목차
Title page 1
Contents 4
Foreword 6
Prelude 7
Acknowledgments 8
Executive Summary 9
Introduction 12
Part 1. Climate Change and Heat Exposure at Work 13
1.1. Climate change and the future of work 14
1.2. Heat stress in occupational settings 17
1.3. Production and loss of heat during physical work 19
Part 2. Global Burden Of Workplace Heat Stress 21
2.1. Morbidity and mortality associated with workplace heat stress 22
2.2. Specific health outcomes associated with workplace heat stress 24
2.2.1. Mild health outcomes associated with workplace heat stress 25
2.2.2. Severe health outcomes associated with workplace heat stress 26
2.2.3. Chronic health consequences 27
2.3. Mental health effects associated with workplace heat stress 27
2.4. Loss of labour productivity due to workplace heat stress 27
2.5. Groups of workers at higher risk for morbidity and mortality related to workplace heat stress 27
2.6. Regions most affected by workplace heat stress 29
2.7. Most affected workplaces 30
2.8. Seasonal and diurnal variations of workplace heat stress exposure 32
2.9. Compound environmental hazards 33
Part 3. Preventing and Mitigating Workplace Heat Stress 35
3.1. From public health prevention to occupational heat action programmes 36
3.2. Development of OHAPs with involvement of workers and relevant stakeholders 36
3.3. From plan to implementation - considerations on effectiveness, feasibility and sustainability 39
3.4. Designing suitable, specific and sustainable OHAPs 39
3.5. Elimination/substitution of workplace heat exposure 40
3.5.1. Training and awareness 41
3.5.2. Fluid and electrolyte replacement/hydration 42
3.5.3. Hygiene facilities 42
3.5.4. First aid and emergency response plan 42
3.5.5. Environmental surveillance 44
3.5.6. Medical surveillance 44
3.5.7. Summary of controls of heat exposure 44
3.6. Engineering controls 47
3.7. Administrative controls and work practices 48
3.8. Personal protective equipment and cooling systems 49
Part 4. Assessment, Monitoring and Management of Workplace Heat Stress 51
4.1. Assessment methods for workplace heat stress 52
4.1.1. Professional judgment and qualitative assessments 53
4.1.2. Wet-bulb globe temperature (WBGT) 54
4.1.3. Universal thermal climate index (UTCI) 57
4.1.4. Heat index 58
4.1.5. Predicted heat strain 59
4.1.6. Comments on assessment methods 60
4.1.7. An existing occupational heat-related warning system 60
4.2. Physiological heat strain monitoring 61
4.3. Risk factors in workplace heat stress assessment 62
4.3.1. Job risk factors 62
4.3.2. Heat acclimatization/adaptation 62
4.3.3. Return to work after severe health outcomes associated with workplace heat stress 63
4.4. Managing health outcomes associated with workplace heat stress 64
4.4.1. Managing mild health outcomes associated with workplace heat stress 64
4.4.2. Treating severe health outcomes associated with workplace heat stress 64
Part 5. Conclusions and Recommendations 69
References 71
Annex 91
Tables 16
Table 1.1. Millions of people living in areas of increased heat currently and in the future, according to varying levels of climate change, as described in the different RCPs 16
Table 2.5. Factors predisposing to severe heat-related disease during work under workplace heat stress conditions 28
Table 2.7. Metabolic rate for different work intensities, with associated physical task and occupation examples 31
Table 3.2. Issues and risk factors to be considered; potential prevention programmes/solutions / strategies; and the associated considerations for different... 38
Table 3.5.4. Response guidelines for health outcomes related to workplace heat stress. Presented in order of decreasing severity/urgency. One or more observations... 43
Table 3.5.7. Summary of heat stress prevention measures at various levels 46
Table 4.1.1. A qualitative method to assess workplace heat stress based on category assessments. If any single factor falls into either of the two far-right categories,... 54
Table 4.1.2a. Values of WBGT (in ℃) used as upper thresholds for continuous work at different levels of work effort (average metabolic rate), proposed by different... 56
Table 4.1.2b. Clothing adjustment values (CAV) in terms of WBGT for selected clothing ensembles 57
Table 4.1.4. Heat index exposure limits based on work effort (average metabolic rate) categories with reference metabolic rate for each category 59
Table 4.3.2. Re-acclimatization schedule for work involving heat stress exposure after routine absence or illness 63
Table 4.4.2. Relative effectiveness and practicality of whole-body cooling methods for use in field workplaces, based on information provided in... 65
Figures 16
Fig. 1.1. Monthly mean WBGT in the shade during the hottest month of the year around the world (0.5° × 0.5° grid cells) for the end of the century (2071-2099)... 16
Fig. 1.2a. Illustration of the interaction of different occupational factors that can increase heat stress. Work demands dictate the internal metabolic rate,... 18
Fig. 1.2b. The incidence and cumulative frequency of heat exhaustion cases occurring for each 0.2℃ rise in core body temperature while individuals perform... 18
Fig. 2.1. Interconnections between factors related to work, environment, clothing and individual worker characteristics in relation to workplace heat stress 23
Fig. 2.6. Monthly mean wet-bulb global temperature (WBGT) in the shade during the hottest month of the year around the world (0 .5° × 0 .5° grid cells)... 30
Fig. 2.8. Outdoor and indoor WBGT (top graph) and resulting ability to perform work (bottom graph) at a moderate to heavy pace (percentage of time that... 32
Fig. 2.9. Impacts of workplace heat stress and its associated physiological strain on the biological response to and consequences of air pollution 33
Fig. 3.4. Important heat adaptation strategies for reducing the risk of workplace heat stress 40
Fig. 4.1.2. WBGT exposure limits adjusted for metabolic rate (work effort) for healthy persons 55
Fig. 4.1.7. Graphical representation of the main components of the HEAT-SHIELD platform, where meteorological data are used to generate short-term (weekly)... 61
Fig. 4.4.2a. Approximate daily water requirements as a function of climate (WBGT) and average daily energy expenditure 67
Fig. 4.4.2a. Simple tools for detecting hypohydration and determining the adequacy of day-to-day water loss replacement in healthy, active, low-risk populations of... 67
Boxes 52
Box 4.1. An example of workplace heat stress exposure, created using the freely available Predicted Heat Strain calculator (63) which follows ISO standard No. 7933 52
Annex Tables 92
Table A1. Members of the Working Group on workplace heat stress who prepared this report 92
