Heat-Related Symptom Profiles Among Construction Workers: A Latent Class Analysis of Behavioral and Workplace Factors

Construction workers face substantial occupational heat exposure, but little is known about whether heat-related symptoms form distinct co-occurring profiles or which modifiable workplace and behavioral factors characterize workers with greater symptom burden. This study used latent class analysis (LCA) to identify heat-related symptom profiles among construction workers and examine associated behavioral and workplace factors.

This cross-sectional study analyzed data from 357 construction workers at seven South Korean worksites in September 2022. Participants reported heat-related symptoms experienced during the preceding summer (June-August 2022). LCA was performed using four binary indicators: dizziness, headache, heat sensation, and near-accident experience. Factors associated with class membership were examined using R3STEP multinomial logistic regression.

A two-class model provided the best fit (entropy = 0.878), identifying a high-symptom class (29.4%) and a low-symptom class (70.6%). Work persistence tendency was most strongly associated with high-symptom class membership, followed by fatigue severity. Rest break guidance and chronic disease status were inversely associated with membership; the latter association may reflect selection effects among currently employed workers. Rest break practice was positively associated with membership, though this association warrants cautious interpretation given the cross-sectional design.

Nearly one-third of workers belonged to a high-symptom class with co-occurring heat-related symptoms. High-symptom class membership was more strongly associated with behavioral and workplace factors than with individual characteristics. The inverse association with organizational rest break guidance highlights the need for institutional protocols that authorize stopping work before symptoms develop. These findings support organizational interventions that reduce reliance on worker-initiated prevention.