Associations between heat exposure, vigilance, and balance performance in summer tree fruit harvesters

Spector, June T.; Krenz, Jennifer; Calkins, Miriam; Ryan, Dawn M.; Carmona, Jose; Pan, Mengjie; Zemke, Anna; Sampson, Paul D.

doi:10.1016/j.apergo.2017.09.002

Cited by 19 publications

(21 citation statements)

References 30 publications

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“…In certain industrial agricultural settings, workers reported that they do not feel that they are allowed by their supervisors to take extra breaks, rest, or drink water and prefer to take less time for rest and hydration in order to maximize earnings (Lam et al 2013). Interestingly, the prevalence of estimated core body temperatures above 38.5°C for at least one minute was approximately 10% in our subsistence agricultural population, which is a lower prevalence of heat strain than was reported in studies in commercial agricultural settings in more temperate climates (Spector et al 2018). Though subsistence agricultural workers in tropical settings may experience different pressures than industrial agricultural workers, such as pressure to sow fields before annual rains, more flexibility in daily work organization may contribute to resilience to heat exposure.…”

Section: Discussioncontrasting

confidence: 60%

Association between work in deforested, compared to forested, areas and human heat strain: an experimental study in a rural tropical environment

Suter

Miller

Anggraeni

et al. 2019

Environ. Res. Lett.

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Background: With climate change, adverse human health effects caused by heat exposure are of increasing public health concern. Forests provide beneficial ecosystem services for human health, including local cooling. Few studies have assessed the relationship between deforestation and heat-related health effects in tropical, rural populations. We sought to determine whether deforested compared to forested landscapes are associated with increased physiological heat strain in a rural, tropical environment. Methods: We analyzed data from 363 healthy adult participants from ten villages who participated in a two-by-two factorial, randomized study in East Kalimantan, Indonesia from 10/1/17 to 11/6/17. Using simple randomization, field staff allocated participants equally to different conditions to conduct a 90-minute outdoor activity, representative of typical work. Core body temperature was estimated at each minute during the activity using a validated algorithm from baseline oral temperatures and sequential heart rate data, measured using chest band monitors. We used linear regression models, clustered by village and with a sandwich variance estimator, to assess the association between deforested versus forested conditions and the number of minutes each participant spent above an estimated core body temperature threshold of 38.5°C. Results: Compared to those in the forested condition (n=172), participants in the deforested condition (n=159) spent an average of 3.08 (95% CI 0.57, 5.60) additional minutes with an estimated core body temperature exceeding 38.5°C, after adjustment for age, sex, body mass index, and experiment start time, with a larger difference among those who began the experiment after 12 noon (5.17 [95% CI 2.20, 8.15]). Conclusions: In this experimental study in a tropical, rural setting, activity in a deforested versus a forested setting was associated with increased objectively measured heat strain. Longer durations of hyperthermia can increase the risk of serious health outcomes. Land use decisions should consider the implications of deforestation on local heat exposure and health as well as on forest services, including carbon storage functions that impact climate change mitigation.

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Section: Discussioncontrasting

confidence: 60%

Association between work in deforested, compared to forested, areas and human heat strain: an experimental study in a rural tropical environment

Suter

Miller

Anggraeni

et al. 2019

Environ. Res. Lett.

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“…Two large-scale epidemiological studies on heat-related illness and mortality (which were not included in our meta-analyses) reported that workplace environmental heat stress is responsible for 13-36 deaths per year in the USA alone. 113,120 It is important to note that seven 67,74,85,87,94,132,135 of the 47 studies excluded in our metaanalyses showed no effect of workplace environmental heat stress on the prevalence of heat-related illness or health outcomes. Most of the 111 studies included in this systematic review suggest that working in hot conditions (WGBT >22°C for very intense work; WBGT >25°C for most occupations) increases the likelihood of experiencing occupational heat strain, with significant detrimental effects on health and productivity.…”

Section: Discussionmentioning

confidence: 84%

“…For meta-analyses five and six, GRADE analysis revealed that the true effect is likely to be substantially different from the estimate of effect (very low confidence). Most (68%) 4,6,26,[33][34][35][39][40][41][42][43]45,46,[50][51][52][53][54][55]56,57, of the included studies incorporated low risk for selection bias, with the remaining studies presenting selection bias that was non-applicable (10%), 36, unclear (16%), 37,[47][48][49]118,[127][128][129][130][131][132] or, in some cases, high risk (6%) 5,38,44,133 due to acrossgroup variation in inclusion or exclusion criteria, and across-group differences in participant recruitment or selection. Most (61%) of the included studies incorporated low risk for confounding factors bias, with the remaining studies presenting confounding factor bias that was unclear (16%) 6 ,26,36,38,60,62,63,67,80,84,85,92,98-100,102,105,107-111,113,114,134-136 or high risk (23%) 33 ,35,37,44,45,47,49,59,66,74,83,86,89,91,94,96,118,127,128,132…”

Section: Resultsmentioning

confidence: 99%

Workers' health and productivity under occupational heat strain: a systematic review and meta-analysis

Flouris

Dinas

Ioannou

et al. 2018

The Lancet Planetary Health

295

233

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Background Occupational heat strain (ie, the effect of environmental heat stress on the body) directly threatens workers' ability to live healthy and productive lives. We estimated the effects of occupational heat strain on workers' health and productivity outcomes. Methods Following PRISMA guidelines for this systematic review and meta-analysis, we searched PubMed and Embase from database inception to Feb 5, 2018, for relevant studies in any labour environment and at any level of occupational heat strain. No restrictions on language, workers' health status, or study design were applied. Occupational heat strain was defined using international health and safety guidelines and standards. We excluded studies that calculated effects using simulations or statistical models instead of actual measurements, and any grey literature. Risk of bias, data extraction, and sensitivity analysis were performed by two independent investigators. Six random-effects meta-analyses estimated the prevalence of occupational heat strain, kidney disease or acute kidney injury, productivity loss, core temperature, change in urine specific gravity, and odds of occupational heat strain occurring during or at the end of a work shift in heat stress conditions. The review protocol is available on PROSPERO, registration number CRD42017083271. Findings Of 958 reports identified through our systematic search, 111 studies done in 30 countries, including 447 million workers from more than 40 different occupations, were eligible for analysis. Our meta-analyses showed that individuals working a single work shift under heat stress (defined as wet-bulb globe temperature beyond 22•0 or 24•8°C depending on work intensity) were 4•01 times (95% CI 2•45-6•58; nine studies with 11 582 workers) more likely to experience occupational heat strain than an individual working in thermoneutral conditions, while their core temperature was increased by 0•7°C (0•4-1•0; 17 studies with 1090 workers) and their urine specific gravity was increased by 14•5% (0•0031, 0•0014-0•0048; 14 studies with 691 workers). During or at the end of a work shift under heat stress, 35% (31-39; 33 studies with 13 088 workers) of workers experienced occupational heat strain, while 30% (21-39; 11 studies with 8076 workers) reported productivity losses. Finally, 15% (11-19; ten studies with 21 721 workers) of individuals who typically or frequently worked under heat stress (minimum of 6 h per day, 5 days per week, for 2 months of the year) experienced kidney disease or acute kidney injury. Overall, this analysis include a variety of populations, exposures, and occupations to comply with a wider adoption of evidence synthesis, but resulted in large heterogeneity in our meta-analyses. Grading of Recommendations, Assessment, Development and Evaluation analysis revealed moderate confidence for most results and very low confidence in two cases (average core temperature and change in urine specific gravity) due to studies being funded by industry. Interpretation Occupational heat strain has importan...

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“…Diurnal patterns have also been observed in vigilance and balance research, where performance was worse in early morning tests. In field studies with agricultural workers in WA State, Spector et al (59) observed significantly longer mean reaction time and a greater number of lapses measured using a psychomotor vigilance test (PVT) as well as longer mean total path length, a measure of postural sway, in pre-shift assessments (ie, prior to a mean shift start time of 06:00 hours). Further research should investigate specific tasks and associated metabolic heat production throughout the work shift, construct task-related injury risk factor profiles by time of day, and better characterize vigilance and postural sway within workers over time and between workers.…”

Section: Discussionmentioning

confidence: 99%

A case-crossover study of heat exposure and injury risk among outdoor construction workers in Washington State

Calkins

Bonauto²,

Hajat³

et al. 2019

Scand J Work Environ Health

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We report methods for using high resolution meteorological data to assess the risk of adverse occupational heat health outcomes and provide insight into construction industry-specific occupational and individual risk factors for heat-related traumatic injuries. The results of this study suggest the need for heat-related injury prevention interventions and awareness at lower heat exposures than have previously been recommended.

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Associations between heat exposure, vigilance, and balance performance in summer tree fruit harvesters

Cited by 19 publications

References 30 publications

Association between work in deforested, compared to forested, areas and human heat strain: an experimental study in a rural tropical environment

Association between work in deforested, compared to forested, areas and human heat strain: an experimental study in a rural tropical environment

Workers' health and productivity under occupational heat strain: a systematic review and meta-analysis

A case-crossover study of heat exposure and injury risk among outdoor construction workers in Washington State

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