title: Perceived heat stress and health effects on construction workers.
abstract: BACKGROUND
  Increasing heat waves-particularly in urban areas where construction is most prevalent, highlight a need for heat exposure assessment of construction workers. This study aims to characterize the effects of heat on construction workers from a site in Gandhinagar.
  
  
  METHODS
  This study involved a mixed methods approach consisting of a cross sectional survey with anthropometric measurements (n = 219) and four focus groups with construction workers, as well as environmental measurements of heat stress exposure at a construction site. Survey data was collected in two seasons i.e., summer and winter months, and heat illness and symptoms were compared between the two time periods. Thematic coding of focus group data was used to identify vulnerability factors and coping mechanisms of the workers. Heat stress, recorded using a wet bulb globe temperature monitor, was compared to international safety standards.
  
  
  RESULTS
  The survey findings suggest that heat-related symptoms increased in summer; 59% of all reports in summer were positive for symptoms (from Mild to Severe) as compared to 41% in winter. Focus groups revealed four dominant themes: (1) Non-occupational stressors compound work stressors; (2) workers were particularly attuned to the impact of heat on their health; (3) workers were aware of heat-related preventive measures; and (4) few resources were currently available to protect workers from heat stress. Working conditions often exceed international heat stress safety thresholds. Female workers and new employees might be at increased risk of illness or injury.
  
  
  CONCLUSIONS
  This study suggests significant health impacts on construction workers from heat stress exposure in the workplace, showed that heat stress levels were higher than those prescribed by international standards and highlights the need for revision of work practices, increased protective measures, and possible development of indigenous work safety standards for heat exposure.
authors.affiliation: Environment and Occupational health Department, Indian Institute of Public Health Gandhinagar, Ahmedabad, Gujarat, India.
authors.forename: Priya
authors.initials: P
authors.lastname: Dutta
authors.affiliation: Environment and Occupational health Department, Indian Institute of Public Health Gandhinagar, Ahmedabad, Gujarat, India.
authors.forename: Ajit
authors.initials: A
authors.lastname: Rajiva
authors.affiliation: Environment and Occupational health Department, Indian Institute of Public Health Gandhinagar, Ahmedabad, Gujarat, India.
authors.forename: Dileep
authors.initials: D
authors.lastname: Andhare
authors.affiliation: Environment and Occupational health Department, Indian Institute of Public Health Gandhinagar, Ahmedabad, Gujarat, India.
authors.forename: Gulrez Shah
authors.initials: GS
authors.lastname: Azhar
authors.affiliation: Environment and Occupational health Department, Indian Institute of Public Health Gandhinagar, Ahmedabad, Gujarat, India.
authors.forename: Abhiyant
authors.initials: A
authors.lastname: Tiwari
authors.affiliation: Department of Pediatrics and Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, USA.
authors.forename: Perry
authors.initials: P
authors.lastname: Sheffield
keywords: Construction worker; heat stress; wet bulb globe temperature