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Heat Stress Impacts on Cardiac Mortality in Nepali Migrant Workers in Qatar

机译：卡塔尔尼泊尔农民工对心脏死亡率的热应激影响

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Background: Qatar is a major destination country for Nepali migrant workers (NMWs; main age range 25-35 years) in the construction trade. These 120,000+ NMWs are exposed to various occupational hazards, including excessive heat, and 3-4 workers die each week. Our study aimed to show whether heat exposure caused deaths. Methods: The worker population and mortality data of NMWs were retrieved from government institutions in Nepal. Heat exposure was assessed by monthly estimates of daily wet bulb globe temperature (WBGT), for in-shade conditions, from data collected at the Doha weather station from 2009 to 2017. Working in the sun during the middle of the day would add 2-3 degrees C to the in-shade WBGT values. Daily deaths and their causes were obtained from the records of the Foreign Employment Promotion Board (FEPB) in Nepal, 2009-2017. Interviews with returning NMWs about their working conditions and the impacts of these conditions added information. The association between the heat variable and mortality was tested with standard statistical methods. Results: The average annual death rate for NMWs in Qatar was 150 deaths/100,000. According to interviews, the majority of NMWs were found working in high WBGT (>31 degrees C) each working day during hot months. The major cause of these deaths was recorded as cardiovascular problems (cardiovascular disease; CVD). Unfortunately, the causes of death were poorly described, and many deaths were listed as cardiac arrest. We included these deaths in the broader category of cardiovascular causes. There was a strong correlation between average monthly afternoon heat levels (WBGT) and CVD mortality. It is likely that a large proportion of these CVD deaths during hot months were due to serious heat stroke. Global studies show that approximately 15% of deaths in the age group 25-35 years are due to CVD causes. However, in this NMW population, the figures were 22% during the cool season and 58% during the hot season. Conclusions: The increased CVD mortality during hot periods is most likely due to severe heat stress. As many as 200 of the 571 CVD deaths during 2009-2017 could have been prevented if effective heat protection had been implemented as a part of local occupational health and safety programs. There is an urgent need for protection against such heat effects among NMWs, and rising temperatures from ongoing climate change are further increasing the health risks. Cause of death records for workers dying in hot conditions should be more precise than cardiac arrest." (c) 2019 S. Karger AG, Basel
机译：背景：卡塔尔是尼泊尔移民工人（NMWS; 25-35岁的主要年龄段）的主要目的地国家。这些120,000多个NMWS暴露于各种职业危害，包括过热，3-4名工人每周死亡。我们的研究旨在展示热暴露是否导致死亡。方法：从尼泊尔的政府机构中检索了NMW的工人人口和死亡率数据。每月湿灯泡全球温度（WBGT）的每月估计评估热曝光，从2009年到2017年的Doha气象站收集的数据。在日期，在一天中的太阳中工作会增加2- 3度C到阴影WBGT值。每日死亡及其原因是从尼泊尔的外国就业促进委员会（FEPB）的记录获得的，2009 - 2017年。采访返回NMW关于他们的工作条件和这些条件的影响增加了信息。用标准统计方法测试热变量与死亡率之间的关联。结果：卡塔尔纳姆斯的平均年死亡率为150人死亡/ 100,000。根据访谈，大多数NMW都被发现在炎热的月份的每个工作日在高WBGT（> 31摄氏度）工作。这些死亡的主要原因被记录为心血管问题（心血管疾病; CVD）。不幸的是，死亡的原因描述不佳，许多死亡被列为心脏骤停。我们将这些死亡包括在更广泛的心血管原因中。平均每月午后水平（WBGT）和CVD死亡率之间存在强烈的相关性。在炎热的月份期间，这些CVD死亡可能是由于严重的热风中风。全球研究表明，年龄组的大约15％的死亡人数为25-35岁是由于CVD原因。然而，在这种NMW人口中，在凉爽的季节期间，这些数字为22％，在炎热的季节期间为58％。结论：热时期的CVD死亡率增加最有可能因严重的热应激而导致。如果有效的热量保护已被实施为当地职业健康和安全计划的一部分，可能会阻止2009年至2017年571年CVD死亡中的多达200年。迫切需要保护NMWS之间的这种热量效应，并且从持续的气候变化的温度上升正在进一步增加健康风险。在热条件下死亡的工人死亡记录应该比心脏骤停更精确。“（c）2019年S. Karger AG，巴塞尔

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