A physiological strain index to evaluate heat stress

Abstract
A physiological strain index (PSI), based on rectal temperature (Tre) and heart rate (HR), capable of indicating heat strain online and analyzing existing databases, has been developed. The index rates the physiological strain on a universal scale of 0–10. It was assumed that the maximal Tre and HR rise during exposure to exercise heat stress from normothermia to hyperthermia was 3°C (36.5–39.5°C) and 120 beats/min (60–180 beats/min), respectively. Tre and HR were assigned the same weight functions as follows: PSI = 5(Tret− Tre0) ⋅ (39.5 − Tre0)−1+ 5(HRt − HR0) ⋅ (180 − HR0)−1, where Tretand HRt are simultaneous measurements taken at any time during the exposure and Tre0 and HR0 are the initial measurements. PSI was applied to data obtained from 100 men performing exercise in the heat (40°C, 40% relative humidity; 1.34 m/s at a 2% grade) for 120 min. A separate database representing seven men wearing protective clothing and exercising in hot-dry and hot-wet environmental conditions was applied to test the validity of the present index. PSI differentiated significantly (P < 0.05) between the two climates. This index has the potential to be widely accepted and to serve universally after extending its validity to women and other age groups.