Abstract
Extreme temperature significantly affects workforce health during the summer in locations with sustained high temperatures. The exposure of workers to excessive heat has increased in the last decades, and it is correlated with reduced productivity and work efficiency. The effects of extreme heat on the health of outdoor workers in the southwestern USA were assessed using the heat index (HI) calculated using temperature and humidity information from National Oceanic and Atmospheric Administration and data on occupational injuries/illnesses from the US Bureau of Labor Statistics. The analysis of the data was performed using the Spearman’s rho nonparametric analysis. A statistically significant increase in the heat index was found in two of the three locations selected for this study. At the Phoenix Sky Harbor Airport (Phoenix, AZ) and Harry Reid International Airport (Las Vegas, NV) stations, seasonal maximum HI values exceeded the extreme danger threshold and seasonal average HI ranges were found within the dangerous range. The number of nonfatal occupational heat-related injuries/illnesses in Arizona, California, and Nevada were also analyzed and were found to be steadily increasing in all three states over the study period (2011–2018). The overall number of nonfatal occupational injuries/illnesses were also analyzed as a function of the length of service with the employer, which showed an increase in the number of events with an increase in the length of service. The time of the day and number of hours worked were also found to significantly affect the overall number of nonfatal occupational injuries/illnesses in the three locations studied. In addition, the number of days away from work after the occurrence of a heat-related, nonfatal occupational injury/illness event was significantly higher for events during which the worker remained away from work for more than 30 days. Results from this study suggest that extreme heat poses a real threat for outdoor workers and decision-making devoted to addressing this risk is required to prevent undesirable effects.
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References
Aboul-Enein F, Turkistani Y, Barnawi O et al (2020) The role of ambient temperature and plasma osmolarity on clinical outcomes of acute myocardial infarction patients during hajj. J Cardiol Res Rev Rep 1:1–7. https://doi.org/10.47363/JCRRR/2020(1)131
Alpers JP, Jones LK (2010) Natural history of exertional rhabdomyolysis: a population-based analysis. Muscle Nerve 42:487–491. https://doi.org/10.1002/mus.21740
Bandala ER, Kebede K, Jonsson N et al (2019) Extreme heat and mortality rates in Las Vegas, Nevada: inter-annual variations and thresholds. Int J Environ Sci Technol 16:7175–7186. https://doi.org/10.1007/s13762-019-02357-9
Benmarhina T, Schwarz L, Nori-Sarma A, Bell ML (2019) Quantifying the impact of changing the threshold of New York City heat emergency plan in reducing heat-related illnesses. Environ Res Lett 4:114006. https://doi.org/10.1088/1748-9326/ab402e
Bloch S (2020) Florida farm workers endure 116 dangerously hot working days every growing season. Laws to protect them have failed three years in a row. The Counter. Available on line at: https://thecounter.org/florida-laws-fail-to-protect-farm-workers-unsafe-working-days-due-to-heat/
Calkins MM, Bonauto D, Hajat A et al (2019) A case-crossover study of heat exposure and injury risk among outdoor construction workers in Washington State. Scand J Work Environ Health 45:588–599. https://doi.org/10.5271/sjweh.3814
Cervellin G, Comelli I, Lippi G (2010) Rhabdomyolysis: historical background, clinical, diagnostic and therapeutic features. Clin Chem Lab Med 48:749–756. https://doi.org/10.1515/CCLM.2010.151
Congress 116th (2019) H.R.3668-asuncion valdivia heat illness and fatality prevention Act of 2019. https://www.congress.gov/bill/116th-congress/house-bill/3668. Accessed 12 Jan 2020
Constable J (2020) Climate crisis: senate moves to protect workers from heat. In: Expert Blog page. https://www.nrdc.org/experts/juanita-constible/climate-crisis-senate-moves-protect-workers-heat. Accessed 12 Feb 2020
Curic M, Zafirovski O, Spiridonov V (2022) Heat and health. In: Curic M, Zafirovski O, Spiridonoc V (eds) Essentials of medical meteorology. Springer Cham, Switzerland, pp 1–9
de Carvalho JF, da Mota LM, Bonfa E (2011) Fatal rhabdomyolysis in systemic lupus erythematosus. Rheumatol Int 31:1243–1245. https://doi.org/10.1007/s00296-010-1674-0
Dutta P, Rajiva A, Andhare D et al (2015) Perceived heat stress and health effects on construction workers. Indian J Occup Environ Med 19:151–158. https://doi.org/10.4103/0019-5278.174002
Ebi KL, Balbus JM, Luber G et al (2018) Human health. In: Reidmiller DR, Avery CW, Easterling DR et al (eds) Impacts, risks, and adaptation in the United States: fourth national climate assessment volume II. U.S Global Change Research Program, Washington, pp 539–571
Faybishenko B, Verteeg R, Pastorello G et al (2021) Challenging problems of quality assurance and quality control (QA/QC) of meteorological time series data. Stoch Environ Res Risk Assess. https://doi.org/10.1007/s00477-021-0216-w
Formetta G, Feyen L (2019) Empirical evidence of declining global vulnerability to climate-related hazards. Glob Environ Change 57:101920. https://doi.org/10.1016/j.gloenvcha.2019.05.004
Golden JS, Hartz D, Brazel A et al (2008) A biometeorology study of climate and heat-related morbidity in Phoenix from 2001 to 2006. Int J Biometeorol 52:471–480. https://doi.org/10.1007/s00484-007-0142-3
Gronlund CJ (2014) Racial and socioeconomic disparities in heat-related health effects and their mechanisms: a review. Curr Epidemiol Rep 1:165–173. https://doi.org/10.1007/s40471-014-0014-4
Jacklitsch B, Williams JB, Musolin K et al (2016) NIOSH criteria for a recommended standard: occupational exposure to heat and hot environments. Department of Health and Human Services. Center for Disease Control and Prevention. National Institute for Occupational Safety and Health. DHHS (NIOSH) Publication 2016-106, p. 192. Available on line at: https://www.cdc.gov/niosh/docs/2016-106/pdfs/2016-106.pdf
Jackson LL, Rosenberg HR (2010) Preventing heat-related illness among agricultural workers. J Agromed 15:200–215. https://doi.org/10.1080/1059924X.2010.487021
Jayasekara KB, Kulasooriya PN, Wijayasiri KN et al (2019) Relevance of heat stress and dehydration to chronic kidney disease (CKDu) in Sri Lanka. Prev Med Reports 15:100928. https://doi.org/10.1016/j.pmedr.2019.10098
Lafakis C, Ratz L, Fazlo E, Cosma M (2019) The economic implications of climate change, London
Lehman HE (2020) Hidden heat: the costly impact of heat-related injuries. In: North Am Clean Energy. https://www.nacleanenergy.com/energy-efficiency/hidden-heat-the-costly-impact-of-heat-related-injuries. Accessed 3 Apr 2022
Lucas RAI, Epstein Y, Kjellstrom T (2014) Excessive occupational heat exposure: a significant ergonomic challenge and health risk for current and future workers. Extreme Physiol Med 3:1–8. https://doi.org/10.1186/2046-7648-3-14
Mannheimer B, Sterea-Grossu A, Falhammar H et al (2022) Current and future burdens of heat-related hyponatremia - a nationwide register-based study. J Clin Endocrinol Metab. https://doi.org/10.1210/clinem/dgac103
Martínez-Austria P, Bandala ER (2018) Heat waves: health effects, observed trends and climate change. Extreme Weather. https://doi.org/10.5772/intechopen.75559
Martínez-Austria PF, Bandala ER, Patiño-Gómez C (2016) Temperature and heat wave trends in northwest Mexico. Phys Chem Earth 91:20–26. https://doi.org/10.1016/j.pce.2015.07.005
Martinez-Austria PF, Bandala ER (2017) Temperature and heat-related mortality trends in the Sonoran and Mojave Desert region. Atmosphere (basel). https://doi.org/10.3390/atmos8030053
Miller VS, Bates GP (2007) The thermal work limit is a simple reliable heat index for the protection of workers in thermally stressful environments. Ann Work Expo Health 51:553–561. https://doi.org/10.1093/annhyg/mem035
Moda HM, Filho WL, Minhas A (2019a) Impacts of climate change on outdoor workers and their safety: some research priorities. Int J Environ Res Public Health 16:3458. https://doi.org/10.3390/ijerph16183458
Moda HM, Filho WL, Minhas A (2019b) Impacts of climate change on outdoor workers and teir safety: some research priorities. Int J Environ Res Public Health 16:3458. https://doi.org/10.3390/ijerph16183458
National Weather Service (2021) What is the heat index? In: Web page. https://www.weather.gov/ama/heatindex. Accessed 3 Feb 2022
NOAA (2016) Weather Prediction Center. In: http://www.wpc.ncep.noaa.gov/html/heatindex.shtml. http://www.wpc.ncep.noaa.gov/html/heatindex.shtml
Opitz-Stapleton S, Sabbag L, Hawley K et al (2016) Heat index trends and climate change implications for occupational heat exposure in Da Nang Vietnam. Clim Serv 2–3:41–51. https://doi.org/10.1016/j.cliser.2016.08.001
Quandt SA, Wiggins MF, Chen H, Bischoff WE (2013) Heat index in migrant farmworker housing : implications for rest and recovery from work-related heat stress. Am J Public Health 103:24–27. https://doi.org/10.2105/AJPH.2012.301135
Ramirez-Beltran ND, Gonzalez JE, Castro JM et al (2017) Analysis of the heat index in the Mesoamerica and Caribbean region. J Appl Meteorol Climatol 56:2905–2925. https://doi.org/10.1175/JAMC-D-16-0167.1
Reich BJ, Shaby BA, Colley D (2014) A hierarchical model for seriallydependent extremes: a study of heat waves in the western US. J Agric Biol Environ Stat 19:119–135. https://doi.org/10.1007/s13253-013-0161-y
Rother H, John J, Wright CY et al (2020) Perceptions of occupational heat, sun exposure, and health risk prevention : a qualitative study of forestry workers in South Africa. Atmosphere (basel) 11:37–56. https://doi.org/10.3390/atmos11010037
Runkle JD, Cui C, Fuhrmann C et al (2019) Evaluation of wearable sensors for physiologic monitoring of individually experienced temperatures in outdoor workers in Southeastern U.S. Environ Int 129:229–238. https://doi.org/10.1016/j.envint.2019.05.026
Sailor DJ, Anand J, Kalkstein L (2021) Potential overall heat exposure reduction associated with implementation of heat mitigation strategies in Los Angeles. Int J Biometeorol 65:407–418. https://doi.org/10.1007/s00484-020-01954-5
Sainato M (2020) Rising temperatures put more US workers at risk of dying from heat. The Guardian. available on line at: https://www.theguardian.com/us-news/2020/jan/22/heat-deaths-workers-safety-climate-crisis
Sampson NR, Gronlund CJ, Buxton MA et al (2013) Staying cool in a changing climate: reaching vulnerable populations during heat events. Glob Environ Change 23:475–484. https://doi.org/10.1016/j.gloenvcha.2012.12.011.Staying
Sanderson M, Arbuthnott K, Kovats S et al (2017) The use of climate information to estimate future mortality from high ambient temperature: a systematic literature review. PLoS ONE 12:e0180369. https://doi.org/10.1371/journal.pone.0180369
Schwarz L, Malig B, Guzman-Morales J et al (2020) The health burden of fall, winter and spring extreme heat events in Southern California and contribution of Santa Ana Winds. Environ Res Lett 15:054017. https://doi.org/10.1088/1748-9326/ab7F0e
Sheridan SC, Kalkstein AJ, Kalkstein LS (2009) Trends in heat-related mortality in the United States, 1975–2004. Nat Hazards 50:145–160. https://doi.org/10.1007/s11069-008-9327-2
Stapleton S, Sabbag L, Hawley K, Tran P, Hoang L, Nguyen HP (2016) Heat index trends and climate change implication for occupational heat exposure. Clim Serv 2–3:41–51
Stoecklin-Marois M, Hennessy-Burt T, Mitchell D, Schenker M (2013) Heat-related illness knowledge and practices among California hired farm workers in the MICASA study. Ind Health 51:47–55. https://doi.org/10.2486/indhealth.2012-0128
Tigchelaar M, Battisti D, Spector J (2020) Work adaptations insufficient to address growing heat risk for US agricultural workers. Environ Res Lett 15:094035. https://doi.org/10.1088/1748-9326/ab86f4
Tymvios N, Behm M, Jia YA (2019) Heat illness: a descriptive analysis withi the U.S. construction industry. Prof Saf 64:40–45
Uejio CK, Wilhelmi OV, Golden JS, Mills DM et al (2011) Intra-urban societal vulnerability to extreme heat: the role of heat exposure and the built environment, socioeconomics, and neighborhood stability. Heal Place 17:498–507. https://doi.org/10.1016/j.healthplace.2010.12.005
Vecellio D, Wolf ST, Cottle RM, Kenney WL (2022) Evaluating the 35°C wet-bulb temperature adaptability threshold for young, healthy subjects (PSU HEAT Project). J Appl Physiol 132:340–345. https://doi.org/10.1152/japplphysiol.00738.2021
Wyatt BM, Ochsner TE, Brown WG et al (2021) MesoSoil v2.0: An updated soil physical property database for the Oklahoma Mesonet. Vadose Zone J 20:e20134. https://doi.org/10.1002/vzj2.20134
**ang J, Hansen A, Pisaniello D, Bi P (2016) Workers ’ perceptions of climate change related extreme heat exposure in South Australia : a cross-sectional survey. BMC Public H 16:549. https://doi.org/10.1186/s12889-016-3241-4
Ye X, Wolff R, Yu W et al (2012) Ambient temperature and morbidity: a review of epidemiological evidence. Environ Health Perspect 120:19–28. https://doi.org/10.1289/ehp.1003198
Zanobetti A, O’Neill MS, Gronlund CJ, Schwartz JD (2013) Susceptibility to mortality in weather extremes: assessing effect modification by zipcode area level characteristic, personal characteristics and specific cause of admission in a multi-city case-only analysis. Epidemiology 24:809–819. https://doi.org/10.1164/ajrccm-conference.2012.185.1
Acknowledgements
This work was partially funded by NOAA/IRAP (Grant no. NA18AR4310341). This publication was made possible by a grant from the National Institute of General Medical Sciences (GM103440) from the National Institutes of Health. The authors also thank Ms. Nicole Damon (DRI) for her editorial review.
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In memoriam, Polioptro F. Martinez-Austria (1956-2022), dear friend, co-author, and devoted advocate for prevention of extreme heat effects.
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Bandala, E.R., Brune, N. & Kebede, K. Assessing the effect of extreme heat on workforce health in the southwestern USA. Int. J. Environ. Sci. Technol. 20, 2995–3008 (2023). https://doi.org/10.1007/s13762-022-04180-1
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DOI: https://doi.org/10.1007/s13762-022-04180-1