Current Heat Safety Projects

Outside Publications

Heat Strain Associated with Working in the Heat

Debela, M. B., Begosaw, A. M., Deyessa, N., & Azage, M. (2023). The Burdens of Occupational Heat Exposure-related Symptoms and Contributing Factors Among Workers in Sugarcane Factories in Ethiopia: Heat Stress Wet Bulb Globe Temperature Meter. Safety and health at work, 14(3), 325–331. https://doi.org/10.1016/j.shaw.2023.08.003

Ioannou, L. G., Mantzios, K., Tsoutsoubi, L., Panagiotaki, Z., Kapnia, A. K., Ciuha, U., Nybo, L., Flouris, A. D., & Mekjavic, I. B. (2021). Effect of a Simulated Heat Wave on Physiological Strain and Labour Productivity. International journal of environmental research and public health, 18(6), 3011. https://doi.org/10.3390/ijerph18063011

Ioannou, L.G., Mantzios, K., Tsoutsoubi, L., Nintou, E., Vliora, M., Gkiata, P., Dallas, C.N., Gkikas, G., Agaliotis, G., Sfakianakis, K., Kapnia, A.K., Testa, D.J., Amorim, T., Dinas, P.C., Mayor, T.S., Gao, C., Nybo, L., Flouris, A.D. (2021). Occupational Heat Stress: Multi-Country Observations and Interventions. Int. J. Environ. Res. Public Health 2021, 18, 6303. https://doi.org/10.3390/ijerph18126303

Piil, J. F., Christiansen, L., Morris, N. B., Mikkelsen, C. J., Ioannou, L. G., Flouris, A. D., Lundbye-Jensen, J., & Nybo, L. (2020). Direct exposure of the head to solar heat radiation impairs motor-cognitive performance. Scientific reports, 10(1), 7812. https://doi.org/10.1038/s41598-020-64768-w

Pogačar, T., Žnidaršič, Z., Kajfež Bogataj, L., Flouris, A. D., Poulianiti, K., & Črepinšek, Z. (2019). Heat Waves Occurrence and Outdoor Workers' Self-assessment of Heat Stress in Slovenia and  Greece. International journal of environmental research and public health, 16(4), 597.  https://doi.org/10.3390/ijerph16040597

Flouris, A. D., Dinas, P. C., Ioannou, L. G., Nybo, L., Havenith, G., Kenny, G. P., & Kjellstrom, T. (2018). Workers' health and productivity under occupational heat strain: a systematic review and meta-analysis. The Lancet. Planetary health, 2(12), e521–e531. https://doi.org/10.1016/S2542-5196(18)30237-7

Jay, O., & Brotherhood, J. R. (2016). Occupational heat stress in Australian workplaces. Temperature, 3(3), 394-411. https://doi.org/10.1080/23328940.2016.1216256

Brearley, M., Harrington, P., Lee, D., & Taylor, R. (2015). Working in hot conditions—A study of electrical utility workers in the northern territory of Australia. Journal of Occupational and Environmental Hygiene, 12(3), 156–162. https://doi.org/10.1080/15459624.2014.957831

Jay, O., & Kenny, G. P. (2010). Heat exposure in the Candian workplace. American Journal of Industrial Medicine, 53, 842-853. https://doi.org/10.1002/ajim.20827

Solutions to Mitigate Occupational Heat Strain

Morris, N. B., Piil, J. F., Morabito, M., Messeri, A., Levi, M., Ioannou, L. G., Ciuha, U., Pogačar, T., Kajfež Bogataj, L., Kingma, B., Casanueva, A., Kotlarski, S., Spirig, C., Foster, J., Havenith, G., Sotto Mayor, T., Flouris, A. D., & Nybo, L. (2021). The HEAT-SHIELD project - Perspectives from an inter-sectoral approach to occupational heat stress. Journal of science and medicine in sport, S1440-2440(21)00053-0. https://doi.org/10.1016/j.jsams.2021.03.001

Morris, N. B., Jay, O., Flouris, A. D., Casanueva, A., Gao, C., Foster, J., Havenith, G., & Nybo, L. (2020). Sustainable solutions to mitigate occupational heat strain - an umbrella review of physiological effects and global health perspectives. Environmental health : a global access science source, 19(1), 95. https://doi.org/10.1186/s12940-020-00641-7.

Morris N.B, Levi M , Morabito M , Messeri A , Ioannou L.G , Flouris A.D , Samoutis G , Pogačar T, Bogataj L . Piil J.F & Nybo L (2020): Health vs. wealth: Employer, employee and policy-maker perspectives on occupational heat stress across multiple European industries. Temperature. https://doi.org/10.1080/23328940.2020.1852049

Jacklitsch, B., Williams, W. J., Musolin, K., Coca, A., Kim, J. H., & Turner, N (2016).  Criteria for a recommended standard: occupational exposure to heat and hot environments. National Institute for Occupational Safety and Health. https://www.cdc.gov/niosh/docs/2016-106/

Effects of Heat on Productivity and Labor

Foster, J., Smallcombe, J. W., Hodder, S. G., Jay, O., Flouris, A. D., Morris, N. B., Nybo, L., & Havenith, G. (2021). Aerobic fitness as a parameter of importance for labour loss in the heat. Journal of science and medicine in sport, S1440-2440(21)00114-6. Advance online publication. https://doi.org/10.1016/j.jsams.2021.05.002

Foster, J., Smallcombe, J.W., Hodder, S. et al. An advanced empirical model for quantifying the impact of heat and climate change on human physical work capacity. Int J Biometeorol 65, 1215–1229 (2021). https://doi-org.ezproxy.lib.uconn.edu/10.1007/s00484-021-02105-0

Kjellstrom, T., Holmer, I., & Lemke, B. (2009). Workplace heat stress, health and productivity - an increasing challenge for low and middle-income countries during climate change. Global health action, 2, 10.3402/gha.v2i0.2047. https://doi.org/10.3402/gha.v2i0.2047

Heat-related Training and Interventions for Prevention

Glaser, J., Wegman, D. H., Arias-Monge, E., Pacheco-Zenteno, F., Prince, H., Chavarria, D., Martinez-Cuadra, W. J., Jakobsson, K., Hansson, E., Lucas, R. A. I., Weiss, I., & Wesseling, C. (2022). Workplace Intervention for Heat Stress: Essential Elements of Design, Implementation, and Assessment. International journal of environmental research and public health, 19(7), 3779. https://doi.org/10.3390/ijerph19073779

Leyk, D., Hoitz, J., Becker, C., Glitz, K. J., Nestler, K., & Piekarski, C. (2019). Health Risks and Interventions in Exertional Heat Stress. Deutsches Arzteblatt international, 116(31-32), 537–544. https://doi.org/10.3238/arztebl.2019.0537

McCarthy, R. B., Shofer, F. S., & Green-McKenzie, J. (2019). Outcomes of a heat stress awareness program on heat-related illness in municipal outdoor workers. Journal of Occupational and Environmental Medicine, 61(9), 724-728. https://doi.org/10.1097/JOM.0000000000001639

Jacklitsch, B. L., King, K. A., Vidourek, R. A., & Merianos, A. L. (2018). Heat-related training and educational material needs among oil spill cleanup responders. Environmental Health Insights. https://doi.org/10.1177/1178630218802295

McCarthy, R. B., Perkison, W. B., Guidotti, T., Nabeel, I., Pensa, M. A., & Green-McKenzie, J. (2018). How can climate change impact the health of workers? Part 1 increased ambient temperature. Journal of Occupational and Environmental Medicine. https://doi.org/10.1097/JOM.0000000000001342

Joubert, D., Thomsen, J., & Harrison, O. (2010). Safety in heat: a comprehensive program for prevention of heat illness among workers in Abu Dhabi, United Arab Emirates. American Public Health Association, 101, 395-401. https://doi.org/10.2105/AJPH.2009.189563

Body Cooling

Jay, O., Hoelzl, R., Weets, J., Morris, N., English, T., Nybo, L., Niu, J., de Dear, R., & Capon, A. (2019). Fanning as an alternative to air conditioning - a sustainable solution for reducing indoor occupational heat stress. Energy & Buildings, 193, 92-98. https://doi.org/10.1016/j.enbuild.2019.03.037

Coen C. W. G. Bongers, Maria T. E. Hopman & Thijs M. H. Eijsvogels (2017) Cooling interventions for athletes: An overview of effectiveness, physiological mechanisms, and practical considerations, Temperature, 4:1, 60-78. https://doi.org/10.1080/23328940.2016.1277003 

Brearley, M., & Walker, A. (2015). Water immersion for post incident cooling of firefighters; a review of practical fire ground cooling modalities. Extreme Physiology & Medicine, 4. https://doi.org/10.1186/s13728-015-0034-9

Hydration

Bethancourt, H. J., Swanson, Z. S., Nzunza, R., Huanca, T., Conde, E., Kenney, W. L., … Rosinger, A. Y. (2020). Hydration in relation to water insecurity, heat index, and lactation status in two small-scale populations in hot-humid and hot-arid environments. American Journal of Human Biology: The Official Journal of the Human Biology Council, 33(1), e23447. https://doi.org/10.1002/ajhb.23447

Chapman, C. L., Johnson, B. D., Vargas, N. T., Hostler, D., Parker, M. D., & Schlader, Z. J. (2020). Both hyperthermia and dehydration during physical work in the heat contribute to the risk of acute kidney injury. Journal of Applied Physiology, 124(4), 715-728.. https://doi.org/10.1152/japplphysiol.00787.2019

Al-Bouwarthan, M., Quinn, M. M., Kriebel, D., & Wegman, D. H. (2020). A field evaluation of construction workers’ activity, hydration status, and heat strain in the extreme summer heat of Saudi Arabia. Annals of Works Exposures and Health, 64(5), 522-535. https://doi.org/10.1093/annweh/wxaa029

Brake, D. J., & Bates, G. P. (2003). Fluid losses and hydration status of industrial workers under thermal stress working extended shifts. Occupational and Environmental Medicine, 60(2), 90–96. https://www.jstor.org/stable/27731866

Environmental Monitoring

Garzon-Villalba, X. P., Ashley, C. D., & Bernard, T. E. (2019). Benchmarking heat index as an occupational limit for heat stress. Journal of Occupational and Environmental Hygiene. https://doi.org/10.1080/15459624.2019.162834

Budd, G. M. (2016). How should we measure occupational heat stress? Temperature. https://doi.org/10.1080/23328940.2016.1218992

Bernard, T. E., & Iheanacho, I. (2015). Heat index and adjusted temperature as surrogates for wet bulb globe temperature to screen for occupational heat stress. Journal of Occupational and Environmental Hygiene, 12(5), 323–333. https://doi.org/10.1080/15459624.2014.989365

Budd, G. M. (2008). Wet-bulb globe temperature (WBGT)—Its history and its limitations. Journal of Science and Medicine in Sport, 11(1), 20–32. https://doi.org/10.1016/j.jsams.2007.07.003

Bernard, T. E., Caravello, V., Schwartz, S. W., & Ashley, C. D. (2008). WBGT clothing adjustment factors for four clothing ensembles and the effects of metabolic demands. Journal of Occupational and Environmental Hygiene, 5(1), 1–5; quiz d21-23. https://doi.org/10.1080/15459620701732355

Bernard, T. E., Luecke, C. L., Schwartz, S. K., Kirkland, K. S., & Ashley, C. D. (2005). WBGT Clothing Adjustments for Four Clothing Ensembles Under Three Relative Humidity Levels. Journal of Occupational and Environmental Hygiene, 2(5), 251–256. https://doi.org/10.1080/15459620590934224

Emergency Procedures and Action Plans

Andersen, J. C., Courson, R. W., Kleiner, D. M., & McLoda, T. A. (2002). National Athletic Trainers’ Association Position Statement: Emergency Planning in Athletics. Journal of Athletic Training, 37(1), 99–104. https://www.nata.org/sites/default/files/emergencyplanninginathletics.pdf

Epidemiology

Arnold, T. J., Arcury, T. A., Sandberg, J. C., Quandt, S. A., Talton, J. W., Mora, D. C., Kearney, G. D., Chen, H., Wiggins, M. F., & Daniel, S. S. (2020). Heat-related illness among latinx child farmworkers in North Carolina: a mixed-methods study. A Journal of Environmental and Occupational Health Policy, 30(2), 111-126. https://doi.org/10.1177/1048291120920571

Hansson, E., Glasser, J., Jakobsson, K., Weiss, I., Wesseling, C., Lucas, R. A., Wei, J. L. K., Ekstrom, U., Wijkstom, J., Bodin, T., Johnson, R. J., & Wegman, D. H. (2020). Pathophysiological mechanisms by which heat stress potentially induces kidney inflammation and chronic kidney disease in sugarcane workers. Nutrients, 12(6), 1639. https://doi.org/10.3390/nu12061639

Al-Bouwarthan, M., Quinn, M. M., Kriebel, D., & Wegman, D. H. (2020). Risk of kidney injury among construction workers exposed to heat stress: a longitudinal study from Saudi Arabia. International Journal of Environmental Research and Public Health, 17(11), 3775. https://doi.org/10.3390/ijerph17113775

Dally, M., Butler-Dawson, J., Krisher, L., Monaghan, A., Weitzenkamp, D., Sorenson, C., Johnson, R. J., Carlton, E. J., Asensio, C., Tenney, L., & Newman, L. S. (2018). The impact of heat and impaired kidney function on productivity of Guatemalan sugarcane workers. PLOS One, 13(10). https://doi.org/10.1371/journal.pone.0205181

Tustin, A. W., Lamson, G. E., Jacklitsch, B. L., Thomas, R. J., Arbury, S. B., Cannon, D. L., Gonzales, R. G., & Hodgson, M. J (2018). Evaluation of occupational exposure limits for heat stress in outdoor workers - United States, 2011-2016. Centers for Disease Control and Prevention. http://dx.doi.org/10.15585/mmwr.mm6726a1

Arbury, S., Jacklitsch, B., Farquah, O., Hodgson, M., Lamson, G., Martin, & H., Profitt, A. (2014). Heat illness and death among workers - United States, 2012-2013. Center for Disease Control and Prevention. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4584656/

Activity Modification

Hosokawa, Y., Casa, D. J., Trtanj, J. M., Belval, L. N., Deuster, P. A., Glitz, S. M., Grundstein, A. J., Hawkins, M. D., Huggins, R. A., Jacklitsch, B., Jardine, J. F., Jones, H., Kazman, J. B., Reynolds, M. E., Stearns, R. L., Vanos, J. K., Williams, A. l., & Williams, W. J. (2019). Activity modification in heat: critical assessment of guidelines across athletic, occupational, and military settings in the USA. International Journal of Biometerology, 63, 405-427. https://doi.org/10.1007/s00484-019-01673-6

 Climate Change and Heat Illness

Puvvula, J., Abadi, A. M., Conlon, K. C., Rennie, J. J., Herring, S. C., Thie, L., Rudolph, M. J., Owen, R., & Bell, J. E. (2022). Estimating the Burden of Heat-Related Illness Morbidity Attributable to Anthropogenic Climate Change in North Carolina. GeoHealth, 6(11), e2022GH000636. https://doi.org/10.1029/2022GH000636

De Lima, C. Z., Buzan, J. R., Moore, F. C., Baldos, U. L., Huber, M., & Hertel, T. W. (2021). Heat stress on agricultural workers exacerbates crop impacts of climate change. Environmental Research Letters, 16. https://doi.org/10.1088/1748-9326/abeb9f

Tigchelaar, M., Battisti, D. S., & Spector, J. T. (2020). Work adaptations insufficient to address growing heat risk agricultural workers. Environmental Research Letters, 15. https://doi.org/10.1088/1748-9326/ab86f4

Kjellstrom, T., Sawada, S. I., Bernard, T. E., Parsons, K., Rintamaki, H., & Holmer, I. (2013). Editorial: Climate Change and Occupational Heat Problems. Industrial Health, 13(1), 1-2. https://doi.org/10.2486/indhealth.MS5101ED

OSHA Policy Reviews

Arbury, S., Lindsley, M., & Hodgson, M. (2016). A Critical Review of OSHA Heat Enforcement Cases: Lessons Learned. Journal of Occupational and Environmental Medicine, 58(4), 359–363. https://doi.org/10.1097/JOM.0000000000000640