Journal of Health and Safety at Work

---

Introduction: Heat stress is considered as a serious risk factor to the health and safety of workers in most working environments, especially in outdoor works and jobs that workers are exposed to heat due to the working process. This study aimed to evaluate heat stress among workers of brick-manufacturing units in Qom city based on WBGT index as well as the relationship between WBGT and physiological indicators.
.

Material and Method: The present study was conducted in 40 brick-manufacturing units in Qom city. WBGT measurements were performed according to ISO7243 standard. Physiological responses of 184 workers (up to 5 people per unit) and also atmospheric parameters were measured. The physiological responses included oral temperature, skin temperature, and temperature for the carotid artery of the ear, heart rate, systolic and diastolic blood pressure. Statistical analysis was done using SPSS software version 16.
.

Result: Mean WBGT index for various brick-manufacturing jobs including firing, manual material handling, working with conveyors, molding, and tempering were 30.8 °C, 26.74 °C 26.58 °C and 24.25 °C, respectively and the average WBGT was estimated 27.98 °C. WBGT levels measured in all units exceeded the level provided in ISO7243 standard. The highest mean WBGT was belonged to kiln section (30.8 °C). The mean WBGT at three heights of head, abdomen and legs were not statistically different (using t-test). The correlation coefficients between mean WBGT and mean oral, skin and ears temperatures were 0.203, 0.319, and 0.490, respectively, with the highest correlation belonged to the carotid arteries of ears. Moreover, WBGT showed no significant association with the mean heart rate, systolic, and diastolic blood pressure (P-value>0.05). Indoor and outdoor WBGT index was significantly different (P-value<0.05).

.

Conclusion: The level of heat stress in all brick-manufacturing units was higher than the recommended limits, and the workers in kiln unit were more exposed to heat stress, in comparison with other units. Therefore, special countermeasures should be adopted to control heat stress for this occupational group.

---

Introduction: Working in hot and inappropriate climate condition is one of the most common problems of occupational health which can lead to heat induced diseases and even death. Heat stress may impair the cognitive processes involved in decision-making and converting simple tasks to complex ones. The aim of present study was to assess selective attention and reaction time among workers in a casting unit of a car manufacturing industry and to investigate the effects of heat stress on mentioned variables.

.

Material and Method: In this retrospective cohort study 70 workers from a hot industry were selected in two of exposed and control groups. First, demographic questionnaire was completed for each of the participants and noise and light were measured as the likely confounding factors. Stroop test 1, 2, and 3 were done before and during the work in order to determine the effects of heat on selective attention and reaction time. Besides,WBGT were measured at the ankle, waist, and head levels. Data were analyzed using SPSS software, version 18.

Result.: WBGT measurements showed that the mean WBGT were 33 and 16.7 for the exposed and not exposed groups, respectively. Moreover, no significant relationships were observed between test duration, reaction time, and number of errors in Stroop tests 1 and 2 and the level of heat (P-value<0.0001). However, the mentioned variables had a significant positive correlation with Stroop test 3. Additionally, for exposed group variables of test duration, reaction time, and number of errors in Stroop 3 were significantly higher than those of control group.

.

Conclusion: According to the findings in present study, heat stress causes an increase in reaction time and a decrease in selective attention. Thus, heat can be assumed as a stressor in hot work environments and the heat should be taken into account while design of job and tasks which needed selective attention or reaction time.

---

Introduction: Outdoor workers are exposed to heat from solar radiation and the atmospheric conditions, in addition to the heat from the working process, which is worse by global warming. The purpose of this study was to evaluate heat stress based on wet bulb globe temperature index and also to examine the relationship between WBGT and physiological indices among outdoor workers of Shabestar city.

.

Material and Methods: This cross-sectional study was conducted in August 2014. WBGT measurements were taken according to ISO7243 standard in different hours. The physiological response of 53outdoor workers (including heart rate, systolic and diastolic blood pressure, oral temperature, and skin temperature) were measured among9occupationalgroups, including municipal workers, concrete makers, porters, construction and road making workers, stonemasons, farmers, traffic officers, and street vendors.

.

Result: The mean WBGT index for all outdoor workers, except for municipal workers, street vendors, traffic officers and stonemason, was greater than threshold limit. The highest average WBGT index was for construction workers and the lowest was for municipal workers (respectively 27 and 26 °C). Moreover, a significant direct association was reported between the WBGT index and physiological parameters (P <0.0001), with the highest correlation coefficient belonged to heart rate (r=0.492).

.

Conclusion: According to WBGT index, porters, Concrete makers, construction and road makers, and farmers had the highest exposure at all times of the day while the lowest level was related to municipal workers. What is more, heat stress showed a significant correlation with the study strains. Therefore, it is essential to conduct further research and in order to represent preventive countermeasures for the workers in this field.

---

Introduction: Heat is one of the hazardous physical agents in the workplace. Exposure to heat and consequent thermal stress influence workers productivity in addition to adverse health effects. The aim of this study was to determine the heat stress induced productivity loss related to different tasks of farmers in Darreh Shahr city, during summer.

.

Material and Method: This cross-sectional study was conducted in summer, 2014, among farmers in Darreh Shahr city. After determining the sample size, farmers’ activities were determined using hierarchical task analysis (HTA), and WBGT measurements were done according to the ISO7243. Metabolism was estimated by the ISO8996. Following, the type of activities were identified according their required metabolism. Knowing WBGT and workload and using the work capacity model, the productivity loss in different tasks and ultimately total productivity loss were calculated.

.

Result: The mean WBGT activities for plowing, terracing, planting seeds, watering, fertilizing, weeding, spraying, and harvesting were 29.98 °C, 31.28 °C,30.66 °C,31.39 °C,31.99 °C,31.75 °C,31.08 °C, and 30.3 °C, respectively. WBGT values were higher than the permissible level provided by ISO7243 in all farming activities. Maximum value of WBGT was belonged to fertilizing activity (31.99 °C) and the lowest value was for plowing (29.98 °C). ANOVA test results did not show a significant difference in WBGT at head, waist, and ankle height. The highest and lowest amount of productivity loss was estimated respectively for weeding and plowing activities. The total productivity loss for farming was calculated 69.3 percent in an hour which is due to high physical activity, working outdoor, with exposure to direct solar radiation, and consequent heat stress imposed to workers.

.

Conclusion: Productivity is a factor which is affected by the workplace heat stress. According to results of the present research, the amount of productivity is reduced in different tasks due to heat and this reduction is exacerbated by increase in temperature and might impact the local economy. Thus, further studies are needed to improve the working conditions.

---

Introduction: Regarding development of several thermal indices and limitations of each, in this research applicability and validity of temperature- humidity index (Humidex) were examined against the standard heat index, Wet Bulb Globe Temperature -WBGT, as well as tympanic temperature of subjects.

Material and Method:  This cross-sectional study was done on 163 subjects at spring and summer (2013) in outdoor jobs of arid and semi-arid climates of Iran. Environmental parameters as well as tympanic temperature of subjects were measured simultaneously and then heat indices were determined. Data were analyzed using linear correlation charts and Kappa coefficient of agreement by means of SPSS software version 20.

Result: A strong correlation was obtained between WBGT and Humidex in both arid and semi-arid regions (r>0.98), while the correlation between Humidex and tympanic temperature was moderate (r=0.5-0.8). Based on the obtained Kappa value, the agreement coefficient between Humidex and WBGT was 0.878. This value was obtained equal to 0.226 for the Humidex and tympanic temperature.

Conclusion: The results of this study showed that Humidex can be applied as an appropriate substitute for the WBGT index. However, if evaluation of environmental condition with low air temperature or very hot situation is considered, relying only on the Humidex results will not provide a realistic estimation of thermal strain imposed to individuals.

---

Introduction: Workers in open pit iron ore mines are exposed to heat stress which can cause health and safety problems. The purpose of this study was to evaluate heat stress among open-pit mine workers of iron ore based on Wet Bulb Globe Temperature (WBGT) index and also to investigate its relationship with physiological Strain.

Material and Method: This cross-sectional study was conducted on 120 healthy miners, working in an open-pit mine, during summer season, in 2014. Physiological parameters, including core body temperatures and heart rate, were measured according to ISO 9886 standard and physiological strain indices, including Physiological Strain Index (PSI) and Physiological Strain Index based on Heart Rate (PSIHR), were calculated using the equation. Environmental variables as well as physiological parameters were simultaneously measured and recorded during work shift. WBGT index was calculated according to ISO 7243 and using the equation. Statistical analysis was performed using the SPSS software version 22.  

Result: The mean WBGT index was estimated 29.09oC for workers. “Drilling” and “factory and Krasher” units showed the highest and lowest WBGT index values of 31.06oC and 29.05oC, respectively. Workers occupational exposure to heat stress were higher than recommended thresholds based on WBGT index in all work units. A statistically significant correlation was found between WBGT index and physiological strain indices
(P value<0.001). The Pearson’s correlation coefficients were obtained 0.658 and 0.566 respectively, between WBGT index and values of PSI and PSIHR.

Conclusion: WBGT index showed a higher correlation with physiological strain Index; and level of heat stress in all work units of mine was higher than recommended thresholds. Thus, countermeasures should be adopted to control heat stress for the workers in this field.

---

Introduction: Heat stress is one of the harmful risks in casting and die casting industries, which can not only cause work-related diseases but also can impair the performance and safety of workers. Since the indicators that are used to evaluate heat stress are very different, it is very difficult to choose a suitable index. The aim of this study was to determine the optimum heat stress index in foundry, die-cast, and road construction industries using FAHP and Topsis methods.

Material and Method: In order to determine optimum heat stress index in foundry, die-cast, and road construction industries, first, the prioritization criteria were defined by experts (including ease of measurement, measurement accuracy, comprehensiveness, time, cost, and correlation). Then, considering these criteria, the best heat stress index was determined based on experts’ opinions and using FAHP and Topsis methods.

Result: The results of this study suggest that given the current conditions and criteria, WBGT and P4SR is the best indices for foundry, die casting and construction.

Conclusion: The results showed that according to comprehensiveness, accuracy and correlation criteria, the WBGT index is considered as the best indicator of heat stress assessment in foundry, die-cast and road construction industries. Moreover, the HSI ranked in the last place due to the complexity and cost of its calculation.

---

Introduction: To evaluate heat stress in the workplace different indices are used. But, none of these measures have been widely accepted. The aim of this study was to determine effective criteria in selecting a heat stress index and weighting of these criteria.

Material and Method:  This study is a qualitative study that was designed and conducted within 10 stages. In the current study, effective criteria for choosing a heat stress index was determined by using Delphi technique and expert’s opinions (30 people), and then the fuzzy analytic hierarchy process was used for weighting and prioritization of these criteria.

Results: Analyzing the completed questionnaires by the experts and according to the percentage of respondents, 11 criteria were finally selected. “Simplicity” criteria by %76.6 had the highest percentage of response. But, the relative weight of this criteria was 0.041, and had the lowest weight after the “low cost” criteria.  The criteria relating to the “Standard” item was 0.141as the highest relative weight.

Conclusion: It can be concluded that the first step to have a reliable and accurate measurement is to choose a proper and correct index. Based on specialists and expert’s opinions, standardization of the index is the most important selection criteria. Other criteria that must be considered were accuracy, reliability and good correlation with the physiological strain indices.

---

Introduction: Heat stress is caused by many factors such as individual factors, environmental factors, and management factors. Individual risk factors can decrease the heat tolerance, and play an important role in heat stress disorders incidence. The aim of this study was to review individual parameters influencing the thermal stress and review the preceding studies.

Material and Method: In this review study sites such as Web of Science, Scopus, Pubmed, Iran Medex, Magiran, Google Scholar and SID databases were used for search. The keywords included heat stress, personal factors and heat exposure. The period of 1995 to 2015 was investigated, and finally 75 original articles were identified.

Result: At the individual level, exposure with a single risk factor may reduce the workers’ heat tolerance; while exposure with a combination of several risk factors probably synergistically increases the risk of heat-related disorders. Individual risk factors include age, gender, obesity, fatigue, race, and previous heat disorders and dehydration. In addition, some diseases (such as cardiovascular disease, diabetes and infectious diseases) or use of certain drugs or alcohol can reduce the heat tolerance.

Conclusion: It is necessary to pay attention to the mentioned items when selecting workers in the hot environments. Also, due to the lack of awareness and knowledge of workers, it is necessary to provide appropriate training programs to reduce the effects of heat stress.

---

Introduction: Considering the necessity of evaluating novel thermal indices for different individual and environmental conditions, the aim of this study was validation of a new enthalpy index for evaluation of heat stress in hot and dry climate.

Material and Method: In this descriptive analytical 97 city services outdoor workers were randomly selected and evaluated in spring and summer seasons in Qom city, Iran. Correlation between new enthalpy index and standard WBGT index, as well as physiological response of deep body temperature was studied and analyzed.

Result: Findings showed that regardless of the time of measurements, correlation between enthalpy and WBGT index was better than its correlation with tympanic temperature (R2= 0.756 versus R2= 0.391). Considering the time of measurement, it was found that with increasing temperature and decreasing humidity, the correlation between indices was reduced, although the correlation ratio was maintained similar.

Conclusion: Due to the simplicity of the enthalpy index measurement ,its independency to measure the globe temperature and the possibility of estimation of this index using daily climate parameters in meteorological stations, and on the other hand, appropriate validity of enthalpy against WBGT and core temperature, it can be a good alternative for WBGT index and as a screening index for thermal environments in hot and dry condition.

---

Introduction: Heat stress is one of the hazardous agents in the steel industries which can threaten the health and safety of workers and lead to serious occupational diseases. The aim of the study was to assess the heat stress in the steel industries and compare PHS (Physiological Strain Index), WBGT (Wet-Bulb Globe Temperature), DI (Discomfort Index) and HSI (Heat Stress Index) indices for the estimation of heat stress and to determine the optimum index for steel industries.
 

Material and Method: This descriptive-analytic study was conducted among 220 workers engaged in two steel industries in Iran. Environmental and physiological parameters were measured according to ISO 7726 and ISO 9886 in three times of measurement, and finally the time-weight average of the heat stress indices were calculated. All data were analyzed using SPSS ver.  20.
 

Result: The time-weight average of WBGT (28.28 oC), DI (29.11 oC), HIS (65.7 %) indices were higher than the recommended limits. Physiological parameters (oral, tympanic and skin temperatures, systolic and diastolic pressures and heart rate) had the greatest value in the second time of measurement (afternoon). WBGT index comparing to the PHS, DI and HSI indices had highest correlation with oral, tympanic and skin temperatures and heartbeat (r=0.314 , 0.408 , 0.459 , 0.302, respectively; P < 0.05), while systolic and diastolic blood pressures showed no significant correlation with WBGT (P > 0.05). The WBGT index had the highest correlation with studied indices which was 0.945, 0.681 and 0.600 for DI, PHS and HSI, respectively.
 

Conclusion: This study assessed the optimal index with regard to the physiological parameters, and it was concluded that the WBGT index has the highest correlation with the most of physiological parameters, and therefore, WBGT index can be the most optimum index to heat stress assessment   in the studied steal industries.

---

Introduction: Working in hot and harsh weather conditions can cause heat related diseases and in some cases, even can lead to death. Risk assessment of heat stress in these environments is of particular importance. As there are many factors that could affect the heat stress, therefore, an index should be applied that could properly reflect the effect of all of these factors.
Material and Method: Initially a five-member expert team was established. Then, the weight of each variable was determined by the fuzzy analytical hierarchy process (FAHP) method. In next step, five work stations of the casting process evaluated applying fuzzy TOPSIS (FTOPSIS) method and the risk of heat stress prioritized in these stations. Lastly, the Pearson’s correlation coefficient was used to determine correlation between the results of proposed method with WBGT index.
Result:  The weights of three main variables including task characteristics, working environment, and worker characteristics was determined as 0.279, 0.526, and 0.195. The risk priority of the five work stations including, stocking, melting furnace, pouring and casting, polishing, and warehousing was established as S1= 4, S2= 2, S3= 1, S4= 3, and S5= 5. The Pearson’s correlation coefficient between the similarity index (CCi) and WBGT was 0.97.
Conclusion: From three main variables that can affect the heat stress, “Working Environment” has main impact in the risk assessment process; therefore, the most efforts must be focused on controlling this variable. The proposed method in this study has the capability of concurrent quantitative and qualitative assessment of factors that could affect the heat stress and can minimize the uncertainties in the risk assessment process relying upon the fuzzy sets.

---

Introduction: Many studies, especially in recent years, have evaluated and controlled the occupational heat stress in Iran using environmental indices. However, so far, no comprehensive study has been conducted to review and classify these studies. Therefore, this study aimed to review and investigate the occupational studies performed by environmental heat stress indices in Iran.
Material and method:  In the present study, the published articles from 2000 to 2016 were searched using Persian and English keywords including heat stress, heat strain, hot condition, warm condition, occupational health, thermal environment and Iran. Search of articles was performed in databases such as Web of Science, Google Scholar, PubMed, Scopus, Science Direct, SID, Magiran, Civilica, Iran Medex, Barakatkns and Irandoc. In total, 323 articles were found and 134 articles of them, based on the exclusion criteria, were selected and included in this study. 
Results: Based on the results, most numbers of the studies, with 93.3 percent of the total researches related to published article, have been carried out between years of 2010 to 2016. As well as, most of studies with 61.9 percent were related to the indoor industrial environments. Most of studies were also performed in cities of Isfahan with 31.08 percent, Tehran with 16.89 percent, and Assaluyeh with 11.48 percent, respectively. As well as, WBGT index with 76 percent and the UTCI and PHS indices with 0.6 percent had the highest and lowest usage in all environments and industries, respectively. In addition, the results showed that WBGT index had most usage in industries of melting and casting with 15.7 percent, petroleum with 8.3 percent, and outdoor small occupations with 8.3 percent, respectively. Based on the results, the industries of the refinery, steel, glasswork, melting and casting, mines, and ship repairs have the highest mean values of WBGT index, respectively.
Conclusion: The results showed the need to more attention of researchers for conducting studies in outdoor environments, in different cities of Iran, on development and validation of novel heat stress indices, and on implementation and evaluation of control measures in the environments with high heat stress.

---

Introduction: This study was designed with the main purpose of examining the compatibility of the two indicators of wet bulb globe temperature (WBGT) and predicted thermal strain (PHS) in assessing the environmental conditions and the heat load imposed on the subjects.
Method: In this cross-sectional study, 163 bakers were included in the study. Thermal stress was determined using the WBGT and PHS. At the same time, physiological responses of subjects were recorded, including tympanic temperature, heart rate and mean skin temperature. Finally, the predicted heat strain was evaluated and compared with actual values.
Results: Based on the results, the WBGT index is accompanied with an underestimation and PHS with  an overestimation, compared to the tympanic temperature. In addition, the WBGT index with the core temperature and the predicted rectal temperature component of the PHS index are the most consistent (kappa value of 0.614 and 0.66, respectively). While the Kappa value is between the amount of water lost and the WBGT index, it indicates a mismatch (Kappa = 0.339).
Conclusion: The prediction of heat strains only based on the PHS index cannot reflect the actual heat load on individuals in thermal environments such as bakeries and it is associated with an overestimation. On the other words, this indicator is more suitable for indoor thermal environments, with minimal variation in individual and environmental factors affecting thermal stress

---

Introduction: Many studies have been carried out on the effects of heat stress on cognitive functions, but the results are contradictory. Therefore, this study was conducted to review the effect of heat stress on cognitive functions.
Material and method:  In this study, all English articles conducted on effect of heat stress on cognitive, perceptual, and psychomotor functions from 1970 to 2018 were reviewed. For this, articles with keywords such as heat strain, heat stress, cognitive function, memory, comprehension, psychomotor, reaction time, mental performance, mood, mental response, error, task performance, fatigue, alertness, hyperthermia, and heat exhaustion in the  Scopus, Web of Science, Science Direct, Pub Med, Springer, Wiley Online Library and ProQuest databases were searched. Out of 157 retrieved articles, 39 articles were finally reviewed according to the inclusion criteria.
Results: Out of 157 retrieved articles related to the topic, according to the inclusion criteria, 39 articles were finally considered for review. Among this articles, 9 (%23) articles were published before 2000 and 30 (%77) after 2000. Two articles were in athletes, four articles (%10.2) in workers, four articles (%10.2) in students, four articles (%10.2) in military soldiers and twenty-five articles (%64.2) were conducted in ordinary people.Based on the results, heat stress was identified as a detrimental factor for decreased cognitive functions such as reading comprehension, memory, focus, mathematical processing, tracking test, reaction time, perception  and decoding text and numeric messages, visual alertness, mental computing, text reading , hidden figures test and verbal fluency.
Conclusion: Based on the results of these studies, heat stress has been introduced as a detrimental factor for disrupting cognitive functions, but conclusion based on the results of studies is a systematic method is difficult because many confounding variables such as type of work, exposure time, skill and adaptation plays a big role.

---

Introduction: Determining methods for assessing heat stress in different work environments is one of the major challenges for researchers in this field. The purpose of this study was to validate WBGT index and heat pressure assessment (HPA) by some physiological responses in Iranian South Oil Company.
Material and Methods: This descriptive-analytical study was carried out on 154 employees of Kharg, Asalouyeh and Mahshahr oil terminals recruited from three different working conditions including indoor, outdoor and rest environments in the summer. The amount of heat stress in the workplace was evaluated by WBGT index HPA method. To meet this purpose, the environmental parameters i.e., temperature, wet temperature, radiation temperature, relative humidity, water vapor pressure and air flow rate were determined. In addition to the direct reading method by the WBGT meter, ISO 7243 was used to calculate the WBGT index. In order to validate the heat stress indicators, physiological parameters of oral temperature, tympanic temperature and work metabolism were measured.
Results: The results of paired sample t-test showed a significant difference between WBGT index and HPA in indoor and outdoor environment (P<0.05). Moreover, there was a significant difference between the physiological indices of oral and tympanic temperatures and work metabolism in the indoor and outdoor environment (P<0.05). Furthermore, the correlation test was significant between WBGT index as an independent variable and HPA as a dependent variable (P<0.05)  and showed a high correlation (R2=0.914) between WBGT index with oral temperature and tympanic temperature . Also, the rate of work metabolism was significantly related with the aforementioned parameters (P<0.05) and was equal to R2=0.423, R2=0.335, R2=0.552, respectively. The correlations were also significant between HPA with Oral temperature, tympanic temperature and work metabolism (P<0.05)and were equal to R2=0.632, R2=0.605, R2=0.557, respectively. The results showed also that the correlation rate between the HPA with physiological parameters is stronger than that between physiological parameters with the WBGT index.
Conclusion: This study showed that WBGT and HPA methods are useful for assessing the heat stress of Iranian South Oil Company. Also, the HPA method is more reliable for assessing heat stress in these regions.

---

Introduction: Heat stress is a critical problem in hot industries, especially in incredibly hot climates. It can greatly impair the work process and put the health of workers at risk. This study aims to investigate the applicability of the WBGT index in determining the allowable working time in very hot weather conditions in one of the steel industries in Ahvaz.
Material and Methods: This study was conducted in different sectors of a steel industry in Ahwaz. The physiological parameters of sixty workers working in different parts of the industry were evaluated. Environmental variables and the Wet-Bulb globe temperature (WBGT) Index were also simultaneously measured during work shifts. The acceptable work time was calculated based on the reserve heart rate (RHR) and the WBGT index.
Results: The heat stress index among all occupational groups, based on the WBGT index, was incredibly high and surpassed the recommended level (P<0.05). The statistical test results also indicated a significant difference between the two indices in predicting the adequate work time at different work stations (P <0.05).
Conclusion: The current study results revealed that using the WBGT index for assessing and managing the risk of heat exposure in a hot climate may not have sufficient reliability and performance. Consequently, it is recommended to use optimal indices based on environmental and physiological assessments in a hot climate in order to monitor and control the heat stress associated with heat exposure. 

---

Introduction: Prevention of heat-related diseases requires the participation of the workers. For this reason, the aim of this study was the development and validation of the tools for evaluating awareness and practice related to heat stress among the workers of warm workplaces.
Material and Methods: The various items and factors related to the awareness and practice of the workers were identified by the literature review. Then, several questions for evaluating these items were designed. In the next step, the reliability and validity of the questionnaires were appraised using calculating the content validity ratio (CVR) and content validity index (CVI), and Cronbach’s alpha coefficient, respectively. After that, these questionnaires were completed by 2338 employees of six industries in various regions of Iran. Finally, collected data were analyzed using SPSS software.
Results: In total, 77 questions, including 53 questions on awareness and 24 questions on practice in six groups of water and beverages, food, snacks and additives, heat exchange, thermal strain risk factors, clothing and heat protection equipment, and heat-related disorders and body reactions, were designed. The values of content validity index (CVI) of remained questions in the questionnaires of awareness and practice were equal to 0.954 and 0.824, respectively. The values of Cronbach’s alpha coefficients of these questionnaires were calculated by 0.755 and 0.716, respectively. The values of the chi-square divided by degrees of freedom (CMIN/DF) and root mean square error of approximation (RMSEA) in the construction of the awareness questionnaire were computed as 4.58 and 0.079, respectively. These values in the construction of the practice questionnaire were calculated by 2.33 and 0.084, respectively.
Conclusion: The results showed that the designed questionnaires had appropriate reliability and validity and could be used to evaluate the awareness and practice in warm workplaces.

---

Introduction: Many industries have multiple factors harmful to health, leading to simultaneous exposure of these factors to each other. Noise is one of the most common physical parameters in the work environment. On the other hand, heat is also increasing due to various energy processes in industries. Therefore, this study was conducted with the aim of determining changes in physiological parameters and visual-auditory attention in acute exposure to heat and noise.
Material and Methods: In this experimental study, 72 individuals (36 men and 36 women) aged between 23 and 33 years participated according to the inclusion criteria. In total, 12 different test modes were performed (3 temperature levels and 4 noise pressure levels). The test was conducted for each person in 4 steps during a specific day. The duration of exposure to each condition was half an hour, and a half-hour rest was given between each test condition. Saliva samples of each subject were collected before and immediately after exposure to noise and heat. Also, The Integrated Visual and Auditory (IVA) was recorded by the participants simultaneously.
Results: The results of combined exposure to noise and heat on visual and auditory attention showed that only two modes of combined exposure, SPL95+WBGT34 and SPL95+WBGT29, caused a significant increase (P < 0.05) in mental workload and a significant decrease (P < 0.05) in visual and auditory attention. In addition, the results showed that independent exposure to noise at the levels of 85 and 95 dB and exposure to heat at higher temperature levels of 34 and 29 degrees Celsius cause a significant increase (P < 0.05) in salivary cortisol after exposure. The results of the effect of combined exposure to noise and heat on salivary cortisol showed that three experimental modes of combined exposure (SPL85+WBGT34, SPL95+WBGT29, and SPL95+WBGT34) caused a noticeable and significant (P<0.001) increase in salivary cortisol.
Conclusion: Indeed, salivary cortisol can be recommended as a physiological index to evaluate noise and heat exposure. It’s also noteworthy that salivary cortisol is more affected by noise and heat exposure than cognitive performance.

---

Introduction: Workers who work in warm situations need clothes with better thermal regulation. Nowadays, improving the thermal regulation properties of cotton fabric by treating it with phase change materials (PCMs) has been considered. The type of fabric plays an important role in providing thermal comfort. Cotton fabric is the most popular raw material in the textile industry due to its distinctive features. Therefore, this systematic review aims to investigate the effects of PCM nanoencapsulation in commonly used cotton fabrics, including morphology, thermal properties, thermal stability, tensile strength, abrasion resistance, leakage, water absorption, washing ability, and breathability of the fabric, related challenges, and future research trends.
Material and Methods: This research was conducted with the papers obtained from the systematic search in Science Direct, Web of Sciences, Scopus, and PubMed databases. Keywords “nanoencapsulated phase change materials”, “nanoenhanced phase change materials”, “cotton”, “cotton fabric”, and “cotton textiles” were used.
Results: Of the 1251 studies identified through search databases, 13 were selected according to the entry criteria. The results revealed that in all the studies, PCM nanocapsules were successfully synthesized and inserted into the cotton fabric, improving the fabric’s thermal properties. Most studies used in situ polymerization and mini-emulsion polymerization for nanoencapsulation. The pad-dry-cure method was also widely used for applying nanocapsules to cotton fabric.
Conclusion: This systematic review showed that synthesized nanocapsules of phase change materials and applied them to cotton fabric can improve the thermoregulating properties of the fabric. It is suggested to expand the research to design thermoregulating clothes made from treated fabrics and investigate their cooling performance.