The HEAT-SHIELD project - Perspectives from an inter-sectoral approach to occupational heat stress

Objectives: To provide perspectives from the HEAT-SHIELD project (www.heat-shield.eu): a multinational, inter-sectoral, and cross-disciplinary initiative, incorporating twenty European research institutions, as well as occupational health and industrial partners, on solutions to combat negative health and productivity effects caused by working on a warmer world. Methods: In this invited review, we focus on the theoretical and methodological advancements developed to combat occupational heat stress during the last five years of operation. Results: We outline how we created climate forecast models to incorporate humidity, wind and solar radiation to the traditional temperature-based climate projections, providing the basis for timely, policy-relevant, industry-specific and individualized information. Further, we summarise the industry-specific guidelines we developed regarding technical and biophysical cooling solutions considering effectiveness, cost, sustainability, and the practical implementation potential in outdoor and indoor settings, in addition to field-testing of selected solutions with time-motion analyses and biophysical evaluations. All recommendations were adjusted following feedback from workshops with employers, employees, safety officers, and adjacent stakeholders such as local or national health policy makers. The cross-scientific approach was also used for providing policy-relevant information based on socioeconomic analyses and identification of vulnerable regions considered to be more relevant for political actions than average continental recommendations and interventions. Discussion: From the HEAT-SHIELD experiences developed within European settings, we discuss how this inter-sectoral approach may be adopted or translated into actionable knowledge across continents where workers and societies are affected by escalating environmental temperatures.The study has received funding from the European Union’s Horizon 2020 research and innovation program under the grant agreement No 66878

Prolonged Heat Acclimation and Aerobic Performance in Endurance Trained Athletes

Heat acclimation (HA) involves physiological adaptations that directly promote exercise performance in hot environments. However, for endurance-athletes it is unclear if adaptations also improve aerobic capacity and performance in cool conditions, partly because previous randomized controlled trial (RCT) studies have been restricted to short intervention periods. Prolonged HA was therefore deployed in the present RCT study including 21 cyclists [38 ± 2 years, 184 ± 1 cm, 80.4 ± 1.7 kg, and maximal oxygen uptake (VO2max) of 58.1 ± 1.2 mL/min/kg; mean ± SE] allocated to either 5½ weeks of training in the heat [HEAT (n = 12)] or cool control [CON (n = 9)]. Training registration, familiarization to test procedures, determination of VO2max, blood volume and 15 km time trial (TT) performance were assessed in cool conditions (14°C) during a 2-week lead-in period, as well as immediately pre and post the intervention. Participants were instructed to maintain total training volume and complete habitual high intensity intervals in normal settings; but HEAT substituted part of cool training with 28 ± 2 sessions in the heat (1 h at 60% VO2max in 40°C; eliciting core temperatures above 39°C in all sessions), while CON completed all training in cool conditions. Acclimation for HEAT was verified by lower sweat sodium [Na+], reduced steady-state heart rate and improved submaximal exercise endurance in the heat. However, when tested in cool conditions both peak power output and VO2max remained unchanged for HEAT (pre 60.0 ± 1.5 vs. 59.8 ± 1.3 mL O2/min/kg). TT performance tested in 14°C was improved for HEAT and average power output increased from 298 ± 6 to 315 ± 6 W (P < 0.05), but a similar improvement was observed for CON (from 294 ± 11 to 311 ± 10 W). Based on the present findings, we conclude that training in the heat was not superior compared to normal (control) training for improving aerobic power or TT performance in cool conditions

High prevalence of hypohydration in occupations with heat stress-Perspectives for performance in combined cognitive and motor tasks.

PURPOSE:To evaluate the prevalence of dehydration in occupational settings and contextualize findings to effects on performance in cognitively dominated tasks, simple and complex motor tasks during moderate and high heat stress. METHODS:The study included an occupational part with hydration assessed in five industries across Europe with urine samples collected from 139 workers and analyzed for urine specific gravity. In addition, laboratory experiments included eight male participants completing mild-intensity exercise once with full fluid replacement to maintain euhydration, and once with restricted water intake until the dehydration level corresponded to 2% bodyweight deficit. Following familiarization, euhydration and dehydration sessions were completed on separate days in random order (cross-over design) with assessment of simple motor (target pinch), complex motor (visuo-motor tracking), cognitive (math addition) and combined motor-cognitive (math and pinch) performance at baseline, at 1°C (MOD) and 2°C (HYPER) delta increase in body core temperature. RESULTS:The field studies revealed that 70% of all workers had urine specific gravity values ≥1.020 corresponding to the urine specific gravity (1.020±0.001) at the end of the laboratory dehydration session. At this hydration level, HYPER was associated with reductions in simple motor task performance by 4±1%, math task by 4±1%, math and pinch by 9±3% and visuo-motor tracking by 16±4% (all P0.05). In the euhydration session, HYPER reduced complex (tracking) motor performance by 10±3% and simple pinch by 3±1% (both P0.05). CONCLUSION:Dehydration at levels commonly observed across a range of occupational settings with environmental heat stress aggravates the impact of hyperthermia on performance in tasks relying on combinations of cognitive function and motor response accuracy

Occupational heat strain in outdoor workers:A comprehensive review and meta-analysis

The present comprehensive review (i) summarizes the current knowledge on the impacts of occupational heat stress on outdoor workers, (ii) provides a historical background on this issue, (iii) presents a meta-analysis of published data, (iv) explores inter-individual and intra-individual factors, (v) discusses the available heat mitigation strategies, (vi) estimates physical work capacity, labour productivity, and metabolic rate for the year 2030, and (vii) provides an overview of existing policy and legal frameworks on occupational heat exposure. Meta-analytic findings from 38 field studies that involved monitoring 2,409 outdoor workers across 41 jobs in 21 countries suggest that occupational heat stress increases the core (r = 0.44) and skin (r = 0.44) temperatures, as well as the heart rate (r = 0.38) and urine specific gravity (r = 0.13) of outdoor workers (all p &lt; 0.05). Moreover, it diminishes the capacity of outdoor workers for manual labour (r = -0.82; p &lt; 0.001) and is responsible for more than two thirds of the reduction in their metabolic rate. Importantly, our analysis shows that physical work capacity is projected to be highly affected by the ongoing anthropogenic global warming. Nevertheless, the metabolic rate and, therefore, labour productivity are projected to remain at levels higher than the workers' physical work capacity, indicating that people will continue to work more intensely than they should to meet their financial obligations for food and shelter. In this respect, complementary measures targeting self-pacing, hydration, work-rest regimes, ventilated garments, and mechanization can be adopted to protect outdoor workers.</p

The Impacts of Sun Exposure on Worker Physiology and Cognition: Multi-Country Evidence and Interventions

Background: A set of four case-control (n = 109), randomized-controlled (n = 7), cross-sectional (n = 78), and intervention (n = 47) studies was conducted across three countries to investigate the effects of sun exposure on worker physiology and cognition. Methods: Physiological, subjective, and cognitive performance data were collected from people working in ambient conditions characterized by the same thermal stress but different solar radiation levels. Results: People working under the sun were more likely to experience dizziness, weakness, and other symptoms of heat strain. These clinical impacts of sun exposure were not accompanied by changes in core body temperature but, instead, were linked with changes in skin temperature. Other physiological responses (heart rate, skin blood flow, and sweat rate) were also increased during sun exposure, while attention and vigilance were reduced by 45% and 67%, respectively, compared to exposure to a similar thermal stress without sunlight. Light-colored clothes reduced workers’ skin temperature by 12–13% compared to darker-colored clothes. Conclusions: Working under the sun worsens the physiological heat strain experienced and compromises cognitive function, even when the level of heat stress is thought to be the same as being in the shade. Wearing light-colored clothes can limit the physiological heat strain experienced by the body

Occupational heat strain in outdoor workers: A comprehensive review and meta-analysis

The present comprehensive review (i) summarizes the current knowledge on the impacts of occupational heat stress on outdoor workers, (ii) provides a historical background on this issue, (iii) presents a meta-analysis of published data, (iv) explores inter-individual and intra-individual factors, (v) discusses the available heat mitigation strategies, (vi) estimates physical work capacity, labour productivity, and metabolic rate for the year 2030, and (vii) provides an overview of existing policy and legal frameworks on occupational heat exposure. Meta-analytic findings from 38 field studies that involved monitoring 2,409 outdoor workers across 41 jobs in 21 countries suggest that occupational heat stress increases the core (r = 0.44) and skin (r = 0.44) temperatures, as well as the heart rate (r = 0.38) and urine specific gravity (r = 0.13) of outdoor workers (all p < 0.05). Moreover, it diminishes the capacity of outdoor workers for manual labour (r = −0.82; p < 0.001) and is responsible for more than two thirds of the reduction in their metabolic rate. Importantly, our analysis shows that physical work capacity is projected to be highly affected by the ongoing anthropogenic global warming. Nevertheless, the metabolic rate and, therefore, labour productivity are projected to remain at levels higher than the workers’ physical work capacity, indicating that people will continue to work more intensely than they should to meet their financial obligations for food and shelter. In this respect, complementary measures targeting self-pacing, hydration, work-rest regimes, ventilated garments, and mechanization can be adopted to protect outdoor workers.</p

The HEAT-SHIELD project - Perspectives from an inter-sectoral approach to occupational heat stress

OBJECTIVES: To provide perspectives from the HEAT-SHIELD project (www.heat-shield.eu): a multi-national, inter-sectoral, and cross-disciplinary initiative, incorporating twenty European research institutions, as well as occupational health and industrial partners, on solutions to combat negative health and productivity effects caused by working on a warmer world.METHODS: In this invited review, we focus on the theoretical and methodological advancements developed to combat occupational heat stress during the last five years of operation.RESULTS: We outline how we created climate forecast models to incorporate humidity, wind and solar radiation to the traditional temperature-based climate projections, providing the basis for timely, policy-relevant, industry-specific and individualized information. Further, we summarise the industry-specific guidelines we developed regarding technical and biophysical cooling solutions considering effectiveness, cost, sustainability, and the practical implementation potential in outdoor and indoor settings, in addition to field-testing of selected solutions with time-motion analyses and biophysical evaluations. All recommendations were adjusted following feedback from workshops with employers, employees, safety officers, and adjacent stakeholders such as local or national health policy makers. The cross-scientific approach was also used for providing policy-relevant information based on socioeconomic analyses and identification of vulnerable regions considered to be more relevant for political actions than average continental recommendations and interventions.DISCUSSION: From the HEAT-SHIELD experiences developed within European settings, we discuss how this inter-sectoral approach may be adopted or translated into actionable knowledge across continents where workers and societies are affected by escalating environmental temperatures.</p

Indicators to assess physiological heat strain – Part 3: Multi-country field evaluation and consensus recommendations

In a series of three companion papers published in this Journal, we identify and validate the available thermal stress indicators (TSIs). In this third paper, we conducted field experiments across nine countries to evaluate the efficacy of 61 meteorology-based TSIs for assessing the physiological strain experienced by individuals working in the heat. We monitored 372 experi-enced and acclimatized workers during 893 full work shifts. We continuously assessed core body temperature, mean skin temperature, and heart rate data together with pre/post urine specific gravity and color. The TSIs were evaluated against 17 published criteria covering physiological parameters, practicality, cost effectiveness, and health guidance issues. Simple meteorological parameters explained only a fraction of the variance in physiological heat strain (R2 = 0.016 to 0.427; p < 0.001), reflecting the importance of adopting more sophisticated TSIs. Nearly all TSIs correlated with mean skin temperature (98%), mean body temperature (97%), and heart rate (92%), while 66% of TSIs correlated with the magnitude of dehydration and 59% correlated with core body temperature (r = 0.031 to 0.602; p < 0.05). When evaluated against the 17 published criteria, the TSIs scored from 4.7 to 55.4% (max score = 100%). The indoor (55.4%) and outdoor (55.1%) Wet-Bulb Globe Temperature and the Universal Thermal Climate Index (51.7%) scored higher compared to other TSIs (4.7 to 42.0%). Therefore, these three TSIs have the highest potential to assess the physiological strain experienced by individuals working in the heat