Health Aff (Millwood). 2026 May;45(5):535-544. doi: 10.1377/hlthaff.2025.01659.
ABSTRACT
Outdoor workers face growing exposure to poor air quality, wildfire smoke, and extreme heat, yet protections remain uneven across states and incomplete federally, and little is known about outdoor workers. We combined data from national labor-force surveys with occupation-based exposure data and county-level environmental indicators on air quality, wildfire, and heat waves to describe and compare outdoor and indoor workers. Outdoor workers accounted for 21.9 percent of the workforce in 2023. About 16.9 percent of outdoor workers lived in counties with the highest frequency of unhealthy air quality days, and nearly one-third lived in counties with the highest wildfire (32.4 percent) and heat wave (31.4 percent) risks. Compared with indoor workers, outdoor workers had higher rates of uninsurance, more self-employment, lower access to paid sick leave, and higher rates of work injuries. Results identified outdoor workforces with elevated climate-related risks and differences in coverage and job arrangements, informing federal, state, and local prevention, standards, and enforcement.
PMID:42081754 | DOI:10.1377/hlthaff.2025.01659
