BMJ
04 November 2025
Abstract
April 2025 brought an intense and unusually early heatwave to India and Pakistan, exposing hundreds of millions to temperatures approaching postulated limits for human heat tolerance.1 The previous year, extreme heat gripped northern India from April to June, leading to over 40?000 cases of heat stroke and 360 deaths, though experts suspect that the official statistics substantially undercount the true toll.23 Deadly heat has become an annual reality across much of the global south, with the burden falling most heavily on those least able to protect themselves. People in working poverty—defined by the International Labour Organisation (ILO) as people whose earnings are insufficient to achieve a decent standard of living4—are disproportionately exposed yet unable to afford essential protections such as adequate housing, cooling, and healthcare. Despite major reductions in working poverty in many regions of the global south, large numbers remain at risk. Even in India, where poverty has fallen sharply over recent decades, nearly 80 million people (around 9% of working age people) were classified as living in working poverty in 2024,5 with millions more living just above the poverty line.
Recognising the growing threat of extreme heat, governments and labour representatives have begun taking steps to protect workers. These have primarily centred around regulations aimed at limiting heat exposure on the worksite.6 However, unless such efforts consider the nature and scale of the daily exposures of people in working poverty—not only at work but also in their homes—many will be left unprotected, especially those falling outside formal regulations (eg, informal and gig workers).
Citation
Meade, Robert D., Felipe González-Casabianca, Rajan Rawal, Vidhya Venugopal, Tanya Isaac, Ahmed Shaikh, Tess Wiskel, Sneha Asrani, Dhruval Gadhvi, Peter j Huybers, Jennier Leaning, Tarun Khanna, Daniel P Schrag, Caroline Buckee, and Satchit Balsari. "Responding to rising heat in workplaces and homes of low income workers." BMJ (04 November 2025).