The Unseen Frontline: Heat Stress, Climate Change and the Sanitation Worker
As heatwaves intensify, India’s sanitation workers face a growing occupational crisis. A look at the health impacts, the policy gaps, and the urgent need to integrate climate resilience with labour rights.
The Pre-requisite
To understand the challenges facing sanitation workers in an era of climate change, it is essential to grasp the legal, institutional, and conceptual landscape that defines their work and rights in India.
(1) KEY TERMS
- Heat Stress — A range of heat-related illnesses that occur when the body is unable to cool itself properly, from mild conditions like heat rash and cramps to severe ones like heat exhaustion and life-threatening heatstroke.
- Occupational Hazard — A risk or danger inherent in a particular job. While physical injuries or chemical exposure are traditionally recognised, climate-related risks like extreme heat are emerging as significant occupational hazards for outdoor workers.
- Climate Resilience — The ability of a system or community to anticipate, absorb, and recover from the effects of a hazardous event, such as a heatwave, in a timely and efficient manner.
- Urban Local Body (ULB) — The constitutionally mandated institutions of local self-government in cities and towns, such as Municipal Corporations, which are primarily responsible for sanitation and the employment of sanitation workers.
(2) BACKGROUND & TIMELINE
The legal framework governing sanitation work has evolved, though it has not yet adapted to climate realities. The practice of manual scavenging was first addressed by The Employment of Manual Scavengers and Construction of Dry Latrines (Prohibition) Act, 1993. This was followed by the Self-Employment Scheme for Rehabilitation of Manual Scavengers (SRMS) in 2007. The framework was strengthened by The Prohibition of Employment as Manual Scavengers and their Rehabilitation Act, 2013, which broadened the definition of manual scavenging and mandated worker rehabilitation. The launch of the Swachh Bharat Mission (SBM) in October 2014 professionalised the sector but also increased the workload on a vast, often informal, workforce. While these laws focused on dignity and biohazards, the increasing frequency of extreme weather events since the 2015 Paris Agreement has highlighted a policy gap. Cities began formulating Heat Action Plans (HAPs) only in the last decade, with Ahmedabad pioneering South Asia's first HAP in 2013.
(3) INSTITUTIONAL FRAMEWORK
Several bodies oversee this workforce. The Ministry of Housing and Urban Affairs (MoHUA) is the nodal ministry for urban sanitation policies, including the SBM. The National Commission for Safai Karamcharis (NCSK), a statutory body established in 1993, monitors policy implementation and addresses grievances. The direct employers are the Urban Local Bodies (ULBs), which manage services through permanent staff or private contractors. Health impacts fall under the Ministry of Health and Family Welfare. The constitutional basis for these protections is rooted in Article 21 (Right to Life and Personal Liberty), which the Supreme Court has interpreted to include the right to a safe working environment.
The Main Explanatory
As India grapples with increasingly frequent and intense heatwaves, a critical but often overlooked group is on the frontline of this climate crisis: the nation's sanitation workers. Their situation highlights a complex intersection of urban governance, labour rights, public health, and climate adaptation.
What is the 'double burden' of climate risk for sanitation workers?
Sanitation workers face a dual vulnerability to climate change. The first is occupational: their work, involving street sweeping, waste collection, and drain cleaning, requires long hours of strenuous physical labour outdoors, directly exposing them to extreme temperatures. As public health expert Aruna Bhattacharya noted in The Hindu on July 1, 2026, for these workers, extreme heat is no longer an occasional hazard but a “routine reality.” This constant exposure leads to significant health risks.
The second burden is residential. A significant proportion of sanitation workers live in informal settlements characterised by overcrowded housing with poor ventilation and heat-absorbent tin roofs. These areas, often lacking green cover and reliable water supply, become urban heat islands, meaning workers find little respite from heat even after their workday ends. This 'double burden' of exposure at work and at home, as documented in a 2025 field study in Delhi by the Centre for Science and Environment, compounds health risks and underscores how climate impacts are filtered through socio-economic conditions.
How does heat stress specifically impact their health and livelihood?
Medically, chronic exposure to extreme heat leads to heat stress. Immediate effects include severe dehydration, heat cramps, and heat exhaustion, which can escalate to a fatal heatstroke. A 2024 World Health Organization report highlights the severe long-term consequences, linking chronic dehydration and heat stress to a higher incidence of kidney disease and cardiovascular complications. For a workforce already facing health challenges from exposure to waste and pollutants, this adds another dangerous layer of risk.
Beyond health, heat stress affects livelihoods. Reduced work capacity during peak heat hours can lead to lower earnings. A survey by the NGO Safai Karmachari Andolan found that daily wage workers reported losing up to 20% of their income during summer months due to illness or the inability to complete work quotas. Increased spending on water and medical care further strains household finances. While urban primary healthcare services exist under the Ayushman Bharat scheme, Bhattacharya questions whether these centres are equipped to treat heat-related illnesses and if workers can access them during work hours.
What are the gaps in the current legal and policy framework?
The existing legal architecture falls short of providing protection against climate-induced threats. The 2013 Prohibition of Employment as Manual Scavengers Act focuses on preventing contact with human excreta and providing gear against biohazards, not thermal protection. The Occupational Safety, Health and Working Conditions (OSH) Code, 2020, consolidates general labour laws on workplace safety but does not explicitly classify heat stress as a compensable occupational disease or mandate specific preventative measures, unlike countries such as Spain, which have legislated work stoppages during extreme heat alerts.
The primary gap is the disconnect between policy domains. Climate Action Plans, labour welfare policies, and public health initiatives often operate in silos. Many city-level HAPs focus on public advisories and infrastructure, often neglecting specific protections for outdoor workers. According to the Centre for Policy Research, social protection schemes often fail to reach intended beneficiaries due to administrative barriers and a lack of awareness among the workers themselves, creating a significant implementation gap.
What are the proposed solutions for a more integrated approach?
To address this governance challenge, experts are advocating for an integrated strategy. A primary recommendation, articulated by analysts like Aruna Bhattacharya, is to formally integrate climate considerations into occupational health and safety (OHS) policies. This involves amending ULB regulations and contracts to mandate modified work schedules that avoid peak heat hours, ensure access to cool rest areas, and provide a consistent supply of drinking water and oral rehydration salts (ORS). Furthermore, there is a push for regular health screenings, particularly for kidney function, to be made a contractual obligation for employers.
Beyond the workplace, solutions must target the residential vulnerability of these workers. This involves targeted investment in informal settlements to upgrade housing with better ventilation, ensure a reliable piped water supply, and increase green cover. Finally, urban primary healthcare systems must be strengthened to become 'climate-sensitive' by training providers to manage heat-related conditions and conducting outreach camps for vulnerable worker populations. Experts stress the urgent need for better data collection on the long-term health impacts of occupational heat exposure to build a stronger evidence base for policy action.
The Way Forward
Why does this matter right now?
The issue of heat stress among sanitation workers has gained critical urgency. First, climate science indicates that heatwaves in India are becoming more frequent and intense, with the summer of 2026 serving as a stark reminder that this is a present-day public health emergency. Second, with new governments and ministers taking charge in key states like Karnataka, a window of political opportunity has opened to embed worker welfare into the next generation of urban climate policies. Analysts argue that overlooking the well-being of these essential workers represents not only a social equity issue but also a systemic risk to the health and functionality of India's cities.
What is the likely trajectory?
In the next one to five years, the discourse is likely to shift from recognition to action. Increased advocacy is expected for the formal notification of heat stress as an occupational disease under the OSH Code, 2020, which would pave the way for compensation and legally mandated protections. As city-level Climate Action Plans mature, their implementation will face greater scrutiny. The Bengaluru Climate Action Plan, expected to be finalised by early 2027, will be a key test case for how well human vulnerability is integrated into urban climate policy. Pilot projects focused on creating climate-resilient informal settlements, potentially funded under the National Adaptation Fund for Climate Change (NAFCC), may also be initiated.
What are the governance implications?
The challenge posed by climate change to sanitation workers reveals deep fragmentation in urban governance, with health, labour, urban development, and environment departments often working in isolation. Addressing this requires an integrated model where public health is a central consideration in all urban planning and labour policies. The experiences of sanitation workers serve as a barometer for urban system performance. This has led to questions about the definitions of 'smart' and 'resilient' cities, with critics arguing that a city cannot be considered as such if it fails to protect its most essential workers from predictable climate threats. Ensuring their safety is a fundamental test of India's capacity to deliver a just and sustainable development model.