strategies to address climate change.

Redox balance and DNA fragmentation in arsenic-exposed occupational workers from different industries of Pakistan

AbstractOccupational exposure accounts for a contact between workers and different toxicants. Present study was designed to measure the arsenic-induced DNA fragmentation and oxidative stress in exposed workers. Blood, hair, and nail samples were collected from welding, brick kiln, furniture, pesticide, and paint industries (n = 50/industry) of Pakistan along with 200 controls. DNA damage was calculated using DNA fragmentation assay. Antioxidant enzymes (CAT, SOD, GPx) were measured using ELISA. Results revealed that arsenic exposure induced DNA fragmentation in brick kiln, furniture, and welding industries. Enzyme activity was reduced in five industries compared to control. In exposed group, significant depletion of enzymes was observed in furniture, welding, and brick kiln workers. Based on age and time of exposure, significant difference was observed in welding and brick kiln group. Smokers of exposed group showed significantly reduced levels of enzymes compared to controls. Arsenic deposition was observed higher in the hair, nail, and blood samples of exposed group (P < 0.001) compared to control. Likewise, lead and cadmium contents were higher in the blood samples of industrial workers compared to control. This study suggests increased trend of cellular damage and oxidative stress in occupational workers profoundly in welding, furniture, and brick kiln industries. Moreover, this study recognizes the contribution of age, exposure time, and smoking status toward arsenic-induced oxidative stress and DNA fragmentation.

Evaluation of the Impact of Ambient Temperatures on Occupational Injuries in Spain

BACKGROUND

Extreme cold and heat have been linked to an increased risk of occupational injuries. However, the evidence is still limited to a small number of studies of people with relatively few injuries and with a limited geographic extent, and the corresponding economic effect has not been studied in detail.

OBJECTIVES

We assessed the relationship between ambient temperatures and occupational injuries in Spain along with its economic effect.

METHODS

The daily number of occupational injuries that caused at least one day of leave and the daily maximum temperature were obtained for each Spanish province for the years 1994-2013. We estimated temperature-injuries associations with distributed lag nonlinear models, and then pooled the results using a multivariate meta-regression model. We calculated the number of injuries attributable to cold and heat, the corresponding workdays lost, and the resulting economic effect.

RESULTS

The study included 15,992,310 occupational injuries. Overall, 2.72% [95% confidence interval (CI): 2.44-2.97] of all occupational injuries were attributed to nonoptimal ambient temperatures, with moderate heat accounting for the highest fraction. This finding corresponds to an estimated 0.67 million (95% CI: 0.60-0.73) person-days of work lost every year in Spain due to temperature, or an annual average of 42 d per 1,000 workers. The estimated annual economic burden is €370 million, or 0.03% of Spain's GDP (€2,015).

CONCLUSIONS

Our findings suggest that extreme ambient temperatures increased the risk of occupational injuries, with substantial estimated health and economic costs. These results call for public health interventions to protect workers in the context of climate change. https://doi.org/10.1289/EHP2590.

Impact of climate change on occupational health and productivity: a systematic literature review focusing on workplace heat

BACKGROUND

With climate change, mean annual air temperatures are getting hotter and extreme weather events will become more and more common in most parts of the world.

OBJECTIVES

As part of the EU funded project HEAT-SHIELD we conducted a systematic review to summarize the epidemiological evidence of the effects of global warming-related heat exposure on workers' health and productivity.

METHODS

Three separate searches, focused, respectively, on: i) heat-related illness (HRI), cardiovascular, respiratory and kidney diseases; ii) traumatic injuries; and iii) vector-borne diseases or vectors distribution, were conducted in PubMed. EMBASE was also consulted to retrieve relevant studies focused on the health effects of climate change. A fourth search strategy to assess the effects on work productivity was conducted both in PubMed and in the SCOPUS database.

RESULTS

A significant proportion of studies reported findings regarding the Mesoamerican nephropathy issue. This is a disease occurring especially among young and middle-aged male sugarcane workers, without conventional risk factors for chronic kidney disease. For injuries, there is a reversed U-shaped exposure-response relationship between Tmax and overall daily injury claims. Outdoor workers are at increased risk of vector-borne infectious diseases, as a positive correlation between higher air temperatures and current or future expansion of the habitat of vectors is being observed. As for productivity, agriculture and construction are the most studied sectors; a day with temperatures exceeding 32°C can reduce daily labour supply in exposed sectors by up to 14%.

CONCLUSIONS

The present findings should inform development of further research and related health policies in the EU and beyond with regard to protecting working people from the effects of workplace heat during climate change.

Estimating population heat exposure and impacts on working people in conjunction with climate change

Increased environmental heat levels as a result of climate change present a major challenge to the health, wellbeing and sustainability of human communities in already hot parts of this planet. This challenge has many facets from direct clinical health effects of daily heat exposure to indirect effects related to poor air quality, poor access to safe drinking water, poor access to nutritious and safe food and inadequate protection from disease vectors and environmental toxic chemicals. The increasing environmental heat is a threat to environmental sustainability. In addition, social conditions can be undermined by the negative effects of increased heat on daily work and life activities and on local cultural practices. The methodology we describe can be used to produce quantitative estimates of the impacts of climate change on work activities in countries and local communities. We show in maps the increasing heat exposures in the shade expressed as the occupational heat stress index Wet Bulb Globe Temperature. Some tropical and sub-tropical areas already experience serious heat stress, and the continuing heating will substantially reduce work capacity and labour productivity in widening parts of the world. Southern parts of Europe and the USA will also be affected. Even the lowest target for climate change (average global temperature change = 1.5 °C at representative concentration pathway (RCP2.6) will increase the loss of daylight work hour output due to heat in many tropical areas from less than 2% now up to more than 6% at the end of the century. A global temperature change of 2.7 °C (at RCP6.0) will double this annual heat impact on work in such areas. Calculations of this type of heat impact at country level show that in the USA, the loss of work capacity in moderate level work in the shade will increase from 0.17% now to more than 1.3% at the end of the century based on the 2.7 °C temperature change. The impact is naturally mainly occurring in the southern hotter areas. In China, the heat impact will increase from 0.3 to 2%, and in India, from 2 to 8%. Especially affected countries, such as Cambodia, may have losses going beyond 10%, while countries with most of the population at high cooler altitude, such as Ethiopia, may experience much lower losses.

Occupational Heat Stress and Kidney Health: From Farms to Factories

Millions of workers around the world are exposed to high temperatures, intense physical activity, and lax labor practices that do not allow for sufficient rehydration breaks. The extent and consequences of heat exposure in different occupational settings, countries, and cultural contexts is not well studied. We conducted an in-depth review to examine the known effects of occupational heat stress on the kidney. We also examined methods of heat-stress assessment, strategies for prevention and mitigation, and the economic consequences of occupational heat stress. Our descriptive review summarizes emerging evidence that extreme occupational heat stress combined with chronic dehydration may contribute to the development of CKD and ultimately kidney failure. Rising global temperatures, coupled with decreasing access to clean drinking water, may exacerbate the effects of heat exposure in both outdoor and indoor workers who are exposed to chronic heat stress and recurrent dehydration. These changes create an urgent need for health researchers and industry to identify work practices that contribute to heat-stress nephropathy, and to test targeted, robust prevention and mitigation strategies. Preventing occupational heat stress presents a great challenge for a concerted multidisciplinary effort from employers, health authorities, engineers, researchers, and governments.

Factors affecting heat-related diseases in outdoor workers exposed to extreme heat

Background

The objectives of the present study are to: (i) evaluate the effect of environmental and metabolic heat on heat-related illnesses in outdoor workers; and (ii) evaluate the effect of personal factors, including heat acclimation, on the risk of heat-related illnesses in outdoor workers.

Methods

We identified 47 cases of illnesses from exposure to environmental heat in outdoor workers in Korea from 2010 to 2014, based on review of workers’ compensation data. We also obtained the information on location, time, and work environment of each heat-related illness.

Results

Our major results are that 29 cases (61.7%) occurred during a heat wave. Forty five cases (95.7%) occurred when the maximum estimated WBGT (WBGTmax) was equal to or greater than the case specific threshold value which was determined by acclimatization and metabolic rate. Twenty two cases (46.8%) were not acclimated to the heat. Thirty-seven cases (78.7%) occurred after tropical night (temperature above 25 °C), during which many people may find it hard to sleep.

Conclusion

Personal risk factors such as heat acclimation as well as environmental factors and high metabolic rate during work are the major determinants of heat-related illnesses.