Heat Stress Prevention in Construction: A Systematic Review and Meta-Analysis of Risk Factors and Control Strategies.

In hot and humid work environments, construction workers can experience heat stress and heat-related illnesses (HRIs). While several studies have investigated engineering and administrative control methods to prevent certain heat stress risk factors, a comprehensive understanding of all existing risk factors and their corresponding control strategies is still lacking. It is crucial to identify gaps in current control strategies and develop a safety management framework for effective heat stress control by implementing existing measures. In addition, the effectiveness of the most common control strategies must be rigorously evaluated to ensure their efficacy and to guide future research aimed at enhancing these strategies or developing more effective ones. This study employed a mixed literature review methodology to address this knowledge gap. A structured literature review investigated and synthesized heat stress risk factors and control methods to find the gaps in control options to address underestimated risk factors. Furthermore, a comprehensive systematic literature review, including trend analysis, scientometric analysis, and meta-analysis, determined research foci and evaluated the effectiveness of the heat stress control methods. The scientometric analysis identified 11 clusters, encompassing key research themes such as environmental risk factors (e.g., high-temperature environments, climate change), administrative controls (e.g., work-rest schedules, climate change risk assessment), and personal interventions (e.g., cooling vests and sleep-related strategies). These findings highlight that the most commonly studied control methods are cooling vests, work-rest schedules, and cooling interventions. According to these results and the availability of quantitative results, the meta-analysis evaluated nine datasets of reductions in core body temperature by using types of cooling vests and anti-heat-stress uniforms and established the significant effectiveness of this control strategy in mitigating heat stress with a medium effect size. Moreover, five potential research studies have been identified to address gaps in control strategies for certain underestimated risk factors, including leveraging sensor technologies, conducting control training, dynamic work-rest schedules, using cutting-edge PPE, and governmental initiatives. Insights gained from this study enhance decision making for resource allocation, selection of control options, and intervention prioritization within a heat-stress-control framework based on the safety management system. The findings also highlight the effectiveness of cooling vests and areas that need to be developed, and evaluate potential heat-stress-control methods in construction.