ArticleBMC public health2026
Occupational heat stress in hospital settings: a combined assessment of staff perceptions and indoor climate to support heat action planning.
Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND AND
aimsOccupational heat stress in healthcare settings is an emerging public health concern, yet evidence on indoor heat exposure and perception in hospitals remains limited. This study assessed perceived occupational heat stress among hospital employees by integrating staff-reported heat perceptions with indoor temperature measurements to identify associations between perceived heat stress, workplace characteristics, preventive behaviors, heat-related knowledge, and indoor thermal conditions.
methodsA cross-sectional study was conducted at a large tertiary care hospital in southern Germany. An anonymous online survey collected data on heat perception, heat-related symptoms, work impairment, preventive behaviors, knowledge, training and heat warning practices among hospital employees. Multiple survey items resulted in a perceived occupational heat stress index (POHSI). Indoor air temperature was measured continuously during the summer periods 2024 and 2025 using calibrated sensor loggers placed in staff rooms across the hospital. Associations between POHSI, workplace factors, preventive measures, and environmental conditions were analyzed descriptively and inferentially.
resultsA total of 681 employees participated. 38.7% of the participants scored high or very high POHSI. Frequently reported symptoms included fatigue, concentration difficulties, and dizziness, accompanied by reduced work performance. Higher POHSIs were observed among physically active staff and clustered spatially in upper floors with elevated indoor temperatures. Lower levels of heat-related knowledge and training were associated with higher POHSIs (ANOVA: F = 15.33, p < 0.001; Kruskal-Wallis: χ² = 54.05, p < 0.001) with moderate effect sizes (η² ≈ 0.09). While some individual preventive measures were associated with lower POHSI, participants predominantly requested structural and organizational interventions. Subjective heat perceptions corresponded closely with measured indoor temperature patterns.
conclusionOccupational heat stress represents a relevant indoor environmental and occupational health challenge in hospital settings. The combination of subjective and objective indicators enabled the identification of heat-vulnerable work environments and associated workplace, knowledge-related, and environmental factors. The findings further indicate that individual coping strategies alone may be insufficient under sustained indoor heat exposure and support the development of hospital-specific heat prevention and adaptation strategies.
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