Heat Stress Prevention and Management in the Construction Industry: A Gap Analysis

<i>Background:</i> Despite decades of efforts to prevent heat stress, it remains a major health risk to workers in the construction industry. This health risk has been exacerbated by the rising ambient temperatures from climate change, as well as the increased susceptibility to heat stress in an aging workforce. <i>Objective:</i> To develop a tailored occupational safety management framework for heat stress prevention in construction, advancing workers' health, safety, and well-being. <i>Methods:</i> We built on the findings of a systematic review and analyzed a large industrial company's current heat stress prevention program through stakeholder engagement, evidence-based practices, and gap analysis. We reviewed the American Conference of Governmental Industrial Hygienists Threshold Limit Values, the International Standard Organization, and country-specific standards and used the National Institute for Occupational Safety and Health (NIOSH) recommended criteria as a benchmark. Gaps were identified by comparing existing measures to best practices. <i>Findings:</i> Most Wet-bulb Globe Temperature (WBGT) measurements (24.4°C-53.7°C) from the systematic review were collected over short durations without accounting for rest breaks, potentially underestimating or overestimating workers' heat stress and heat-related injuries/illnesses (HRIs) risks. Rest breaks did not follow the WBGT values, which is crucial for mitigating heat stress. Water consumption from the systematic review was below the NIOSH recommendations, with no electrolytes provided. Working 10 h/day, 13 days/two weeks, increases fatigue levels, significantly impacting workers' sleep quality and HRI risks. <i>Conclusion:</i> Preventing heat stress, addressing heat stress management gaps, and advancing construction workers' health, safety, and well-being require stakeholder involvement at all levels.