{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T15:24:39Z","timestamp":1793201079153,"version":"4.5.0"},"reference-count":64,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100003579","name":"university of toronto","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003579","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Environ\ufffdHealth\ufffdInsights"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:p>\n                    Climate change is becoming a recognized health concern in the scientific community, as heat exposure poses escalating health risks to outdoor occupational groups, particularly construction workers. Heat stress and climate change may lead to adverse physical health outcomes and reduced workability among construction workers. This systematic review and meta-analysis aimed to (1) examine the prevalence of physical health outcomes of construction workers in relation to heat exposure and (2) analyze the association between physical health outcomes of heat exposure and work performance by sex and age. Following the PRISMA guidelines and using a PICO framework, we conducted a comprehensive search across APA PsycINFO, MEDLINE, Embase, CINAHL, and Web of Science. Seventeen studies met our inclusion criteria. Outcomes were grouped into dehydration, heat-related illnesses (HRI), kidney function impairments, and heat-related deaths. Random-effects models were used for the meta-analysis, and subgroup analyses were performed using demographic variables. Pooled meta-analysis and heterogeneity statistics are only provided for the HRI outcome, as all other outcomes are only represented by single eligible studies. Dehydration demonstrated the highest single-study prevalence (0.97, 95% CI: 0.88, 1.00), contrasting with HRI pooled prevalence (0.40, 95% CI: 0.24, 0.58) and kidney function impairment single-study prevalence (0.17, 95% CI: 0.05, 0.39), which showed much lower estimates. High heterogeneity was present in the HRI symptoms category (\n                    <jats:italic toggle=\"yes\">I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009&gt;\u200995%). Meta-regression revealed that males reported lower heat disorder prevalences in studies with both sexes (\n                    <jats:italic toggle=\"yes\">\u00df<\/jats:italic>\n                    \u2009=\u2009\u22122.09,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u2009.049). Heat exposure significantly impairs the physical health of construction workers, particularly through dehydration and heat-related illnesses. Sex-responsive, psychological, and intervention-based studies are essential for protecting this vulnerable occupational group from accelerating climate change.\n                  <\/jats:p>","DOI":"10.1177\/11786302261426720","type":"journal-article","created":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T09:24:14Z","timestamp":1773307454000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Heat Exposure and Health Outcomes in Construction Workers: A Systematic Review and Meta-Analysis"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5586-4282","authenticated-orcid":false,"given":"Behdin","family":"Nowrouzi-Kia","sequence":"first","affiliation":[{"name":"Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, ON, Canada"},{"name":"Krembil Research Institute-University Health Network, Toronto, ON, Canada"},{"name":"Centre for Research in Occupational Safety &amp; Health, Laurentian University, Sudbury, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9840-8335","authenticated-orcid":false,"given":"Vijay Kumar","family":"Chattu","sequence":"additional","affiliation":[{"name":"Department of Public Health, Health Administration and Health Sciences, College of Health Sciences, Tennessee State University, Nashville, TN, USA"},{"name":"Central Asian Regional Center for Planetary Health (CARCPH), Semey Medical University, Kazakhstan"},{"name":"Department of Community Medicine, Faculty of Medicine, Datta Meghe Institute of Medical Sciences, Wardha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thankam S.","family":"Sunil","sequence":"additional","affiliation":[{"name":"Department of Public Health, College of Education, Health, and Human Sciences, The University of Tennessee, Knoxville, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7892-5626","authenticated-orcid":false,"given":"Nancy","family":"Carnide","sequence":"additional","affiliation":[{"name":"Institute for Work &amp; Health, Toronto, ON, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Thomson","sequence":"additional","affiliation":[{"name":"Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9167-7445","authenticated-orcid":false,"given":"Raihana","family":"Premji","sequence":"additional","affiliation":[{"name":"Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aishvinigaa","family":"Sathananthan","sequence":"additional","affiliation":[{"name":"Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlene","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Mencia-Ledo","sequence":"additional","affiliation":[{"name":"Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,3,12]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"Canadian Climate Institute. 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