Background and Aims:
Heatwaves have potential health and safety implications for many workers, and heatwaves are predicted to increase in frequency and intensity with climate change. There is currently a lack of comparative evidence for the effects of heatwaves on workers’ health and safety in different climates (sub-tropical and temperate). This study examined the relationship between heatwave severity (as defined by the Excess Heat Factor) and workers’ compensation claims, to define impacts and identify workers at higher risk.
Workers’ compensation claims data from Australian cities with temperate (Melbourne and Perth) and subtropical (Brisbane) climates for the years 2006–2016 were analysed in relation to heatwave severity categories (low and moderate/high severity) using time-stratified case-crossover models.
Consistent impacts of heatwaves were observed in each city with either a protective or null effect during heatwaves of low-intensity while claims increased during moderate/high-severity heatwaves compared with non-heatwave days. The highest effect during moderate/high-severity heatwaves was in Brisbane (RR 1.45, 95% CI: 1.42–1.48). Vulnerable worker subgroups identified across the three cities included: males, workers aged under 34 years, apprentice/trainee workers, labour hire workers, those employed in medium and heavy strength occupations, and workers from outdoor and indoor industrial sectors.
These findings show that work-related injuries and illnesses increase during moderate/high-severity heatwaves in both sub-tropical and temperate climates. Heatwave forecasts should signal the need for heightened heat awareness and preventive measures to minimise the risks to workers.
This is a preview of subscription content, access via your institution
Subscribe to Journal
Get full journal access for 1 year
only $19.83 per issue
All prices are NET prices.
VAT will be added later in the checkout.
Tax calculation will be finalised during checkout.
Get time limited or full article access on ReadCube.
All prices are NET prices.
Steffen W, Hughes L, Perkins S. Heatwaves: hotter, longer, more often. Sydney: Climate Council of Australia; 2014. p. 62.
Gubernot DM, Anderson GB, Hunting KL. The epidemiology of occupational heat exposure in the United States: a review of the literature and assessment of research needs in a changing climate. Int J Biometeorol. 2014;58:1779–88.
Coates L, Haynes K, O’Brien J, McAneney J, de Oliveira FD. Exploring 167 years of vulnerability: an examination of extreme heat events in Australia 1844–2010. Environ Sci Policy. 2014;42:33–44.
Anderson BG, Bell ML. Weather-related mortality: how heat, cold, and heat waves affect mortality in the United States. Epidemiology. 2009;20:205–13.
Xu Z, FitzGerald G, Guo Y, Jalaludin B, Tong S. Impact of heatwave on mortality under different heatwave definitions: a systematic review and meta-analysis. Environ Int. 2016;89-90:193–203.
Li M, Gu S, Bi P, Yang J, Liu Q. Heat waves and morbidity: current knowledge and further direction-a comprehensive literature review. Int J Environ Res Public Health. 2015;12:5256–83.
Xiang J, Bi P, Pisaniello D, Hansen A. The impact of heatwaves on workers’ health and safety in Adelaide, South Australia. Environ Res. 2014;133:90–5.
Varghese BM, Hansen A, Bi P, Pisaniello D. Are workers at risk of occupational injuries due to heat exposure? A comprehensive literature review. Safety Sci. 2018;110(Part A):380–92.
Ricco M. Air temperature exposure and agricultural occupational injuries in the Autonomous Province of Trento (2000-2013, North-Eastern Italy). Int J Occup Med Environ Health. 2018;31:317–31.
Varghese BM, Hansen A, Nitschke M, Nairn J, Hanson-Easey S, Bi P, et al. Heatwave and work-related injuries and illnesses in Adelaide, Australia: a case-crossover analysis using the Excess Heat Factor (EHF) as a universal heatwave index. Int Arch Occup Environ Health. 2018;92:263–72.
McInnes JA, MacFarlane EM, Sim MR, Smith P. The impact of sustained hot weather on risk of acute work-related injury in Melbourne, Australia. Int J Biometeorol. 2017;62:153–63.
Rameezdeen R, Elmualim A. The impact of heat waves on occurrence and severity of construction accidents. Int J Environ Res Public Health. 2017;14:70.
Guo Y, Gasparrini A, Armstrong BG, Tawatsupa B, Tobias A, Lavigne E, et al. Heat wave and mortality: a multicountry, multicommunity study. Environ Health Perspect. 2017;125:087006.
World Meterological Organization and World Health Organization. Heatwaves and health: guidance on warning-system development. Geneva: World Meterological Organization; 2015.
Nairn JR, Fawcett RJ. The excess heat factor: a metric for heatwave intensity and its use in classifying heatwave severity. Int J Environ Res Public Health. 2014;12:227–53.
Kovats RS, Hajat S. Heat stress and public health: a critical review. Annu Rev Public Health. 2008;29:41–55.
Anderson GB, Bell ML. Heat waves in the United States: mortality risk during heat waves and effect modification by heat wave characteristics in 43 U.S. communities. Environ Health Perspect. 2011;119:210–8.
Kent ST, McClure LA, Zaitchik BF, Smith TT, Gohlke JM. Heat waves and health outcomes in Alabama (USA): the importance of heat wave definition. Environ Health Perspect. 2014;122:151–8.
Ma W, Zeng W, Zhou M, Wang L, Rutherford S, Lin H, et al. The short-term effect of heat waves on mortality and its modifiers in China: an analysis from 66 communities. Environ Int. 2015;75:103–9.
Hatvani-Kovacs G, Belusko M, Pockett J, Boland J. Can the excess heat factor indicate heatwave-related morbidity? a case study in Adelaide, South Australia. Ecohealth. 2016;13:100–10.
Scalley BD, Spicer T, Jian L, Xiao J, Nairn J, Robertson A, et al. Responding to heatwave intensity: Excess Heat Factor is a superior predictor of health service utilisation and a trigger for heatwave plans. Aust N Z J Public Health. 2015;39:582–7.
Xiao J, Spicer T, Jian L, Yun GY, Shao C, Nairn J, et al. Variation in population vulnerability to heat wave in Western Australia. Front Public Health. 2017;5:64.
Jegasothy E, McGuire R, Nairn J, Fawcett R, Scalley B. Extreme climatic conditions and health service utilisation across rural and metropolitan New South Wales. Int J Biometeorol. 2017;61:1359–70.
Williams S, Venugopal K, Nitschke M, Nairn J, Fawcett R, Beattie C, et al. Regional morbidity and mortality during heatwaves in South Australia. Int J Biometeorol. 2018;62:1911–26.
Wang Y, Nordio F, Nairn J, Zanobetti A, Schwartz JD. Accounting for adaptation and intensity in projecting heat wave-related mortality. Environ Res. 2018;161:464–71.
Urban A, Hanzlikova H, Kysely J, Plavcova E. Impacts of the 2015 heat waves on mortality in the Czech Republic-a comparison with previous heat waves. Int J Environ Res Public Health. 2017;14:e1562.
Xu Z, Tong S. Decompose the association between heatwave and mortality: Which type of heatwave is more detrimental? Environ Res. 2017;156:770–4.
Tong S, FitzGerald G, Wang XY, Aitken P, Tippett V, Chen D, et al. Exploration of the health risk-based definition for heatwave: A multi-city study. Environ Res. 2015;142:696–702.
Tong S, Wang XY, Yu W, Chen D, Wang X. The impact of heatwaves on mortality in Australia: a multicity study. BMJ Open. 2014;4:e003579.
Wang XY, Guo Y, FitzGerald G, Aitken P, Tippett V, Chen D, et al. The impacts of heatwaves on mortality differ with different study periods: a multi-city time series investigation. PLoS ONE. 2015;10:e0134233.
IPCC. Climate Change 2014: impacts, adaptation, and vulnerability. Part A: Global and Sectoral Aspects. Contribution of Working Group II to the Fifth Assessment Report of the Intergovernmental Panel on Climate. 2014.
Sturman A, Tapper N. The weather and climate of Australia and New Zealand. 2nd ed. Melbourne, Australia: Oxford University Press; 2006. p. 520.
Williams S, Nitschke M, Weinstein P, Pisaniello DL, Parton KA, Bi P. The impact of summer temperatures and heatwaves on mortality and morbidity in Perth, Australia 1994-2008. Environ Int. 2012;40:33–8.
Australian Bureau of Statistics. 2001.0 - Census of Population and Housing: General Community Profile, Australia, 2016. Canberra: Australian Bureau of Statistics; 2017.
Safe Work Australia. Australian workers’ compensation statistics 2015–16. Statistical reports. Canberra: Safe Work Australia; 2017.
Gray SE, Collie A. The nature and burden of occupational injury among first responder occupations: a retrospective cohort study in Australian workers. Injury. 2017;48:2470–7.
Collie A, Lane TJ, Hassani-Mahmooei B, Thompson J, McLeod C. Does time off work after injury vary by jurisdiction? A comparative study of eight Australian workers’ compensation systems. BMJ Open. 2016;6:e010910.
Safe Work Australia. Comparison of workers’ compensation arrangements in Australia and New Zealand (2017). 25th ed. Canberra: Safe Work Australia; 2017.
McInnes JA, Akram M, MacFarlane EM, Keegel T, Sim MR, Smith P. Association between high ambient temperature and acute work-related injury: a case-crossover analysis using workers’ compensation claims data. Scand J Work Environ Health. 2017;43:86–94.
Australian Bureau of Statistics. 1220.0 – ANZSCO – Australian and New Zealand Standard Classification of Occupations, 2013, version 1.2. Canberra: ABS; 2013.
Human Resources & Skills Development Canada. National Occupational Classification Career Handbook. Ottawa, ON: Government of Canada; 2011.
Qiao Z, Guo Y, Yu W, Tong S. Assessment of short- and long-term mortality displacement in heat-related deaths in brisbane, australia, 1996–2004. Environ Health Perspect. 2015;123:766–72.
Loughnan M, Tapper N, Loughnan T. The impact of “unseasonably” warm spring temperatures on acute myocardial infarction hospital admissions in Melbourne, Australia: a city with a temperate climate. J Environ Public Health. 2014;2014:483785.
Loughnan M, Tapper N, Phan T, Lynch K, McInnes J. A spatial vulnerability analysis of urban populations during extreme heat events in Australian capital cities. Gold Coast: National Climate Change Adaptation Research Facility; 2013.
Maclure M. The case-crossover design: a method for studying transient effects on the risk of acute events. Am J Epidemiol. 1991;133:144–53.
Janes H, Sheppard L, Lumley T. Case-crossover analyses of air pollution exposure data: referent selection strategies and their implications for bias. Epidemiology. 2005;16:717–26.
Spector JT, Bonauto DK, Sheppard L, Busch-Isaksen T, Calkins M, Adams D, et al. A case-crossover study of heat exposure and injury risk in outdoor agricultural workers. PLoS ONE. 2016;11:e0164498.
Xiang J, Bi P, Pisaniello D, Hansen A, Sullivan T. Association between high temperature and work-related injuries in Adelaide, South Australia, 2001–2010. Occup Environ Med. 2014;71:246–52.
Morabito M, Cecchi L, Crisci A, Modesti PA, Orlandini S. Relationship between work-related accidents and hot weather conditions in Tuscany (central Italy). Ind Health. 2006;44:458–64.
Adam-Poupart A, Smargiassi A, Busque MA, Duguay P, Fournier M, Zayed J, et al. Effect of summer outdoor temperatures on work-related injuries in Quebec (Canada). Occup Environ Med. 2015;72:338–45.
Xiang J, Bi P, Pisaniello D, Hansen A. Health impacts of workplace heat exposure: an epidemiological review. Ind Health. 2014;52:91–101.
Toloo GS, Yu W, Aitken P, FitzGerald G, Tong S. The impact of heatwaves on emergency department visits in Brisbane, Australia: a time series study. Crit Care. 2014;18:R69.
Tong S, Wang XY, Guo Y. Assessing the short-term effects of heatwaves on mortality and morbidity in Brisbane, Australia: comparison of case-crossover and time series analyses. PLoS ONE. 2012;7:e37500.
Tong S, Wang XY, Barnett AG. Assessment of heat-related health impacts in Brisbane, Australia: comparison of different heatwave definitions. PLoS ONE. 2010;5:e12155.
Tong S, Wang XY, FitzGerald G, McRae D, Neville G, Tippett V, et al. Development of health risk-based metrics for defining a heatwave: a time series study in Brisbane, Australia. BMC Public Health. 2014;14:435.
Toloo GS, Guo Y, Turner L, Qi X, Aitken P, Tong S. Socio-demographic vulnerability to heatwave impacts in Brisbane, Australia: a time series analysis. Aust N Z J Public Health. 2014;38:430–5.
Wang XY, Barnett AG, Yu W, FitzGerald G, Tippett V, Aitken P, et al. The impact of heatwaves on mortality and emergency hospital admissions from non-external causes in Brisbane, Australia. Occup Environ Med. 2012;69:163–9.
Wang XY, Barnett A, Guo YM, Yu WW, Shen XM, Tong SL. Increased risk of emergency hospital admissions for children with renal diseases during heatwaves in Brisbane, Australia. World J Pediatr. 2014;10:330–5.
Turner LR, Connell D, Tong S. The effect of heat waves on ambulance attendances in Brisbane, Australia. Prehosp Disaster Med. 2013;28:482–7.
Tanaka M. Heat stress standard for hot work environments in Japan. Ind Health. 2007;45:85–90.
Parsons K. Human thermal environments: the effects of hot, moderate, and cold environments on human health, comfort, and performance. 3rd edn. Boca Raton, FL: CRC press; 2014.
Nairn J, Fawcett R. Heatwaves in Queensland. Aust J Emerg Manag. 2017;32:44–53.
Industrial Relations Victoria. Victorian Inquiry into the Labour Hire Industry and Insecure Work. Melbourne: Department of Economic Development, Jobs, Transport and Resources; 2016.
Hansen A, Pisaniello D, Varghese B, Rowett S, Hanson-Easey S, Bi P, et al. What can we learn about workplace heat stress management from a safety regulator complaints database? Int J Environ Res Public Health. 2018;15:3.
Jay O, Kenny GP. Heat exposure in the Canadian workplace. Am J Ind Med. 2010;53:842–53.
Hanna EG, Tait PW. Limitations to thermoregulation and acclimatization challenge human adaptation to global warming. Int J Environ Res Public Health. 2015;12:8034–74.
Safe Work Australia. Model Code of Practice: managing the work environment and facilities. Canberra: Safe Work Australia; 2018. p. 17–18.
Cheung SS, Lee JKW, Oksa J. Thermal stress, human performance, and physical employment standards. Appl Physiol Nutr Metab. 2016;41(6 (Suppl. 2)):S148–S64.
McInnes JA, MacFarlane EM, Sim MR, Smith P. Working in hot weather: a review of policies and guidelines to minimise the risk of harm to Australian workers. Inj Prev. 2016;23:334–9.
Australian Government Bureau of Meterology. Heatwave Service for Australia Canberra: BOM. 2017 [cited 29 Nov 2017]. http://www.bom.gov.au/australia/heatwave/.
Lane TCA, Hassani-Mahmooei B. Work-related injury and illness in Australia, 2004 to 2014. What is the incidence of work-related conditions and their impact on time lost from work by state and territory, age, gender and injury type? Melbourne (AU): Monash University, ISCRR: Monash University; 2016.
We would like to thank SafeWork Australia and the Australian Bureau of Meteorology for the provision of the workers’ compensation claims and meteorological data. Special thanks to Dr Susan Williams for providing comments on the manuscript.
This research is funded by the Australian Research Council (ARC Project ID DP160103059 to Dino Pisaniello). BMV is supported by the University of Adelaide Faculty Of Health Sciences Divisional Scholarship. AGB is supported by the National Health and Medical Research Council (APP1117784).
Conflict of interest
The authors declare that they have no conflict of interest.
Publisher’s note: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
About this article
Cite this article
Varghese, B.M., Barnett, A.G., Hansen, A.L. et al. Characterising the impact of heatwaves on work-related injuries and illnesses in three Australian cities using a standard heatwave definition- Excess Heat Factor (EHF). J Expo Sci Environ Epidemiol 29, 821–830 (2019). https://doi.org/10.1038/s41370-019-0138-1
- Workers health and safety