OCCUPATIONAL

Comprehensive and updated throughout, this new edition makes it easy to detect, diagnose, and treat the full spectrum of problems caused by occupational or environmental factors, including physical, chemical, and biologic agents. An international cast of experts offers in-depth, authoritative guidance on clinical problems as well as the legal and regulatory issues impacting the practice of occupational and environmental medicine today. Section 1 is on principles and practice. Section 2 on work sectors and special populations includes a chapter on mining.

While climate change continues to increase ambient temperatures, the resulting heat stress exposure to workers in non-climate controlled settings is not well characterized, particularly in low and middle income countries. This preliminary report describes current heat stress in Nicaraguan work places and estimates occupational heat stress in 2050. From over 400 measurements of heat exposure using wet bulb globe temperature, more than 10% of all measurements exceeded the safety threshold for the combination of light work and rest at the ratio of 25:75.

Excessive workplace heat exposures create well-known risks of heat stroke, and it limits the workers' capacity to sustain physical activity. There is very limited evidence available on how these effects reduce work productivity, while the quantitative relationship between heat and work productivity is an essential basis for climate change impact assessments. We measured hourly heat exposure in rice fields in West Bengal and recorded perceived health problems via interviews of 124 rice harvesters. In a sub-group (n = 48) heart rate was recorded every minute in a standard work situation.