Occupational Heat Research Articles

Practical Precooling Methods for Alleviating Heat Strain during Occupational Heat Exposure

Working in hot and humid environments poses significant challenges to thermoregulation and potentially affects performance and health. Strategies for mitigating heat stress are critical for workers exposed to high thermal loads. This study investigated practical cooling strategies, that is, phase-change vest (PCV) cooling and crushed ice (ICE) ingestion, before a physical activity in a hot and humid environment to alleviate heat strain. Two experiments were conducted to evaluate the efficacy of the cooling methods: the first experiment involved participants wearing a PCV for precooling, and the second experiment involved participants consuming an ICE (7.5 g/kg body mass) before exercising under the same conditions. Physiological responses including tympanic temperature, skin temperature, and heart rate, along with perceptual measures such as thermal sensation and perceived exertion, were assessed. The results showed that both the PCV and ICE interventions effectively reduced heat strain, although they had different effects. PCV cooling effectively reduces physiological and perceptual strains immediately after physical exertion; however, this effect does not last in the recovery phase. In contrast, ICE ingestion reliably lessens physiological and perceptual strains throughout the activity and recovery periods, substantially impacting both physical strain and the perception of effort. These findings highlight the significance of ICE ingestion as an effective strategy for enhancing worker health and safety in demanding thermal environments.

The cumulative effects of consecutive days of prolonged, physical work or activity on heat strain and physical performance: A Systematic Review.

With climate warming, there is an urgent need to understand the health effects of occupational heat exposure. This systematic review examined the cumulative effects of consecutive days of prolonged physical work or activity on heat strain and physical performance. Electronic databases MEDLINE, SPORTDiscus, PsychInfo and Academic Search Complete were searched until July 2024 with terms related to work, consecutive days and heat. Studies were included if they involved ≥4 hours of physical work/activity on ≥2 consecutive days, and included a measure of heat strain (e.g., core temperature) or physical performance (e.g., repetitions). After removing duplicates, 6030 studies were screened (title and abstract), 133 progressed to full-text screening, and 33 met the inclusion criteria with risk of bias assessed. However, only 5 studies used standardised environmental and work conditions across days. Synthesis of the cumulative effects (without meta-analysis) was therefore restricted to these studies. None observed a cumulative impact on heat strain, as indexed by a higher core temperature or heart rate compared to day 1. None reported a reduction in physical task performance across days. These findings indicate that cumulative effects of occupational heat exposure on heat strain and physical task performance were minimal, evidence supporting this conclusion is sparse. PROSPERO registration: CRD42023452936.

Influence of work intensity on acute kidney injury risk during simulated occupational heat stress.

Violation of the National Institute of Occupational Safety and Health (NIOSH) heat stress recommendations by exceeding the allowable wet bulb globe temperature (WBGT) for a given work intensity and work-rest ratio augments acute kidney injury (AKI) risk. Here we tested the hypothesis that exceeding the allowable work intensity at a given WBGT and work-rest ratio would also worsen AKI risk. Twelve healthy adults completed two NIOSH recommendation compliant trials and one noncompliant trial consisting of a 4 h (half workday) exposure. Work-rest ratio was fixed at 30 min of walking and 30 min of rest each hour. Work intensity (metabolic heat production) was prescribed as a function of WBGT- 412±51 W (27.3±0.3°C; high intensity compliant [Chigh]), 290±75 W (31.6±0.2°C; low intensity compliant [Clow]), and 410±61 W (31.7±0.2°C; high intensity noncompliant [NChigh]). AKI risk was quantified by the product of urinary insulin-like growth factor-binding protein 7 and tissue inhibitor of metalloproteinase 2 normalized to urine specific gravity ([IGFBP7•TIMP-2]USG). Peak core temperature was higher in NChigh trial (38.3±0.4°C) compared to the compliant trials (Chigh: 38.0±0.3°C; Clow: 37.8±0.4°C; p≤0.0095). [IGFBP7•TIMP-2]USG increased from pre- to immediately postexposure in all trials (time effect: p=0.0454) but the peak increase was not different between trials (Chigh: 0.89±1.7 [ng/mL]2/1000; Clow: 0.78±1.7 [ng/mL]2/1000; NChigh: 1.0±1.4 [ng/mL]2/1000; p=0.7811). Violating the NIOSH recommendations by exceeding either the allowable work intensity (i.e., NChigh versus Clow) or WBGT (i.e., NChigh versus Chigh) resulted in a modest elevation in peak core temperature but did not modify AKI risk.

Inequitable distribution of risks associated with occupational heat exposure driven by trade

The exposure to extreme heat at workplaces poses substantial threat to human effort and manual labour. This becomes more prominent due to the global dispersion of labour-intensive production activities via trade. We combine a climate model with an input–output model to quantify the risks associated with trade-related occupational extreme heat exposure. Here we show an 89% surge in trade-related labour exposure to extreme heat, escalating from 221.5 to 419.0 billion person-hours between 1995 and 2020. Lower-middle-income and low-income economies constituted 53.7% and 18.3% of global exposure but only 5.7% and 1.0% of global labour compensation. In countries highly susceptible to extreme heat conditions, workers perform tasks in heated conditions for up to about 50% of their working hours. The disproportionate trade effects in redistributing global benefits and costs leads to the inequality in heat exposure between developed and developing economies. In striving for equitable and safe work conditions, workers vulnerable to heat extremes in developing economies should be protected by climate adaptation infrastructure, given their critical roles in the global production system.

Packing house climatizado com resfriadores evaporativos - parte 1: Exposição ocupacional ao calor

ABSTRACT Agribusiness workers are regularly exposed to high temperatures, even in covered environments such as packing houses. This study aimed to assess the effect of evaporative coolers on reducing occupational heat exposure for workers and consequently improving the thermal comfort of the selection and packaging areas in a table grape packing house. The evaluation was conducted as per the criteria of the Brazilian legislation, based on the Regulatory Norms (NR’s) 15 and 17 of the Department of Labor. The study was conducted during two climatic production periods, dry and rainy, with the evaporative coolers on and off. With the coolers on, the workers’ occupational exposure to heat was reduced without exceeding the wet bulb globe temperature index tolerance limit for the activities carried out according to the NR 15. However, it did not provide adequate thermal comfort indices according to NR 17. Under semiarid conditions, coolers rendered the environment thermally comfortable for local workers. To reduce the risks to workers’ health, it is suggested that they take breaks in case of discomfort from the heat and provide workers with water and mineral salts to replenish sweat loss.

Acute Kidney Injury Among Florida Construction Workers: A Pilot Study.

While construction workers have the second highest rate of heat-related mortality, less is known about the prevelance of heat-related illness (HRI) symptoms, dehydration and kidney dysfunction. The aim of this study was to conduct a biomedical field-based study with construction workers to characterize HRI symptoms, dehydration, and kidney dysfunction, and analyze relationships between post-work urine specific gravity (USG) percentiles and predictors such as work hours, water consumption, and sugary beverage consumption. In collaboration with the Farmworker Association of Florida, 58 construction workers in Central Florida were monitored pre- and post-work shift on one workday. Research staff used a recreational vehicle to meet workers at their worksites, collect blood and urine pre- and post-work shift, and administer a survey on HRI symptoms. Acute kidney injury (AKI) was measured using serum creatinine and dehydration with USG. Predictors were examined in single covariate linear quantile mixed models against USG percentiles. The mean heat index was 88.4°F. Forty-two percent reported at least one symptom of HRI. Dehydration rates were 75% pre-work shift and 78% post-work shift. Severe dehydration increased from 16% to 33%. AKI was observed in 38% of the participants. This is, to our knowledge, the first US field-based biomedical study to document AKI, dehydration, and HRI symptoms in construction workers. This study adds to the literature that supports occupational heat exposure as a risk factor for AKI and dehydration.

The kidney under heat stress: a vulnerable state.

This review examines the effects of occupational heat stress on kidney health. It focuses on the role of hyperthermia in the development of acute kidney injury (AKI) and its potential progression to chronic kidney disease of nontraditional etiology (CKDnt). We highlight the physiological mechanisms by which hyperthermia affects kidney function and discuss emerging preventive strategies. Hyperthermia places the kidneys in a vulnerable state. As body temperature increases, blood flow is directed toward the skin to aid in cooling, diverting it away from internal organs like the kidneys to support blood pressure regulation. At the same time, hyperthermia and dehydration increases energetic demand to promote fluid and electrolyte conservation. Collectively, this can create a localized supply-demand mismatch, resulting in tissue hypoxia that can damage kidney tissues. These findings highlight that heat hyperthermia can lead to subclinical kidney damage, with potential long-term implications for kidney health. Heat-induced AKI is a growing public health concern. Individuals engaged in manual labor with prolonged exposure are at risk of CKDnt. Interventions aimed to prevent hyperthermia show promise in mitigating the risk of AKI. Further research is necessary to refine these strategies and establish evidence-based guidelines for reducing heat-related kidney injuries.

Assessing implications of occupational heat stress on the physiological and productive attributes of small-scale foundry workers in Northern India

Assessing implications of occupational heat stress on the physiological and productive attributes of small-scale foundry workers in Northern India

Heat strain in road construction workers during the summer in New Mexico: a preliminary study.

To report heat strain and environmental heat stress in a pilot study of road construction workers during work in the summer. Seven male road construction workers in New Mexico were observed performing physically demanding work during a summer work shift. Environmental heat stress (heat index [HI], dry/wet bulb temperature, and relative humidity), Tcore, and skin temperature (Tskin) were measured continuously at a single job site throughout the workday. Hydration was assessed pre- and post-shift via measurements of urine specific gravity (USG) and changes in body weight. The peak HI recorded throughout the workday was 34.1 °C, corresponding to a "warning" heat risk level according to the Occupational Safety and Health Administration Heat Safety Tool App. Two of seven (29%) workers reached a peak Tcore of greater than 38.0 °C, and 4 (57%) began the work shift dehydrated, indicated by a USG >1.020. Findings from this pilot study suggest that road construction workers may begin their shifts dehydrated and some experience moderate hyperthermia while performing physically demanding work in hot environmental conditions.

ERGONOMIC RISKS IN SEMI-MECHANIZED CUTTING OPERATIONS IN THE SOUTHERN AMAZON

Sustainable forest management in the Amazon must be carried out to guarantee the maintenance of forest resources and the safety and health of workers. In this region, workers are subject to various ergonomic risks that compromise their quality of life. In this context, the objective was to assess the ergonomic risks to which workers are exposed when cutting trees of different densities. Assessments of occupational heat exposure levels and physical workload were performed using a portable digital IBUTG thermometer and heart rate monitor, respectively. The IBUTG limits indicated the workers’ exposure to thermal overload. The tree-cutting operation did not indicate a high physical workload or potential postural risks, without the requirement for immediate action to change the work routine. Thermal overload is a factor that requires the adoption of mitigating ergonomic measures to preserve the health of workers in the Amazon region.

An exploratory study of household conditions and youth personal exposure to extreme heat during a heatwave in urban Nashville, Tennessee, USA.

Extreme heat is the deadliest meteorological hazard and is increasingly affecting the southeastern United States. Health effects of extreme heat are often not felt for hours or days after exposure and disproportionately affect vulnerable populations (e.g., youth, minorities). Personal heat exposure research has focused on occupational and everyday heat exposure among adults. To date, heat exposure in teenage populations has not been investigated. This population has unique heat exposure patterns that result from lifestyles that include outdoor jobs (e.g., lifeguard) and participation in outdoor sports. Better understanding of these exposure patterns is needed to reduce youth exposure and illnesses during heat events. Likewise, there have been no studies comparing paired indoor home conditions with individual exposure. Participants (n = 10) wore sensors to collect six days of personal heat exposure data (temperature and humidity) and placed sensors in and around their homes to collect ambient household data. When comparing individual exposure with ambient outdoor conditions and household conditions, this study revealed that: 1) teenagers are less exposed to dangerous heat (> 37.8°C heat index) during the day; 2) teenagers are more exposed to dangerous heat (> 23.9°C temperature) at night; 2) some teenagers are exposed to long periods of high heat at night, which is typically a time for heat recovery; and 3) household temperatures are typically not representative of heat exposure. To better understand teen exposure, we recommend future research focus on larger, representative sample sizes, collecting exposure data during the school year, and comparing exposure between heatwave and normal summer conditions.

The effect of consuming a sucrose-containing sports drink on acute kidney injury risk during a 4 h simulated occupational heat stress.

Occupational heat stress increases acute kidney injury risk. Drinking a soft drink sweetened with high fructose corn syrup further elevates this acute kidney injury risk. However, the impact of sucrose, another fructose-containing sweetener, on acute kidney injury risk remains unexplored. We tested the hypothesis that drinking a sucrose-containing sports drink increases acute kidney injury risk when compared to drinking a sugar-free sports drink during 4 h of simulated occupational heat stress. Ten healthy adults consumed a sucrose-containing or sugar-free sport drink ad libitum during 4 h exposures to wet bulb globe temperatures of ∼28 °C. Thirtymin of work and 30min of rest were completed each hour. Work involved treadmill walking at a fixed rate of metabolic heat production (sucrose-containing: 6.0±1.2W/kg, sugar-free: 5.5±0.9W/kg, p=0.267). The product of urinary insulin-like growth factor-binding protein 7 and tissue inhibitor of metalloproteinase-2, normalized to urine specific gravity ([IGFBP7·TIMP-2]USG), provided an acute kidney injury risk index. Mean core (intestinal: n=13, rectal: n=7) temperature (sucrose-containing: 37.5±0.1 °C, sugar-free: 37.5±0.3 °C; p=0.914), peak core temperature (sucrose-containing: 37.8±0.2 °C, sugar-free: 37.9±0.3 °C; p=0.398), and percent changes in body mass (sucrose-containing: -0.5±0.4%, sugar-free: -0.3±0.6%; p=0.386) did not differ between groups. [IGFBP7∙TIMP-2]USG increased in both groups (time effect: p=0.025) with no drink (p=0.675) or interaction (p=0.715) effects. Peak change [IGFBP7∙TIMP-2]USG did not differ between sucrose-containing (median 0.0116 [-0.0012, 0.1760] (ng/mL)2/1000) and sugar-free (median 0.0021 [0.0003, 0.2077] (ng/mL)2/1000; p=0.796). Sucrose-containing sports drink consumption during simulated occupational heat stress does not modify acute kidney injury risk when compared to sugar free-sport drink consumption.

Efficacy Of A Potential Wearable Cooling Technology During Simulated Occupational Heat Stress - A Pilot Study

Efficacy Of A Potential Wearable Cooling Technology During Simulated Occupational Heat Stress - A Pilot Study

Foot Cooling To Preserve Physical Work Capacity During Occupational Heat Stress -a Pilot Study

Foot Cooling To Preserve Physical Work Capacity During Occupational Heat Stress -a Pilot Study

Effect of cold beverages on whole-body heat exchange in young and older males during intermittent exercise in the heat.

To mitigate health risks associated with occupational heat stress, workers are advised to adhere to a work-rest regimen, and hydrate regularly. However, it remains unclear if beverage temperature influences whole-body heat exchange during work-rest cycles, and if responses differ in older workers who have a blunted heat loss capacity. Ten young (mean [SD]: 22 [3] years) and 10 older (60 [4] years) males performed four 15-min bouts of moderate-intensity cycling at a fixed rate of metabolic heat production (200 W·m-2), each interspersed by 15-min rest in dry heat (40°C, ~12% relative humidity). On separate days, participants consumed either ice-slurry (~0°C), standardized to provide a heat transfer capacity of 75 kJ·m-2, or an identical mass of warm fluid (37.5°C) before the first and third exercise bouts. Evaporative and dry heat exchange (direct calorimetry) and metabolic heat production (indirect calorimetry) were measured continuously to determine cumulative heat storage (summation of heat loss and heat gain) over the entire protocol. Rectal temperature was also measured continuously. Relative to warm fluid, ice-slurry ingestion reduced cumulative heat storage in young (69 [181] vs. 216 [94] kJ) and older males (90 [104] vs. 254 [140] kJ, main effect: p < 0.01), but was unaffected by age (p = 0.49). However, rectal temperature was unaffected by beverage temperature in both groups (all p ≥ 0.15). We show that cold fluid ingestion is an appropriate administrative control for both young and older males as it can mitigate increases in body heat content during moderate-intensity work-rest cycles in dry heat.

Examining Management and Employees' Perceptions of Occupational Heat Exposure and the Effectiveness of a Heat Stress Prevention Intervention on Safety and Well-Being among Natural Gas Construction Workers: A Qualitative Field-Based Study.

Numerous risk factors have been identified as significantly influencing outdoor workers' risk for heat stress and heat-related conditions, impacting their health, well-being, and productivity. However, the specific effects of these factors on construction workers' safety, health, and well-being remain under-researched. With climate change increasing temperatures, assessing heat stress among construction workers is imperative. To identify the barriers and facilitators influencing the safety of natural gas construction workers and evaluate an implemented heat stress intervention. In the summer of 2023, two semi-structured interviews and six focus groups were conducted with twenty-one stakeholders at a Texas natural gas construction site. Key facilitators include employee preparedness, use of employer-provided resources, hydration logs, and real-time communication tools. Contrarily, the barriers include daily work schedules, access to dehydrating beverages, and generational differences with the non-implementation of mandatory rest breaks. The heat stress program was perceived as effective, surpassing recommended guidelines. To advance construction workers' safety, health, and well-being, both employee involvement and employer management are needed, along with no-cost accessible resources. Additionally, implementing a required routine rest break and comprehensive heat stress education, particularly for older workers, will significantly promote safety and safe work practices in hot environments. Note: in this study, the terms 'worker' and 'employee' are used interchangeably.

Occupational heat stress and its health impacts- an overview of research status and need for further research in Southeast Asia with special emphasis on mitigation strategies in North East India.

The Intergovernmental Panel on Climate Change, IPCC predicts that hot seasons will get even hotter due to global climate change. There exists a critical dependence of human metabolic processes on temperature. Changes in thermal balance therefore, have an adverse effect on health because they raise body temperature, cause excessive sweating, and accelerate the rate of dehydration. Different nations and professional groups use different techniques to measure heat strain. This paper aims to review previous research conducted in the area of heat strain due to heat exposure among workers in Southeast Asia and also to profile mitigation strategies in North East India. Studies conducted between the years 2011 to 2023 in the evaluation of the health impacts of occupational heat stress were searched systematically using several sources of databases like PubMed, Google Scholar, Science Direct, Web of Science, Scopus, etc. It was noted that a greater proportion of previous research on evaluating physiological effects was carried out in controlled environments as opposed to real-world field settings. While such studies give us valuable insights into the relationship, applying the same methodology in the workplace may not be feasible. In India, very few research has been carried out on workplace heat stress, and even fewer have been done in North East India using physiological indicators. North East India is also affected by global climate change leading top more hotter days than before. The region of Northeast India, particularly Guwahati (Assam), has recently seen extreme heat waves during the sweltering summer months. With less literature available in this geographical location, studies with actual field-based settings are much needed to understand the occupational health impacts in this region. This review can formulate a suitable methodology for assessing the health impacts in working environment. This can also help the local health professionals to recognize the heat strain parameters that are acceptable worldwide, and use as pertinent indicators to scrutinize worker's health and develop preventive agendas as climate change advances.

Occupational Heat Exposure-related Symptoms Prevalence and Associated Factors Among Hospitality Industry Kitchen Workers in Ethiopia: Wet Bulb Globe Temperature

BackgroundOccupational heat stress caused by excessive environmental heat gain disrupts thermoregulatory mechanisms and harm workers' health and productivity. Kitchens are known for their thermal risks; however, research on heat stress in kitchen is limited. This study aimed to bridge this knowledge gap by assessing, the prevalence of heat-stress-related symptoms, and associated factors among kitchen workers in Gondar City, Ethiopia. MethodsThis institutional-based cross-sectional study (April to June 2023) evaluated heat stress among hospitality kitchen workers in Ethiopia. Heat exposure was measured using hygrometers. A simple random sample of 605 participants completed a survey and data was exported to Statistical Package for Social Science version 26. To assess strength and direction an adjusted odds ratio with 95% confidence interval (CI) was employed. A p-value of less than 0.05 was utilized to identify significant associations. ResultsOver the last 6 months 67.1% (95% CI: 63.0, 71.1), of the participants reported heat-stress symptoms. Multivariable analysis revealed that age ≥40 years [AOR: 2.28; 95% CI (1.08, 4.82)], high workload [AOR: 1.89; 95% CI (1.04, 3.49)], poor heat mitigation practice [AOR: 2.39; 95% CI (1.58, 3.59), wood fuel [AOR: 2.60; 95% CI (1.54, 4.40)], improper ventilation [AOR: 3.28; 95% CI (1.56, 6.87)], and higher heat index value [AOR: 2.15; 95% CI (1.35, 3.42)] were factors significatly associated with heat stress related symptoms. ConclusionThis study identified a high prevalence of heat–stress-related symptoms among kitchen workers. Mitigation strategies include improved ventilation, cooling, advanced building designs, and heat reduction technologies. Future research should utilize standard heat-stress assessment tools.

Creatinine clearance is maintained in a range of wet-bulb globe temperatures and work-rest ratios during simulated occupational heat stress.

We tested the hypothesis that compliance with the National Institute for Occupational Safety and Health (NIOSH) heat stress recommendations will prevent reductions in glomerular filtration rate (GFR) across a range of wet-bulb globe temperatures (WBGTs) and work-rest ratios at a fixed work intensity. We also tested the hypothesis that noncompliance would result in a reduction in GFR compared with a work-rest matched compliant trial. Twelve healthy adults completed five trials (four NIOSH compliant and one noncompliant) that consisted of 4 h of exposure to a range of WBGTs. Subjects walked on a treadmill (heat production: approximately 430 W) and work-rest ratios (work/h: 60, 45, 30, and 15 min) were prescribed as a function of WBGT (24°C, 26.5°C, 28.5°C, 30°C, and 36°C), and subjects drank a sport drink ad libitum. Peak core temperature (TC) and percentage change in body weight (%ΔBW) were measured. Creatinine clearance measured pre- and postexposure provided a primary marker of GFR. Peak TC did not differ among NIOSH-compliant trials (P = 0.065) but differed between compliant versus noncompliant trials (P < 0.001). %ΔBW did not differ among NIOSH-compliant trials (P = 0.131) or between compliant versus noncompliant trials (P = 0.185). Creatinine clearance did not change or differ among compliant trials (P ≥ 0.079). Creatinine clearance did not change or differ between compliant versus noncompliant trials (P ≥ 0.661). Compliance with the NIOSH recommendations maintained GFR. Surprisingly, despite a greater heat strain in a noncompliant trial, GFR was maintained highlighting the potential relative importance of hydration.NEW & NOTEWORTHY We highlight that glomerular filtration rate (GFR) is maintained during simulated occupational heat stress across a range of total work, work-rest ratios, and wet-bulb globe temperatures with ad libitum consumption of an electrolyte and sugar-containing sports drink. Compared with a work-rest matched compliant trial, noncompliance resulted in augmented heat strain but did not induce a reduction in GFR likely due to an increased relative fluid intake and robust fluid conservatory responses.

Occupational heat exposure and its impact on kidney health among cashew workers.

Rising temperatures increase workers' risk of heat-related illnesses due to heat stress (HS). Chronic Kidney Disease of unknown etiology (CKDu) is rising in non-agricultural workers in hot climates. Dehydration, heat stress, and physical exertion can damage cashew workers' kidney health. In 2020-2021, 262 cashew workers in Cuddalore, Tamil Nadu were assessed for Wet Bulb Globe Temperature (WBGT), and job-specific American Conference of Governmental Industrial Hygienists standard was used to evaluate workload. "High heat-exposed" meant heat stress exceeded the Threshold Limit Value for safe manual work (27.5°C for heavy and 28°C for moderate physical activity). Heat Strain Indicators (HSIs) such as Tympanic Temperature (Ttemp), Sweat Rate (SwR), Urine Specific Gravity (USG), and urine dipstick parameters were measured in all workers, however serum creatinine was measured only in 100 workers. Glomerular Filtration Rate(eGFR) was calculated using theCKD-EPIequation. A standardized questionnaire assessed heat-related health symptoms. Over 65% of workers experienced wet bulb globe temperature exposures exceeding the threshold limit value (Avg.- wet bulb globe temperature 30.4°C ± 1.8°C). Ninety-five percent of heat-exposed workers experienced at least one of the physiological heat strain indicators. The risk of urogenital symptoms was 7.7 times greater among high-heat-exposed workers (95% CI 3.4-17.1), which corroborates well with the measured post shift urine specific gravity (37%). Despite controlling for relevant confounders (age & gender), high-heat-exposed workers had 3.5-fold higher odds of eGFR < 90ml/min/1.73m2 compared to less-exposed workers (95% CI 1.1-10.6). Persistent heat stress promotes heat-related disorders in cashew workers and lowers eGFR. This needs further investigation to determine its longer term effects on kidney function. Workplace cooling solutions that reduce heat stress are critically needed to protect thekidneys and ensureoccupational health.