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Heat Stress in the Workplace

As we head into summer, and temperatures continue to rise, it’s worth a discussion about what this means for many workers. While many of our prior blog posts have focused on implementing evidence-based physical therapy practices to enhance patient outcomes, we’d like to shift our focus this month to a different topic: heat stress. Defined as the body’s inability to shed excess heat, heat stress can result in heat exhaustion and heat stroke. Heat stress is a significant occupational health hazard, particularly in industries such as construction, agriculture, and manufacturing, where employees are exposed to high temperatures, often for prolonged periods. In the paragraphs below, we will discuss the how heat affects worker’s health, strategies to mitigate this growing danger, and the costs associated with heat stress.

Heat Stress can be thought of as a variety of different types of heat-related illness. For the purpose of this piece, we’ll discuss the more severe types of heat stress: heat exhaustion and heat stroke. Heat Exhaustion is defined as body’s response to an excessive loss of water and salt, usually through excessive sweating. It commonly affects who work in hot environments. Symptoms of heat exhaustion include: headache, nausea, dizziness, weakness, irritability, heavy sweating, decreased urine output and elevated body temperature. It’s important to intervene with actions that focuses on cooling the body down. This can be as simple as removing the individual from the hot environment, removing excessive clothing (like shoes/socks), applying cold compresses, applying a fan to promote air circulation, and encouraging frequent sips of cool water.  If symptoms do not improve, it’s important to get medical care.1

While heat exhaustion is a serious condition, it’s not quite a severe as heat stroke; which is outlined as the most serious of the heat-related illness. This occurs when the body simply cannot cool itself down. As temperature rises and sweating mechanisms fail, body temperature can rise to over 105 degrees within 10-15 minutes. Symptoms of heat stroke include: confusion/altered mental status, loss of consciousness, and seizures. If treatment (which includes many of the strategies listed above) is delayed or not available, heat stroke can be deadly. 1

Considering the potential ramifications of workers overheating, what can be done to mitigate this growing danger? There are several strategies that can be implemented to reduce risk, from a variety of different perspectives.2

  1. Engineering Controls – Modifying the work environment can significantly reduce heat exposure. This includes installing air conditioning, improving ventilation, and using reflective or heat-absorbing materials in buildings. In outdoor settings, providing shaded areas and using cooling fans can help lower temperatures.
  2. Administrative Controls – Adjusting work practices can also mitigate heat stress. Employers can implement schedules that avoid heavy labor during peak heat hours, increase the frequency of breaks, and ensure that breaks are taken in cool areas. Job rotation can help distribute the physical burden and heat exposure among multiple workers. Employers and supervisors can also prioritize acclimatization for all employees that will work in a hot environment. Acclimatization is the gradual increase in exposure to hot temperatures. For example, it’s advised that new hires who will be exposed to hot work environments incrementally step up their time in the hot environment by no more than 20% per day. This typically means the employee will gradually progress their workload over the course of 7-14 days, giving the body a chance to adapt to this new, physically stressing environment.2
  3. Personal Protective Equipment (PPE) – Specialized clothing and equipment can help protect workers from heat. This includes lightweight, breathable fabrics, cooling vests, and hats that provide shade. Ensuring that workers have access to plenty of water and encouraging regular hydration is also crucial.
  4. Training and Education – Educating workers about the signs and symptoms of heat stress, and training them on prevention strategies, is essential. Workers and supervisors should be encouraged to recognize when they or their colleagues are experiencing heat-related symptoms and to seek help immediately.

While it’s clear that employers and employees alike should take active steps to prevent heat-related illness, it’s also a decision that makes sense financially. One meta-analysis performed in 2021 evaluated the past, current and projected costs associated with lost productivity secondary to hot work environments. Predicted global costs from lost worktime were $280 billion in 1995, $311 billion in 2010, and are projected at 2.5 trillion by 2030.3 This troubling finding was also highlighted in a 2023 publication, which outlined that productivity losses secondary to hot work environments are currently at about 10%.4 While some of these costs are associated with factors beyond the immediate control of any single employer, the total proposed expense of this problem should have employers looking for any and every possible opportunity to reduce the burden on workers. Not only will this protect worker health, but should facilitate improvements in productivity.

Heat stress in the workplace is a critical issue that impacts both worker health and economic productivity. Addressing this challenge requires a multifaceted approach involving engineering controls, administrative changes, personal protective equipment, and comprehensive training programs. By implementing these strategies, employers can significantly reduce the incidence of heat-related illnesses, while improving overall workplace safety and productivity.

To learn about how Upstream Rehabilitation and our family of brands can assist with Workers’ Compensation, or how physical therapy plays an effective role in helping injured workers return to work, contact our Workers’ Compensation team today!


  1. Occupational Safety and Health Administration (OSHA). “Prevent Heat Illness at Work.” Accessed May 16, 2024. OSHA Heat Stress
  2. Occupational Safety and Health Administration (OSHA). “Heat Stress Recommendations.” Access May 22,
  3. Borg M, Xiang J, et al. Occupational heat stress and economic burden: A review of global evidence, Environmental Research, Volume 195, 2021,
  4. De Sario M, de’Donato FK, Bonafede M, et al. Occupational heat stress, heat-related effects and the related social and economic loss: a scoping literature review. Front Public Health. 2023;11:1173553. Published 2023 Aug 2. doi:10.3389/fpubh.2023.1173553