Extreme Heat and COVID-19: The Impact on the Urban Poor in Asia and Africa

The research on which this report was based was funded by the UK Research and Innovation and the Global Challenges Research Fund through the Economic and Social Research Council (Award ES/T008091/1) and by the Scottish Funding Council as part of Cool Infrastructures, a multi-disciplinary project into life with heat in global cities. We also thank the Norwegian Red Cross and Norwegian Ministry of Foreign Affairs for publication support.The study provides substantial new data on the direct as well as indirect impacts of the COVID-19 pandemic, thermal comfort and heat-related illness, in Jakarta (Indonesia), Hyderabad (India), Karachi and Hyderabad (Pakistan) and Douala (Cameroon). These cities are home to very large or rapidly growing low-income populations dealing with extreme heat. Alongside data on heat exposure and symptoms associated with heat-related illness, the report supplies supplementary data points on access to electricity, water, food, health services, as well as income and food intake during the COVID-19 pandemic, that will be of use to policy makers and researchers. The report is intended for use by governmental and non-governmental organisations in these cities and countries as they work to fine-tune policy and programme responses to the COVID-19 pandemic and avoid heat-related health impacts. Its broader findings are intended to be of use to inform interventions in urban areas facing similar challenges across Sub-Saharan Africa, South Asia and South East Asia

Heat-health vulnerabilities in the climate change context—comparing risk profiles between indoor and outdoor workers in developing country settings

Occupational heat stress is a crucial risk factor for a range of Heat-Related Illnesses (HRI). Outdoor workers in unorganized work sectors exposed to high ambient temperatures are at increased risk in developing countries. We aim to compare HRI, Productivity Loss (PL), and reduced renal health risk between workers from outdoor unorganized ( N = 1053) and indoor organized ( N = 1051) work sectors. Using descriptive methods and a large epidemiological cross-sectional study using mixed methods, we compared risk patterns between the two groups. We analyzed the risk of self-reported HRI symptoms, Heat Strain Indicators (HSIs), PL, and reduced kidney function using Multivariate Logistic Regression (MLR) models. Although Wet Bulb Globe Temperature (WBGT) exposures were high in both the outdoor and indoor sectors, significantly more Outdoor Unorganized Workers (OUWs) reported heat stress symptoms (45.2% vs 39.1%) among 2104 workers. OUWs had a significantly higher share of the heavy workload (86.7%) and long years of heat exposures (41.9%), the key drivers of HRIs, than the workers in indoor sectors. MLR models comparing the indoor vs outdoor workers showed significantly increased risk of HRI symptoms (Adjusted Odds Ratio) (AOR _outdoor = 2.1; 95% C.I:1.60–2.77), HSI (AOR _outdoor = 1.7; 95% C.I:1.00–2.93), PL (AOR _outdoor = 11.4; 95% C.I:7.39–17.6), and reduced kidney function (Crude Odds Ratio) (COR _outdoor = 1.4; 95% C.I:1.10–1.84) for the OUWs. Among the heat-exposed workers, OUW had a higher risk of HRI, HSI, and PL even after adjusting for potential confounders. The risk of reduced kidney function was significantly higher among OUWs, particularly for those with heat exposures and heavy workload (AOR _outdoor = 1.5; 95% C.I: 0.96–2.44, p = 0.073) compared to the indoor workers. Further, in-depth studies, protective policies, feasible interventions, adaptive strategies, and proactive mitigation efforts are urgently needed to avert health and productivity risks for a few million vulnerable workers in developing nations as climate change proceeds

Integrative Approach of MAP and Active Antimicrobial Packaging for Prolonged Shelf-Life of Composite Bottle Gourd Milk Cake

The current research explored the integrative effect of antimicrobial edible films and modified atmosphere packaging (MAP) on the quality parameters and shelf-life of bottle gourd burfi, which is a heat-desiccated composite Indian confection. The edible antimicrobial films prepared using a combination of nisin and natamycin (NANIF) were evaluated for their antimicrobial activity as the first line of defense against Bacillus cereus and Aspergillus niger. The product was wrapped in developed films, which was followed by flushing of the altered environment employing MAP in a closed PP box and evaluation during refrigerated storage at 4 ± 2 °C, comparing the product with the control counterpart. During this period, the physicochemical, sensory, and microbiological status of the product was assessed. Results indicated a significant (p ≤ 0.05) variance between the two kinds of samples wherein the antimicrobial film produced excellent results in terms of being less supportive toward microbial growth, thereby extending the life of film-treated samples beyond 35 days compared to the control (21 days). In addition, the product conformed to the legal standards of microbiological count well under the permissible limits laid by the FSSAI. Furthermore, the sensory characteristics of the product did not change much, illustrating the significance of the integrative approach

Impact of Zinc Oxide Nano Particles, Poly Vinyl Alcohol, and Natural Polymers on Quality Characteristics of Nanocomposite Film

The use of biodegradable films to replace the synthetic polymers prepared from natural polymers has been strongly limited owing to their poor barrier and mechanical properties. The modification was carried out with a partial replacement of natural polymers with synthetic polymer, such as PVA (poly vinyl alcohol), to increase the barrier properties of the film. The addition of an active ingredient in the form of nanoparticles such as Zinc Oxide (ZnO), enhanced the properties of the packaging materials compared to the conventional composite film, to which sonication imparted an excellent dispersion of nanoparticles in the slurry. The film thickness, water vapor permeability, film solubility, and mechanical properties of the composite, the composite with PVA, and the composite with PVA and ZnO nanoparticle film (active film) values differed significantly (p Bacillus cereus and Gram-negative Escherichia coli in the treated films counterpart to the control films. The active film conferred excellent mechanical and barrier properties, including antibacterial properties

Occupational Heat Stress Impacts on Health and Productivity in a Steel Industry in Southern India

Background: Workers laboring in steel industries in tropical settings with high ambient temperatures are subjected to thermally stressful environments that can create well-known risks of heat-related illnesses and limit workers’ productivity. Methods: A cross-sectional study undertaken in a steel industry in a city nicknamed “Steel City” in Southern India assessed thermal stress by wet bulb globe temperature (WBGT) and level of dehydration from urine color and urine specific gravity. A structured questionnaire captured self-reported heat-related health symptoms of workers. Results: Some 90% WBGT measurements were higher than recommended threshold limit values (27.2–41.7°C) for heavy and moderate workloads and radiational heat from processes were very high in blooming-mill/coke-oven (67.6°C globe temperature). Widespread heat-related health concerns were prevalent among workers, including excessive sweating, fatigue, and tiredness reported by 50% workers. Productivity loss was significantly reported high in workers with direct heat exposures compared to those with indirect heat exposures (χ2 = 26.1258, degrees of freedom = 1, p<0.001). Change in urine color was 7.4 times higher among workers exposed to WBGTs above threshold limit values (TLVs). Conclusion: Preliminary evidence shows that high heat exposures and heavy workload adversely affect the workers’ health and reduce their work capacities. Health and productivity risks in developing tropical country work settings can be further aggravated by the predicted temperature rise due to climate change, without appropriate interventions. Apart from industries enhancing welfare facilities and designing control interventions, further physiological studies with a seasonal approach and interventional studies are needed to strengthen evidence for developing comprehensive policies to protect workers employed in high heat industries

Heat stress and inadequate sanitary facilities at workplaces – an occupational health concern for women?

Background: Health concerns unique to women are growing with the large number of women venturing into different trades that expose them to hot working environments and inadequate sanitation facilities, common in many Indian workplaces. Objective: The study was carried out to investigate the health implications of exposures to hot work environments and inadequate sanitation facilities at their workplaces for women workers. Design: A cross-sectional study was conducted with 312 women workers in three occupational sectors in 2014–2015. Quantitative data on heat exposures and physiological heat strain indicators such as core body temperature (CBT), sweat rate (SwR), and urine specific gravity (USG) were collected. A structured questionnaire captured workers perceptions about health impacts of heat stress and inadequate sanitary facilities at the workplace. Results: Workplace heat exposures exceeded the threshold limit value for safe manual work for 71% women (Avg. wet bulb globe temperature=30°C±2.3°C) during the study period. Eighty-seven percent of the 200 women who had inadequate/no toilets at their workplaces reported experiencing genitourinary problems periodically. Above normal CBT, SwR, and USG in about 10% women workers indicated heat strain and moderate dehydration that corroborated well with their perceptions. Observed significant associations between high-heat exposures and SwR (t=−2.3879, p=0.0192), inadequate toilet facilities and self-reported adverse heat-related health symptoms (χ2=4.03, p=0.0444), and prevalence of genitourinary issues (χ2=42.92, p=0.0005×10−7) reemphasize that heat is a risk and lack of sanitation facilities is a major health concern for women workers. Conclusions: The preliminary evidence suggests that health of women workers is at risk due to occupational heat exposures and inadequate sanitation facilities at many Indian workplaces. Intervention through strong labor policies with gender sensitivity is the need of the hour to empower women, avert further health risks, and also enhance productivity for the few million women workers who contribute largely to the country's economy

Recurrence of pulmonary tuberculosis in India: Findings from the 2019-2021 nationwide community-based TB prevalence survey.

Recurrent Tuberculosis patients contribute to a significant proportion of TB burden in India. A nationwide survey was conducted during 2019-2021 across India among adults to estimate the prevalence of TB. A total of 322480 individuals were screened and 1402 were having TB. Of this, 381 (27.1%) had recurrent TB. The crude prevalence (95% CI) of recurrent TB was 118 (107-131) per 100,000 population. The median duration between episodes of TB was 24 months. The proportion of drug resistant TB was 11.3% and 3.6% in the recurrent group and new TB patients respectively. Higher prevalence of recurrent TB was observed in elderly, males, malnourished, known diabetics, smokers, and alcohol users. (p<0.001). To prevent TB recurrence, all treated tuberculosis patients must be followed at least for 24 months, with screening for Chest X-ray, liquid culture every 6 months, smoking cessation, alcohol cessation, nutritional interventions and good diabetic management