As the sun blazed across India’s hottest regions, people faced an unprecedented heat risk this year. While Rajasthan, Maharashtra, Delhi, Tamil Nadu, Gujarat and many other states reported hundreds of heatstroke cases and heat-related illnesses, experts have warned that the actual toll of the heat wave impact may be underreported in India.
Summer may be officially over, and the monsoon has brought respite, but the impact of heat on all aspects of life remains a real and present danger. Heat-related deaths can occur even when there are no heat wave warnings, and factors like humidity, wind speed, pre-existing medical conditions, socio-economic factors and occupational factors play a major role.
“Many lesser-known heat-related illnesses often go unrecognised,” says Vidhya Venugopal, Professor of Climate Change, Occupational and Environmental Health at Sri Ramachandra Institute of Higher Education and Research in Chennai.
An occupational hygienist and climate change scientist, she works with a dedicated team of interdisciplinary scientists to find the links between “heat, workload and occupational health.” She also serves in several national and international committees related to climate change and health, including the climate mission led by the Government of India.
In a telephonic interview with Citizen Matters, the scientist talks about the impact of heat on health and the need-of-the-hour mitigation measures that must be integrated into policy.
Heat-related illnesses
What are some of the lesser-known health effects of heat?
Several heat-related issues often go unrecognised, and people are not connecting them to heat. Direct effects like heat strokes are widely acknowledged, while kidney ailments and cardiovascular diseases are not commonly associated with heat. They are indirect consequences, so people often assume that they are not related to heat exposure.
How does heat shock lead to DNA damage? Could you explain the connection?
The core body temperature (CBT) increases in a hot environment. Even when your CBT increases by one degree Celsius, it triggers several responses in the body. Heart and kidneys start to work faster to cope with the heat amid the exertion. Cellular ageing occurs because of overwork and radiation exposure. Your internal organs also age faster, causing DNA damage.
During our research, we measured the extent of micronuclei damage and found that steel workers exposed to very high temperatures — such as over 40 degrees Celsius — were at a higher risk of DNA damage compared to workers exposed to lower temperatures.
Does this mean the damaged DNA could pass onto the future generations?
There is a possibility. Future generations may get affected in many mental and physical health aspects due to heat, which we have to wait and watch out for. There’s a new study where they found the sperm quality and the sperm count of men who work in hot environments is negatively impacted. Women’s fertility is also affected due to increased heat.
Psychological impact
What is the mental health impact of heat stress?
The current mental health concern (regarding heat impact) is mostly to do with eco-anxiety. People are worried about the heat. Workers constantly complain that it’s so hot and that they have to work in dire conditions. This leads to increased aggression. They may have interpersonal issues with their peers and supervisors, which may even lead to violence in many cases. This may also lead to domestic violence and substance abuse, much of this being related to the suppression of the hypothalamus (the area of the brain that controls body temperature, hunger and thirst).
Heat and livelihood
What are some of the industries at risk of heat exposure but often go unnoticed?
We have almost covered all industries in our research, and we would like to focus more on commercial kitchens where the heat is very high. We also want to throw more light on the condition of workers in stone quarries, where the heat, exertion and air pollution are all high. We plan to examine the heat stress at large-scale bakery houses and small and medium enterprises.
What policy changes are necessary to protect outdoor workers (such as gig workers, coastal communities, construction workers) from heat-induced illnesses and subsequent livelihood impact?
Timely issuance of heat advisories, holding small and medium owners accountable to ensure people are not working at certain peak heat periods or heat waves, and having welfare facilities in workspaces are some of the basic measures that can be implemented. These facilities would include access to safe drinking water, water to cool themselves, toilet facilities, and flexible work timings for both men and women. Not all outdoor workers have smartphones, so when the supervisor gets an advisory from the government regarding heat waves, it should be communicated to the workers. In these ways, the workplaces should be held accountable.
Need for parametric insurance
What is the connection between heat stress and productivity loss, as mentioned in one of your studies?
There are set targets and expectations in workspaces. In hot environments, you either take a long time to complete your tasks, or you can only do a small portion of work in a given time. This gap is called productivity loss. Implementing job rotations, hiring more people, and restricting work during peak heat hours are some administrative policies that can help mitigate heat-related risks. If a worker has a heat stroke or dies from a heat stroke, the rest of the employees should get some time off. The company must ensure the workers get insurance coverage. Wherever adaptation can happen, it should be incorporated.
Do we as a country have provisions to enable paid leave to workers during heatwaves?
It has happened before. Last year, during heatwaves in Madurai, Chennai and Delhi, construction workers were asked to stop work in the afternoon and were paid. A parametric insurance policy is also being floated by SEWA (Self-Employed Women’s Association), an organisation working for women’s rights, in Gujarat, Madhya Pradesh and some parts of Maharashtra. The women pay Rs 1 a day for the insurance scheme. When the temperature goes beyond a certain degree, the women can choose not to work and get paid under the scheme. It’s important to introduce more such schemes and also provide paid leave wherever necessary.
Heat and gender
What do gender-based cooling interventions look like? What can be included in Heat Action Plans?
There is nothing called gender-based cooling interventions. It’s just cooling interventions and gender-sensitive welfare facilities. For example, when you’re talking about heat impact on menstruation and occupational heat impact on women overall, it’s about having gender-specific toilets, adequate water and flexible work timings. However, cooling interventions will be the same for everyone. When you want to protect a person from occupational heat stress, you will not look at protecting men and women differently, it’s going to be the same for both. There is a requirement for adaptation and welfare facilities to ensure both genders are equally treated in relation to heat impact.
Then, what is the difference in the impact of heat on men versus women?
In certain cases, men are going to be more impacted than women. For example, men do over-exerting jobs, which is a factor that influences their health. Women comparatively do less-exerting jobs, hence we find renal health issues and cardiovascular issues more in men. Due to prolonged heat exposure, diabetes affects more men, whereas hypertension affects more women. Pregnant women are also highly impacted due to heat stress. The requirement for welfare facilities at workspaces might be a little higher for women due to basic biological reasons. For example, a woman cannot relieve herself in the absence of a toilet, but a man can. Women, especially menstruating women, need toilets and sufficient drinking water.
Heat and adaptation
Most state-specific heat health plans focus on mitigation, but not on long-term preventive measures. What long-term measures would you suggest?
I beg to differ. Long-term mitigation requires eliminating greenhouse gas emissions, reducing road traffic, and phasing out fossil fuel use. However, with rising temperatures now inevitable, the focus must shift to climate adaptation to ensure resilience and survival. Policies should focus on adapting today and in the future. Since we’re talking about workers, these adaptation policies have to be integrated: access to water, rest and shade (WRS), establishing cooling centres, improving welfare facilities, climate advisories, and bringing the workers under the Ministry of Small and Medium Enterprises. All these measures must be mandated by law, enforced and monitored.
Are people aware of heat impact on health? How can we ensure better awareness?
People are aware of the heat impact only on the surface level. For example, people know that eating pizza or ice cream before a run won’t help, but do we know what exactly happens in the body? We don’t exactly know what happens when we drink buttermilk or fermented rice water before the run, compared to eating a pizza. Similarly, the workers know about the health impact, and yet, some of them resign to the fact that nothing can be done about it, and they have to go back to work in hot environments.
Awareness must be raised about the signs and symptoms of heat-related illnesses, how to protect yourself and others when these symptoms appear, and effective coping mechanisms. Television is the best medium to spread this information, and broadcasts should be scheduled according to workers’ timings for wider reach. Just as we conquered COVID-19, we must now tackle heat.
Fantastic study..As a CEO of a reputed real estate developer company I used to suggest to contractors to have working hours of 7am to 11am , have long lunch and rest break, restart 3pm and end the day at 6pm during summer time. Such a timing will take care of not only workers’ health but also ensure better productivity