Screening criteria for increased susceptibility to heat stress during work or leisure in hot environments in healthy individuals aged 31-70 years

Andreas D Flouris; Ryan McGinn; Martin P Poirier; Jeffrey C Louie; Leonidas G Ioannou; Lydia Tsoutsoubi; Ronald J Sigal; Pierre Boulay; Stephen G Hardcastle; Glen P Kenny

doi:10.1080/23328940.2017.1381800

Screening criteria for increased susceptibility to heat stress during work or leisure in hot environments in healthy individuals aged 31-70 years

Temperature (Austin). 2017 Dec 18;5(1):86-99. doi: 10.1080/23328940.2017.1381800. eCollection 2018.

Authors

Andreas D Flouris^{1

2}, Ryan McGinn², Martin P Poirier², Jeffrey C Louie², Leonidas G Ioannou¹, Lydia Tsoutsoubi¹, Ronald J Sigal^{2

3

4}, Pierre Boulay⁵, Stephen G Hardcastle⁶, Glen P Kenny^{2

4}

Affiliations

¹ FAME Laboratory, Department of Exercise Science, University of Thessaly, Trikala, Greece.
² Human and Environmental Physiological Research Unit, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ontario, Canada.
³ Departments of Medicine, Cardiac Sciences, and Community Health Sciences, Faculties of Medicine and Kinesiology, University of Calgary, Calgary, Canada.
⁴ Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.
⁵ Faculty of Physical Activity Sciences, Department of Human Kinetics, University of Sherbrooke, Sherbrooke, Canada.
⁶ BBE Consulting Canada, 1 Serpentine St., Copper Cliff, Ontario, Canada.

Abstract

Population aging and global warming generate important public health risks, as older adults have increased susceptibility to heat stress (SHS). We defined and validated sex-specific screening criteria for SHS during work and leisure activities in hot environments in individuals aged 31-70 years using age, anthropometry, and cardiorespiratory fitness. A total of 123 males and 44 females [44 ± 14 years; 22.9 ± 7.4% body fat; 40.3 ± 8.6 peak oxygen uptake (mlO₂/kg/min)] participated, separated into the Analysis (n = 111) and Validation (n = 56) groups. Within these groups, participants were categorized into YOUNG (19-30 years; n = 47) and OLDER (31-70 years; n = 120). All participants performed exercise in the heat inside a direct calorimeter. Screening criteria for OLDER participants were defined from the Analysis group and were cross-validated in the Validation group. Results showed that 30% of OLDER individuals in the Analysis group were screened as SHS positive. A total of 274 statistically valid (p < 0.05) criteria were identified suggesting that OLDER participants were at risk for SHS when demonstrating two or more of the following (males/females): age ≥ 53.0/55.8 years; body mass index ≥29.5/25.7 kg/m²; body fat percentage ≥ 28.8/34.9; body surface area ≤2.0/1.7 m²; peak oxygen uptake ≤48.3/41.4 mlO₂/kg fat free mass/min. In the Validation group, McNemar χ² comparisons confirmed acceptable validity for the developed criteria. We conclude that the developed criteria can effectively screen individuals 31-70 years who are at risk for SHS during work and leisure activities in hot environments and can provide simple and effective means to mitigate the public health risks caused by heat exposure.

Keywords: ROC curve; elderly; heat stress; hyperthermia; prevention; standards; thermal strain; workplace.

Grants and funding

This study was funded in part by the Canadian Institutes of Health Research (286363) and the Workplace Safety and Insurance Board (Ontario) (10001) (grants held by Glen P. Kenny). G.P. Kenny was supported by a University Research Chair. M.P. Poirier was supported by an NSERC Canada Alexander Graham Bell Graduate Scholarship (CGS-D). A.D. Flouris, L.G. Ioannou, and L. Tsoutsoubi were supported by funding from the European Union's Horizon 2020 research and innovation programme under the grant agreement No 668786. All experimental trials were conducted at the Human and Environmental Physiology of the University of Ottawa.