Home care workers’ perceived heat strain at work

Introduction: While a large body of research examined heat stress in outdoor workers, less is known about heat strain among home care workers, despite these professionals being exposed to heat and physical demands as well. Home care workers are required to commute between their clients’ homes, often under time pressure, and are engaged in physically strenuous tasks such as lifting people. In addition, their workload increases in case of heat episodes, due to their client’s high vulnerability to heat. From a public health perspective, heat strain among home care workers may be mitigated by climate change adaptation strategies specifically targeted to the needs and circumstances for home care workers. Methods: To investigate the influence of occupational factors on home care workers’ perceived heat strain, we conducted an online survey among home care workers in German- and Italianspeaking Switzerland using REDCap (N=359; 87.7% female; mean age 44.7; summer 2024). Results: Results show that 86.4% of home care workers reported working during heat episodes to be rather strenuous or very strenuous, 12.0% reported little or no heat strain. Heat strain is most strongly associated with an increase in workload during heat episodes (OR= 13.90, 95% CI [6.99; 28.71]), the experience of heat-related symptoms (OR=5.95, 95% CI [2.39; 15.2]) or the restriction of fluid intake (OR=2.56, 95% CI [1.32; 5.02]). Using an e-Bike to commute between clients’ homes was associated with lower heat strain (OR=0.40, 95% CI [0.17; 0.93]). Discussion: Our analysis shows, that home care workers’ working conditions are substantially affected by heat episodes. One of the main contributing factors are increased workload and insufficient fluid intake (e.g., due to insufficient time or restroom availability). From a public health perspective, to protect workers’ health and ensure ambulant health services, profession specific heat adaptation strategies are needed, as heat episodes are expected to continue to increase in Switzerland.