Women working in Cambodian factories supplying some of the world’s best-known sportswear brands are suffering from repeated mass faintings linked to conditions.

Over the past year more than 500 workers in four factories supplying to Nike, Puma, Asics and VF Corporation were hospitalised. The most serious episode, recorded over three days in November, saw 360 workers collapse. The brands confirmed the incidents, part of a pattern of faintings that has dogged the 600,000-strong mostly female garment workforce for years.

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The Observer and Danwatch, a Danish investigative media group, interviewed workers, unions, doctors, charities and government officials in the country’s garment industry, worth $5.7bn in 2015.

The women who collapsed worked 10 hour days, six days a week and reported feeling exhausted and hungry. Excessive heat was also an issue in three factories, with temperatures of 37C. Unlike in neighbouring Vietnam, where factory temperatures must not exceed 32C, Cambodia sets no limit, though if temperatures reach a “very high level” causing difficulties for workers, employers must install fans or air conditioning.

According to unions, short-term contracts – common for workers in three of the factories – were also a key source of stress and exhaustion.

If workers are fainting, it should be a clear indication that you need to do something more drastic Bent Gehrt, Worker Rights Consortium

The minimum monthly wage in Cambodia is £120 and two hours’ overtime a day boosts it to between £150 and £190, depending on the factory. Wages vary, but none of the four factories pays the “living wage”, which in Cambodia is £300 a month, according to the workers’ rights alliance Asia Floor Wage.

Bent Gehrt, south-east Asia field director for the Worker Rights Consortium, which monitors factories making clothing for US universities, said: “There is no proper investment in an adequate working environment and no investment in the living wage. If workers are fainting, it should be a clear indication you need to do something more drastic.”



Short-term contracts were a “root cause” of job insecurity, he added, meaning people cannot refuse overtime: “Workers say if you don’t do overtime, you won’t get your contract renewed.”

Mass collapses bring factories to a standstill and cost “hundreds of thousands” of pounds in lost productivity, according to the Garment Makers Association in Cambodia. A factory supplying shoes for Asics in Kamong Speu province had to close temporarily when 360 workers passed out over three days.

“Mass panic” had occurred when one woman suffered a seizure in a factory where temperatures were later found to be reaching 37C, said Norn Sophea, who represents the Collective Union of Movement of Workers. “Certain departments have small fans to cool the area, but in others the fans are only designed to remove dust from the factory. So it gets very hot,” said Sophea.

Workers feared for their lives in one incident when 28 people collapsed rushing to escape a fire at a factory supplying Nike. Another described panic after thick smoke seeped into a factory supplying Puma.

On the outskirts of Phnom Penh, at a factory that makes sportswear for Puma, 150 workers passed out in March after thick smoke seeped across the factory floor. One woman, 28, was unconscious for two hours. “I heard the explosion. Smoke came into the factory. Workers were afraid and panicked. I ran to the gate to get out. It was locked but I ran to the manager’s door,” she said. “More and more workers came behind. Other workers could not run to get out and I heard they started fainting.”

Kim So Thet, president of the Coalition of Cambodian Apparel Workers’ Democratic Union, has asked the factory to set up a cooling system. “It was very hot in the dry season,” said So Thet. “The combination of the fire in the generator, which smells like a poison, and the heat, makes the workers sick.”

Puma said an investigation found no reports of an explosion. It added that a generator malfunction produced the smoke and workers left via the fire exit.

There needs to be sweeping reforms in the areas of long hours, stressful conditions and poor wages Robert Bartholomew, medical sociologist

Poor ventilation and chemicals inside and outside factories contribute to the gruelling working environment, while workers at provincial factories can face exhausting journeys into work, standing for up to two hours in trucks.

Cheav Bunrith, director at Cambodia’s Ministry of Labour’s National Social Security Fund, says the number of faintings has decreased, from 1,800 in 2015 to 1,160 last year, thanks to education programmes on nutrition and free treatment for those feeling unwell. But he admitted factories could improve: “The cooling systems need to be set up appropriate to the size of the factory and a safe electrical system has to be set up.”

Medical sociologist Robert Bartholomew, who has studied mass faintings, compares episodes in Cambodia to similar outbreaks in 19th century Britain when people worked long hours in unsafe conditions. It was, he said, a form of “subconscious political resistance”. “The reason for these outbreaks is not so much physical but psychological, in the form of mass psychogenic illness” said Bartholomew.

“Providing some workers with better nutrition is all well and good, but there needs to be sweeping reforms in the areas of long hours, stressful conditions and poor wages,” he said.

Contacted by the Observer and Danwatch, Puma, VF Corporation, Nike and Asics said they had investigated the episodes, which took place from last November to March. Nike said action had been taken to prevent fires and fire drills had been increased. It had also installed cooling systems and air conditioning, after an audit found temperatures above Nike’s code of conduct limits up to 30C. “We take the issue of fainting seriously, as it can be both a social response and an indication of issues within a factory that may require corrective action.” Nike doesn’t use short-term contracts.

Puma said it made recommendations, including providing energy bars and medical checks, maintenance of the ventilation system and a worker management committee. Puma is now replacing short-term contracts for workers who have given more than two years’ service. It was engaging with Better Factories Cambodia – a partnership between the United Nations’ labour organisation and the International Finance Corporation. “The causes for mass faintings seem to be multiple and often complex,” it said. “Only when there is a collaborative approach between the brands, factories, the workers and the government will the situation improve.”

Asics also works with BFC: “Workers fainting appear to be a complex situation, caused by a number of different factors,” it said. “The factory, alongside Asics and BFC, will address specific measures, with a focus on workers’ awareness and health and safety training, as well as including an improved air ventilation system.”

VF said it worked with 1,000 supplier factories internationally: “Our teams work hard to make certain that working conditions in our contract supplier factories, including temperature or working breaks, are followed per local laws and regulations.”