Occupational heat perception and susceptibility in outdoor workers: a mini review

Abstract

The effect of climate change is worsening occupational heat exposure across the world, putting outdoor workers at the forefront of thermal risk. While the physiological effects of heat stress are well-documented, there has been little attention paid to how workers themselves perceive heat exposure and associated health threats. This mini-review synthesizes empirical evidence on occupational heat perception among outdoor workers, focusing on perceived heat burden, symptom experience, vulnerability, and adaptive responses. A structured search of major scientific databases identified 16 original studies across South Asia, Southeast Asia, Africa, Australia, and North America, covering the agriculture, construction, brick kilns, forestry, and informal labor sectors. Across regions and occupations, workers commonly perceived heat as a leading occupational hazard associated with symptoms of HRIs: exhaustion, dehydration, dizziness, headaches, and reduced productivity. Heat was more often characterized as a daily bodily burden than a general environmental condition. Physiological perception of heat consistently emerged as an embodied indicator of underlying thermal strain, linking subjective experience with cardiovascular and hydration stress. Perceived vulnerability was not homogeneous: women, pregnant workers, older workers, workers with chronic disease, and those in the informal sector repetitively reported heightened perceived vulnerability and lower coping capacity. Importantly, workers’ accounts strongly mirrored objective indicators of physiological strain, confirming perceived heat stress as a valid occupational health indicator. Yet despite broad-based awareness of heat-related risks, effective protective practices were often limited due to economic constraints and weak organizational support. Heat perception is an important but often disregarded feature of occupational heat risk. Incorporating lived thermal experience into surveillance, research, and prevention may enhance early identification of heat strain and permit more worker-centred and equitable climate adaptation approaches.