Evaluating the effectiveness of labor protection policy on occupational injuries caused by extreme heat in a large subtropical city of China

Yanan Su; Liangliang Cheng; Wenjia Cai; Jason Kai Wei Lee; Shuang Zhong; Siyu Chen; Teng Li; Xinfei Huang; Cunrui Huang

doi:10.1016/j.envres.2020.109532

Evaluating the effectiveness of labor protection policy on occupational injuries caused by extreme heat in a large subtropical city of China

Environ Res. 2020 Jul:186:109532. doi: 10.1016/j.envres.2020.109532. Epub 2020 Apr 15.

Authors

Yanan Su¹, Liangliang Cheng², Wenjia Cai³, Jason Kai Wei Lee⁴, Shuang Zhong⁵, Siyu Chen⁶, Teng Li⁷, Xinfei Huang⁸, Cunrui Huang⁹

Affiliations

¹ School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China; Shanghai Typhoon Institute, China Meteorological Administration, Shanghai, 200030, China.
² School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
³ Ministry of Education Key Laboratory for Earth System Modeling, Department of Earth System Science, Tsinghua University, Beijing, 100084, China; Joint Center for Global Change Studies (JCGCS), Beijing, 100875, China.
⁴ Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Global Asia Institute, National University of Singapore, Singapore; N.1 Institute for Health, National University of Singapore, Singapore.
⁵ Center for Chinese Public Administration Research, School of Government, Sun Yat-sen University, Guangzhou, 510275, China.
⁶ Institute for Economic and Social Research, Jinan University, Guangzhou, 510632, China.
⁷ International School of Business and Finance, Sun Yat-sen University, Guangzhou, 510275, China.
⁸ International School of Business and Finance, Sun Yat-sen University, Guangzhou, 510275, China. Electronic address: huangxf3@mail.sysu.edu.cn.
⁹ School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China; Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, 200030, China; School of Public Health, Zhengzhou University, Zhengzhou, 450001, China. Electronic address: huangcr@mail.sysu.edu.cn.

PMID: 32334170
DOI: 10.1016/j.envres.2020.109532

Abstract

On March 1, 2012, the Chinese government implemented the Administrative Measures on Heatstroke Prevention (AMHP2012) to combat the occupational health impacts of extreme heat, and reducing occupational injury was one of the main purposes. This study aimed at quantifying the intervention effects of the AMHP2012 on extreme heat-related occupational injuries and subsequent insurance payouts in Guangzhou, China. Data on occupational injuries and insurance payouts were collected from March 1, 2011, to February 28, 2013, from the occupational injury insurance system of Guangzhou. A quasi-experimental design with before-after control was adopted. Interrupted time series analysis was performed to quantify the change of occupational injuries and insurance payouts after policy implementation. The distributed lag non-linear model was used to explore whether injury claims and insurance payouts due to extreme heat decreased. A total of 9851 injury claims were included in the analysis. After policy implementation, the risk of occupational injuries and insurance payouts decreased by 13% (RR = 0.87, 95%CI: 0.75, 0.99) and 24% (RR = 0.76, 95% CI: 0.58, 0.94), respectively. The attributable fraction of extreme heat-related occupational injuries decreased from 3.17% (95%eCI: 1.35, 4.69) to 1.52% (95%eCI: -0.36, 3.15), which contributed to 0.86 million USD reduction of insurance payouts. Both males and females, low-educated, young and middle-aged workers, workers at small or medium-sized enterprises, engaging in manufacturing, and with both minor and severe injuries were apparently associated with decreased rates of extreme heat-related occupational injuries. The AMHP2012 policy contributed to the reduction of extreme heat-related occupational injuries and insurance payouts in Guangzhou, China, and this research provided novel evidence for decision-makers to better understand the necessity of implementing health protection policies among laborers under climate change.

Keywords: Climate change; Extreme heat; Injury claim; Insurance payout; Policy evaluation.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

China / epidemiology
Cities
Extreme Heat*
Female
Humans
Male
Middle Aged
Occupational Exposure*
Occupational Injuries* / epidemiology
Occupational Injuries* / prevention & control