Physiological responses to temperature and humidity compared to the assessment by UTCI, WGBT and PHS

Short-term impact of diurnal temperature range on cardiovascular diseases mortality in residents in northeast China

It has been reported that cardiovascular disease (CVD) has become one of the major threats to global public health and is associated with climate change. Several previous studies have shown the influence of ambient temperature on CVD, but lack some evidence for the short-term effect of diurnal temperature range (DTR) on CVD mortality in northeast China. This is the first study to assess the correlation between DTR and CVD mortality in Hulunbuir located in northeast China. Daily CVD mortality data and meteorological data were collected from 2014 to 2020. A quasi-Poisson generalized linear regression with a distributed lag non-linear model (DLNM) was applied to exploring the short-term impact of DTR on CVD mortality. Stratified analyses by gender, age, and season were conducted and the short-term impacts of extremely high DTR on CVD mortality were investigated. In this study, a total of 21,067 CVD mortality cases were recorded in Hulunbuir, China from 2014 to 2020. Compared to the reference value (11.20 [Formula: see text]C, 50[Formula: see text] percentile), a "U-shaped" non-linear relationship between DTR and CVD mortality was observed, and extremely high DTR increased the risk of CVD mortality. The short-term effect of extremely high DTR occurred immediately and lasted up to 6 days. In addition, the male and the age [Formula: see text] 65 groups were more likely to be affected by extremely high DTR compared with the female and the age < 65 groups, respectively. The results also showed that extremely high DTR in cold season had a more adverse effect on CVD mortality than warm season. This study suggests that extremely high DTR for cold season should be paid enough attention to for residents in northeast China. The male and the age [Formula: see text] 65 groups were more vulnerable to the impacts of DTR. The study results may provide some suggestions for decision-making by local public health authorities to avoid the adverse impacts of high DTR, and improve the health of residents, especially vulnerable groups in cold season.

Temperature-Humidity-Dependent Wind Effects on Physiological Heat Strain of Moderately Exercising Individuals Reproduced by the Universal Thermal Climate Index (UTCI)

Increasing wind speed alleviates physiological heat strain; however, health policies have advised against using ventilators or fans under heat wave conditions with air temperatures above the typical skin temperature of 35 °C. Recent research, mostly with sedentary participants, suggests mitigating the effects of wind at even higher temperatures, depending on the humidity level. Our study aimed at exploring and quantifying whether such results are transferable to moderate exercise levels, and whether the Universal Thermal Climate Index (UTCI) reproduces those effects. We measured heart rates, core and skin temperatures, and sweat rates in 198 laboratory experiments completed by five young, semi-nude, heat-acclimated, moderately exercising males walking the treadmill at 4 km/h on the level for three hours under widely varying temperature-humidity combinations and two wind conditions. We quantified the cooling effect of increasing the wind speed from 0.3 to 2 m/s by fitting generalized additive models predicting the physiological heat stress responses depending on ambient temperature, humidity, and wind speed. We then compared the observed wind effects to the assessment performed by the UTCI. Increasing the wind speed lowered the physiological heat strain for air temperatures below 35 °C, but also for higher temperatures with humidity levels above 2 kPa water vapor pressure concerning heart rate and core temperature, and 3 kPa concerning skin temperature and sweat rate, respectively. The UTCI assessment of wind effects correlated positively with the observed changes in physiological responses, showing the closest agreement (r = 0.9) for skin temperature and sweat rate, where wind is known for elevating the relevant convective and evaporative heat transfer. These results demonstrate the potential of the UTCI for adequately assessing sustainable strategies for heat stress mitigation involving fans or ventilators, depending on temperature and humidity, for moderately exercising individuals.

Prenatal exposure to long-term heat stress and stillbirth in Ghana: A within-space time-series analysis

INTRODUCTION

Few studies examined the association between prenatal long-term ambient temperature exposure and stillbirth and fewer still from developing countries. Rather than ambient temperature, we used a human thermophysiological index, Universal Thermal Climate Index (UTCI) to investigate the role of long-term heat stress exposure on stillbirth in Ghana.

METHODS

District-level monthly UTCI was linked with 90,532 stillbirths of 5,961,328 births across all 260 local districts between 1^st January 2012 and 31^st December 2020. A within-space time-series design was applied with distributed lag nonlinear models and conditional quasi-Poisson regression.

RESULTS

The mean (28.5 ± 2.1 °C) and median UTCI (28.8 °C) indicated moderate heat stress. The Relative Risks (RRs) and 95% Confidence Intervals (CIs) for exposure to lower-moderate heat (1st to 25th percentiles of UTCI) and strong heat (99th percentile) stresses showed lower risks, relative to the median UTCI. The higher-moderate heat stress exposures (75th and 90th percentiles) showed greater risks which increased with the duration of heat stress exposures and were stronger in the 90th percentile. The risk ranged from 2% (RR = 1.02, 95% CI 0.99, 1.05) to 18% (RR = 1.18, 95% CI 1.02, 1.36) for the 90th percentile, relative to the median UTCI. Assuming causality, 19 (95% CI 3, 37) and 27 (95% CI 3, 54) excess stillbirths per 10,000 births were attributable to long-term exposure to the 90th percentile relative to median UTCI for the past six and nine months, respectively. Districts with low population density, low gross domestic product, and low air pollution which collectively defined rural districts were at higher risk as compared to those in the high level (urban districts).

DISCUSSION

Maternal exposure to long-term heat stress was associated with a greater risk of stillbirth. Climate change-resilient interventional measures to reduce maternal exposure to heat stress, particularly in rural areas may help lower the risk of stillbirth.

A modelling framework for local thermal comfort assessment related to bicycle helmet use

Thermal discomfort due to accumulated sweat increasing head skin wettedness may contribute to low wearing rates of bicycle helmets. Using curated data on human head sweating and helmet thermal properties, a modelling framework for the thermal comfort assessment of bicycle helmet use is proposed. Local sweat rates (LSR) at the head were predicted as the ratio to the gross sweat rate (GSR) of the whole body or by sudomotor sensitivity (SUD), the change in LSR per change in body core temperature (Δt_re). Combining those local models with Δt_re and GSR output from thermoregulation models, we simulated head sweating depending on the characteristics of the thermal environment, clothing, activity, and exposure duration. Local thermal comfort thresholds for head skin wettedness were derived in relation to thermal properties of bicycle helmets. The modelling framework was supplemented by regression equations predicting the wind-related reductions in thermal insulation and evaporative resistance of the headgear and boundary air layer, respectively. Comparing the predictions of local models coupled with different thermoregulation models to LSR measured at the frontal, lateral and medial head under bicycle helmet use revealed a large spread in LSR predictions predominantly determined by the local models and the considered head region. SUD tended to overestimate frontal LSR but performed better for lateral and medial head regions, whereas predictions by LSR/GSR ratios were lower and agreed better with measured frontal LSR. However, even for the best models root mean squared prediction errors exceeded experimental SD by 18-30%. From the high correlation (R > 0.9) of skin wettedness comfort thresholds with local sweating sensitivity reported for different body regions, we derived a threshold value of 0.37 for head skin wettedness. We illustrate the application of the modelling framework using a commuter-cycling scenario, and discuss its potential as well as the needs for further research.

Investigation into the thermal comfort and physiological adaptability of outdoor physical training in college students

Over the last few decades, increase in global temperatures have led to a deterioration in the quality of open spaces, urban vitality, and public health. Strenuous physical training under hot conditions outdoors increases the potential for developing heat illnesses. It is therefore necessary to examine the relationships between human physiological indices, psychological responses, and outdoor thermal indices to predict and evaluate human thermal safety in hot environments. A 9-day experiment was conducted in September 2019, which tested the thermal comfort and cognitive ability of 1102 students. Their physiological parameters (Heart rate, Auditory canal temperature) were recorded before and after physical training. Results showed that there were significant differences in the thermal sensation vote before and after physical training. The classification of heat stress was modified based on the MTSV regression model and PET. The maximum acceptable PET was 23.0 °C before physical training and 21.7 °C after physical training. When PET ≥ 40.1 °C, a reduction in physical training intensity is recommended. When PET ≥ 45.7 °C, cessation of physical training should take place and sun exposure should be reduced to avoid health hazards. It is important to use the auditory canal temperature instead of the core temperature to calculate the physiological strain index (PSI). More than 15% of the subjects had a PSI ≥ 7.0 during the test. When the body is in a thermally neutral state (MTSV = -0.5- 0.5), PSI ≤ 2.0. When the MTSV ≥3.2, PSI ≥ 7.0, physical training intensity should be reduced, and warning information should be provided. According to the expected distribution of physical training time and rest time, it is recommended that the time of each physical training session should be within 30 min, with a resting period of more than 30 min in hot environments.

Prenatal acute thermophysiological stress and spontaneous preterm birth in Western Australia, 2000-2015: A space-time-stratified case-crossover analysis

Epidemiologic evidence on acute heat and cold stress and preterm birth (PTB) is inconsistent and based on ambient temperature rather than a thermophysiological index. The aim of this study was to use a spatiotemporal thermophysiological index (Universal Thermal Climate Index, UTCI) to investigate prenatal acute heat and cold stress exposures and spontaneous PTB. We conducted a space-time-stratified case-crossover analysis of 15,576 singleton live births with spontaneous PTB between January 1, 2000 and December 31, 2015 in Western Australia. The association between UTCI and spontaneous PTB was examined with distributed lag nonlinear models and conditional quasi-Poisson regression. Relative to the median UTCI, there was negligible evidence for associations at the lower range of exposures (1st to 25th percentiles). We found positive associations in the 95th and 99th percentiles, which increased with increasing days of heat stress in the first week of delivery. The relative risk (RR) and 95% confidence interval (CI) for the immediate (delivery day) and cumulative short-term (up to six preceding days) exposures to heat stress (99th percentile, 31.2 °C) relative to no thermal stress (median UTCI, 13.8 °C) were 1.01 (95% CI: 1.01, 1.02) and 1.05 (95% CI: 1.04, 1.06), respectively. Elevated effect estimates for heat stress were observed for the transition season, the year 2005-2009, male infants, women who smoked, unmarried, ≤ 19 years old, non-Caucasians, and high socioeconomic status. Effect estimates for cold stress (1st percentile, 0.7 °C) were highest in the transition season, during 2005-2009, and for married, non-Caucasian, and high socioeconomic status women. Acute heat stress was associated with an elevated risk of spontaneous PTB with sociodemographic vulnerability. Cold stress was associated with risk in a few vulnerable subgroups. Awareness and mitigation strategies such as hydration, reducing outdoor activities, affordable heating and cooling systems, and climate change governance may be beneficial. Further studies with the UTCI are required.

Optimal Strategy on Radiation Estimation for Calculating Universal Thermal Climate Index in Tourism Cities of China

The Universal Thermal Climate Index (UTCI) is believed to be a very powerful tool for providing information on human thermal perception in the domain of public health, but the solar radiation as an input variable is difficult to access. Thus, this study aimed to explore the optimal strategy on estimation of solar radiation to increase the accuracy in UTCI calculation, and to identify the spatial and temporal variation in UTCI over China. With daily meteorological data collected in 35 tourism cities in China from 1961 to 2020, two sunshine-based Angstrom and Ogelman models, and two temperature-based Bristow and Hargreaves models, together with neural network and support vector machine-learning methods, were tested against radiation measurements. The results indicated that temperature-based models performed the worst with the lowest NSE and highest RMSE. The machine-learning methods performed better in calibration, but the predictive ability decreased significantly in validation due to big data requirements. In contrast, the sunshine-based Angstrom model performed best with high NSE (Nash–Sutcliffe Efficiency) of 0.84 and low RMSE (Root Mean Square Error) of 35.4 J/m² s in validation, which resulted in a small RMSE of about 1.2 °C in UTCI calculation. Thus, Angstrom model was selected as the optimal strategy on radiation estimation for UTCI calculation over China. The spatial distribution of UTCI showed that days under no thermal stress were high in tourism cities in central China within a range from 135 to 225 days, while the largest values occurred in Kunming and Lijiang in southwest China. In addition, days under no thermal stress during a year have decreased in most tourism cities of China, which could be attributed to the asymmetric changes in significant decrease in frost days and slightly increase in hot days. However, days under no thermal stress in summer time have indeed decreased, accompanying with increasing days under strong stress, especially in the developed regions such as Yangze River Delta and Zhujiang River Delta. Based on the study, we conclude that UTCI can successfully depict the overall spatial distribution and temporal change of the thermal environments in the tourism cities over China, and can be recommend as an efficient index in the operational services for assessing and predicting thermal perception for public health. However, extreme cold and heat stress in the tourism cities of China were not revealed by UTCI due to mismatch of the daily UTCI with category at hourly scale, which makes it an urgent task to redefine category at daily scale in the next research work.

Association between ambient temperature and cardiovascular disease hospitalisations among farmers in suburban northwest China

Cardiovascular disease (CVD) has become a severe public health and social issue in China. However, in northwest China, evidence on the association between ambient temperature and CVD hospitalisations in suburban farmers is somewhat limited. We collected CVD hospitalisations and meteorological data (2012-2015) in Zhangye suburbs and assessed the temperature-related risk and burden of admission by fitting a distributed lag nonlinear model to probe the relationship between ambient temperature and CVD hospitalisations among farmers in suburban northwest China. The results show that 23,921 cases of CVD admissions were recorded from 2012 to 2015. There was a "U-shaped" association between temperature and hospitalisations. Compared with the minimum admissions temperature (MAT) at 15.3 °C, the cumulative relative risk (RR) over lag 0-21 days was 1.369 (95% CI 0.980-1.911) for extreme cold temperature (1st percentile, -15 °C), 1.353 (95% CI 1.063-1.720) for moderate cold (5th percentile, -11 °C), 1.415 (95% CI 1.117-1.792) for extreme heat (99th percentile, 26 °C), and 1.241 (95% CI 1.053-1.464) for moderate heat (95th percentile, 24 °C). Female farmers were more susceptible to low and high temperatures than male farmers. Farmers aged ≥ 65 years old were more sensitive to low temperatures, while farmers aged < 65 years old were more sensitive to high temperatures. A total of 13.4% (3,208 cases) of the hospitalisation burden for CVD were attributed to temperature exposure, with the moderate range of temperatures accounting for the most significant proportion (12.2%). Ambient temperature, primarily moderate temperatures, might be an essential factor for cardiovascular-related hospitalisations among farmers in suburban northwest China.

Outdoor thermal stress changes in South Korea: Increasing inter-annual variability induced by different trends of heat and cold stresses

Changes of thermal environment can lead to unfavorable impacts such as a decrease of thermal stratification, increase of energy consumption, and increase of thermal health risk. Investigating changes in outdoor thermal environments can provide meaningful information for addressing economic and social issues and related challenges. In this study, thermal environment changes in South Korea were investigated using a nonstationary two-component Gaussian mixture model (NSGMM) for air temperature and two thermal comfort indices. For this, the perceived temperature (PT) and universal thermal climate index (UTCI) were employed as the thermal comfort index. Thermal comfort indices were computed using observed meteorological data at 26 weather stations for 37 years in South Korea. Meanwhile, trends of thermal comforts in the warm and cool seasons were simultaneously modeled by the NSGMM. The results indicate significant increasing trends in thermal comfort indices for South Korea. The increasing trends in thermal comfort indices both the warm and cool seasons were detected while the magnitudes of the trends are significantly different. This difference between the magnitude of trends led to an increase in mean and inter-annual variability of thermal comfort indices based on PT, while an increase of mean and decrease of inter-annual variability were observed based on the UTCI. Moreover, the annual proportion of the category referring to days in comfort based on the results of PT has decreased due to the different trends of thermal comfort indices in the warm and cool seasons. This decrease may lead to an increase of thermal health risk that is larger than what would be expected from the results considering the increasing trend of the annual mean temperature in South Korea. From this result, it can be inferred that the thermal health risk in South Korea may be more adverse than what we originally expected from the current temperature trend.

A randomized cross-over trial investigating differences in 24-h personal air and skin temperatures using wearable sensors between two climatologically contrasting settings

The influence of elevated air temperatures recorded in various urban microenvironments in adversely impacting biologically relevant disease end points has not yet been extensively tackled. This study is a post hoc analysis of the TEMP pilot trial, a randomized 2 × 2 cross-over trial that examined changes in metabolic and stress hormonal profiles of healthy adults in two settings (urban vs. rural) with distinctly different climatological characteristics during the Mediterranean summer. This analysis aimed to study the association between the 24-h personal air or skin temperature sensor measurements and the diary-based location type (indoors vs. outdoors) in urban (seaside) vs. rural (higher in altitude) microenvironments. Out of 41 eligible participants, a total of 37 participants were included in this post-hoc TEMP trial analysis. Wearable sensors recorded personal air temperature, skin temperature, and activity (as a surrogate marker of physical activity) in each setting, while a time-stamped personal diary recorded the types of indoor or outdoor activities. Temperature peaks during the 24-h sampling period were detected using a peak finding algorithm. Mixed effect logistic regression models were fitted for the odds of participant location (being indoors vs. outdoors) as a function of setting (urban vs. rural) and sensor-based personal temperature data (either raw temperature values or number of temperature peaks). During the study period (July-end of September), median [interquartile range, IQR] personal air temperature in the rural (higher altitude) settings was 1.5 °C lower than that in the urban settings (27.1 °C [25.4, 29.2] vs. 28.6 °C [27.1, 30.5], p < 0.001), being consistent with the Mediterranean climate. Median [IQR] personal air temperature in indoor (micro)environments was lower than those in outdoors (28.0 °C [26.4, 30.3] vs 28.5 °C [26.8, 30.7], p < 0.001). However, median [IQR] skin temperature was higher in indoor (micro)environments vs. outdoors (34.8 °C [34.0, 35.6] and 33.9 °C [32.9, 34.8], p < 0.001) and the number of both personal air and skin temperature peaks was higher indoors compared to outdoors (median [IQR] 3.0 [2.0,4.0] vs 1.0 [1.0,1.3], p < 0.007, for the skin sensors). A significant association between the number of temperature peaks and indoor location types was observed with either the personal air sensor (OR 3.1; 95% CI 1.2-8.2; p = 0.02) or the skin sensor (OR 3.7; 95% CI 1.4-9.9; p = 0.01), suggesting higher number of indoor air temperature fluctuations. Amidst the global climate crisis, more population health studies or personalized medicine approaches that utilize continuous tracking of individual-level air/skin temperatures in both indoor/outdoor locations would be warranted, if we were to better characterize the disease phenotype in response to climate change manifestations.

Summer UTCI variability in Poland in the twenty-first century

The paper analyses the temporal and spatial variability of the Universal Thermal Climate Index (UTCI) in Poland in summer. Summer is the season with the highest intensity of tourism traffic that is why it is important to determine biometeorological conditions, especially in popular tourist destinations such as coastal, mountain and urban areas, in the times of climate changes. The analysis was based on data from 18 stations of IMGW-PIB (Institute of Meteorology and Water Management-National Research Institute), distributed evenly in the territory of the country, and representing all eight bioclimatic regions. The data include air temperature, relative humidity, wind velocity and cloudiness at 12 UTC from summer months: June, July and August from the years 2001-2018. Thermoneutral zone was the most frequently occurring UTCI class in Poland. It was recorded during 56-75% of summer days (with the exception of mountain stations, where it occurred on 30-35% of days). Moderate heat stress is the second most frequently occurring category with a frequency from 18 to 29% with the exception of mountain and coastal areas. Extreme and very strong cold stress occurred particularly in high mountain stations, and was sporadically observed at the coast of the Baltic Sea; however, the occurrence of such conditions decreases, which if favourable for beach tourism. No cases of extreme heat stress were recorded in any of the stations. The most unfavourable bioclimatic conditions were characteristic of the Upland Region (IV), represented by Kraków and Sandomierz, where very strong heat stress occurred with a 10% frequency. This is a limitation for urban tourism in those regions. The highest UTCI values were recorded in Kraków on 17 July 2007 and 29 July 2005. The highest number of cases with strong and very strong heat stress was recorded in 2015 as a consequence of the heat wave observed in Poland in the first half of August. In the majority of the analysed stations, in the second half of the analysed period (2010-2018), an increase in the number of days with strong and very strong heat stress was observed in comparison with the first half of period (2001-2009). The highest frequency of such days was observed in July. Based on the data, there are 4 potential periods of occurrence of such days, with two most intense being 26. July-13 August and 14-22 July.

Impact of ambient temperature on cardiovascular disease hospital admissions in farmers in China's Western suburbs

Cardiovascular disease (CVD) has been a major threat to global public health. The association between temperature and CVD has been widely studied and reported in cities in developed countries. However, information from developing countries, especially from suburbs and countryside, is quite limited. In this study, the daily time series data on CVD hospital admissions in farmers in the suburbs of Tianshui, China, and the meteorological data from 2012 to 2015, were collected; besides, a quasi-Poisson regression with a distributed-lag non-linear model (DLNM) was used to explore the impact of local daily mean temperature on CVD hospital admissions in suburban farmers. This study found that, first, from 2011 to 2015, a total of 30,611 person-times of CVD hospital admissions in farmers were recorded; second, there was a "J-shaped" relation between temperature and CVD hospital admissions, and both low and high temperature increased the risk of hospital admission, but the impact of high temperature was greater; third, compared with the minimum hospitalization temperature (MHT) at 0.3 °C, during 0 to 21 lag days, the cumulative relative risk (RR) for extreme cold and heat (1st and 99th percentile of temperature, respectively) was 1.117 (95% CI 0.941-1.325) and 1.740 (95% CI 1.302-2.327), respectively, and that of moderate cold and heat (5st and 95th percentile of temperature, respectively) was 1.029 (95% CI 0.958-1.106) and 1.572 (95% CI 1.210-2.042), respectively; fourth, compared with male and ≥ 65 years groups, the risk for low temperature was greater for female and < 65 years groups, the risk for high temperature was just the opposite; last, about 21.04% of CVD hospital admissions burden were attributed to the ambient temperature, and most of (about 19.26%) were caused by moderate heat. In Tianshui, alongside with extreme temperature, the moderate temperature might be an important risk factor for CVD hospital admissions in suburban farmers.

Intensity-duration-frequency relationship of WBGT extremes using regional frequency analysis in South Korea

The risk levels of heat-related extreme events need to be estimated for prediction and real-time monitoring to mitigate their impacts on air quality, public health, the ecosystem, and critical infrastructure. Many countries have adopted meteorological variable base thresholds for assessing the risk level of heat-related extreme events. These thresholds provide an approximate risk level for a specific event but do not consider its intensity and duration in the risk assessment. The current study provides a statistical tool to assess the risk of heat-related extreme events while concurrently considering their intensities and durations based on the wet-bulb globe temperature (WBGT). To this end, the intensity-duration-frequency (IDF) relationship of the extreme WBGT in South Korea was derived. Regional frequency analysis was employed to understand the IDF relationship. Return levels of heat-related extreme events in South Korea were calculated and their characteristics were investigated based on the annual maximum WBGT observations. The results showed that the IDF relationship could provide the risks of heat-related extreme events while concurrently considering their intensities and durations. The extreme WBGT in South Korea was used to categorize two regions such as coastal and inland based on their statistical characteristics. The return levels of the annual maximum WBGT events were found to vary largely by location. The return levels corresponding to 32 °C with 3-h duration for stations in the coastal and inland regions ranged from 1- to 100-years and 3- to 1000-years, respectively. Mean values of return levels for heatwave events in Seoul, Incheon, Daejon, Gwangju, Daegu, and Busan were 2.8-, 8.4-, 15.3-, 2.8-, 1.6-, and 2.2-years, respectively. The return levels of heatwaves for the warmer cities are smaller than those for cooler cities. The return levels of the heatwave events in South Korea showed a significant increasing trend in several cities, supporting the notion that the impact of heatwave events on South Korea might become more severe in the future.

Comparison of correction factor for both dynamic total thermal insulation and evaporative resistance between ISO 7933 and ISO 9920

BACKGROUND

Thermal insulation and evaporative resistance of clothing are the physical parameters to quantify heat transfer and evaporative dissipation from the human body to the environment, respectively. Wind and body movement decrease thermal insulation and evaporative resistance of clothing, which is represented as correction factors for dynamic total thermal insulation (CF_i) and evaporative resistance (CF_e), respectively. Then, CF_i and CF_e are parts of the key parameters to predict heat strain of workers by computer simulation. The objective of this study was to elucidate the difference of CF_i and CF_e between ISO 7933 and ISO 9920 and compare the difference of predicted rectal temperature, water loss, and exposure time limit calculated by using each correction factor.

METHODS

CF_i of ISO 7933 (CF_i7933) and ISO 9920 (CF_i9920), and CF_e of ISO 7933 (CF_e7933) and two kinds of CF_e of ISO 9920 (CF_e9920a, CF_e9920b) were compared in terms of relative air velocity, walking speed for three kinds of thermal insulation of clothing. Next, two modified predicted heat strain (PHS) models were developed: modified PHS integrated with CF_i9920 and CF_e9920a (PHS_mA) and modified PHS integrated with CF_i9920 and CF_e9920b (PHS_mB). We calculated the rectal temperature, water loss, and exposure time limit by PHS, PHS_mA, and PHS_mB and compared the results.

RESULTS

CF_i7933 and CF_i9920 were almost similar in terms of V_ar and walking speed, while CF_e9920a and CF_e9920b were larger than CF_e7933 when V_ar was more than 1.0 m·s^-1. Intrinsic clothing insulation (I_cl) diminished the effects of V_ar on CF_i7933, CF_i9920, CF_e7933, and CF_e9920b. However, CF_e9920a was not influenced by I_cl. The predicted rectal temperature and water loss difference were larger between PHS and PHS_mA as CF_e difference got larger. The duration time when limit of rectal temperature of 38 °C was reached (D_limTre38) calculated by PHS was significantly longer than PHS_mA, PHS_mB at higher V_ar.

CONCLUSIONS

Precise correction factors for evaporative resistance are required to predict rectal temperature, water loss, and work-time limits.

Diverse Effects of Thermal Conditions on Performance of Marathon Runners

Heat exposure affects human performance in many ways. Both physiological (i.e., glycogen sparing, oxygen uptake, thermoregulation) and biomechanical mechanisms (i.e., contact time, knee flexion, muscle activity) are affected, hence reducing performance. However, the exposure affects persons differently. Not all athletes necessarily experience an identical thermal condition similarly, and this point has been overlooked to date. We analyzed endurance performances of the top 1000 runners for every year during the last 12 New York City Marathons. Thermal conditions were estimated with wet-bulb globe temperature (WBGT) and universal thermal climate index (UTCI). Under identical thermal exposure, the fastest runners experienced a larger decline in performance than the slower ones. The empirical evidence offered here not only shows that thermal conditions affect runners differently, but also that some groups might consistently suffer more than others. Further research may inspect other factors that could be affected by thermal conditions, as pacing and race strategy.

Is There a Need to Integrate Human Thermal Models with Weather Forecasts to Predict Thermal Stress?

More and more people will experience thermal stress in the future as the global temperature is increasing at an alarming rate and the risk for extreme weather events is growing. The increased exposure to extreme weather events poses a challenge for societies around the world. This literature review investigates the feasibility of making advanced human thermal models in connection with meteorological data publicly available for more versatile practices and a wider population. By providing society and individuals with personalized heat and cold stress warnings, coping advice and educational purposes, the risks of thermal stress can effectively be reduced. One interesting approach is to use weather station data as input for the wet bulb globe temperature heat stress index, human heat balance models, and wind chill index to assess heat and cold stress. This review explores the advantages and challenges of this approach for the ongoing EU project ClimApp where more advanced models may provide society with warnings on an individual basis for different thermal environments such as tropical heat or polar cold. The biggest challenges identified are properly assessing mean radiant temperature, microclimate weather data availability, integration and continuity of different thermal models, and further model validation for vulnerable groups.

How 'hot' is too hot? Evaluating acceptable outdoor thermal comfort ranges in an equatorial urban park

Urban green spaces offer vital ecosystem services such as regulating elevated temperatures in cities. Less information exists, however, on how urban green spaces influence outdoor thermal comfort (OTC), which is dependent on people's perceptions of the complex interactions amongst ambient humidity, wind and both air and radiant temperatures. In this study, we analysed an existing OTC dataset compiled within a large Singapore urban park and calibrated OTC thresholds for physiological equivalent temperatures (PET) by analysing PET against thermal perception survey responses from the park visitors (n = 1508). We examined OTC according to (i) neutral, (ii) acceptable and (iii) preferred temperatures, where respondents felt 'comfortable' outdoors in the park. We estimated that neutral temperature, when all respondents experience neither heat nor cold stress, is 26.2 °C; acceptable temperatures, when only slight heat or cold stress is experienced, range between 21.6 and 31.6 °C; and preferred ('ideal') temperature for all respondents is 24.2 °C. Respondents residing for more than 6 months in Singapore achieved thermal neutrality, suggesting that a greater degree of thermal adaptation likely developed during acclimatisation to local climate through a combination of physiological, behavioural and psychological circumstances. Comparisons with other OTC studies showed differences in synoptic climates are linked to variations in the magnitude and ranges of perceived PET. Lastly, respondents in this study perceived lower neutral and preferred temperatures compared to respondents surveyed over a variety of urban land use categories in another local study. The differences in neutral and preferred temperatures between studies suggest that lower park temperatures and different environmental attitudes influence perceived OTC.

Occupational heat stress assessment and protective strategies in the context of climate change

Global warming will unquestionably increase the impact of heat on individuals who work in already hot workplaces in hot climate areas. The increasing prevalence of this environmental health risk requires the improvement of assessment methods linked to meteorological data. Such new methods will help to reveal the size of the problem and design appropriate interventions at individual, workplace and societal level. The evaluation of occupational heat stress requires measurement of four thermal climate factors (air temperature, humidity, air velocity and heat radiation); available weather station data may serve this purpose. However, the use of meteorological data for occupational heat stress assessment is limited because weather stations do not traditionally and directly measure some important climate factors, e.g. solar radiation. In addition, local workplace environmental conditions such as local heat sources, metabolic heat production within the human body, and clothing properties, all affect the exchange of heat between the body and the environment. A robust occupational heat stress index should properly address all these factors. This article reviews and highlights a number of selected heat stress indices, indicating their advantages and disadvantages in relation to meteorological data, local workplace environments, body heat production and the use of protective clothing. These heat stress and heat strain indices include Wet Bulb Globe Temperature, Discomfort Index, Predicted Heat Strain index, and Universal Thermal Climate Index. In some cases, individuals may be monitored for heat strain through physiological measurements and medical supervision prior to and during exposure. Relevant protective and preventive strategies for alleviating heat strain are also reviewed and proposed.

Heat stress mortality and desired adaptation responses of healthcare system in Poland

Heat stress is one of the environmental factors influencing the health of individuals and the wider population. There is a large body of research to document significant increases in mortality and morbidity during heat waves all over the world. This paper presents key results of research dealing with heat-related mortality (HRM) in various cities in Poland which cover about 25% of the country's population. Daily mortality and weather data reports for the years 1991-2000 were used. The intensity of heat stress was assessed by the universal thermal climate index (UTCI). The research considers also the projections of future bioclimate to the end of twenty-first century. Brain storming discussions were applied to find necessary adaptation strategies of healthcare system (HCS) in Poland, to minimise negative effects of heat stress. In general, in days with strong and very strong heat stress, ones must expect increase in mortality (in relation to no thermal stress days) of 12 and 47%, respectively. Because of projected rise in global temperature and heat stress frequency, we must expect significant increase in HRM to the end of twenty-first century of even 165% in comparison to present days. The results of research show necessity of urgent implementation of adaptation strategies to heat in HCS.

Estimated work ability in warm outdoor environments depends on the chosen heat stress assessment metric

With a view to occupational effects of climate change, we performed a simulation study on the influence of different heat stress assessment metrics on estimated workability (WA) of labour in warm outdoor environments. Whole-day shifts with varying workloads were simulated using as input meteorological records for the hottest month from four cities with prevailing hot (Dallas, New Delhi) or warm-humid conditions (Managua, Osaka), respectively. In addition, we considered the effects of adaptive strategies like shielding against solar radiation and different work-rest schedules assuming an acclimated person wearing light work clothes (0.6 clo). We assessed WA according to Wet Bulb Globe Temperature (WBGT) by means of an empirical relation of worker performance from field studies (Hothaps), and as allowed work hours using safety threshold limits proposed by the corresponding standards. Using the physiological models Predicted Heat Strain (PHS) and Universal Thermal Climate Index (UTCI)-Fiala, we calculated WA as the percentage of working hours with body core temperature and cumulated sweat loss below standard limits (38 °C and 7.5% of body weight, respectively) recommended by ISO 7933 and below conservative (38 °C; 3%) and liberal (38.2 °C; 7.5%) limits in comparison. ANOVA results showed that the different metrics, workload, time of day and climate type determined the largest part of WA variance. WBGT-based metrics were highly correlated and indicated slightly more constrained WA for moderate workload, but were less restrictive with high workload and for afternoon work hours compared to PHS and UTCI-Fiala. Though PHS showed unrealistic dynamic responses to rest from work compared to UTCI-Fiala, differences in WA assessed by the physiological models largely depended on the applied limit criteria. In conclusion, our study showed that the choice of the heat stress assessment metric impacts notably on the estimated WA. Whereas PHS and UTCI-Fiala can account for cumulative physiological strain imposed by extended work hours when working heavily under high heat stress, the current WBGT standards do not include this. Advanced thermophysiological models might help developing alternatives, where not only modelling details but also the choice of physiological limit criteria will require attention. There is also an urgent need for suitable empirical data relating workplace heat exposure to workability.

Application of Universal Thermal Climate Index (UTCI) for assessment of occupational heat stress in open-pit mines

The purpose of this article is to examine the applicability of Universal Thermal Climate Index (UTCI) index as an innovative index for evaluating of occupational heat stress in outdoor environments. 175 workers of 12 open-pit mines in Tehran, Iran were selected for this research study. First, the environmental variables such as air temperature, wet-bulb temperature, globe temperature, relative humidity and air flow rate were measured; then UTCI, wet-bulb globe temperature (WBGT) and heat stress index (HSI) indices were calculated. Simultaneously, physiological parameters including heart rate, oral temperature, tympanic temperature and skin temperature of workers were measured. UTCI and WBGT are positively significantly correlated with all environmental parameters (p<0.03), except for air velocity (r<-0.39; p>0.05). Moreover, a strong significant relationship was found between UTCI and WBGT (r=0.95; p<0.001). The significant positive correlations exist between physiological parameters including oral temperature, tympanic and skin temperatures and heart rate and both the UTCI and WBGT indices (p<0.029). The highest correlation coefficient has been found between the UTCI and physiological parameters. Due to the low humidity and air velocity (~<1 m/s) in understudied mines, UTCI index appears to be appropriate to assess the occupational heat stress in these outdoor workplaces.

Relationship among environmental quality variables, housing variables, and residential needs: a secondary analysis of the relationship among indoor, outdoor, and personal air (RIOPA) concentrations database

Retrospective descriptive secondary analyses of data from relationships of indoor, outdoor, and personal air (RIOPA) study homes (in Houston, Texas; Los Angeles County, California; and, Elizabeth, New Jersey May 1999-February 2001) were conducted. Data included air exchange rates, associations between indoor and outdoor temperature and humidity, and calculated apparent temperature and humidex. Analyses examined if study homes provided optimum thermal comfort for residents during both heating and cooling seasons when compared to current American Society of Heating, Refrigerating and Air Conditioning Engineers (ASHRAE) Standards 62/62.1 and 55. Results suggested outdoor temperature, humidex, and apparent temperature during the cooling season potentially served as indicators of indoor personal exposure to parameters of thermal comfort. Outdoor temperatures, humidex, and apparent temperature during the cooling season had statistically significant predictive abilities in predicting indoor temperature. During the heating season, only humidex in Texas and combined data across study states were statistically significant, but with weaker to moderate predicative ability. The high degree of correlation between outdoor and indoor environmental variables provided support for the validity of epidemiologic studies of weather relying on temporal comparisons. Results indicated most RIOPA study residents experienced thermal comfort; however, many values indicated how several residents may have experienced some discomfort depending on clothing and indoor activities. With climate change, increases in temperature are expected, with more days of extreme heat and humidity and, potentially harsher, longer winters. Homes being built or modernized should be created with the appropriate guidelines to provide comfort for residents daily and in extreme weather events.

Applicability of Universal Thermal Climate Index (UTCI) in occupational heat stress assessment: a case study in brick industries

The present study aimed to investigate the applicability of Universal Thermal Climate Index (UTCI) as an innovative and science-based index in public health researches, in occupational heat stress assessment. All indoor and outdoor workers (200 people) of Brick industries of Shahroud, Iran participated in the research. First, the environmental variables such as air temperature, wet-bulb temperature, globe temperature, air velocity and relative humidity were measured; then UTCI and WBGT (wet-bulb globe temperature) indices were calculated. Simultaneously, physiological parameters including systolic and diastolic blood pressure, oral temperature, skin temperature, tympanic temperature and heart rate of workers were measured. UTCI and WBGT indices were 34.2 ± 2°C, 21.8 ± 1.8°C in the outdoor environments and 38.1 ± 4.4°C, 24.7 ± 3.3°C at the indoor environments, respectively. There were the weak inverse relationships between UTCI and WBGT indices at the outdoor environments and physiological responses such as systolic blood pressure, and diastolic blood pressure. However, there were no similar results for indoor environments. The significant relationships were found between UTCI and WBGT at both indoor and outdoor environments. Both UTCI and WBGT indices are suitable for assessing the occupational heat stress. Although, UTCI index seems more appropriate for heat stress assessment in the environments with low humidity and air velocity.

Effect of ambient temperature on Australian northern territory public hospital admissions for cardiovascular disease among indigenous and non-indigenous populations

Hospitalisations are associated with ambient temperature, but little is known about responses in population sub-groups. In this study, heat responses for Indigenous and non-Indigenous people in two age groups were examined for two categories of cardiac diseases using daily hospital admissions from five Northern Territory hospitals (1992-2011). Admission rates during the hottest five per cent of days and the coolest five per cent of days were compared with rates at other times. Among 25-64 year olds, the Indigenous female population was more adversely affected by very hot days than the non-Indigenous female population, with admission rates for ischaemic heart disease (IHD) increasing by 32%. People older than 65 were more sensitive to cold, with non-Indigenous male admissions for heart failure increasing by 64%, and for IHD by 29%. For older Indigenous males, IHD admissions increased by 52% during cold conditions. For older non-Indigenous females, increases in admissions for heart failure were around 50% on these cold days, and 64% for older Indigenous females. We conclude that under projected climate change conditions, admissions for IHD amongst younger Indigenous people would increase in hot conditions, while admissions among elderly people during cold weather may be reduced. The responses to temperature, while showing significant relationships across the Northern Territory, may vary by region. These variations were not explored in this assessment.

Prediction of human core body temperature using non-invasive measurement methods

The measurement of core body temperature is an efficient method for monitoring heat stress amongst workers in hot conditions. However, invasive measurement of core body temperature (e.g. rectal, intestinal, oesophageal temperature) is impractical for such applications. Therefore, the aim of this study was to define relevant non-invasive measures to predict core body temperature under various conditions. We conducted two human subject studies with different experimental protocols, different environmental temperatures (10 °C, 30 °C) and different subjects. In both studies the same non-invasive measurement methods (skin temperature, skin heat flux, heart rate) were applied. A principle component analysis was conducted to extract independent factors, which were then used in a linear regression model. We identified six parameters (three skin temperatures, two skin heat fluxes and heart rate), which were included for the calculation of two factors. The predictive value of these factors for core body temperature was evaluated by a multiple regression analysis. The calculated root mean square deviation (rmsd) was in the range from 0.28 °C to 0.34 °C for all environmental conditions. These errors are similar to previous models using non-invasive measures to predict core body temperature. The results from this study illustrate that multiple physiological parameters (e.g. skin temperature and skin heat fluxes) are needed to predict core body temperature. In addition, the physiological measurements chosen in this study and the algorithm defined in this work are potentially applicable as real-time core body temperature monitoring to assess health risk in broad range of working conditions.

The uncertainty of UTCI due to uncertainties in the determination of radiation fluxes derived from numerical weather prediction and regional climate model simulations

In this study we examine the determination accuracy of both the mean radiant temperature (Tmrt) and the Universal Thermal Climate Index (UTCI) within the scope of numerical weather prediction (NWP), and global (GCM) and regional (RCM) climate model simulations. First, Tmrt is determined and the so-called UTCI-Fiala model is then used for the calculation of UTCI. Taking into account the uncertainties of NWP model (among others the HIgh Resolution Limited Area Model HIRLAM) output (temperature, downwelling short-wave and long-wave radiation) stated in the literature, we simulate and discuss the uncertainties of Tmrt and UTCI at three stations in different climatic regions of Europe. The results show that highest negative (positive) differences to reference cases (under assumed clear-sky conditions) of up to -21°C (9°C) for Tmrt and up to -6°C (3.5°C) for UTCI occur in summer (winter) due to cloudiness. In a second step, the uncertainties of RCM simulations are analyzed: three RCMs, namely ALADIN (Aire Limitée Adaptation dynamique Développement InterNational), RegCM (REGional Climate Model) and REMO (REgional MOdel) are nested into GCMs and used for the prediction of temperature and radiation fluxes in order to estimate Tmrt and UTCI. The inter-comparison of RCM output for the three selected locations shows that biases between 0.0 and ±17.7°C (between 0.0 and ±13.3°C) for Tmrt (UTCI), and RMSE between ±0.5 and ±17.8°C (between ±0.8 and ±13.4°C) for Tmrt (UTCI) may be expected. In general the study shows that uncertainties of UTCI, due to uncertainties arising from calculations of radiation fluxes (based on NWP models) required for the prediction of Tmrt, are well below ±2°C for clear-sky cases. However, significant higher uncertainties in UTCI of up to ±6°C are found, especially when prediction of cloudiness is wrong.

Effects of heat stress on working populations when facing climate change

It is accepted that the earth's climate is changing in an accelerating pace, with already documented implications for human health and the environment. This literature review provides an overview of existing research findings about the effects of heat stress on the working population in relation to climate change. In the light of climate change adaptation, the purpose of the literature review was to explore recent and previous research into the impacts of heat stress on humans in an occupational setting. Heat stress in the workplace has been researched extensively in the past however, in the contemporary context of climate change, information is lacking on its extent and implications. The main factors found to exacerbate heat stress in the current and future workplace are the urban 'heat island effect', physical work, individual differences, and the developing country context where technological fixes are often not applicable. There is also a lack of information on the effects on vulnerable groups such as elderly people and pregnant women. As increasing temperatures reduce work productivity, world economic productivity could be condensed, affecting developing countries in the tropical climate zone disproportionately. Future research is needed taking an interdisciplinary approach, including social, economic, environmental and technical aspects.

The Universal Thermal Climate Index UTCI compared to ergonomics standards for assessing the thermal environment

The growing need for valid assessment procedures of the outdoor thermal environment in the fields of public weather services, public health systems, urban planning, tourism & recreation and climate impact research raised the idea to develop the Universal Thermal Climate Index UTCI based on the most recent scientific progress both in thermo-physiology and in heat exchange theory. Following extensive validation of accessible models of human thermoregulation, the advanced multi-node 'Fiala' model was selected to form the basis of UTCI. This model was coupled with an adaptive clothing model which considers clothing habits by the general urban population and behavioral changes in clothing insulation related to actual environmental temperature. UTCI was developed conceptually as an equivalent temperature. Thus, for any combination of air temperature, wind, radiation, and humidity, UTCI is defined as the air temperature in the reference condition which would elicit the same dynamic response of the physiological model. This review analyses the sensitivity of UTCI to humidity and radiation in the heat and to wind in the cold and compares the results with observational studies and internationally standardized assessment procedures. The capabilities, restrictions and potential future extensions of UTCI are discussed.

UTCI-Fiala multi-node model of human heat transfer and temperature regulation

The UTCI-Fiala mathematical model of human temperature regulation forms the basis of the new Universal Thermal Climate Index (UTC). Following extensive validation tests, adaptations and extensions, such as the inclusion of an adaptive clothing model, the model was used to predict human temperature and regulatory responses for combinations of the prevailing outdoor climate conditions. This paper provides an overview of the underlying algorithms and methods that constitute the multi-node dynamic UTCI-Fiala model of human thermal physiology and comfort. Treated topics include modelling heat and mass transfer within the body, numerical techniques, modelling environmental heat exchanges, thermoregulatory reactions of the central nervous system, and perceptual responses. Other contributions of this special issue describe the validation of the UTCI-Fiala model against measured data and the development of the adaptive clothing model for outdoor climates.

UTCI--why another thermal index?

Existing procedures for the assessment of the thermal environment in the fields of public weather services, public health systems, precautionary planning, urban design, tourism and recreation and climate impact research exhibit significant shortcomings. This is most evident for simple (mostly two-parameter) indices, when comparing them to complete heat budget models developed since the 1960s. ISB Commission 6 took up the idea of developing a Universal Thermal Climate Index (UTCI) based on the most advanced multi-node model of thermoregulation representing progress in science within the last three to four decades, both in thermo-physiological and heat exchange theory. Creating the essential research synergies for the development of UTCI required pooling the resources of multidisciplinary experts in the fields of thermal physiology, mathematical modelling, occupational medicine, meteorological data handling (in particular radiation modelling) and application development in a network. It was possible to extend the expertise of ISB Commission 6 substantially by COST (a European programme promoting Cooperation in Science and Technology) Action 730 so that finally over 45 scientists from 23 countries (Australia, Canada, Israel, several Europe countries, New Zealand, and the United States) worked together. The work was performed under the umbrella of the WMO Commission on Climatology (CCl). After extensive evaluations, Fiala's multi-node human physiology and thermal comfort model (FPC) was adopted for this study. The model was validated extensively, applying as yet unused data from other research groups, and extended for the purposes of the project. This model was coupled with a state-of-the-art clothing model taking into consideration behavioural adaptation of clothing insulation by the general urban population in response to actual environmental temperature. UTCI was then derived conceptually as an equivalent temperature (ET). Thus, for any combination of air temperature, wind, radiation, and humidity (stress), UTCI is defined as the isothermal air temperature of the reference condition that would elicit the same dynamic response (strain) of the physiological model. As UTCI is based on contemporary science its use will standardise applications in the major fields of human biometeorology, thus making research results comparable and physiologically relevant.