Climate change in the workforce: A systematic review of knowledge, attitudes and practices among vulnerable workers categories.

OBJECTIVES: To map the existing literature on knowledge, attitudes, and practices (KAP) regarding climate change among workers vulnerable to climate-related occupational risks. STUDY DESIGN: Systematic review of cross-sectional studies. METHODS: We performed a systematic review of survey-based cross-sectional studies. We searched PubMed, Scopus, and Google Scholar for articles published between January 2000 and December 2025. Eligible studies reported measurable outcomes for at least one KAP component related to climate change. Methodological quality was assessed using the Joanna Briggs Institute checklist for analytical cross-sectional studies. KAP patterns were analyzed according to occupational sectors, geographic regions, and worker characteristics. RESULTS: Among 2126 records, we included 19 studies, covering a sample of 10,000 workers, mainly engaged in agriculture. Most studies reported high awareness of climate variability (84.2%) and perceived vulnerability (78.9%), while adoption of at least one adaptive practice was observed in 68.4% of articles. A knowledge-practice gap emerged in one-quarter of the evidence. Adaptation among farmers included agronomic and livestock management strategies, often influenced by access to education and resources. In contrast, surveys on construction and informal workers reported more limited knowledge of heat-related health risks and reliance on individual coping behaviors, with few employer-led protective measures. CONCLUSION: Evidence on workers' knowledge, attitudes, and practices regarding climate change remains limited and uneven. Future studies should include a broader range of highly exposed occupational groups, beyond agriculture. Although workers report high awareness and risk perception, this does not consistently translate into preventive practices, reflecting structural and institutional barriers. Strengthening research and implementing workplace-level protections and occupational health policies addressing climate-related risks is essential.