Risk Factors for Heat-Related Illness Among Workers — California, 2000–2017

  • Occupational and environmental health
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Background:
As climate change raises global temperatures, studies have projected that heat-related morbidity and mortality will increase. Workers who perform exertional tasks or work in non-climate-controlled environments are particularly susceptible to heat-related illness (HRI). California is 1 of 3 states with an occupational standard to prevent HRI, requiring employers to provide employees with training and access to water, shade, and rest. We assessed occupational HRI patterns in California during 2000–2017 to identify workers at highest risk and guide prevention strategies.

Methods:
We identified HRI claims in California’s Workers’ Compensation Information System (WCIS) during 2000–2017, using International Classification of Diseases Ninth and Tenth Revision codes, WCIS nature and cause of injury codes, and HRI keywords. We assigned census industry and occupation codes using NIOSH’s Industry and Occupation Computerized Coding System (NIOCCS). We calculated average annual HRI rates/100,000 workers during 2000–2017, by sex, age group, year, county, and industry and occupation, using employment denominator data from NIOSH’s Employed Labor Force and California’s Employment Development Department.

Results:
We identified 15,996 cases of HRI during 2000–2017 (average 6.0 cases/100,000 workers/year). Among age groups, those aged 16–24 years had the highest HRI rate (7.6); men (8.1) had a higher rate than women (3.5). Geographically, rates were highest in southern California, including Imperial (36.6), San Diego (32.7), and Los Angeles (31.8) Counties. Occupational groups with the highest HRI rates were protective service (56.6), farming, fishing, and forestry (36.6), and material moving occupations (12.3). Among individual occupations, firefighters had the highest rate (389.6).

Conclusion:
Young workers, male workers, workers in southern California, and workers in firefighting, agriculture, and material moving occupations are particularly susceptible to occupational HRI in California. Collaboration with these workers and their employers to develop prevention strategies, such as education and training, may help reduce HRI in the workplace.

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