Health vs. wealth: Employer, employee and policy-maker perspectives on occupational heat stress across multiple European industries

Abstract

Successful implementation of cooling strategies obviously depends on identifying effective interventions, but in industrial settings, it is equally important to consider feasibility and economic viability. Many cooling interventions are available, but the decision processes affecting adoption by end-users are not well elucidated. We therefore arranged two series of meetings with stakeholders to identify knowledge gaps, receive feedback on proposed cooling interventions, and discuss factors affecting implementation of heat-health interventions. This included four meetings attended by employers, employees, and health and safety officers (n = 41), and three meetings attended primarily by policy makers (n = 74), with feedback obtained via qualitative and quantitative questionnaires and focus group discussions. On a 10-point scale, both employers and employees valued worker safety (9.1 ± 1.8; mean±SD) and health (8.5 ± 1.9) as more important than protecting company profits (6.3 ± 2.3). Of the respondents, 41% were unaware of any cooling strategies at their company and of those who were aware, only 30% thought the interventions were effective. Following presentation of proposed interventions, the respondents rated "facilitated hydration", "optimization of clothing/protective equipment", and "rescheduling of work tasks" as the top-three preferred solutions. The main barriers for adopting cooling interventions were cost, feasibility, employer perceptions, and legislation. In conclusion, preventing negative health and safety effects was deemed to be more important than preventing productivity loss. Regardless of work sector or occupation, both health and wealth were emphasized as important parameters and considered as somewhat interrelated. However, a large fraction of the European worker force lacks information on effective measures to mitigate occupational heat stress.

The HEAT-SHIELD project — Perspectives from an inter-sectoral approach to occupational heat stress

“…57 To this end, we verified our recommenda-tions at 7 different workshops in Italy, Denmark, Cyprus, Germany and Greece by presenting our recommendations to 115 stakeholders including employers/managers, employees, safety officers and policy makers and obtained feedback regarding the strengths and weaknesses of these recommendations. 18 Stakeholders were generally positive about our recommendations, with 88% of respondents agreeing that the presented guidelines would be effective and 57% of respondents stating that they perceived no barriers to implementing our recommendations. Of the recommendations presented, the three most favoured by stakeholders were providing drinking water, improving the thermal qualities of clothing, and optimizing the work schedule.…”

“…Specifically, in order to accurately assess whether OH-Stress will be an issue, and to what degree, six key factors are needed: the ambient temperature, humidity, wind speed, thermal (usually solar) radiation, the thermal insulation and the breathability of the clothing worn, and the amount of internal heat being produced by the workers, consequent of the metabolism needed to fuel their work. 19 In addition to the weather measurements, which will be outlined below, reference tables can be used to estimate the level of heat being produced for a given task. 20 Interestingly, however, many of the occupational metabolic equivalents had not been updated since the 1800s, but were recently updated as part of the HEAT-SHIELD project.…”

“…53 Further, from a survey provided to employees, managers, and health and safety officials in Denmark, Italy, and Cyprus, 14% of respondents reported being unaware of any protective measures and 48% thought that the methods their companies employed to combat heat stress were ineffective. 18 In contrast to cooling for sporting events with a relative short duration, implementation in occupational setting require additional resources or frequent repetition (Fig. 2A) for effective mitigation of OH-Stress over an entire work-shift.…”

“…Of the perceived barriers to implementation that were listed, cost was the most common (30%), followed by feasibility with certain job tasks and employer perceptions (15% each), and then cultural habits and fixed work hours (10% each). 18 It is necessary to increase the knowledge of employers and workers through clear and simple steps to help them understand the escalation of the problem, so that they can start implementing mitigation and adaptation measures. 53 Health education in relation to heat stress would improve risk awareness and should therefore become a part of the education system, with the younger generations being competent as soon as they enter the labour market.…”

“…However, for the public and private managers, employers, and policy/decision makers, who often do not directly work in the heat, the issue is less clear and personal, and therefore these people may need convincing policy-relevant health data to emphasize the problem and cost-benefit analyses to prove that investing resources on cooling interventions will benefit the economic bottom line. 18 To address these issues, the HEAT-SHIELD project (European Commission Horizon 2020 Grant 668786) was launched in 2016 with the dedicated aim to improve heat resilience in European workers by combining the knowledge of experts from a wide range of disciplines. The project aims to provide accurate guidance to the European community, ranging from the individual citizen to public and private policy makers, to better protect European health and productivity during present and future climatic heat scenarios.…”