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Prevention of Adverse Health Outcomes Related to Heat Exposure in Working Populations

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Climate Change".

Deadline for manuscript submissions: closed (30 November 2022) | Viewed by 29837

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Special Issue Editor

Dr. June T. Spector

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Guest Editor

School of Public Health and School of Medicine, University of Washington, Seattle, WA 98105, USA
Interests: clean air; safe workplaces; sustainable communities; agricultural health and safety; climate change; environmental health; occupational health; occupational medicine; occupational safety

Special Issue Information

Dear Colleagues,

Heat exposure is associated with an increased risk of occupational heat-related illness and other adverse health outcomes, including traumatic injury and kidney injury. Certain workers who perform heavy physical labor in warm conditions are at disproportionate risk. Factors contributing to the development of adverse health outcomes from heat exposure occur at multiple social–ecological levels, and individual susceptibility, workplace controls, community and housing contexts, policies, and other factors are relevant to prevention. Heat can also interact with toxicants and can co-occur with other exposures such as fine particulate matter (PM2.5) during wildfire season.

Enhanced resilience to heat is needed given projected increases in the frequency and severity of extreme heat. Promising interventions—and approaches to evaluate these interventions—may use new technology, focus on heat alone or within the context of co-exposures, address prevention at one or multiple social–ecological levels, and/or address disparities that occur when working populations with the most social and economic disadvantage experience disproportionate exposure and lack adequate means to address exposures and health effects.

You are invited to contribute to a unique issue that stimulates further discussion and catalyzes advances in practical, evidence-based, solutions—and methods to evaluate solutions—to prevent adverse health outcomes related to heat exposure for working populations in a changing climate.

Dr. June T. Spector
Guest Editor

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Keywords

heat exposure
heat stress
heat-related illness
occupational health
climate change
prevention
interventions
practical solutions

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Published Papers (6 papers)

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Research

14 pages, 1036 KiB

Open AccessArticle

Analysis of Exertion-Related Injuries and Fatalities in Laborers in the United States

by Margaret C. Morrissey, Zachary Yukio Kerr, Gabrielle J. Brewer, Faton Tishukaj, Douglas J. Casa and Rebecca L. Stearns

Int. J. Environ. Res. Public Health 2023, 20(3), 2683; https://doi.org/10.3390/ijerph20032683 - 2 Feb 2023

Cited by 8 | Viewed by 3227

Abstract

Laborers are particularly vulnerable to exertional injuries and illnesses, as they often engage in heavy physical work for prolonged hours, yet no studies have examined the top causes of catastrophic exertional injuries and fatalities among this population. The purpose of the investigation was to characterize the top causes of exertional injury and fatality within open access, Occupational Safety and Health Administration (OSHA) reportable data. A secondary analysis of OSHA reported injury and fatality data was performed through open access records from OSHA Severe Injury Reports (2015–2022) and OSHA fatality inspection data (2017–2020), respectively. The research team characterized each reported injury and fatality as “exertion-related” or “non-exertion-related. Injury and fatality rates were reported per 100,000 equivalent full-time worker years and included 95% confidence intervals (95% CI). Of 58,648 cases in the OSHA Severe Injury Report database from 2015–2020, 1682 cases (2.9%) were characterized as exertional (0.20 injuries per 100,000 full-time worker years, 95% CI: 0.19, 0.22). Heat-related injuries encompassed 91.9% of the exertional injuries (n = 1546). From the 2017–2022 OSHA fatality inspection database, 89 (1.9%) of 4598 fatalities were characterized as exertion-related (fatality rate: 0.0160 per 100,000 full-time equivalent workers, 95% CI: 0.009, 0.0134). The exertion-related fatalities primarily consisted of heat-related cases (87.6%). Exertion-related injuries and fatalities were most reported in Southeast states, in the construction and excavation industry, and among nonunionized workers. As heat stress continues to be recognized as an occupational health and safety hazard, this analysis further highlights the need for targeted interventions or further evaluation of the impact of heat stress on construction and excavation workers, nonunionized workers, and workers in Southeastern states. Full article

(This article belongs to the Special Issue Prevention of Adverse Health Outcomes Related to Heat Exposure in Working Populations)

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24 pages, 7682 KiB

Open AccessArticle

Potential Impacts of Different Occupational Outdoor Heat Exposure Thresholds among Washington State Crop and Construction Workers and Implications for Other Jurisdictions

by John C. Flunker, Christopher Zuidema, Jihoon Jung, Edward Kasner, Martin Cohen, Edmund Seto, Elena Austin and June T. Spector

Int. J. Environ. Res. Public Health 2022, 19(18), 11583; https://doi.org/10.3390/ijerph191811583 - 14 Sep 2022

Cited by 7 | Viewed by 2900

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. Full article

(This article belongs to the Special Issue Prevention of Adverse Health Outcomes Related to Heat Exposure in Working Populations)

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15 pages, 1228 KiB

Open AccessArticle

Kidney Function in Rice Workers Exposed to Heat and Dehydration in Costa Rica

by Jennifer Crowe, Daniel Rojas-Valverde, Marianela Rojas-Garbanzo, Randall Gutiérrez-Vargas, José Alexis Ugalde-Ramírez, José Pablo Ledezma-Rojas, William Cabrera-Alpizar, Minor Salazar-Salazar, Rodrigo Mauricio-La Torre, Lázara Valera-Amador and Berna van Wendel de Joode

Int. J. Environ. Res. Public Health 2022, 19(9), 4962; https://doi.org/10.3390/ijerph19094962 - 19 Apr 2022

Cited by 5 | Viewed by 2778

Abstract

The aim of this study was to evaluate heat exposure, dehydration, and kidney function in rice workers over the course of three months, in Guanacaste, Costa Rica. We collected biological and questionnaire data across a three-month-period in male field (n = 27) and other (n = 45) workers from a rice company where chronic kidney disease of unknown origin (CKDu) is endemic. We used stepwise forward regression to determine variables associated with estimated glomerular filtration rate eGFR at enrollment and/or change in eGFR, and Poisson regression to assess associations with incident kidney injury (IKI) over the course of three months. Participants were 20–62 years old (median = 40 in both groups). Dehydration was common (≥37%) in both groups, particularly among other workers at enrollment, but field workers were more exposed to heat and had higher workloads. Low eGFR (<60 mL/min/1.73 m²) was more prevalent in field workers at enrollment (19% vs. 4%) and follow-up (26% vs. 7%). Field workers experienced incident kidney injury (IKI) more frequently than other workers: 26% versus 2%, respectively. Age (β = −0.71, 95%CI: −1.1, −0.4), current position as a field worker (β = −2.75, 95%CI: −6.49, 0.99) and past work in construction (β = 3.8, 95%CI: −0.1, 7.6) were included in the multivariate regression model to explain eGFR at enrollment. The multivariate regression model for decreased in eGFR over three month included current field worker (β = −3.9, 95%CI: −8.2, 0.4), current smoking (β= −6.2, 95%CI: −13.7–1.3), dehydration (USG ≥ 1.025) at both visits (β= −3.19, 95%CI: −7.6, 1.2) and pain medication at follow-up (β= −3.2, 95%CI: −8.2, 1.95). Current fieldwork [IR (incidence rate) = 2.2, 95%CI 1.1, 5.8) and being diabetic (IR = 1.8, 95%CI 0.9, 3.6) were associated with IKI. Low eGFR was common in field workers from a rice company in Guanacaste, and being a field worker was a risk factor for IKI, consistent with the hypothesis that occupational heat exposure is a critical risk factor for CKDu in Mesoamerica. Full article

(This article belongs to the Special Issue Prevention of Adverse Health Outcomes Related to Heat Exposure in Working Populations)

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17 pages, 1538 KiB

Open AccessArticle

High-Heat Days and Presentations to Emergency Departments in Regional Victoria, Australia

by Jessie Adams, Susan Brumby, Kate Kloot, Tim Baker and Mohammadreza Mohebbi

Int. J. Environ. Res. Public Health 2022, 19(4), 2131; https://doi.org/10.3390/ijerph19042131 - 14 Feb 2022

Cited by 7 | Viewed by 2883

Abstract

Heat kills more Australians than any other natural disaster. Previous Australian research has identified increases in Emergency Department presentations in capital cities; however, little research has examined the effects of heat in rural/regional locations. This retrospective cohort study aimed to determine if Emergency Department (ED) presentations across the south-west region of Victoria, Australia, increased on high-heat days (1 February 2017 to 31 January 2020) using the Rural Acute Hospital Data Register (RAHDaR). The study also explored differences in presentations between farming towns and non-farming towns. High-heat days were defined as days over the 95th temperature percentile. International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) codes associated with heat-related illness were identified from previous studies. As the region has a large agricultural sector, a framework was developed to identify towns estimated to have 70% or more of the population involved in farming. Overall, there were 61,631 presentations from individuals residing in the nine Local Government Areas. Of these presentations, 3064 (5.0%) were on days of high-heat, and 58,567 (95.0%) were of days of non-high-heat. Unlike previous metropolitan studies, ED presentations in rural south-west Victoria decrease on high-heat days. This decrease was more prominent in the farming cohort; a potential explanation for this may be behavioural adaption. Full article

(This article belongs to the Special Issue Prevention of Adverse Health Outcomes Related to Heat Exposure in Working Populations)

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21 pages, 5719 KiB

Open AccessArticle

Occupational Heat Stress: Multi-Country Observations and Interventions

by Leonidas G. Ioannou, Konstantinos Mantzios, Lydia Tsoutsoubi, Eleni Nintou, Maria Vliora, Paraskevi Gkiata, Constantinos N. Dallas, Giorgos Gkikas, Gerasimos Agaliotis, Kostas Sfakianakis, Areti K. Kapnia, Davide J. Testa, Tânia Amorim, Petros C. Dinas, Tiago S. Mayor, Chuansi Gao, Lars Nybo and Andreas D. Flouris

Int. J. Environ. Res. Public Health 2021, 18(12), 6303; https://doi.org/10.3390/ijerph18126303 - 10 Jun 2021

Cited by 55 | Viewed by 10355

Abstract

Background: Occupational heat exposure can provoke health problems that increase the risk of certain diseases and affect workers’ ability to maintain healthy and productive lives. This study investigates the effects of occupational heat stress on workers’ physiological strain and labor productivity, as well as examining multiple interventions to mitigate the problem. Methods: We monitored 518 full work-shifts obtained from 238 experienced and acclimatized individuals who work in key industrial sectors located in Cyprus, Greece, Qatar, and Spain. Continuous core body temperature, mean skin temperature, heart rate, and labor productivity were collected from the beginning to the end of all work-shifts. Results: In workplaces where self-pacing is not feasible or very limited, we found that occupational heat stress is associated with the heat strain experienced by workers. Strategies focusing on hydration, work-rest cycles, and ventilated clothing were able to mitigate the physiological heat strain experienced by workers. Increasing mechanization enhanced labor productivity without increasing workers’ physiological strain. Conclusions: Empowering laborers to self-pace is the basis of heat mitigation, while tailored strategies focusing on hydration, work-rest cycles, ventilated garments, and mechanization can further reduce the physiological heat strain experienced by workers under certain conditions. Full article

(This article belongs to the Special Issue Prevention of Adverse Health Outcomes Related to Heat Exposure in Working Populations)

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17 pages, 4817 KiB

Open AccessArticle

Effect of a Simulated Heat Wave on Physiological Strain and Labour Productivity

by Leonidas G. Ioannou, Konstantinos Mantzios, Lydia Tsoutsoubi, Zoe Panagiotaki, Areti K. Kapnia, Ursa Ciuha, Lars Nybo, Andreas D. Flouris and Igor B. Mekjavic

Int. J. Environ. Res. Public Health 2021, 18(6), 3011; https://doi.org/10.3390/ijerph18063011 - 15 Mar 2021

Cited by 32 | Viewed by 6517

Abstract

Background: The aim of the study was to investigate the effect of a simulated heat-wave on the labour productivity and physiological strain experienced by workers. Methods: Seven males were confined for ten days in controlled ambient conditions. A familiarisation day was followed by three (pre, during, and post-heat-wave) 3-day periods. During each day volunteers participated in a simulated work-shift incorporating two physical activity sessions each followed by a session of assembly line task. Conditions were hot (work: 35.4 °C; rest: 26.3 °C) during, and temperate (work: 25.4 °C; rest: 22.3 °C) pre and post the simulated heat-wave. Physiological, biological, behavioural, and subjective data were collected throughout the study. Results: The simulated heat-wave undermined human capacity for work by increasing the number of mistakes committed, time spent on unplanned breaks, and the physiological strain experienced by the participants. Early adaptations were able to mitigate the observed implications on the second and third days of the heat-wave, as well as impacting positively on the post-heat-wave period. Conclusions: Here, we show for first time that a controlled simulated heat-wave increases workers’ physiological strain and reduces labour productivity on the first day, but it promotes adaptations mitigating the observed implications during the subsequent days. Full article

(This article belongs to the Special Issue Prevention of Adverse Health Outcomes Related to Heat Exposure in Working Populations)

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