Hot ambient conditions and associated heat stress can increase mortality and morbidity, as well as increase adverse pregnancy outcomes and negatively affect mental health. High heat stress can also ...reduce physical work capacity and motor-cognitive performances, with consequences for productivity, and increase the risk of occupational health problems. Almost half of the global population and more than 1 billion workers are exposed to high heat episodes and about a third of all exposed workers have negative health effects. However, excess deaths and many heat-related health risks are preventable, with appropriate heat action plans involving behavioural strategies and biophysical solutions. Extreme heat events are becoming permanent features of summer seasons worldwide, causing many excess deaths. Heat-related morbidity and mortality are projected to increase further as climate change progresses, with greater risk associated with higher degrees of global warming. Particularly in tropical regions, increased warming might mean that physiological limits related to heat tolerance (survival) will be reached regularly and more often in coming decades. Climate change is interacting with other trends, such as population growth and ageing, urbanisation, and socioeconomic development, that can either exacerbate or ameliorate heat-related hazards. Urban temperatures are further enhanced by anthropogenic heat from vehicular transport and heat waste from buildings. Although there is some evidence of adaptation to increasing temperatures in high-income countries, projections of a hotter future suggest that without investment in research and risk management actions, heat-related morbidity and mortality are likely to increase.
Regional variation in sweating over the body is widely recognised. However, most studies only measured a limited number of regions, with the use of differing thermal states across studies making a ...good meta-analysis to obtain a whole body map problematic. A study was therefore conducted to investigate regional sweat rates (RSR) and distributions over the whole body in male athletes. A modified absorbent technique was used to collect sweat at two exercise intensities 55% (I1) and 75% (I2)
in moderately warm conditions (25°C, 50% rh, 2 m s
−1
air velocity). At I1 and I2, highest sweat rates were observed on the central (upper and mid) and lower back, with values as high as 1,197, 1,148, and 856 g m
−2
h
−1
, respectively, at I2. Lowest values were observed on the fingers, thumbs, and palms, with values of 144, 254, and 119 g m
−2
h
−1
, respectively at I2. Sweat mapping of the head demonstrated high sweat rates on the forehead (1,710 g m
−2
h
−1
at I2) compared with low values on the chin (302 g m
−2
h
−1
at I2) and cheeks (279 g m
−2
h
−1
at I2). Sweat rate increased significantly in all regions from the low to high exercise intensity, with exception of the feet and ankles. No significant correlation was present between RSR and regional skin temperature (
T
sk
), nor did RSR correspond to known patterns of regional sweat gland density. The present study has provided detailed regional sweat data over the whole body and has demonstrated large intra- and inter-segmental variation and the presence of consistent patterns of regional high versus low sweat rate areas in Caucasians male athletes. This data may have important applications for clothing design, thermophysiological modelling and thermal manikin design.
Occupational heat strain (ie, the effect of environmental heat stress on the body) directly threatens workers' ability to live healthy and productive lives. We estimated the effects of occupational ...heat strain on workers' health and productivity outcomes.
Following PRISMA guidelines for this systematic review and meta-analysis, we searched PubMed and Embase from database inception to Feb 5, 2018, for relevant studies in any labour environment and at any level of occupational heat strain. No restrictions on language, workers' health status, or study design were applied. Occupational heat strain was defined using international health and safety guidelines and standards. We excluded studies that calculated effects using simulations or statistical models instead of actual measurements, and any grey literature. Risk of bias, data extraction, and sensitivity analysis were performed by two independent investigators. Six random-effects meta-analyses estimated the prevalence of occupational heat strain, kidney disease or acute kidney injury, productivity loss, core temperature, change in urine specific gravity, and odds of occupational heat strain occurring during or at the end of a work shift in heat stress conditions. The review protocol is available on PROSPERO, registration number CRD42017083271.
Of 958 reports identified through our systematic search, 111 studies done in 30 countries, including 447 million workers from more than 40 different occupations, were eligible for analysis. Our meta-analyses showed that individuals working a single work shift under heat stress (defined as wet-bulb globe temperature beyond 22·0 or 24·8°C depending on work intensity) were 4·01 times (95% CI 2·45–6·58; nine studies with 11 582 workers) more likely to experience occupational heat strain than an individual working in thermoneutral conditions, while their core temperature was increased by 0·7°C (0·4–1·0; 17 studies with 1090 workers) and their urine specific gravity was increased by 14·5% (0·0031, 0·0014–0·0048; 14 studies with 691 workers). During or at the end of a work shift under heat stress, 35% (31–39; 33 studies with 13 088 workers) of workers experienced occupational heat strain, while 30% (21–39; 11 studies with 8076 workers) reported productivity losses. Finally, 15% (11–19; ten studies with 21 721 workers) of individuals who typically or frequently worked under heat stress (minimum of 6 h per day, 5 days per week, for 2 months of the year) experienced kidney disease or acute kidney injury. Overall, this analysis include a variety of populations, exposures, and occupations to comply with a wider adoption of evidence synthesis, but resulted in large heterogeneity in our meta-analyses. Grading of Recommendations, Assessment, Development and Evaluation analysis revealed moderate confidence for most results and very low confidence in two cases (average core temperature and change in urine specific gravity) due to studies being funded by industry.
Occupational heat strain has important health and productivity outcomes and should be recognised as a public health problem. Concerted international action is needed to mitigate its effects in light of climate change and the anticipated rise in heat stress.
EU Horizon 2020 research and innovation programme.
Although the ability to sense skin wetness and humidity is critical for behavioral and autonomic adaptations, humans are not provided with specific skin receptors for sensing wetness. It has been ...proposed that we "learn" to perceive the wetness experienced when the skin is in contact with a wet surface or when sweat is produced through a multisensory integration of thermal and tactile inputs generated by the interaction between skin and moisture. However, the individual roles of thermal and tactile cues and how these are integrated peripherally and centrally by our nervous system is still poorly understood. Here we tested the hypothesis that the central integration of coldness and mechanosensation, as subserved by peripheral A-nerve afferents, might be the primary neural process underpinning human wetness sensitivity. During a quantitative sensory test, we found that individuals perceived warm-wet and neutral-wet stimuli as significantly less wet than cold-wet stimuli, although these were characterized by the same moisture content. Also, when cutaneous cold and tactile sensitivity was diminished by a selective reduction in the activity of A-nerve afferents, wetness perception was significantly reduced. Based on a concept of perceptual learning and Bayesian perceptual inference, we developed the first neurophysiological model of cutaneous wetness sensitivity centered on the multisensory integration of cold-sensitive and mechanosensitive skin afferents. Our results provide evidence for the existence of a specific information processing model that underpins the neural representation of a typical wet stimulus. These findings contribute to explaining how humans sense warm, neutral, and cold skin wetness.
The assessment of energy cost (EC) at the workplace remains a key topic in occupational health due to the ever-increasing prevalence of work-related issues. This review provides a detailed list of EC ...estimations in jobs/tasks included in tourism, agriculture, construction, manufacturing, and transportation industries. A total of 61 studies evaluated the EC of 1,667 workers while performing a large number of tasks related to each of the aforementioned five industries. Agriculture includes the most energy-demanding jobs (males: 6.0 ± 2.5 kcal/min; females: 2.9 ± 1.0 kcal/min). Jobs in the construction industry were the 2nd most demanding (males: 4.9 ± 1.6 kcal/min; no data for females). The industry with the 3rd highest EC estimate was manufacturing (males: 3.8 ± 1.1 kcal/min; females: 3.0 ± 1.3 kcal/min). Transportation presented relatively moderate EC estimates (males: 3.1 ± 1.0 kcal/min; no data for females). Tourism jobs demonstrated the lowest EC values (2.5 ± 0.9 kcal/min for males and females). It is hoped that this information will aid the development of future instruments and guidelines aiming to protect workers’ health, safety, and productivity. Future research should provide updated EC estimates within a wide spectrum of occupational settings taking into account the sex, age, and physiological characteristics of the workers as well as the individual characteristics of each workplace.
Extreme heat events are increasing in frequency, severity, and duration. It is well known that heat stress can have a negative impact on occupational health and productivity, particularly during ...physical work. However, there are no up-to-date reviews on how vulnerability to heat changes as a function of individual characteristics in relation to the risk of hyperthermia and work capacity loss. The objective of this narrative review is to examine the role of individual characteristics on the human heat stress response, specifically in relation to hyperthermia risk and productivity loss in hot workplaces. Finally, we aim to generate practical guidance for industrial hygienists considering our findings. Factors included in the analysis were body mass, body surface area to mass ratio, body fat, aerobic fitness and training, heat adaptation, aging, sex, and chronic health conditions.
We found the relevance of any factor to be dynamic, based on the work-type (fixed pace or relative to fitness level), work intensity (low, moderate, or heavy work), climate type (humidity, clothing vapor resistance), and variable of interest (risk of hyperthermia or likelihood of productivity loss). Heat adaptation, high aerobic fitness, and having a large body mass are the most protective factors during heat exposure. Primary detrimental factors include low fitness, low body mass, and lack of heat adaptation. Aging beyond 50 years, being female, and diabetes are less impactful negative factors, since their independent effect is quite small in well matched participants. Skin surface area to mass ratio, body composition, hypertension, and cardiovascular disease are not strong independent predictors of the heat stress response.
Understanding how individual factors impact responses to heat stress is necessary for the prediction of heat wave impacts on occupational health and work capacity. The recommendations provided in this report could be utilized to help curtail hyperthermia risk and productivity losses induced by heat.
Relevance of local skin wettedness (
w
local
) to general thermal comfort while wearing clothing was investigated in eight males. In the experiments, skin wettedness of the whole body (
w
body
) was ...controlled to be around the thermal comfort limit, while
w
local
in different target locations of equal area (anterior and dorsal torso, arms, and thighs) was pushed beyond the comfort limit using special test garments. Subjects walked on a treadmill at 4.5 km h
−1
under 22°C 50% RH. Arms and thighs were thermally in discomfort when their
w
local
exceeded 0.32. On the other hand, discomfort in the anterior and dorsal torso was initiated when their
w
local
arrived at 0.42 and 0.45. That is, the relation of the local comfort limit with
w
local
differed depending upon the location. It was observed; however, that general discomfort was not induced when
w
body
remained below 0.36 even if
w
local
was higher than its local comfort limit.
This study investigated causative factors behind the expression of different interaction types during exposure to multistressor environments. Neuromuscular fatigue rates and time to exhaustion (TTE) ...were investigated in active men (n = 9) exposed to three climates 5 °C, 50% relative humidity (rh); 23 °C, 50% rh; and 42 °C, 70% rh at two inspired oxygen fractions (0.209 and 0.125 FiO2; equivalent attitude = 4,100 m). After a 40-min rest in the three climatic conditions, participants performed constant-workload (high intensity) knee extension exercise until exhaustion, with brief assessments of neuromuscular function every 110 s. Independent exposure to cold, heat, and hypoxia significantly (P < 0.01) reduced TTE from thermoneutral normoxia (reductions of 190, 405, and 505 s from 915 s, respectively). The TTE decrease was consistent with a faster rate of peripheral fatigue development (P < 0.01) compared with thermoneutral normoxia (increase of 1.6, 3.1, and 4.9%/min from 4.1%/min, respectively). Combined exposure to hypoxic-cold resulted in an even greater TTE reduction (-589 s), likely due to an increase in the rate of peripheral fatigue development (increased by 7.6%/min), but this was without significant interaction between stressors (P > 0.198). In contrast, combined exposure to hypoxic heat reduced TTE by 609 s, showing a significant antagonistic interaction (P = 0.003) similarly supported by an increased rate of peripheral fatigue development (which increased by 8.3%/min). A small decline (<0.4%/min) in voluntary muscle activation was observed only in thermoneutral normoxia. In conclusion, interaction type is influenced by the impact magnitude of the effect of the individual stressors' effect on exercise capacity, whereby the greater the effect of stressors, the greater the probability that one stressor will be abolished by the other. This indicates that humans respond to severe and simultaneous physiological strains on the basis of a worst-strain-takes-precedence principle.
The Universal Thermal Climate Index (UTCI) aimed for a one-dimensional quantity adequately reflecting the human physiological reaction to the multi-dimensionally defined actual outdoor thermal ...environment. The human reaction was simulated by the UTCI-Fiala multi-node model of human thermoregulation, which was integrated with an adaptive clothing model. Following the concept of an equivalent temperature, UTCI for a given combination of wind speed, radiation, humidity and air temperature was defined as the air temperature of the reference environment, which according to the model produces an equivalent dynamic physiological response. Operationalising this concept involved (1) the definition of a reference environment with 50% relative humidity (but vapour pressure capped at 20 hPa), with calm air and radiant temperature equalling air temperature and (2) the development of a one-dimensional representation of the multivariate model output at different exposure times. The latter was achieved by principal component analyses showing that the linear combination of 7 parameters of thermophysiological strain (core, mean and facial skin temperatures, sweat production, skin wettedness, skin blood flow, shivering) after 30 and 120 min exposure time accounted for two-thirds of the total variation in the multi-dimensional dynamic physiological response. The operational procedure was completed by a scale categorising UTCI equivalent temperature values in terms of thermal stress, and by providing simplified routines for fast but sufficiently accurate calculation, which included look-up tables of pre-calculated UTCI values for a grid of all relevant combinations of climate parameters and polynomial regression equations predicting UTCI over the same grid. The analyses of the sensitivity of UTCI to humidity, radiation and wind speed showed plausible reactions in the heat as well as in the cold, and indicate that UTCI may in this regard be universally useable in the major areas of research and application in human biometeorology.
A population-based dynamic model of human thermoregulation was expanded with control equations incorporating the individual person's characteristics (body surface area, mass, fat%, maximal O(2) ...uptake, acclimation). These affect both the passive (heat capacity, insulation) and active systems (sweating and skin blood flow function). Model parameters were estimated from literature data. Other data, collected for the study of individual differences (working at relative or absolute workloads in hot-dry 45 degrees C, 20% relative humidity (rh), warm-humid 35 degrees C, 80% rh, and cool 21 degrees C, 50% rh environments), were used for validation. The individualized model provides an improved prediction mean core temperature error, -0.21 --> -0.07 degrees C (P < 0.001); mean squared error, 0.40 --> 0.16 degrees C, (P < 0.001). The magnitude of improvement varies substantially with the climate and work type. Relative to an empirical multiple-regression model derived from these specific data sets, the analytical simulation model has between 54 and 89% of its predictive power, except for the cool climate, in which this ratio is zero. In conclusion, individualization of the model allows improved prediction of heat strain, although a substantial error remains.
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