Working in Extreme Heat, an Invisible Occupational Risk: Legislation, Risk Management and Policy Recommendations for Türkiye: Turkish Thoracic Society Workshop Report on the Regulation of Working Conditions in Extreme Heat

Extreme heat, amplified by climate change, has become a predictable and escalating occupational hazard in Türkiye, increasing the burden of heat-related illnesses, traumatic workplace injuries, and productivity losses among both outdoor and indoor workers, particularly in labor-intensive sectors and among vulnerable populations. This Turkish Thoracic Society workshop report synthesizes interdisciplinary expert input and available evidence to propose a practical, prevention-focused framework for regulating working conditions in extreme temperatures. The recommendations were systematically developed through four thematic interdisciplinary working groups and finalized by plenary consensus. Key recommendations include explicitly defining employers' duties to assess, prevent, and manage extreme weather-related risks within Occupational Health and Safety Law No. 6331; establishing secondary regulations that operationalize temperature/Wet-Bulb Globe Temperature (WBGT)-triggered work-rest schedules, hydration and cooling requirements, and acclimatization protocols; and standardizing objective heat-stress monitoring using the WBGT index (aligned with ISO 7243). The report prioritizes engineering and administrative controls (shading, ventilation/cooling, shift adjustments, rest areas, and "buddy systems") over reliance on personal protective equipment, and calls for strengthened labor inspection capacity "through the lens of climate change." Additional policy actions include integrating heat-related outcomes into occupational disease and injury surveillance systems, enhancing inter-institutional coordination for rapid reporting and work-stoppage mechanisms during extreme heat events, and implementing multilingual, sector-specific training and emergency preparedness pathways. Protecting informal and migrant workers, seasonal agricultural laborers, and individuals with chronic cardiopulmonary disease is highlighted as a core priority for equity and climate justice.