Background: The aim of the study was to investigate the effect of a simulated heat-wave on the labour productivity and physiological strain experienced by workers. Methods: Seven males were confined for ten days in controlled ambient conditions. A familiarisation day was followed by three (pre, during, and post-heat-wave) 3-day periods. During each day volunteers participated in a simulated work-shift incorporating two physical activity sessions each followed by a session of assembly line task. Conditions were hot (work: 35.4 °C; rest: 26.3 °C) during, and temperate (work: 25.4 °C; rest: 22.3 °C) pre and post the simulated heat-wave. Physiological, biological, behavioural, and subjective data were collected throughout the study. Results: The simulated heat-wave undermined human capacity for work by increasing the number of mistakes committed, time spent on unplanned breaks, and the physiological strain experienced by the participants. Early adaptations were able to mitigate the observed implications on the second and third days of the heat-wave, as well as impacting positively on the post-heat-wave period. Conclusions: Here, we show for first time that a controlled simulated heat-wave increases workers’ physiological strain and reduces labour productivity on the first day, but it promotes adaptations mitigating the observed implications during the subsequent days.

Climate change is expected to exacerbate heat stress at the workplace in temperate regions, such as Slovenia. It is therefore of paramount importance to study present and future summer heat conditions and analyze the impact of heat on workers. A set of climate indices based on summer mean (Tmean) and maximum (Tmax) air temperatures, such as the number of hot days (HD: Tmax above 30 °C), and Wet Bulb Globe Temperature (WBGT) were used to account for heat conditions in Slovenia at six locations in the period 1981–2010. Observed trends (1961–2011) of Tmean and Tmax in July were positive, being larger in the eastern part of the country. Climate change projections showed an increase up to 4.5 °C for mean temperature and 35 days for HD by the end of the twenty-first century under the high emission scenario. The increase in WBGT was smaller, although sufficiently high to increase the frequency of days with a high risk of heat stress up to an average of a third of the summer days. A case study performed at a Slovenian automobile parts manufacturing plant revealed non-optimal working conditions during summer 2016 (WBGT mainly between 20 and 25 °C). A survey conducted on 400 workers revealed that 96% perceived the temperature conditions as unsuitable, and 56% experienced headaches and fatigue. Given these conditions and climate change projections, the escalating problem of heat is worrisome. The European Commission initiated a program of research within the Horizon 2020 program to develop a heat warning system for European workers and employers, which will incorporate case-specific solutions to mitigate heat stress.Electronic supplementary materialThe online version of this article (10.1007/s00484-018-1530-6) contains supplementary material, which is available to authorized users.

New Findings What is the central question of this study?Controlled‐hyperthermia heat‐acclimation protocols induce an array of thermoregulatory and cardiovascular adaptations that facilitate exercise in hot conditions. We investigated whether this ergogenic potential can be transferred to thermoneutral normoxic or hypoxic exercise conditions. What is the main finding and its importance?We showed that heat acclimation did not affect maximal cardiac output or maximal aerobic power in thermoneutral normoxic or hypoxic conditions. Heat acclimation augmented the sweating response in thermoneutral normoxic conditions. The cross‐adaptation theory, according to which heat acclimation could facilitate hypoxic exercise capacity, is not supported by our data. Abstract Heat acclimation (HA) mitigates heat‐induced decrements in maximal aerobic power (V̇O2 peak ) and augments exercise thermoregulatory responses in the heat. Whether this beneficial effect of HA is observed in hypoxic or thermoneutral conditions remains unresolved. We explored the effects of HA on cardiorespiratory and thermoregulatory responses to exercise in normoxic, hypoxic and hot conditions. Twelve men [V̇O2 peak 54.7(standard deviation 5.7) ml kg−1 min−1] participated in a HA protocol consisting of 10 daily 90‐min controlled‐hyperthermia (target rectal temperature, Tre = 38.5°C) exercise sessions. Before and after HA, we determined V̇O2 peak in thermoneutral normoxic (NOR), thermoneutral hypoxic (fractional inspired O2 = 13.5%; HYP) and hot (35°C, 50% relative humidity; HE) conditions in a randomized and counterbalanced order. Preceding each maximal cycling test, a 30‐min steady‐state exercise bout at 40% of the NOR peak power output was used to evaluate thermoregulatory responses. Heat acclimation induced the expected adaptations in HE: reduced Tre and submaximal heart rate, enhanced sweating response and expanded plasma volume. However, HA did not affect V̇O2 peak or maximal cardiac output (P = 0.61). The peak power output was increased post‐HA in NOR (P < 0.001) and HE (P < 0.001) by 41 ± 21 and 26 ± 22 W, respectively, but not in HYP (P = 0.14). Gross mechanical efficiency was higher (P = 0.004), whereas resting Tre and sweating thresholds were lower (P < 0.01) post‐HA across environments. Nevertheless, the gain of the sweating response decreased (P = 0.05) in HYP. In conclusion, our data do not support a beneficial cross‐over effect of HA on V̇O2 peak in normoxic or hypoxic conditions.

Monitoring core body temperature (Tc) during training and competitions, especially in a hot environment, can help enhance an athlete’s performance, as well as lower the risk for heat stroke. Accordingly, a noninvasive sensor that allows reliable monitoring of Tc would be highly beneficial in this context. One such novel non-invasive sensor was recently introduced onto the market (CORE, greenTEG, Rümlang, Switzerland), but, to our knowledge, a validation study of this device has not yet been reported. Therefore, the purpose of this study was to evaluate the validity and reliability of the CORE sensor. In Study I, 12 males were subjected to a low-to-moderate heat load by performing, on two separate occasions several days apart, two identical 60-min bouts of steady-state cycling in the laboratory at 19 °C and 30% relative humidity. In Study II, 13 males were subjected to moderate-to-high heat load by performing 90 min of cycling in the laboratory at 31 °C and 39% relative humidity. In both cases the core body temperatures indicated by the CORE sensor were compared to the corresponding values obtained using a rectal sensor (Trec). The first major finding was that the reliability of the CORE sensor is acceptable, since the mean bias between the two identical trials of exercise (0.02 °C) was not statistically significant. However, under both levels of heat load, the body temperature indicated by the CORE sensor did not agree well with Trec, with approximately 50% of all paired measurements differing by more than the predefined threshold for validity of ≤ 0.3 °C. In conclusion, the results obtained do not support the manufacturer’s claim that the CORE sensor provides a valid measure of core body temperature.

We examined the effects of acclimatization to normobaric hypoxia on aerobic performance and exercise thermoregulatory responses under normoxic, hypoxic and hot conditions. Twelve males performed tests of maximal oxygen uptake (V̇O) in normoxic (NOR), hypoxic (13.5% FO; HYP) and hot (35℃, 50% RH; HE) conditions in a randomized manner before and after a 10-day continuous normobaric hypoxic exposure (FO = 13.65(0.35)%, PO = 87(3) mmHg). The acclimatization protocol included daily exercise (60min @ 50% hypoxia-specific peak power output, W). All maximal tests were preceded by a steady-state exercise (30 min at 40% W) to assess the sweating response. Hematological data were assessed from venous blood samples obtained before and after acclimatization. V̇O increased by 10.7% (P = 0.002) and 7.9% (P = 0.03) from pre- to post-acclimatization in NOR and HE, respectively, whereas no differences were found in HYP (pre: 39.9(3.8) vs post: 39.4(5.1) mL.kg.min, P = 1.0). However, the increase in V̇O did not translate into increased W in either NOR or HE. Maximal heart rate and ventilation remained unchanged following acclimatization. Νo differences were noted in the sweating gain and thresholds independent of the acclimatization or environmental conditions. Hypoxic acclimatization markedly increased hemoglobin (P < 0.001), hematocrit (P < 0.001) and extracellular HSP72 (P = 0.01). These data suggest that 10 days of normobaric hypoxic acclimatization combined with moderate-intensity exercise training improves V̇O in NOR and HE, but does not seem to affect exercise performance or thermoregulatory responses in any of the tested environmental conditions.

Occupational heat strain is a public health threat, and for outdoor industries there is a direct influence from elevated environmental temperatures during heat waves. However, the impact in indoor settings is more complex as industrial heat production and building architecture become factors of importance. Therefore, this study evaluated effects of heat waves on manufacturing productivity. Production halls in a manufacturing company were instrumented with 33 dataloggers to track air temperature and humidity. In addition, outdoor thermal conditions collected from a weather station next to the factory and daily productivity evaluated as overall equipment efficiency (OEE) were obtained, with interaction between productivity and thermal conditions analyzed before, during, and after four documented heat waves (average daily air temperature above 24°C on at least three consecutive days). Outdoor (before: 21.3° ± 4.6°C, during: 25.5° ± 4.3°C, and after: 19.8° ± 3.8°C) and indoor air temperatures (before: 30.4° ± 1.3°C, during: 32.8° ± 1.4°C, and after: 30.1° ± 1.4°C) were significantly elevated during the heat waves (p &lt; 0.05). OEE was not different during the heat waves when compared with control, pre-heat-wave, and post-heat-wave OEE. Reduced OEE was observed in 3-day periods following the second and fourth heat wave (p &lt; 0.05). Indoor workers in settings with high industrial heat production are exposed to a significant thermal stress that may increase during heat waves, but the impact on productivity cannot be directly derived from outdoor factors. The significant decline in productivity immediately following two of the documented heat waves could relate to a cumulative effect of the thermal strain experienced during work combined with high heat stress in the recovery time between work shifts.

Moderate‐intensity exercise sessions are incorporated into heat‐acclimation and hypoxic‐training protocols to improve performance in hot and hypoxic environments, respectively. Consequently, a training effect might contribute to aerobic performance gains, at least in less fit participants. To explore the interaction between fitness level and a training stimulus commonly applied during acclimation protocols, we recruited 10 young males of a higher (more fit‐MF, peak aerobic power [VO2peak]: 57.9 [6.2] ml·kg−1·min−1) and 10 of a lower (less fit‐LF, VO2peak: 41.7 [5.0] ml·kg−1·min−1) fitness level. They underwent 10 daily exercise sessions (60 min@50% peak power output [Wpeak]) in thermoneutral conditions. The participants performed exercise testing on a cycle ergometer before and after the training period in normoxic (NOR), hypoxic (13.5% FiO2; HYP), and hot (35°C, 50% RH; HE) conditions in a randomized and counterbalanced order. Each test consisted of two stages; a steady‐state exercise (30 min@40% NOR Wpeak to evaluate thermoregulatory function) followed by incremental exercise to exhaustion. VO2peak increased by 9.2 (8.5)% (p = .024) and 10.2 (15.4)% (p = .037) only in the LF group in NOR and HE, respectively. Wpeak increases were correlated with baseline values in NOR (r = −.58, p = .010) and HYP (r = −.52, p = .018). MF individuals improved gross mechanical efficiency in HYP. Peak sweat rate increased in both groups in HE, whereas MF participants activated the forehead sweating response at lower rectal temperatures post‐training. In conclusion, an increase in VO2peak but not mechanical efficiency seems probable in LF males after a 10‐day moderate‐exercise training protocol.

Objectives: To provide perspectives from the HEAT-SHIELD project (www.heat-shield.eu): a multinational, inter-sectoral, and cross-disciplinary initiative, incorporating twenty European research institutions, as well as occupational health and industrial partners, on solutions to combat negative health and productivity effects caused by working on a warmer world. Methods: In this invited review, we focus on the theoretical and methodological advancements developed to combat occupational heat stress during the last five years of operation. Results: We outline how we created climate forecast models to incorporate humidity, wind and solar radiation to the traditional temperature-based climate projections, providing the basis for timely, policyrelevant, industry-specific and individualized information. Further, we summarise the industry-specific guidelines we developed regarding technical and biophysical cooling solutions considering effectiveness, cost, sustainability, and the practical implementation potential in outdoor and indoor settings, in addition to field-testing of selected solutions with time-motion analyses and biophysical evaluations. All recommendations were adjusted following feedback from workshops with employers, employees, safety officers, and adjacent stakeholders such as local or national health policy makers. The cross-scientific approach was also used for providing policy-relevant information based on socioeconomic analyses and identification of vulnerable regions considered to be more relevant for political actions than average continental recommendations and interventions. Discussion: From the HEAT-SHIELD experiences developed within European settings, we discuss how this inter-sectoral approach may be adopted or translated into actionable knowledge across continents where workers and societies are affected by escalating environmental temperatures.