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Objectives The primary objective of this study was to assess the relationship between heat exposure and occupational traumatic injuries among construction workers. Methods We assessed the relationship between humidex, a measure of apparent temperature, and Washington State Fund workers' compensation injuries among outdoor construction workers using a case-crossover design with time-stratified referent selection. Warm month (March-October) adult outdoor construction traumatic injury claims from 2000-2012 were spatiotemporally joined with high-resolution meteorological data. We used conditional logistic regression with linear splines to assess the association between maximum daily humidex and injuries. Results There were 63 720 occupational traumatic injury claims in construction that met our eligibility criteria during the study period. The traumatic injury odds ratio (OR) was 1.005 [95% confidence interval (CI) 1.003-1.007] per one °C change in humidex. In the spline analyses, we observed a nearly linear association of humidex with the risk of a traumatic injury. Effect estimates were higher among younger (18-24 years) and older (>54 years) workers, workers with lower extremity injuries, workers with less job experience, smaller employers, workers working in Western Washington, and time of injury before 12:30 hours, although CI of effect estimates overlapped in stratified analysis categories. Conclusions In this study of Washington outdoor construction workers, increasing maximum daily humidex was associated with increasing traumatic injury risk. Further work should explore mechanisms of the association between heat exposure and traumatic injuries. Injury prevention efforts targeted at construction should address heat-related risk factors. In addition, heat awareness campaigns should address outcomes beyond heat-related illness.

Climate change poses increasing risks to outdoor occupations, including construction work. This study explores how vulnerability is constructed in narratives of manual labour within the Swedish construction sector, particularly under extreme weather conditions. Drawing on 16 qualitative interviews with Swedish construction workers, the study adopts a social constructionist lens to explore how vulnerability is shaped and experienced. The findings identify multiple, intersecting forms of vulnerability-bodily, hierarchical, material, social, and market-driven-exacerbated by climate-related challenges such as high temperatures, heavy rainfall, and strong winds. Crucially, the analysis highlights how extreme weather disrupts temporal rhythms, widening the gap between scheduled work plans and the actual time needed to complete tasks. The paper concludes that vulnerability arises not only from direct exposure to adverse weather, but also through indirect social, material, and temporal dynamics inherent in the construction sector and exacerbated by climate change.

Occupational heat exposure is associated with substantial morbidity and mortality among outdoor workers. We sought to descriptively evaluate spatiotemporal variability in heat threshold exceedances and describe potential impacts of these exposures for crop and construction workers. We also present general considerations for approaching heat policy-relevant analyses. We analyzed county-level 2011–2020 monthly employment (Bureau of Labor Statistics Quarterly Census of Employment and Wages) and environmental exposure (Parameter-elevation Relationships on Independent Slopes Model (PRISM)) data for Washington State (WA), USA, crop (North American Industry Classification System (NAICS) 111 and 1151) and construction (NAICS 23) sectors. Days exceeding maximum daily temperature thresholds, averaged per county, were linked with employment estimates to generate employment days of exceedances. We found spatiotemporal variability in WA temperature threshold exceedances and crop and construction employment. Maximum temperature exceedances peaked in July and August and were most numerous in Central WA counties. Counties with high employment and/or high numbers of threshold exceedance days, led by Yakima and King Counties, experienced the greatest total employment days of exceedances. Crop employment contributed to the largest proportion of total state-wide employment days of exceedances with Central WA counties experiencing the greatest potential workforce burden of exposure. Considerations from this analysis can help inform decision-making regarding thresholds, timing of provisions for heat rules, and tailoring of best practices in different industries and areas.

(1) Solar ultraviolet radiation (UVR) poses a major risk factor for developing skin cancer after years of chronic exposure. The irradiation is strongly dependent upon the activity or occupation carried out, but also on the climate conditions at the workplace. Knowledge of both has been tested within the occupational group of road construction workers in Colombia and Germany. (2) The GENESIS-UV measurement system has been used at both locations for consistency. A number of workers in both countries wore an electronic data logging dosimeter for several months to deliver detailed information on UVR exposure. (3) It was found that in a tropical climate, UVR exposure remains constant throughout the year, while in a temperate climate seasonal effects are visible, superimposed by behavioural aspects e.g., in springtime. The daily distribution of the radiation shows a distinct dip, especially in the Colombian data. Derived data show the high fraction of working days exceeding a threshold set by the skin type. (4) Road construction work involves high UVR exposure. In both countries, preventive measures are required to reduce the personal exposure to a minimum. Exceedance of the minimal erythema dose (MED) suggests a possible enhancing effect, especially in fair skinned people. Intercomparison of UVR exposure at workplaces is possible between countries and climate zones, emphasizing efforts for global action against skin cancer.

Climate change is one of the most important current threats to global health. Outdoor workers are among the most vulnerable people to its effects. The aim of this systematic review is to assess the occupational risks related to climate change, investigating health outcomes in outdoor workers and estimating its impact in the occupational context. The review was performed following PRISMA guidelines, screening three databases (PubMed, Web of Science, and Scopus). Studies written in English or Italian languages, performed on outdoor workers, assessing occupational risks linked to climate change, and reporting on health outcomes were included. A quality assessment was performed using the Newcastle–Ottawa Scale. Thirteen studies were included in the review, performed mostly on construction (seven studies, 53.8%) and agricultural (five studies, 38.5%) workers. Twelve of the included studies (92.3%) reported on occupational risks related to heat stress, one on the effects of cold weather. Four studies (30.8%) reported a high prevalence of heat-related symptoms, ranging from 64.0% to 90.3% of workers. This systematic review highlights heat-related stress in outdoor workers as an important occupational risk, but it also underlines an important gap in scientific knowledge regarding other occupational risks relating to climate change.

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.

Background Women in India’s informal economy face significant occupational health risks that remain largely undocumented and unaddressed. With limited labour protections and inadequate access to health services, informal women workers (IWWs) experience overlapping vulnerabilities related to gender, work conditions, and environmental exposures. This study explored the multi-level determinants of health among IWWs in Ahmedabad, India, to inform gender-responsive integration of occupational health within primary health care systems. Methods A qualitative study was conducted using focus group discussions (FGDs) guided by the Socioecological Model (SEM). Five FGDs were held with 41 women representing key occupational groups—agricultural workers, construction workers, street vendors, home-based workers, and waste recyclers. Discussions were recorded, transcribed, translated, and thematically analysed. Themes were organized across SEM domains: intrapersonal, interpersonal, organizational, community, and policy levels. Findings Participants reported multiple, intersecting health risks such as musculoskeletal disorders, respiratory problems, skin irritation, and heat-related illnesses. Psychological stress, economic insecurity, and work-family conflict were pervasive, compounded by gendered expectations and absence of social protection. Poor workplace infrastructure, including lack of sanitation and shade exacerbated illness and fatigue. Many women avoided drinking water due to lack of toilets, leading to dehydration and urinary problems. Health-seeking behaviour was shaped by trust and convenience; private clinics were preferred over public facilities despite higher costs. Awareness of government schemes such as Ayushman Bharat and e-Shram was limited. Participants expressed demand for pensions, maternity protection, and home-based livelihood support. Conclusion Findings underscore the urgent need for gender-responsive occupational health integration into primary health care system. The study informed a national policy roundtable that convened key stakeholders to co-develop actionable recommendations to improve occupational health coverage for women in India’s informal economy.

Background: The relationship between occupational sun exposure and melanoma risk is complex and multifaceted, with existing evidence yielding contradictory findings. Unlike Non-Melanoma Skin Cancer (NMSC), for which occupational sun exposure is a well-established risk factor, the link with cutaneous melanoma remains contentious. Objectives: This study aimed to evaluate whether, in a cohort of patients with cutaneous melanoma, an association existed between occupational sun exposure and melanoma, specifically with histotype, site of occurrence, and Breslow index. Methods: This is a retrospective cohort analysis conducted to evaluate whether occupational sun exposure constitutes a risk factor for the development of cutaneous melanoma in patients diagnosed between January 2005 and October 2023 at the Dermatology Unit, Azienda USL Toscana Centro, Florence. Occupational ultraviolet (UV) exposure was examined by classifying each participant’s job into categories based on solar UV exposure levels—outdoor (e.g., agriculture and construction roles), mixed indoor/outdoor (e.g., trades and public safety professions), and indoor settings (e.g., office-based work). Results: A final total of 1417 patients were analyzed. Occupational categorization revealed that 1171 patients (82.64%) were classified as non-occupationally exposed (indoor), while 246 (17.36%) were occupationally exposed to solar UV radiation (including 14.82% mixed indoor/outdoor and 2.54% outdoor workers). A significant association was observed between occupational sun exposure and lentigo maligna, which was more prevalent among exposed workers and even more so in the outdoor subgroup. Anatomical site distribution exhibited a significant association with occupational sun exposure. Indeed occupationally exposed individuals showed a higher prevalence of melanomas in the head and neck region, a distribution pattern particularly evident among outdoor workers, suggesting that these sites may be more susceptible to chronic sun exposure in outdoor and mixed occupations. Moreover, a significant association was found between occupational exposure and Breslow thickness, with exposed workers presenting with thicker melanomas at diagnosis, suggesting more advanced disease. Conclusions: The finding of this study may reflect variations in occupational sun exposure patterns and warrants further investigation into protective measures and early-detection strategies tailored to occupational groups.

Background: A set of four case-control (n = 109), randomized-controlled (n = 7), cross-sectional (n = 78), and intervention (n = 47) studies was conducted across three countries to investigate the effects of sun exposure on worker physiology and cognition. Methods: Physiological, subjective, and cognitive performance data were collected from people working in ambient conditions characterized by the same thermal stress but different solar radiation levels. Results: People working under the sun were more likely to experience dizziness, weakness, and other symptoms of heat strain. These clinical impacts of sun exposure were not accompanied by changes in core body temperature but, instead, were linked with changes in skin temperature. Other physiological responses (heart rate, skin blood flow, and sweat rate) were also increased during sun exposure, while attention and vigilance were reduced by 45% and 67%, respectively, compared to exposure to a similar thermal stress without sunlight. Light-colored clothes reduced workers’ skin temperature by 12–13% compared to darker-colored clothes. Conclusions: Working under the sun worsens the physiological heat strain experienced and compromises cognitive function, even when the level of heat stress is thought to be the same as being in the shade. Wearing light-colored clothes can limit the physiological heat strain experienced by the body.

IntroductionSquamous cell carcinoma and multiple actinic keratoses caused by solar ultraviolet radiation (UVR) are among the most frequently recognised occupational diseases in Germany. Employees who regularly work outdoors, for example, in the construction industry, agriculture, forestry and gardening, are at a higher risk of developing occupational skin cancer. However, sun-safety behaviour in outdoor workers is currently insufficient. Therefore, this study aims to investigate the effectiveness of an intervention to increase sunscreen use among outdoor workers.Methods and analysisIn this non-randomised, controlled intervention study, 234 outdoor workers from different companies in industries with outdoor working activities based in Germany will be included. The study population, aged 18 years and above, has to be intensively exposed to solar UVR of regularly 1 hour or more per day. The intervention group will receive a sunscreen package as well as health education. The control group follows the practice in their companies (‘treatment-as-usual’). At the beginning of the study, after 3 months and at the end of the study (after 6 months), both groups filled in different questionnaires. In addition, stratum corneum (SC) samples will be collected at the beginning and after 3 months. The primary outcome—increase in the frequency of sunscreen use during work and in leisure time—will be assessed from data on self-reported sunscreen use. The secondary outcomes include sun protection behaviour, knowledge about sun protection and skin cancer, and acceptance of the provided sunscreens. Further secondary outcomes include internal UV dose and UV-related immune response, determined by the levels of SC biomarkers. Data will be analysed using both descriptive and inferential methods.Ethics and disseminationThe study protocol followed the principles of the Declaration of Helsinki (2013) and was approved by the Ethics Committee of Osnabrück University, Germany (reference Ethik-37/2024). Study results will be disseminated through peer-reviewed publications and conference presentations.Trial registration numberDRKS00035178.