A Comprehensive Systematic Review of Heat Stress Assessment Questionnaires in Workplace Environments: The Gaps and Recommendations
Heat Stress Assessment Questionnaires
-
Mohammad Javad SheikhMozafari
,
Farideh Golbabaei
,
Ali Mohsenian
,
Soqrat Omari Shekaftik
,
Jamal Biganeh
Abstract
Background: Heat stress is considered one of the harmful factors in workplace environments, and prolonged exposure beyond recommended levels can adversely affect workers’ health. Various methods have been proposed to assess heat stress. Questionnaires are among the most important subjective tools, gaining popularity among researchers due to their ease of use and non-intrusiveness for workers. Nonetheless, a comprehensive questionnaire that covers all aspects of heat stress and is recognized as a standard tool by international organizations has not yet been fully established. This study aims to review existing questionnaires used to assess heat stress in workplace environments and compare their various dimensions from 2010 to 2022.
Methods: First, relevant keywords were extracted. Then, using the chosen search strategy, searches were conducted in the PubMed and Web of Science databases, considering inclusion and exclusion criteria. After thoroughly reviewing the extracted articles (448 in total), 11 articles were selected for final analysis
Results: The dimensions of “individuals’ perceptions of workplace environmental conditions” and “workload” were included in most studies (8 studies). In contrast, the dimension “availability of work guidelines in hot environments” was mentioned in only one study. Some questions were not categorized within the identified dimensions and were therefore grouped under a “miscellaneous” category.
Conclusion: The review of questionnaires revealed that none fully covered all aspects of heat stress in workplace environments, likely due to the multifactorial and complex nature of heat stress. These findings suggest a need for the development of a more comprehensive and standardized questionnaire to provide a complete assessment of heat stress.
1. Messeri A, Morabito M, Bonafede M, Bugani M, Levi M, Baldasseroni A, et al. Heat stress perception among native and migrant workers in Italian industries—case studies from the construction and agricultural sectors. Int J Environ Res Public Health. 2019;16(7):1090.
2. Pogačar T, Žnidaršič Z, Kajfež Bogataj L, Flouris AD, Poulianiti K, Črepinšek Z. Heat waves occurrence and outdoor workers’ self-assessment of heat stress in Slovenia and Greece. Int J Environ Res Public Health. 2019;16(4):597.
3. Watts N, Amann M, Ayeb-Karlsson S, Belesova K, Bouley T, Boykoff M, et al. The Lancet Countdown on health and climate change: from 25 years of inaction to a global transformation for public health. Lancet. 2018;391(10120):581–630.
4. Bonafede M, Levi M, Pietrafesa E, Binazzi A, Marinaccio A, Morabito M, et al. Workers’ perception heat stress: results from a pilot study conducted in Italy during the COVID-19 pandemic in 2020. Int J Environ Res Public Health. 2022;19(13):8196.
5. Dehghan H, Mortzavi SB, Jafari MJ, Maracy MR. Development and validation of a questionnaire for preliminary assessment of heat stress at workplace. J Res Health Sci. 2015;15(3):175–81.
6. Mutwedu V, Nyongesa A, Oduma J, Kitaa J, Mbaria J. Thermal stress causes oxidative stress and physiological changes in female rabbits. J Therm Biol. 2021;95:102780.
7. Flouris AD, Dinas PC, Ioannou LG, Nybo L, Havenith G, Kenny GP, et al. Workers’ health and productivity under occupational heat strain: a systematic review and meta-analysis. Lancet Planet Health. 2018;2(12):e521–31.
8. Zamanian Z, Sedaghat Z, Hemehrezaee M, Khajehnasiri F. Evaluation of environmental heat stress on physiological parameters. J Environ Health Sci Eng. 2017;15(1):1–8.
9. Tewari S, Vinay D. Workplace heat stress and its effect on worker’s health employed in glass manufacturing unit. In: Technology Enabled Ergonomic Design. Springer; 2022. p. 491–500.
10. de Lima CZ, Buzan JR, Moore FC, Baldos ULC, Huber M, Hertel TW. Heat stress on agricultural workers exacerbates crop impacts of climate change. Environ Res Lett. 2021;16(4):044020.
11. Dehghan Sh MS, Jafari MJ, Meraci MR, Khavanin A. Designing and investigating content validity and reliability of a questionnaire for preliminary assessment of heat stress at workplace. Health Syst Res. 2011;7(2):0.
12. Xiang J, Hansen A, Pisaniello D, Bi P. Workers’ perceptions of climate change related extreme heat exposure in South Australia: a cross-sectional survey. BMC Public Health. 2016;16:549.
13. Venugopal V, Rekha S, Manikandan K, Latha PK, Vennila V, Ganesan N, et al. Heat stress and inadequate sanitary facilities at workplaces—an occupational health concern for women? Glob Health Action. 2016;9:31945.
14. Dehghan H, Habibi E, Habibi P, Maracy MR. Validation of a questionnaire for heat strain evaluation in women workers. Int J Prev Med. 2013;4(6):631.
15. Messeri A, Morabito M, Bonafede M, Bugani M, Levi M, Baldasseroni A, et al. Heat stress perception among native and migrant workers in Italian industries—case studies from the construction and agricultural sectors. Int J Environ Res Public Health. 2019;16(7).
16. Nunfam VF, Afrifa-Yamoah E, Adusei-Asante K, Van Etten EJ, Frimpong K, Mensah IA, et al. Construct validity and invariance assessment of the social impacts of occupational heat stress scale (SIOHSS) among Ghanaian mining workers. Sci Total Environ. 2021;771:144911.
17. Yazdanirad S, Foroushani AR, Monazzam MR, Dehghan H, Golbabaei F. Development of an observational-perceptual heat strain risk assessment (OPHSRA) index and its validation. BMC Public Health. 2021;21(1):2323.
18. Flouris AD, Ioannou LG, Notley SR, Kenny GP. Determinants of heat stress and strain in electrical utilities workers across North America as assessed by means of an exploratory questionnaire. J Occup Environ Hyg. 2022;19(1):12–22.
19. Hunt AP. Heat strain, hydration status, and symptoms of heat illness in surface mine workers [dissertation]. Brisbane: Queensland Univ Technol; 2011.
20. Cui W, Cao G, Park JH, Ouyang Q, Zhu Y. Influence of indoor air temperature on human thermal comfort, motivation and performance. Build Environ. 2013;68:114–22.
21. Nunfam VF, Adusei-Asante K, Van Etten EJ, Oosthuizen J, Frimpong K. Social impacts of occupational heat stress and adaptation strategies of workers: a narrative synthesis of the literature. Sci Total Environ. 2018;643:1542–52.
22. International Organization for Standardization. Ergonomics of the thermal environment—assessment of the influence of the thermal environment using subjective judgement scales. ISO. Geneva, Switzerland; 1995.
23. Lucas RA, Bodin T, García-Trabanino R, Wesseling C, Glaser J, Weiss I, et al., editors. Heat stress and workload associated with sugarcane cutting—an excessively strenuous occupation! Ext Physiol Med. 2015.
24. Park J. The role of base-layer cooling conditions in human error occurrences during doffing of personal protective equipment in health care. Int J Occup Saf Ergon. 2022;28(2):1016–24.
25. Davey SL, Lee BJ, Robbins T, Randeva H, Thake CD. Heat stress and PPE during COVID-19: impact on healthcare workers’ performance, safety and well-being in NHS settings. J Hosp Infect. 2021;108:185–8.
26. Smith DL, Haller J, Lefferts WK, Hultquist EM, Fehling PC. PPE, heat stress, and cardiac strain: a study. Fire Eng. 2015;168:41–7.
27. Mohammadyan M, Sepehr P. Design of cool spot and assessment of its effect on WBGT index among furnace workers’ position in Shimi Madani industry in Hamadan. J Mazandaran Univ Med Sci. 2010;20(76):2–7.
28. Meng X, Lv Y, Yang H, Wang Y. The cooling effect of a spray fan in an indoor hot environment. Indoor Built Environ. 2021;30(6):851–8.
29. Horie S. Prevention of heat stress disorders in the workplace. JMAJ. 2013;56(3):186–92.
30. Mazlomi A, Golbabaei F, Farhang Dehghan S, Abbasinia M, Mahmoud Khani S, Ansari M, et al. The influence of occupational heat exposure on cognitive performance and blood level of stress hormones: a field study report. Int J Occup Saf Ergon. 2017;23(3):431–9.
31. Tawatsupa B, Yiengprugsawan V, Kjellstrom T, Seubsman S-a, Sleigh A, Thai Cohort Study Team. Heat stress, health and well-being: findings from a large national cohort of Thai adults. BMJ Open. 2012;2(6):e001396.
32. Lan L, Wargocki P, Wyon DP, Lian Z. Effects of thermal discomfort in an office on perceived air quality, SBS symptoms, physiological responses, and human performance. Indoor Air. 2011;21(5):376–90.
33. Karthick S, Kermanshachi S, Pamidimukkala A, editors. Impact analysis of heat on physical and mental health of construction workforce. Int Conf Transp Dev (ICTD); 2022.
34. Yi W, Chan AP. Effects of heat stress on construction labor productivity in Hong Kong: a case study of rebar workers. Int J Environ Res Public Health. 2017;14(9):1055.
35. Umar T, Egbu C, editors. Heat stress, a hidden cause of accidents in construction. Proc Inst Civ Eng–Munic Eng. 2020.
36. Davies M, Guenther B, Leavy J, Mitchell T, Tanner T. Climate change adaptation, disaster risk reduction and social protection: complementary roles in agriculture and rural growth? IDS Work Pap. 2009;2009(320):1–37.
37. Kjellstrom T, Briggs D, Freyberg C, Lemke B, Otto M, Hyatt O. Heat, human performance, and occupational health: a key issue for the assessment of global climate change impacts. Annu Rev Public Health. 2016;37:97–112.
38. Venugopal V, Chinnadurai J, Lucas R, Vishwanathan V, Rajiva A, Kjellstrom T. The social implications of occupational heat stress on migrant workers engaged in public construction: a case study from Southern India. Int J Constr Environ. 2016;7(2).
39. Yamazaki F. Effectiveness of exercise-heat acclimation for preventing heat illness in the workplace. J UOEH. 2013;35(3):183–92.
2. Pogačar T, Žnidaršič Z, Kajfež Bogataj L, Flouris AD, Poulianiti K, Črepinšek Z. Heat waves occurrence and outdoor workers’ self-assessment of heat stress in Slovenia and Greece. Int J Environ Res Public Health. 2019;16(4):597.
3. Watts N, Amann M, Ayeb-Karlsson S, Belesova K, Bouley T, Boykoff M, et al. The Lancet Countdown on health and climate change: from 25 years of inaction to a global transformation for public health. Lancet. 2018;391(10120):581–630.
4. Bonafede M, Levi M, Pietrafesa E, Binazzi A, Marinaccio A, Morabito M, et al. Workers’ perception heat stress: results from a pilot study conducted in Italy during the COVID-19 pandemic in 2020. Int J Environ Res Public Health. 2022;19(13):8196.
5. Dehghan H, Mortzavi SB, Jafari MJ, Maracy MR. Development and validation of a questionnaire for preliminary assessment of heat stress at workplace. J Res Health Sci. 2015;15(3):175–81.
6. Mutwedu V, Nyongesa A, Oduma J, Kitaa J, Mbaria J. Thermal stress causes oxidative stress and physiological changes in female rabbits. J Therm Biol. 2021;95:102780.
7. Flouris AD, Dinas PC, Ioannou LG, Nybo L, Havenith G, Kenny GP, et al. Workers’ health and productivity under occupational heat strain: a systematic review and meta-analysis. Lancet Planet Health. 2018;2(12):e521–31.
8. Zamanian Z, Sedaghat Z, Hemehrezaee M, Khajehnasiri F. Evaluation of environmental heat stress on physiological parameters. J Environ Health Sci Eng. 2017;15(1):1–8.
9. Tewari S, Vinay D. Workplace heat stress and its effect on worker’s health employed in glass manufacturing unit. In: Technology Enabled Ergonomic Design. Springer; 2022. p. 491–500.
10. de Lima CZ, Buzan JR, Moore FC, Baldos ULC, Huber M, Hertel TW. Heat stress on agricultural workers exacerbates crop impacts of climate change. Environ Res Lett. 2021;16(4):044020.
11. Dehghan Sh MS, Jafari MJ, Meraci MR, Khavanin A. Designing and investigating content validity and reliability of a questionnaire for preliminary assessment of heat stress at workplace. Health Syst Res. 2011;7(2):0.
12. Xiang J, Hansen A, Pisaniello D, Bi P. Workers’ perceptions of climate change related extreme heat exposure in South Australia: a cross-sectional survey. BMC Public Health. 2016;16:549.
13. Venugopal V, Rekha S, Manikandan K, Latha PK, Vennila V, Ganesan N, et al. Heat stress and inadequate sanitary facilities at workplaces—an occupational health concern for women? Glob Health Action. 2016;9:31945.
14. Dehghan H, Habibi E, Habibi P, Maracy MR. Validation of a questionnaire for heat strain evaluation in women workers. Int J Prev Med. 2013;4(6):631.
15. Messeri A, Morabito M, Bonafede M, Bugani M, Levi M, Baldasseroni A, et al. Heat stress perception among native and migrant workers in Italian industries—case studies from the construction and agricultural sectors. Int J Environ Res Public Health. 2019;16(7).
16. Nunfam VF, Afrifa-Yamoah E, Adusei-Asante K, Van Etten EJ, Frimpong K, Mensah IA, et al. Construct validity and invariance assessment of the social impacts of occupational heat stress scale (SIOHSS) among Ghanaian mining workers. Sci Total Environ. 2021;771:144911.
17. Yazdanirad S, Foroushani AR, Monazzam MR, Dehghan H, Golbabaei F. Development of an observational-perceptual heat strain risk assessment (OPHSRA) index and its validation. BMC Public Health. 2021;21(1):2323.
18. Flouris AD, Ioannou LG, Notley SR, Kenny GP. Determinants of heat stress and strain in electrical utilities workers across North America as assessed by means of an exploratory questionnaire. J Occup Environ Hyg. 2022;19(1):12–22.
19. Hunt AP. Heat strain, hydration status, and symptoms of heat illness in surface mine workers [dissertation]. Brisbane: Queensland Univ Technol; 2011.
20. Cui W, Cao G, Park JH, Ouyang Q, Zhu Y. Influence of indoor air temperature on human thermal comfort, motivation and performance. Build Environ. 2013;68:114–22.
21. Nunfam VF, Adusei-Asante K, Van Etten EJ, Oosthuizen J, Frimpong K. Social impacts of occupational heat stress and adaptation strategies of workers: a narrative synthesis of the literature. Sci Total Environ. 2018;643:1542–52.
22. International Organization for Standardization. Ergonomics of the thermal environment—assessment of the influence of the thermal environment using subjective judgement scales. ISO. Geneva, Switzerland; 1995.
23. Lucas RA, Bodin T, García-Trabanino R, Wesseling C, Glaser J, Weiss I, et al., editors. Heat stress and workload associated with sugarcane cutting—an excessively strenuous occupation! Ext Physiol Med. 2015.
24. Park J. The role of base-layer cooling conditions in human error occurrences during doffing of personal protective equipment in health care. Int J Occup Saf Ergon. 2022;28(2):1016–24.
25. Davey SL, Lee BJ, Robbins T, Randeva H, Thake CD. Heat stress and PPE during COVID-19: impact on healthcare workers’ performance, safety and well-being in NHS settings. J Hosp Infect. 2021;108:185–8.
26. Smith DL, Haller J, Lefferts WK, Hultquist EM, Fehling PC. PPE, heat stress, and cardiac strain: a study. Fire Eng. 2015;168:41–7.
27. Mohammadyan M, Sepehr P. Design of cool spot and assessment of its effect on WBGT index among furnace workers’ position in Shimi Madani industry in Hamadan. J Mazandaran Univ Med Sci. 2010;20(76):2–7.
28. Meng X, Lv Y, Yang H, Wang Y. The cooling effect of a spray fan in an indoor hot environment. Indoor Built Environ. 2021;30(6):851–8.
29. Horie S. Prevention of heat stress disorders in the workplace. JMAJ. 2013;56(3):186–92.
30. Mazlomi A, Golbabaei F, Farhang Dehghan S, Abbasinia M, Mahmoud Khani S, Ansari M, et al. The influence of occupational heat exposure on cognitive performance and blood level of stress hormones: a field study report. Int J Occup Saf Ergon. 2017;23(3):431–9.
31. Tawatsupa B, Yiengprugsawan V, Kjellstrom T, Seubsman S-a, Sleigh A, Thai Cohort Study Team. Heat stress, health and well-being: findings from a large national cohort of Thai adults. BMJ Open. 2012;2(6):e001396.
32. Lan L, Wargocki P, Wyon DP, Lian Z. Effects of thermal discomfort in an office on perceived air quality, SBS symptoms, physiological responses, and human performance. Indoor Air. 2011;21(5):376–90.
33. Karthick S, Kermanshachi S, Pamidimukkala A, editors. Impact analysis of heat on physical and mental health of construction workforce. Int Conf Transp Dev (ICTD); 2022.
34. Yi W, Chan AP. Effects of heat stress on construction labor productivity in Hong Kong: a case study of rebar workers. Int J Environ Res Public Health. 2017;14(9):1055.
35. Umar T, Egbu C, editors. Heat stress, a hidden cause of accidents in construction. Proc Inst Civ Eng–Munic Eng. 2020.
36. Davies M, Guenther B, Leavy J, Mitchell T, Tanner T. Climate change adaptation, disaster risk reduction and social protection: complementary roles in agriculture and rural growth? IDS Work Pap. 2009;2009(320):1–37.
37. Kjellstrom T, Briggs D, Freyberg C, Lemke B, Otto M, Hyatt O. Heat, human performance, and occupational health: a key issue for the assessment of global climate change impacts. Annu Rev Public Health. 2016;37:97–112.
38. Venugopal V, Chinnadurai J, Lucas R, Vishwanathan V, Rajiva A, Kjellstrom T. The social implications of occupational heat stress on migrant workers engaged in public construction: a case study from Southern India. Int J Constr Environ. 2016;7(2).
39. Yamazaki F. Effectiveness of exercise-heat acclimation for preventing heat illness in the workplace. J UOEH. 2013;35(3):183–92.
| Files | ||
| Issue | Vol 15 No 1 (2023) | |
| Section | Original Article(s) | |
| Published | 2025-08-30 | |
| Keywords | ||
| Heat stress questionnaire Subjective evaluation workplace environments | ||
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How to Cite
1.
SheikhMozafari MJ, Golbabaei F, Mohsenian A, Omari Shekaftik S, Biganeh J. A Comprehensive Systematic Review of Heat Stress Assessment Questionnaires in Workplace Environments: The Gaps and Recommendations. Int J Occup Hyg. 2025;15(1):1-11.
