Madeleine Thomson outlines critical workplace adaptations and policy actions needed to protect workers from rising temperatures and hidden health risks
The future of work is getting hotter—literally. And according to Dr. Madeleine Thomson, Head of Climate Impacts & Adaptation at Wellcome, we need to fundamentally rethink how we protect workers before rising temperatures exact an even greater toll on lives, livelihoods, and economies.
Thomson’s recent response to a joint WHO-WMO report on climate change-driven heat stress affecting workers laid out a clear framework for what must happen next. Her message is urgent but practical: we have the solutions, we understand the risks, and the only question remaining is whether governments and employers will act before it’s too late.
The Scale of the Challenge
Climate change isn’t just making work uncomfortable—it’s making it dangerous in ways that extend far beyond traditional concerns about heat stroke.
“The health and wellbeing threat to workers from extreme heat goes far beyond heat stress—rising temperatures are linked to heart disease, kidney failure, pregnancy complications, and poor mental health,” Thomson warned. “And these health impacts affect economies and healthcare systems, and yet we remain dangerously unprepared.”
This comprehensive threat assessment reflects Thomson’s 25+ years of experience studying climate-sensitive health interventions across low- and middle-income countries. As a former Senior Research Scientist at Columbia University’s International Research Institute for Climate and Society, where she directed the WHO Collaborating Centre on Malaria Early Warning Systems, Thomson has seen firsthand how environmental changes cascade through human health systems in unexpected and devastating ways.
Now the same pattern is emerging in workplaces worldwide: rising temperatures creating health crises that ripple through families, communities, healthcare systems, and entire economies.
The Research Foundation
Thomson’s call for action isn’t based on speculation—it’s grounded in the growing body of evidence connecting climate science and health outcomes.
“Innovative research that brings together climate science and health is increasingly revealing how significantly climate change affects our health and wellbeing, and provides the critical evidence that underpins this important new WHO-WMO report,” she explained.
At Wellcome, Thomson oversees research initiatives that examine these connections, funding teams developing tools and methodologies to predict and respond to climate-sensitive health threats. This evidence base makes clear that the worker heat crisis isn’t a future problem—it’s happening now and accelerating.
Immediate Workplace Adaptations
Thomson outlines several practical interventions that employers can—and must—implement immediately to protect workers:
Adapted Work Schedules
The simplest and often most effective intervention is adjusting when work happens. Thomson advocates for shifting physically demanding outdoor work to cooler parts of the day—early mornings or evenings—and avoiding the most dangerous heat during midday hours.
This isn’t revolutionary, but it requires employers to prioritize worker safety over convenience and traditional scheduling practices. In sectors like construction, agriculture, and delivery services, this means rethinking operational norms that were established for a cooler climate.
Regular Access to Shaded Areas
Creating and mandating regular breaks in shaded areas can dramatically reduce heat exposure. Thomson’s emphasis on “regular access” is critical—occasional breaks aren’t sufficient. Workers need consistent opportunities to cool down throughout their shifts, with shaded rest areas positioned close to work sites.
For outdoor work environments, this might mean investing in portable shade structures, strategically planting trees, or redesigning work sites to include covered rest areas. For indoor environments without air conditioning, it means ensuring adequate ventilation and cool spaces for recovery breaks.
Consistent Rehydration Opportunities
Access to water sounds basic, but Thomson’s specific mention of “rehydration” highlights a critical gap in many workplaces. Workers need not just water availability but active protocols ensuring regular fluid intake before dehydration sets in.
This means more than water coolers—it means scheduled hydration breaks, education about proper fluid intake, and workplace cultures that encourage rather than discourage taking time to drink water. For workers in remote locations, it means ensuring water is transported to job sites and remains accessible throughout shifts.
Monitoring and Protocols
While Thomson doesn’t explicitly detail monitoring systems in her statement, her background developing early warning systems for climate-sensitive diseases suggests the importance of proactive surveillance. Workplaces need clear protocols for:
- Monitoring temperature conditions and triggering protective measures at specific thresholds
- Identifying workers at elevated risk (those with cardiovascular conditions, pregnant workers, older employees)
- Recognizing early warning signs of heat-related illness
- Responding rapidly when workers show symptoms
The Long-Term Imperative: Emissions Reductions
Thomson is clear that workplace adaptations, while essential, aren’t sufficient on their own. The root cause must be addressed.
“Governments and employers must act now by cutting greenhouse gas emissions,” she insists.
This dual approach—adaptation and mitigation—reflects Thomson’s sophisticated understanding of climate health challenges. During her time at Columbia, she worked on climate variability and longer-term climate trends, understanding that while adaptation helps communities cope with current conditions, mitigation is essential to prevent future conditions from becoming unmanageable.
For employers, this means:
Operational Changes: Reducing emissions from company operations, transportation fleets, and supply chains. The same businesses employing vulnerable workers often contribute to the climate change threatening those workers’ health.
Advocacy: Using corporate influence to support climate policies and emissions reduction targets. Employers have both moral and economic stakes in climate action—protecting workers and ensuring long-term business viability.
Investment: Directing resources toward clean energy, sustainable practices, and climate-resilient infrastructure that protects both workers and operations.
Government Responsibilities
Thomson’s framework places significant responsibility on governments to create policy environments that protect workers:
Regulatory Standards
Governments must establish and enforce heat exposure limits, mandatory rest periods, and workplace safety standards that reflect current and projected climate realities. These standards need updating as conditions change—regulations designed for historical temperature ranges won’t suffice in a warming world.
Labor Protections
Workers need legal protections that prevent retaliation when they refuse unsafe work in extreme heat or request reasonable accommodations. This is particularly crucial for vulnerable workers in precarious employment situations who may fear job loss if they prioritize their health.
Healthcare System Preparation
As Thomson notes, heat-related health impacts strain healthcare systems. Governments must ensure hospitals, clinics, and emergency services are prepared for surges in heat-related conditions, particularly cardiovascular events, kidney problems, and pregnancy complications.
Climate Policy Leadership
Most fundamentally, governments must pursue aggressive emissions reduction policies. Thomson’s call for governments to “cut greenhouse gas emissions” recognizes that workplace protections alone won’t suffice if temperatures continue rising unchecked.
The Economic Case for Action
Thomson emphasizes that heat-related health impacts “affect economies and healthcare systems”—a reality that should concern businesses and policymakers focused on economic outcomes.
Consider the cascading economic costs of inaction:
Direct Healthcare Costs: Treating heat-related cardiovascular disease, kidney failure, and other conditions strains healthcare budgets and insurance systems.
Lost Productivity: Workers suffering from heat exposure work more slowly, make more mistakes, and miss more days. Studies suggest productivity losses from heat already cost the global economy billions annually—costs that will escalate as temperatures rise.
Workforce Participation: Workers developing chronic conditions from heat exposure may leave the workforce entirely, reducing the labor pool and increasing disability costs.
Infrastructure and Operations: Businesses face disruptions from extreme heat events, from construction delays to supply chain interruptions to increased cooling costs.
By contrast, investing in worker protections generates economic returns through maintained productivity, reduced healthcare costs, and sustained workforce participation.
The Urgency Factor
Perhaps Thomson’s most important message is about timing: “The longer we delay action, the greater the threat to lives and livelihoods.”
This isn’t hyperbole. Global temperatures continue rising, extreme heat events become more frequent and severe, and the window for effective action narrows. Every year of delay means:
- More workers developing chronic conditions from heat exposure
- Greater adaptation costs as conditions worsen
- Reduced effectiveness of mitigation efforts as emissions accumulate
- Larger economic disruptions as climate impacts compound
Thomson’s career studying climate-sensitive health threats has given her a front-row seat to the consequences of delayed action. She watched as slow responses to emerging infectious diseases led to preventable suffering. She sees the same pattern unfolding with worker heat stress—the difference is we still have time to act, if we choose to.
A Model from Climate-Sensitive Disease Work
Thomson’s experience offers a useful model for addressing worker heat stress. During her time directing the WHO Collaborating Centre, she focused on integrating climate data with health information to create early warning systems. The same approach applies here:
Data Integration: Combining temperature forecasts, workplace conditions, and health monitoring to predict and prevent heat-related illness.
Targeted Interventions: Using data to identify high-risk workers, locations, and time periods requiring enhanced protections.
Rapid Response: Developing protocols that trigger protective measures automatically when conditions reach dangerous thresholds.
Continuous Improvement: Learning from each heat event to refine protections and build resilience.
This systematic approach, successfully applied to diseases like malaria and meningitis, can protect workers from heat-related health threats.
The Path Forward
Thomson’s framework for addressing the worker heat crisis is comprehensive but achievable:
Immediate Actions:
- Implement workplace adaptations (schedule changes, shade access, hydration protocols)
- Establish monitoring and response systems
- Identify and protect vulnerable workers
Medium-Term Measures:
- Develop and enforce regulatory standards
- Invest in climate-resilient workplace infrastructure
- Build healthcare system capacity for heat-related conditions
Long-Term Commitments:
- Pursue aggressive emissions reductions
- Transform industries toward sustainable practices
- Build climate-literate workforces and management systems
The Bottom Line
Dr. Madeleine Thomson’s response to the WHO-WMO report provides both warning and roadmap. Climate change is fundamentally reshaping the future of work, creating health threats that extend far beyond what most people understand. But we have the knowledge and tools to protect workers—what’s needed now is decisive action from employers and governments.
The choice, as Thomson frames it, is stark: act now with urgency, or watch the toll on lives, livelihoods, and economies continue to mount.
For someone who has spent more than 25 years studying climate-sensitive health challenges, Thomson understands that delayed action leads to preventable suffering. The worker heat crisis is no exception.
The solutions exist. The evidence is clear. The only question is whether we’ll implement them before “dangerously unprepared” becomes a tragic reality for millions of workers worldwide.
