Tawatsupa, BYiengprugsawan, VKjellstrom, TSeubsman, Sam-angSleigh, AdrianThai Cohort Study Team2016-01-142016-01-142044-6055http://hdl.handle.net/1885/95386OBJECTIVES This study aims to examine the association between self-reported heat stress interference with daily activities (sleeping, work, travel, housework and exercise) and three graded-holistic health and well-being outcomes (energy, emotions and life satisfaction). DESIGN A cross-sectional study. SETTING The setting is tropical and developing countries as Thailand, where high temperature and high humidity are common, particularly during the hottest seasons. PARTICIPANTS This study is based on an ongoing national Thai Cohort Study of distance-learning open-university adult students (N=60 569) established in 2005 to study the health-risk transition. PRIMARY AND SECONDARY OUTCOME MEASURES Health impacts from heat stress in our study are categorised as physical health impacts (energy levels), mental health impacts (emotions) and well-being (life satisfaction). For each health and well-being outcome we report ORs and 95% CIs using multinomial logistic regression adjusting for a wide array of potential confounders. RESULTS Negative health and well-being outcomes (low-energy level, emotional problems and low life satisfaction) associated with increasing frequency of heat stress interfering with daily activities. Adjusted ORs for emotional problems were between 1.5 and 4.8 and in general worse than energy level (between 1.31 and 2.91) and life satisfaction (between 1.10 and 2.49). The worst health outcomes were when heat interfered with sleeping, followed by interference with daily travel, work, housework and exercise. CONCLUSIONS In tropical Thailand there already are substantial heat stress impacts on health and well-being. Increasing temperatures from climate change plus the ageing and urbanisation of the population could significantly worsen the situation. There is a need to improve public health surveillance and public awareness regarding the risks of heat stress in daily life.The International Collaborative Research Grants Scheme with joint grants from the Wellcome Trust UK (GR071587MA) and the Australian National Health and Medical Research Council (NHMRC 268055), and as a global health grant from the NHMRC (585426).© The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.Keywords: adult; article; cohort analysis; cross-sectional study; daily life activity; emotion; exercise; female; heat stress; high temperature; human; humidity; life satisfaction; male; mental health; outcome assessment; self report; sleep; Thailand; travel; wellb2012-11-0610.1136/bmjopen-2012-0013962016-02-24