Occupational heat strain among home health care workers: a cross-sectional study

Extreme heat events affect workers' health. Home health care workers face physically strenuous tasks, mobility demands, and increased workloads during heat events. Yet little is known about the extent of heat strain and the specific symptoms they experience. This study aims to examine how home health care workers in Switzerland perceive heat exposure at work and what heat-related symptoms they experience. We examine which factors are associated with perceived heat strain.

We conducted an anonymous online cross‑sectional survey of home health care workers (N = 359) in north-eastern and Southern Switzerland, two climatically distinct regions. Using items from previous studies on occupational heat strain, we assessed perceived heat strain, heat-related symptoms and a set of independent variables. Differences were tested using Mann-Whitney U and chi‑square tests, followed by ordinal logistic regression to identify associations and regional moderation effects.

Substantial perceived heat strain was reported by 86% of participants. Higher levels of perceived heat strain were significantly associated with increased workload (OR 14.06, 95% CI 7.12-28.85), heat-related symptoms (OR 5.27, 2.20-12.88), constrained hydration (OR 2.59, 1.35-5.02), working in southern Switzerland (OR 3.98, 2.11-7.61), and seeking cool environments to rest (OR 3.78, 1.55-9.60).

Home health care workers reported substantial perceived heat strain at work, particularly when workload increased or hydration was constrained. Regional differences were evident, with stronger heat strain in southern Switzerland. Findings highlight the need to develop heat-protection measures tailored to workplace characteristics-such as workload, constrained hydration, and geographical region-to strengthen climate resilience in this essential and understudied workforce.