BACKGROUND AND AIM: The Center for Health, Work & Environment began a collaborative project to address Total Worker Health® (TWH) with a Latin American sugarcane agribusiness. TWH is an approach which integrates hazard protection with promotion of injury and illness prevention. TWH strategies are especially relevant when addressing a complex mix of occupational, environmental, social, and personal risk factors that impact health, such as those related to climate change. Climate change has increased the risk to workers’ health and safety. Workers are at increased risk of heat-related disorders, occupational injuries and illnesses, and reduced work capacity. METHODS: The CHWE conducted a TWH needs assessment across all levels of the organization, in Guatemala, Nicaragua and Mexico. The assessment was conducted through in person and online Employee Health and Safety Culture surveys, Employee Health Risk Assessments, a Leadership Self-Assessment, as well as through semi-structured interviews and focus groups with top leaders and managers at the company. RESULTS:We will present preliminary results of the needs assessment. The priority areas identified were 1) chronic disease prevention & management, 2) sleep hygiene, and 3) stress management and mental health. This collaboration aimed to address climate-related hazards such as heat stress and dehydration, while also evaluating and addressing other risks including chronic disease, fatigue, stress and mental health that have been further exacerbated by the COVID-19 pandemic. CONCLUSIONS:This project represents one of the first examples of international TWH in practice within the agricultural industry. Workers face both new and existing risks that require an integrated approach to protect health, safety and well-being to address the dual crisis of climate change and a global pandemic. TWH programs, policies and practices can be utilized and adapted by employers to meet the health, safety and well-being needs of workers. KEYWORDS: Climate, Occupational exposures, International collaboration, Health co-benefits, Mental health outcomes