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Background: The health impacts of heatwaves are a growing public health concern with the frequency, intensity, and duration of heatwaves increasing with global climate change. However, little is known about the healthcare costs and the attributable morbidity associated with heatwaves Objective This study aims to examine the relationship between heatwaves and costs of emergency department (ED) presentations, and to quantify heat-attributable burden during the warm seasons of 2014–2017, in Adelaide, South Australia. Methods: Daily data on ED presentations and associated costs for the period 2014–2017 were obtained from the South Australian Department of Health and Wellbeing. Heatwave intensity was determined using the excess heat factor (EHF) index, obtained from the Australian Bureau of Meteorology. A distributed lag non-linear model (DLNM) was used to quantify the cumulative risk of heatwave-intensity over a lag of 0–7 days on ED presentations and costs. Effects of heatwaves were estimated relative to no heatwave. The number of ED presentations and costs attributable to heatwaves was calculated separately for two EHF severity categories (low-intensity and severe/extreme heatwaves). Subgroup analyses by disease-diagnosis groups and age categories were performed. Results: For most disease diagnosis and age categories, low-intensity and severe heatwaves were associated with higher rates of ED presentations and costs. We estimated a total of 1161 (95% empirical confidence interval (eCI): 342, 1944) heatwave-attributable all-cause ED presentations and associated healthcare costs (thousands) of AU$1020.3 (95% eCI: 224.9, 1804.7) during the warm seasons of 2014–2017. The heat-related illness was the disease category contributing most to ED presentations and costs. Age groups 0–14 and ≥ 65 years were most susceptible to heat. Conclusions: Heatwaves produced a statistically significant case-load and cost burden to the ED. Developing tailored interventions for the most vul

Introduction: Hot workplace environments can lead to adverse health effects and contribute to a range of injuries. However, there is limited contextual understanding of heat-related injury occurrence. Gaining the perspectives of occupational health and safety professionals (HSPs) may elucidate the issue and inform targeted interventions. Methods: A cross-sectional national online survey was conducted in Australia to characterise HSP perceptions of heat-related injuries; current preventive measures; training, policies and guidelines; and perspectives on barriers for prevention. Results were analysed descriptively and a log-Poisson regression model was used to identify risk factors associated with HSP reported injury occurrence, assessed through prevalence ratio (PR). Results: Of the 307 HSP survey participants, 74% acknowledged the potential for increased risk of occupational injuries in hot weather. A variety of injury types and mechanisms were reported, including manual handling injuries, hand injuries, wounds or lacerations, and loss of control of power tools. Correlates of reported heat-related injuries included working in the sun without shade [PR: 1.26; 95% CI: 1.07–1.48] and too few rest breaks [PR: 1.28; 95% CI: 1.04–1.44]. Other factors of significance were inadequate hydration; issues with personal protective equipment (PPE) and poor supervision of workers. Only 42% reported that adequate heat training was available and 54% reported the provision for outdoor work to cease in extreme temperatures. It was acknowledged that the frequency of injuries could be reduced with wider adoption of self-pacing, and work/rest regimes. Perceived barriers for prevention included: lack of awareness of physical injury risks, and management concerns about productivity loss and/or deadlines. Conclusion: The findings indicate a range of potentially modifiable work and organisational risk factors such as more suitable PPE and better supervision. More attention to these factor

Background: The thermal environment can directly affect workers’ occupational health and safety, and act as a contributing factor to injury or illness. However, the literature addressing risks posed by varying temperatures on work-related injuries and illnesses is limited. Objectives: To examine the occupational injury and illness risk profiles for hot and cold conditions. Methods: Daily numbers of workers’ compensation claims in Adelaide, South Australia from 2003 to 2013 (n = 224,631) were sourced together with daily weather data. The impacts of maximum daily temperature on the risk of work-related injuries and illnesses was assessed using a time-stratified case-crossover study design combined with a distributed lag non-linear model. Results: The minimum number of workers’ compensation claims occurred when the maximum daily temperature was 25 °C. Compared with this optimal temperature, extremely hot temperatures (99th percentile) were associated with an increase in overall claims (RR: 1.30, 95%CI: 1.18–1.44) whereas a non-significant increase was observed with extremely cold temperatures (1st percentile, RR: 1.10 (95%CI: 0.99–1.21). Heat exposure had an acute effect on workers’ injuries whereas cold conditions resulted in delayed effects. Moderate temperatures were associated with a greater injury burden than extreme temperatures. Conclusion: Days of very high temperatures were associated with the greatest risks of occupational injuries; whereas moderate temperatures, which occur more commonly, have the greatest burden. These findings suggest that the broader range of thermal conditions should be considered in workplace injury and illness prevention strategies.