“The heat is changing my period blood — it’s not blood anymore, just dry clots. I know it’s because of the factory heat and because I avoid drinking water. I’ve had to take those clots out with my hands from the cloth I use during my periods and throw them away. The heat makes me feel embarrassed about my own body.”

— Thangamal, garment worker

Stories like Thangamal’s aren’t rare. Across Tamil Nadu’s garment factories, women are increasingly reporting heat-related health complications. As climate change pushes temperatures beyond safe limits, factory floors are becoming hazardous.

Between March and April 2025, Tamil Nadu Textile and Common Labour Union (TTCU) members recorded temperatures between 35°C and 40°C in garment factories across the state – hovering dangerously close to the upper threshold of what’s considered “safe” for sustained, high-paced industrial work. Through these extreme conditions, women worked nine to 11-hour shifts, often without breaks, ventilation, or any form of heat adaptation or paid leave.

For the women producing clothes for some of the world’s wealthiest fashion brands, this heat compounds already harsh conditions: long shifts, poor nutrition, limited toilet access and unrelenting production pressure. Workers report a cascade of harms: fatigue, chronic vaginal infections, haemorrhoids, skin rashes, fainting and severe menstrual complications. Extreme heat is not only felt in their bodies, but also in the quiet shame and emotional distress of being unable to maintain basic hygiene.

The International Labour Organization and other global bodies have flagged heat stress as a growing risk, but the gap between global guidance and ground-level reality is stark – with women workers from some of the most marginalised communities, bearing the burden of corporate inaction.

The Business & Human Rights Resource Centre’s 2025 report The Missing Thread makes this disconnect painfully clear: only ten out of 65 leading fashion brands acknowledged heat stress as an occupational health issue in their policies. Just four – Adidas, Levi’s, Nike and Next – have published supplier guidance on the issue, and only one involves unions in implementation.

Extreme heat remains unaddressed in risk assessments and in practice, partly due to the misconception that indoor factory work is less vulnerable to heat. But evidence suggests otherwise: factories are enclosed, poorly ventilated spaces filled with heat-generating machines and tightly packed workers – making indoor heat not just oppressive, but life-threatening.

The health toll: Compounded and gendered

Women workers across Dindigul, Erode and Tiruppur districts linked the heat to a wide range of serious and debilitating health impacts. Many described how extreme heat, overwork and lack of adequate workplace protections are steadily eroding their health and dignity.

Soumya, a 52-year-old garment worker, told us: "I feel like a piece of meat roasted in an oven. There’s no ventilation, the fans are too few and far away, and even the bathrooms don’t have water throughout the day. If we stop to rest or drink water, the supervisor shouts at us."

Almost every woman reported limiting water intake to avoid needing the toilet, with most only urinating once during their shift and often experiencing dark yellow painful urine. Many reported urinary tract infections, headaches, body fatigue and discomfort in the pelvic region from dehydration.

Respiratory and skin conditions are also rampant due to exposure to fabric dust in overheated, poorly ventilated spaces. Women reported chronic white discharge, yeast and fungal infections, and painful vaginal rashes – the result of long hours spent in sweat-soaked synthetic undergarments, with limited water intake due to restricted restroom access. Irregular periods, excessive bleeding and menstrual blood clots due to dehydration and heat were also reported. Some now wear sanitary pads every day to manage excessive vaginal white discharge – a cost they can hardly afford.

Psychological distress and loss of dignity

Beyond physical suffering, workers spoke of shame from their inability to maintain basic hygiene. Some said supervisors frown upon them wiping sweat from their faces in case it “dirties” the garments.

Kamla, a worker in her late 30s, said: "By the time we’re 36 or 40, our bodies feel like they’re 80. We’re just trying to stay alive, not live."

Despite the scale of harm, basic relief measures are absent. Workers say fans are broken or too few. Medical rooms offer only paracetamol, with hardly any ORS packets and there are no protocols for hydration or rest.

The Business & Human Rights Resource Centre’s research in Bangladesh and Cambodia affirms this crisis extends beyond Tamil Nadu: workers reported similar experiences, including fainting, rashes, typhoid and dengue during heatwaves, alongside increased domestic violence and psychological distress linked to heat stress.

A call for urgent, worker-centred action

The connection between rising temperatures and worsening working conditions is undeniable. Yet, the burden of response is placed on suppliers, many of whom already operate razor-thin margins – while fashion brands controlling the supply chain fail to act. Brands speak about their sustainability strategies, but these often focus on carbon offsets, recycled packaging or circular fashion pilots – ignoring the women workers bearing the brunt of the climate crisis, from extreme heat to factory flooding. Out of the 65 brands which had announced climate targets, not one acknowledged the need to address climate change impacts – such as extreme heat – on workers in their supply chains.

As one garment worker told us: “Brands are writing their sustainability policies in air-conditioned rooms at 20 degrees — for people working in 40-degree heat.”

What are workers asking for? Not luxuries — just the bare minimum to survive:

• “Cold drinking water.”
• “Lime juice with sugar to prevent fainting.”
• “A functioning fan for every five to ten workers.”
• “Clean toilets with running water.”
• “Uncontaminated water that doesn’t upset our stomachs.”

The cost of meeting these needs is negligible. The question is not about affordability: it’s about willingness.

What must happen now

Based on conversations with workers and unions, we call on brands, investors and multistakeholder initiatives to:

• Recognise heat stress as a human rights issue and embed it into human rights due diligence, occupational safety and climate adaptation plans.
• Mandate heat-mitigation infrastructure as a core compliance requirement. Fans, AC, ventilation, clean water, shaded rest areas and rest breaks must be non-negotiable. Brands must pay for implementation where suppliers cannot.
• Share the financial burden of adaptation. Brands must fund infrastructure improvements, especially for low-margin suppliers. Tariff changes must not be an excuse to deny basic rights of workers.
• Commit to long-term sourcing agreements so suppliers can invest in worker safety and climate resilience without fear of losing contracts.
• Involve workers and unions in solution design. Ensure workers and their unions are central to designing solutions — no climate adaptation strategy can succeed without the insight and leadership of those experiencing the crisis firsthand.

Just weeks ago, the fashion industry marked the Rana Plaza collapse anniversary – a tragedy that claimed over 1,100 lives and exposed the deadly consequences of neglecting worker safety. Unlike a sudden collapse, the heat stress crisis is slow, silent and unfolding daily on overheated factory floors.

This is not a future crisis. It is already here – and it is costing lives.

This article is based on the lived experiences and testimonies of members of the Tamil Nadu Textile and Common Labour Union (TTCU), a women-led union representing over 12,000 garment and textile workers across Tamil Nadu.

If you’d like to support TTCU’s efforts to address heat stress and ensure safer, more dignified workplaces for women garment workers, please reach out at [email protected].

Nandita Shivakumar is a labour rights researcher and consultant who works with trade unions and labour rights organisations.

Apekshita Varshney is the founder of HeatWatch, a non-profit that focuses on amplifying and demanding ground-up action for the impact of extreme heat on vulnerable worker groups.