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O'Connor FK, Meade RD, Notley SR, Ioannou LG, Flouris AD, Kenny GP. Agreement between measured and self-reported physiological strain in males and females during simulated occupational heat stress. Am J Ind Med 2024; 67:466-473. [PMID: 38493300 DOI: 10.1002/ajim.23580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/26/2024] [Accepted: 02/23/2024] [Indexed: 03/18/2024]
Abstract
RATIONALE Monitoring physiological strain is recommended to safeguard workers during heat exposure, but is logistically challenging. The perceptual strain index (PeSI) is a subjective estimate thought to reflect the physiological strain index (PSI) that requires no physiological monitoring. However, sex is known to influence perceptions of heat stress, potentially limiting the utility of the PeSI. OBJECTIVES The objective of this study was to assess whether sex modifies the relationship between PeSI and PSI. METHODS Thirty-four adults (15 females) walked on a treadmill (moderate intensity; ~200 W/m2) for 180 min or until termination (volitional fatigue, rectal temperature ≥39.5°C) in 16°C, 24°C, 28°C, and 32°C wet-bulb globe temperatures. Rectal temperature and heart rate were recorded to calculate PSI (0-10 scale). Rating of perceived exertion and thermal sensation were recorded to calculate PeSI (0-10 scale). Relationships between PSI and PeSI were evaluated via linear mixed models. Mean bias (95% limits of agreement [LoA]) between PSI and PeSI was assessed via Bland-Altman analysis. Mean absolute error between measures was calculated by summing absolute errors between the PeSI and the PSI and dividing by the sample size. FINDINGS PSI increased with PeSI (p < 0.01) but the slope of this relation was not different between males and females (p = 0.83). Mean bias between PSI and PeSI was small (-0.4 points), but the 95% LoA (-3.5 to 2.7 points) and mean absolute error were wide (1.3 points). IMPACT Our findings indicate that sex does not appreciably impact the agreement between the PeSI and PSI during simulated occupational heat stress. The PeSI is not a suitable surrogate for the PSI in either male or female workers.
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Affiliation(s)
- Fergus K O'Connor
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Robert D Meade
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Sean R Notley
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Leonidas G Ioannou
- Department of Automatics, Biocybernetics and Robotics, Jožef Stefan Institute, Ljubljana, Slovenia
| | - Andreas D Flouris
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
- FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Karies, Trikala, Greece
| | - Glen P Kenny
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
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Morrissey-Basler MC, Eason CM, Clines SH, Kaufman CE, Casa DJ. Perceived challenges and barriers for females working in the heat. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2024; 21:97-107. [PMID: 37801404 DOI: 10.1080/15459624.2023.2268725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/08/2023]
Abstract
Given rising temperatures, globally, heat exposures and catastrophic heat illnesses are a major concern in laborer and industrial sectors. The purpose of this study was to evaluate the perceptions of females laboring in the heat regarding challenges and barriers encountered in their respective industries while working in the heat. A consensual qualitative research (CQR) design was employed to gain information related to participant occupational and job characteristics, feelings while working in the heat, adjustments made by employers when they work in the heat, and their experience working in the heat specific to their identified sex. Females were eligible to participate if they were currently employed in an environment that required them to work in the heat. Twelve females participated in a single, 45-60 min one-on-one semi-structured interview. Participants reported working in the manufacturing, agriculture, tourism, and railroad industries. Upon completion of data analysis, one primary theme was identified: heat stress mitigation strategies, which were further broken down into two subthemes of formal strategies provided by the employer and informal strategies driven by the employees. Participants indicated there was a lack of heat stress prevention strategies implemented by their employers, which resulted in employees creating their own strategies to protect themselves and their coworkers from heat stress. Results indicated there are limited heat stress prevention strategies that are provided in industries that include females working in the heat. Unique considerations should be made to protect this population from the dangers of heat stress and must go beyond workers protecting themselves.
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Affiliation(s)
- Margaret C Morrissey-Basler
- Department of Health Sciences, Providence College, Providence, Rhode Island
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs, Connecticut
| | - Christianne M Eason
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs, Connecticut
| | - Stephanie H Clines
- Department of Athletic Training, Sacred Heart University, Fairfield, Connecticut
| | - Cecilia E Kaufman
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs, Connecticut
| | - Douglas J Casa
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs, Connecticut
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Morrissey MC, Langan SP, Brewer GJ, Struder JF, Navarro JS, Nye MN, Casa DJ. Limitations associated with thermoregulation and cardiovascular research assessing laborers performing work in the heat. Am J Ind Med 2023; 66:267-280. [PMID: 36748881 DOI: 10.1002/ajim.23462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 12/13/2022] [Accepted: 01/10/2023] [Indexed: 02/08/2023]
Abstract
PURPOSE To quantify the current literature and limitations associated with research examining thermoregulatory and cardiovascular strain in laborers working in the heat. METHODS PubMed, SCOPUS, and SPORTDiscus were searched for terms related to the cardiovascular system, heat stress, and physical work. Qualifying studies included adult participants (18-65 years old), a labor-intensive environment or exercise protocol simulating a labor environment, a minimum duration of 120 min of physical work, and environmental heat stress (ambient temperature ≥26.0°C and ≥30% relative humidity). Studies included at least one of the following outcomes: pre- and peak physical work, core temperature, heart rate (HR), systolic blood pressure, diastolic blood pressure, HR variability, and rate pressure product. RESULTS Twenty-one out of 1559 potential studies qualified from our search. There was a total of 598 participants (mean = 28 ± 50 participants per study, range = 4-238 participants per study), which included 51 females (8.5%) and 547 males (91.5%). Of the participants, 3.8% had cardiovascular risk factors (diabetes: n = 10; hypertension: n = 13) and 96.2% were characterized as "healthy". Fifty-seven percent of the included studies were performed in a laboratory setting. CONCLUSIONS Studies were predominantly in men (91.5%), laboratory settings (57%), and "healthy" individuals (96.2%). To advance equity in protection against occupational heat stress and better inform future heat safety recommendations to protect all workers, future studies must focus on addressing these limitations. Employers, supervisors, and other safety stakeholders should consider these limitations while implementing current heat safety recommendations.
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Affiliation(s)
| | - Sean P Langan
- Korey Stringer Institute, University of Connecticut, Storrs, Connecticut, USA
| | - Gabrielle J Brewer
- Korey Stringer Institute, University of Connecticut, Storrs, Connecticut, USA
| | - Jeb F Struder
- Korey Stringer Institute, University of Connecticut, Storrs, Connecticut, USA
| | - John S Navarro
- Korey Stringer Institute, University of Connecticut, Storrs, Connecticut, USA
| | - Megan N Nye
- Korey Stringer Institute, University of Connecticut, Storrs, Connecticut, USA
| | - Douglas J Casa
- Korey Stringer Institute, University of Connecticut, Storrs, Connecticut, USA
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De Barros JA, Macartney MJ, Peoples GE, Notley SR, Herry CL, Kenny GP. Effects of sex and wet-bulb globe temperature on heart rate variability during prolonged moderate-intensity exercise: A secondary analysis. Appl Physiol Nutr Metab 2022; 47:725-736. [PMID: 35290752 DOI: 10.1139/apnm-2022-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Sex-differences in heart rate (HR) and heart rate variability (HRV), a surrogate of cardiac autonomic modulation, are evident during rest and exercise in young healthy individuals. However, it remains unclear whether sex impacts HRV during prolonged exercise at differing levels of environmental heat stress. Therefore, we completed a secondary analysis upon the effects of sex and wet-bulb globe temperature (WBGT) on HR and HRV during prolonged exercise. To achieve this, HR and HRV were assessed in non-endurance-trained and non-heat-acclimatized healthy men (n=19) and women (n=15) aged 18-45 years during 180-min treadmill walking at a moderate metabolic rate (200 W/m2: equivalent to ~35% peak aerobic power) in 16, 24, 28, and 32°C WBGT. In the final 5 min prior to exercise termination, HR was observed to be higher in women relative to men in all but the 32°C WBGT. Although no sex-differences were observed for the HRV metric of root-mean-square of successive differences, high frequency power was higher in women relative to men across WBGT conditions. These findings indicate that, in healthy non-heat-acclimatized individuals, women respond to prolonged exercise-heat stress with a greater increase in HR despite cardiac vagal autonomic modulation remaining equal or increasing compared to men. Novelty points. • Prior to exercise termination, females respond with a greater increase in heart rate under all wet-bulb globe temperatures except the hottest (32°C). • Sex influenced heart rate variability (HRV) metrics during all wet-bulb globe temperatures, but results were mixed. • Further characterisation of HRV sex differences remains an important area of research.
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Affiliation(s)
| | - Michael J Macartney
- University of Wollongong, 8691, Wollongong, Australia.,University of New South Wales, 7800, Sydney, New South Wales, Australia;
| | - Gregory E Peoples
- University of Wollongong, 8691, School of Medicine, Wollongong, New South Wales, Australia;
| | - Sean R Notley
- University of Ottawa, Faculty of Health Sciences, Ottawa, Ontario, Canada;
| | - Christophe L Herry
- Ottawa Hospital Research Institute, 10055, Clinical Epidemiology, Ottawa, Ontario, Canada;
| | - Glen P Kenny
- University of Ottawa, 6363, Ottawa, Canada, K1N 6N5.,Ottawa Hospital Research Institute, 10055, Ottawa, Canada, K1Y 4E9;
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