Resilience and burnout among dual-role staff in a Chinese closed prison hospital during COVID-19.

The United States Environmental Protection Agency (EPA) [] and the World Health Organization (WHO) [] both emphasize that rising global temperatures have intensified heat exposure, creating a growing threat to public health, occupational safety, and productivity. The WHO has recommended programs that integrate engineering and administrative controls, hydration and rest management, medical surveillance, and alignment with global sustainability objectives. Together, these frameworks highlight the pressing need for coordinated, evidence‐based strategies that integrate public health and occupational safety approaches to mitigate the increasing human and economic costs of heat in a warming climate [, ]. Occupational heat stress refers to situations in which a worker's body accumulates excessive heat due to the combined effects of internal metabolic activity, surrounding environmental conditions, and the insulating properties of their clothing [, ]. Physiologically, heat stress alters fluid balance, elevates heart rate [], increases core body temperature [], and intensifies thermoregulatory and perceptual strain []. Prolonged exposure may lead to a range of heat‐related illnesses (HRI), including heat exhaustion, rhabdomyolysis, heat syncope, heat cramps, and heat rash []. The most severe outcome, heat stroke, can result in irreversible organ damage or death if not treated immediately. When the body's thermoregulatory mechanisms can no longer maintain thermal equilibrium, the risk of HRI increases substantially []. Outdoor workers are particularly susceptible to heat stress due to prolonged physical activity in extreme environmental conditions. High‐risk occupational groups include agricultural laborers, forestry and fisheries personnel, construction workers, members of the armed forces, first responders, and athletes []. Agricultural work requires especially demanding tasks, such as harvesting, planting, pruning, load carrying, weeding, and digging, which often occur in hot and humid climates, which amplify physiological strain [, ]. Preventive measures should intensify as environmental heat levels rise []. Heat stress can be assessed using both physiological and environmental metrics. Hydration status, a key determinant of thermoregulation, can be evaluated using urine and blood samples collected before, during, and after heat exposure [, ], where several studies have relied on urine analysis to estimate hydration [, , ], and sweat loss is typically calculated from the difference in body weight before and after exposure []. Core body temperature is commonly measured using rectal probes [, ], tympanic thermometers [, ], or oral thermometers []. Heart rate can be recorded using electrocardiography or transmissive pulse oximetry by trained professionals [, ]. These data are then integrated to compute the PSI, providing an overall indicator of physiological strain []. However, these tools are discrete measurements and lack real‐time implications that could immediately affect workers.