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Background: The thermal strain can be measured using subjective methods without the use of sensitive equipment. The purpose of the present study was the development and validation of an observational - perceptual heat strain risk assessment (OPHSRA) method., Methods: This cross-sectional study, in 2019, was performed. At first, an observational-perceptual questionnaire was designed using effective items in producing heat strain. Then, the reliability and validity of the questionnaire were examined. Later, 201 male workers were asked to perform the routine tasks for 90 min under various climatic conditions after resting in a cool room. At the end of the activity, the tympanic temperature of the subjects was accurately measured. Also, the designed questionnaire was completed by researchers and participants. Then, the effect coefficients of the items were calculated and used for developing the novel index. At final, the index validity was investigated., Results: The values of the content validity ratio (CVR), content validity index (CVI), and Cronbach's coefficient alpha (α) of the designed questionnaire with 16 questions were equal to 0.793, 0.913, and 0.910, respectively. The results indicated that environmental, job, administrative, and clothing items assessed by the questionnaire with the coefficients of 0.860, 0.658, 0.783, and 0.566 had significant effects on the thermal strain, respectively. These coefficients were exploited to develop the index. The result revealed that the OPHSRA index justified 69% of the variations of the tympanic temperature (R 2  = 0.69)., Conclusion: The novel index developed by the questionnaire had an acceptable validity. Therefore, this index can be used for estimating the risk of thermal strain in a variety of thermal conditions., (© 2021. The Author(s).)

Background: Need to a simple, available, accurate, comprehensive, and valid indicator is felt to assess thermal effects. Therefore, the present study was aimed to develop and validate the environmental heat strain risk assessment (EHSRA) index using structural equation modeling (SEM) based on empirical relations., Methods: This cross-sectional study was performed on 201 male workers in environments with various climatic conditions. The heart rate and tympanic temperature of the individuals were monitored at times of 30, 60, and 90 min after beginning the work. At these times, values of dry temperature, wet temperature, globe temperature, and air velocity were also measured and metabolism rate and clothing thermal insulation value were estimated. At the end, a theoretical model was depicted in AMOS software and obtained coefficients were applied to develop a novel index. The scores of this indicator were categorized into four risk levels via ROC curves and validate using linear regression analysis., Results: Indirect effect coefficients of the globe temperature, dry temperature, wet temperature, air velocity, metabolism, and clothing thermal insulation variables on the tympanic temperature were computed by 0.77, 0.75, 0.69, 0.24, 0.49, and 0.39, respectively. These coefficients were applied to develop the index. Optimal cut-off points of boundaries between risk levels included 12.02, 15.88, and 17.56. The results showed that the EHSRA index justified 75% of the variations of the tympanic temperature (R 2 = 0.75)., Conclusions: The novel index possesses appropriate validity. It was suggested that this indicator is applied and validated in various environments in the next studies.

Objectives: The aims of this study were (a) to assess the agreement coefficient between tympanic temperatures and the most popular and valid heat stress index, wet bulb globe temperature (WBGT), in outdoor environments; (b) to determine a cut-off point for tympanic temperature as a heat strain index for evaluation of outdoor workers., Methods: 1452 measurements of WBGT index and tympanic temperature were recorded for outdoor workers from nine different climatic regions. Consistency of the WBGT and tympanic temperature were tested. The cut-off point for tympanic temperature in outdoor environments regarding WBGT evaluation was suggested based on obtained sensitivity and specificity from a receiver operating characteristic curve., Results: The results showed that there were numerous situations in which WBGT exceeded the reference value, whilst the measured values of tympanic temperature rarely reached a permissible value for core temperature (38 °C). Therefore, appropriate consistency of results between the heat stress and strain indices was not achieved., Conclusion: The criterion of tympanic temperature equaling 37 °C was suggested as a cut-off point for tympanic temperature as a heat strain index for outdoor environment evaluation.

Background: Heat stress evaluation and timely notification, especially using meteorological data is an important issue attracted attention in recent years. Therefore, this study aimed at answering the following research questions: 1) can enthalpy as a common environmental parameter reported by meteorological agencies be applied accurately for evaluation of thermal condition of outdoor settings, and 2) if so, what is it's the best criterion to detect areas in stress or stress-free situations, separately., Methods: Nine climatic regions were selected throughout Iran covering a wide variety of climatic conditions like those, which exist around the world. Three types of parameters including measured (ta, RH, Pa and WBGT), estimated (metabolic rate and cloth thermal insulation), and calculated parameters (enthalpy and effective WBGT) were recorded for 1452 different situations. Enthalpy as a new indicator in this research was compared to WBGT in selected regions., Results: Altogether, a good consistency was obtained between enthalpy and WBGT in selected regions (Kappa value: 0.815). Based on the good ROC curve obtained using MedCal software, the criterion of the values more than 74.24 for the new index was determined to explain heat stress situation for outdoor environments., Conclusions: Because of simplicity in measurement, applicability of the indicator for weather agencies, the consistency observed between enthalpy and a valid as well as accurate index (WBGT), sensor requirements which take only a few seconds to reach equilibrium and so on, enthalpy indicator can be introduced and applied as a good substitute for WBGT for outdoor settings.

Background: Necessity of evaluating heat stress in the workplace, require validation of indices and selection optimal index. The present study aimed to assess the precision and validity of some heat stress indices and select the optimum index for using in heavy work activities in hot and dry climates., Methods: It carried out on 184 workers from 40 brick kilns workshops in the city of Qom, central Iran (as representative hot and dry climates). After reviewing the working process and evaluation the activity of workers and the type of work, environmental and physiological parameters according to standards recommended by International Organization for Standardization (ISO) including ISO 7243 and ISO 9886 were measured and indices were calculated., Results: Workers engaged in indoor kiln experienced the highest values of natural wet temperature, dry temperature, globe temperature and relative humidity among studied sections (P<0.05). Indoor workplaces had the higher levels of all environmental parameters than outdoors (P=0.0001), except for air velocity. The wet-bulb globe temperature (WBGT) and heat stress index (HSI) indices had the highest correlation with other physiological parameters among the other heat stress indices. Relationship between WBGT index and carotid artery temperature (r=0.49), skin temperature (r=0.319), and oral temperature (r=0.203) was statistically significant (P=0.006)., Conclusions: Since WBGT index, as the most applicable index for evaluating heat stress in workplaces is approved by ISO, and due to the positive features of WBGT such as ease of measurement and calculation, and with respect to some limitation in application of HSI; WBGT can be introduced as the most valid empirical index of heat stress in the brick workshops.