Heat Exposure and Health Outcomes in Construction Workers: A Systematic Review and Meta-Analysis
Nowrouzi-Kia B. Chattu V.K. Sunil T.S. Carnide N. Thomson H. Premji R. Sathananthan A. Choi C. Mencia-Ledo J.
January-December 2026SAGE Publications Inc.
Environmental Health Insights
2026#20
Climate change is becoming a recognized health concern in the scientific community, as heat exposure poses escalating health risks to outdoor occupational groups, particularly construction workers. Heat stress and climate change may lead to adverse physical health outcomes and reduced workability among construction workers. This systematic review and meta-analysis aimed to (1) examine the prevalence of physical health outcomes of construction workers in relation to heat exposure and (2) analyze the association between physical health outcomes of heat exposure and work performance by sex and age. Following the PRISMA guidelines and using a PICO framework, we conducted a comprehensive search across APA PsycINFO, MEDLINE, Embase, CINAHL, and Web of Science. Seventeen studies met our inclusion criteria. Outcomes were grouped into dehydration, heat-related illnesses (HRI), kidney function impairments, and heat-related deaths. Random-effects models were used for the meta-analysis, and subgroup analyses were performed using demographic variables. Pooled meta-analysis and heterogeneity statistics are only provided for the HRI outcome, as all other outcomes are only represented by single eligible studies. Dehydration demonstrated the highest single-study prevalence (0.97, 95% CI: 0.88, 1.00), contrasting with HRI pooled prevalence (0.40, 95% CI: 0.24, 0.58) and kidney function impairment single-study prevalence (0.17, 95% CI: 0.05, 0.39), which showed much lower estimates. High heterogeneity was present in the HRI symptoms category (I2 > 95%). Meta-regression revealed that males reported lower heat disorder prevalences in studies with both sexes (ß = −2.09, P = .049). Heat exposure significantly impairs the physical health of construction workers, particularly through dehydration and heat-related illnesses. Sex-responsive, psychological, and intervention-based studies are essential for protecting this vulnerable occupational group from accelerating climate change.
construction workers , heat exposure , heat-related illness , occupational health , systematic review
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Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, ON, Canada
Krembil Research Institute-University Health Network, Toronto, ON, Canada
Centre for Research in Occupational Safety & Health, Laurentian University, Sudbury, ON, Canada
Department of Public Health, Health Administration and Health Sciences, College of Health Sciences, Tennessee State University, Nashville, TN, United States
Central Asian Regional Center for Planetary Health (CARCPH), Semey Medical University, Kazakhstan
Department of Community Medicine, Faculty of Medicine, Datta Meghe Institute of Medical Sciences, Wardha, India
Department of Public Health, College of Education, Health, and Human Sciences, The University of Tennessee, Knoxville, TN, United States
Institute for Work & Health, Toronto, ON, Canada
Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
Department of Occupational Science and Occupational Therapy
Krembil Research Institute-University Health Network
Centre for Research in Occupational Safety & Health
Department of Public Health
Central Asian Regional Center for Planetary Health (CARCPH)
Department of Community Medicine
Department of Public Health
Institute for Work & Health
Dalla Lana School of Public Health
Lawrence Bloomberg Faculty of Nursing
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