Workers' health and productivity under occupational heat strain: a systematic review and meta-analysis
Summary: Background: Occupational heat strain (ie, the effect of environmental heat stress on the body) directly threatens workers' ability to live healthy and productive lives. We estimated the effects of occupational heat strain on workers' health and productivity outcomes. Methods: Fol...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2018-12-01
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| Series: | The Lancet Planetary Health |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2542519618302377 |
| _version_ | 1819074095895019520 |
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| author | Andreas D Flouris, PhD Petros C Dinas, PhD Leonidas G Ioannou, MSc Lars Nybo, ProfPhD George Havenith, ProfPhD Glen P Kenny, ProfPhD Tord Kjellstrom, ProfPhD |
| author_facet | Andreas D Flouris, PhD Petros C Dinas, PhD Leonidas G Ioannou, MSc Lars Nybo, ProfPhD George Havenith, ProfPhD Glen P Kenny, ProfPhD Tord Kjellstrom, ProfPhD |
| author_sort | Andreas D Flouris, PhD |
| collection | DOAJ |
| description | Summary: Background: Occupational heat strain (ie, the effect of environmental heat stress on the body) directly threatens workers' ability to live healthy and productive lives. We estimated the effects of occupational heat strain on workers' health and productivity outcomes. Methods: Following PRISMA guidelines for this systematic review and meta-analysis, we searched PubMed and Embase from database inception to Feb 5, 2018, for relevant studies in any labour environment and at any level of occupational heat strain. No restrictions on language, workers' health status, or study design were applied. Occupational heat strain was defined using international health and safety guidelines and standards. We excluded studies that calculated effects using simulations or statistical models instead of actual measurements, and any grey literature. Risk of bias, data extraction, and sensitivity analysis were performed by two independent investigators. Six random-effects meta-analyses estimated the prevalence of occupational heat strain, kidney disease or acute kidney injury, productivity loss, core temperature, change in urine specific gravity, and odds of occupational heat strain occurring during or at the end of a work shift in heat stress conditions. The review protocol is available on PROSPERO, registration number CRD42017083271. Findings: Of 958 reports identified through our systematic search, 111 studies done in 30 countries, including 447 million workers from more than 40 different occupations, were eligible for analysis. Our meta-analyses showed that individuals working a single work shift under heat stress (defined as wet-bulb globe temperature beyond 22·0 or 24·8°C depending on work intensity) were 4·01 times (95% CI 2·45–6·58; nine studies with 11 582 workers) more likely to experience occupational heat strain than an individual working in thermoneutral conditions, while their core temperature was increased by 0·7°C (0·4–1·0; 17 studies with 1090 workers) and their urine specific gravity was increased by 14·5% (0·0031, 0·0014–0·0048; 14 studies with 691 workers). During or at the end of a work shift under heat stress, 35% (31–39; 33 studies with 13 088 workers) of workers experienced occupational heat strain, while 30% (21–39; 11 studies with 8076 workers) reported productivity losses. Finally, 15% (11–19; ten studies with 21 721 workers) of individuals who typically or frequently worked under heat stress (minimum of 6 h per day, 5 days per week, for 2 months of the year) experienced kidney disease or acute kidney injury. Overall, this analysis include a variety of populations, exposures, and occupations to comply with a wider adoption of evidence synthesis, but resulted in large heterogeneity in our meta-analyses. Grading of Recommendations, Assessment, Development and Evaluation analysis revealed moderate confidence for most results and very low confidence in two cases (average core temperature and change in urine specific gravity) due to studies being funded by industry. Interpretation: Occupational heat strain has important health and productivity outcomes and should be recognised as a public health problem. Concerted international action is needed to mitigate its effects in light of climate change and the anticipated rise in heat stress. Funding: EU Horizon 2020 research and innovation programme. |
| first_indexed | 2024-12-21T18:04:04Z |
| format | Article |
| id | doaj.art-1c4132da3f984bf0929fd68b20a110e2 |
| institution | Directory Open Access Journal |
| issn | 2542-5196 |
| language | English |
| last_indexed | 2024-12-21T18:04:04Z |
| publishDate | 2018-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Planetary Health |
| spelling | doaj.art-1c4132da3f984bf0929fd68b20a110e22022-12-21T18:54:59ZengElsevierThe Lancet Planetary Health2542-51962018-12-01212e521e531Workers' health and productivity under occupational heat strain: a systematic review and meta-analysisAndreas D Flouris, PhD0Petros C Dinas, PhD1Leonidas G Ioannou, MSc2Lars Nybo, ProfPhD3George Havenith, ProfPhD4Glen P Kenny, ProfPhD5Tord Kjellstrom, ProfPhD6FAME Laboratory, Department of Exercise Science, University of Thessaly, Trikala, Greece; Human and Environmental Physiological Research Unit, Faculty of Health Sciences, University of Ottawa, Ottowa, ON, Canada; Correspondence to: Dr Andreas D Flouris, FAME Laboratory, Department of Exercise Science, University of Thessaly, Trikala 42100, GreeceFAME Laboratory, Department of Exercise Science, University of Thessaly, Trikala, GreeceFAME Laboratory, Department of Exercise Science, University of Thessaly, Trikala, Greece; Department of Nutrition, Exercise and Sports, August Krogh Building, University of Copenhagen, Copenhagen, Denmark; Centre for Technology Research and Innovation, Lemesos, CyprusDepartment of Nutrition, Exercise and Sports, August Krogh Building, University of Copenhagen, Copenhagen, DenmarkEnvironmental Ergonomics Research Centre, Loughborough Design School, Loughborough University, Loughborough, UKHuman and Environmental Physiological Research Unit, Faculty of Health Sciences, University of Ottawa, Ottowa, ON, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, CanadaCentre for Technology Research and Innovation, Lemesos, CyprusSummary: Background: Occupational heat strain (ie, the effect of environmental heat stress on the body) directly threatens workers' ability to live healthy and productive lives. We estimated the effects of occupational heat strain on workers' health and productivity outcomes. Methods: Following PRISMA guidelines for this systematic review and meta-analysis, we searched PubMed and Embase from database inception to Feb 5, 2018, for relevant studies in any labour environment and at any level of occupational heat strain. No restrictions on language, workers' health status, or study design were applied. Occupational heat strain was defined using international health and safety guidelines and standards. We excluded studies that calculated effects using simulations or statistical models instead of actual measurements, and any grey literature. Risk of bias, data extraction, and sensitivity analysis were performed by two independent investigators. Six random-effects meta-analyses estimated the prevalence of occupational heat strain, kidney disease or acute kidney injury, productivity loss, core temperature, change in urine specific gravity, and odds of occupational heat strain occurring during or at the end of a work shift in heat stress conditions. The review protocol is available on PROSPERO, registration number CRD42017083271. Findings: Of 958 reports identified through our systematic search, 111 studies done in 30 countries, including 447 million workers from more than 40 different occupations, were eligible for analysis. Our meta-analyses showed that individuals working a single work shift under heat stress (defined as wet-bulb globe temperature beyond 22·0 or 24·8°C depending on work intensity) were 4·01 times (95% CI 2·45–6·58; nine studies with 11 582 workers) more likely to experience occupational heat strain than an individual working in thermoneutral conditions, while their core temperature was increased by 0·7°C (0·4–1·0; 17 studies with 1090 workers) and their urine specific gravity was increased by 14·5% (0·0031, 0·0014–0·0048; 14 studies with 691 workers). During or at the end of a work shift under heat stress, 35% (31–39; 33 studies with 13 088 workers) of workers experienced occupational heat strain, while 30% (21–39; 11 studies with 8076 workers) reported productivity losses. Finally, 15% (11–19; ten studies with 21 721 workers) of individuals who typically or frequently worked under heat stress (minimum of 6 h per day, 5 days per week, for 2 months of the year) experienced kidney disease or acute kidney injury. Overall, this analysis include a variety of populations, exposures, and occupations to comply with a wider adoption of evidence synthesis, but resulted in large heterogeneity in our meta-analyses. Grading of Recommendations, Assessment, Development and Evaluation analysis revealed moderate confidence for most results and very low confidence in two cases (average core temperature and change in urine specific gravity) due to studies being funded by industry. Interpretation: Occupational heat strain has important health and productivity outcomes and should be recognised as a public health problem. Concerted international action is needed to mitigate its effects in light of climate change and the anticipated rise in heat stress. Funding: EU Horizon 2020 research and innovation programme.http://www.sciencedirect.com/science/article/pii/S2542519618302377 |
| spellingShingle | Andreas D Flouris, PhD Petros C Dinas, PhD Leonidas G Ioannou, MSc Lars Nybo, ProfPhD George Havenith, ProfPhD Glen P Kenny, ProfPhD Tord Kjellstrom, ProfPhD Workers' health and productivity under occupational heat strain: a systematic review and meta-analysis The Lancet Planetary Health |
| title | Workers' health and productivity under occupational heat strain: a systematic review and meta-analysis |
| title_full | Workers' health and productivity under occupational heat strain: a systematic review and meta-analysis |
| title_fullStr | Workers' health and productivity under occupational heat strain: a systematic review and meta-analysis |
| title_full_unstemmed | Workers' health and productivity under occupational heat strain: a systematic review and meta-analysis |
| title_short | Workers' health and productivity under occupational heat strain: a systematic review and meta-analysis |
| title_sort | workers health and productivity under occupational heat strain a systematic review and meta analysis |
| url | http://www.sciencedirect.com/science/article/pii/S2542519618302377 |
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