Extreme heat threatens the health of Australians

To the Editor:

Carey and colleagues are to be applauded for drawing attention to the potential impacts of extreme hot weather on the health of vulnerable groups in the community, particularly older people.1 However, in addition to the public health effects they covered, it is important to highlight the health impacts of high ambient temperature on Australian workers.

The working population, ranging widely in age, is subject to many of the factors described in the article that influence vulnerability to heat illness, including chronic diseases and medications used to manage these. In addition, workers are often exposed to other heat stress factors, such as requirements to wear restrictive, impermeable personal protective clothing or to operate heavy machinery. Occupational circumstances may limit opportunity for acclimatisation, rest breaks, maintenance of adequate hydration or access to assistance if heat illness arises.

A growing body of evidence shows associations between high ambient temperature and the risk of work-related injury.2,3 Importantly, this increased risk is not just observed among outdoor workers. Studies set in Adelaide2 and Melbourne3 have identified young workers (< 25 years of age) and male workers as being at increased risk of injury in association with increasing ambient daytime temperatures. Associations have also been observed between daily maximum temperature and risk of injury for workers engaged in occupations with the heaviest physical strength requirements (such as plumbers, paramedics and bricklayers).3 Moreover, a relationship has been observed between overnight temperatures and risk of injury for younger workers and female workers.3

In spite of climate projections for more frequent hot days and more severe heatwaves, there is currently a lack of specific and consistent policy and guidance targeting the work-related health impacts of hot weather.4 It is important that the health of workers and factors that influence their vulnerability to injury and illness are included in heat health discussions and are considered in the development of adaptive strategies.