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CONCEPT OF HEAT STRESS & HEAT DISORDERS PREVENTION THROUGH PHYSIOLOGY

P.C.GHOSH
DIRECTOR (PHYSIOLOGY&ERGONOMICS), RETIRED

DEFENCE ENCLAVE, AIR FORCE STATION

6th STREET, 5th LANE, 38, MES ROAD
AVADI, CHENNAI-600 055
TEL: (044) 2684 1499, MOB: 09869534184 & 09790972857
Email: ghoshpareshchandra@yahoo.in
pcg_ghosh@rediffmail.com
ghoshpcg@gmail.com

(Opinion expressed in the article is of author)

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GENERAL INTRODUCTION

Heat is one of the major industrial as well as natural problems in our Country. Being the tropical in
nature, major industrial problems are faced on heat front. Man is the homothermous creature. It means
man can neither works in extreme heat nor can survive in extreme cold. It has the capacity to maintain
the body temperature closer to the ambient condition. That is why; man is called the homothermous
creature. Its endured capacity of changing body temperature according to environmental condition has
narrow limits. Beyond this, he can not maintain the homeothermicity hence the level of stress wills starts
increase in human system. When body fails to maintain this increase temperature, thus vassomotortone
of the human system start to gain heat then this stress in human system is called "Heat stress". It is the
state body will pass when most of the physiological function in the body will disturb. This is the state
when man will start committing mistake, reducing the performance capacity, and in long run, various
occupational diseases will on sets in. This situation needs to be addressed immediately irrespective of
any constrain.

THE HUMAN HEAT BALANCE EQUATION:

The human heat balance equation is an important factor that we required to be considered in all
types of working condition in order to sustain our activities. The human heat balance equation is
expressed as follows:
M± R±C−E= ± S
Where
M= Metabolic heat is always plus.
R= Radiant heat either may gain or loss depending on the ambient condition being Represented in plus
or minus.
C = Conductive heat either may gain or loss depending on the Ambient condition being Represented in
plus or minus.
E = Evaporative heat loss always represented by Minus.
S = Storage of Body Heat

In Industries such as mining, steel or glass manufacture, agriculture, and road building, workers
are often exposed to severe environmental heat stress, which may even threaten survival. Hard physical
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work or exercise in hot surroundings is rightly considered the main hazard, for the total heat load on the
body is in fact the sum of environmental and metabolic heat. Physiologists, engineers and doctors have
paid increasing attention to the problem, with the result that much is known about the measurement and
evaluation of three important aspects. These are (a) the components of heat stress – notably metabolic
heat, air temperature, humidity, air movement, and radiant temperature; (b) man’s responses to working
in heat, in terms of body temperature, heart rate, and sweat loss; and (c) the kind of hot conditions that
men tolerate well, not so well, or for strictly limited periods of time only.

The study of these factors is described in its own adopted terms, of which heat stress, heat strain,
tolerance limits, and optimum conditions are examples. The investigation of various industrial heat
problems provides information that is often of no more than local significance. On the other hand, the
research worker’s need for strict control of the environmental and human factors involved in heat stress
was early appreciated, and for many years studies have been conducted in laboratory hot-rooms.
Unfortunately, few texts are available that make a serious attempt to provide Governments, industrial
management, engineers, medical officers, and hygienists with all the information available, expressed in
reasonably understandable language.

In addition, the information available deals almost exclusively with industry in developed countries
and can not be applied without reservations to circumstances in tropical countries. In the tropics, the
worker is expected to cope with the combined effects of industrial and climatic heat – with the probability,
indeed, of having to work hard in hot spaces during an eight-hour shift, and of living for many months at a
stretch without complete relief from heat stress at any time of the day or night. To complicate matters, his
diet may well be inadequate to support him in this ordeal. The need for more quantitative information in
this respect is emphasized and made more urgent by the current industrial development of countries in
the tropical zones. It is the responsibility of governments and industrial managements – and in some
instances of trade unions – to stimulate research into those aspects of the work environment that directly
affect the health, efficiency, and comfort of the work force. Financial support for these studies should be
provided where necessary. Due attention must be given to occupational considerations, such as the
construction of the factory, air conditioning, the engineering control of localized heat sources, the
provision of cool rest rooms, suitable methods and hours of work, the provision of adequate supplies of
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portable water, medical examinations and the provision of certain items of personal protective clothing.
The importance of such matters as adequate housing and diet must also be fully recognized.

MAN’S RESPONSES TO HEAT

Man’s thermoregulatory system is complex, serving the need to maintain thermal equilibrium of the core
tissues of the body within a relatively narrow range of temperatures. If the deep body temperature is to be
maintained in equilibrium, than the amount of heat gained by the body must be equaled by the amount of
heat lost from it. Since the amount of heat involved can vary considerably, depending on the energy
expenditure and the environmental conditions, the mechanisms controlling heat loss must necessarily be
both flexible and efficient. Ultimately, the amount of heat exchanged between the body and its
environment depends on the differences of temperature and of vapour pressure that exist between the
skin and its surroundings. Three mechanisms are involved: (1) Heat is lost from, or gained by, the body
by convection when the air temperature is respectively lower or higher than skin temperature and, as the
air movement increases, so does the rate of convective heat exchange. (2) When the surface
temperature of the surroundings is above or below the skin temperature, radiant heat is gained or lost by
the body. (3) Evaporation of sweat results in the loss of heat from the body; the amount of sweat that can
be evaporated, and hence the efficiency of sweating for cooling, depends on the difference between the
vapour pressure of the environment and that of the skin and is increased as air movement increases. The
coefficients of heat exchange through these three channels have been determined experimentally for
men and can be applied to the calculation of heat gain or loss if the air temperature, the humidity, the
amount of radiant heat and the air speed are known. With the additional knowledge of the metabolic heat
production, a simple arithmetical heat balance can be written: M ± C ± R - E = ± S1 where M represents
metabolic heat production: C, R and E. convective, radiant, and evaporative heat exchanges; and S the
amount of heat stored in the tissues or lost from the tissues with a consequent rise or fall of body
temperature. If the body maintains thermal equilibrium, then S is zero.

These purely physical relationships are in turn affected by the dynamic action of two physiological
mechanisms, namely, those that regulate cardiovascular function and sweating. In addition to changing
the rate of heat transfer from the deep body tissues to the periphery, these two mechanisms can alter
both the temperature of and the vapour pressure on the surface of the skin and thereby influence the rate
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of heat transfer between the body and its environment. These dynamic physiological exchanges cannot
be undertaken without cost to the organism as a whole, and there are many associated physiological
reactions – for example, those affecting salt and water balance and humoral functions – that involve the
thermoregulatory system during exposure to hot climates.

It is to be expected, then, that the physiological strain experienced by a man seated or working in
a hot environment will be related to the total heat stress to which he is exposed. This logical supposition
has been the subject of a good deal of investigation, often with the supplementary aim of constructing a
heat stress scale by which to assess conditions producing equivalent physiological strain; some of these
scales are described below. When attempting to define different metabolic and environmental conditions
that may give rise to the same physiological strain, it is necessary to measure the levels of, or the
changes in, several bodily functions, and it is appropriate to measure those that are the product of
thermoregulation or are intimately associated with it. Obviously, the temperature of the deep tissues of
the body or of the skin must provide some indication of the degree of strain to which the thermoregulatory
system is being subjected. Similarly, the heart rate may be considered a simple and readily observable
indicator of the demands imposed by work and heat load on the circulatory system, and the amount of
sweat produced can reasonably be expected to reflect the heat strain, since the evaporation of sweat
constitutes the body’s main defence against overheating. In fact, it is now generally possible to analyze
the factors responsible for the changes in these functions in response to different levels of metabolic and
environmental stress and to determine which measurements are likely to be most suitable for different
purposes. The ways in which this can be done are described in the section dealing with heat stress
indices. Most investigators attempt to measure two or more of the physiological functions and to integrate
them into a single index of the heat strain in any given set of circumstances. This is a wise procedure,
since thermoregulation, so simple in concept, is a highly complicated mechanism and since it appears
that its component functions may be affected differently, depending on the circumstances of climatic heat
stress and metabolic activity Nevertheless, it may not always be feasible, at the work site, to make
reliable measurements of all relevant factors simultaneously. Not infrequently, however, there is a need
to examine one or other of these factors, either separately or together. It is worthwhile to discuss the
implications of each of these measurements in turn, and to decide whether, in practice, they provide a
reliable indication of whether or not an individual is suffering over-strain during a given exposure to heat.
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Naturally, most of the data available have been derived from experimental laboratory
investigations. There is insufficient information about the industrial situation. It is highly desirable that this
state of affairs be rectified, particularly as there are many practical features of the industrial situation that
may affect the thermoregulatory responses observed in experimental studies. For example, there is a
dearth of information concerning the metabolic rates of industrial workers in many tropical countries,
where body weights are substantially lower than in Europe and the USE; too little is known also about the
extent to which the state of nutrition and health and variations in economic, technical or housing
conditions may influence physiological responses to industrial heat exposures. There are also a number
of personal factors, some of which are known to influence thermoregulation. It is necessary to discuss
some of those factors before considering the specific physiological measurements.

DISORDERS OF HEAT STRESS

When a person is exposes to heat at the on set of stress one’s skin temperature is starts
increasing. Increase skin temperature induces to peripheral vasoconstriction which in turn resulted to
inadequate supply to vital organs. The reduced supply to vital organs result heat exhaustion to
individuals. This is the first heat disorder though a minor person tends to ignore because it do not affect
activities or other operations. If not attended and continued to expose to heat then consequently
vasodilatation sets in due to intended increase core body temperature. This vasodilatation induces to
sweating. Sweating will results loss of water from body causing dehydration to individual. Dehydration is
serious if not attended. Along with body water vital electrolytes is also lost during profussed sweating
causing a specific painful muscular spasm resulting severe pain in calf muscle. This is called Heat cramp.
If not address properly then further vasodilatations continued to compensate increase core body
temperature thus a layers of salts deposited over skin. The sweating tends to reduce deposited salts
cause itching to affected are this sate is known as heat rush The deposition of salts. Blocks the sweat
gland’s pore and finally sweating stops, skin become dry encouraging to quick jump of core body
temperature in quick suxation of time. This ones is call red alert that the person is entering to a state
develops in body which is known as heat stroke. In most of the cases heat stroke is fatal only in some
exceptional cases of medical alerts one can survive. Thus we can see that the heat discords such as
heat exhaustion, Dehydration, Heat cramp and Heat rush or prickly heat can be treated on shop floor
whereas the heat stroke and dehydration can not be address on shop floor. These needs most
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sophisticated expensive hospital facilities to cope with such cases successfully. Heat strains are quick in
suxation to develop that is why one must be care full to manage such cases. A critical review is given in
Fig-1

Figure 1 ILL EFFECTS OF HEAT

Heat Stress

Rise in Skin- Circulatory and

Temperature vasomotor Heat syncope
instability

Vasodilatatio
Salt depletion Heat Cramps

Further Salt-depletion
vasodilatation Water depletion heat exhaustion
and sweating

Water–depletion
Fatigue of
Sweating
Heat exhaustion
sweating reduced

An-hydrotic heat
Skin disorders Rise in core exhaustion
temperature

Cessation of Heat stroke

sweating

EVALUATION OF WORK PLACE.

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The evaluation of work place is done by measuring four basic physical parameters. These are
namely, dry bulb, wet bulb, and globe temperatures by using sling psychrometer and globe
thermometer respectively. The air velocity of the area will be measure by using the "Kata
thermometer". Once all the physical measurements are done then all these parameters are combine
into various physiological indices of heat namely, effective Temperature in 0 c (ET), Corrected
Effective Temperature in 0c, Wet-Bulb-Globe Temperature Index in 0c(WBGT),
INDICESES OF HEAT STRESS
Routine use
(1) Effective Temperature (ET) o C: It is the feeling of sensation of warmth in any given combination of
dry & wet bulb temperature, with respect of air velocity in reference to still saturated environment. The
safe limits of ET is ≤ 30 0 C in any working environment.

o
(2) Corrected Effective Temperature (CET) C: It is the feeling of sensation of warmth in any given
combination of dry & wet bulb temperature, with respect to air velocity in reference to still saturated
environment. When it is corrected by replacing dry bulb temperature with globe temperature then it is
known as CET. Both the indices are derived by British school of thought. It is logical, systematic,
simple to use in field thus become most popular tool for heat stress evaluation around the world. The
safe limits of CET is ≤ 29 0 C in any working environment.

(3) WET-BULB-GLOBE TEMPERATURE INDEX (WBGT) oC: The wetted average was used by
American school of thought to simplify further then ET&CET which involved deep knowledge of
English & rationality etc. The WBGT index for indoor & out door was computed as follows.
0
WBGT (Out door) C = 0.7WB + 0.2GT + 0.1DB
0
WBGT (In door) C = 0.7WB + 0.3DB

For all practical purpose one should use WBGT out Door condition rather then in door. It is simple,
reliable and easy to calculate. The safe limits of WBGT (out Door) condition is ≤ 31 0 C in any working
environment.
Complicated Indices
Predicted four hour sweat rate (P4 SR)
It is the predicted amount of sweat would have been excreted from body if one exposed himself in
high heat stress where body’s metabolic heat has been considered thus making one of the most
complicated and accurate for industrial application. The safe limit of P4 SR is 2.5 to 3 lits of sweat per
four hours in any working environment. In such situations all muscular activity has to be suspended.
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Belding & Hatch Or Heat stress indices (HSI): It is further complicated heat stress indices considering
metabolic as well as evaporative heat loss from body thus making one of the most potentially strong
indices of heat. It is expressed as units’. Thus safe limits of Belding & Hatch index is 24 units for
industrial application. Predicted Four-Hour-Sweat rate in lit per 4 hours (P 4SR), Belding and Hatch
Index in units (HIS) etc. All these physiological indices of heat are useful to any industrial setup and
can be used safely for routine evaluation of any industrial setup. Among all those indices, the P4SR
and the Belding & Hatch index are the two indices where the metabolic heat is also considered in
addition to all other factors. Thus, these indices are superior then other indices in terms of all points
evaluation, objectively, and decesicevely. Daily, routine, application ET, CET, and WBGT (i) are the
choice of industrial application, whereas the P4SR and HSI are the choice of Industrial dispute,
judicial dispute in addition to Industrial research. There are many other indices of heat stress, which
has the specific application in Industrial processes like the "Oxford Index" (OD), which are preferred
indices for application to textile mills as hot & humid environment.

One of the main interests of Physiologist during the post second world war was the
development of thermal physiology in relation to industrial application. The development of thermal
physiology has greatly increase the potential of taking the knowledge of physiology in industry as a
tool for higher productivity, Lower accident rate, and lower occupational diseases in shop floor. We
have achieved number of milestones in this direction however; more is needed to be done for total
control of such industrial hazard.
CONTROL OF HEAT STRESS IN INDUSTRY.
The concept of controlling of heat stress is one of the most important phenomenon in any
industrial setup where hot process is to be carried out. The main action in this direction is divided into
two parts. One is engineering control and other is physiological control. In some cases both are to be
applied if situation is grave. The control of heat is being done by applying of engineering techniques
mainly because of complexity of problems as well as permanent solution of the problems.

ENGINEERING CONCEPT OF CONTROLING HEAT STRESS:

(1). Control the source of heat by redesigning the layout so that the maximum heat is being Reflected
back to the processes keeping the working area comparably cool.

(2) Using the heat barrier material such as calcium silicate slab, which is cheap, reliable economical,
easy to maintain for absorbing maximum heat so that the operational Area is under control.
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(3). The closed system processes should be encouraged for controlling dissipation of heat to
surrounding area so that other factors can be kept under control.

(4) Semi mechanization, partial mechanization, and full automation etc should be explored as and
when required as because these options are expensive, investment oriented not much popular
among industry.

(4) Robotizing the operations should be encouraged for protecting the human being from excessive
exposure to heat. Many industry especially automobile are using successfully the robot for all
repetitive operations in hot climate

PHYSIOLOGICAL CONCEPT OF CONTROLING HEAT STRESS.

(1). The workers will have to be provided with heat resistance garment for protecting skin and Heat
burn through extremely good quality of personal protective Equipment.

(2), The workers will have to be encouraged frequently to drink cold water at 22 to 230 C periodically
for reducing body Temperature fast. The water source should be provided closed to their work place.

(3) The workers will be provided water-cooled jacket for absorbing body heat so that the endurance
time of the workers will be increase as operation is in progresses.

(4) The restoration of electrolyte balance is a must if found absolutely needed by under physicians
supervision. In Indian context it was found the requirement of salt is low compare to westerners.

(5) Air-cooled rest room should be provided to workers for taking rest after every heat processes
operation.

(6) Rest allowance should be provided to workers in exceptional cases as last resort measure if no
other branch of science can contribute to control the situation to satisfactory levels of safety.
The control measures thus taken in shop floor will ensure the safety, health, and the
productivity of industrial workers will be ensured. Thus, one such act will ensure the safety,
productivity, and the health of workers. The benefit of such control measures goes to both the
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employees and the employers. The benefit of the workers is health, safety, and long productive
working period, whereas the benefit of the management is higher productivity, lower accident
compensation, lower administrative cost and more saving on medical expense etc. Thus, for mutual
benefit this action is required to be taken in shop floor. Some suggested books are also
recommended for further reading for the readers. Further correspondence can be with author if need
be.

FURTHER READING.
1. C. S. Leathead & A. R. Lind: Heat stress and heat disorders. Cassella London, 1964.
2. NIOH Occupational exposure to hot environment. National institute of occupational safety &
health. DHHS (NIOSH) publication, 1986.
3. Parson K.C. Human response to thermal environment Principles & methods in J. R.Wilson & E. N.
corlett (edit) Evaluation of human Work. Taylor & Francis London, 1990.
4. Stammers R.B. Curry M. S., Asttay J. A. Task analysis In J. R .wilson, & E.N. corlett Evaluation Of
human work. Taylor & Francis, London, 1990.
5. Health factors involve in working under condition of Heat stress. Technical report No-412, WHO,
Geneva, 1969.
6. Youle A. Collins K. J. Rockford G. Fisherman D. Person K. C. and Skyes J. The thermal
Environment BOHS Technical guide No-8 Scientific reviews LTD, 1990
7. Stolwijk J.A.J. & Hardy J. D. Control of body temperature in hand book of Physiology, Section –
9, reaction to environmental Agents,Bathesda, Maryland, American Physiological society, pp-45-
68, 1977.
8. Wordsworth P.M. Person KC laboratory evaluation of ISO/DIS 7933 analytical Determination Of
heat stress in J. D .Oberneo (Ed). Contemporary ergonomics, Taylor & Francis, London. PP-193-
197, 1983.
9. Voget J.J. Candas V, Libert J. R. Dalt F, Required sweat Rate as an index of thermal Strain in
Industry in K. cena, and J. A. Clark (edi) Bioengineering & thermal physiology And comfort.
Elsevier, Amsterdam PP- 99-110, 1981.
10. Lumbach K.H. Physiological tests and evaluations Model for the optimization of the Performance
of prospective clothing In I.B. Mekjavic, E.W. Banister & J.B. Morrison (Edi) Environmental
Ergonomics, Taylor & Francis, 1988.
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QUESTION PAPER & ANSWAR

01. What is human heat balance equation?

Ans: M ± R ± C – E = ± S

02. Enumerate all factors

Ans: M= Metabolic Heat, R= Radiant Heat, C= Conductive Heat, E = Evaporative Heat loss,
S = Storage of Body Heat

03. What are the basic Measurements you do to evaluate heat stress in an working environment?

Ans: Minimum these four basic measurements are require to measure. (1) Dry Bulb Temperature0 C
(2,) Wet Bulb Temperature0 C.( 3) Globe Temperatures 0 C, ( 4). Air Velocity in ft.min-1

04. What is Effective Temperature?

Ans: It is a Scale of feeling of sensation of warmth in different combination of Dry & wet Bulb & air
velocity of working area. ( It is the British School of Thought)

05. What is Corrected Effective Temperature?

Ans: It is modified scale of effective temperature by considering globe temperature which effects
one’s physiological state during heat exposure significantly. Since it is a correction of Effective
temperature it is termed as corrected effective Temperature superior then effective temperature scale