Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA.
Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
Am J Ind Med. 2021 Apr;64(4):258-265. doi: 10.1002/ajim.23230. Epub 2021 Feb 4.
As global temperatures rise, increasing numbers of individuals will work in hot environments. Interventions to protect their health are critical, as are reliable methods to measure the physiological strain experienced from heat exposure. The physiological strain index (PSI) is a measure of heat strain that relies on heart rate and core temperature but is challenging to calculate in a real-world occupational setting.
We modified the PSI for use in field settings where resting temperature and heart rate are not available and used the modified physiological strain index (mPSI) to describe risk factors for high heat strain (mPSI ≥ 7) experienced by agricultural workers in Florida during the summers of 2015 through 2017. mPSI was calculated for 221 workers, yielding 465 days of data.
A higher heat index (β = 0.185; 95% CI: 0.064, 0.307) and higher levels of physical activity at work (0.033; 95% CI: 0.017, 0.050) were associated with a higher maximum mPSI. More years worked in US agriculture (-0.041; 95% CI: -0.061, -0.020) were protective against a higher maximum mPSI. Out of 23 workdays that a participant experienced a maximum mPSI ≥ 7, 22 were also classified as strained by at least one other measure of high heat strain (core temperature [Tc] >38.5°C, sustained heart rate >(180 - age), and mean heart rate > 115 bpm).
This study provides critical information on risk factors for elevated heat strain for agricultural workers and suggests a practical approach for using PSI in field-based settings.
随着全球气温的上升,越来越多的人将在高温环境中工作。保护他们健康的干预措施至关重要,同时还需要可靠的方法来衡量因暴露于热环境而产生的生理压力。生理压力指数(PSI)是衡量热应激的一种方法,它依赖于心率和核心温度,但在现实的职业环境中很难计算。
我们修改了 PSI,使其可用于现场环境,在现场环境中无法获得休息时的温度和心率,但我们使用改良的生理压力指数(mPSI)来描述佛罗里达州农业工人在 2015 年至 2017 年夏季经历的高热应激(mPSI≥7)的危险因素。我们为 221 名工人计算了 mPSI,得到了 465 天的数据。
较高的热指数(β=0.185;95%置信区间:0.064,0.307)和工作时较高的体力活动水平(0.033;95%置信区间:0.017,0.050)与较高的最大 mPSI 相关。在美国农业工作的年限较长(-0.041;95%置信区间:-0.061,-0.020)可预防最大 mPSI 升高。在 23 个工人经历最大 mPSI≥7 的工作日中,有 22 个也被至少另一种高热应激的衡量标准(核心温度[Tc]>38.5°C,持续心率>(180-年龄),和平均心率>115 bpm)判定为紧张。
本研究为农业工人的高温应激升高的危险因素提供了重要信息,并提出了一种在现场环境中使用 PSI 的实用方法。