Background/Objectives

Climate change means occupational illnesses and injuries related to heat stress are becoming a greater risk, affecting millions of workers across the globe, including those in the EU and USA. La Isla Network has implemented an integrated occupational heat stress intervention: PREP  (Protection Resilience Efficiency and Prevention) for workers at an industrial sugarcane plantation facing occupational heat stress in Nicaragua with wet bulb globe temperatures consistently exceeding 32°Celsius during the workday. PREP has expanded throughout Mesoamerica via a cooperative agreement with the U.S. Dept of Labor-International Labor Affairs Bureau and through a related program with DIAGEO to protect workers in their rum, cachaça and tequila supply chains. Contrary to ingrained biases that assume protecting workers is costly, PREP has led to a significant reduction in harm for workers, while increasing productivity and providing an ROI for the employer. We look now to bring lessons home to the USA with a primary focus on developing systems for the construction industry. We have already undertaken initial work with Turner Construction and garnered the interest of leading insurers. As we expand into new settings we are exploring the use of novel management systems and real time heat stress monitoring tech to improve outcomes for workers.

Approach/Activities

PREP undertakes fieldwork entailing the following: 1) sssessment of current knowledge, attitudes, policies and practices and primary exposures such as workload and heat strain via meassuremnet of core body temperature and their outcomes on worker health and productivity. This lays the foundation for the development of protocols that effectively protect workers and are viable for employers; 2) sddressing gaps in current knowledge, attitudes, policies, onsite practices and organizational systems and structures in a collaborative manner that immediately increases buy-in and provides insights into what shifts are required to implement the prescribed improvements; 3) sssistance in implementation through organizational management support and continued evaluation of the program by a transdisciplinary team of management professional, labor economists, physiologists, occupational health physicians, epidemiologists and occupational hygienists. Technology is being developed also to improve adherence.  The research in Nicaragua has a population of ~1500, the pilot study in the USA ~40.

Results/Lessons Learned

In Nicaragua, heat-related acute kidney injury (AKI) rates in conditions where heavy work and high temperatures intersect was much higher than previously thought, with hundreds of events occurring over a 6-year retrospective analysis. Despite inconsistent implementation of the program there was a 84% reduction in hospitalized AKI achieved, and other occupational injuries such as falls and cuts were also reduced. This success was accompanied by a 10 to 20% increase in productivity depending on job-category and despite a reduction in active work hours. A 22% positive ROI for the employer was garnered, subverting expectations of greater costs accompanying greater protection of the workforce. Preventative systems appear to be adequate via physiological assessment but adherence must be improved. The initial pilot with Turner Construction in the USA found that 43% of workers had elevated indicators of heat strain despite the assessment period being uncharacteristically cool for the midsummer evaluation period. This suggests that given the increase in frequency, intensity and duration of heatwaves in much of the USA that interventions are needed.  As we adapt to new settings, it is essential that implementation support is prioritized. Evaluation of new organizational management systems and technologies that allow for real time monitoring of heat strain in workers should be evaluated.