title: Workplace heat stress, health and productivity - an increasing challenge for low and middle-income countries during climate change.
abstract: BACKGROUND
  Global climate change is already increasing the average temperature and direct heat exposure in many places around the world.
  
  
  OBJECTIVE
  To assess the potential impact on occupational health and work capacity for people exposed at work to increasing heat due to climate change.
  
  
  METHODS
  A brief review of basic thermal physiology mechanisms, occupational heat exposure guidelines and heat exposure changes in selected cities.
  
  
  RESULTS
  In countries with very hot seasons, workers are already affected by working environments hotter than that with which human physiological mechanisms can cope. To protect workers from excessive heat, a number of heat exposure indices have been developed. One that is commonly used in occupational health is the Wet Bulb Globe Temperature (WBGT). We use WBGT to illustrate assessing the proportion of a working hour during which a worker can sustain work and the proportion of that same working hour that (s)he needs to rest to cool the body down and maintain core body temperature below 38 degrees C. Using this proportion a 'work capacity' estimate was calculated for selected heat exposure levels and work intensity levels. The work capacity rapidly reduces as the WBGT exceeds 26-30 degrees C and this can be used to estimate the impact of increasing heat exposure as a result of climate change in tropical countries.
  
  
  CONCLUSIONS
  One result of climate change is a reduced work capacity in heat-exposed jobs and greater difficulty in achieving economic and social development in the countries affected by this somewhat neglected impact of climate change.
authors.affiliation: National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia.
authors.forename: Tord
authors.initials: T
authors.lastname: Kjellstrom
authors.forename: Ingvar
authors.initials: I
authors.lastname: Holmer
authors.forename: Bruno
authors.initials: B
authors.lastname: Lemke