Risk factors for occupational heat-related illness among California workers, 2000-2017.

As climate change increases global temperatures, heat-related morbidity and mortality are projected to rise. Outdoor workers and those who perform exertional tasks are particularly susceptible to heat-related illness (HRI). Using workers' compensation data, we aimed to describe rates of occupational HRI in California and identify demographic and occupational risk factors to inform prevention efforts. We identified HRI cases during 2000-2017 in the California Workers' Compensation Information System (WCIS) using International Classification of Diseases Ninth and Tenth Revision codes, WCIS nature and cause of injury codes, and HRI keywords. We assigned industry and occupation codes using the NIOSH Industry and Occupation Computerized Coding System (NIOCCS). We calculated HRI rates by sex, age group, year, county, industry, and occupation, and estimated confidence intervals using generalized linear models. We identified 15,996 HRI cases during 2000-2017 (6.0 cases/100,000 workers). Workers aged 16-24 years had the highest HRI rate (7.6) among age groups, and men (8.1) had a higher rate than women (3.5). Industry sectors with the highest HRI rates were Agriculture, Farming, Fishing, and Forestry (38.6), and Public Administration (35.3). Occupational groups with the highest HRI rates were Protective Services (56.6) and Farming, Fishing, and Forestry (36.6). Firefighters had the highest HRI rate (389.6) among individual occupations. Workers in certain demographic and occupational groups are particularly susceptible to HRI. Additional prevention efforts, including outreach and enforcement targeting high-risk groups, are needed to reduce occupational HRI. Workers' compensation data can provide timely information about temporal trends and risk factors for HRI.

Heinzerling A ，Laws RL ，Frederick M ，Jackson R ，Windham G ，Materna B ，Harrison R ... -  《-》

Heat-Related Illness in California Firefighters, 2001-2020.

Firefighters have a higher rate of heat-related illness (HRI) compared to other occupations. Given the changing climate, firefighters' risk of occupational HRI merits attention. Therefore, we aimed to identify demographic, temporal, and geographic risk factors associated with occupational HRI in California firefighters between 2001 and 2020. Within the California Workers' Compensation Information Systems (WCIS), we identified firefighters from 2001 to 2020 using industry and class codes and assigned occupation titles using the NIOSH Industry and Occupation Computerized Coding system (NIOCCS). HRI claims among firefighters were identified using International Classification of Diseases (ICD) Ninth or Tenth revision codes, WCIS nature and cause of injury codes, and keywords. We calculated HRI incidence rates adjusted by sex, age, year, and county. Estimates of California firefighter employment were obtained from the American Community Survey. We identified 2185 firefighter HRI claims between 2001 and 2020 (305.5 claims/100,000 firefighters, 90% CI: 278.7-740.7). Firefighters aged 18 to 29 years had a statistically significant higher risk of HRI compared to those aged 40 to 49 years (rate ratio = 3.5, 90% CI: 3.1-3.9). The HRI rate increased over time, and the risk from 2016 to 2020 was 1.8 times higher than it was from 2001 to 2005 (90% CI: 1.7-1.9). Northern California counties, including Shasta (2313.9) and Sacramento (1772.1), had the highest HRI rates. Firefighters in certain demographic groups and northern California counties were at highest risk of HRI. With rising temperatures and larger wildfires, additional prevention efforts are needed to reduce HRI in California firefighters.

Murray M ，Beckman S ，Heinzerling A ，Frederick M ，Cummings KJ ，Gandhi S ，Harrison R ... -  《-》

Emergency department visits for heat-related illness among workers: Occupational health surveillance using Washington syndromic surveillance data.

Information on worker occupation and industry is critical to understanding the occupational risks of heat-related illness (HRI), yet few syndromic surveillance systems capture these key data elements. This study evaluates the work data reported through Washington syndromic surveillance for its utility in characterizing HRI ED visits by industry and occupation. Standard industry and occupation codes were assigned to employer name and occupation descriptions reported in Washington ED visit records maintained within the state's syndromic surveillance system, for visits involving HRI in 2020-2022. HRI ED visits involving workplace heat exposure were identified based on discharge diagnoses or on keywords in the triage note or chief complaint fields. HRI ED visits were summarized by patient characteristics, and visit rates were calculated by industry and occupation. Employer name or occupation descriptions were reported in 21.5% of HRI ED records among patients age 16 and older, and in 41.2% of records with mention of heat exposure at work. Twice as many records were classified for industry as for occupation. Agriculture, forestry, fishing, and hunting and transportation and warehousing had the highest rates of HRI ED visits. Specific industries with the highest rates included support activities for agriculture and forestry, the postal service, and fruit and vegetable preserving and specialty food manufacturing. Syndromic surveillance data are a valuable source of occupational health surveillance information when work characteristics are reported, enhancing our understanding of the occupational risks of injuries and illnesses.

Wuellner S ，Turner K ，Spector JT 《-》

Heat-related illness among workers in British Columbia, Canada: Extreme hot weather in 2021 compared to 2001-2020.

Guo X ，Weinberger KR ，Tamburic L ，Peters CE ，McLeod CB ... -  《-》

Heat related illness among workers in Washington State: A descriptive study using workers' compensation claims, 2006-2017.

Heat related illness (HRI) places a significant burden on the health and safety of working populations and its impacts will likely increase with climate change. The aim of this study was to characterize the demographic and occupational characteristics of Washington workers who suffered from HRI from 2006 to 2017 using workers' compensation claims data. We used Washington workers' compensation data linked to weather station data to identify cases of work-related HRI. We utilized Occupational Injury and Illness Classification System codes, International Classification of Diseases 9/10 codes, and medical review to identify accepted and rejected Washington State (WA) workers' compensation claims for HRI from 2006 to 2017. We estimated rates of HRI by industry and evaluated patterns by ambient temperature. We detected 918 confirmed Washington workers' compensation HRI claims from 2006 to 2017, 654 were accepted and 264 were rejected. Public Administration had the highest third quarter rate (131.3 per 100 000 full time employees [FTE]), followed by Agriculture, Forestry, Fishing, and Hunting (102.6 per 100 000 FTE). The median maximum daytime temperature was below the Washington heat rule threshold for 45% of the accepted HRI claims. Latinos were estimated to be overrepresented in HRI cases. The WA heat rule threshold may not be adequately protecting workers and racial disparities are present in occupational HRI. Employers should take additional precautions to prevent HRI depending on the intensity of heat exposure. States without heat rules and with large industry sectors disproportionately affected by HRI should consider regulations to protect outdoor workers in the face of more frequent and extreme heat waves.

Hesketh M ，Wuellner S ，Robinson A ，Adams D ，Smith C ，Bonauto D ... -  《-》