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Due to heavy physical outdoor work construction workers’ safety is compromised by climatic heat stress. Heat stress in construction consists of environmental, organizational, technological, and personal elements. Administrative controls, environmental engineering controls, and personal engineering controls are safety interventions in the construction industry adopted to cope with heat stress. Numerous indices, models, and protective guidelines are introduced to measure and manage heat stress. Wet-bulb globe temperature (WBGT), Humidex, thermal work limit (TWL), predicted heat strain (PHS) are common indices used to measure heat stress. Imposing mandatory work-rest regimens is done through regulations as well as organizational work systems. Self-pacing, an alternative method of heat stress management, can be optimized by work system design using self-regulating worker groups. Because of the pragmatic and loosely-coupled nature of the construction industry, the design of self-regulating worker groups needs to be addressed in a socio-technical approach. It would comprise of consultative and substantive worker participation to optimize the work system for the benefit of individual and organization.