Social impacts of occupational heat stress and adaptation strategies of workers: A narrative synthesis of the literature

2018·1.1 MB·English

by  Victor Fannam Nunfam

ScienceoftheTotalEnvironment643(2018)1542–1552
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Science of the Total Environment
journal homepage: www.elsevier.com/locate/scitotenv
Review
Social impacts of occupational heat stress and adaptation strategies of
workers: A narrative synthesis of the literature
VictorFannamNunfama,b,⁎,KwadwoAdusei-Asantea,EddieJohnVanEttena,
JacquesOosthuizena,KwasiFrimponga,c
aEdithCowanUniversity,Perth,WesternAustralia,Australia
bTakoradiTechnicalUniversity,WesternRegion,Ghana
cGhanaInstituteofManagementandPublicAdministration,Ghana
H I G H L I G H T S G R A P H I C A L A B S T R A C T
• Workers possess varying but clear
awarenessofoccupationalheatstress,
impactsandadaptationstrategies
• Social impacts of heat stress include
heatillnesses,injuries,deaths,produc-
tivelosses,andinadequatesocialwell-
being
• Adaptationstrategiesinpolicydecisions
aresustainableapproachestoenhance
adaptivecapacityofworkers
• Implementingadaptationstrategiesare
importantforpolicydecisionstowards
improvingoccupationalheatstress
a r t i c l e i n f o a b s t r a c t
Articlehistory: Dimensionsofrisksandimpactsofoccupationalheatstressduetoclimatechangeonworkers'healthand
Received27February2018 safety,productivity,andsocialwell-beingaresignificantlydeleterious.Asidefromempiricalevidence,no
Receivedinrevisedform20June2018 systematicreviewexistsforpolicydevelopmentanddecisionmakinginmanagingoccupationheatstress
Accepted21June2018
impactsandadaptationstrategiesofworkers.Thisstudysoughttosynthesiseevidenceonthesocialim-
Availableonline4July2018
pactsofoccupationalheatstressandadaptationstrategiesofworkers.Fromareviewofexistingliterature,
eightcategorieswereobtainedfrom25studiesandgroupedintothreesyntheses:(1)awarenessofoccupa-
Editor:ScottSheridan
tionalheatstress,(2)socialimpactsofoccupationalheatstressand(3)workers'adaptationtooccupational
Keywords: heatstressduetochangingclimate.Awarenessofoccupationalheatstressamongworkersvariedandtheir
Adaptationpolicies socialimpactswererelatedtoworkers'healthandsafety,productivityandsocialwell-being.Sustainable
Literaturereview adaptationtooccupationheatstressduetoclimatechangehingesonfinancialresourceavailability.Ade-
Work-relatedheatstress quateinvestmentandresearcharerequiredtodevelopandimplementpoliciestocombatthethreatofris-
Socialwell-being ingtemperatureandclimatechangetoenhanceworkers'adaptivecapacity,boostresilienceandfoster
Synthesis sustainabledevelopment.
Workers
©2018ElsevierB.V.Allrightsreserved.
⁎ Correspondingauthorat:EdithCowanUniversity,Perth,WesternAustralia,Australia.
E-mailaddress:[email protected](V.F.Nunfam).
https://doi.org/10.1016/j.scitotenv.2018.06.255
0048-9697/©2018ElsevierB.V.Allrightsreserved.
V.F.Nunfametal./ScienceoftheTotalEnvironment643(2018)1542–1552 1543
Contents
1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1543
2. Materialsandmethods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1543
2.1. Searchcriteria. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1544
2.2. Characteristicsofincludedstudies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1544
2.3. Abstractionoffindingsfromincludedstudies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1544
3. Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1544
3.1. Narrativesynthesisandcategorisationoffindingsfromincludedstudies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1544
3.1.1. SynthesisOne:workers'awarenessofoccupationalheatstress. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1545
3.1.2. SynthesisTwo:socialimpactsofoccupationalheatstress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1547
3.1.3. SynthesisThree:adaptationtooccupationalheatstressduetoclimatechange. . . . . . . . . . . . . . . . . . . . . . . . . 1548
4. Discussion. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1549
4.1. Workers'awarenessofoccupationalheatstress. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1549
4.2. Socialimpactsofoccupationalheatstress. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1549
4.3. Adaptationofworkerstooccupationalheatstress. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1550
5. Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1551
Conflictofinterest. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1551
Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1551
AppendixA. Supplementarydata. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1551
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1551
1.Introduction threats (Adusei-Asante, 2017; Kalkstein et al., 2009; Miller, 2014;
ScheffranandRemling,2013;UN,2011).
Excessive heat exposure due to intensifying temperature and ExceptforafewstudiessuchasMiller(2014)andVenugopaletal.
climatechangehasemergedasoneoftheexistentialthreatstohuman- (2016a),thereseemstobenospecificempiricalstudies,systematicre-
ityandthesocio-economic,health,andenvironmentalwell-beingof vieworsynthesisthathaveassessedthesocialimpactsofoccupational
workingpopulations(UnitedNations(UN),2009).Hence,theglobal heatstressandadaptationstrategiesofworkers.Accessiblesystematic
agendaforimprovingthewell-beingofpeople,asembodiedinthe reviewshavetendedtofocusonadaptationtoheat-relatedmortality
2030SustainableDevelopmentGoals(SDGs),reiteratestheneedfor andillness,andheat-relatedmortalityandclimatechangeotherthan
combatingrisingtemperatureandclimatechangeimpacts(SDG13) onsocialimpactsofclimatechange,occupationalheatstressandadap-
(UN,2015). tationstrategiesofworkers(BoeckmannandRohn,2014;Huangetal.,
Intensivephysicalworkinanenvironmentofhighheatexposure 2011).Consideringtheimportanceofsystematicreviewstoevidence-
duetothetemperaturerisingbeyond37°Candinadequaterehydration basedpolicymaking,thereisaneedforthisreviewtocollatefindings
createsheatstress-relatedmorbidityandmortality(CDCP,2008;Lucas fromavailablepublishedandunpublishedstudies.
etal.,2014;Parsons,2014).Workersintheconstruction,agriculture, Giventhesocio-economicandhealthimplicationsofclimatechange
firefighting,armedforces,manufacturing,oilandgas,andminingindus- andoccupationalheatstress,itisappropriateandtimelytoconductthis
triesareexamplesofworkersatriskofadverseimpactsrelatedtoheat reviewtoupdateandexpandtheliteratureontherisksandimpactsof
stress(Lucasetal.,2014;Xiangetal.,2014a,2014b).Climatechange occupationalheatstressduetoclimatechangeonworkers'healthand
and occupational heat stress risks and impacts on working people safety,productivity,andsocialwell-being.Itwillalsoinformoccupa-
pronetoheatexposureinclude,butarenotlimitedto,physiological, tionalheatstressadaptationandresilienceplanningandpolicies,the
psychological,healthandsafety,socio-economicandproductivitycon- ongoingrisingtemperatureandclimatechange-socialimpactdiscourse
sequences(Dunneetal.,2013;Kjellstrometal.,2016a;Lucasetal., andfutureresearchneeds.Thisreviewexaminesavailableevidenceon
2014;Venugopaletal.,2016a;Xiangetal.,2016).Climatechange- socialimpactsofoccupationalheatstressdrivenbyclimatechangeand
relatedoccupationalheatstressisaconditioninwhichheatstressisin- adaptationstrategiesofworkerswithemphasisontheresearchdesign
duced by intensive physical work, rising temperature and climate and methodology, study setting, and significant findings based on
changeorisbeingexacerbatedbyintensivephysicalwork,risingtem- threeresearchquestions:(1)Whatareworkers'perceptionsandexpe-
peratureandclimatechange(Kjellstrometal.,2016a). riencesofoccupationalheatstress(RQ1)?(2)Whataretheeffectsofoc-
Climatechange,occupationalheatstressrisksandassociatedim- cupational heat stress on workers' health and safety, productivity,
pactshaveengenderedmultidisciplinaryresearch,cooperation,frame- psychologicalbehaviour,andsocialwell-being(RQ2)?(3)Whatare
works and protocols to combat its consequences for the world's theadaptationstrategiesofworkerstooccupationalheatstress(RQ3)?
population.Priorstudies focusingon impact assessment ofclimate
change,heatstressandadaptationhaveneglectedsocialimpactassess- 2.Materialsandmethods
ment(SIA)andfocusedmainlyonenvironmentalimpactassessment
(EIA)andhealthimpactassessment(HIA)ofclimatechangeandheat ThisreviewwasguidedbythephilosophyofthePreferredReporting
stressonworkingpeople.Socialimpactsrefertothedirectorindirect ItemsforSystematicReviewsandMeta-Analysis(PRISMA)andthe
perceptualorphysicaleffectofaphenomenon(e.g.,policies,projects, JoannaBriggsInstitute(JBI)frameworkforsystematicreview,synthesis,
naturalandsocialrisk)onthelives,culture,cohesion,politicalsystem, andreporting(JBI,2014;Moheretal.,2015;Popayetal.,2006).Asys-
environment,healthandwell-being,rights,andfearsofindividuals,so- tematicreviewandsynthesisoftheliteraturewereadoptedinthis
cialunits,andcommunities(Vanclay,2003;Vanclayetal.,2015).SIAas studybecauseitisscientificandprovidesthebasisfordescribingthe
conceptualisedbyVanclayetal.(2015)focusesonresourceandcapital patterns,similaritiesanddifferencesamongtheresultsoftheincluded
projects,apracticethatAdusei-Asante(2017)hascriticised.Current studiesbasedonwell-definedselectioncriteria(JBI,2014;Petticrew
thinkinginSIAiscallingfortheneedtofocusonpoliciesandphenom- andRoberts,2008;Popayetal.,2006).Themixed-methodsapproach
enasuchasclimatechangeandwork-relatedheatstresstoaugment wasemployedtoprovideanswerstoenhanceunderstandingofthere-
global efforts at combating rising temperature and climate change searchquestions.Theuseofthetextualapproachtonarrativesynthesis
1544 V.F.Nunfametal./ScienceoftheTotalEnvironment643(2018)1542–1552
wasinformedbytheheterogeneousnatureoffindingsfrommultiple conclusions.Thestudieswereorganisedaccordingtotheresearchques-
studiesonrisksandimpactsofoccupationalheatstressandadaptation tionsandmethodology.Somestudiesaddressedeitheroneoracombi-
strategiesofworkersinthecontextofrisingtemperatureandclimate nationoftwoorthreeresearchquestions.Tables2to6providean
change.Synthesisingempiricalqualitativeandquantitativeevidenceis overviewofthe25includedstudies.Ofthe25studies,fiveaddressed
warrantedbecausethereisamutualinterestinaggregatingempirical ResearchQuestion1(RQ1),eightansweredRQ2,fourfocusedonRQ1
studies(Dixon-Woodsetal.,2005;NoblitandHare,1988).Moreover, andRQ2,sevenaddressedRQ1andRQ3,whileonecentredonRQ1,
mixedmethodstudiesareamenabletothenarrativemethodofsynthe- RQ2, and RQ3. However, 17 studies were on issues related to RQ1
sisandthemostsuitableinsystematicreviewsinwhichthestudies (Tables4,5&6),13studieswereassociatedwithRQ2(Tables3,4&
werenotexactlysimilartowarrantmeta-analysis(Maysetal.,2005). 6),andeightstudiesfocusedonissuesbasedonRQ3(Tables5&6).
Narrativesynthesisallowsthecombinationofvarioustypesofevidence Regardingresearchmethodology,19outofthe25selectedstudies
frommultiplestudiesofdifferentnaturetoanswerarangeofdifferent usedquantitativetechniques,threeemployedqualitativetechniques,
researchquestions(Goughetal.,2017;PetticrewandRoberts,2008). andthreestudiesappliedthemixedmethodsapproach.Thequantita-
TheconceptofPopulation,Intervention,ComparatorContextOut- tive studiesused descriptive, cross-sectional,cohorts,comparative,
come(PICO)informedthescopingofthereview(Cookeetal.,2012). evaluative,correlational,andexperimentalresearchdesigns.Theyalso
Thescopecovered:workersofbothsexesabove18years;workers'per- applieddescriptivestatistics,trendanalysis,bivariatelogisticalregres-
ceptionsandexperiencesofoccupationalheatstressandadaptation sion,andmultivariatelogisticalregressionasmethodsofdataanalysis.
strategies;effectsofoccupationalheatstressonworkers'healthand Thequalitativestudiesusednarrative,exploratoryobservation,and
safety,productivity,psychologicalbehaviour,andsocialwell-being casestudyresearchdesignswhilethematicandinterpretivephenome-
basedonaseriesofinclusionandexclusioncriteria(Table1). nologywereusedasthetechniquesofdataanalysis.Cross-sectionalsur-
vey,quantitative,qualitative,andgroundedtheoryresearchdesignsas
2.1.Searchcriteria wellasacombinationofSTATA,thematicanalysis,descriptive,trend,
qualitative,andquantitativeanalysiswereusedinthemixedmethod
The authors conducted a systematic search of Web of Science, studiesasmethodsofdataanalysis.
PubMed,ScienceDirect,GoogleScholar,ProQuest,TaylorandFrancis Geographically,thestudylocationsofthe25articles,variedwidely
Online,andthereferencelistsofincludedstudiesforevidenceofpeer- acrosscountriesfrom thecontinentalregionsofAsia,Africa,North
reviewedpublishedstudiesinEnglishfrom2007to2017toprovidea America,andCentralAmerica.Outoftheincludedstudies,14articles
contemporaryoutlook.‘Assessment’,‘perceptions’,‘experiences’,‘social werefromIndia,Thailand,ChinaandNepalinAsia(56%),fourstudies
impact’,‘climatechange’,‘occupationalheatstress’,‘healthandsafety’, werefromtheStatesofFlorida,California,Georgia,andCarolinain
‘productivity’,‘psychologicalbehaviour’,‘socialwell-being’,‘adaptation North America (12%), three papers were from Costa Rica and
strategies’,and‘workers’weresearchtermsusedaspartofthesearch Nicaragua in Central America (16%), three studies from Australia
strategy.TheassessmentprocesswasguidedbytheJBIcriticalappraisal (12%),andonefromSouthAfrica(4%)(Fig.2).Thesearetropicaland
checklistforsystematicreviewsandresearchsyntheses(Supplemental sub-tropical regions with moderate to high risk of heat exposure
Table1)(JBI,2014).Fiveresearchersindependentlyassessedthequality (Hyattetal.,2010;Lucasetal.,2014).Basedontheselectioncriteria,
ofincludedstudiesandanydifferencesresolvedthroughconsensus.The itappearsnoprimarystudies,otherthanreportsandreviews,focusing
searchprocessyielded25studiesbasedontheselectioncriteriaoutof onoccupationalheatstresswerefoundfromEurope.Thismaybedueto
23,352studiesidentified(Fig.1). itslowriskofheatexposure,adequateadaptationcapacity,andtechno-
logicaladvancement.However,therehavebeenoccasionsofinjuries
2.2.Characteristicsofincludedstudies anddeathsrelatedtoheatwavesinEurope.Forinstance,in2003excess
mortalityof30,000deathsoccurredinFranceaspartofthemorethan
Descriptivecharacteristicsofincludedstudieswereillustratedby 70,000deathsduringtheextremeheatwaveeventinEurope(Robine
thenameoftheauthor(s),yearofpublication,studylocation,study etal.,2008).Ananalysisoftheperiodofpublicationoftheincluded
design, population and sample size, methods, data analysis, and studiesshowedthatsevenarticleswerepublishedbetween2007and
2011,while18studieswerepublishedfrom2012to2017.Thisindicates
Table1 anincreasingtrendofinterestbyresearchersonissuesrelatedtooccu-
Inclusionandexclusioncriteria. pationalheatstressduetoclimatechangeandadaptationinthelast
decade.
Inclusioncriteria Exclusioncriteria
Studiesusingquantitative,qualitative Comments,letters,editorials, 2.3.Abstractionoffindingsfromincludedstudies
andmixed-methodapproaches viewpoints,reviews,reports,and
correspondence
Peer-reviewedjournalpublicationsof Studiespublishedinotherlanguages Thefindingsofeachstudywereusedasthebasisfordataextraction
originalstudiesinEnglish exceptforEnglish for categorisation and narrative synthesis using tables and figures
Studiesonworkers'perceptionsand Studiesonclimatechange-related whereappropriate(JBI,2014;Popayetal.,2006).Thevalueofextracted
experiencesofoccupationalheat storms,rainfall,drought,cyclones,and
dataofincludedstudieswasdeterminedbyusingJBI'sinterpretationof
stress,andadaptationstrategies risingsealevelsotherthanclimate
change-relatedtemperature,humidity, degreeofevidence(SupplementalTable2)(JBI,2014).Abstractionof
airmovement,andheatradiation datafromthe25includedstudies(SupplementalTables3to27)was
Studiesmeasuringambient Studiesunrelatedtoobjectives, presentedaccordingtotheirfindings,anillustrationofevidenceandde-
temperatureatworkandresting population,intervention/exposure,
greeofevidence.
environmentofworkers outcome,andcontextofthestudy
Studiesassessingtheeffectof Studiesontheeffectofclimatechange
occupationalheatstressonworkers' andheatstressonpeople,communities, 3.Results
healthandsafety,productivity, plants,animals,andcrops,otherthan
psychologicalbehaviour,andsocial workers'healthandsafety,productivity, 3.1.Narrativesynthesisandcategorisationoffindingsfromincludedstudies
well-being psychologicalbehaviour,andsocial
well-being
Studiesonbarriersofworkersto Studiesusingonlysecondarydata Theresultsof thedata abstraction process yielded 121findings
occupationalheatstressadaptation withoutprimarydata whichweregroupedintoeightcategoriesandthensynthesisedinto
Studiesinthelocalandinternational Studiesonmitigationtoclimatechange threethemesbasedonobservedemergingpatterns,similaritiesanddif-
context andoccupationalheatstress ferences.Thefindingswerecategorisedas:perceptionsofoccupational
V.F.Nunfametal./ScienceoftheTotalEnvironment643(2018)1542–1552 1545
Fig.1.Flowchartillustratingasummaryofincludedstudies.
heatstressrisk;experiencesofoccupationalheatstressrisk;magnitude (2)socialimpactsofoccupationalheatstress;and(3)adaptationtooc-
ofheatexposurerisk;healthandsafetyeffectsofoccupationalheat cupationalheatstress.
stress; productivity effects of occupational heat stress; social well-
beingeffectsofoccupationalheatstress;adaptationstrategiestooccu- 3.1.1.SynthesisOne:workers'awarenessofoccupationalheatstress
pationalheatstress;andbarrierstoimplementationofoccupational Workers'awarenessofoccupationalheatstressconstitutesSynthesis
heat stress adaptation. The eight categories were then synthesised One.Itistheresultofaggregatingthreecategorieswithsimilarattributes
intothreethemes:(1)workers'awarenessofoccupationalheatstress; ofdescribingworkers'awarenessofoccupationalheatstress(Fig.3).
Table2
Detailsofpapersaddressingworkers'perceptionsandexperiencesofoccupationalheatstress.
Author,year&title Study Studydesign Population/sample Methods Dataanalysis Author(s)conclusions
location size
Balakrishnanetal.(2010).Case India Casestudy 242manufacturing Questionnaires Correlationanalysis Giventhepotentialimplicationsoffuture
studiesonheatstressrelated workers andWetBulb climatechange-relatedincreasesinambient
perceptionsindifferent Globe heatstressthatarelikelytotranslateinto
industrialsectorsinsouthern Temperature workplaceexposuresindevelopingcountry
India (WBGT)index settings
Croweetal.(2013).Heatexposure Costa Descriptive 105harvesters WBGTand Descriptiveanalysis Sugarcaneharvestersareatriskofheatstress
insugarcaneharvestersinCosta Rica studydesign non-participatory usingWBGTdata, forthemajorityoftheworkshift.Immediate
Rica observation metabolicrateand actioniswarrantedtoreducesuchexposures
thresholdlimit
values
Flocksetal.(2013).Female Central CBRapproach 35female Focusgroup Thematicanalysis Participantsbelievethatheatexposurecan
farmworkers'perceptionsof Florida using farmworkers discussion adverselyaffectgeneral,pregnancy,andfetal
heat-relatedillnessand narrative health,yetfeeltheylackcontrolover
pregnancyhealth interviews workplaceconditionsandthattheylack
trainingaboutthesespecificrisks
Croweetal.(2010).Heatexposure Costa Exploratory 45sugarcane WBGT Descriptiveanalysis Itisthereforeimportanttotakeactionto
insugarcaneworkersinCosta Rica observational workers decreasecurrentandfutureheat-related
Ricaduringthenon-harvest study risksforsugarcaneworkersinbothharvest
season andnon-harvestconditionsandinall
sugarcanegrowingregionsinCostaRica.Itis
alsonecessarytoimproveguidelinesand
occupationalhealthstandardsforprotecting
workerhealthandproductivityinthetropics
Stoecklin-Maroisetal.(2013). California Comparative 467hiredfarm Structured Statisticalanalysis Thestudysuggestsimportantareastotarget
Heat-relatedillnessknowledge studydesign workers interviews usingmultivariate forheatillnesspreventioninfarmworker
andpracticesamongCalifornia questions surveylogistic population,andthatgender-specific
hiredfarmworkersinThe regression approachesmaybeneededforeffectiveheat
MICASAstudy illness
1546 V.F.Nunfametal./ScienceoftheTotalEnvironment643(2018)1542–1552
Table3
Detailsofpapersaddressingeffectsofoccupationalheatstressonworkers'healthandsafety,psychologicalbehaviour,productivityandsocialwell-being.
Author,year&title Study Studydesign Population/sample Methods Data Author(s)conclusions
location size analysis
Tawatsupaetal.(2013).Association Thailand Cohortstudies 58,495workers Mailouthealth Logistic Thestudyprovidesusefulevidence
betweenheatstressand questionnaires regression linkingheatstresstooccupationalinjury
occupationalinjuryamongThai using intropicalThailandandidentifiesfactors
worker:findingsoftheThaicohort STATA thatincreaseheatexposure
studies version12
Tawatsupaetal.(2012).Association Thailand Cohortstudies 37,816workers Self-reported Logistic Thereisanassociationbetween
betweenoccupationalheatstress questionnaires regression self-reportedoccupationalheatstress
andkidneydiseaseamong37,816 andtheself-reporteddoctordiagnosed
workersintheThaicohortstudies kidneydiseaseinThailand.Thereisa
(TCS) needforoccupationalhealthinterven-
tionsforheatstressamongworkersin
tropicalclimates
SettandSahu(2014).Effectsof India Evaluative 120brickmoulders WBGTandquestionnaires Statistical Highheatexposureinbrickfieldsduring
occupationalheatexposureon studydesign andcarriers analysis summercausedphysiologicalstrainin
femalebrickworkersinWestBengal, usingt-test bothcategoriesoffemalebrickfield
India andANOVA workers
Luoetal.(2014).Exposuretoambient China Correlational 190casesand760 2003–2010healthcheck Conditional Significantassociationbetween
heatandurolithiasisamongoutdoor case-control control data logistic exposuretoambientheatand
workersinGuangzhou,China studydesign shipbuilding regression urolithiasisamongoutdoorworking
workers populations
Langkulsenetal.(2010).Health Thailand Descriptive 21workers WBGTandquestionnaires Descriptive ClimateconditionsinThailandpoten-
impactofclimatechangeon cross-sectional andtrend tiallyaffectboththehealthandproduc-
occupationalhealthandproductivity study analysis tivityinoccupationalsettings
inThailand
Sahuetal.(2013).Heatstress, India Comparative 124riceharvesters WBGTandan Trendand Highheatexposureinagriculturecaused
cardiovascularstressandwork studydesign interviewer-administered Statistical heatstrainandreducedwork
productivityinriceharvestersin questionnaire analysis productivity.Thisreductionwillbe
India:Implicationsforaclimate usinga exacerbatedbyclimatechangeandmay
changefuture t-test underminethelocaleconomy
Krishnamurthyetal.(2017). South Cross-sectional 84steelworker WBGTandstructured Statistical Highheatexposuresandheavy
Occupationalheatstressimpactson India studydesign questionnaires analysis workloadadverselyaffecttheworkers'
healthandproductivityinasteel healthandreducetheirworkcapacities.
industryinSouthernIndia Healthandproductivityrisksin
developingtropicalcountrywork
settingscanbeaggravatedby
temperatureriseduetoclimatechange,
withoutappropriateinterventions
Tawatsupaetal.(2010).The Thailand Cohortstudies 40,913workers Self-reported Descriptive Thisassociationbetweenoccupational
associationbetweenoverallhealth, questionnaires statistical heatstressandworsehealthneedsmore
psychologicaldistress,and analysis publichealthattentionandfurther
occupationalheatstressamonga developmentofoccupationalhealth
largenationalcohortof40,913Thai interventionsasclimatechange
workers increasesThailand'stemperatures
CategoryOnedescribesworkersvariedperceptionsofoccupational Furthermore, widely prevalent heat-related issues among workers
heatstressrisk.ThirteenfindingsweregroupedintoCategoryOne. werefatigueandsweatingexcessively(Krishnamurthyetal.,2017).Ex-
Findingsfromcategoryoneindicatedthatalthoughworkers'awareness periencesofoccupationalheatstresswerealsoreportedinotherstudies
oftrendsofweatherpatternsvariedwidely,occupationalheatstress asheatstressresultedinvariousoccupationalinjuries(Tawatsupaetal.,
riskisperceivedasaseasonalconditionassociatedwithsymptoms 2013).Heatstressconditionswerecommonamongmales,labourers,
(e.g.,dehydration,skinrashes,anditchyskin)(Balakrishnanetal., low income and low education workers (Tawatsupa et al., 2010).
2010),andoccupationalheatstressriskisrecognisedasanissueofse- Workers'experiencesofheat-relatedhealtheffectswereheadaches,de-
riousconcerninsummer(Venugopaletal.,2016b).Also,heatstressis hydration,andheatstroke(Laoetal.,2016).Heat-relatedtrainingwas
perceivedbyworkerstoaffectproductivityandabilitytoworkdueto receivedbyalmosthalfoftheworkers,andworkerswithinagesof25
dehydration, lack of insulation (deficiency in reducing heat loss or and54yearswithexperiencesofheat-relatedillnessorinjuryhada
gain),andinadequateventilation(Balakrishnanetal.,2010),workers' positiveattitudetowardsheat-relatedtraining(Xiangetal.,2016)(Sup-
perceptionsofheatstressconcernswasmoderatetosevereandwasre- plementalFig.2).
latedtoageandworkthatrequireheavyphysicalefforts(Xiangetal., CategoryThreerelatestothemagnitudeofheatexposureriskof
2016).Similarly,managementisconsciousofheatstressriskasevident workers.Thiscategoryresultedfromaggregationof33findings.Find-
intheroutineassessmentandmonitoring,managementknowledgeof ingsonthemagnitudeofheatexposureriskswereidentifiedasbeing
heatstressriskisonaccountofseveralheat-relatedworkerincidents higherduringpeakhotmonths,whentheaveragetemperaturereached
duringsummermonth,andworkers'perceivedprovisionofwater,elec- over39°Candwhenenvironmentalconditionsinselectedfactories
trolytes,andfansaswaysofcontrollingheatstress(Balakrishnanetal., weretoohotforcontinuousworkinsummermonths(Pradhanetal.,
2010)(SupplementalFig.1). 2013).Heatstressexposurevaluesatmostlocationsofindustrialunits
CategoryTwodescribesworkers'experiencesofoccupationalheat exceededrecommendedlevels(Tawatsupaetal.,2012),andvaluesof
stress.Thereviewyielded16findingsinthiscategory.Forexample, WetBulbGlobeTemperature(WBGT)increasedsharplyinmostmorn-
studiesreportedexperiencesofheatstressconditions(e.g.,fainting, ingsatabout7:00amto12:00noon(Croweetal.,2013).Similarly,
tension,andirritation,nausea,hotanddryskin,cramps,andconfusion) workingconditionsoffouroutoffivestudysiteswerewithinthelikeli-
among workers (Fleischer et al., 2013; Pradhan et al., 2013). hood of ‘extreme caution’ or ‘danger’ of heat stress conditions
V.F.Nunfametal./ScienceoftheTotalEnvironment643(2018)1542–1552 1547
Table4
Detailsofpapersaddressingworkers'perceptionsandexperiencesofoccupationalheatstressriskandeffectsofoccupationalheatstressonworkers'healthandsafety,psychologicalbe-
haviour,productivityandsocialwell-being.
Author,year&title Studylocation Studydesign Population/sample Methods Dataanalysis Author(s)conclusions
size
Delgado-Cortez(2009).Heat Nicaragua 22sugarcane dataloggers Descriptivestatistics Productivityimprovedwiththe
stressassessmentamong workers anddata andChi-squareanalysis newrehydrationmeasures.
workersinaNicaraguansug- collection Awarenessamongworkers
arcanefarm sheet concerningheatstressprevention
wasincreased
Venugopaletal.(2016b). India Experimental 442workers WBGTand Statisticalanalysis Reducingworkplaceheatstress
Occupationalheatstress studydesign questionnaires usingZ-testa benefitsindustriesandworkers
profilesinselected chi-squareforbivariate viaimprovingworkerhealthand
workplacesinIndia productivity.Adaptationand
mitigationmeasurestotackleheat
stressareimperativetoprotect
thepresentandfutureworkforce
asclimatechangeprogresses
Duttaetal.(2015).Perceived Gandhinagar-Western A 219construction WBGT,focus Thematicanalysisusing Thisstudysuggestssignificant
heatstressandhealtheffects India cross-sectional workers group groundedtheory healthimpactsonconstruction
onconstructionworkers surveyusing discussionand approachforqualitative workersfromheatstressexposure
mixedmethod survey dataanddescriptive intheworkplace,showedthat
approach questionnaires statisticalanalysisand heatstresslevelswerehigherthan
trendanalysis thoseprescribedbyinternational
standardsandhighlightstheneed
forrevisionofworkpractices
increasedprotectivemeasures,
andpossibledevelopmentof
indigenousworksafetystandards
forheatexposure
Venugopaletal.(2016a).The India Both 142migrant WBGTand Quantitativeand Inanincreasinglywarmerglobal
socialimplicationsof quantitative workers questionnaires qualitativeanalysis climateandwithincreasing
occupationalheatstresson andqualitative constructiondemand,stronger
migrantworkersengagedin studies policiestoprevent
publicconstruction:acase morbidity/mortalityamong
studyfromSouthernIndia vulnerablemigrantworkersinthe
constructionsectorare
imperative.Betterhealth,literacy
rates,anddecreasedcrime
statisticsamongmigrant
communityarepotentialpositive
implicationsofprotectivepolicies
(Langkulsenetal.,2010).Furthermore,workers'exposuretoheatlevels 2013).Theassociatedeffectofheatstressontheincidenceofkidneydis-
ofWBGTperhourwere26–32°Candairtemperatures(30–38°C),ex- easeformenwithexperienceofheatexposureissignificant(Tawatsupa
ceedinginternationalstandards(Sahuetal.,2013),withWBGTvalues etal.,2012).Similarly,workers'reportedadversehealthimpactofheat
(90%)alsoexceedingrecommendedthresholdvalues(27.0°C–41.7 stress(e.g.,excessivesweating,nausea,pricklyheat,infection,head-
°C)forheavyandmoderateworkloads(Krishnamurthyetal.,2017). aches, dehydration, increased thirst, tiredness, itchy skin, burning
Also,workers'exposuretoheatstresssettingswasaboveapproved eyes,backache,legpains,andnosebleeds).Thesewereattributedto
AmericanConferenceofGovernmentalIndustrialHygienists(ACGIH) climate-related hot and dry conditions (Crowe et al., 2013; Flocks
ThresholdLimitValues(TLVs)forheavyworkloads(Venugopaletal., etal.,2013;Venugopaletal.,2016a;Ayyappanetal.,2009)(Supple-
2016a).Factorswiththepotentialofaffectingworkers'levelofheatex- mentalFig.4).
posureincludedpersonalprotectiveequipment(PPE),relativehumid- CategoryFivedescribestheproductivityeffectsofoccupationalheat
ity,accesstocoldwaterandshade,typeofwork,andlocationofwork stressonworkers.Elevenfindingsweregroupedtoformcategoryfive.
(Laoetal.,2016)(SupplementalFig.3). Examplesoffindingsinthiscategorywerethatsupervisorsperceive
workasstrenuousandtiringinhotenvironmentresultinginreduced
3.1.2.SynthesisTwo:socialimpactsofoccupationalheatstress productivityandoptimalperformance(Matheeetal.,2010),productiv-
Socialimpactsofoccupationalheatstressduetoclimatechangecon- itylosseswereintherangeof10to60%oftheconstructionandpottery
stituteSynthesisTwo.ItistheoutcomeofcombiningCategoriesFour, workers(Langkulsenetal.,2010),farmworkers'productivityincreased
Five,andSix(Fig.4). withimprovedhydration(Delgado-Cortez,2009).Workersexposedto
Theremainingcategories(4,5&6)emanatedfromaggregating37 direct heat reported significant production losses as compared to
findingsofincludedstudies.CategoryFourcentredonthemixtureof workersexposedtoindirect heat(χ2=26.13,df =1,p=0.001)
25 findings related to thehealth and safety effectsof occupational (Krishnamurthyetal.,2017).Furthermore,heatstressimpactonpro-
heatstressonworkers.Somefindingsofstudiesincategoryfourin- ductivitylosseswasstatedby69%ofworkersasinabilitytofinishtask
cludedthefollowing:occupationalinjuryrisksdecreasewithagefor ontime,absenteeismandwagelossduetoillness(Venugopaletal.,
both sexes, but increases with lower income, physical workload, 2016a),andworkersperceiveheattoimpedeworkefficiency,slow
sleepingfewerhours,existingdiseaseandfastworkpace(Tawatsupa workpaceandaffectproductivity(Laoetal.,2016)(Supplemental
etal.,2013).Also,heatstress-relatedoccupationalinjurywasworse Fig.5).
formales,youngeragedworkerswithlowerincomeandphysicaljobs, Effectsofoccupationalheatstressonsocialwell-beingarethesixth
andoccupationalinjuryeffectwasexperiencedbymoremalesandfe- andlastcategoryofSynthesisTwo.Thefindingsincategorysixshowed
malesexposedtoheatstressthanthoseunexposed(Tawatsupaetal., thatheatstressimpactonworkers'socialliveswaslimitedtimefor
1548 V.F.Nunfametal./ScienceoftheTotalEnvironment643(2018)1542–1552
Table5
Detailsofpapersaddressingworkers'perceptionsandexperiencesofoccupationalheatstressriskandadaptationstrategies.
Author,year&title Study Studydesign Population/sample Methods Dataanalysis Authors'conclusion
location size
Pradhanetal.(2013).Assessing Nepal Casestudy 120household Dataloggers, Comparative Morequantitativemeasurementof
climatechangeandheat household factoryworkers questionnaireand analysisof workers'healtheffectandproductivity
stressresponseintheTarai survey observationchecklist quantitativedata losswillbeofinterestforfuturework
RegionofNepal
Xiangetal.(2015).Perceptions Australia Cross-sectional 180occupational Questionnaire Descriptive Thefindingssuggestaneedtorefine
ofworkplaceheatexposure researchdesign hygienists analysisusing occupationalheatmanagementand
andcontrolsamong STATAandExcel preventionstrategies
occupationalhygienistsand
relevantspecialistsin
Australia
Fleischeretal.(2013).Public Georgia Cross-sectional 405farmworkers In-personinterview Statisticalanalysis Migrantfarmworkersexperiencedhigh
healthimpactofheat-related surveyresearch usinglogistic levelsofHRIsymptomsandfaced
illnessamongmigrant design regression substantialbarrierstopreventing.
farmworkers Heat-RelatedIllnessmaybereduced
throughappropriatetrainingofworkers
onHRIprevention,aswellasregular
breaksinshadedareasthesesymptoms
Mirabellietal.(2010). Carolina Cross-sectional 300farmworkers Interviewer-administered Descriptive Thesefındingssuggesttheneedto
Symptomsofheatillness study questionnaires statisticalanalysis improvetheunderstandingofworking
amongLatinofarmworkers usinglog-binomial conditionsforfarmworkersandto
inNorthCarolina regression assessstrategiestoreduceagricultural
workers'environmentalheatexposure
Ayyappanetal.(2009). India Quantitative WBGT Descriptive Thestudyre-emphasisestheneedfor
Work-relatedheatstress researchdesign statisticalanalysis recognisingheatstressasanimportant
concernsinautomotive occupationalhealthriskinbothformal
industries:acasestudyfrom andinformalsectorsinIndia.Making
Chennai,India availablegoodbaselinedataiscriticalfor
estimatingfutureimpacts
Xiangetal.(2016).Workers' Australia Cross-sectional 479workers Questionnairesurvey Bivariateand Needtostrengthenworkers'heatrisk
perceptionsofclimatechange researchstudy multivariate awarenessandrefinecurrentheat
relatedextremeheat analysis preventionstrategiesinawarming
exposureinSouthAustralia:a climate.Heateducationandtraining
cross-sectionalsurvey shouldfocusonthoseundertaking
physicallydemandingworkoutdoors,in
particular,youngandolderworkers
withloweducation
Laoetal.(2016).Working Australia Aqualitative 32councilmale Focusgroups Thematicanalysis Theresultsshowedtheimportanceof
smart:Anexplorationof casestudy workers andinterpretative workplacemanagementandtraining,
councilworkers'experiences design phenomenological andanunderstandingoftheneedfor
andperceptionsofheatin analysis workerstobeabletoself-paceduring
Adelaide,SouthAustralia hotweather
familycare,householdchores,andfamilydisagreementduetofatigue, workingatsiteswithlesssunexposure,wearingawide-brimmedhat,
physicalviolenceandinterpersonalissues(Venugopaletal.,2016a) and use of fan and sunblock (Flocks et al., 2013) (Supplemental
(SupplementalFig.6). Fig.7).Heatadaptationmeasureswerealsoidentifiedasaccesstodrink-
ingwater,heatstresstraining,reschedulingworktime,provisionofa
3.1.3.SynthesisThree:adaptationtooccupationalheatstressduetoclimate centralcoolingsystem,electricfansuse,andceaseworkinextreme
change heat(Xiangetal.,2015).Theprovisionofhydrationbreaks,improving
AdaptationtooccupationalheatstressisthefocusofSynthesisThree ventilationandinstallingaircoolingdevicesweretherangeofapproved
andwasderivedfromtheaggregationof22findingsintoCategory improvementsinheatstressexposurelocations(Ayyappanetal.,2009).
SevenandEight(Fig.5). Also,personal coping strategies toheatexposurewere self-pacing,
CategorySevencoversworkers'adaptationstrategiestooccupa- wearingsunprotectivegear,drinkingwater,takingbreaks,slowing
tionalheatstress.Itisderivedfromtheaggregationof18findings. down,workself-efficacyandmodifyingworkpractices,andthepolicy
Thisisexemplifiedbyanalogousfindingssuchasworkersadaptedcop- athelpingworkerstocopewithheatexposureincludeprovisionof
ingmeasuressuchasfan,ashiftinworkingtime,wearingthinclothes water,air-conditionedvehiclesandPPEs(Laoetal.,2016).
anddrinkingwater(Pradhanetal.,2013).Also,workers'recognised Finally,CategoryEightconsistsoffourfindingscombinedtodescribe
heatprotectionstrategiesasdrinkingenoughwater,takingbreaks, thebarrierstoimplementationofoccupationalheatstressadaptation.
Table6
Detailsofpapersimultaneouslyaddressingworkers'perceptionsandexperiencesofoccupationalheatstressrisk,effectsofoccupationalheatstressonworkers'healthandsafety,behav-
iour,productivityandsocialwell-beingandadaptationstrategies.
Author,year&title Study Study Population/sample Methods Dataanalysis Authors'conclusion
location design size
Matheeetal.(2010).Climatechange South Grounded 151workers Focus STATAfor Peopleworkinginsun-exposedconditionsin
impactsonworkingpeople(the Africa theory group quantitativedata hotpartsofSouthAfricacurrentlyexperience
HOTHAPSinitiative):findingsofthe discussion analysisandthematic heat-relatedhealtheffect,withimplicationsfor
SouthAfricanpilotstudy and analysisfor theirwell-beingandabilitytoworkandthat
interviews qualitativedata furtherresearchiswarranted
V.F.Nunfametal./ScienceoftheTotalEnvironment643(2018)1542–1552 1549
Theextentofworkers'awarenessandexperiencesofoccupational
heatstress,impactsandadaptationstrategiescansignificantlydefine
theattitudeandcollectiveeffortofallstakeholdersinactingconscien-
tiouslytomanagethevulnerabilityandimpactofoccupationalheatex-
posurerisks.Thevulnerabilityprinciplestatesthattheextentofseverity
ofclimatechangeandheatexposurehazardsdefinetheextentofexpo-
sureofindividuals,andthemagnitudeofadaptationtoclimatechange
and heat exposure stressors to individuals determine vulnerability
levels(Davidsonetal.,2003;Fordetal.,2006;KellyandAdger,2000).
Hence,theseverityandmagnitudeofoccupationalheatstressimpact
onworkersandadaptationstrategiesmaydependonworkershaving
adequateknowledgeandawarenessofperceivedandactualvulnerabil-
ities,adaptivecapacityandresilienceplanning.Thevaryingheatstress
Fig.2.Continentallocationofincludedstudies. risksawarenessandexperiences,andhighmagnitudeofheatexposure
mayserveasthebasistoinformpolicydecisions,futureresearch,and
Findingsthattypifycategoryeightwereidentifiedasinadequatecoping thedevelopmentofinformation,trainingandeducationonheatstress
measuresagainstheatstressduetopoorhousingdesigns(Pradhan risks.Thesemeasurescanboostworkers'adaptivecapacityandresil-
etal.,2013)andinsufficientresourcesforprotectingworkersfrom ienceplanningforeffectiveoccupationalheatstressmanagement.It
heatstress(Duttaetal.,2015).Italsoincludeslackofawareness,lack alsoholdsthepotentialformanagingthethreatsandworseningim-
of management commitment, lack of training, lack of financial re- pactsofheatstressinthecontextofrisingtemperatureandclimate
sources,lowcompliance,andlackofheat-relatedguidelines(Xiang changeonworkers'healthandsafety,productivity,andsocialwell-
etal.,2015).Similarbarrierstoheatillnesspreventionatworkwerea being.
lackofpreventiontraining,noregularbreaks,noaccesstoshadeor
medicalattention(Fleischeretal.,2013)(SupplementalFig.8). 4.2.Socialimpactsofoccupationalheatstress
TheuseoftheSIAframeworkmostlyintheassessmentofresource
4.Discussion
andcapitalprojects(Vanclay,2003;Vanclayetal.,2015),otherthan
concernsrelatedtosocialimpactsofpolicies,occupationalheatexpo-
Thisstudyisthefirstandmostrecentsystematicreviewandnarra-
sureandclimatechangehavebeencriticised(Adusei-Asante,2017;
tivesynthesisexaminingthesocialimpactsofoccupationalheatstress
Kalksteinetal.,2009;Miller,2014;ScheffranandRemling,2013;UN,
andadaptationstrategiesofworkersinthefaceofrisingtemperature
2011). Accordingly, the reported range of social impacts resulting
andclimatechange.Theprocessculminatedinaggregating121findings
fromoccupationalheatstressonworkersvulnerabletoheatexposure
intoeightcategoriesandthreesynthesesbasedonpatternsofsignifi-
included physical, mental, behavioural, health and safety, socio-
cantsimilaritiesanddifferences.It wasguidedbytheneedto find
economicandproductivityconsequences(Costelloetal.,2009;Dunne
evidence-basedanswerstothreereviewquestionsrelatedtoworkers'
etal.,2013;Hannaetal.,2011;Kjellstrometal.,2009;Smithetal.,
perceptions,socialimpacts,andadaptationstrategiestooccupational
2014;Venugopaletal.,2016a;Xiangetal.,2014a,2014b).
heatstress.
Similarlyevidencefromthereviewrevealedthesignificantinflu-
encesofoccupationalheatstressonthehealth,safety,productivity
4.1.Workers'awarenessofoccupationalheatstress andsocialwell-beingofoutdoorandindoorworkersacrossarangeof
differentindustrialsettingsacrosstheworld(Ayyappanetal.,2009;
Evidence-basedunderstandingofhowworkersperceiveandexperi- Flocksetal.,2013;Tawatsupaetal.,2012;Venugopaletal.,2016b).Re-
enceheatstressrisksbasedonthemagnitudeofworkplaceheatexpo- sultsofthereviewonimpactsofoccupationalheatstressonhealthand
suremaybeusefulinimprovingheatexposurerisksmanagementand safetyofworkersresonatewithvariousstudies(e.g.,Acharyaetal.,
occupationhealthandsafetypoliciesinthecontextofrisingtempera- 2018;Arburyetal.,2014;KjellstromandCrowe,2011;Xiangetal.,
tureandclimatechange.Inthisreview,clearbutvariedawarenessof 2014a,2014b)whereheat-relatedillnessesandinjuriesofworkers
heatstress,experiencesofheatstress,andhighmagnitudesofheatex- wereattributedtooccupationalheatexposurefactors.Forinstance,
posureriskswerereportedamongcohortsofworkers,managersand the20casesofheatillnessanddeathsamongworkersintheUnited
keystakeholders(e.g.,Balakrishnanetal.,2010;Matheeetal.,2010; States(U.S.)duringthe2012–2013reviewofOccupationalSafetyand
Stoecklin-Maroisetal.,2013;Xiangetal.,2015,2016).Thisfindingis HealthAdministration(OSHA)wereattributedtoheatexposurewith
consistentwiththeresultsofotherstudiesinvariousindustriesin aheatindexintherange(29.0°C–41.0°C)(Arburyetal.,2014).Heat-
whichvariedawarenessandexperiencesofheat-relatedmorbidity relatedillnesses,injuriesanddeathsamongworkersreflectthepreva-
andmortalityaswellasthemagnitudeofheatexposureriskswereob- lenceofwork-relatedheatexposurefactors,individual-relatedvulnera-
servedamongworkers,employersandotherstakeholders(Jacklitsch, bilityfactorsandworsenedbyclimatechange-relatedheatexposure
2017;Lametal.,2013;Singhetal.,2015).Also,excessiveheatexposure factorssuchasrisingtemperature,highhumidity,airspeed,andradiant
inchangingclimatehasbeenperceivedandremainedasignificantcon- heat.
cernforworkers'healthandsafety,productivity,andworkplaceenvi- Furthermore, multiple studies (e.g., Delgado-Cortez, 2009;
ronmentalconditions(Kjellstrometal.,2016b;Lucasetal.,2014). Krishnamurthyetal.,2017;Langkulsenetal.,2010;Laoetal.,2016;
Fig.3.SynthesisOne:workers'awarenessofoccupationalheatstress.
1550 V.F.Nunfametal./ScienceoftheTotalEnvironment643(2018)1542–1552
Fig.4.SynthesisTwo:socialimpactsofoccupationalheatstress.
Matheeetal.,2010;Sahuetal.,2013;Venugopaletal.,2016a)inthisre- ofoccupationalheatstresstofindexpressionintheletterandspiritof
viewhavedemonstratedthat,occupationalheatstressresultsinre- policydecisionsandSIAframeworksattheglobal,nationalandlocal
ducedproductivityinavarietyofworkplacesandindustriesincluding levelstoreduceworkers'vulnerability,boostadaptivecapacityandre-
construction(Venugopaletal.,2016a),agriculture(Delgado-Cortez, silienceplanning(Miller,2014).
2009;Sahuetal.,2013),andmanufacturing(Krishnamurthyetal.,
2017). Findings of the review relating to productivity impacts on 4.3.Adaptationofworkerstooccupationalheatstress
workerscorroborateotherstudiesshowingdeclinesinproductivity
due to working under increasing heat exposure reported across a Occupationalheatstressbasedonrisingtemperatureduetoclimate
rangeofcountriesandregions(e.g.,Dunneetal.,2013;Kjellstrom changehassubstantialsocio-economicandhealthramificationsonwork-
et al., 2016a; Kjellstrom et al., 2016b; Gibson and Pattisson, 2014; ing populations. Devoting significant resources in incorporating and
Singhetal.,2015),havecontinuallybeenshowntodecreasedueto enforcingmitigation,adaptationandsocialprotectionstrategiesinpolicy
workingunderrisingheatexposureconditionsinavarietyofwork- decisionsaresustainablewaystoreducevulnerability,enhanceresilience
placesandcountriesincluding,butarenotlimitedto,Australia,U.S., andadaptivecapacityofworkingpeopletoensureviablewell-being
Indonesia,Malaysia,China,Qatar,India,SouthAfrica,andBangladesh. (SpectorandSheffield,2014;Venugopaletal.,2016a;Venugopaletal.,
Productivitylosses,absenteeism,reducedworkpace,andperformance 2016b;Xiangetal.,2016).Theneedformitigation,adaptationandsocial
efficiencywillbeexacerbatedbyprojectedriseintemperatureandcli- protectionpoliciesaspreventiveandcontrolmeasureshavebeenin-
matechange.Forinstance,internationalanalysisoflabourproductivity formedbyprotocols,frameworks,andtargetstoreducevulnerability,
lossover1975–2200showedthatduringthewarmestperiod,there risks,andsensitivitytoclimatechangeandheatstress,andtoenhancere-
mightbeworkcapacityreduction(37%basedonRepresentativeCon- silienceandadaptivecapacityofworkers(Brechin,2016;IPCC,2014;
centration Pathways [RCP]8.5 and 20% based on RCP4.5) in most Rhodes,2016;UNFCCC,2006;WMOandWHO,2015).
humidmonths(Dunneetal.,2013).Also,reductioninworkcapacity Accordingly,severalstudies(e.g.,Ayyappanetal.,2009;Flocksetal.,
andabsenteeismcausedbyheatstressledtoindividualeconomiclosses 2013;Laoetal.,2016;Pradhanetal.,2013;Xiangetal.,2015)inthere-
ofUS$655,andanoverallfinanciallossofUS$6.2billion(Zanderetal., viewaddressedavarietyofissuesrelatedtoworkers'copingandadap-
2015).Also,globalanalysiscentredonnationalGrossDomesticProduct tationtooccupationalheatstressandbarrierstoadaptationstrategies.
(GDP)andannualmeantemperaturesindicatedthatcountrieswould Theuseofcopingandadaptationstrategiesassuitableoptionsforde-
lose23%oftheirGDPtorisingtemperaturesandclimatechangeby creasingandmanagingrisks,vulnerabilitiesandsensitivitytooccupa-
2100(Burkeetal.,2015). tionalheatstressimpactsonworkers'health,productivity,andsocial
Inaddition,heatstresseffectonworkers'sociallivesandwell-being lives are diverse (Davies et al., 2009; Kjellstrom et al., 2016a;
asindicatedinthereviewincludedinadequatetimefortasksuchas Venugopaletal.,2016a).Generally,interventionsofoccupationalheat
familycareandhouseholdchores,aswellasanincreaseinfamilybreak- stressfromtheperspectiveofcopingmechanisms,adaptation,andso-
down due to fatigue, physical violence and interpersonal disputes cialprotectionstrategiesasencapsulatedinthereviewincludeengi-
(Venugopaletal.,2016a).Theeffectofextremeheatonworkers'social neeringsolutions,administrativecontrols,andconsistenteducation
livesandwell-beingalsoresultsinincomeerosionandlossofemploy- andtrainingregimes.Itcanalsobereinforcedbyimplementingsuch
ment due to heat-related morbidity, absenteeism and productivity regulationsandpolicies,ensuringashiftinstructuresofeconomiesto
loss,therebyaffectingworkers'socialnetworkrelationshipwiththeir non-outdoorwork,providecompensationsforproductivelosses,and
families and co-workers, and access to community services socialprotectionforworkers(Frimpongetal.,2015;Kjellstrometal.,
(Venugopaletal.,2016a).Similarly,extremeheateventshavebeen 2016b;Lucasetal.,2014;Lundgrenetal.,2013;UN,2011).
showntopresentmulti-stressvulnerabilitiesthataffectpeopleinclud- However,workersencounterbarriers(e.g.,inadequatehousingde-
ingtheirhealthandwell-being,financialsituation,mobility,socialrela- signs,inadequateresources,lackofawareness,absenceofmanagement
tions,andaccesstobasicservices(Miller,2014;BolithoandMiller, commitment,lackofpreventiontraining,lowcompliance,lackofheat
2017).However,thereispaucityofknowledgeandresearch-basedev- stressguidelines,lackofregularbreaks,andthelimitedaccesstoshade
idenceonthesocialimpactdimensionsandthenexusbetweenclimate ormedicalattention)inimplementingadaptationstrategiestooccupa-
change-relatedheatexposureanditsconsequencesonhealth,safety, tional heat stress(Duttaet al., 2015; Fleischer etal., 2013; Pradhan
productivity, and economic output, and adaptation strategies for etal.,2013;Xiangetal.,2015).Similarly,the20casesofheatillnessand
workers'sociallives,theirfamilies,coworkers,socialunits,andwider fatalitiesintheU.S.duringthe2010–2013reviewwerelinkedtopoorap-
communities (Kjellstrom et al., 2016a; Miller, 2014; UN, 2011; proachtoheatillnessriskidentificationinpreventionprogramme,inade-
Venugopaletal.,2016a).Itisessentialforthefactorsofsocialimpacts quate or no heat illness prevention programme, inadequate water
Fig.5.SynthesisThree:adaptationtooccupationalheatstressasaresultofclimatechange.
V.F.Nunfametal./ScienceoftheTotalEnvironment643(2018)1542–1552 1551
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