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Abstract Introduction Heat stress will worsen in developing nations with large informal economies and manual labor affecting health and productivity. Materials and Methods We compared heat exposures, job-specific workload, Heat-Related Illnesses (HRIs), Heat Strain Indicators (HSIs), and kidney function data collected from 963 female and 1349 male informal workers in Indian workplaces between 2015 and 2022 to determine who is more vulnerable to heat exposures. Wet Bulb Globe Temperature (WBGT), HSIs, and renal function were measured. Results Average WBGT exposure was 28.8 ± 3.1°C and 66% of workers were subjected to heat levels exceeding the Threshold Limit Values (TLVs). Compared to men, women had 3-fold higher risk of HRIs (95%CI: 1.8-5.2), 2.7-times increased risk of reduction in kidney function (95%CI: 1.8-4.1) and 50% higher risk of HSI and elevated urine specific gravity adjusting for confounders. Among female workers with heat exposures exceeding WBGT-TLVs, heavy workload was associated with a 5-fold increased risk of higher sweat rates (95%CI:1.1-19.7) and a 10-fold increased risk of HRIs (95%CI:5.0-18.4). Conclusions Significant differences in risk of HRI, HSI, and kidney function associated with occupational heat exposures between men and women indicate an increased risk for women which is exacerbated by a lack of welfare facilities and sanitation. Gender inequalities are inherently connected and have an impact on heat vulnerability and adaptability in informal workplaces, necessitating immediate gender-based cooling interventions to empower women, particularly in the rising temperatures scenario. Action is urgent, with or without evidence.
Venugopal et al. (Mon,) studied this question.