Occupational heat risk perceptions and behavioral adaptation strategies among construction and welding workers in Bangladesh.

The increasing frequency and intensity of extreme heat events pose severe health risks to outdoor workers. Despite growing global recognition of occupational heat illness, evidence from low- and middle-income countries (LMICs) remains limited. This cross-sectional study surveyed 320 construction and welding workers to assess perceived heat-related health risk and behavioral adaptation in Bangladesh. Multinomial logistic regression examined factors associated with adaptive behaviors. Over 80% of workers perceived themselves as vulnerable, commonly reporting excessive sweating, thirst, cramps, irritability, and emotional instability. Construction workers were more likely to increase adaptive behaviors such as taking regular breaks (OR = 9.49, 95%CI: 2.45-36.74), wearing loose clothing (OR = 4.26, 95%CI: 1.14-15.90), and using electric fans (OR = 2.84, 95%CI: 1.12-7.22). However, they were also more likely to report a decrease in slowing their work pace (OR = 14.20, 95%CI: 2.03-99.21) and in planning work during cooler hours (OR = 34.81, 95%CI: 2.22-546.80). Long work experience was associated with increased use of electric fans as a cooling option (OR = 6.97, 95%CI: 1.97-24.68) and greater attention to weather forecasts (OR = 3.81, 95%CI: 1.01-14.37). Workers who experienced burns or memory decline adopted specific protective measures. Surprisingly, higher education was linked to lower participation in heat-safety training. These findings highlight the urgent need for occupational heat-safety policies, awareness campaigns, and targeted interventions to safeguard vulnerable outdoor workers in Bangladesh.