Speaker 1: You're listening to AC N A podcast
Speaker 2: that means la la. It's hot bonjour. Everyone le here
Speaker 2: back from vacation in France where the Paris Olympics has
Speaker 2: been in full swing along with the erratic weather that
Speaker 2: went from stormy, start to intense heat. And then over
Speaker 2: the weeks peppered by heat warnings and storm alerts. I'm
Speaker 2: solo hosting today without co-host Jack Board who is taking
Speaker 2: his turn to go on holiday, hopefully somewhere with less
Speaker 2: punishing weather
Speaker 2: and that's what's on the agenda. This episode grueling, punishing
Speaker 2: weather
Speaker 2: in Paris athletes have been braving the heat that's gone
Speaker 2: up to as high as 37 °C and fans have
Speaker 2: had to bake under full on sun exposure for open
Speaker 2: air events. Our correspondent in France, Ross Collins spoke to
Speaker 2: a few of them. We were sat in the sun
Speaker 2: for like three hours watching the basketball, but yeah, an
Speaker 2: ice cream afterwards. So it's been really hot here. Very sweaty.
Speaker 2: What's the weather like here?
Speaker 2: It's not just France and the Olympic athletes and fans
Speaker 2: wrestling with this weather though, here in our part of
Speaker 2: the world, things are also heating up and we're putting
Speaker 2: the spotlight on a very different group of people dealing
Speaker 2: with the brunt of it.
Speaker 2: They are our workers laboring in the elements. Migrant workers
Speaker 2: at construction sites, landscapers and gardeners tending to urban greenery,
Speaker 2: painters and cleaners and people whose livelihoods require that they
Speaker 2: work outdoors and with temperatures breaking records in Singapore, what
Speaker 2: risks do these folks face and what options are there
Speaker 2: to cool down and keep safe
Speaker 2: here with me to answer these questions is Associate Professor
Speaker 2: Jason Lee who is also the Director of the Heat
Speaker 2: Resilience and Performance Center at the Yong Luin School of
Speaker 2: Medicine at N US. Thank you, Doctor Lee for joining
Speaker 2: us here today. Now doctor Li, if I understand correctly,
Speaker 2: your field is physiology and you study the impact of
Speaker 2: heat stress on the human body to find ways to
Speaker 2: limit the impact
Speaker 2: and improve performance and productivity. Now, we recently saw that
Speaker 2: on 21st July, the planet recorded its hottest day ever.
Speaker 2: It's certainly feeling a lot hotter here in Singapore. What
Speaker 2: does all this mean for Singapore and the region and
Speaker 2: the people here? It means we get more and more
Speaker 2: uncomfortable and it really depends who you are for most
Speaker 2: of us
Speaker 2: because we can avoid the heat. And we thought ok,
Speaker 2: since we have air con cooling facilities and therefore we
Speaker 2: are not paying the price of a warming world. No,
Speaker 2: in fact, we are paying the price indirectly, lack of
Speaker 2: incidental physical activity, lack of outdoor exposure, which means our
Speaker 2: physical health, mental health, even eye health will be compromised.
Speaker 2: But there are other sectors like the workers who don't
Speaker 2: have a choice to avoid the heat and they still
Speaker 2: have the toy out there.
Speaker 2: And the usual concern in that sector is there could
Speaker 2: be increased heat injuries, severe work productivity losses. And then
Speaker 2: when you are uncomfortable, right? If I put you in
Speaker 2: the context where you are too hot, too cold, too noisy,
Speaker 2: too smelly, the default human response is I want to
Speaker 2: finish the work and get out of here as soon
Speaker 2: as possible.
Speaker 2: And therefore our decision making can also be compromised leading
Speaker 2: to accidents at workplaces. So we are after
Speaker 2: hi injury, productivity loss and then decision making leading to
Speaker 2: the increase in accidents. Yeah. Speaking of accidents, this really
Speaker 2: is a matter of life and death, isn't it? We
Speaker 2: had the case last year, I believe of a migrant
Speaker 2: worker who fell from the roof of a seven story building.
Speaker 2: I think that one got a lot of attention and
Speaker 2: the coroner said it was likely because he was just
Speaker 2: oriented from the heat. We're talking about not just the
Speaker 2: impact on our physical health from the heat stress, but
Speaker 2: all these other repercussions from it. How bad is this situation?
Speaker 2: What is a clear and present danger? Yeah, if I
Speaker 2: may just to speculate on that case, of course, we
Speaker 2: didn't measure him during that incident, but basic physiology, tell
Speaker 2: us
Speaker 2: you get hot right immediately, you will need to shun
Speaker 2: your blood onto the skin to dissipate it onto the environment.
Speaker 2: And then if that is insufficient, we usually need to
Speaker 2: sweat to fight the heat. So there is this vassal
Speaker 2: dilation that is this uh increase in sweating. And hopefully,
Speaker 2: if the environment is dry enough, you can evaporate the
Speaker 2: sweat
Speaker 2: and therefore you lose the heat. Ok. In our context,
Speaker 2: the letter is also compromised because you can sweat. But
Speaker 2: it doesn't mean you can evaporate all your sweats and
Speaker 2: therefore your heat will be building up continuously. So in
Speaker 2: that case, it is not difficult to speculate when you
Speaker 2: have it in the
Speaker 2: vision. And remember that in the individual wasn't a young man,
Speaker 2: so probably have limited physiological capacity. So when the blood
Speaker 2: get shuns to the skin to lose the heat, right,
Speaker 2: there could be a drop in blood pressure and then
Speaker 2: you get lightheaded and then you could fall off. That
Speaker 2: happens quite commonly in other contexts where you go to
Speaker 2: Onsen
Speaker 2: and Sauna, you experience the acute experiences p that the experience,
Speaker 2: you feel some lightheadedness because the blood now is being
Speaker 2: shunned to the skin.
Speaker 2: And you experience that acute light hitters. In most cases,
Speaker 2: you see you lie down, you know, but in few cases,
Speaker 2: you didn't have a chance and you collapse. And then
Speaker 2: in this case, he fell from heights. What specific risks
Speaker 2: do construction workers, migrant workers face that most of us
Speaker 2: cannot fully appreciate if we now zoom into occupational workers. Right?
Speaker 2: There are two type of work in general. One is
Speaker 2: what we call a salary. You are paid by time,
Speaker 2: as long as you are there long enough you get pay.
Speaker 2: And in that case, most of the time you expect
Speaker 2: huge productivity loss, you know, because there's no motivation for
Speaker 2: them to work harder because they get the same pay
Speaker 2: and then you will definitely suffer huge productive losses. In fact,
Speaker 2: in project hit safe, they just concluded it was a
Speaker 2: 3.5 years project, we found there's a lot of productive
Speaker 2: implications because you tend to slow down when you are uncomfortable.
Speaker 2: But when we went to South Korea and profile a
Speaker 2: group of workers, they were doing delivering job and they
Speaker 2: were paid by peace. The ambient conditions were much milder
Speaker 2: than what we experienced in Singapore in Singapore, hovering about
Speaker 2: 30 plus and minus
Speaker 2: in South Korea. Then it was 20. I was surprised
Speaker 2: the physiological strain was much higher in those workers working
Speaker 2: in cooler conditions. Why? Because they were paid by peace
Speaker 2: and therefore had the intrinsic motivation to work as hard
Speaker 2: as possible when you work as hard as possible. That
Speaker 2: is where you produce a lot of heat resulting in
Speaker 2: the hot human body. Also
Speaker 2: a point to emphasize is not always the case that
Speaker 2: hot environment means a hot human it depends on the context. Wow.
Speaker 2: So it cannot be looked at in isolation. That's what
Speaker 2: you're saying. Just the heat, the heat temperature alone broadly
Speaker 2: what equates the hot worker as a function of the environment,
Speaker 2: the attire and the work. So environment is just one
Speaker 2: factor we need to account for the attire and the
Speaker 2: kind of work. Singapore's Manpower Ministry last year imposed heat
Speaker 2: safety rules that employers need to follow. These include regular breaks,
Speaker 2: a lot of water and hydration, a place to cool down.
Speaker 2: But in a recent news report, the ministry said nearly 30%
Speaker 2: of some 250 work sites inspected in the second quarter
Speaker 2: of the year did not have those measures in place.
Speaker 2: Fines were imposed on some of them but should penalties
Speaker 2: be heavier in order to actually get these rules implemented
Speaker 2: the recommendations made last year, they called it enhanced hi measures.
Speaker 2: There's a list of things, but you mentioned a few
Speaker 2: get yourself heat acclimatize rest drink and when you rest,
Speaker 2: rest under shade, these are evidence based options. And so
Speaker 2: we don't have to innovate for the sake of innovation.
Speaker 2: They are proven solution in this case, very low cost,
Speaker 2: very sustainable. We just say that you know
Speaker 2: this because your body temperature can recover and therefore you
Speaker 2: can be more productive to your point on whether we
Speaker 2: should punish eventually. Well, there's always a space for that.
Speaker 2: But before that, I think there is still room for
Speaker 2: us to increase the awareness. Why we are talking about
Speaker 2: providing these measures because I think
Speaker 2: you talk about rest, right? Immediately the employer would assume
Speaker 2: more rest. Yes, more welfare but bad business. I think
Speaker 2: that's the number one thing we need to debunk because
Speaker 2: in project he safe, we found when we introduce more
Speaker 2: rest productivity increases. Remember a lot of these workplaces are
Speaker 2: not paid by time ie they are not paid by peace, right?
Speaker 2: So if you don't give them rest,
Speaker 2: humans are very creative, I can slow down, I can
Speaker 2: go to the toilet in higher frequency. No one is
Speaker 2: going to stop me. So I'll find ways to rest
Speaker 2: huge present to occur in workplaces. Ah, so I think
Speaker 2: number one, we need to increase awareness. Convince the boardroom
Speaker 2: say that when we introduce hid measures, it's not just
Speaker 2: welfare
Speaker 2: is for good business. So if everyone believes and convince right,
Speaker 2: it is good for welfare, good for business, right? I
Speaker 2: would assume most will come on board. I think that 30%
Speaker 2: that Dean, right is because number one, they probably didn't
Speaker 2: appreciate said no, no, no. At the end of it
Speaker 2: is bottom line, we need to profit. There are other
Speaker 2: priorities so I cannot afford to give more rest. Number two,
Speaker 2: you have to see it from a recipient's perspective. We
Speaker 2: are saying now if you don't do this right? There's
Speaker 2: a risk of getting hit injured if I'm the worker.
Speaker 2: If I'm the delivery man, I said you're talking about risk, Jason,
Speaker 2: I'm talking about if I don't deliver more, right? It's
Speaker 2: not risk. I will earn less at the end of
Speaker 2: the day. You know, so I'm willing to take the
Speaker 2: risk
Speaker 2: and also from a behavioral and implementation sciences consideration. I
Speaker 2: think we need to incorporate that. We cannot assume when
Speaker 2: there are solutions, human will use the solution. So you
Speaker 2: must create a value why they should respond to these
Speaker 2: enhanced policies? If not, I think the
Speaker 2: the mindset will be wow, this is new set, then
Speaker 2: they will do the audit, they will check us out.
Speaker 2: You know, I think the spirit of which we conduct
Speaker 2: this will be wrong. I think there is still room
Speaker 2: for us to augment maybe be 100%. But I think
Speaker 2: there's still this 30% of poor adherence we can continue
Speaker 2: to reduce. So 30% of poor adherence. Do you think
Speaker 2: the owners then should be on the companies or the individual?
Speaker 2: Both? Yeah, I think the individuals must first understand because
Speaker 2: at the end of it, we talk about heat injury, right?
Speaker 2: It goes down to the last man that he must
Speaker 2: be aware. If there are signs, I must take actions,
Speaker 2: but they will tell you I don't have the resources
Speaker 2: to incorporate all these measures. So
Speaker 2: my supervisors or employers have to be responsible and therefore
Speaker 2: going back to my earlier point, we must create a
Speaker 2: value why they should react in the first place. So
Speaker 2: you talked about simple low cost solutions to regulating body temperature.
Speaker 2: But what about long term innovative solutions that could
Speaker 2: viable? So swimming the proven solutions like getting yourself aerobically
Speaker 2: feed heat, acclimatize, optimizing your work rest cycle cooling and
Speaker 2: appropriate hydration is in place. And we find that oh
Speaker 2: it is still not enough, right? That is where it
Speaker 2: give us the motivation. Maybe innovation can fill the gap.
Speaker 2: So they work on automation. Do we need that labor
Speaker 2: intensive efforts every time that can come in specific to
Speaker 2: heat management? The workplace safety and Health institute also tested
Speaker 2: out the provision of ice slushy. OK, not the slurpee
Speaker 2: we get at the 7-Eleven, those are high in sugar
Speaker 2: but you can say pour any kind of sports ring
Speaker 2: that usually low in sugar with some electrolyte. It makes
Speaker 2: wonderful tasty ice slushy. So they have
Speaker 2: trial that the size is convincing and the biggest takeaway
Speaker 2: from that uh testing by WSH I was the workers
Speaker 2: like it so much. They say if this were to
Speaker 2: be implemented, they will pay for it
Speaker 2: today how it works in workplaces. They get their drinks
Speaker 2: from the vending machine, they pay back and then they
Speaker 2: get it. So we are asking for vendors to come
Speaker 2: on board to say now, can those vending machine also
Speaker 2: dispense isolate? There's also a concept especially from insights from
Speaker 2: project heat safe. We found actually most of the workers
Speaker 2: are were OK in terms of a physiological screen, in fact,
Speaker 2: as an average mean group response, right? We found that
Speaker 2: if anything they were under working, which picks the general
Speaker 2: impression if you if you are not paid by peace, right?
Speaker 2: I would slow down to preserve my health. And therefore,
Speaker 2: there's huge productivity implications. Having said that there were few
Speaker 2: individuals who were pushing the limits physiologically.
Speaker 2: And these are the individuals, they could be more vulnerable.
Speaker 2: They could be for other reason, very motivated individuals, even
Speaker 2: I'm not paid by piece, right. I'm just a motivated worker.
Speaker 2: I will give all out and the physiological strain were
Speaker 2: dangerously high above 39 °C while working, for example. So
Speaker 2: from an innovation perspective, we are exploring whether we can
Speaker 2: first profile
Speaker 2: the group of workers who are more vulnerable to heat, right?
Speaker 2: There's this concept called the heats vulnerability index that incorporates
Speaker 2: a lot of inputs, parameters, know your age, whether you
Speaker 2: are on medication, so and so forth and give you
Speaker 2: a score.
Speaker 2: So imagine we have that. Then we picked out these
Speaker 2: five guys out of 100 who are already more vulnerable.
Speaker 2: We could layer heart rate monitoring. That's another innovative approach, right?
Speaker 2: There are proven heart rate solutions there
Speaker 2: and then develop that threshold individually. So where no you
Speaker 2: cross a certain number, your heart rates, for example, I
Speaker 2: can pull you out by doing So, right, you pick
Speaker 2: out those who are high risk, then you can use
Speaker 2: this also to say, oh actually there are a group
Speaker 2: that is not pushing hard enough, they want to because
Speaker 2: they have more physiological reserve to do so. So the
Speaker 2: whole work model can also be revisited.
Speaker 2: So maybe there are some more intensive work you can
Speaker 2: segment then since you are healthier, you can push more.
Speaker 2: I will group you and you get paid more and
Speaker 2: those who are not so strong, maybe they are ok
Speaker 2: not to be overused. So especially when the manpower is shrinking, right?
Speaker 2: We need to job fits every worker in a more
Speaker 2: targeted manner. And don't assume everyone is the same
Speaker 2: in terms of a lot of these migrant workers, the
Speaker 2: issue for them isn't just outdoors though, right? Dormitories are
Speaker 2: also an area of concern. Given the number of people
Speaker 2: who are housed in an enclosed area, air conditioning rooms
Speaker 2: is also often too costly, not an option and not
Speaker 2: very climate friendly either. So space is a real issue.
Speaker 2: What can we do or what can companies do to
Speaker 2: better manage this indoor heat factor?
Speaker 2: Yeah, that's an important point, right? Because our life is
Speaker 2: not just during the work exposure, we assume when we
Speaker 2: come home, in this case to the dormitories, they will
Speaker 2: be well rested. Most of the dorms based on my
Speaker 2: knowledge are not air conditioned, I think for the right
Speaker 2: reason also air con, by the way, is a great
Speaker 2: invention is the
Speaker 2: allocation of air con like a lot of other big
Speaker 2: ticket items of in our society just disproportionately allocated usually
Speaker 2: the most vulnerable to have access to all the bells
Speaker 2: and whistles. But coming back to the conversations, we need
Speaker 2: to also ensure they rest well at night and thermal
Speaker 2: discomforts will degrade your sleep quality and some
Speaker 2: duration. This is all the more relevant in our context
Speaker 2: where the recent V three projection says that by mid century, OK,
Speaker 2: the scary statement is that based on best case scenario.
Speaker 2: So we don't have to imagine it will happen almost
Speaker 2: every night will be a warm night. So not rocket
Speaker 2: science if you don't recover, well, you keep on working
Speaker 2: over days, overweight, right. Then when you return to work
Speaker 2: next day, you don't expect you are fully sound and
Speaker 2: therefore as a higher risk, not just productivity losses, your concentration,
Speaker 2: therefore accidents and plus the accumulative work exposure, right? I
Speaker 2: think turns things will turn even worse if you don't
Speaker 2: ensure sufficient recovery at rest.
Speaker 2: So that is another segment through project heats, right? In
Speaker 2: collaboration with overseas partner, we are also now looking at
Speaker 2: the dormitories condition and approaching the fan first approach design,
Speaker 2: the dormitories to make sure that we can optimize thermal
Speaker 2: comfort while they are resting. And earlier, you also touched
Speaker 2: on air conditioning, which really isn't the solution. And what
Speaker 2: struck me was that, as I mentioned earlier, I just
Speaker 2: came back from France and I don't know if you've
Speaker 2: been there
Speaker 2: in the dead heat of summer, it gets so hot
Speaker 2: that it's almost like the weather here. But this is
Speaker 2: not an air conditioned country. So it's not like you
Speaker 2: can just run into a shopping center or go back
Speaker 2: home or your hotel or airbnb and turn on the
Speaker 2: air con. So for about two weeks, we had no
Speaker 2: air con and then I came back to Singapore and
Speaker 2: I had a climatized and you don't, it really struck
Speaker 2: me how two weeks away without air con
Speaker 2: and you're back in Singapore and you feel like there's
Speaker 2: less of this dependence or addiction to it
Speaker 2: and it just became a really tangible way for me
Speaker 2: to think about. Oh, maybe I don't need to use
Speaker 2: my air con so much. There's somebody in your field.
Speaker 2: Do you look at how people can acclimatize better? Yeah.
Speaker 2: In fact, you have just unintentionally put yourself through two
Speaker 2: weeks of heat acclimatization and you are feeling the benefits, right?
Speaker 2: If I got to deal with this stress or called heat, right,
Speaker 2: then I expose myself. And in this case, exactly two
Speaker 2: or three weeks, that is actually
Speaker 2: the same recommendation or two or three weeks of exposure
Speaker 2: to heat will induce certain physiological responses and also behavior
Speaker 2: responses for you to better deal with heat. So you
Speaker 2: have increased skin blood flow, you have increased sweat loss.
Speaker 2: These are all favorable physiological adaptations. You also know how
Speaker 2: to pace yourself better upon exposure to heat.
Speaker 2: You say, oh Singapore after two weeks, surprising is not
Speaker 2: as hot because it was hotter elsewhere. The key difference
Speaker 2: between these two context is a population that only deal
Speaker 2: with heat. In France, right? Every summer for us in Singapore,
Speaker 2: we deal with heat. So our behavior response is really
Speaker 2: quite a thing, not so much that we will face
Speaker 2: the heat because we are living in the tropics, especially
Speaker 2: in Singapore coupled with the air con facilities almost everywhere, right?
Speaker 2: We are quite good
Speaker 2: in avoiding the heat too by hiding in your malls,
Speaker 2: cooling facilities. So actually most Singaporeans are actually not as
Speaker 2: physiologically heat acclimatized. As many assume when we travel, you're
Speaker 2: from Singapore, you must be tropical heat acclimatized, not true.
Speaker 2: You know, we are very good in avoiding the heat.
Speaker 2: And we thought and therefore look at our epidemiological evidence
Speaker 2: or data, we hardly have any heat stroke death.
Speaker 2: And that has been the exact reason why for the
Speaker 2: longest time, we have not take urgent action because we
Speaker 2: say usually we see heat news if somebody dying summer
Speaker 2: heat waves, you know fronts. But in Singapore, we don't
Speaker 2: have therefore, heat is not a problem. And we explain
Speaker 2: because we are very used to heat. We are very
Speaker 2: used to heat in Singapore because we have options to
Speaker 2: avoid the heat and that itself will incur a lot
Speaker 2: of indirect implications. You know,
Speaker 2: lack of incidental physical activity, outdoor your activity count, you
Speaker 2: must almost like proportion time for it, right? You cannot
Speaker 2: say no this morning, I just walked five K to work. No,
Speaker 2: it won't happen in Singapore because you will get uncomfortable
Speaker 2: mental health, which is a hot topic these days. And
Speaker 2: with no lack of outdoor exposure, we will exacerbate mental health.
Speaker 2: Have we link our eye health
Speaker 2: huge prevalence, you know, on eye health because of lack
Speaker 2: of outdoor exposure. So we are actually paying the price
Speaker 2: for most of us here, not the workers for eye health. Yeah,
Speaker 2: lack of vitamin D. And there is evidence to say
Speaker 2: that there is a dopamine pathway that affects your eye
Speaker 2: and therefore your eye health can also be compromised, you know,
Speaker 2: but for the workers, right, this chronic heat exposure, not
Speaker 2: just the acute heat injury you will get,
Speaker 2: there are evidence coming from overseas. One of those things
Speaker 2: are li if you don't measure, we assume it's not
Speaker 2: a problem until you measure. Oh, you know this also
Speaker 2: because it's a function of whether you bother to find
Speaker 2: in the first place. So now in Central America and
Speaker 2: we see it happening in India and elsewhere
Speaker 2: that they begin to see long term exposure working in
Speaker 2: hot environment, you may not die due to heat stroke,
Speaker 2: but you will have this condition called chronic kidney disease.
Speaker 2: And they bracket it of an unknown source or nontraditional.
Speaker 2: So not the CD, usually because you have,
Speaker 2: have diabetes or you get it at the older age,
Speaker 2: you have young men in their thirties, early forties who
Speaker 2: are now performing dialysis, often diy dialysis back home because
Speaker 2: of the chronic heat exposure. Of course, heat is just
Speaker 2: one and the leading hypothesis is chronic heat stress, the
Speaker 2: other confounders. Is it because a lot of this? Ok.
Speaker 2: This worker I was just describing the sugar cane cutters.
Speaker 2: So they are being paid by peace. So in the
Speaker 2: whole psyche, I want to cut as much as possible.
Speaker 2: And if I keep on going to the toilet, it
Speaker 2: means I will cut less. So not just the heat,
Speaker 2: I will deliberately not drink. And then you see you
Speaker 2: have all the metabolic waste produced by hard work. You
Speaker 2: don't flush it out by hydration and then overweight over months,
Speaker 2: over years, right? You pay the price and the more
Speaker 2: obvious case was probably during the building of the World
Speaker 2: Cup stadiums. A lot of migrant workers were in Qatar
Speaker 2: and many died.
Speaker 2: Those who didn't die, many are now back home performing
Speaker 2: dialysis and we are still uncovering what are the acute
Speaker 2: and chronic implications of working in the hot environment? Thank
Speaker 2: you so much, Associate professor, Doctor Jason Lee, director of
Speaker 2: the Heat Resilience and Performance Center at the YL Lin
Speaker 2: School of Medicine. And a big thanks as well to
Speaker 2: our listeners and the team behind this podcast, Tiffany Joan Chan,
Speaker 2: Jaini, Johari, Sae Wind and Christina Robert. We'll see you
Speaker 2: again next week along with Jack Board who will be
Speaker 2: back from vacation until then. I'm Li Ling Tan. Bye
Speaker 2: for now.