Occupational Safety and Health in Climate Change Epidemiology: A Systematic Review and Meta-analysis
Abstract
Background: Climate-related exposures increasingly affect workers, especially in outdoor and heat-exposed occupations, but the overall burden across sectors has not been quantified. This study examined associations between temperature extremes, air pollution, wildfire smoke, extreme weather, vector-related exposures and occupational health outcomes.
Methods: A systematic review and meta-analysis following PRISMA guidelines, searched PubMed, Scopus, Embase and Web of Science for studies published from January 2000 to March 2026. Eligible studies reported quantitative associations between climate-related exposures and occupational health outcomes. Random-effects models pooled relative risks and incidence rate ratios with 95% confidence intervals. Heterogeneity was assessed with I², risk of bias with the Newcastle–Ottawa Scale and GRADE.
Results: Thirty-seven studies, including 4.2 million workers from 28 countries, were included. Occupational injury risk increased by 34% (95% CI:1.21–1.48) per 5 °C rise above regional heat thresholds. Agricultural workers had the highest heat-related mortality (RR 2.15, 95% CI:1.67–2.78) and increased renal dysfunction. Construction injuries rose by 18% during extreme heat events (95% CI:12–24%), while emergency responders had higher cardiovascular risk during wildfire smoke exposure (RR 1.42, 95% CI:1.18–1.71). Forestry workers in expanding transmission zones showed a 2.3-fold increase in vector-borne disease risk. Heterogeneity was substantial (I²=76%), was partly associated with protective equipment access, acclimatisation, and regulatory enforcement.
Conclusions: Climate-related exposures are associated with higher occupational risk across sectors, with the greatest burden among outdoor and precariously employed workers. The findings support heat prevention plans, climate-informed exposure standards and stronger occupational surveillance. Longitudinal studies are needed to assess the effectiveness of mitigation across settings.
Key messages: • The impacts of climate change on worker morbidity, mortality, and injury patterns, addressing critical gaps and informing public health adaptation strategies.
• Need for public health policy to focus on vulnerable worker populations by implementing adaptive workplace standards, cooling interventions, and climate-resilient occupational health infrastructure.
Related
- Occupational health risks from climate-related and infectious-disease stressors: A scoping review of worker safety and resilience
- Occupational anxiety, workplace risk attitudes, and clinical learning safety climate among nursing students: a path analysis
- Asymmetric impact of the 2012 Occupational Health and Safety Law on occupational injury and disease reporting in Türkiye: An interrupted time series analysis with emphasis on emerging female occupational disease patterns
- Analysis of Occupational Health and Safety (K3) Risk Management in PT X Steel Pipe Production Process using the HIRADC Method
- Identification and control of potential occupational safety and health hazards of artificial intelligence: a scoping review
BibTeX
@article{adamopoulos2026occupational,
title = {{Occupational Safety and Health in Climate Change Epidemiology: A Systematic Review and Meta-analysis}},
author = {I Adamopoulos and A Vafae Eslahi and A Frantzana and P Tsirkas and M Olfatifar and M Badri and A Valamontes and N Syrou and N Karanikas and FJG Silva},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.1171},
url = {https://doi.org/10.1093/eurpub/ckag169.1171},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Occupational Safety and Health in Climate Change Epidemiology: A Systematic Review and Meta-analysis
AU - I Adamopoulos
AU - A Vafae Eslahi
AU - A Frantzana
AU - P Tsirkas
AU - M Olfatifar
AU - M Badri
AU - A Valamontes
AU - N Syrou
AU - N Karanikas
AU - FJG Silva
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.1171
UR - https://doi.org/10.1093/eurpub/ckag169.1171
AB - Background: Climate-related exposures increasingly affect workers, especially in outdoor and heat-exposed occupations, but the overall burden across sectors has not been quantified. This study examined associations between temperature extremes, air pollution, wildfire smoke, extreme weather, vector-related exposures and occupational health outcomes. Methods: A systematic review and meta-analysis following PRISMA guidelines, searched PubMed, Scopus, Embase and Web of Science for studies published from January 2000 to March 2026. Eligible studies reported quantitative associations between climate-related exposures and occupational health outcomes. Random-effects models pooled relative risks and incidence rate ratios with 95% confidence intervals. Heterogeneity was assessed with I², risk of bias with the Newcastle–Ottawa Scale and GRADE. Results: Thirty-seven studies, including 4.2 million workers from 28 countries, were included. Occupational injury risk increased by 34% (95% CI:1.21–1.48) per 5 °C rise above regional heat thresholds. Agricultural workers had the highest heat-related mortality (RR 2.15, 95% CI:1.67–2.78) and increased renal dysfunction. Construction injuries rose by 18% during extreme heat events (95% CI:12–24%), while emergency responders had higher cardiovascular risk during wildfire smoke exposure (RR 1.42, 95% CI:1.18–1.71). Forestry workers in expanding transmission zones showed a 2.3-fold increase in vector-borne disease risk. Heterogeneity was substantial (I²=76%), was partly associated with protective equipment access, acclimatisation, and regulatory enforcement. Conclusions: Climate-related exposures are associated with higher occupational risk across sectors, with the greatest burden among outdoor and precariously employed workers. The findings support heat prevention plans, climate-informed exposure standards and stronger occupational surveillance. Longitudinal studies are needed to assess the effectiveness of mitigation across settings. Key messages: • The impacts of climate change on worker morbidity, mortality, and injury patterns, addressing critical gaps and informing public health adaptation strategies. • Need for public health policy to focus on vulnerable worker populations by implementing adaptive workplace standards, cooling interventions, and climate-resilient occupational health infrastructure.
SN - 1101-1262
SN - 1464-360X
ER -