Download PDFOpen PDF in browserPhysiological Strain in Construction Workers: A Systematic Review of Heat-Workload Synergy and the Impact of Personal Protective Equipment10 pages•Published: June 2, 2026AbstractConstruction workers face a severe physiological burden from the synergistic interaction between ergonomic workload and environmental heat stress. However, current risk assessments fail to account for a critical amplifying factor: the additional thermal load imposed by mandatory Personal Protective Equipment (PPE), a research gap this study addresses by synthesizing the available evidence on dual stressors. This study uses a systematic literature review, following Preferred Reporting Items for Systemic Reviews guidelines, to analyze secondary data from peer-reviewed studies that concurrently investigated both heat and ergonomic stressors using objective physiological or performance-based outcomes. The results show that the combined exposure produces a multiplicative strain, causing quantifiable decrements in physical work capacity, including endurance time reductions of up to 35%, and significant productivity losses. Critically, none of the synthesized studies measured the thermal burden of PPE, indicating that current risk models systematically underestimate the total physiological strain on workers. This study benefits the construction industry by establishing that even dual-stressor safety models are insufficient. It provides a directive for professionals and policymakers to shift future research and development from simply documenting the problem to engineering solutions, such as thermally managed PPE, which is essential for creating genuinely safer and more resilient work environments.Keyphrases: construction workers, ergonomic workload, heat stress, personal protective equipment, productivity In: Wesley Collins, Anthony Perrenoud and John Posillico (editors). Proceedings of Associated Schools of Construction 62nd Annual International Conference, vol 7, pages 1162-1171.
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