Abstract
<h3>Introduction</h3> Climate change and extreme heat events threaten the global work force. Outdoor workers are particularly at risk in tropical and subtropical regions with middle- and low-income, when protective workplace policies and appropriate controls are insufficient. We examine epidemiological evidence from research studies undertaken in outdoor workplaces in India to evaluate the health consequences of occupational heat exposures, and also discuss critical future steps. <h3>Materials & Methods</h3> Epidemiological evidence from the author’s seasonal studies with workers engaged in manual labour in outdoor workplaces collected over a 10-year period for occupational heat exposures (n=2000) was analysed to determine the magnitude of heat stress impacts on heat strain indicators, heat-related illnesses, and productivity losses. <h3>Results & Conclusion</h3> A significant proportion of workers (65%) were exposed to wet bulb globe temperatures (Avg. WBGT 28.8°C±3.3°C) that exceeded the Threshold Limit Values (TLVs). Workers who were exposed to WBGTs above-TLV had a significantly higher risk of adverse health outcomes (OR=2.1; 95% CI=1.4–2.8) than workers who were exposed to below-TLVs. Significantly higher prevalence of heat strain indicators was evident among heat-exposed workers, including an increase in Core Body Temperature, above-normal sweat rates, urine specific gravities, and dehydration (OR=1.8; 95% CI=1.3–2.4). Heat-exposed workers, particularly those with significant physical labour, had 2.8-times higher risk of compromised renal health issues (95%CI=2.1–3.7). Climate estimates predict that future temperature increases and heat waves will exacerbate health and productivity risks for workers. Occupational exposure standards must be reevaluated, optimised for tropical environments, and aligned with worker protection. Urgently necessary is in-depth research with a holistic approach to understand the ramifications of heat exposures. Even though interventions that reduce heat stress in the workplace have multiple benefits, adaptation and mitigation techniques, including policy changes, are required to address heat stress in the workplace in the climate change era.
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