{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T18:29:29Z","timestamp":1786386569877,"version":"build-2736575974"},"reference-count":64,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100005620","name":"North Carolina GlaxoSmithKline Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005620","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Industrial Med"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Outdoor agricultural workers experience significant heat exposure, yet few studies have evaluated whether wearable sensors can reliably measure continuous physiological responses in real field conditions. This pilot study examined the feasibility and predictive utility of core temperature, hydration, heart rate, and movement data collected from commercially available wearables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thirty farmworkers in eastern North Carolina wore three devices, the CALERA core temperature sensor, the Nix Hydration Biosensor, and the Garmin Vivoactive smartwatch, during one July work shift. 1 min, physiological and environmental data were aligned to compute the modified Physiological Strain Index, mPSI. Device reliability, physiological responses, and heat exposure were summarized. Multi\u2010linear regression and machine learning, Random Forest (RF) and Gradient Boosting Regression (GBR), models were evaluated to predict mPSI, using raw and smoothed predictors to estimate mPSI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      CALERA retrieved 100 percent of the data, Garmin retrieved 97 percent, and Nix retrieved 80 percent. WBGT remained consistently high, approximately 28 to 29 degrees Celsius, and 12.6 percent of core temperature measurements exceeded 38 degrees Celsius. mPSI ranged from minimal to high heat strain, with 8.3 percent of observations at or above 5. Heart rate showed the strongest association with mPSI. The RF model using 60\u2010min moving averages achieved the highest predictive accuracy with an\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      of 0.96 and a root mean squared error of 0.25. Wearables captured meaningful physiological patterns that corresponded with environmental heat exposure, and WBGT\u2010based risk levels consistently overestimated heat strain relative to mPSI.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Multi\u2010sensor wearable systems are feasible for continuous heat strain monitoring and can support accurate prediction of heat\u2010related risk among agricultural workers. This study is the first to evaluate the CALERA, Nix, and Garmin devices combined for heat strain monitoring in outdoor agricultural workers. By combining all three wearables in a field\u2010based feasibility assessment, it addresses a key gap in validating consumer\u2010grade technology for occupational safety in this high\u2010risk workforce. The findings of the study support the use of wearable devices for real\u2010time heat strain alerts, individualized hydration and work\u2010rest guidance, and early warning systems to help prevent heat\u2010related illness in physically demanding outdoor occupations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ajim.70103","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T04:02:57Z","timestamp":1781064177000},"page":"722-744","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Assessing the Feasibility of Wearable Devices for Physiological Monitoring and Heat Risk Prediction in Outdoor Agricultural Workers"],"prefix":"10.1002","volume":"69","author":[{"given":"Sinan","family":"Sousan","sequence":"first","affiliation":[{"name":"Department of Public Health, Brody School of Medicine East Carolina University Greenville North Carolina USA"},{"name":"North Carolina Agromedicine Institute Greenville North Carolina USA"},{"name":"Center for Human Health and the Environment NC State University Raleigh North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Mizelle","sequence":"additional","affiliation":[{"name":"College of Nursing East Carolina University Greenville North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Public Health, Brody School of Medicine East Carolina University Greenville North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Information Technology, College of Computing and Software Engineering Kennesaw State University Kennesaw Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0081-3899","authenticated-orcid":false,"given":"Guy","family":"Iverson","sequence":"additional","affiliation":[{"name":"Environmental Health Sciences Program, Department of Health Education and Promotion East Carolina University Greenville North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2084-2240","authenticated-orcid":false,"given":"Ciprian","family":"Popoviciu","sequence":"additional","affiliation":[{"name":"Department of Technology Systems East Carolina University Greenville North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dylan","family":"Hemedinger","sequence":"additional","affiliation":[{"name":"Department of Biology, Thomas Harriot College of Arts and Sciences East Carolina University Greenville North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliezer","family":"Loyola","sequence":"additional","affiliation":[{"name":"Department of Foreign Languages &amp; Literatures, College of Arts and Sciences East Carolina University Greenville North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takari","family":"Hood","sequence":"additional","affiliation":[{"name":"Department of Public Health Education, College of Health and Sciences North Carolina Central University Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Ramirez","sequence":"additional","affiliation":[{"name":"Department of Psychology, Thomas Harriot College of Arts and Sciences East Carolina University Greenville North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3173-3293","authenticated-orcid":false,"given":"Jo Anne","family":"Balanay","sequence":"additional","affiliation":[{"name":"Environmental Health Sciences Program, Department of Health Education and Promotion East Carolina University Greenville North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,9]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Environmental Protection Agency: Excessive Heat Events Guidebook. 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