Occupational Heat Stress and Kidney Health Among Construction Workers: A Review of Emerging Evidence

This paper presents a structured narrative review of ten empirical studies published between 2008 and 2025, examining the relationships between heat exposure, hydration and kidney-related outcomes among construction workers. The studies were identified through targeted searches of Scopus and PubMed and interpreted using an ergonomics-informed work systems perspective. The findings suggest that construction workers are frequently exposed to heat levels that exceed recommended safety thresholds, with dehydration remaining common under real-world site conditions. Across the studies, there are indications of recurring kidney stress, including biomarkers associated with acute kidney injury (AKI), although reported rates vary due to differences in study design and measurement methods. Evidence relating to longer-term outcomes is still limited and remains inconclusive. A key contribution of this study is the development of a conceptual framework that brings together environmental heat exposure, pathophysiological response pathways and organisational and behavioural influences within a work systems context. This framework suggests that heat-related kidney risk is influenced not only by environmental exposure, but also by the interaction between work demands, organisational conditions and the factors that shape worker behaviours. Evidence points towards the need for multi-level strategies to protect workers, including better hydration practices, more adaptive work–rest scheduling and improved occupational health monitoring. The review also highlights important gaps in current knowledge, particularly the need for more longitudinal research and greater consistency in how outcomes are measured. Addressing heat-related kidney risks will be increasingly important for protecting worker health and supporting safe and sustainable construction practices in a warming climate.