Thermal Stress

ITEC 471
Spring 2003
Jon Judge: Guest Lecturer
 What is thermal stress?
By the end of this unit, you will be able to:
-define thermal stress
-calculate WGBT (loaded/unloaded)
-recognize control measures for thermal stress
-assess risk/exposure for thermal stress
-determine exposure limits for thermal stress
 Thermal Stress

Thermal stress is defined as the physical and

physiological reactions of the worker to
temperatures that fall outside of the worker’s
normal comfort zone.
 Comfort Zones
-Accepted method of determining comfort zones is
through the use of an ASHRAE chart.
-ASHRAE –American Society of Refrigeration,
Heating, and Air-Conditioning Engineers.
-ASHRAE standard 55-1981 outlines human
comfort zones based on temperature and
humidity.
 Heat and Heat Balance

Cooling

External Heat
Source

Internal Heat Source

(Muscular Activity)
Temperature Regulation is a “balancing act”
Measuring temperature

Accurate temperature measurement is crucial for

determining thermal stress.
WBGT (Wet Bulb Globe Temperature) is the
accepted method for determining true
temperature
Accounts for air currents, relative humidity, solar load
WBGT – Heat Stress Monitor

Heat Stress Monitor takes

readings from, and calculates
WGBT by:
-Dry Bulb Thermometer
-Wet Bulb Thermometer
-Globe Temperature
 WBGT Formulae:

For indoor or shaded environments:

WBGT = 0.7 x Tnwb + 0.3 x Tg
Tnwb = natural wet-bulb temperature
Tg = globe temperature

For direct sunlight exposure:

WBGT = 0.7 x Tnwb + 0.2 x Tg + 0.1 x Tdb
Tdb = dry-bulb temperature
WGBT Example

Using the reading from the thermostat on the west

wall, convert that temperature to WBGT using
the following info:

-WB = 64.1 F
-GT = Temperature reading from thermostat
WBGT Example, cont’d
Step 1 : Convert F temps to C

-5/9 (temp F) –32 = temp C

*5/9 (64F) –32 = 17.77C

*5/9 (thermostat F) –32 = ?
WBGT example, cont’d
WBGT = 0.7 x WB + 0.3 x GT

WBGT = ?

WBGT =
WBGT example, cont’d

Verification of readings :
Using WB temp and WBGT from monitor,
calculate the corresponding GT, which should
agree with the thermostat…if it’s accurate.

* GT = (WBGT – 0.7(WB))/0.3
* convert temp to F - 9/5(Temp C) + 32 = Temp F
Using the readings from WBGT

WBGT is used by Industrial Hygienists to

determine the workload requirements/restrictions
for work areas, using Heat Stress/Strain TLV.
TLV’s
TLV’s, cont’d

Notice the ACGIH Heat Stress/Strain TLV’s take

into account the workload as well as the
work/rest cycle.

Also to note that the TLV’s make a few

assumptions regarding acclimatization, clothing,
water and salt intake, as well as the ability of
most workers to work continuously at 38C.
TLV workload definitions:

Light: standing with light work at machine/bench

using mostly arms; using table saw
Moderate: walking about with moderate lifting or
pushing; scrubbing in a standing position
Heavy: shoveling dry sand; cutting with a hand
saw
Very Heavy: shoveling wet sand
TLV correction factors

The following correction factors for the WBGT

should be used:
WBGT and TLV – Screening
work demands: light moderate heavy very
heavy
100% work; 29.5 27.5 26.0 not
(breaks incl.) 27.5 25.0 22.5 allowed
75% work; 25% 30.5 28.5 27.5 not
rest 29.0 26.5 24.5 allowed
50% work; 50% 31.5 29.5 28.5 27.5
rest 30.0 28.0 26.5 25.0
25% work; 75% 32.5 31.0 30.0 29.5
rest 31.0 29.0 28.0 26.5

Acclimatized Unacclimatized
Acclimatization
-The process whereby the body adapts to the
temperature variations of the area.

Acclimatization requires up to 3 weeks to be fully

established and is noticeably decreased after 4
days (for TLV® purposes: use 5 of last 7 days)
Having lost 1.5% of your body weight due to
dehydration eliminates any benefit of being
acclimatized
Acclimatization, cont’d
Body Changes due to Acclimatization:

Ability to get rid of excess heat improves

sweating becomes more “efficient” (1500 mL/h vs. 700
mL/h non-acclimatized)
Decreased loss of electrolytes (less salt in sweat)
Blood flow to skin is reduced; more blood is
available to muscles
Heart rate more stable, heart stoke volume
increases and blood volume increases
Decreased stress response(s)
Screening Measurements:
Heat Stress/Strain measurements (WBGT) should
be taken prior to work being performed, to allow
for measures to be taken to protect exposed
individuals.
Anticipated workload, work/rest cycle, clothing
should be taken into account in determination.
If work/rest cycle is not constant, time-weighted
average should be used in determination.
 Cooling the body
The body’s cooling system can be likened to the
cooling system of a car.

-Coolant (blood) is circulated through a pump

(heart) and moves heat from the hot inner core
to a radiator (skin surface).
 Temperature Regulation
The hypothalamus is a small organelle within the
brain which adjusts bodily functions through
hormones which:
-Increase heart rate
-Begin the sweating mechanism
-Increase blood flow to the skin surface
 Changes in blood flow
14
skin
12 core
blood flow (L/min)

muscles
10
organs
8

0
cool hot
 How does the body rid itself of
excess heat?
There are 4 means of heat removal from the body.

Convection
Radiation
Evaporation
Conduction
Convection
Convection is the transfer of heat by movements
of air masses.
Air cooling

Hot air rising

Cool air descending

Radiation
Radiation is the outward flow of energy from a
source to the surrounding environment.
Evaporation
Evaporation is the process of a liquid changing
state into a gas. For our discussion, it is the
process where large sweat droplets are reduced
in size and become vapor suspended in air.

Sweat vapor

Sweat droplet
Conduction
Conduction is the process where energy is
transferred between objects through direct
contact.

Hot Cold
Heat loss, cont’d

When the body is cool the majority of heat

escapes from the body by convection (draft
passing over the skin) and radiation (60% heat
loss at cool temperatures; the reason why it’s
important to cover your head in winter)
… BUT …
When under heat stress up to 80% of heat loss
is by evaporation
Heat Sources

It must be remembered that there are two

sources of exposure to heat (external and
internal)
70-80% of muscle expended activity in the body
is changed into heat (rather inefficient) called
metabolic heat
What are the health effects of heat
stress/strain?
Heat Injuries

Heat Rash (prickly heat):

Cause: Heat buildup in the skin due to clogged pores and

sweat ducts. Prolonged skin wetness from sweating.
Symptoms: Area becomes reddened and may itch or
hurt. Skin eruptions.
First Aid: Practice good personal hygiene; keep the skin
clean and the pores unclogged, allow skin to dry, wear
loose clothing, see doctor if rash persists.
Seriousness: Relatively minor.
Heat Injuries
Radiation Burns (Sunburn)

Cause: UV radiation is absorbed by the skin.

Symptoms: Water molecules within skin are disrupted,
leading to drying-out of tissues. Extreme cases involve
blisters, ruptures, and deep-tissue damage.
First Aid: Covering of exposed skin. Use of protective
creams (sunscreen). Bandaging of serious burns.
Seriousness: Minor to relatively serious.
Heat Injuries, cont’d

Transient Heat Fatigue:

Cause: Loss of fluids reduces circulatory

efficiency.
Symptoms: General feeling of tiredness or
fatigue.
First Aid: Fluid replacement and rest.
Seriousness: No long-term adverse effects.
Heat Injuries, cont’d
Heat Syncope:

Cause: the body’s circulation system allows blood to

“pool” in the lower extremities causing insufficient blood,
and oxygen in the brain.
Symptoms: Syncope means “fainting.”
First Aid: Lay victim in a cool location horizontally with
feet elevated. If conscious, give fluids.
Seriousness: Victim may take a day or two to recover.
May subsequently be more sensitive to heat until re-
acclimated.
Heat Injuries, cont’d
Heat Cramps:
Cause: Loss of important electrolytes in the blood and
muscle tissues due to excessive amounts of “salts”
being lost in the victim’s sweat.
Symptoms: Cramping of either voluntary (skeletal)
muscles or involuntary (principally abdominal) muscles
(or both).
First Aid: Replenish electrolytes through drinking of fluids
constituted for this purpose such as Gator-Aide. Rest in
a cool environment.
Seriousness: May debilitate the victim for several days.
Full recovery is necessary before going back into heat
stress conditions.
Heat Injuries, cont’d
Heat Exhaustion:

Cause: Depressed condition of the circulatory system due

for the most part to a lack of adequate fluid replacement
(dehydration). Blood vessels dilate and blood flow is
seriously reduced (clinical condition of shock has
occurred). A victim may be able to take actions that will
alleviate the condition, if the symptoms are recognized
early enough.
Symptoms: Nausea, dizziness, weakness, headache,
blurred vision, profuse sweating, cold/wet (clammy)
grayish skin, unconsciousness, coma and death.
Heat Injuries, cont’d
Heat Exhaustion (continued):

First Aid: Place victim in a face down position in a cool

location, administer fluids if the victim is conscious. If
unconscious, seek medical care or transport to a
medical emergency room.
Seriousness: Shock is a serious medical condition
regardless of the cause of its onset. Victims may
require several days or even weeks to recover. Even
longer periods may be necessary before the victim can
resume working in heat stress conditions.
Heat Injuries, cont’d
Heat Stroke:

Cause: The body’s temperature regulation mechanism,

located in the hypothalamus, fails and sweating stops.
Core body temperature rises dramatically and the
victim’s condition becomes a serious medical
emergency. The victim is unlikely to be able to reverse
the condition without assistance or medical intervention.
Symptoms: Chills, restlessness, irritability, euphoria, red
face and skin, disorientation, hot/dry skin (not always),
collapse, unconsciousness, convulsions and death.
Heat Injuries, cont’d
Heat Stroke (continued):

First Aid: Immediate, aggressive cooling of the victim’s

body using wet cloths, immersion into cool water or
using alcohol wipes. Transport to emergency medical
facility.
Seriousness: Heat Stroke is a MEDICAL EMERGENCY.
Without outside intervention, the victim will die. By the
time the victim realizes s/he is in trouble, it is usually too
late to employ effective self-intervention procedures that
can reverse the thermo-regulatory failure and reduce
core temperatures. Recovery times from heat stroke are
generally the longest of any heat-related disorder.
Heat Injuries, cont’d
Indirect Heat-Related Health Effects:

Reduced Work Performance: tired, fatigued workers perform with

reduced accuracy, efficiency
Increased Accidents: tired, fatigued workers are more susceptible
to accident and injury
Reproductive Problems: heat has been shown to reduce both
male and female fertility and can be a problem for the fetus
Heart/Lung Strain: if you already have heart, lung, kidney or
circulatory problems; heat stress is an added strain on your body
which in severe situation may precipitate serious episodes of
acute problems
Heat effects and people

Heat affects people in different ways. People come

in all different sizes, shapes, and tolerances for
heat.

Some people can work comfortably in high

temperatures, while others will develop sickness
from heat stress/strain
Heat effects, cont’d
Predisposing Factors:
 very small body size
 poor nutrition
 overweight
 over 40 years old (the older the more sensitive)
 previous heat illness
 heart disease
 high blood pressure
 diabetes
 skin disease
 liver, kidney, and lung problems
Heat effects, cont’d
Predisposing Factors, cont’d:
 physical activity
 poor physical condition
 fatigue
 excessive clothing
 dehydration
 being female
 being pregnant
 alcohol, caffeine, nicotine intake
 Sunbathing
Heat effects, cont’d - Drugs
Drugs that interfere with body’s thermo-regulation:
Heat production:
thyroid hormone
amphetamines
TCA’s
LSD
Decrease thirst:
Haldol
Decrease sweating:
antihistamines
anticholinergics
phenothiazines
Benztropine
Control methods
Engineering controls

Administrative controls

Personal protective equipment

Control methods - Engineering
- Use machinery instead of people where
applicable
- Take steps to cool building or worksite
- Use thermal barriers (mylar reflective surfaces)
- More?
Control methods - Administrative
-Conduct training on Heat stress/strain
-Work during coolest part of day
-Co-worker observation
-Implement work/rest schedule
-More?
Control methods - PPE
-Drinking adequate amounts of fluids
-Protective clothing (light colors reflect heat)
-Protective equipment (vests, fans)
-More?
Control methods – PPE, cont’d
Cooling vest
Personal Safeguards
How Much Water is Enough?
More than you want just to satisfy your thirst
Sources of water are:
1. Fluids - 1 cup or 8 oz = 240 mL every 20 min
2. Foods - fruit & veggies are 90% water
Why 10-15°C? … to maximize the amount you
drink (not too cold, not luke warm)
Does it need to be delivered to the work station?
… depends on workplace logistics …
Personal Safeguards, cont’d
What to drink:
Electrolyte drinks (e.g. Gatorade) are usually not
needed for typical North American diet (can be used for
first aid).
Stay away from caffeinated, carbonated, diet drinks,
and alcohol as they take water out of your body.
Water is the best; juices and/or no caffeine sport drinks
are also good (juices contain energy restoring glucose).
Personal Safeguards, cont’d
% weight fluid time* effect & symptoms
loss loss (* timing may vary based on intensity of work
and heat/humidity)

1% 0.75 L 1 hr unnoticed (at 1.5% weight loss you are

considered dehydrated)
2% 1.5 L 2-3 hrs loss of endurance, start to feel thirsty,
feel hot, uncomfortable
3% 2.25 L 3-4 hrs loss of strength, loss of energy,
moderate discomfort
4% 3L 4-5 hrs cramps, headaches, extreme
discomfort
5-6% 3.5-4 L 5-6 hrs heat exhaustion, nausea, faint

7+% 5+ L 7+ hrs heat stroke, collapse,

unconsciousness
Personal Safeguards, cont’d
Fans:

Purpose of a cooling fan is primarily to increase the rate

of sweat evaporation but it also cools by convection if
the air is cooler than the skin
Fan coolers may interfere with local exhaust
ventilation for contaminant control, therefore be careful
in where they are placed
Personal Safeguards, cont’d
Fans, cont’d:
The lower the relative humidity the better the
evaporation the more effective the cooling
If the relative humidity is close to 100% the fan will no
longer increase evaporation of sweat
The closer the air temperature is to skin temperature
(35-36°C) the less effective the cooling
if the air temperature exceeds skin temperature then the fan
may even heat up the body (like a convection oven)!
Protective/Corrective measures
Take readings:
Select a representative spot to place your
thermometer(s) and/or hygrometer
Designate someone to take readings on an hourly
basis (on the hour) and record them
If activities are altered in response to the heat (slow
down, more breaks, water distribution) record the
details including the time and the degree
If heat stress health conditions appear record time
and describe symptoms and situation
Protective/Corrective measures
Things you can check:

Look for typical heat strain symptoms; feeling over-

heated, fatigue, headache, nausea, weakness, dark
concentrated urine, etc.
Sweat that drips off your body no longer allows for
cooling by evaporation; thus, unless there’s another
medical reason for it, this is a sign that your body is
heating up
Check your pulse; heat stress is unlikely if your pulse
rate is under 100 beats per minute after 1 minute rest.
MAKE SURE YOU’RE DRINKING ENOUGH!!!
Thermal Stress – Cold Stress
Cold Stress
Just as high temperatures have far-reaching effects on the
body, cold temperatures present their own challenges to
the thermal regulation of the human body.

Let’s examine what the effects of cold temperatures are,

what health effects cold temperatures present, and
methods for treatment of cold-related injuries.
Normal vs. Hypothermic environment
 Hypothermic environment
As we see, the four causes of heat loss in a
hypothermic environment are convection,
radiation, evaporation, and conduction.

The large difference is that in hypothermic

environments, you are trying to retain heat,
instead of releasing it to the environment.
Body’s cold response
Determining the risk of cold-injuries is done using
the following formula:

Heat Retention + Heat Production > Cold Factors

or
Heat Retention + Heat Production < Cold Factors
Cold Response, cont’d
- Heat Retention:
- Size/shape (Eskimo vs. Masai)
- Insulation (Clothing type/# of layers)
- Fat (Used as insulation)
- Shell (Blood in core of body)

These are positive factors. Increase of any or all of

these factors decreases risk of injury.
Cold Response, cont’d
- Heat Production
- Activity level
- Shivering response
- * Limited by:
- Fitness level
- Nutrition
- Fluid intake
Cold Response, cont’d
Cold Response, cont’d
- Cold Factors:
- Temperature
- Humidity
- Wind

The total of these represents the challenge to the

thermo-regulation of the human body.

If Retention + Production < Cold Factors, Hypothermic

condition could develop.
Hypothermia
“a decrease in the core body temperature to a
level at which normal muscular and neurological
functions are impaired” – Medicine for
Mountaineers

Hypothermia is possible at any temperature

under 98.6 degrees, if the right conditions exist
(lack of insulation, increased heat loss, etc.)
Hypothermia - signs

“Umbles” – Stumbles, Mumbles, Fumbles, and

Grumbles
Shows decreased physical and mental capacity.
Hypothermia - mild
Mild Hypothermia:
- core temperature 98.6 – 96 F
- non-voluntary shivering
-complex motor functions impossible
-vasoconstriction to periphery
Hypothermia - moderate
Moderate Hypothermia:
- core temperature 95 – 93 F
- loss of fine motor coordination
- slurred speech
- violent shivering
- paradoxical undressing
- apathetic attitude
Hypothermia - severe
Severe Hypothermia:
- core temperature 92 – 86 F or below
- shivering in waves (violent then pause)
- person curled in fetal position to conserve heat
- muscle rigidity develops
- pale skin/dilated pupils
- reduced pulse
Hypothermia – severe, cont’d
-at 90 degrees F, the person goes into hibernation,
slowing heart rate and respiration, shunting
blood to peripheral tissues.
-at 86 degrees F or below, the person looks dead,
but is still alive…barely.

Severe Hypothermia is LIFE THREATENING!

Cold Injuries
Although hypothermia is well known, there are
other cold injuries.

-Frostnip
-Frostbite
-Immersion foot (trench foot)
Frostnip
Frostnip is the freezing of upper layers of the skin.

Characterized by:
- white, waxy skin.
- general numbness

Frostnip is generally reversible and does no major

tissue damage.
Frostnip - treatment
Gently warm area by blowing warm air on it or by
placing it near a warm body part.

DO NOT rub the area! Rubbing can rupture frozen

cells, causing extensive damage.

• Frostnip is a warning sign of possible frostbite*

Frostbite
Frostbite is a freezing of the surface and deep
layers of tissue.

Characterized by:
- white, and feels “woody”
- numbness, possible anesthesia
- deep frostbite can affect bone and muscle
- purple/black color is from ruptured blood
vessels
Frostbite – a view
Frostbite - treatment
Immerse affected area in 105 – 110 degree F water
until thawing is complete.
- part will be extremely painful
Wrap affected part in sterile gauze
Affected part should not be used for anything
- keep part from refreezing
Chart
Immersion Foot – trench foot
Immersion foot is caused by prolonged exposure of the
feet to wet, cool conditions.

Characterized by:
- yellowish, smelly feet
- possibly numb
- sloughing of skin tissue/itching

*Immersion foot may cause permanent damage to foot

tissues, leaving person susceptible to cold injuries in
future.
Immersion Foot – a view
Immersion Foot - treatment

- Careful washing and drying of feet.

- Keep feet dry as much as possible.

- Keep off feet as much as possible until healed.

Final Thoughts or Questions?
References
Curtis, Rick. Outdoor Action Program. Princeton University. 1995
Occupational Safety and Health Administration 3154
Occupational Safety and Health Administration 3156
Occupational Health Clinics for Ontario Workers. Heat Stress
Training. 2001
Plog, Barbara A. et al. Fundamentals of Industrial Hygiene. 1996
USAF. Heat Stress Fact Sheet. 1998
www.firstworldwar.com/atoz/trenchfoot.html