The ‘Hothaps’ programme for assessing climate change impacts on occupational health and productivity: an invitation to carry out field studies

The ‘high occupational temperature health and productivity suppression’ programme (Hothaps) is a multi-centre health research and prevention programme aimed at quantifying the extent to which working people are affected by, or adapt to, heat exposure while working, and how global heating during climate change may increase such effects. The programme will produce essential new evidence for local, national and global assessment of negative impacts of climate change that have largely been overlooked. It will also identify and evaluate preventive interventions in different social and economic settings

Heat stress, health and well-being: findings from a large national cohort of Thai adults

OBJECTIVES This study aims to examine the association between self-reported heat stress interference with daily activities (sleeping, work, travel, housework and exercise) and three graded-holistic health and well-being outcomes (energy, emotions and life satisfaction). DESIGN A cross-sectional study. SETTING The setting is tropical and developing countries as Thailand, where high temperature and high humidity are common, particularly during the hottest seasons. PARTICIPANTS This study is based on an ongoing national Thai Cohort Study of distance-learning open-university adult students (N=60 569) established in 2005 to study the health-risk transition. PRIMARY AND SECONDARY OUTCOME MEASURES Health impacts from heat stress in our study are categorised as physical health impacts (energy levels), mental health impacts (emotions) and well-being (life satisfaction). For each health and well-being outcome we report ORs and 95% CIs using multinomial logistic regression adjusting for a wide array of potential confounders. RESULTS Negative health and well-being outcomes (low-energy level, emotional problems and low life satisfaction) associated with increasing frequency of heat stress interfering with daily activities. Adjusted ORs for emotional problems were between 1.5 and 4.8 and in general worse than energy level (between 1.31 and 2.91) and life satisfaction (between 1.10 and 2.49). The worst health outcomes were when heat interfered with sleeping, followed by interference with daily travel, work, housework and exercise. CONCLUSIONS In tropical Thailand there already are substantial heat stress impacts on health and well-being. Increasing temperatures from climate change plus the ageing and urbanisation of the population could significantly worsen the situation. There is a need to improve public health surveillance and public awareness regarding the risks of heat stress in daily life.The International Collaborative Research Grants Scheme with joint grants from the Wellcome Trust UK (GR071587MA) and the Australian National Health and Medical Research Council (NHMRC 268055), and as a global health grant from the NHMRC (585426)

Identifying Priority Health Conditions, Environmental Data, and Infrastructure Needs: A Synopsis of the Pew Environmental Health Tracking Project

In this article we describe the methodologic approaches of the Pew Environmental Health Commission at the Johns Hopkins Bloomberg School of Public Health used to identify priority environmental health conditions and develop recommendations to establish a national environmental public health tracking network. We present the results of a survey of public health and environmental practitioners to uncover state and local health tracking needs and priorities. We describe the steps that combined the findings from the state and local health tracking survey and a review of the state of the science on environmental impacts on health to identify priority health end points. Through an examination of national health and health care databases, we then describe trends and public health effects of those diseases that may be linked to the environment. Based on this analysis, respiratory diseases and neurologic diseases are recommended as priorities for tracking. Specific end points recommended for tracking include asthma and chronic respiratory diseases, and chronic neurodegenerative diseases such as multiple sclerosis. Based on trends in reported prevalence, consideration should also be given to developmental disabilities, reproductive disorders, and endocrine/metabolic disorders. Strengthening of current efforts to track cancer and birth defects should also be included as components of a nationwide health tracking network. Finally, we present the recommendations for environmental public health tracking. These recommendations provided the groundwork for the development of the Centers for Disease Control and Prevention’s National Environmental Public Health Tracking Progam that now includes 21 states, three cities, and three academic centers throughout the nation

Climate change and occupational health: A South African perspective

A number of aspects of human health are caused by, or associated with, local climate conditions, such as heat and cold, rainfall, wind and cloudiness. Any of these aspects of health can also be affected by climate change, and the predicted higher temperatures, changes in rainfall, and more frequent extreme weather conditions will create increased health risks in many workplaces. Important occupational health risks include heat stress effects, injuries due to extreme weather, increased chemical exposures, vector-borne diseases and under-nutrition.  In South Africa (SA), and many other parts of the world experiencing a hot season each year, the effects of heat stress may be of greatest relevance to the large working populations in mining, agriculture, construction, quarries and outdoor services. Factory and workshop heat will also become an increasing problem in the numerous workplaces without effective cooling systems. SA was the location for some of the most detailed research on heat effects at work in mines in the 1950s and 1960s, and the future will bring new challenges not only for mines, but also for many other workplaces. The climate model trends for this century indicate that the heat exposure may increase by 2 - 4°C during the hottest months, and this would change the occupational heat situation from ‘low risk’ to ‘moderate or high risk’ in much of SA.

The association between overall health, psychological distress, and occupational heat stress among a large national cohort of 40,913 Thai workers

Background: Occupational heat stress is a well-known problem, particularly in tropical countries, affecting workers, health and well-being. There are very few recent studies that have reported on the effect of heat stress on mental health, or overall health in workers, although socioeconomic development and rapid urbanization in tropical developing countries like Thailand create working conditions in which heat stress is likely. Objective: This study is aimed at identifying the relationship between self-reported heat stress and psychological distress, and overall health status in Thai workers. Results: 18% of our large national cohort (>40,000 subjects) often works under heat stress conditions and males are exposed to heat stress more often than females. Furthermore, working under heat stress conditions is associated with both worse overall health and psychological distress (adjusted odds ratios ranging from 1.49 to 1.84). Conclusions: This association between occupational heat stress and worse health needs more public health attention and further development on occupational health interventions as climate change increases Thailand's temperatures

Comparisons of urban and rural heat stress conditions in a hot–humid tropical city

Background: In recent years the developing world, much of which is located in the tropical countries, has seen dramatic growth of its urban population associated with serious degradation of environmental quality. Climate change is producing major impacts including increasing temperatures in these countries that are considered to be most vulnerable to the impact of climate change due to inadequate public health infrastructure and low income status. However, relevant information and data for informed decision making on human health and comfort are lacking in these countries. Objective: The aim of this paper is to study and compare heat stress conditions in an urban (city centre) and rural (airport) environments in Akure, a medium-sized tropical city in south-western Nigeria during the dry harmattan season (January–March) of 2009. Materials and methods: We analysed heat stress conditions in terms of the mean hourly values of the thermohygrometric index (THI), defined by simultaneous in situ air temperature and relative humidity measurements at both sites. Results: The urban heat island (UHI) exists in Akure as the city centre is warmer than the rural airport throughout the day. However, the maximum UHI intensity occurs at night between 1900 and 2200 hours local time. Hot conditions were predominant at both sites, comfortable conditions were only experienced in the morning and evenings of January at both sites, but the rural area has more pleasant morning and evenings and less of very hot and torrid conditions. January has the lowest frequency of hot and torrid conditions at both sites, while March and February has the highest at the city centre and the airport, respectively. The higher frequencies of high temperatures in the city centre suggest a significant heat stress and health risk in this hot humid environment of Akure. Conclusions: More research is needed to achieve better understanding of the seasonal variation of indoor and outdoor heat stress and factors interacting with it in order to improve the health, safety, and productivity of Akure city dwellers

Case studies on heat stress related perceptions in different industrial sectors in southern India

Linkages between thermal loads and its physiological consequences have been widely studied in non-tropical developed country settings. In many developing countries like India, despite the widespread recognition of the problem, limited attempts have been made to estimate health impacts related to occupational heat stress and fewer yet to link heat stress with potential productivity losses. This is reflected in the ubiquity of workplaces with limited or no controls to reduce exposures. As a prelude to understanding the feasibility of alternative interventions in different industrial sectors, we present case studies from 10 different industrial units in Tamil Nadu, Chennai, which describe perceptions of occupational heat stress among the workers and supervisors/management

Invited Editorial: Health as a crucial driver for climate policy

Health impacts of climate change and the need to prevent them should be at centre stage of the ongoing debate on climate policies (1). We have specifically prepared this series of papers to be available for the COP151 conference in Copenhagen, to which the world looks to agree on targets and procedures to reduce greenhouse gas (GHG) emissions on the basis of fair burden-sharing between high and low-income countries

Prenatal Methylmercury Exposure and Developmental Outcomes: Review of the Evidence and Discussion of Future Directions

I conducted a review of the published literature to assess the strength of the evidence for an association between prenatal exposure to methylmercury (MeHg) and subsequent child development. I identified 12 studies on this subject published since 1980. Of these, 3 were longitudinal studies—2 conducted in the Seychelle Islands, and 1 in the Faroe Islands. Nine were cross-sectional studies conducted in different countries where seafood, a source of MeHg, constituted a major part of the diet. The ages of the children studied ranged from 2 weeks to 12 years. The results of the longitudinal studies were contradictory. Researchers in the Faroe Islands identified an association between MeHg exposure and developmental effects, whereas those in the Seychelle Islands identified no such association. This inconsistency was mirrored in the results of the cross-sectional studies where there were some positive and some negative findings. It was concluded that it was not possible from currently available data to determine whether there is an association between prenatal MeHg exposure and adverse developmental effects in children. In advance of future research, consideration should be given to resolving the uncertainties surrounding exposure assessment and outcome measurement, as both elements varied between studies. It was suggested that questions of exposure assessment would benefit from the application of an expert review process. Outcome assessment would benefit from the development of theoretically based measures of specific aspects of cognitive functioning to replace the relatively crude measures of attainment and IQ currently employed in most studies. This would assist in the development of classic longitudinal studies by allowing repeated assessment over the full age range and providing data that are more readily interpretable and comparable between studies