Estimating metabolic rate from International Organization for Standardization heart rate method and two walking equations.

Assigning a value for metabolic rate is central to heat stress assessment. ISO 8996 describes a predictive method for walking based on the American College of Sports Medicine (ACSM) method and another generalized method based on average heart rate. In addition, the US Army uses the load carriage decision aid (LCDA) predictive equation to estimate metabolic rate. The purpose of this study was to assess the accuracy/bias and precision of the ISO heart rate method and the ACSM and LCDA equations. The laboratory database included metabolic rate, heart rate, treadmill speed, and grade during a progressive heat stress protocol. Treadmill speed and grade were set to represent one of three metabolic rates. Accuracy and precision were assessed with Bland-Altman plots. All three methods had good accuracy (low bias). For precision, the ISO heart rate method had a root mean square error (RMSE) of 34 W and 11% when adjusted for repeated measures. The RMSE for two equations was 20 W and 7%. Although the heart method had less accuracy, its application is more generalizable. The heart rate method should be used below the occupational exposure limit to avoid a bias toward higher predicted values due to heat strain.

A Novel Conceptual Model for Human Heat Tolerance.

Human "heat tolerance" has no accepted definition or physiological underpinnings; rather, it is almost always discussed in relative or comparative terms. We propose to use environmental limits to heat balance accounting for metabolic rate and clothing, that is, the environments for which heat stress becomes uncompensable for a specified metabolic rate and clothing, as a novel metric for quantifying heat tolerance.

Core temperature and heart rate at the upper limit of the prescriptive zone.

The expressed goal of limiting workplace heat stress exposures to a core temperature (Tc ) of 38°C traces back to a 1969 World Health Organization Technical Report (WHO Series 412). The actual goal was to limit exposures to the upper limit of the prescriptive zone (ULPZ). To explore the physiological strain at the ULPZ, progressive heat stress protocol data from Penn State University (PSU) and University of South Florida (USF) below and at the ULPZ were used to articulate the relation of Tc and heart rate (HR) to metabolic rate (MR) with consideration of acclimatization state, clothing, exposure condition (PreULPZ vs. ULPZ), and sex. Regression models demonstrated the association of MR and sex with Tc and HR. At the ULPZ, women had systematically higher values of Tc and HR than men at the same MR likely due to higher relative demands. There was no effect for acclimatization state and clothing. As expected for individuals, Tc was practically constant below the ULPZ and HR exhibited increasing values approaching the ULPZ. At 490 W, the high MR cited in the WHO document, the mean Tc for men was near the 38°C limit with systematically lower Tc at lower MRs.

Distribution of upper limit of the prescriptive zone values for acclimatized and unacclimatized individuals.

Heat stress has an adverse impact on worker health and well-being, and the effects will increase with more frequent and severe heat events associated with global warming. Acclimatization to heat stress is widely considered to be a critical mitigation strategy and wet bulb globe temperature- (WBGT-) based occupational standards and guidelines contain adjustments for acclimatization. The purpose here was to 1) compare the mean values for the upper limit of the prescriptive zone (ULPZ, below which the rise in core temperature is minimal) between unacclimatized and acclimatized men and women; 2) demonstrate that the change in the occupational exposure limit (ΔOEL) due to acclimatization is independent of metabolic rate; 3) examine the relation between ΔOEL and body surface area (BSA); and 4) compare the exposure-response curves between unacclimatized and acclimatized populations. Empirically derived ULPZ data for unacclimatized participants from Pennsylvania State University (PSU) and acclimatized participants from University of South Florida (USF) were used to explore the difference between unacclimatized and acclimatized heat exposure limits. The findings provide support for a constant 3°C WBGT OEL decrease to account for unacclimatized workers. Body surface area explained part of the difference in ULPZ values between men and women. In addition, the pooled PSU and USF data provide insight into the distribution of individual values for the ULPZ among young, healthy unacclimatized and acclimatized populations in support of occupational heat stress guidelines.NEW & NOTEWORTHY Occupational exposure limit guidelines using wet bulb globe temperature (WBGT) distinguish between acclimatized and unacclimatized workers with about a 3°C difference between them. For the first time, empirical data from two laboratories provide support for acclimatization state adjustments. Using a constant difference rather than increasing differences with metabolic rate better describes the limit for unacclimatized participants. Furthermore, the lower upper limit of the prescriptive zone (ULPZ) values set forth for women do not relate to fitness level but are partly explained by their smaller body surface area (BSA). An examination of individual ULPZ values suggests that many unacclimatized individuals should be able to sustain safe work at the exposure limit for acclimatized workers.

Group Outcomes for Time-Weighted Averaging in WBGT-Based Heat Stress Exposure Assessment.

The wet bulb globe temperature (WBGT)-based occupational exposure limits (OELs) were developed from steady exposures to heat stress at constant WBGT and metabolic rate (M). The exposure limits were based on compensable heat stress exposures at the upper limit of the prescriptive zone for most healthy people. Professional practice allows for using time-weighted averages (TWAs) of WBGT and M to account for heterogeneous heat stress exposures. The purpose of the current paper was to report on the effectiveness of time-weighted averaging to assess occupational heat stress using published studies. Our hypothesis was using TWA-WBGT and TWA-M was as protective as the recommended OELs for steady exposures. The current paper reports on 62 observations of work that alternate between at least two heat stress conditions (usually work and recovery) reported in 16 papers. The TWA-WBGT and TWA-M were determined for all observations. ΔLimit was the observed TWA-WBGT minus the exposure limit at the TWA-M based on acclimatization state. The observations were then classified as above or below ΔLimit = 0. Each observation was also classified as uncompensable if the mean core temperature for the group was greater than 38°C or a less tolerant individual was above 38.5°C. When comparing exposure classifications to outcome classifications using 2 × 2 tables, the sensitivity and specificity for all observations were 0.72 and 0.73, respectively. The sensitivity was much less than the expected value near 1.0, and the large difference called into question the ability of TWAs to represent actual heat stress. There was some suspicion that there were differences between acclimatized and unacclimatized observations. Before any of these findings are embedded in policy or practice, a more careful evaluation of TWAs is required. In conclusion, we believe that the use of TWAs for heat stress analysis was not fully evaluated, and we proposed a framework for evaluation.

Indicators to assess physiological heat strain - Part 1: Systematic review.

In a series of three companion papers published in this Journal, we identify and validate the available thermal stress indicators (TSIs). In this first paper of the series, we conducted a systematic review (registration: INPLASY202090088) to identify all TSIs and provide reliable information regarding their use (funded by EU Horizon 2020; HEAT-SHIELD). Eight databases (PubMed, Agricultural and Environmental Science Collection, Web of Science, Scopus, Embase, Russian Science Citation Index, MEDLINE, and Google Scholar) were searched from database inception to 15 April 2020. No restrictions on language or study design were applied. Of the 879 publications identified, 232 records were considered for further analysis. This search identified 340 instruments and indicators developed between 200 BC and 2019 AD. Of these, 153 are nomograms, instruments, and/or require detailed non-meteorological information, while 187 can be mathematically calculated utilizing only meteorological data. Of these meteorology-based TSIs, 127 were developed for people who are physically active, and 61 of those are eligible for use in occupational settings. Information regarding the equation, operating range, interpretation categories, required input data, as well as a free software to calculate all 187 meteorology-based TSIs is provided. The information presented in this systematic review should be adopted by those interested in performing on-site monitoring and/or big data analytics for climate services to ensure appropriate use of the meteorology-based TSIs. Studies two and three in this series of companion papers present guidance on the application and validation of these TSIs, to guide end users of these indicators for more effective use.

Indicators to assess physiological heat strain - Part 2: Delphi exercise.

In a series of three companion papers published in this Journal, we identify and validate the available thermal stress indicators (TSIs). In this second paper of the series, we identified the criteria to consider when adopting a TSI to protect individuals who work in the heat, and we weighed their relative importance using a Delphi exercise with 20 experts. Two Delphi iterations were adequate to reach consensus within the expert panel (Cronbach's α = 0.86) for a set of 17 criteria with varying weights that should be considered when adopting a TSI to protect individuals who work in the heat. These criteria considered physiological parameters such as core/skin/mean body temperature, heart rate, and hydration status, as well as practicality, cost effectiveness, and health guidance issues. The 17 criteria were distributed across three occupational health-and-safety pillars: (i) contribution to improving occupational health (55% of total importance), (ii) mitigation of worker physiological strain (35.5% of total importance), and (iii) cost-effectiveness (9.5% of total importance). Three criteria [(i) relationship of a TSI with core temperature, (ii) having categories indicating the level of heat stress experienced by workers, and (iii) using its heat stress categories to provide recommendations for occupational safety and health] were considered significantly more important when selecting a TSI for protecting individuals who work in the heat, accumulating 37.2 percentage points. These 17 criteria allow the validation and comparison of TSIs that presently exist as well as those that may be developed in the coming years.

Heat exposure limits for young unacclimatized males and females at low and high humidity.

Little is known about the separate and combined influences of humidity conditions, sex, and aerobic fitness on heat tolerance in unacclimatized males and females. The purpose of the current study was to describe heat tolerance, in terms of critical WBGT (WBGTcrit), in unacclimatized young males and females in hot-dry (HD) and warm-humid (WH) environments. Eighteen subjects (9 M/9F; 21 ± 2 yr) were tested during exercise at 30% V̇O2max in a controlled environmental chamber. Progressive heat stress exposures were performed with either (1) constant dry-bulb temperature (Tdb) of 34 and 36 °C and increasing ambient water vapor pressure (Pa) (Pcrit trials; WH); or (2) constant Pa of 12 and 16 mmHg and increasing Tdb (Tcrit trials; HD). Chamber Tdb and Pa, and subject esophageal temperature (Tes), were continuously monitored throughout each trial. After a 30-min equilibration period, progressive heat stress continued until subject heat balance could no longer be maintained and a clear rise in Tes was observed. Absolute WBGTcrit and WBGTcrit adjusted to a metabolic rate of 300 W (WBGT300), and the difference between WBGTcrit and occupational exposure limits (OEL; ΔOEL) was assessed. WBGTcrit, WBGT300, and ΔOEL were higher in WH compared to HD (p < 0.0001) for females but were the same between environments for males (p ≥ 0.21). WBGTcrit was higher in females compared to males in WH (p < 0.0001) but was similar between sexes in HD (p = 0.44). When controlling for metabolic rate, WBGT300 and ΔOEL were higher in males compared to females in WH and HD (both p < 0.0001). When controlling for sex, V̇O2max was not associated with WBGT300 or ΔOEL for either sex (r ≤ 0.12, p ≥ 0.49). These findings suggest that WBGTcrit is higher in females compared to males in WH, but not HD, conditions. Additionally, the WBGTcrit is lower in females, but not males, in HD compared to WH conditions.

Ability of Thermal Work Limit (TWL) to Assess Sustainable Heat Stress Exposures.

Thermal Work Limit (TWL) recommends a maximum metabolic rate for a given environmental condition, clothing ensemble, and acclimatization state so that thermal equilibrium can be sustained at or below the limiting metabolic rate. The purpose of this paper was to assess the ability of TWL to recommend maximum sustainable levels of heat stress using an existing database of progressive heat stress trials using four levels of clothing (woven clothing, particle barrier, water barrier, and vapor barrier), three levels of relative humidity, and three levels of metabolic rate. Each trial had a compensable and an uncompensable observation plus and observation at the transition point from compensable to uncompensable. Each observation was classified as a case (steady increase in rectal temperature) or non-case (steady rectal temperature). The data were used to compare the difference between the observed metabolic rate (Mobs) and the limiting metabolic rate of TWL (i.e., ∆LimitTWL = Mobs - TWL), where ∆LimitTWL > 0 was above the TWL limit. The sensitivity and specificity for each of the four clothing ensembles were about 0.96 and about 0.20, respectively. Logistic regression for all the data found that ∆LimitTWL, clothing, metabolic rate, and water vapor pressure were significant predictors of outcome. The ln(odds) equations for each clothing ensemble predicted a probability of an uncompensable exposure. The probability of an uncompensable outcome (case) when ∆LimitTWL = 0 was 0.14 for work clothes and particle barrier, and 0.22 for water barrier and vapor barrier. The probability of a case at ∆LimitTWL = 0 was greater than the probability of a case for the wet bulb globe temperature-based exposure limits where the probability of a case was 0.01. That is, the TWL was less restrictive than WBGT but with higher risk.

Benchmarking Heat Index as an occupational exposure limit for heat stress.

While wet bulb globe temperature (WBGT) is the long-accepted index to represent the environmental contributions to heat stress, Heat Index (HI) is a commonly reported index and is used for heat stress guidance. The purpose of this article was to propose an HI-based heat stress exposure limit. The data came from previous progressive heat stress studies that identified the critical conditions between sustainable and unsustainable exposures. The experimental trials included five clothing ensembles at three levels each of relative humidity (rh) and metabolic rate (M). The critical Heat Index (HIcrit) was used to characterize the trial exposure. An analysis of variance (ANOVA) assessed the effects of M, clothing, and rh on HIcrit. After proposing a relationship between HIcrit and M to represent a benchmark exposure limit based on HI (called HIbel), the ability of the proposed relationship to discriminate between Sustainable and Unsustainable conditions was assessed using receiver operating characteristics curves (ROC curves). Based on the ANOVA results, the main effects of M, rh, and clothing on HIcrit were significant; the interaction between rh and clothing was not significant. There were differences in mean HIcrit among all the ensembles. For effects of relative humidity on HIcrit, the mean HIcrit at rh at 20% was 3 °C lower than the mean values for 50% and 70%. The benchmark exposure limit from the woven clothing data was HIbel [°C] = 49-0.026 M [W]. In terms of the ability of HIbel to discriminate, area under the ROC curve was 0.86, which was similar to WBGT-based exposure limits. Similar in purpose for WBGT-based exposure assessment, HI clothing adjustment values (HIcav) of 1.5 °C (particle barrier coveralls), 6 °C (water barrier coveralls), and 18.5 °C (vapor barrier coveralls) were supported. It should also be noted that the effects of the sun and lack of acclimatization were not included in this analysis; where the sun might reasonably increase the effects of the ambient HI by an additional 3.5 °C and being unacclimatized by 5.5 °C.

Heat stress risk profiles for three non-woven coveralls.

The ACGIH® Threshold Limit Value® (TLV®) is used to limit heat stress exposures so that most workers can maintain thermal equilibrium. That is, the TLV was set to an upper limit of Sustainable exposures for most people. This article addresses the ability of the TLV to differentiate between Sustainable and Unsustainable heat exposures for four clothing ensembles over a range of environmental factors and metabolic rates (M). The four clothing ensembles (woven clothing, and particle barrier, water barrier and vapor barrier coveralls) represented a wide range of evaporative resistances. Two progressive heat stress studies provided data on 480 trials with 1440 pairs of Sustainable and Unsustainable exposures for the clothing over three levels of relative humidity (rh) (20, 50 and 70%), three levels of metabolic rate (115, 180, and 254 Wm-2) using 29 participants. The exposure metric was the difference between the observed wet bulb globe temperature (WBGT) and the TLV. Risk was characterized by odds ratios (ORs), Receiver Operating Characteristic (ROC) curves, and dose-response curves for the four ensembles. Conditional logistic regression models provided information on ORs. Logistic regressions were used to determine ROC curves with area under the curve (AUC), model the dose-response curve, and estimate offsets from woven clothing. The ORs were about 2.5 per 1°C-WBGT for woven clothing, particle barrier, and water barrier and for vapor barrier at 50% rh. When using the published Clothing Adjustment Values (CAVs, also known as Clothing Adjustment Factors, CAFs) or the offsets that included different values for vapor barrier based on rh, the AUC for all clothing was 0.86. When the fixed CAVs of the TLV were used, the AUC was 0.81. In conclusion, (1) ORs and the shapes of the dose-response curves for the nonwoven coveralls were similar to woven clothing, and (2) CAVs provided a robust way to account for the risk of nonwoven clothing. The robust nature of CAV extended to the exclusion of different adjustments for vapor barrier by rh.

Prediction of WBGT-based clothing adjustment values from evaporative resistance.

Wet bulb globe temperature (WBGT) index is used by many professionals in combination with metabolic rate and clothing adjustments to assess whether a heat stress exposure is sustainable. The progressive heat stress protocol is a systematic method to prescribe a clothing adjustment value (CAV) from human wear trials, and it also provides an estimate of apparent total evaporative resistance (Re,T,a). It is clear that there is a direct relationship between the two descriptors of clothing thermal effects with diminishing increases in CAV at high Re,T,a. There were data to suggest an interaction of CAV and Re,T,a with relative humidity at high evaporative resistance. Because human trials are expensive, manikin data can reduce the cost by considering the static total evaporative resistance (Re,T,s). In fact, as the static evaporative resistance increases, the CAV increases in a similar fashion as Re,T,a. While the results look promising that Re,T,s can predict CAV, some validation remains, especially for high evaporative resistance. The data only supports air velocities near 0.5 m/s.

Ability to Discriminate Between Sustainable and Unsustainable Heat Stress Exposures-Part 1: WBGT Exposure Limits.

OBJECTIVES: Heat stress exposure limits based on wet-bulb globe temperature (WBGT) were designed to limit exposures to those that could be sustained for an 8-h day using limited data from Lind in the 1960s. In general, Sustainable exposures are heat stress levels at which thermal equilibrium can be achieved, and Unsustainable exposures occur when there is a steady increase in core temperature. This paper addresses the ability of the ACGIH® Threshold Limit Value (TLV®) to differentiate between Sustainable and Unsustainable heat exposures, to propose alternative occupational exposure limits, and ask whether an adjustment for body surface area improves the exposure decision. METHODS: Two progressive heat stress studies provided data on 176 trials with 352 pairs of Sustainable and Unsustainable exposures over a range of relative humidities and metabolic rates using 29 participants wearing woven cotton clothing. To assess the discrimination ability of the TLV, the exposure metric was the difference between the observed WBGT and the TLV adjusted for metabolic rate. Conditional logistic regression models and receiver operating characteristic curves (ROC) along with ROC's area under the curve (AUC) were used. Four alternative models for an occupational exposure limit were also developed and compared to the TLV. RESULTS: For the TLV, the odds ratio (OR) for Unsustainable was 2.5 per 1°C-WBGT [confidence interval (CI) 2.12-2.88]. The AUC for the TLV was 0.85 (CI 0.81-0.89). For the alternative models, the ORs were also about 2.5/°C-WBGT, with AUCs between 0.84 and 0.88, which were significantly different from the TLV's AUC but have little practical difference. CONCLUSIONS: This study (1) confirmed that the TLV is appropriate for heat stress screening; (2) demonstrated the TLV's discrimination accuracy with an ROC AUC of 0.85; and (3) established the OR of 2.5/°C-WBGT for unsustainable exposures. The TLV has high sensitivity, but its specificity is very low, which is protective. There were no important improvements with alternative exposure limits, and there was weak evidence to support metabolic rate normalized to body surface area. In sum, the TLV is protective with an appropriate margin of safety for relatively constant occupational exposures to heat stress.

Ability to Discriminate Between Sustainable and Unsustainable Heat Stress Exposures-Part 2: Physiological Indicators.

OBJECTIVES: There are times when it is not practical to assess heat stress using environmental metrics and metabolic rate, and heat strain may provide an alternative approach. Heat strain indicators have been used for decades as tools for monitoring physiological responses to work in hot environments. Common indicators of heat strain are body core temperature (assessed here as rectal temperature Tre), heart rate (HR), and average skin temperature (Tsk). Data collected from progressive heat stress trials were used to (1) demonstrate if physiological heat strain indicators (PHSIs) at the upper limit of Sustainable heat stress were below generally accepted limits; (2) suggest values for PHSIs that demonstrate a Sustainable level of heat stress; (3) suggest alternative PHSIs; and (4) determine if metabolic rate was an effect modifier. METHODS: Two previous progressive heat stress studies included 176 trials with 352 pairs of Sustainable and Unsustainable exposures over a range of relative humidities and metabolic rates using 29 participants. To assess the discrimination ability of PHSIs, conditional logistic regression and stepwise logistic regression were used to find the best combinations of predictors of Unsustainable exposures. The accuracy of the models was assessed using receiver operating characteristic curves. RESULTS: Current recommendations for physiological heat strain limits were associated with probabilities of Unsustainable greater than 0.5. Screening limits for Sustainable heat stress were Tre of 37.5°C, HR of 105 bpm, and Tsk of 35.8°C. Tsk alone resulted in an area under the curve of 0.85 and the combination of Tsk and HR (area under the curve = 0.88) performed the best. The adjustment for metabolic rate was statistically significant for physiological strain index or ∆Tre-sk as main predictors, but its effect modification was negligible and could be ignored. CONCLUSIONS: Based on the receiver operating characteristic curve, PHSIs (Tre, HR, and Tsk) can accurately predict Unsustainable heat stress exposures. Tsk alone or in combination with HR has a high sensitivity, and makes better discriminations than the other PHSIs under relatively constant exposure (metabolic rate and environment) for an hour or so. Screening limits with high sensitivity, however, have low thresholds that limit utility. To the extent that the observed strain is low, there is good evidence that the exposure is Sustainable.

Effects of heat stress on risk perceptions and risk taking.

Exposure to extreme heat at work is a serious occupational hazard, as exposure can result in heat-related illnesses, and it has been linked to increased risk of accidents and injuries. The current study aimed to examine whether heat exposure is related to changes in individuals' psychological process of risk evaluation, and whether acclimatization can mitigate the effect of heat exposure. A study with quasi-experiment research design was used to compare participants' risk perceptions and risk-taking behaviors at baseline, initial exposure to heat, and exposure after acclimatization across male participants who were exposed to heat (N = 6), and males (N = 5) and females (N = 6) who were in the control group who were exposed to ambient temperature. Results show that participants perceived the same risky behaviors to be less risky (p = 0.003) and demonstrated increased risk-taking behaviors (p = 0.001) after initial heat exposure. While their risk perceptions returned to baseline level after acclimatization, their risk-taking behaviors remained heightened (p = 0.031). Participants who were not exposed to heat showed no significant fluctuation in their risk perceptions and risk-taking. Our findings support that risk-related processes may explain the effects of heat exposure on increased accidents and injuries beyond its direct impact on heat-related illnesses.

Exertional heat illness and acute injury related to ambient wet bulb globe temperature.

BACKGROUND: The Deepwater Horizon disaster cleanup effort provided an opportunity to examine the effects of ambient thermal conditions on exertional heat illness (EHI) and acute injury (AI). METHODS: The outcomes were daily person-based frequencies of EHI and AI. Exposures were maximum estimated WBGT (WBGTmax) and severity. Previous day's cumulative effect was assessed by introducing previous day's WBGTmax into the model. RESULTS: EHI and AI were higher in workers exposed above a WBGTmax of 20°C (RR 1.40 and RR 1.06/°C, respectively). Exposures above 28°C-WBGTmax on the day of the EHI and/or the day before were associated with higher risk of EHI due to an interaction between previous day's environmental conditions and the current day (RRs from 1.0-10.4). CONCLUSIONS: The risk for EHI and AI were higher with increasing WBGTmax. There was evidence of a cumulative effect from the prior day's WBGTmax for EHI. Am. J. Ind. Med. 59:1169-1176, 2016. © 2016 Wiley Periodicals, Inc.

Loss of heat acclimation and time to re-establish acclimation.

Acclimation in a hot environment is one potent means to decrease the heat strain of work in a hot environment. However, with diminished heat exposure, positive adaptations of acclimation may be lost. This rate of loss is equivocal and, once established, could be used to prescribe the time for re-acclimation. The purpose of this study was to determine the rate of loss of heat acclimation over a period of 6 weeks and determine the time needed for re-acclimation after 2 weeks and 4 weeks of de-acclimation in ten healthy participants. All participants first underwent an initial acclimation period (a 3-day plateau in Tre was used to signify acclimation). Based on the mean time to acclimate in Phase 1 (mean time to acclimate = 6.1 ± 1.4 days), the loss of acclimation was mapped and participants were randomly assigned to one of two groups: one that underwent one 2-hr heat exposure at 1, 3, and 5 weeks post-acclimation, and one that underwent one 2-hr heat exposure session at 2,4, and 6 weeks. Complete loss of acclimation occurred in 6 weeks and, as expected, work HR and Tre increased with increasing time away from the heat (p<0.05). Based on the time for total loss of acclimation from Phase 1, participants in Phase 2 (n = 8) first underwent acclimation. Then, after either a 2-week or 4-week absence from the heat, participants returned to the laboratory for re-acclimation. While not statistically significant yet practically significant (p = 0.18; one-tailed confidence interval), average days for re-acclimation in the 2-week group tended to be fewer than in the 4-week group (days for re-acclimation = 3.8 ± 1.2 and 5.3 ± 1.9, respectively). Based on these general trends, for occupational settings, a re-acclimation period of 4 days is recommended after 2 weeks absence from the heat, 5 days for 4 weeks absence from the heat, and complete acclimation (6 days) after 6 weeks absence or more from the heat.

Heat index and adjusted temperature as surrogates for wet bulb globe temperature to screen for occupational heat stress.

Ambient temperature and relative humidity are readily ava-ilable and thus tempting metrics for heat stress assessment. Two methods of using air temperature and relative humidity to create an index are Heat Index and Adjusted Temperature. The purposes of this article are: (1) to examine how well Heat Index and Adjusted Temperature estimated the wet bulb globe temperature (WBGT) index, and (2) to suggest how Heat Index and Adjusted Temperature can be used to screen for heat stress level. Psychrometric relationships were used to estimate values of actual WBGT for conditions of air temperature, relative humidity, and radiant heat at an air speed of 0.5 m/s. A relationship between Heat Index [°F] and WBGT [°C] was described by WBGT = -0.0034 HI(2) + 0.96 HI - 34. At lower Heat Index values, the equation estimated WBGTs that were ± 2 °C-WBGT around the actual value, and to about ± 0.5 °C-WBGT for Heat Index values > 100 °F. A relationship between Adjusted Temperature [°F] and WBGT [°C] was described by WBGT = 0.45 Tadj - 16. The actual WBGT was between 1 °C-WBGT below the estimated value and 1.4 °C-WBGT above. That is, there was a slight bias toward overestimating WBGT from Adjusted Temperature. Heat stress screening tables were constructed for metabolic rates of 180, 300, and 450 W. The screening decisions were divided into four categories: (1) < alert limit, (2) < exposure limit, (3) hourly time-weighted averages (TWAs) of work and recovery, and (4) a caution zone for an exposure > exposure limit at rest. The authors do not recommend using Heat Index or Adjusted Temperature instead of WBGT, but they may be used to screen for circumstances when a more detailed analysis using WBGT is appropriate. A particular weakness is accounting for radiant heat; and neither air speed nor clothing was considered.

Heat stress evaluation of two-layer chemical demilitarization ensembles with a full face negative pressure respirator.

The purpose of this study was to examine the heat stress effects of three protective clothing ensembles: (1) protective apron over cloth coveralls including full face negative pressure respirator (APRON); (2) the apron over cloth coveralls with respirator plus protective pants (APRON+PANTS); and (3) protective coveralls over cloth coveralls with respirator (PROTECTIVE COVERALLS). In addition, there was a no-respirator ensemble (PROTECTIVE COVERALLS-noR), and WORK CLOTHES as a reference ensemble. Four acclimatized male participants completed a full set of five trials, and two of the participants repeated the full set. The progressive heat stress protocol was used to find the critical WBGT (WBGTcrit) and apparent total evaporative resistance (Re,T,a) at the upper limit of thermal equilibrium. The results (WBGTcrit [°C-WBGT] and Re,T,a [kPa m(2) W(-1)]) were WORK CLOTHES (35.5, 0.0115), APRON (31.6, 0.0179), APRON+PANTS (27.7, 0.0244), PROTECTIVE COVERALLS (25.9, 0.0290), and PROTECTIVE COVERALLS-noR (26.2, 0.0296). There were significant differences among the ensembles. Supporting previous studies, there was little evidence to suggest that the respirator contributed to heat stress.