Too Hot To Work

As more heatwaves sweep through Southeast Asia, outdoor workers are confronted with an increased risk of deaths, disabilities and health issues in the region.

AsianScientist (May.28, 2024) – On an unbearably hot afternoon in April 2023, Shamrul Sheikh, a 23-year-old mason, was sitting on a bamboo scaffolding, beating and molding the steel skeleton of a four-story building in Kolkata, a metropolis in eastern India. That month, the highest recorded temperature in Kolkata ranged between 40 and 43 degrees Celsius.

Sheikh wore a red and white checkered scarf on his head to shield it from the sun. Sweat trickled down his body, soaking the vest he wore. At one point, Sheikh started feeling dizzy but continued to work. Moments later, his co-workers heard a loud thud. Sheikh had fainted and fell from his perch on the scaffolding. He was bleeding profusely on the ground.

His fellow masons and the building contractor quickly arranged for an ambulance to take him to a nearby hospital, where he remained for months, recovering from his injuries. Sheikh, like many masons from Murshidabad, a district 200 km north of Kolkata, would stay in Kolkata for almost nine months every year to make his living as a construction worker.

He was the sole breadwinner of his family of four people. Workers like him earn between US$4.4 and US$9 daily and missing even a day of work can put them under financial strain. The contractor compensated Sheikh but he ran out of that money soon because of his medical expenses.

“Prolonged exposure to sun leads to dehydration and disturbs blood’s electrolyte balance,” Subhrojyoti Bhowmick, clinical director, Research and Academics, Peerless Hospital, Kolkata, told Asian Scientist Magazine. “The body’s dehydration can lower blood pressure, which can make people feel dizzy. For workers engaged in tasks at heights, there is an increased risk of falls,” he added.


Effects on health

In 2023, Asia experienced extreme heatwaves with temperatures reaching up to 41.9 degrees in China, 44.5 degrees in India and 45 degrees in Myanmar. In China, the heatwave lasted over 70 days, consistently exceeding 40 degrees, according to the Beijing Climate Center.

Such high temperatures can exacerbate existing health problems and lead to early death and disability. Heatrelated mortality increased by about 70 percent globally since the early 2000s, stated a 2022 Lancet report. In India alone, heatwaves have killed 17,000 people in the last 50 years and the heat induced mortality rate has gone up by 62.5 percent, according to a 2021 study in Weather and Climate Extremes.

There is more. Consistent exposure to heat stress among outdoor workers including farmers and construction laborers can lead to chronic kidney disease (CKD). A 2023 study, published in Kidney International Reports, found that more time in the heat was linked to a higher risk of CKD, increasing by 2.3 percent with each degree rise in temperature.

Besides physiological repercussions, heatwaves and elevated ambient temperatures have also been linked to adverse mental health outcomes including impact on memory, reduction in reaction time and ability to pay attention.

Additionally, heatwaves are likely to occur earlier than before. In 2023, an international team of researchers, including members of the World Weather Attribution group dedicated to climate change research, examined the humid heat experienced in South and Southeast Asia and noted that while April is typically a hot month in South and Southeast Asia, the 2023 April heatwave was exceptional. This early onset can be hazardous because sudden temperature spikes do not allow individuals to gradually acclimatize to higher temperatures. This puts vulnerable populations, including people over 65 years, infants and outdoor workers, at a heightened risk of dehydration, heat-related illnesses and death.

Despite such alarming consequences, people like Sheikh don’t have a choice but to go out and work because their livelihood depends on it. “In addition to production losses, heatwaves have a detrimental effect on farm workers’ health, something that is not often talked about,” said Aditi Mukherji, director of the Climate Change  Adaptation and Mitigation Impact Action Platform at the Consultative Group on International Agricultural Research, a global research partnership dedicated to transforming food, land and water systems in a climate crisis.

One particular concern, she pointed out, is the disproportionate impact of extreme heat on women who work outdoors. For example, in India women lose almost 20 percent of their paid working hours due to heat. Extreme heat also causes female wages to fall below the poverty line in sectors like agriculture, construction, and other service activities, which make up 70 percent of total female employment in the country, according to The Scorching Divide, a 2023 report by the Adrienne Arsht-Rockefeller Foundation Resilience Center, a nonprofit in the United States.

The concerns do not stop at health; heatwaves can severely affect the economy of countries which rely heavily on outdoor labor. Take Bangladesh, for example. According to the World Bank, in 2019, 38 percent of Bangladeshi workers were employed in agriculture and 21 percent in mining, quarrying, construction and manufacturing industries. In sectors like these, labor supply and productivity is projected to decrease by 16 percent in the country if the global temperatures rise by 1.5 degrees, stated a 2021 study in The Lancet Planetary Health.

Along with outdoor workers, their families who rely on them financially are also at significant risk due to the scale and distribution of the effects of heat on labor loss.


Policy Initiatives in Asia

In May 2023, the Labour Department in Hong Kong issued guidelines on the prevention of heat stress at work, in response to calls by labor unions when Hong Kong experienced 22 hot nights in July 2022.

The government recommended that the employers and workers follow the Hong Kong Heat Index comprising a three-color code system: amber, red and black. Amber warning is issued when the index reaches 30, changing to red at 32 and switching to black when it hits 34. The guidelines say that outdoor workers in strenuous jobs rest during black or red warnings.

Similarly, other countries are implementing measures to protect outdoor workers from extreme heat. The Centre for Climate Research Singapore recently forecasted that the maximum daily temperature in the country can range between 35 and 37 degrees by 2100. Currently, the average day temperature in Singapore hovers between 31 and 33 degrees. Keeping such projections in mind, Project HeatSafe, a collaborative research initiative at the National University of Singapore (NUS), is researching ways to mitigate the impact of rising heat in Southeast Asia.

Among other things, the project is studying the effects of heat stress on workers’ productivity and well-being in Singapore. In an analysis of 19 outdoor worksites in the country in 2022, the project revealed repeated occurrences of high heat stress among workers. To help them, the project team designed an experiment. They provided specially formulated ice slurries to more than 200 construction workers during their day breaks. This nearly sugar-free and thick icy drink containing essential salts and minerals effectively reduced the workers’ risk of heat strain, leaving them feeling cooler, better hydrated and more energetic.

These ice slurries were more effective than iced liquids at lowering core body temperatures due to their larger surface area for heat transfer upon ingestion. Ice slurries induce the body’s heat to melt the ice particles, thus reducing the core body temperature, explained Jason Lee, director, Heat Resilience and Performance Centre, and associate professor at Yong Loo Lin School of Medicine, NUS.

Lee added that ice slurries was one of several proposed solutions that the Ministry of Manpower (MOM), Singapore, tried out through the Workplace Safety and Health Institute. Given that the experiment yielded positive results, the team at Project HeatSafe is considering scaling it up in partnership with commercial companies. The intervention was so favorable that the workers were willing to pay a nominal fee to purchase the slurries, Lee explained.

In October 2023, after MOM’s consultation with the Ministry of Health’s Heat Stress Expert Panel, MOM mandated that employers provide outdoor workers with hourly breaks of at least five minutes when the wet bulb global temperature reaches 32 degrees. Wet-bulb temperature is the lowest temperature that can be reached under current ambient conditions by evaporation of water. In a 2020 study published in Science Advances, researchers warned that a wet bulb temperature of 35 degrees at 100 percent humidity may surpass the body’s capacity to cool itself via sweating, which can lead to dehydration and heat-related sickness.

While the most effective way to control such extreme situations is to reduce global greenhouse gas emissions, in the meantime, outdoor workers need solutions that enable them to adapt to the existing conditions.

“For example, technologies that mechanize women’s work have long been available but their uptake is deficient. More research is needed on the specific circumstances and preferences of these women to pave the way for existing technologies to be improved and delivered in ways that would encourage their adoption and reduce on-farm exertion and risk,” said Mukherji.

According to Lee, it is crucial to make a national heat stress advisory as specific as possible to different sections of a society so that it can be implemented successfully. Depending on their social and economic contexts, different individuals perceive and tolerate heat differently.

Lee added that governments across Asia need to shift their old perspective that onsite interventions to support outdoor workers are costly.

“The reality is that delivering interventions is not just about welfare; it’s good for business too. When workers are happy and healthy, they are more productive. Proper rest contributes to productivity, reduces sick leaves and benefits welfare and business.”

This article was first published in the print version of Asian Scientist Magazine, January 2024.
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Copyright: Asian Scientist Magazine.

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Puja is a multimedia journalist based in Kolkata, India. She writes about social justice, health, policy, LGBTQIA+ issues and culture.

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