Lives under the scorching sun: Outdoor workers racing against climate change

Amid the scorching May heat of Hanoi, Ninh (name changed for privacy), a ride-hailing driver, wheeled his motorbike out of his house just before 5 a.m. He started his day early, trying to pick up passengers while the weather was still bearable before temperatures could soar to nearly 40°C - the highest in years.

For over five years since becoming a ride-hailing driver, Ninh has often thought about switching jobs. The work is grueling, with long hours under the sun and rain. On some days, he waits for 5 - 6 hours without any passengers, and the platform fees keep rising. 

Although still young, constant outdoor work under the sun, wind, and city dust has taken a toll on his health. His back pains have become more frequent, his persistent coughs last longer, and his skin grows darker with each passing day.

On scorching days, he still ventures out because, as a high school graduate, his job options are limited. Moreover, the debt he incurred after a failed attempt at opening a small restaurant in his hometown leaves him no choice but to keep working. “My wife and children live in our hometown, where she runs a hair salon. I owe so much that I can’t even face going back until I’ve saved enough to pay off the debts, for fear of the creditors,” Ninh shared.

Ninh is not alone. Many outdoor workers must continue their jobs even during peak daytime temperatures - that is high enough to fry eggs.

Outdoor workers are defined by the International Labour Organization (ILO) as those who are directly exposed to weather conditions like solar radiation, humidity, and heat.

Outdoor laborers, especially informal workers, are the backbone of urban economies, keeping bustling cities running smoothly. Yet, they are the ones directly suffering from the rising heat caused by climate change and are often excluded from social safety nets.

“Climate change and heat will affect the large share of the global workforce that operates outdoors and in non-climate controlled conditions in populous affected regions, implying significant economic costs”, according to the United Nations Development Programme (UNDP).

ILO’s analysis reveals that extreme heat has devastating effects on the global economy, particularly through reduced worker productivity. When temperatures rise above 24–26°C, labor productivity begins to decline. At 33–34°C, productivity drops by 50 per cent.

Workers in all sectors are affected, but certain jobs are at higher risk due to physical demands and outdoor exposure. These include agriculture, natural resource management, construction, refuse collection, emergency repair, transport, tourism, and sports. 

Projections suggest that, by 2030, with a global temperature increase of 1.5°C and current labor trends, 2.2 per cent of total working hours worldwide will be lost to high temperatures, equivalent to the productivity of 80 million full-time jobs.

Economic losses from heat stress at work are projected to reach $2.4 trillion by 2030, with the impact being most pronounced in low- and lower-middle-income countries.  

In Vietnam, there is no comprehensive data on the number of outdoor workers. However, studies have highlighted the health and productivity impacts of extreme heat on this group.

Extreme heat on outdoor workers

Dr. Anh Ngoc Vu, Research director of the UK’s National Centre for Social Research, revealed that nearly 60 per cent of outdoor workers must work during peak midday hours (10 a.m.–2 p.m.) when temperatures are at their highest.  

“This not only highlights their work patterns but also the high level of heat exposure they face. The significant number of workers active during peak heat hours raises serious concerns about their health and safety, especially as climate change worsens,” she added at the first Global Heat Health Information Network (GHHIN) Southeast Asia Heat Health Forum held in Singapore this month.

GHHIN is an independent forum of scientists, practitioners, and policy makers focused on improving capacity to protect populations from the avoidable health risks of extreme heat in our changing climate.

Data from the project ‘The Health Impacts of Climate Change on Precarious Outdoor Workers in Megacities in Vietnam’, led by Dr. Anh, showed that half of outdoor workers have chronic medical conditions such as depression, bone and joint diseases or immune diseases.

In addition, more than 90 per cent have experienced health issues like skin diseases, sunstroke, heat shock due to extreme weather events.

However, only 27 per cent seek professional medical care when sick. Strikingly, almost 60 per cent of outdoor workers use their own money to buy voluntary medical insurance, but few use it when ill.

Nguyen Minh Tu (name changed for privacy), a construction worker, is one such person. With no qualifications and already over 45, Tu works for a small contractor in Ho Chi Minh City on a seasonal basis, without health insurance benefits.  

Concerned about her declining health, she proactively purchased voluntary health insurance but has never used it. “I bought insurance just in case, but it’s lucky if I don’t need it because it means I’m still healthy,” she laughed when asked.  

Despite her words, Tu admits she avoids using the insurance, not because of her health, but due to inconveniences and fears. “Going for a check-up, waiting, getting examined, and picking up medicine takes a whole day. And what if they find something wrong? If I end up in the hospital, who will take care of my family and the kids?” she shared.  

Her physically demanding construction work leaves her knees and shoulders aching whenever the weather changes. Each time, she chooses quick fixes by buying painkillers or medications suggested by the nearest pharmacy because of convenience.

Dr. Anh noted with TheLEADER on the sidelines of the forum that women face greater challenges than men in balancing work, childcare, and health protection in extreme weather. Meanwhile, younger workers adapt better, while older workers suffer greater income losses.  

When issues arise, these workers receive limited help and social support. “They feel isolated, and the precariousness of their lives is very iconic,” Dr. Anh explained.  

Notably, many workers, including women, normalize health risks from extreme weather as part of their daily work. Many believe that health problems caused by rising temperatures are simply part of the job, so they don’t complain or seek help. “This is deeply embedded in their mindset,” she added.  

This normalization serves as a coping mechanism, helping them manage stress and continue working despite harsh conditions. By downplaying the severity, they maintain mental resilience and reduce anxiety. 

“This is a quite concerning issue, and we should take it into account when designing policies,” she emphasized. “Moreover, we need to empower these workers to decide the value they want to perceive, and this process will undoubtedly take time.”

Finding solutions for heat health

According to Dr. Tran Nu Quy Linh, Senior research officer at the University of Queensland’s School of Public Health, there are gaps in policies and adaptation strategies for health.  

Speaking to TheLEADER on the sidelines of the forum, Linh noted that current policies focus on natural disaster reduction and infectious disease prevention but neglect heat-related health risks. Surveillance systems primarily target infectious diseases, with limited attention to heat-exacerbated non-communicable conditions like cardiovascular and respiratory issues.

In addition, heat illness prevention is under-prioritized, and there is insufficient coordination between health, meteorology, disaster management, and other sectors to implement heat-related policies effectively.  

Vietnam also lacks a robust heat-health warning system that provides localized, timely, and actionable alerts. The absence of longitudinal health and weather data further limits the accuracy and coverage of heat advisories.  

She suggested enhancing inter-ministerial coordination for climate adaptation and heat prevention policies, aligning strategies with population vulnerabilities, and monitoring the effectiveness of existing climate action plans to allocate resources accordingly.  

Based on joint research with Dr. Anh, Ho Chi Minh-based SocialLife Institute proposed three policy recommendations, including improving working conditions, enhancing health, and supporting livelihoods for outdoor workers.  

Suggestions include establishing mobile rest stations in high-density worker areas, developing an app to locate shelter points and provide weather warnings, and creating an early warning system for severe weather with tailored recommendations for safe working hours.  

To strengthen resilience, short-term vocational training programs can equip workers with skills for indoor jobs, while seasonal job-matching platforms can help them find alternative employment during extreme weather.  

Contributing to these solutions, Dr. Nguyen Minh Nhut of Ho Chi Minh City People’s Council emphasized the importance of balancing free and paid services to make policies sustainable. He also suggested converting parks into “themed parks” for outdoor workers and utilizing bus stops or cafes for rest services.  

Until these solutions become reality, outdoor workers like Tu and Ninh will continue to face health risks as temperatures rise, tackling challenges on their own while navigating the uncertainties of life.