Occupational heat perception and susceptibility in outdoor workers: A mini review

Abstract

The impacts of climate change are worsening occupational heat exposure worldwide, putting outdoor workers at the forefront of thermal risk. While the physiological impacts of heat stress are well documented, little attention has been paid to how workers themselves perceive heat exposure and the associated health threats. This mini-review synthesizes objective evidence on occupational heat perception among outdoor workers, focusing on perceived heat burden, symptom experience, vulnerability, and adaptive responses. A structured search of major scientific databases identified 16 original studies across different geographical settings, covering agriculture, construction, brick kilns, forestry, and informal labor. Across regions and occupations, workers commonly perceived heat as a leading occupational hazard associated with heat-related symptoms (HRIs): exhaustion, dehydration, dizziness, headaches, and reduced productivity. Heat was more often characterized as a daily bodily burden than a general environmental condition. Physiological perception of heat consistently emerged as an embodied indicator of underlying thermal strain, linking subjective experience with cardiovascular and hydration stress. Perceived vulnerability was not homogeneous: women, pregnant workers, older workers, workers with chronic disease, and those in the informal sector repetitively reported heightened perceived vulnerability and lower coping capacity. Importantly, workers’ accounts strongly mirrored objective indicators of physiological strain, confirming perceived heat stress as a valid occupational health indicator. Yet despite broad awareness of heat-related risks, effective protective practices were often limited by economic constraints and weak organizational support. Heat perception is an important yet often overlooked factor in occupational heat risk. Incorporating lived thermal experience into surveillance, research, and prevention may enhance early identification of heat strain and enable more worker- centered, equitable climate adaptation approaches.