Objective The aim of this Discussion Paper is to examine the integration of occupational health within the European Strategic Research and Innovation Agenda on Health and Climate Change (SRIAHCC) and identify critical gaps relevant to worker health, equity, and the European Green Deal.

Methods We analyze the SRIAHCC in relation to related EU policy documents on occupational safety and health, climate change and the green transition, and other current scientific evidence. In addition, we performed an original survey and workshop consultations with key stakeholders in the field and conducted a Delphi-inspired consultation round within the EU INTERCAMBIO project.

Results While the SRIAHCC appropriately frames climate change as a public health emergency, occupational health is not systematically addressed either as a structural determinant of climate vulnerability or as a core domain of adaptation and mitigation research. Direct and indirect occupational exposures including heat stress, extreme weather events, air pollution, and emerging risks in relevant sectors, eg, decarbonization and circular economy, receive limited attention beyond the healthcare sector. Psychosocial impacts, inequalities affecting migrant and precarious workers, and productivity and income consequences are insufficiently addressed. Furthermore, the agenda lacks a clear implementation framework for workplace adaptation and harmonized occupational-climate monitoring systems.

Conclusions Without explicit integration of work and working conditions into the SRIAHCC, Europe’s climate and health strategy likely underestimates the true health costs of climate change and the green transition. Embedding occupational health as a core pillar of the SRIAHCC is essential to ensure coherent EU governance, equitable worker protection, and a resilient, sustainable transition.

Key terms climate; climate change; environmental policy; green transition; health; occupational health; occupational safety; research; working condition