Developed in collaboration with EU-OSHA

Overview of several major climate change related risks for occupational health and safety

Occupational safety and health issues

Climate change affects workers’ safety and health through increased temperatures, ultraviolet radiation exposure, contact with pathogens, in- and outdoor air pollution, and extreme weather. It can amplify existing risks or create new ones, such as heat-related disorders, vector- and water-borne diseases, accidents, allergies and cancer (ANSES, 2018). This can result in higher health costs, reduced quality of life, and production losses (Kjellstrom et al., 2016; Dasgupta et al. 2021; Dasgupta & Robinson, 2023). Nearly every sector may be affected, with risks for outdoor workers in agriculture, forestry and construction, first responders and healthcare workers as well as indoor workers, especially in heat-intensive or physically demanding industries. Age, pre-existing medical conditions, and socio-economic status may affect the severity of health problems, and occupational safety and health (OSH) risk with geographical location. Risk mitigation strategies should therefore be adapted to the diversity of the working population and the regional hazards. A thorough understanding of climate change threats to OSH is necessary to assess and manage the risks adequately (OSH wiki, 2023).

Observed effects

Increased temperatures are a major concern to OSH, both for in- and outdoor workers. Extreme heat can affect concentration and cause mental fatigue, dehydration, exhaustion, worsening of heart, respiratory and kidney diseases, and potentially heat stroke, exhaustion and syncope, if the body is unable to maintain its usual temperature (Parsons, 2014; Varghese et al., 2018; EEA, 2022; EU-OSHA, 2023b; OSH wiki, 2023;). Intense physical work can further contribute to internally generated body heat. Prolonged exposure to heat may result in impaired judgement, reduced vigilance and fatigue, hence increasing the risk of accidents. Further heat exposure outside working hours may prevent workers from adequately recovering from heat stress between work shifts, particularly if they live in poorly cooled conditions (Hansen et al., 2013). In certain regions, working patterns may need to be modified to avoid the hottest and sunniest hours and night work may increase to compensate. This may lead to reduced concentration and speed of reflexes and visibility may also be affected, leading to an increased risk of work-related injuries (Jones et al., 2020; Narocki, 2021).

Outdoor workers

Heat stress is a significant risk for outdoor workers, especially when they do intense physical work in direct exposure to sunlight and heat in sectors like agriculture, forestry, fisheries, construction, mining and quarrying, transport and maintenance and utilities supplies. Those employed in low-paid occupations requiring physical work outside may be particularly exposed. Extreme temperatures and heatwaves in Southern Europe in the summers of 2020 to 2022 caused heat strokes and heat-related fatalities among outdoor workers including street sweepers and rubbish collectors. Overall, a fifth to a quarter of the total workforce in Europe indicates to be exposed to uncomfortable high temperatures during at least one quarter of their working time. Around half of the outdoor and manually active workers are exposed to very high temperatures (Eurofound, 2017).

People working outside are also at risk of increased exposure to UV radiation under a changing climate, which increases the risk of sunburn and ultimately skin cancer. In Europe, outdoor workers are more at risk of skin cancer than indoor workers with similar skin type (Trakatelli et al., 2016). Direct exposure to solar radiation may also impair motor-cognitive performance (Piil et al., 2020) and increase the risk of injuries.

Due to climate change, the geographic range of pathogens and transmitting vectors (e.g., ticks or mosquitoes) is expanding. This puts outdoor workers in many professions at risk of infectious vector‐borne diseases (Jones et al., 2020; Meima et al., 2020), including diseases already established in Europe and becoming more prevalent under the changing climate (e.g., tick-borne encephalitis), and those previously not endemic in Europe such as Rift Valley fever, yellow fever, malaria, dengue and chikungunya.

Extreme weather events, like floods and wildfires, are projected to increase in number, severity, and intensity across Europe and can cause injuries and fatalities. Severe weather conditions may increase the risk of drowning, burns, frostbite, and for frontline emergency workers, risks from toxic gases, explosions, extreme heat and fighting fires. Next to the physical impacts, climate hazards also affect workers’ mental health (Schulte et al., 2016; Dasgupta et al., 2021; WHO, 2022).

Agriculture and forestry

The EU farming population faces particularly severe risks from climate change, including heat-related kidney diseases and other illnesses, given the older age hence high vulnerability of the EU farmers (a third is over 65 years old; Jones et al., 2020; El Khayat et al., 2022).

Farmers and forestry labourers work in areas with woods, bushes or high grass, where pathogen-carrying ticks and insects thrive (Covert & Langley, 2002). The workers increasingly risk contracting vector-borne diseases like Lyme disease and tick-borne encephalitis (Jones et al., 2020; Meima et al., 2020)

Farmers and foresters also face risk during the clean-up after extreme events, for example from falling trees or objects. Reforestation of damaged areas and clearing of brushwood to mitigate fire risks may increase the occurrence of musculoskeletal disorders (Jones et al., 2020) since these tasks are still mainly a manual activity.

Construction industry

Workers in the construction industry often operate within areas under the urban heat island (UHI) effect (i.e., higher temperatures in urban areas than in the rural surroundings due to concrete and asphalt, human activities, and lack of shade-bearing vegetation). The physically demanding activities of construction workers increase their metabolic rate and internal heat generation, which ultimately results in more heat stress (Nybo et al., 2021). During the 2022 summer heatwave in France, seven fatal accidents at work with a possible link to the hot weather were reported, including three deaths in the construction sector (Santé publique France, 2022).

Emergency workers

Extreme weather events can seriously affect emergency workers, including firefighters, police officers, emergency medical staff and psychologists and, in major disasters, also rescue workers, technicians, military personnel, antiterrorist forces, body handlers, clean-up workers, construction workers, and volunteers.

Frontline firefighters face severe occupational health risks, including heat exhaustion, skin injuries or burns, mental trauma, or exposure to toxic gases or carcinogenic substances and respiratory irritation (Ioannou et al., 2022). Among firefighters, cardiovascular disease is the leading cause of death, with higher risks for older workers with physically strenuous tasks (EU-OSHA, 2023a). In worst-case scenarios, lives can be lost. One of the forest fires with the highest fatality rate occurred in August 2007 in Croatia, where 12 firefighters lost their lives and one was seriously injured (Stipaničev et al., 2008).

Natural disasters may involve flooding and related risks such as drowning and the spread of water- and vector-borne diseases. Rodents attracted by waste may spread leptospirosis. Through contact with survivors, emergency workers may be affected by wound infections, droplet-transmitted infections such as tuberculosis, gastrointestinal diseases, and blood-borne diseases (e.g., HIV, hepatitis B and C). Other infections through contact with dead bodies include group A streptococcal infection (meningitis), sepsis or rare diseases such as Creutzfeld-Jakob disease (Hauke et al., 2011).

Collapsing buildings and other structures, dust and smoke from collapses, and general devastation may increase accident risks. Ash, gas, smoke and dust from fires related to natural disasters or landslides may cause eye and pulmonary irritation, and potentially suffocation.

Emergency workers often have a high workload and severe time pressure, are confronted with death, and are required to suppress emotions while working and at the same time being emotionally empathic. These features are risk factors for poor mental health and burnout (Hauke et al., 2011).

Indoor workers

Indoor workers are also at risk of climatic stress that may increase during heat waves, especially those who work in poorly cooled buildings or in settings with high industrial heat production, carry out heavy physical work or must use PPE in heat conditions. This includes the electricity, gas and water supply and manufacturing (e.g., of metals) sectors (Ciuha et al., 2019; Fatima et al., 2021).

High temperatures also increase indoor CO2 levels that can reduce cognitive capacities (Kapalo et al., 2020). High temperatures in combination with indoor air pollutants can also worsen the so-called “sick building syndrome” (Nazaroff, 2013).

Healthcare workers

For healthcare workers, the use of PPE in hot conditions can unintendedly contribute to heat stress. In a study among health professionals in Germany, over 95% of surveyed nurses working with COVID patients and wearing PPE reported exhaustion during hot weather and 93% and 86%, respectively, reported breathing problems and concentration impairment (Jegodka et al., 2021). High demand for healthcare during heat waves may lead to high workload, stressful and physically challenging conditions for health workers. Moreover, the European health workforce is ageing, hence becoming more vulnerable to heat stress and other OSH risks. The share of people above 50 years working in the health sector increased by almost 25% between 2008 and 2016 (from 27.6% to 34.1% of all health care workers (European Commission, 2017). In urban settings, the central location of hospitals is often associated with additional exposure to high temperatures via the UHI effect; nearly half of urban hospitals in Europe face a strong UHI effect.

Projected effects

The burden of several climate-sensitive hazards at work is expected to increase in the future. These impacts are likely to be heterogenous across Europe, with regions that are currently exposed to high temperatures expected to be impacted the most. Regions with temperate climates, where workers are less acclimatized to work in hot conditions, may be facing increased occupational risks during sudden hot periods. Whilst humans can physiologically adapt to working in hot conditions, acclimatisation takes several days and depends on environmental, occupational, and lifestyle factors (Ioannou et al., 2022). While negative impacts of future warming in Europe are projected to be lower compared to other regions in the world (Dasgupta et al. 2021), workers in Southern Europe including Cyprus, the South Aegean (Greece), the Balearic Islands (Spain), and Liguria (Italy), are projected to suffer most from increased heat stress risk, and the highest declines in effective labour in the outdoor sector are expected in these regions (Dasgupta et al. 2021).

Wider impacts of climate change may have a significant effect on the circumstances of work. For example, the need to adapt crops to the changing climatic conditions may profoundly affect the agricultural sector across the European Union and create high pressure on farmers to adapt as well as cause profound changes to how work is organised, and consequently the risks for workers (Jones et al., 2020). Yet, the consequences of rising temperatures on many industrial sectors remain largely unassessed. In addition, there is very limited information on the cost of health impacts related to climate change for workers, which would largely depend on the measures taken to address heat risks at work, whether at policy, sectoral or enterprise level.

Policy responses

The is implemented in all EU Member States and provides the frame for worker protection. Employers must carry out a workplace risk assessment and set preventive measures to protect workers from any workplace risk, following a hierarchy of control and prioritising technical and organisational measures over personal measures. Some OSH risks are addressed by specific Directives and the national regulations implementing them (e.g., related to workplaces and machinery).

Heat and UV exposure

At the national level, Cyprus has regulations covering heat stress in workers. Other countries (e.g., Greece) are developing legislation (Ioannou et al., 2022). In some countries, recommended temperature limits or indicative temperatures are included in workplace regulations or in collective agreements. Those depend on the type of work (e.g., light vs. heavy physical work) or the location of the workplace (e.g., outdoors, indoors or office work).

Guidance documents exist for protection from UV radiation and heat at work in different working environments. For firefighters, for instance, the European Trade Union Institute (ETUI) together with the European Federation of Public Service Unions (EPSU) published a guide on firefighters’ working conditions, the challenges of heat and smoke risks, physical and psychosocial risks and on the priorities for prevention (Scandella, 2012).

Guidance is available at the European level to address heat risks at work (EU-OSHA, 2023b). Employers should prepare heat action plans - in combination with an early warning system where available, such as the SunSmart Global UV app (Modenese, 2022), or the heat alert tool developed in the Heat-Shield project (Flouris et al., 2017). Awareness raising about occupational heat-health impacts and adaptation solutions for both workers and employers are important (Morris et al., 2021). For all preventive measures or action plans, employers must consult their workers and train them in applying the measures.

Periods of lower work intensity and shorter working hours help to adapt to heat, especially during the first days of heat exposure. Hence, employers should set up acclimatisation schemes for workers (see for example NIOSH, 2016). Organisational measures include adapting work schedules and planning physically demanding work when it is cooler (early morning or late evening) as well as temperature-dependent breaks or guidelines for working from home.

Other specific preventive measures could include (Morris et al., 2018; Jones et al., 2020; Ioannou et al., 2021; OSH wiki, 2023; EU-OSHA, 2023a,b):

  • providing sufficient shade, sunscreen and protective clothing;
  • adequate rest areas to cool down during breaks;
  • providing vehicles equipped with air-conditioned closed cabins (e.g., on tractors, trucks, loaders, cranes);
  • adapting working hours to avoid times of the day with high temperatures and UV exposure;
  • non-reflective surfaces to avoid UV reflection;
  • providing drinking water;
  • monitoring the temperature.

For indoor workplaces, additional preventive measures include:

  • adapting work processes e.g., reducing heat release;
  • isolating machinery/processes that generate heat (or separating them from workers);
  • lifting and handling aids to reduce handling loads;
  • sustainable cooling systems;
  • dedicated cooling areas (indoor areas equipped with air conditioning).

Wetting of clothes and limbs, and fans can be effective, but care has to be taken not to cause draught and to keep air humidity within acceptable limits. While protective clothing (e.g., shirts with long sleeves and hats) shields against UV radiation exposure, it may also lead to overheating (OSH wiki, 2017). Workers who must wear protective clothing or equipment could be provided with specific protective clothing (e.g., water-cooled garments, air-cooled garments, cooling vests, and wetted overgarments) and must take more frequent breaks (NIOSH, 2016; Morris et al., 2018).

Biological agents

According to the Biological agents Directive, employers must assess workplace risks from exposure to biological agents and avoid or reduce exposure where possible. Under the Directive, relevant health surveillance of workers prior to exposure and at regular intervals thereafter. If a worker is suffering from an infection or illness because of exposure, surveillance should be offered to other workers. Effective vaccines must be made available free of charge for workers not already immune to biological agents they will likely be exposed to. In some European countries, TBE vaccination is reimbursed for individuals with an exposure risk at work, e.g., in Slovenia (mandatory vaccination), Estonia and Slovakia (recommended vaccination) (Steffen, 2019).

Specific guidance is available for workers in certain countries, for instance the guidelines for working in agriculture or forestry in Germany (TRBA 230).

Prevention measures include (Meima et al., 2020):

  • ventilation, aerosol- and dust-avoiding measures;
  • ensuring the separation of work and street clothing and of contaminated and clean (black/white) areas;
  • limiting the number of workers exposed;
  • providing and maintaining adequate protective clothing;
  • hygiene measures, including prohibiting eating or drinking in working areas;
  • appropriate washing, changing and decontamination facilities and rest areas.

In addition, workers must be provided with instructions on what to do in case of serious incidents, and employers must keep a record of workers exposed to certain biological agents.

Links to further information


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