Assessing heat stress, ambulatory hypertension and thermal symptoms in fish smokers along coastal areas in Ghana: a cross-sectional study.

Background: Many workplace illnesses are increasing exponentially because of the rapid change in climate and associated workplace heat exposure that lead to heat stress and ambulatory hypertension among workers. Fish smoking is a common livelihood among people residing along the coastal areas in developing countries who work outdoors and in extreme heat. Objective: The objective of this study is to assess the prevalence of heat stress and ambulatory hypertension among fish smokers in coastal areas of Ghana and to identify work-related factors that influence these conditions. Methods: This exploratory cross-sectional survey sampled 2018 fish smokers from various communities along the coastal areas of Ghana. Using a convenient sampling method to select the workers, data were collected with a questionnaire, collecting anthropometric information like weight, height and physiological parameters, including blood pressure, heart rate and body temperature using sphygmomanometer and thermometer. Also, the Wet Bulb Globe Temperature index was used to measure heat stress exposure among the workers. The data were analysed using descriptive statistics, Kruskal-Wallis H test, in SPSS V.25.0. Results: The study found that 87.6% of fish smokers in coastal Ghana reported high levels of heat stress, and 59.0% recorded ambulatory hypertension. Workers on the afternoon shift showed higher levels of heat stress compared with those on morning and evening shifts. The number of workdays per week was also linked to severe ambulatory hypertension. The analysis confirmed significant differences in heat stress across shifts (χ²=103.51, p<0.001, η²p=0.165) and in ambulatory blood pressure among workers based on workdays (χ²=96.04, p<0.001, η²p=0.352), showing moderate-to-large effects. Conclusions: The study emphasises the importance of creating safe and healthy work environments that protect fish smokers from health hazards associated with heat exposure. There is the need for fish smokers to adopt less heat emission ovens for fish smoking and regularly cool their bodies during the afternoon shift as they pay attention to rehydration.