Heat-related Illness Symptoms Research Articles

Inflammatory profiles, gut microbiome, and kidney function are impacted after high-fidelity firefighter training.

Firefighters are frequently exposed to high temperatures, environmental toxicants, and strenuous physical demands. The health impacts of these occupational exposures on processes including inflammation and kidney function as well as on the gut microbiota are poorly understood. A firefighter training course may provide a controlled environment to assess these health risks. Basic health measures, stool, and blood samples were obtained from 24 firefighters participating in a one-week, heat-intensive training course. Indicators of inflammation, gut permeability, kidney health, and stool microbiota composition were measured before and after the training course in 18 participants. Urine specific gravity was measured before and after a heat-intensive training day to evaluate dehydration. The majority of firefighters in this cohort were categorized as hypertensive and experienced multiple heat-related illness symptoms during the training week and dehydration after the heat-intensive training day. While plasma IL-1β, CXCL8, and NGAL decreased over the training week, other indicators of inflammation and acute kidney injury increased, and estimated kidney function declined. Microbiota composition shifted over the course of the training week, with changes in Peptostreptococcus anaerobius and Streptococcus. This pilot study conducted in a controlled field setting suggests that the occupational environment of firefighters may increase their risk for systemic inflammation and kidney disease.

The effect of the participatory heat education and awareness tools (HEAT) intervention on agricultural worker physiological heat strain: results from a parallel, comparison, group randomized study

BackgroundFarmworkers are at risk of heat-related illness (HRI). We sought to: 1) evaluate the effectiveness of farmworker Spanish/English participatory heat education and a supervisor decision-support mobile application (HEAT intervention) on physiological heat strain; and 2) describe factors associated with HRI symptoms reporting.MethodsWe conducted a parallel, comparison group intervention study from May–September of 2019 in Central/Eastern Washington State, USA. We used convenience sampling to recruit adult outdoor farmworkers and allocated participating crews to intervention (n = 37 participants) and alternative-training comparison (n = 38 participants) groups. We measured heat strain monthly using heart rate and estimated core body temperature to compute the maximum work-shift physiological strain index (PSImax) and assessed self-reported HRI symptoms using a weekly survey. Multivariable linear mixed effects models were used to assess associations of the HEAT intervention with PSImax, and bivariate mixed models were used to describe factors associated with HRI symptoms reported (0, 1, 2+ symptoms), with random effects for workers.ResultsWe observed larger decreases in PSImax in the intervention versus comparison group for higher work exertion levels (categorized as low, low/medium-low, and high effort), after adjustment for maximum work-shift ambient Heat Index (HImax), but this was not statistically significant (interaction − 0.91 for high versus low/medium-low effort, t = − 1.60, p = 0.11). We observed a higher PSImax with high versus low/medium-low effort (main effect 1.96, t = 3.81, p < 0.001) and a lower PSImax with older age (− 0.03, t = − 2.95, p = 0.004), after covariate adjustment. There was no clear relationship between PSImax and the number of HRI symptoms reported. Reporting more symptoms was associated with older age, higher HImax, 10+ years agricultural work, not being an H-2A guest worker, and walking > 3 min to get to the toilet at work.ConclusionsEffort level should be addressed in heat management plans, for example through work/rest cycles, rotation, and pacing, in addition to education and other factors that influence heat stress. Both symptoms and indicators of physiological heat strain should be monitored, if possible, during periods of high heat stress to increase the sensitivity of early HRI detection and prevention. Structural barriers to HRI prevention must also be addressed.Trial registrationClinicalTrials.gov Registration Number: NCT04234802, date first posted 21/01/2020.

Heat Exposure and Physiological Changes among Cooks

Cooks who are exposed to heat produced from stoves when working in the kitchen are at risk of thermal stress and heat-related illness. Physiological changes such as increased heart rate, sweat production and blood pressure may also affect them. This study aimed to determine the area heat exposure levels and physiological changes including core body temperature, blood pressure and heart rate during pre-, mid- and post-shift among cooks and its association, and to compare the mean difference of physiological changes between the shifts. This cross-sectional study utilised the purposive sampling method and recruited 30 cooks from food stalls and cafeterias in Kelantan. Area heat measurements were collected from 14 sites (7 inside and 7 outside the USM Health Campus). Wet-bulb Globe Temperature (WBGT) monitor was mounted on a tripod at 1.1 m height near the source of heat for 8 hours. The core body temperature, blood pressure, and heart rate were taken three times per day during pre-, mid- and post-shift for physiological changes measurement. Respondents’ personal information, health history, work description, and symptoms of heat-related illness were collected using a questionnaire. The overall WBGT area levels at each sampling site were homogeneously distributed. There was significant increase in core body temperature and heart rate from pre-shift to post-shift. However, there was no significant correlation (p&gt;0.05) between heat exposure (WBGT index) established with the physiological changes. This may suggest that the increase in core body temperature and heart rate might be attributed to other factors and needed further investigation.

Risk factors associated with heat-related illness among sugarcane farmers in Thailand.

Heatstroke is defined as severe symptoms of heat-related illness, which could lead to death. Sugarcane farmers are at high risk of heatstroke under extremely hot outdoor working conditions. We explored the prevalence of heat-related illness symptoms and risk factors related to heat-related illness among sugarcane farmers working in the summer. We conducted a cross-sectional study using questionnaire interviews among 200 sugarcane farmers in Kamphaeng Phet Province, Thailand. The questionnaire addressed demographics, heat-related symptoms experienced during summer at work, and occupational factors. Bioelectrical impedance analysis was used to assess body mass index and body fat percentage. Watson formula equations were used to estimate total body water. The prevalence of heat-related illness symptoms was 48%; symptoms included heavy sweating, weakness/fatigue, dizziness, muscle cramps, headache, and vertigo. Factors associated with heat-related illness included women and clothing. Sugarcane farmers wearing two-layer shirts had a higher risk of heat-related illness. Farmers with fluid intake 3.1–5.0 liters per day had a 79% lower risk of heat-related illness. Our findings demonstrated that sugarcane farmers are at risk of heat-related illness. We confirmed that working conditions, including wearing proper clothing and water-drinking habits, can reduce this risk.

Occupational Health Problems among Seasonal and Migrant Farmworkers in Ethiopia: A Cross-Sectional Study.

BackgroundMigrant and seasonal farmworkers are at increased risk for occupational fatalities and injuries. Although such employment-related geographical mobility is receiving increasing attention, there is limited evidence about occupational health problems among seasonal farmworkers. Therefore, this study aims to investigate occupational health problems among seasonal and migrant farmworkers in Ethiopia.MethodsA cross-sectional study design was employed from October to December 2019 among seasonal and migrant farmworkers. The study was carried out in two sites of Amhara regional state, northwest Ethiopia. A cluster sampling technique was used to recruit 990 study participants. Bivariable and multivariable binary logistic regression analyses were performed using SPSS version 20 to identify factors associated with injuries. The significance level was obtained at 95% CI and p-value ≤0.05.ResultsIn this study, the period prevalence of work-related injury among seasonal and migrant farmworkers was 32.5% (95% CI: 29.7, 35.9). Being unemployed before migration (AOR = 2.22, 95% CI: 1.26, 3.91), working for >8 h/day (AOR = 1.62, 95% CI: 1.16, 2.27), stress (AOR = 1.38, 95% CI: 1.02, 1.88) and thermal discomfort (AOR = 1.48, 95% CI: 1.09, 1.98) were the significant risk factors for work-related injury. In addition, nearly two-third (60.9%) of the study participants have shown three or more heat-related illness symptoms. Moreover, the prevalence of work-related stress among seasonal and migrant farmworkers was 67.6% (95% CI: 64.6, 70.7).ConclusionOccupational health problems among seasonal and migrant farmworkers in northwest Ethiopia remain a major public health problem. Hence, implementing tailored preventive measures like training on health and safety, and hazard control measures would be supremely important to minimize the risk.

Cooling Interventions Among Agricultural Workers: A Pilot Study

BACKGROUND AND AIM: Agricultural workers perform intense labor outside in direct sunlight and in humid environmental conditions, exposing workers to a high risk of heat-related illness (HRI). The aim of this study was to use biomonitoring equipment to examine the effectiveness of selected cooling devices at preventing agricultural workers from exceeding the core body temperature threshold of 38.0°C (Tc38) and attenuating heat-related illness symptoms. METHODS: A sample of 84 agricultural workers in Florida were randomized to 1 of 4 groups: 1) no intervention, clothing as usual; 2) cooling bandana; 3) cooling vest; and 4) both the cooling bandana and cooling vest. Biomonitoring equipment worn by the participants included core body temperature and heart rate monitor belts, and an accelerometer to capture physical activity. RESULTS:A total of 78 agricultural workers completed one intervention workday. Logistic regression analysis revealed the bandana group had lower odds of exceeding a core body temperature of 38.0°C (OR 0.7, CI90 [0.2, 3.2]) and the vest group had higher odds of exceeding 38.0°C (OR 1.8, CI90 [0.4, 7.9). The use of both the cooling vest and bandana (combination group) showed the effect was little different from the control group (OR 1.3, CI90 [0.3, 5.6]. CONCLUSIONS:This is the first field-based study to examine cooling intervention among agricultural workers in the United States using biomonitoring equipment. This study found that agricultural workers that used a bandana while working in a hot environment has the potential to be protective against exceeding a core body temperature of 38.0°C. KEYWORDS: Temperature, Occupational exposures

The multi-level heat education and awareness tools [HEAT] intervention study for farmworkers: Rationale and methods

BackgroundThe burden of adverse health effects from heat exposure is substantial, and outdoor workers who perform heavy physical work are at high risk. Though heat prevention interventions have been developed, studies have not yet systematically evaluated the effectiveness of approaches that address risk factors at multiple levels. ObjectiveWe sought to test the effectiveness of a multi-level heat prevention approach (heat education and awareness tools [HEAT]), which includes participatory training for outdoor agricultural workers that addresses individual and community factors and a heat awareness mobile application for agricultural supervisors that supports decisions about workplace heat prevention, in the Northwest United States. DesignWe designed the HEAT study as a parallel, comparison, randomized group intervention study that recruited workers and supervisors from agricultural workplaces. In intervention arm crews, workers received HEAT training, and supervisors received the HEAT awareness application. In comparison arm crews, workers were offered non-HEAT training. Primary outcomes were worker physiological heat strain and heat-related illness (HRI) symptoms. In both worker groups, we assessed HRI symptoms approximately weekly, and heat strain physiological monitoring was conducted at worksites approximately monthly, from June through August. DiscussionTo our knowledge, this is the first study to evaluate the effectiveness of a multi-level heat prevention intervention on physiological heat strain and HRI symptoms for outdoor agricultural workers. Trial registrationClinicalTrials.gov Registration Number: NCT04234802;

Heat-related knowledge, perceptions, and needs among oil spill cleanup responders

BACKGROUND: Occupational exposure to heat and hot environments can result in heat-related illness (HRI), injury, and death among workers, particularly those in outdoor environments such as oil spill cleanup responders. Education and training can help prevent these detrimental heat-related health outcomes. PURPOSE: This study assessed: heat-related knowledge, perceptions, and barriers among oil spill cleanup responders, and heat-related training and educational materials currently used and desired. METHODS: A needs assessment was completed by 65 oil spill cleanup responders regarding their occupational heat-related experiences during oil spill cleanup activities and training needs. RESULTS: Most respondents had 25 or more years' experience (52.4%), worked for companies with 19 or fewer employees (53.5%), and were not classified as safety and health professionals (67.7%). Responders reported experiencing HRI risk factors, such as, high temperatures (71.9%) and humidity (85.9%), and wearing personal protective equipment (PPE) and clothing ensembles (96.9%), respirators (71.9%), and personal flotation devices (78.1%). Many reported experiencing symptoms of HRI (41.5%), and 11% reported experiencing heat exhaustion. While most respondents were knowledgeable of heat stress, they were least knowledgeable about: differentiating between heat exhaustion and heat stroke (12.5% responded correctly), salt tablet usage (62.5% responded correctly), effects of air conditioning on acclimatization (70.3% responded correctly), and previous HRI as a risk factor (73.4% responded correctly). Respondents reported they perceived heat stress to be severe and that HRIs affect workers; and most reported feeling confident in recognizing signs and symptoms of HRI, and knowing what to do if a coworker became ill. While multiple prevention controls were reported, only one in four reported using an acclimatization plan. The most common training and education received included just-in-time training (68.9%) and printed materials (50.8%). The most desirable future training and education products were smartphone or tablet applications (61.0%), printed materials (51.2%), and online training (46.3%). DISCUSSION: Oil spill cleanup responders are at high risk for HRI, injury, and death; and those responsible for their training need to be knowledgeable about all the aspects of occupational heat stress. Findings from this study may be beneficial to safety and health professionals and health educators, particularly those interested in developing heat stress training and educational materials for oil spill cleanup responders.

Cooling Interventions Among Agricultural Workers: A Pilot Study.

Adverse health effects among agricultural workers due to chronic heat exposure have been characterized in the literature as not only due to high ambient temperatures but also due to intensive manual labor in hot and humid conditions. The aim of this study was to use biomonitoring equipment to examine the effectiveness of selected cooling devices at preventing agricultural workers from exceeding the core body temperature threshold of 38.0°C (Tc38) and attenuating heat-related illness symptoms. A convenience sample of 84 agricultural workers in Florida was randomized to one of four groups: (a) no intervention, clothing as usual; (b) cooling bandana; (c) cooling vest; and (d) both the cooling bandana and cooling vest. Biomonitoring equipment worn by the participants included core body temperature monitor and an accelerometer to capture physical activity. A total of 78 agricultural workers completed one intervention workday trial. Compared with the control group, the bandana group had lower odds of exceeding Tc38 (odds ratio [OR] = 0.7, 90% confidence interval [CI] = [0.2, 3.2]) and the vest group had higher odds of exceeding Tc38 (OR = 1.8, 90% CI = [0.4, 7.9]). The simultaneous use of cooling vest and bandana showed an effect little different from the control group (OR = 1.3, 90% CI = [0.3, 5.6]). This is the first field-based study to examine cooling intervention among agricultural workers in the United States using biomonitoring equipment. This study found that using a bandana while working in a hot agricultural environment has the potential to be protective against exceeding the recommended Tc38 threshold.

Heat stress and PPE during COVID-19: impact on healthcare workers' performance, safety and well-being in NHS settings

Personal protective equipment (PPE) can potentiate heat stress, which may have a negative impact on the wearer's performance, safety and well-being. In view of this, a survey was distributed to healthcare workers (HCWs) required to wear PPE during the coronavirus disease 2019 pandemic in the UK to evaluate perceived levels of heat stress and its consequences. Respondents reported experiencing several heat-related illness symptoms, and heat stress impaired both cognitive and physical performance. The majority of respondents stated that wearing PPE made their job more difficult. These, and additional, responses suggest that modification to current working practices is required urgently to improve the resilience of HCWs to wearing PPE during pandemics.

“We Force Ourselves”: Productivity, Workplace Culture, and HRI Prevention in Florida’s Citrus Groves

Efforts to disseminate heat-related illness (HRI) prevention practices among Latino farmworkers represent a critical occupational safety strategy in Florida. Targeted initiatives, however, require understanding the workplace dynamics that guide agricultural safety behaviors. This article reports focus group data collected in 2018 from citrus harvesters in central Florida and provides an in-depth perspective on the workplace culture that shapes their implementation of heat safety measures. Results indicate that citrus harvesters regularly suffered HRI symptoms yet rarely reported or sought treatment for their injuries. In some cases, the risks of developing HRI were accepted as a facet of agricultural work and harvesters blamed themselves for their illnesses. Implementation of safety practices hinged less on knowledge than on the availability of water and rest breaks and the quality of employer-employee relations and exchanges. Thus, trust was a determinant of workers’ attitudes toward management that contributed to a harvesting operation’s safety climate. Results highlight the difficulties of putting into practice measures that are not rewarded by the workplace culture and suggest that the extent to which intervention strategies promote not only individual safety behaviors but organizational accountability may predict their effectiveness.

What the Agricultural Sector in Florida Needs to Know about Heat-Related Illness (HRI)

Heat-related illness (HRI) can range from rashes, fainting, and cramps to heat exhaustion and heat stroke. It can be fatal, and all outdoor workers in agriculture (as well as those in high-heat indoor settings such as greenhouses) are at risk. This new 6-page publication of the UF/IFAS Department of Agricultural Education and Communication provides basic information on how to recognize the symptoms of HRI, on the underlying physiological processes and related risk factors, and on how to treat it. This publication also provides a list of preventative measures that growers, supervisors, and agricultural workers can follow, along with links to additional resources. Written by Paul Monaghan, Karissa Raskin, Maria Morera, Antonio Tovar, Valerie Mac, and Joan Flocks.https://edis.ifas.ufl.edu/wc359

Knowledge of Heat-Related Illness First Aid and Self-Reported Hydration and Heat-Related Illness Symptoms in Migrant Farmworkers.

Background: Outdoor workers are exposed to hot work environments and are at risk of heat-related morbidity and mortality. The purpose of this study was to evaluate the knowledge of migrant farmworkers about first aid for heat-related illness (HRI) symptoms. Methods: The authors recruited 60 migrant farmworkers out of 66 who were approached from vegetable farms in Georgia. They were workers who participated in the 2018 Farmworker Family Health Program (FWFHP). The authors surveyed the workers to assess demographics, prevalence of HRI symptoms, hydration practices, and knowledge of HRI first aid. Descriptive statistics for worker demographics, HRI symptoms, and hydration data were calculated, as were the percentages of correctly answered pilot questions. Findings: Of the 60 workers who chose to participate in this study, more than 50% incorrectly answered pilot questions related to their knowledge of HRI first aid. The two most common HRI symptoms reported were heavy sweating and muscle cramps. More than two thirds reported experiencing at least one HRI symptom during the workday. Mean liquid consumption within this sample was 72.95 oz per day, which is much less than the recommended 32 oz per hour. Conclusion/Application to Practice: Until larger structural change can occur to protect farmworkers, farm owners can prevent morbidity and mortality from inadequate hydration practices and working in high-heat conditions by providing migrant farmworkers with training in heat-related first aid. Appropriate heat-illness interventions should focus on first aid measures to reduce morbidity and mortality related to heat illness in farmworkers.

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-Related Illness Among Latinx Child Farmworkers in North Carolina: A Mixed-Methods Study.

Children as young as ten are legally hired for farm work. In North Carolina, many of these hired children are Latinx; they often work long hours during hot and humid summer conditions. Heat-related illness occurs along a continuum of severity ranging from heat cramps and rashes to heat exhaustion and heat stroke, which can be fatal. The literature on the negative health effects of occupational heat exposure is growing; however, few studies have examined this exposure and health outcomes among child agricultural workers. To understand Latinx child farmworkers' experiences of working in heat, we conducted in-depth interviews (n = 30). To estimate the prevalence of heat-related illness symptoms and associated factors, we conducted survey interviews (n = 165). Heat-related illness is common among these child farmworkers. While children often understand the dangers of working in heat, work organization often prevents their taking precautions. Formal workplace protections to prevent heat-related illness are limited.

Monitoring Heat-Related Illness through Syndromic Surveillance in Los Angeles County

ObjectiveTo analyze Los Angeles County’s (LAC) extreme heat season in 2018 and evaluate the Council of State and Territorial Epidemiologists’ (CSTE) syndrome query for heat-related-illness (HRI) in Los Angeles County (LAC)IntroductionLAC experienced several days of record-breaking temperatures during the summer of 2018. Downtown Los Angeles temperatures soared to 108°F in July with an average daily maximum of 92°F. Extreme heat events such as these can pose major risks to human health. Syndromic surveillance can be a useful tool in providing near real-time surveillance of HRI. In 2014, a working group was formed within the CSTE Climate Change Subcommittee to define and analyze HRI. The workgroup’s goal was to provide guidance to public health professionals in adapting and implementing an HRI syndrome surveillance query. The Acute Communicable Disease Control Program’s (ACDC) Syndromic Surveillance Unit utilized CSTE’s HRI query to provide surveillance during the extreme heat season in 2018 in LAC. Additional modifications to the CSTE query were evaluated for potential improvements towards characterizing HRI trends.MethodsFrom May 1 to September 30, 2018, Emergency Department (ED) data were queried for cases using the CSTEs definition for HRI. The queries consisted of key word searches within the chief complaint (CC) data field, and, if available, the diagnosis data fields. The query was derived from the CSTE HRI query published in 20161. In addition, ACDC explored the utility of expanding the CSTE syndrome definition to include additional chief complaints commonly associated with HRI such as dehydration and syncope. Both queries were applied on all participating syndromic EDs in LAC alongside daily high temperature data trends. Local temperature data for downtown Los Angeles weather station KCQT were taken from the Weather Underground website. Spearman correlation coefficients were calculated for each query during the heat season. Similarly, both queries were also applied during colder months from October 1, 2017 to April 30, 2018 for comparison. Lastly, results for dehydration and syncope were independently assessed apart from other HRI query terms during both heat seasons and colder months.ResultsThe CSTE HRI query and the query with the added terms yielded 1,258 and 63,332 ED visits, respectively, during the heat season. On July 6, the maximum daily temperature peaked at 108 °F; the HRI and the query with the added terms yielded 136 and 618 ED visits, respectively. The HRI query and the HRI query with the added terms had a correlation coefficient of 0.714 (p &lt;0.0001) and 0.427 (p &lt;0.0001), respectively. During colder months, the CSTE HRI query and the query with the added terms yielded 377 and 86,008, respectively, with correlation coefficients of 0.342 (p &lt; 0.0001) and 0.133 (p &lt; 0.052). The syncope-only query saw no variation in HRI classified encounters throughout the heat season (mean: 328; min: 228; max: 404) or colder months (mean: 328; min: 261; max: 404) with correlation coefficients of 0.238 (p = 0.003) and 0.155 (p = 0.024), respectively. Similarly, the dehydration-only query saw no variation in HRI classified encounters throughout the heat season (mean: 96; min: 58; max: 258) or colder months (mean: 94; min: 60; max: 160) with correlation coefficients of 0.596 (p &lt; 0.0001) and -0.016 (p = 0.822).ConclusionsThe CSTE HRI query proved to be a strong indicator for HRI, and the addition of terms associated with dehydration and syncope to the CSTE HRI query weakened the correlation with temperature. Compared to the original CSTE HRI query, the added terms yielded a 4934% increase in HRI classified encounters during the heat season; however, these were likely due to causes other than HRI -- adding the extra terms resulted in a weaker correlation with temperature. Additionally, the comparative analysis showed that, with the added terms, the volume of HRI encounters was larger during colder months than hotter months suggesting misclassification of non-HRI illnesses. Surveillance of HRI has proven to be difficult because many of the HRI symptoms are too commonly associated with non-HRI conditions which would explain the weaker correlations when adding additional chief complaints associated with HRI. In conclusion, the CSTE syndrome definition for HRI proved to be the most robust query for HRI during the heat season. Case counts of HRI are difficult due to symptom overlap with many other medical conditions. However, syndromic surveillance using the CSTE HRI query is useful for trend analysis in near real-time during heat events.

Heat-Related Illness in Midwestern Hispanic Farmworkers: A Descriptive Analysis of Hydration Status and Reported Symptoms.

Heat-related illness (HRI) is a largely undocumented phenomenon in Midwestern Hispanic migrant and seasonal farmworkers in the United States. Frequently, the physiological burden of crop production is overlooked while workers are in the fields. We completed a mixed-methods study using a cross-sectional survey among migrant and seasonal farmworkers about their experience with HRI symptoms ( N = 148) and conducted an intensive surveillance on a smaller group of workers ( N = 20) in field trials ( N = 57 trials) using a chest-strapped multi-parameter monitoring wearable sensor (MPMWS) that measured skin/body temperature, heart and breathing rate, kilocalories burned per hour, and provided a physiological intensity (PI) score. The field trials were conducted across three classes of climate conditions and three PI score categories. We found that those in the uncomfortable category (PI score > 4.0) had a statistically significant ( F ratio = 16.41, p < .001) higher body temperatures ( M = 100.05°F) than those with a mild PI (range = 0-5) score ⩽ 2.5 ( M = 99.56°F) or moderate PI score > 2.5-4 (99.84°F). We also found that those in the uncomfortable climate condition category had a higher mean heart rate and breathing rate than those working under mild and moderate field trials.

Impacts of Tropical Deforestation and Increased Heat Exposure on Health and Productivity in Rural Areas: The Case of Forest Dwelling Communities in East Kalimantan, Indonesia

There is growing evidence that temperature increases associated with tropical deforestation are having negative impacts on human health and productivity. These changes are projected to disproportionately affect poor, rural populations. We report selected findings from a larger study that aims to characterize heat exposure in primary forest and cleared areas, describe how rural communities are adapting to deforestation, and investigate the impacts of increased heat exposure on human health and productivity. A total of 361 participants from ten villages in East Kalimantan, Indonesia were in the study. Continuous measurements in forested and cleared areas were collected in each village using 3M&amp;#8482; heat stress monitors. Households completed surveys that included demographics, health status and medical conditions, and time-use modules. Mean maximum temperatures were 33&amp;#176;C and 37&amp;#176;C in forest and open areas, respectively, and mean forest temperatures were 2.6&amp;#176;C cooler than open areas. We find 74% of participants work only in open areas, while 26% work in forests and open areas. Self-reported heat-related illness symptoms in the past week were 4.1% higher among those working only in open areas. Participants reported modifying work schedules to adapt to heat, with nearly 75% of participants working less than in previous years and 37% unable to work the hours they would like in a day. Participants working only in open areas took longer midday breaks and worked longer afternoon shifts. Questions on future adaptation to hotter temperatures indicate more than a third of participants will work less or shift work schedules to avoid the hottest periods of the day. Our findings indicate that heat exposure is higher in deforested areas and adaptation strategies to avoid heat will impact work and productivity in this population.

Frequency of firefighters' heat-related illness and its association with removing personal protective equipment and working hours.

The purpose of this study was to examine the frequency of firefighters’ heat-related illness (HRI) in the line of duty with relation to resting/working hours and the behaviour of taking off PPE during rest periods based on nationwide survey (N=674). The results showed that 74.8% of firefighters experienced HRI symptoms and 5% of firefighters suffered from symptoms of HRI 20 times or more in a year. This study also showed a statistically significant correlation between working hours and removing PPE with the experience of HRI symptoms (p<0.05). In addition, removing PPE except the helmet was correlated with resting hours (p<0.001; Gloves: p=0.051), which indicates that removing PPE is related to resting time. This study revealed that firefighters routinely experienced mild HRI symptoms and the fatalities were just a tiny fraction. It is also emphasized that attention should be given on the significant role of taking off PPE during rest and on the standardized firefighters’ rehabilitation followed by its application.

Characterizing Heat Stress and Strain in Electric Utility Workers by Means of a Questionnaire

In recent field work we showed that the high physical demands combined with restrictions to heat loss due to protective work uniforms caused some electric utility workers to experience dangerous levels of hyperthermia (J Occup Environ Hyg. 2015;12:708). These findings indicate that heat stress in the electric utility industry may be detrimental to worker health and safety. In the present study, 414 workers in the power generation and delivery industry across 15 US states completed a two‐part on‐line questionnaire anonymously. Part 1 comprised 15 general questions on the worker's age, sex, role in the organization, general duties, workplace location, work shift duration, years of experience, level of physical activity, frequency of heat exposure, other. The second part consisted of a validated questionnaire for the assessment of heat stress at the workplace – the ‘Heat Strain Score Index (HSSI)’ (Int J Prev Med 2013; 4:631). It was composed of 18 questions which included key factors in heat stress evaluation (environmental parameters, work intensity, level of heat exposure, clothing insulation and permeability, etc.) and indicators of heat strain (sweat rate, fatigue, thirst, symptoms of heat‐related illness, etc.) with cut‐off scores as follows: ≤13.5, green zone or safe level; 13.6 to 18.0, yellow zone or alarm level; &gt;18.0, red zone or danger level. The average (±SD) age of the respondents was 46(10) years and they reported being in their present position for 11(10) years. They typically performed 5(1) consecutive days of work lasting 10(6) hours each day. For all job types (all workers), 79% of respondents reported heat stress was a problem. This number was greater (93%) in those performing physically demanding jobs (e.g. linesman). Further, 30% and 67% of all workers indicated they were exposed to heat stress occasionally and daily, respectively. In contrast, 81% of linesman reported being exposed to heat stress on a daily basis with only 19% experiencing occasional exposure. Based on the HSSI, 43% of all workers and 68% of linesman were categorized in the red zone (danger level) and therefore at an elevated risk of a heat‐related injury (both p&lt;0.01). Our findings demonstrate that electric utility workers are likely to experience excessive heat strain and research must be conducted to explore methods to effectively and efficiently manage heat stress and strain in these workers.Support or Funding InformationHuman and Environmental Physiology Research Unit (G.P. Kenny).This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.