Ding Ranyi, Wang Yutong, Yu Yuelin, Meng Xianglong, Gong Quanquan, Tang Yuchuan, Wang Jinhao, Mu Xianlin, Li Huiping, Zhou Huziwei, Wang Shengfeng, Liu Ping
School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Eye Institute of Shandong First Medical University, Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), State Key Laboratory Cultivation Base, Shandong Key Laboratory of Eye Diseases, School of Ophthalmology, Shandong First Medical University, Jinan, Shandong, China.
Environ Health Perspect. 2025 Jan;133(1):17001. doi: 10.1289/EHP14172. Epub 2025 Jan 8.
Occupational heat-related illness (OHI) is a health threat to workers that can be fatal in severe cases. Effective and feasible measures are urgently needed to prevent OHI.
We evaluated the effectiveness of a multifaceted intervention, TEMP, in reducing the OHI risk among outdoor workers in the power grid industry.
A cluster randomized controlled trial was conducted with power grid outdoor workers in Southern China from 4 July 2022 to 28 August 2022. Work groups were randomly allocated (1:1) to the intervention or control groups. The multifaceted intervention TEMP comprised mobile application (app)-based education training (T), personal protective equipment [PPE (E)], OHI risk monitoring (M), and educational posters (P). Four follow-ups were conducted every 2 wk after the trial began. The primary outcome was the OHI incidence, and the secondary outcome was PPE usage. The app usage was considered as the compliance of intervention in the intervention group. The primary analysis used was intention-to-treat analysis. Multilevel analyses using random effects logistic regression models were performed to compare the odds of OHI between the two groups, adjusted for individual-level (education and work position) and work-related (including water intake when feeling thirsty, cooling measures, and poor sleep before work) covariates.
Of 528 participants, 422 (79.92%) were males, and the age was y. The primary outcome, OHI incidence, was 1.80% in the intervention group and 4.82% in the control group at the end of the whole follow-up. OHI mainly occurred between 1100 and 1500 hours, with nausea, significantly increased heart rate, and oliguria being the top three reported OHI symptoms. Compared with the control group, the adjusted odds ratios between the intervention group and control group were 0.73 [95% confidence interval (CI): 0.30, 1.76] in the first follow-up wave, with 0.38 (95% CI: 0.15, 0.97), 0.29 (95% CI: 0.08, 1.05), and 0.39 (95% CI: 0.13, 1.19) in the following three follow-up waves, respectively. The intervention also significantly improved PPE usage in the intervention group.
This multifaceted intervention reduced the OHI risk among outdoor workers in the power grid industry. However, further research is needed to design a more flexible intervention strategy and evaluate its effectiveness in a larger population. https://doi.org/10.1289/EHP14172.
职业性热相关疾病（OHI）对工人的健康构成威胁，严重时可能致命。迫切需要采取有效可行的措施来预防职业性热相关疾病。
我们评估了多方面干预措施TEMP在降低电网行业户外工作者职业性热相关疾病风险方面的有效性。
于2022年7月4日至2022年8月28日对中国南方电网户外工作者进行了一项整群随机对照试验。工作小组被随机分配（1:1）到干预组或对照组。多方面干预措施TEMP包括基于移动应用程序（app）的教育培训（T）、个人防护装备[PPE（E）]、职业性热相关疾病风险监测（M）和教育海报（P）。试验开始后每2周进行4次随访。主要结局是职业性热相关疾病发病率，次要结局是个人防护装备的使用情况。应用程序的使用被视为干预组的干预依从性。主要分析采用意向性分析。使用随机效应逻辑回归模型进行多水平分析，以比较两组之间职业性热相关疾病的发病几率，并对个体水平（教育程度和工作岗位）和工作相关因素（包括感到口渴时的饮水量、降温措施以及工作前睡眠不佳）进行协变量调整。
528名参与者中，422名（79.92%）为男性，平均年龄为 岁。在整个随访结束时，主要结局职业性热相关疾病发病率在干预组为1.80%，在对照组为4.82%。职业性热相关疾病主要发生在11:00至15:00之间，恶心、心率显著加快和少尿是报告最多的职业性热相关疾病的三大症状。与对照组相比，在第一次随访中，干预组与对照组调整后的比值比为0.73[95%置信区间（CI）：0.30，1.76]，在随后的三次随访中分别为0.38（95%CI：0.15，0.97）、0.29（95%CI：0.08，1.05）和0.39（95%CI：0.13，1.19）。该干预措施还显著提高了干预组个人防护装备的使用情况。
这种多方面干预降低了电网行业户外工作者职业性热相关疾病的风险。然而，需要进一步研究以设计更灵活的干预策略，并在更大规模人群中评估其有效性。https://doi.org/10.1289/EHP14172 。
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