Table 1.

Possible interventions for medical and non-medical personnel.

Recommendations and options specifically for occupational health and safety for medical and non-medical personnel:
➢Technical measures
•Air conditioning system (RLT) or mobile air conditioning units. Air-conditioning systems need to be well maintained, while adequate settings and filters need to be adopted. Setting climate control systems to low “cold” temperatures (below 70 F/ 21C) and “dry” low humidity settings (below 40%) should be avoided. Devices without adequate filters could spread SARS-CoV-2 (www.ghhin.org/heat-and-covid-19/ac-and-ventilation) (Chirico et al., 2020; Correia et al., 2020; Jay et al., 2015; Lu et al., 2020; Morawska and Cao, 2020; Pease et al., 2021).
•Passive, structural protection against solar radiation and avoidance of other heat sources (Matthies et al., 2008; Widerynski et al., 2016)
•Systematic and continuous recording of temperature/humidity in affected work areas, definition of threshold values (Jacklitsch et al., 2016; World Health Organization (WHO), 2011)
•Ventilating over night to use cooler air if possible (Matthies et al., 2008)
•In many places, electric fans may be more accessible; but may help transmit the virus indoors, and in very hot and dry environments these can increase heat stress; fans should be avoided if more people are in one room (www.ghhin.org/heat-and-covid-19/ac-and-ventilation(Jay et al., 2015; Morris et al., 2020)
➢Organizational measures
•Awareness raising and training of personnel on heat and virus related health risks and prevention measures (Jacklitsch et al., 2016; Schoierer et al., 2019; Zielo and Matzarakis, 2018)
•Observance of heat warnings and implementation of respective prevention measures •(Matthies et al., 2008; Morabito et al., 2020; Singh et al., 2019)
•Establishing shorter work cycles in overheated rooms, more frequent breaks, changed shift patterns, better staff shift schedules (Jacklitsch et al., 2016)
•Planning/shifting longer activities with the need for infection control to times of day/building areas with lower temperature/solar radiation
•Taking organisational measures within the team, e.g. for early symptoms of heat stress ->stop working in the heat ->seek cooler premises and direct help (colleagues)
•Encouraging mindfulness of oneself and colleagues; fostering open communication of problems in the institution (www.ghhin.org/assets/technical-brief-COVID-and-Heat-final.pdf)
•Wearing adequate clothing under the protective equipment, if necessary, consider special clothing (cooling vests) in particularly stressful conditions (Bach et al., 2019; Daanen et al., 2020; Gao et al., 2018; Luze et al., 2020; Morris et al., 2020; Quinn et al., 2017; Teunissen et al., 2014; Watson et al., 2019)
•Consideration of the possible overlap of hot spells (increased need for personnel) with the summer holidays (less available personnel due to increased holiday volume) in the duty roster or holiday planning (consider heat warnings)
➢Personal measures
•Heat acclimatization and aerobic conditioning to enhance heat tolerance (Alhadad et al., 2019; Douzi et al., 2020; Lee et al., 2008; Leyk, 2019; Morris et al., 2020)
•Start to work precooled (www.ghhin.org/heat-and-covid-19/PPE) (Alhadad et al., 2019; Daanen et al., 2020; Douzi et al., 2020; McLellan et al., 2013; Morris et al., 2020)
•Encourage staff to self-monitor their hydration; drinking unsweetened liquids/sports drinks/cold fluids/ice slushies before and during work; self-control of the body's own fluid balance (toilet); start work cooled and well hydrated (Foster et al., 2020; Lee et al, 2008, 2013, 2020; McLellan et al., 2013; Tan and Lee, 2015)