Protective clothing ensembles are worn by workers as a barrier to chemical and physical hazards, but can restrict heat loss and increase worker heat stress. The question of whether a respirator adds to heat stress or strain burden is a continuing concern among occupational health professionals. The purpose of this study was to determine if there are differences in heat stress or strain among the current Toxicological Agent Protective (TAP) ensemble and two ensemble variations used in demilitarization of chemical weapons. Four acclimatized adult males wore five ensembles in a balanced design while walking in a climatic chamber at a metabolic rate of about 170 W m-2. Heat stress (critical wet bulb globe temperature-WBGTcrit, evaporative resistance-Re,T,a, Clothing Adjustment Factor [CAF]) and heat strain (physiological strain index [PSI]) were compared against work clothes (WC) without respirator (a baseline ensemble); the current TAP apron over cloth coveralls with respirator (TAP+CA); the current TAP apron over cloth coveralls with respirator plus Tychem F® chemical barrier pants (TAP+CA+P); and Tychem F® Coveralls over cloth coveralls with respirator (VB+CA). A no-respirator comparison with the Tychem F coveralls (VB+CA-noR) was added to evaluate the contribution of a full-face negative pressure air-purifying respirator to heat stress. A progressive heat stress protocol was used to determine WBGTcrit, Re,T,a, CAF, and PSI. The results (WBGTcrit [°C-WBGT], Re,T,a [kPa m2 W-1], and PSI) were WC (35.5, 0.0112, 2.0), TAP (31.6, 0.0175, 1.8), TAP+P (27.7, 0.0240, 1.9), VB+CA (25.9, 0.0287, 1.8), and VB+CA-noR (26.2, 0.0293, 1.8). Mixed effects ANOVA was used to assess ensemble effects. Tukey's test was used to determine where significant differences occurred. WBGTcrit was the WBGT at the upper limit of thermal balance. Re,T,a increased while WBGTcrit progressively decreased going from WC to TAP+CA to TAP+CA+P to VB+CA. WBGTcrit was different between Work Clothes and TAP+CA and between WC and TAP+CA and the other ensembles. Re,T,a was different among all ensembles, except no differences in WBGTcrit and Re,T,a were observed between the presence and absence of a respirator with VB+CA. There were no differences among all ensembles for rectal temperature, heart rate, and PSI. Based on both WBGTcrit and Re,T,a, there were significant increases in heat stress going from WC to TAP+CA to TAP+CA+P to VB+CA. No differences in WBGTcrit, Re,T,a, and PSI were found for the presence or absence of a respirator, indicating no additional heat stress or strain burden. CAF is the WC WBGTcrit minus the ensemble WBGTcrit.. The recommended clothing adjustment factors (CAFs) are 0°C-WBGT for WC, 4 °C-WBGT for TAP+CA, 8 °C-WBGT for TAP+CA+P and 10 °C-WBGT for VB+CA. As vapor-barrier ensembles are sensitive to humidity, adding 2 °C-WBGT to VA+CA for a CAF of 12 °C-WBGT is recommended. This implicates the type of protective clothing ensemble worn will play a much bigger role in workplace heat stress effects and risk than the wear of a respirator.

Motivation: The South-African deep level gold mining industry has adapted in many ways, as the pursuit for gold has led deep into the earth core, where rock face temperatures measure around 60°C. Ventilation adapted through engineering developments like refrigeration systems, creating cooler work environments to an extent. Despite these developments the risks of high ambient temperatures coupled with strenuous work and dehydration remains, leading to alternative methods of control that have to indicate whether employees have the necessary functional capacity to perform daily work tasks. Objectives: The objectives of this study were: to measure and compare the physiological effects of the tasks performed by workers in an underground mining environment; To measure the soundness of heart rate as a gauge of work stress in real-life work conditions, taking into account the stressors that influence it; to determine the efficacy of functional and physical work capacity assessments as a method of determining work readiness. Methods: A study group (n = 16) was chosen to represent the “most exposed” work population, all of whom have previously passed the functional work capacity and physical work capacity assessments. The assessments were repeated and the maximal oxygen uptake assessment was done. The participants were divided into two groups (n = 8) according to their work areas. Measurements were taken over a period of eight consecutive shifts. Each group was later divided into three groups as per the work they performed. Dehydration was determined through urine analysis and body weight changes. Heart rate was observed continuously through a heart rate monitor and oral temperature was measured on an hourly basis. Results: The shift durations seen during this study were much longer than the customary 8-hour work day. The mean HR results of group I, which was suspected of having the most strenuous work, were very similar to the results for group II and III. This group did, however, have the highest % heart rate ≥ 120 beats per minute and mean cumulative heart beats, group III having the lowest. All of the groups were found to be mildly dehydrated at the end of their shifts, the urine specific gravity indicating that the participants were generally already considerably dehydrated at the onset of the shifts. Group I was the only group whose mean heart rate had a statistically significant correlation (r ≥ 0.5) with % weight loss. There was a statistically significant (p ≤ 0.05) correlation between heart rate and mean oral temperature for all of the groups. The participants that passed the functional work capacity and physical work capacity assessments were found to have performed comparatively better during the real-time shifts than those that failed. Conclusions: Although there were several employees that had a high mean maximum heart rate, none of the mean heart rates were higher than the self-pacing rate of 110 beats per minute. This ability of self- pacing was seen in the way the participants were able to manage energy expenditure by alternating between heavy and lighter tasks. A great concern is the fact that all of the participants had a % weight loss (0.9 – 2.8% weight loss) indicative of mild dehydration after the shifts, on top of morning urine specific gravity samples (1.020 – 1.025) showing signs of considerable dehydration. Several correlations were found between the functional work capacity and physical work capacity assessments and maximum temperature, maximum heart rate and maximal oxygen uptake, suggesting a significant relationship between the real life situation and the homogenous laboratory setting. comparing the employees that passed the functional work capacity and physical work capacity assessment to those that failed, a marked difference was seen in their respective performances. The groups that passed had a lower mean heart rate and maximum heart rate and higher maximal oxygen uptake. It may, therefore, be concluded that the functional work capacity and physical work capacity assessments provide a valid evaluation of an individual’s work capacity and potential to cope with the varying demands of underground work. / Thesis (MSc (Occupational Hygiene))--North-West University, Potchefstroom Campus, 2013.

Motivation: The South-African deep level gold mining industry has adapted in many ways, as the pursuit for gold has led deep into the earth core, where rock face temperatures measure around 60°C. Ventilation adapted through engineering developments like refrigeration systems, creating cooler work environments to an extent. Despite these developments the risks of high ambient temperatures coupled with strenuous work and dehydration remains, leading to alternative methods of control that have to indicate whether employees have the necessary functional capacity to perform daily work tasks. Objectives: The objectives of this study were: to measure and compare the physiological effects of the tasks performed by workers in an underground mining environment; To measure the soundness of heart rate as a gauge of work stress in real-life work conditions, taking into account the stressors that influence it; to determine the efficacy of functional and physical work capacity assessments as a method of determining work readiness. Methods: A study group (n = 16) was chosen to represent the “most exposed” work population, all of whom have previously passed the functional work capacity and physical work capacity assessments. The assessments were repeated and the maximal oxygen uptake assessment was done. The participants were divided into two groups (n = 8) according to their work areas. Measurements were taken over a period of eight consecutive shifts. Each group was later divided into three groups as per the work they performed. Dehydration was determined through urine analysis and body weight changes. Heart rate was observed continuously through a heart rate monitor and oral temperature was measured on an hourly basis. Results: The shift durations seen during this study were much longer than the customary 8-hour work day. The mean HR results of group I, which was suspected of having the most strenuous work, were very similar to the results for group II and III. This group did, however, have the highest % heart rate ≥ 120 beats per minute and mean cumulative heart beats, group III having the lowest. All of the groups were found to be mildly dehydrated at the end of their shifts, the urine specific gravity indicating that the participants were generally already considerably dehydrated at the onset of the shifts. Group I was the only group whose mean heart rate had a statistically significant correlation (r ≥ 0.5) with % weight loss. There was a statistically significant (p ≤ 0.05) correlation between heart rate and mean oral temperature for all of the groups. The participants that passed the functional work capacity and physical work capacity assessments were found to have performed comparatively better during the real-time shifts than those that failed. Conclusions: Although there were several employees that had a high mean maximum heart rate, none of the mean heart rates were higher than the self-pacing rate of 110 beats per minute. This ability of self- pacing was seen in the way the participants were able to manage energy expenditure by alternating between heavy and lighter tasks. A great concern is the fact that all of the participants had a % weight loss (0.9 – 2.8% weight loss) indicative of mild dehydration after the shifts, on top of morning urine specific gravity samples (1.020 – 1.025) showing signs of considerable dehydration. Several correlations were found between the functional work capacity and physical work capacity assessments and maximum temperature, maximum heart rate and maximal oxygen uptake, suggesting a significant relationship between the real life situation and the homogenous laboratory setting. comparing the employees that passed the functional work capacity and physical work capacity assessment to those that failed, a marked difference was seen in their respective performances. The groups that passed had a lower mean heart rate and maximum heart rate and higher maximal oxygen uptake. It may, therefore, be concluded that the functional work capacity and physical work capacity assessments provide a valid evaluation of an individual’s work capacity and potential to cope with the varying demands of underground work. / Thesis (MSc (Occupational Hygiene))--North-West University, Potchefstroom Campus, 2013.

Assessment of heat strain considers an individual's tolerance and indicates the risk and physiological cost of working in hot environments. This study evaluated the discrimination ability of metrics of heat strain. The null hypotheses were that (1) the metrics individually could not discriminate between acceptable and unacceptable heat strain, (2) there were no significant differences among these metrics, and (3) there were no significant differences in the applicability of the metrics due to clothing or heat stress level. The experimental design was a case crossover. Clothing and heat stress level were potential confounders. Two clothing ensembles were work clothes and vapor-barrier coveralls with hood. Two heat stress levels for a moderate metabolic rate were 5°C-WBGT and 10°C-WBGT above the Threshold Limit Value adjusted for clothing. Eight male and four female acclimated individuals (age 18-36 years) participated. Four experimental trials were randomized in sequence. The transition point, when a participant's status changed from control (acceptable heat strain) to case (unacceptable), was the first occurrence of rectal temperature equal to or greater than 38.5°C, heart rate equal to or greater than 90% of maximum, or volitional fatigue. The metrics were rectal, ear canal, oral, and disk temperatures, heart rate including moving time averages of 5, 10, 20, 30 and 45 minutes, recovery heart rate, and physiological strain index. The data at the transition point were the case data; the data 10 minutes prior to that point were the control data. Analyses used primarily receiver operating characteristic (ROC) curves, which indicated the ability to distinguish acceptable from unacceptable heat strain. Further analyses included factorial analysis of variance and exact conditional logistic regression. Based on the ROC curve analyses, the physiological metrics can distinguish between acceptable and unacceptable heat strain with average area under the curves between 0.529 and 0.861. While there were no differences among the metrics based on the 95% confidence intervals of the areas under the curve, the results were compromised by low power. Based on ANOVA and logistic regression, clothing did not influence the metrics. There were insufficient data to evaluate the role of heat stress level.

Ebola, a type of filovirus that causes hemorrhagic fevers, dominated global headlines in 2014 when the largest Ebola epidemic in history took place in West Africa. Healthcare practitioners were at particular risk of contracting Ebola while taking care of patients with the disease because they were easily exposed to bodily fluids such as blood, urine, saliva, and feces, quite often in the intensive care unit (ICU). While personal protective equipment (PPE) protects the healthcare practitioner by providing an effective barrier against the virus, users were also at risk for heat stress because of the type of protective clothing. In this study, coveralls made of monolithic barriers, which prevent water vapor from escaping the suit, were compared to coveralls made of micro- porous material, which allows evaporated sweat to escape the suit. The Microgard® 2000 TS Plus, made of micro-porous barrier material and the monolithic barrier Microgard® 2300 Plus were compared against a control ensemble of work clothes consisting of a long-sleeve shirt and trouser. A progressive heat stress protocol was used to determine the critical environment at the upper limit of compensable heat stress. The critical condition was the point at which the heat gain caused by wearing the protective ensemble as well as dry heat exchange was balanced by the maximum heat loss due to evaporative cooling. Wet bulb globe temperature at the critical condition (WBGTcrit ) ,total evaporative resistance (Re,T,a), and clothing adjustable factor (CAF) were calculated for each ensemble based on data at the critical point. Also at the critical condition, participant rectal temperature vi (Tre) , heart rate (HR), skin temperature (Tsk), and physiological strain index (PSI) were noted and compared for each ensemble. A two-way ANOVA (ensemble x participant) for WBGTcrit and Re,T,a as dependent variables was used to determine whether or not there were differences among ensembles. Tukey’s honest significance test was used to determine where significant differences occurred. WBGTcrit was 33.8, 26.3, and 22.9 °C-WBGT for Work Clothes, M2000, and M2300 respectively. Re,T,a was 0.012, 0.031, and 0.054 kPa m2 W-1 for WC, M2000, and M2300 respectively. The higher the WBGTcrit for an ensemble, the more it can support evaporative cooling and hence the better it is at ameliorating heat stress. Based on this trial, the micro-porous ensemble Microgard® 2000 TS Plus has better heat stress performance than vapor-barrier Microgard® 2300 Plus. As expected, there were no differences for any of the physiological metrics at the critical conditions.