Ss20-03 Farmworkers Working on a Grape Farm in the Northern Cape, South Africa, Die From Heatstroke: Lessons Learned in the Face of Climate Change

Introduction Extreme heat is an increasingly common occurrence worldwide and results in heat-related illnesses and deaths. South Africa is experiencing increased frequency and intensity of heatwaves. In January 2023, the media reported on farmworkers who supposedly presented at health facilities with heatstroke. Here, we report on the first comprehensive collection of data about heatstroke in an occupational setting in South Africa. Materials and Methods The Northern Cape Provincial Department of Health: Environmental Health Division investigated the heatstroke cases that presented at the Kakamas Hospital between 17-23 January 2023. Discussions with hospital management and staff, together with extraction of information from patient files, informed the preparation of this case study. Results Seven seasonal table grape farmworkers (aged 37 - 53 years) from the same farm were received at the Kakamas Hospital. Of the seven workers, two were pronounced dead on arrival. Five workers presented with similar symptoms (i.e., body temperatures >42°C; hemodynamic shock syndrome; and neurological symptoms) and two were successfully resuscitated after receiving cooling therapy, hemodynamic and ventilator support. Three deaths were confirmed as heatstroke while the remaining two could not be specified as such. Ambient maximum temperatures during these heatstroke occurrences ranged between 32-42°C. Conclusions While a full epidemiological study is needed to ascertain whether other factors influenced the deaths of the farmworkers, this incident prompted heat-health interventions in the Northern Cape. All environmental health practitioners and health promotion units were provided with heat-health training to implement an education campaign prior to the 2024 grape harvesting season.