Climate, Toxic Exposures and Work: Linking the Amazon, Africa, and Southern Europe through a COP30 Dialogue.

Climate change, toxic pollution, and social inequities are converging to create new risks for workers and communities, particularly in the Global South. Yet occupational and environmental health research and policy still tend to address these stressors in isolation, not considering their interactions. To synthesize the main messages of the COP30 side event, "Amazon and Heat: Community-First Climate-Environment-Health Action from the Amazon Basin to Africa and Europe", presented in the context of the LIMA2025 Conference on Occupational Medicine, and to propose a framework for integrated climate-environment-health action in work and community settings. This conference report and policy perspective are based on a narrative synthesis of presentations and discussions delivered during the COP30 side event and subsequently presented at LIMA2025 by researchers, Indigenous leaders, occupational health practitioners and civil society organizations from the Amazon Basin, Africa and Europe. Contributions were grouped into thematic domains: (1) climate and toxic exposures in the Amazon; (2) work and heat in African and Southern European settings; and (3) cross-cutting challenges and policy opportunities. The analysis followed a qualitative thematic approach. Across regions, participants described intersecting exposures to heat, toxic chemicals, air pollution, deforestation and psychosocial stress, disproportionately affecting workers, Indigenous peoples, traditional populations, pregnant women and children. Evidence from cohort studies, intervention projects, and remote-sensing analyses highlighted: (i) elevated mercury exposure and increasing microplastics and diesel contamination in Amazonian communities, alongside climate-sensitive food-system vulnerabilities; (ii) growing heat-related health risks among children and pregnant women in African cities; and (iii) dehydration, kidney dysfunction, and cardiometabolic risks among agricultural and construction workers in Southern Europe. Cross-cutting themes included exposure mixtures, inequities in access to care and justice, persistent data gaps, and the need for locally owned technologies, capacity building, and sustainable solutions. The side event catalyzed the development of an Amazon Climate-Environment-Health Consortium and a shared policy agenda. Integrated, equity-focused action on heat, toxic exposures, and work is essential for a just climate transition.