{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T20:12:53Z","timestamp":1774987973914,"version":"3.50.1"},"reference-count":59,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2021,6,10]],"date-time":"2021-06-10T00:00:00Z","timestamp":1623283200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008633","name":"International Labour Organization","doi-asserted-by":"publisher","award":["40262271 \/ 1"],"award-info":[{"award-number":["40262271 \/ 1"]}],"id":[{"id":"10.13039\/100008633","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Horizon 2020","award":["project HEAT-SHIELD; Grant agreement No 668786"],"award-info":[{"award-number":["project HEAT-SHIELD; Grant agreement No 668786"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Occupational heat exposure can provoke health problems that increase the risk of certain diseases and affect workers\u2019 ability to maintain healthy and productive lives. This study investigates the effects of occupational heat stress on workers\u2019 physiological strain and labor productivity, as well as examining multiple interventions to mitigate the problem. Methods: We monitored 518 full work-shifts obtained from 238 experienced and acclimatized individuals who work in key industrial sectors located in Cyprus, Greece, Qatar, and Spain. Continuous core body temperature, mean skin temperature, heart rate, and labor productivity were collected from the beginning to the end of all work-shifts. Results: In workplaces where self-pacing is not feasible or very limited, we found that occupational heat stress is associated with the heat strain experienced by workers. Strategies focusing on hydration, work-rest cycles, and ventilated clothing were able to mitigate the physiological heat strain experienced by workers. Increasing mechanization enhanced labor productivity without increasing workers\u2019 physiological strain. Conclusions: Empowering laborers to self-pace is the basis of heat mitigation, while tailored strategies focusing on hydration, work-rest cycles, ventilated garments, and mechanization can further reduce the physiological heat strain experienced by workers under certain conditions.<\/jats:p>","DOI":"10.3390\/ijerph18126303","type":"journal-article","created":{"date-parts":[[2021,6,10]],"date-time":"2021-06-10T13:31:39Z","timestamp":1623331899000},"page":"6303","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":90,"title":["Occupational Heat Stress: Multi-Country Observations and Interventions"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5460-8167","authenticated-orcid":false,"given":"Leonidas G.","family":"Ioannou","sequence":"first","affiliation":[{"name":"FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece"},{"name":"Department of Nutrition, Exercise and Sports, August Krogh Building, University of Copenhagen, 2100 Copenhagen, Denmark"}]},{"given":"Konstantinos","family":"Mantzios","sequence":"additional","affiliation":[{"name":"FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5093-1458","authenticated-orcid":false,"given":"Lydia","family":"Tsoutsoubi","sequence":"additional","affiliation":[{"name":"FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece"}]},{"given":"Eleni","family":"Nintou","sequence":"additional","affiliation":[{"name":"FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1884-1057","authenticated-orcid":false,"given":"Maria","family":"Vliora","sequence":"additional","affiliation":[{"name":"FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece"}]},{"given":"Paraskevi","family":"Gkiata","sequence":"additional","affiliation":[{"name":"FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece"}]},{"given":"Constantinos N.","family":"Dallas","sequence":"additional","affiliation":[{"name":"FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece"}]},{"given":"Giorgos","family":"Gkikas","sequence":"additional","affiliation":[{"name":"FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece"}]},{"given":"Gerasimos","family":"Agaliotis","sequence":"additional","affiliation":[{"name":"FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece"}]},{"given":"Kostas","family":"Sfakianakis","sequence":"additional","affiliation":[{"name":"FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece"}]},{"given":"Areti K.","family":"Kapnia","sequence":"additional","affiliation":[{"name":"FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9452-9663","authenticated-orcid":false,"given":"Davide J.","family":"Testa","sequence":"additional","affiliation":[{"name":"FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece"}]},{"given":"T\u00e2nia","family":"Amorim","sequence":"additional","affiliation":[{"name":"FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6853-9238","authenticated-orcid":false,"given":"Petros C.","family":"Dinas","sequence":"additional","affiliation":[{"name":"FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece"}]},{"given":"Tiago S.","family":"Mayor","sequence":"additional","affiliation":[{"name":"SIMTECH Laboratory, Transport Phenomena Research Centre, Engineering Faculty of Porto University, 4200-465 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7386-692X","authenticated-orcid":false,"given":"Chuansi","family":"Gao","sequence":"additional","affiliation":[{"name":"Thermal Environment Laboratory, Division of Ergonomics and Aerosol Technology, Department of Design Sciences, Faculty of Engineering, Lund University, 22100 Lund, Sweden"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9090-1958","authenticated-orcid":false,"given":"Lars","family":"Nybo","sequence":"additional","affiliation":[{"name":"Department of Nutrition, Exercise and Sports, August Krogh Building, University of Copenhagen, 2100 Copenhagen, Denmark"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9823-3915","authenticated-orcid":false,"given":"Andreas D.","family":"Flouris","sequence":"additional","affiliation":[{"name":"FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece"}]}],"member":"1968","published-online":{"date-parts":[[2021,6,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Piil, J.F., Lundbye-Jensen, J., Christiansen, L., Ioannou, L., Tsoutsoubi, L., Dallas, C.N., Mantzios, K., Flouris, A.D., and Nybo, L. 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