As the impacts of climate change accelerate, so does heat stress and ill health among NHS workers. Tom Pashby reports
The climate emergency is often illustrated with vulnerable people in the Global South experiencing heat stress due to poor or non-existent climate adaptation measures, such as access to suitable buildings and clean water. What has been less well studied is the impact of extreme heat on workers in the UK who are not typically seen as vulnerable.
Heat-stress-related illnesses experienced by workers in the so-called developed world are likely to increase because of climate breakdown, despite better access to cutting-edge technology and building design compared with those in the majority world.
The UK faces many obstacles in attempting to reduce the likelihood of workers experiencing heat stress. These include an ageing building stock, which was designed to keep heat in when the climate was cooler, infrastructure that was built at a time when the urban heat island effect was not fully understood, poor levels of education among the public about how to keep cool and hydrated, and a lack of coordination between government, developers and retrofitters.
Dr Maddy Wedge-Bull, a junior doctor from Brighton, says the NHS hospital where she works in Chichester “is always too hot”.
“Even in the winter, it’s way too hot, because we have the heating on all the time. At the moment [in summer] it is worse, because we have no way to regulate that heat and keep it cool. The buildings in the UK are just not designed for hot weather.”
Even newer buildings aren’t constructed to withstand heat, she adds. “The first one I worked in, around nine years ago, was built about 25 years ago, and that was like a greenhouse in summer.”
Addressing heat stress in workers in ageing buildings is not simply a matter of turning down the thermostat or commissioning more effective insulation. There are a whole series of unhelpful culturally embedded assumptions about the UK – for example, that it is temperate with few heatwaves, and that air conditioning is only needed in countries that are hotter than the UK. Such assumptions need to be overcome in order to provide conditions in the UK that are better for workers’ health.
Wedge-Bull says: “There are more reports of staff becoming exhausted and collapsing from the heat, but looking after yourself in the heat is not something that is really drilled into you at medical school.”
As things stand, action to reduce exposure to heat stress is piecemeal and takes more of a bottom-up approach, which some would argue is inadequate given the systemic nature of the climate emergency. Global average temperatures have risen 1.2°C since the Industrial Revolution, which has increased the intensity and frequency
of heatwaves in the UK.
With the government focused on decarbonisation as its key response to the climate emergency, the market is reacting to the need to adapt our buildings.
While many people in the UK do work in exposed environments, such as construction and agriculture, others are employed in the services sector, which relies heavily on older buildings for offices.
Rebecca Armstrong, managing director at retrofitting company Making Energy Greener, says: “We’re really interested in looking at a building in its current state, rather than dismantling the whole building, with all the carbon that removing that building and replacing it with a new one would entail. It’s where you remove some of the existing structure and refit it using modern installation techniques. But it’s a huge task.”
Armstrong says bringing old buildings in line with modern energy efficiency, ventilation and cooling standards can be difficult because of the materials used in the original build. This is further complicated if a building is ‘listed’.
Firms such as Making Energy Greener are only able to retrofit a relatively small number of buildings, and yet most of the UK’s housing stock needs to be assessed and potentially brought up to date.
A need for speed
To retrofit at the scale and speed required, there may need to be a shift in the attitude of policymakers, an increase in the capacity of businesses providing retrofit services to respond, and the resources of government, to rise to the challenge of heat stress experienced by workers in buildings.
It is unclear whether there is enough awareness about the lack of action on preventing heat-stress-related health issues in the UK. A best-case scenario is that tackling heat stress in workers is a ‘known unknown’ for decision-makers and will be dealt with soon.
The worst-case scenario is that it remains a niche issue with too little attention given to retrofitting buildings and informing workers about how to look after themselves.
With the UK expecting a rise in hotter and longer heatwaves, it is critical to resolve the situation.
Tom Pashby, AIEMA, is a digital journalist at IEMA
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