Prevention Of Heat-Related Illness Research Articles

US Farmworkers’ Barriers to Preventing Heat‐Related Illness: An Integrative Review

ABSTRACTBackgroundOccupational heat‐related illness (HRI) is problematic in the United States. Farmworkers are disproportionately affected by HRI compared to other workers. Uncovering barriers that farmworkers face to the prevention of HRI is crucial to reducing HRI‐associated morbidity and mortality. This integrative review aimed to understand US farmworkers’ barriers to preventing HRI.MethodsAn integrative review occurred following Whittemore and Knafl guidelines. Literature searches occurred on PubMed, Medline, and Agricola. After applying inclusion and exclusion criteria and removing duplicates, nine articles remained for review.ResultsThere were nine articles in the review. The majority of articles used a convenience sample. In all studies, the populations were farmworkers or agricultural workers. The study designs included cross‐sectional, mixed methods, qualitative focus groups, and a longitudinal study. The articles revealed several themes related to prevention barriers: access to prevention, education and training, work culture, and compensation. Farmworkers often lack access to proper prevention measures, education, and training. Work culture and compensation were obstacles to preventing HRI as some workers feel powerless to speak up for themselves, whereas others are tempted to forgo breaks because of the way they are compensated.ConclusionsThis review indicates the need for more research to understand the barriers farmworkers face to HRI prevention. Providing prevention measures without considering obstacles to their use is ineffective in reducing HRI. Because many farmworkers lack oversight and regulation of prevention measures, focusing on barriers and areas over which farmworkers have more control could have a significant impact.

Patients with heat-related illness admitted to an intensive care unit in Hong Kong: A single-centre retrospective study (2009–2020)

Introduction: In Hong Kong, heat-related illness (HRI) represents an important cause of morbidity and mortality among healthy adults engaging in outdoor activities during summer. It can result in intensive care unit (ICU) admission. This retrospective study aimed to profile critically ill patients with HRI and identify potential risk factors for mortality. Methods: This retrospective case series included adults with HRI from 1 January 2009 to 30 June 2020 admitted to the ICU of Pamela Youde Nethersole Eastern Hospital (PYNEH). Demographics, admission severity, co-morbidities, and laboratory investigations were analysed. Outcome data studied included mortality, ICU length of stay (LOS), ventilator days, and hospital LOS. Results: Among the 38 individuals included, 97% were hikers. About 92.1% of patients survived, while 7.9% expired. The median age of the patients was 48 years, and 78.9% were men. Hypertension was the most frequent concurrent disorder. Most cases were presented during the hot summer months of May (29%), July (24%) and August (18%). The localities’ median peak temperature and humidity were 33.2°C and 88%, respectively. Ninety-two percent of patients were airlifted to the hospital by helicopters. The median peak body temperature was 40.3°C. Central nervous system derangement (Glasgow Coma Scale (GCS) score ⩽ 8) was the top presenting feature (65.7%). About 57.9% of patients required vasopressor support, followed by mechanical ventilation (50%) and renal replacement therapy (31.6%). Conclusions: Most critically ill patients suffering from HRI were hikers and middle-aged adults. Mortality was 7.9% despite advanced life support in ICU. Raising public awareness of the associated risk with hiking in hot summer is essential for the prevention of HRI.

Heat-related illness risk and associated personal and environmental factors of construction workers during work in summer

Heat-related illness (HRI) is a common occupational injury, especially in construction workers. To explore the factors related to HRI risk in construction workers under hot outdoor working conditions, we surveyed vital and environmental data of construction workers in the summer season. Sixty-one workers joined the study and the total number of days when their vital data during working hours and environmental data were recorded was 1165. Heart rate with high-risk HRI was determined using the following formula: 180 − 0.65 × age. As a result of the logistic regression analysis, age, working area, maximum skin temperature, and heart rate immediately after warming up were significantly positively related, and experience of construction was significantly negatively related to heart rate with high-risk HRI. Heart rate immediately after warming up may indicate morning fatigue due to reasons such as insufficient sleep, too much alcohol intake the night before, and sickness. Asking morning conditions may lead to the prevention of HRI. For occupational risk management, monitoring of environmental and personal conditions is required.

COVID-19 and heatwaves: a double whammy for Indian cities

COVID-19 and heatwaves: a double whammy for Indian cities

JA:2021-19. Developing a Social Marketing Intervention for Heat Safety among Florida Tomato Harvesters: Preliminary Findings of Formative Research

ABSTRACT Purpose: Despite recent improvements in the quality and availability of educational materials to promote heat safety in agriculture, success in addressing the factors that inhibit the adoption of self-protective practices among farmworkers remains limited. Social marketing interventions can address gaps between safety knowledge and implementation by targeting segmented audiences with tailored behavioral products that compete with comfortable yet potentially harmful alternatives. The purpose of this study was to collect preliminary biological and survey data during a 5-day period in the spring of 2019 to identify hydration levels, perceptions, attitudes, knowledge, and behaviors associated with the prevention of heat-related illness (HRI) among 29 tomato harvesters in southwest Florida. Methods: Urine samples were collected before and at the end of each workday. Survey data were collected at baseline and at the end of each workday. Reagent strips were used to assess urine specific gravity, a measurement of hydration status. Descriptive statistics, relative frequency distributions, and bivariate correlation analysis were used to summarize the data. Results/Findings: Results showed that a majority of study participants were slightly or not at all concerned about becoming ill from the heat while working despite the wide prevalence of HRI symptoms. On average, participants were hypohydrated both at the start and end of each workday. Certain cooling practices, such as consumption of electrolyte drinks, tended to be implemented at the onset of HRI symptoms. More than 75% of the harvesters typically avoided taking any rest breaks. Yet all had received some form of heat safety training; knowledge test scores averaged 78%. Findings suggest safety behaviors had more to do with the amelioration of HRI symptoms than with training and knowledge. Practical application: To effectively encourage heat safety among Florida tomato harvesters, social marketing efforts must shift current behaviors from a reactive to a preventive orientation.

Heat stress monitoring based on heart rate measurements.

Currently, occupational heat exposure is usually measured using environmental variables such as the wet bulb globe temperature index. The costs of heat stress monitoring include the acquisition of specialized equipment and the recruitment of trained personnel. In rapidly changing environments, such as outdoor settings, these assessments must be conducted on a daily basis. The wet bulb globe temperature index has been criticized as a measure of heat stress for its failure to account for individual differences in susceptibility to heat stress, age, body mass index, physical fitness, clothing, illnesses and use of alcohol or drugs. The objective of this study was to assess the relationship between heart rate and body temperature in heat-exposed workers to determine whether heart rate can be used to monitor and prevent heat stress and physiological strain. This study was based on previous literature as well as physiological and environmental data collected from 10 individuals engaged in heavy physical labor. Heart rate, which has been recommended by the American Conference of Governmental Industrial Hygienists (ACGIH) as a possible measure of heat stress, follows a similar trend to body temperature with a slight temporal delay. Heart rate monitors with alarm systems could be developed to notify workers when to slow down their activities or take a break for thermal recovery, thereby contributing to the prevention of heat-related illness.

Lower thermal sensation in normothermic and mildly hyperthermic older adults.

It is important to know how thermal sensation is affected by normal aging under conditions that elevate core body temperature for the prevention of heat-related illness in older people. We assessed whether thermal sensation under conditions of normothermia (NT) and mild hyperthermia (HT) is lowered in older adults. Seventeen younger (23±3years) and 12 older (71±3years) healthy men underwent measurements of the cold and warmth detection thresholds (±0.1°C/s) of their chest and forearm skin, and whole body warmth perception under NT (esophageal temperature, T es, ~36.5°C) and HT (T es, ~37.3°C; lower legs immersed in 42°C water) conditions. Warmth detection threshold at the forearm was increased in older compared with younger participants under both NT (P=0.006) and HT (P=0.004) conditions. In contrast, cold detection threshold at the forearm was decreased in older compared with younger participants under NT (P=0.001) but not HT (P=0.16). Mild hyperthermia decreased cold detection threshold at forearm in younger participants (P=0.001) only. There were no effects of age and condition on warmth and cold detection thresholds at chest. Whole body warmth perception increased during HT compared with NT in both groups (both, P<0.001), and older participants had lower values than the younger group under NT (P=0.001) and HT (P=0.051). Skin warmth detection thresholds at forearm and whole body warmth perception under NT and HT and skin cold detection thresholds at forearm under NT deteriorated with aging.

Prevention of Heat-Related Illness: A New Modality Offers New Insight

Prevention of Heat-Related Illness: A New Modality Offers New Insight

Prevention of Heat-Related Illness

Heat-related illnesses, especially heat stroke, are a significant cause of morbidity and mortality in vulnerable persons during prolonged heat spells in temperate climates. Heat stroke produces a classic triad of symptoms: anhidrosis, temperature above 40°C (105°F), and mental changes. The very young and very old are especially vulnerable. Timely cooling measures must be initiated to prevent progression to multiple complications and death.

Public health response for the 1996 Olympic Games.

Extensive planning and preparation by public health agencies were required for the provision of public health services during the 1996 Centennial Olympic Games, which brought together more than 10000 athletes from 197 countries and more than 2 million visitors. Public health activities included the development and use of an augmented surveillance system to monitor health conditions and detect disease outbreaks; creation and implementation of 6 environmental health regulations; establishment of a central Public Health Command Center and response teams to coordinate response to public health emergencies; planning for potential mass casualties and the provision of emergency medical services; implementation of strategies for the prevention of heat-related illness; and distribution of health promotion and disease prevention information. Public health agencies should take the lead in organizing and implementing a system for preventing and managing public health issues at future large-scale public events such as the Olympics.