title: Heat stress and inadequate sanitary facilities at workplaces - an occupational health concern for women?
abstract: BACKGROUND
  Health concerns unique to women are growing with the large number of women venturing into different trades that expose them to hot working environments and inadequate sanitation facilities, common in many Indian workplaces.
  
  
  OBJECTIVE
  The study was carried out to investigate the health implications of exposures to hot work environments and inadequate sanitation facilities at their workplaces for women workers.
  
  
  METHODS
  A cross-sectional study was conducted with 312 women workers in three occupational sectors in 2014-2015. Quantitative data on heat exposures and physiological heat strain indicators such as core body temperature (CBT), sweat rate (SwR), and urine specific gravity (USG) were collected. A structured questionnaire captured workers perceptions about health impacts of heat stress and inadequate sanitary facilities at the workplace.
  
  
  RESULTS
  Workplace heat exposures exceeded the threshold limit value for safe manual work for 71% women (Avg. wet bulb globe temperature=30°C±2.3°C) during the study period. Eighty-seven percent of the 200 women who had inadequate/no toilets at their workplaces reported experiencing genitourinary problems periodically. Above normal CBT, SwR, and USG in about 10% women workers indicated heat strain and moderate dehydration that corroborated well with their perceptions. Observed significant associations between high-heat exposures and SwR (t=-2.3879, p=0.0192), inadequate toilet facilities and self-reported adverse heat-related health symptoms (χ (2)=4.03, p=0.0444), and prevalence of genitourinary issues (χ (2)=42.92, p=0.0005×10(-7)) reemphasize that heat is a risk and lack of sanitation facilities is a major health concern for women workers.
  
  
  CONCLUSIONS
  The preliminary evidence suggests that health of women workers is at risk due to occupational heat exposures and inadequate sanitation facilities at many Indian workplaces. Intervention through strong labor policies with gender sensitivity is the need of the hour to empower women, avert further health risks, and also enhance productivity for the few million women workers who contribute largely to the country's economy.
authors.affiliation: Department of Environmental Health Engineering, Sri Ramachandra University, Chennai, India; vvidhya@ehe.org.in.
authors.forename: Vidhya
authors.initials: V
authors.lastname: Venugopal
authors.affiliation: Department of Environmental Health Engineering, Sri Ramachandra University, Chennai, India.
authors.forename: Shanmugam
authors.initials: S
authors.lastname: Rekha
authors.affiliation: Department of Environmental Health Engineering, Sri Ramachandra University, Chennai, India.
authors.forename: Krishnamoorthy
authors.initials: K
authors.lastname: Manikandan
authors.affiliation: Department of Environmental Health Engineering, Sri Ramachandra University, Chennai, India.
authors.forename: Perumal Kamalakkannan
authors.initials: PK
authors.lastname: Latha
authors.affiliation: Department of Environmental Health Engineering, Sri Ramachandra University, Chennai, India.
authors.forename: Viswanathan
authors.initials: V
authors.lastname: Vennila
authors.affiliation: Department of Biochemistry, Sri Ramachandra University, Chennai, India.
authors.forename: Nalini
authors.initials: N
authors.lastname: Ganesan
authors.affiliation: Department of Environmental Health Engineering, Sri Ramachandra University, Chennai, India.
authors.forename: Perumal
authors.initials: P
authors.lastname: Kumaravel
authors.affiliation: Department of Environmental Health Engineering, Sri Ramachandra University, Chennai, India.
authors.forename: Stephen Jeremiah
authors.initials: SJ
authors.lastname: Chinnadurai
keywords: genitourinary issues; heat stress; sanitation facilities