Workplace Intervention for Heat Stress: Essential Elements of Design, Implementation, and Assessment

Abstract

Heat stress is associated with numerous health effects that potentially harm workers, especially in a warming world. This investigation occurred in a setting where laborers are confronted with occupational heat stress from physically demanding work in high environmental temperatures. Collaboration with a major Nicaraguan sugarcane producer offered the opportunity to study interventions to prevent occupational heat-stress-related kidney disease. Two aims for this study of a rest-shade-water intervention program were: (1) describe the evolving intervention, summarize findings that motivated proposed improvements, assess impact of those improvements, and identify challenges to successful implementation and (2) extract primary lessons learned about intervention research that have both general relevance to investigations of work-related disease prevention and specific relevance to this setting. The learning curve for the various stakeholders as well as the barriers to success demonstrate that effectiveness of an intervention cannot be adequately assessed without considerations of implementation. Designing, effectively implementing, and assessing both health impacts and implementation quality is a resource-intensive endeavor requiring a transdisciplinary approach. Both general and specific lessons learned are presented for decisions on study design and study elements, implementation assessment, and management engagement in understanding how productivity and health can be successfully balanced and for building effective communication between investigators and all levels of management.

Public Health Measures to Address the Impact of Climate Change on Population Health—Proceedings from a Stakeholder Workshop

“…The workshop was opened with three introductory talks (NR, KA, DS), followed by three researcher presentations (KJ, MFC, SRA) on climate and health interventions and research translation into practice that constituted the first part of the workshop ( Appendix A ). Details of these presentations have been published elsewhere [ 9 , 31 , 32 , 33 , 34 , 35 , 36 ]. In the second part of the workshop, an international panel of three public health experts (AMG, AS, IK) and four of the workshop speakers (DS, KJ, MFC, SRA) discussed a number of questions from within the workshop group and the workshop audience, described in this paper.…”

Targeting workload to ameliorate risk of heat stress in industrial sugarcane workers

“…On H3 data collection days, RSH recommendations were followed and appeared to create strong rest:work norms in the observed BCC and SC (see 95% CI in table 1a). This is in contrast with uneven adherence in H2 where field monitoring indicated intervention implementation varied between work squads (7). Effective intervention implementation in industrial agricultural may demand continuous monitoring and prioritization to ensure workers protections are upheld.…”

Heat stroke – the tip of an iceberg

“…Interventions to reduce symptoms and signs of dehydration and to reduce kidney function damage from hard labour among sugarcane workers working in El Salvador and Nicaragua have shown favourable effects. This has been achieved by an intervention program providing sufficient amounts of a water, providing rest and shade to the labourers cutting sugar cane in a hot and humid environment [9].…”