Climate change is driving ticks into new regions and increasing on-the-job exposure, making prevention, worker education, and stronger workplace protections essential to curb rising tick-borne illness risks.
Editorial note: Patient’s names used in the story are pseudonyms.
This article is part of the National Commission on Climate and Workforce Health’s series “Climate Prescription.”
Written by Dr. Leah B. Topper, a family medicine physician and Climate & Health Science Policy Fellow at the University of Colorado School of Medicine, the series translates the latest research on climate-driven health risks into practical insights for employers, HR leaders, and workplace health professionals.
Skin rashes are infamous for the complexity of their physical features, and the multitude of underlying causes they can signal. For this reason, medical training devotes considerable attention to ensuring that clinicians can identify “must-not-miss” rashes with just the briefest glance. One category of dangerous rashes are those caused by tick-borne illnesses, such as lyme disease and rocky mountain spotted fever.
As a primary care doctor working in the Southeast, I have identified and treated patients who contracted these tick-borne illnesses. Unfortunately, warmer temperatures, milder winters, and expanding human development have created ideal conditions for ticks to thrive and for people to encounter them more often in the outdoors. In North Carolina, this shift is especially noticeable as bacteria-carrying ticks spread to areas that were once too cool for them, turning once low-risk regions into emerging hotspots.
One patient, Mark, came to my clinic after removing two ticks from his body following a day of clearing overgrown shrubs at work. He brought the ticks in a plastic bag and showed me the places they had bitten him.
Mark had acted quickly and showed no symptoms, but he asked questions I hear often after an encounter with a tick: How long before a tick transmits infection? How will I know if I’m sick? How do I prevent this from happening again? These are smart questions, and they’re becoming increasingly important as climate changes reshape our environments and workplace hazards.
Outdoor workers, especially those who work in industries like agriculture, construction, landscaping, and forestry, are very likely to be exposed to ticks. From 2011 to 2020, nearly a thousand U.S. workers each year reported tick or mite bites that required days away from work — a number likely far below reality, given how often tick bites go unnoticed or are misdiagnosed. Additionally, Hispanic people disproportionately face infections and symptoms from tick-borne diseases, in part because they make up nearly half of the nation’s outdoor workforce.
To reduce the likelihood of a tick bite, whether outside for pleasure or for work, advice is prevention-oriented. Those who spend a lot of time outdoors can wear light-colored long sleeves and pants, tuck pants into socks, and use insect repellent. Ticks are easier to spot on white or lighter colored clothing, and clothes that cover the wrists and ankles can make it harder for a tick to find its way to the skin. Additionally, full-body tick checks are essential after a day of being outdoors.
These guidelines can also be applied in workplace settings. Knowing which ticks and diseases are present locally, educating workers (especially in their primary language) on early symptoms, and encouraging protective clothing and repellents can reduce risk of tick-borne illnesses at work.
For clinicians like me, tick-borne illnesses are a daily reminder that our health is intimately tied to the environments we live and work in. We must continue to evolve our policies and strategies, recreationally and at work, to effectively protect our communities.
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The National Commission on Climate and Workforce Health is a group of business, health, and climate leaders who share a mission to protect workers from the health risks posed by extreme weather.
The Commission was created by the Health Action Alliance in partnership with Mercer and with strategic input from the CDC Foundation. Additional support for the initiative is being provided by Elevance Health and The Hartford. Learn more at ClimateHealthCommission.org.
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