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Background Occupational exposure to extreme heat without sufficient protection may not only increase the risk of heat-related illnesses and injuries but also compromise economic productivity. With predictions of more frequent and intense bouts of hot weather, workplace heat exposure is presenting a growing challenge to workers’ health and safety. This study aims to investigate workers’ perceptions and behavioural responses towards extreme heat exposure in a warming climate. Methods A cross-sectional questionnaire survey was conducted in 2012 in South Australia among selected outdoor industries. Workers’ heat risk perceptions were measured in the following five aspects: concerns about heat exposure, attitudes towards more training, policy and guideline support, the adjustment of work habits, and degree of satisfaction of current preventive measures. Bivariate and multivariate logistic regression analyses were used to identify factors significantly associated with workers’ heat perceptions. Results A total of 749 respondents participated in this survey, with a response rate of 50.9 %. A little more than half (51.2 %) of respondents were moderately or very much concerned about workplace heat exposure. Factors associated with workers’ heat concerns included age, undertaking very physically demanding work, and the use of personal protective equipment, heat illness history, and injury experience during hot weather. Less than half (43.4 %) of the respondents had received heat-related training. Workers aged 25–54 years and those with previous heat-related illness/injury history showed more supportive attitudes towards heat-related training. The provision of cool drinking water was the most common heat prevention measure. A little more than half (51.4 %) of respondents were satisfied with the current heat prevention measures. About two-thirds (63.8 %) of respondents agreed that there should be more heat-related regulations and guidelines for working during very hot weather. More than two-thirds (68.8 %) of the respondents were willing to adjust their current work habits to adapt to the likely increasing extreme heat, especially those with previous heat illness experience. Conclusions The findings suggest a need to strengthen workers’ heat risk awareness and refine current heat prevention strategies in a warming climate. Further heat educational programmes and training should focus on those undertaking physically demanding work outdoors, in particular young workers and those over 55 years with low education levels.

Background Global warming is raising increasing concerns about its impact on worker productivity, particularly in industries like construction where outdoor physically demanding jobs are prevalent. This study aimed to perform a meta-analysis to assess the existing evidence on the impact of heat exposure on productivity loss among construction workers. Methods We conducted a comprehensive literature search across six databases—Web of Science, PubMed, Embase, Scopus, ScienceDirect, and IEEE—covering the period from database inception to September 18, 2024. The Joanna Briggs Institute (JBI) critical appraisal checklist was used for quality assessment. A random-effect model meta-analysis was performed, and publication bias was evaluated by Egger’s and Begg’s tests. Results From an initial pool of 1209 studies, 14 met the inclusion criteria, representing data from 2387 workers. Our findings indicate that 60% (95% CI: 0.48–0.72, p  < 0.01) of construction workers exposed to elevated temperatures experienced significant productivity loss. Productivity loss was more pronounced when the Wet Bulb Globe Temperature (WBGT) exceeded 28 °C or when ambient temperatures surpassed 35 °C. Furthermore, workers aged over 38 (proportion = 0.61, 95% CI: 0.49–0.72) and teams with female workers (ratio = 0.74, 95% CI: 0.60–0.87) were more susceptible to productivity loss. Conclusions This review highlights heat exposure as a significant factor affecting productivity in the construction industry. We recommend prioritizing the protection of vulnerable groups such as women and older workers, developing innovative technologies and equipment for working in hot conditions, and improving the working environment to safeguard workers’ health and productivity. Further research is needed to investigate the long-term health impacts of heat exposure and develop strategies for optimizing microclimate management in construction settings.

Objectives (1) To investigate the association between temperature and work-related injuries and (2) to identify groups of workers at high risk of work-related injuries in hot environments in Adelaide, South Australia. Methods Workers’ compensation claims in Adelaide, South Australia for 2001–2010 were used. The relationship between temperature and daily injury claims was estimated using a generalised estimating equation model. A piecewise linear spline function was used to quantify the effect of temperature on injury claims below and above thresholds. Results Overall, a 1°C increase in maximum temperature between 14.2°C and 37.7°C was associated with a 0.2% increase in daily injury claims. Specifically, the incidence rate ratios (IRRs) for male workers and young workers aged ≤24 were (1.004, 95% CI 1.002 to 1.006) and (1.005, 95% CI 1.002 to 1.008), respectively. Significant associations were also found for labourers (IRR 1.005, 95% CI 1.001 to 1.010), intermediate production and transport workers (IRR 1.003, 95% CI 1.001 to 1.005) and tradespersons (IRR 1.002, 95% CI 1.001 to 1.005). Industries at risk were agriculture, forestry and fishing (IRR 1.007, 95% CI 1.001 to 1.013), construction (IRR 1.006, 95% CI 1.002 to 1.011), and electricity, gas and water (IRR 1.029, 95% CI 1.002 to 1.058). Conclusions There is a significant association between injury claims and temperature in Adelaide, South Australia, for certain industries and groups. Relevant adaptation and prevention measures are required at both policy and practice levels to address occupational exposure to high temperatures.

This cross-sectional study examined the health impacts of occupational dust exposure on workers in Fujian Province, China, using data collected from 2020 to 2021. The primary objective was to assess the associations between occupational dust exposure and several adverse health outcomes, including abnormal chest X-ray (Abn-CXR), abnormal pulmonary function tests (Abn-PFTs), pneumoconiosis (PC), abnormal electrocardiograms (Abn-ECGs), abnormal liver function tests (Abn-LFTs), hypertension (HTN), and hearing loss (HL). logistic regression models were employed to identify significant risk factors. Stratified analyses by age and gender were performed to evaluate demographic differences in health risks. The results showed that workers currently employed, those with over 10 years of dust exposure, and workers exposed to silica, cement, or coal dust had a higher risk of Abn-CXR, Abn-PFTs, PC, Abn-ECGs, Abn-LFTs, HTN, and HL. Stratified analyses further revealed that male workers and individuals over 40 years old experienced a higher risk of abnormal health outcomes. These findings underscore the urgent need for targeted interventions, improved protective measures, and stricter occupational safety regulations to reduce the health burden associated with dust exposure in the workplace.

With warmer weather projections, workplace heat exposure is presenting a growing challenge to workers' health and safety. Occupational hygienists are the specialist group conducting measurements and providing advice on heat stress management to industry. In order to provide insights into hygienists perceptions on workplace heat exposure, current and future preparedness for extreme heat, and barriers to possible heat adaptation strategies, a self-administered questionnaire survey was conducted during a national conference of the Australian Institute of Occupational Hygienists. Nearly 90% of the 180 respondents were at least moderately concerned about extreme heat and 19% were dissatisfied with current heat stress prevention measures. Barriers recognized by the participants were lack of awareness (68%), insufficient training (56%), unsatisfactory management commitment (52%), and low compliance with prevention policies (40%). The findings suggest a need to refine occupational heat management and prevention strategies.

ObjectivesThis study aims to examine the epidemiological characteristics of occupational heat illnesses in South Australia, to quantify the association between ambient temperature and occupational heat illnesses, and to investigate the impact of heatwaves on occupational heat illnesses.MethodsWorkers’ compensation claims data and weather data were obtained from SafeWork South Australia and the Bureau of Meteorology, respectively, for 2001–2010. Time series analysis with generalised estimation equation models and linear spline functions was used to quantify the temperature–heat illness claims association. A case-crossover design was applied to investigate the impact of heatwaves on occupational heat illnesses.ResultsThere were 306 heat illness claims during the study period, with an incidence rate of 4.5 per 100 000 employees. The overall risk of occupational heat illness was positively associated with maximum temperature (Tmax), especially when Tmax was over the threshold of 35.5°C. One degree increase of Tmax was associated with a 12.7% (incidence rate ratio 1.127, 95% CI 1.067 to 1.190) increase of occupational heat illness claims. During heatwave periods, the risk of occupational heat illness was about 4–7 times higher than that of non-heatwave periods.ConclusionsThere is a need to develop or refine current heat-related regulations and guidelines to minimise the risk of occupational heat illnesses in vulnerable workers in a warming climate.

Objective The present study aimed to evaluate the association between advanced lung cancer inflammation index (ALI) and all-cause mortality in a population of patients with Coronary Heart Disease(CHD) using a retrospective cohort study design. Methods Data were obtained from the 1999–2018 National Health and Nutrition Examination Survey (NHANES). ALI was calculated as BMI × albumin level ÷ NLR, integrating anthropometric, nutritional, and inflammatory biomarkers. History of CHD was obtained using a questionnaire. We used Cox regression analysis to explore potential relationships and examined the nonlinear relationship using Restricted Cubic Splines (RCS). Results A total of 1,295 participants were included in the study. Cox regression results revealed that a higher ALI was associated with lower all-cause mortality in patients with CHD. The subgroup and interaction analyses showed that the results were consistent. After adjusting for all covariates, participants in quartile 4 of ALI showed a 39% reduction in all-cause mortality compared to quartile 1. RCS analysis indicates a U-shaped relationship with a breaking point of 117.33. Conclusion In the United States, higher ALI was associated with lower all-cause mortality among patients with CHD. These findings suggest a potential association between ALI and all-cause mortality in CHD patients that warrants further investigation in prospective studies. Future interventional studies are needed to determine whether strategies targeting the components of ALI could improve clinical outcomes in this population.

Background Workplace heat exposure can cause a series of heat-related illnesses and injuries. Protecting workers especially those undertake work outdoors from the risk of heat strain is a great challenge for many workplaces in China under the context of climate change. The aim of this study is to investigate the perceptions and adaptation behaviors of heat exposure among construction workers and to provide evidence for the development of targeted heat adaptation strategies nationally and internationally. Methods In 2020, we conducted a cross-sectional online questionnaire survey via WeChat Survey Star in China, using a purposive snowball sampling approach. A total of 326 construction workers submitted completed questionnaires. The perceptions of workplace heat exposure were measured using seven indicators: concerns over high temperature, perception of high temperature injury, attitudes towards both heat-related training and regulations, adjustment of working habits during heat, heat prevention measures in the workplace, and reduction of work efficiency. Bivariate and multivariate regression analyses were used to identify the factors significantly associated with workers’ heat perceptions and behavioral responses. Results 33.3% of the respondents were moderately or very concerned about heat exposure in the workplace. Less than half of the workers (43.8%) were worried about heat-related injuries. Workers who have either experienced work-related injuries (OR = 1.30, 95% CI 1.03–1.62) or witnessed injuries to others during high temperatures (OR = 1.12, 95% CI 1.02–1.27) were more concerned about heat exposure compared to other workers. Most respondents (63.5%) stated that their work efficiency declined during extremely hot weather. The factors significantly associated with a reduction of work efficiency included undertaking physically demanding jobs (OR = 1.28, 95% CI 1.07–1.54) and witnessing other workers’ injuries during high temperatures (OR = 1.26, 95% CI 1.11–1.43). More than half of the workers were willing to adjust their work habits to adapt to the impact of high temperatures (81.6%). The internet was the most common method to obtain heat prevention information (44.7%), and the most frequently used heat prevention measure was the provision of cool drinking water (64.8%). Conclusions Chinese construction workers lack heat risk awareness and are not well prepared for the likely increasing heat exposure in the workplace due to global warming. Therefore, there is a need to improve their awareness of heat-related injuries, strengthen high temperature related education and training, and update the current heat prevention policies to ensure compliance and implementation.

Bacillary dysentery (BD) remains a significant public health issue, especially in developing countries. Evidence assessing the risk of BD from temperature is limited, particularly from national studies including multiple locations with different climatic characteristics. We estimated the effect of temperature on BD across China, assessed heterogeneity and attributable risks across cities and regions, and projected the future risk of BD under climate change. Daily BD surveillance and meteorological data over 2014-2016 were collected from the Chinese Center for Disease Control and Prevention and the China Meteorology Administration, respectively. A two-stage statistical model was used to estimate city-specific temperature-BD relationships that were pooled to derive regional and national estimates. The risk of BD attributable to temperature was estimated, and the future burden of BD attributable to temperature was projected under different climate change scenarios. A positive linear relationship for the pooled effect was estimated at the national level. Subgroup analyses indicate that the estimated effect of temperature on BD was similar by age ( or ) and gender. At baseline, estimated attributable risks for BD due to average daily mean temperatures above the 50th percentile were highest for the Inner Mongolia (16%), Northeast China (14%), and Northern China (13%). Most of the individual cities in the same regions and most of the cities in the Northwest, Southern, and Southwest regions, had high attributable risks ( ). The Northern, Northeast, Inner Mongolia, Northwest, and Southern China regions were identified as high risk for future BD, with estimated increases by the 2090s compared with baseline of 20% (95% confidence interval: 11%, 27%), 15% (6%, 20%), 15% ( , 22%), 12% (1%, 19%), and 11% (5%, 15%), respectively, under Representative Concentration Pathway 8.5. The positive association between temperature and BD in different climatic regions of China, and the projection for increased risk due to climate change, support efforts to mitigate future risks. https://doi.org/10.1289/EHP5779.

Objectives This study aimed to investigate the synergistic effects of co-exposure to occupational heat and noise on multi-system health outcomes among Chinese workers, and to examine the mediating role of systemic inflammation, indicated by white blood cell (WBC) count. Methods A cross-sectional analysis was conducted using data from the Fujian Workplace Occupational Hazards Comprehensive Surveillance Program (2020–2022), encompassing 10,275 workers from the manufacturing, petrochemical, mining, and construction industries. Multivariate logistic regression, relative excess risk due to interaction (RERI), random forest with SHAP values, and mediation analysis were used to explore interaction effects and mediating pathways. Results Co-exposure to heat and noise in the workplace was associated with increased risks of hypertension (OR = 1.94, 95%CI:1.61–2.36; RERI = 0.26, P interaction <0.001) and abnormal ECG (OR = 1.81, 95%CI:1.48–2.12; RERI = 0.16, P interaction <0.001), indicating synergistic effects beyond individual exposures. WBC partially mediated the effects of occupational heat and noise exposure on hypertension (heat: 9.2%; noise: 7.4%; co-exposure: 15.3%), liver dysfunction (heat: 5.4%; noise: 13.2%; co-exposure: 11.5%), and abnormal ECG findings (heat: 7.0%; noise: 6.4%; co-exposure: 8.7%). Machine learning models further confirmed that interaction between heat and noise was a stronger predictor of adverse health outcomes than either exposure alone. Conclusion Co-exposure to occupational heat and noise significantly exacerbates health risks across multiple organ systems, with systemic inflammation playing a partial mediating role. These findings highlight the importance of integrated occupational hazard assessments and targeted interventions that consider multiple concurrent occupational hazards.