School of Public Health, University of Washington, Seattle, Washington.
Safety and Health Assessment and Research for Prevention Program, Washington State Department of Labor and Industries, Olympia, Washington.
Am J Ind Med. 2020 Apr;63(4):300-311. doi: 10.1002/ajim.23092. Epub 2020 Jan 28.
Heat related illness (HRI) places a significant burden on the health and safety of working populations and its impacts will likely increase with climate change. The aim of this study was to characterize the demographic and occupational characteristics of Washington workers who suffered from HRI from 2006 to 2017 using workers' compensation claims data.
We used Washington workers' compensation data linked to weather station data to identify cases of work-related HRI. We utilized Occupational Injury and Illness Classification System codes, International Classification of Diseases 9/10 codes, and medical review to identify accepted and rejected Washington State (WA) workers' compensation claims for HRI from 2006 to 2017. We estimated rates of HRI by industry and evaluated patterns by ambient temperature.
We detected 918 confirmed Washington workers' compensation HRI claims from 2006 to 2017, 654 were accepted and 264 were rejected. Public Administration had the highest third quarter rate (131.3 per 100 000 full time employees [FTE]), followed by Agriculture, Forestry, Fishing, and Hunting (102.6 per 100 000 FTE). The median maximum daytime temperature was below the Washington heat rule threshold for 45% of the accepted HRI claims. Latinos were estimated to be overrepresented in HRI cases.
The WA heat rule threshold may not be adequately protecting workers and racial disparities are present in occupational HRI. Employers should take additional precautions to prevent HRI depending on the intensity of heat exposure. States without heat rules and with large industry sectors disproportionately affected by HRI should consider regulations to protect outdoor workers in the face of more frequent and extreme heat waves.
热相关疾病（HRI）对工作人群的健康和安全造成了重大负担，随着气候变化，其影响可能会增加。本研究的目的是利用工人赔偿数据，描述 2006 年至 2017 年期间华盛顿州因 HRI 而患病的工人的人口统计学和职业特征。
我们使用华盛顿州工人赔偿数据与气象站数据相关联，以确定与工作相关的 HRI 病例。我们利用职业伤害和疾病分类系统代码、国际疾病分类第 9/10 版代码和医疗审查，来识别 2006 年至 2017 年期间被接受和拒绝的华盛顿州（WA）工人赔偿 HRI 索赔。我们按行业估算 HRI 的发生率，并评估环境温度的模式。
我们从 2006 年至 2017 年检测到 918 例确诊的华盛顿州工人赔偿 HRI 索赔，其中 654 例被接受，264 例被拒绝。公共管理部门的第三季度发病率最高（每 100000 名全职员工 131.3 例[FTE]），其次是农业、林业、渔业和狩猎（每 100000 名 FTE 102.6 例）。接受的 HRI 索赔中，有 45%的最高日白天温度中位数低于华盛顿州的热规则阈值。估计拉丁裔在 HRI 病例中所占比例过高。
华盛顿州的热规则阈值可能不足以保护工人，职业性 HRI 存在种族差异。雇主应根据热暴露的强度采取额外的预防措施来防止 HRI。没有热规则且受 HRI 影响较大的行业部门比例较大的州应考虑制定法规，以在更频繁和更极端的热浪面前保护户外工作者。
