The impact of high temperatures and heatwaves on health outcomes among working-age adults (15-64 years): a systematic review and meta-analysis

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2026

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Li, Y.
Varghese, B.M.
Anikeeva, O.
Liu, J.
Bi, P.

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Environment International, 2026; 208:110142-1-110142-16

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Yannan Li, Blesson Mathew Varghese, Olga Anikeeva, Jingwen Liu, Peng Bi

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Abstract

Background: High temperature is a well-documented public health threat affecting people of all age groups. While occupational studies have assessed heat impacts on workers, the broader health effects on the working-age population remain underexplored. This study systematically reviewed and quantified the health effects of high temperatures and heatwaves among working-age adults. Method: Systematic searches were conducted in PubMed, Scopus, and Embase for peer-reviewed epidemiological studies published up to January 2025. Eligible studies examined the effects of high temperatures and heatwaves on all-cause and cause-specific morbidity and mortality in individuals aged 15–64 years. A random-effects meta-analysis was performed to pool relative risks (RRs) per 1°C increase in temperature and across heatwave intensities. The study protocol was registered with PROSPERO (CRD42024528637). Findings: Of 4,755 identified studies, 165 met the inclusion criteria, with 138 eligible for meta-analysis. A 1°C increase in heat exposure was associated with a 2.3% increase in morbidity (RR 1.023 [95% CI 1.019–1.027], I² = 99.7%) and a 1.6% increase in mortality (RR 1.016 [95% CI 1.013–1.018], I² = 78.9%) among working-age adults. The risk of morbidity and mortality associated with rising temperatures was greater in lower-income countries. Heatwaves also significantly affected health among working-age adults, with a 5.3% increase in morbidity (RR 1.053 [95% CI 1.042–1.064], I² = 90.7%) and a 3.8% increase in mortality (RR 1.038 [95% CI 1.020–1.057], I² = 57.7%). The greatest risk of morbidity was observed during middle-intensity heatwaves, while the highest risk of mortality was found during high-intensity heatwaves. The risk of morbidity from heat-related illnesses and genitourinary disorders showed the strongest associations with rising temperatures and heatwaves. Interpretation: High temperatures and heatwaves significantly increase morbidity and mortality among working-age adults (15–64 years), particularly due to occupational and environmental factors. Greater risks were observed in humid subtropical and Mediterranean climates, with notable increases in heat-related illnesses and genitourinary disorders. These findings highlight the need for broader heat vulnerability assessments and inclusive prevention strategies beyond workplace settings.

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© 2026 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

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