Developing a Feasible Integrated Framework for Occupational Heat Stress Protection: A Step Towards Safer Working Environments

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Georgios Gourzoulidis
Flora Gofa
Leonidas G. Ioannou
Ioannis Konstantakopoulos
Andreas D. Flouris


Occupational heat stress, WBGT index, Occupational Health and Safety (OHS), climate crisis


Background: Specialized occupational health and safety (OHS) issues are covered at the EU level through detailed legislation and guidelines. Unfortunately, this does not extend to occupational heat stress, not only in Greece but also (with few exceptions) internationally. One possible explanation could be the difficulty in accurately identifying the dangerous conditions, as many environmental and individualized elements are involved, and hundreds of "thermal stress indicators" are available. Another explanation could be the difficulty in adequately measuring hazardous conditions for workers affected more (i.e., outdoor and high intensity) since the biological protection framework is based on the human body's internal temperature. Methods: The Wet Bulb Globe Temperature (WBGT) has been proposed as the most efficacious thermal stress indicator. Since 2021, the Hellenic National Meteorological Service has provided 48-h WBGT forecast predictions to serve as a first level of alert. Real-time measurements and 48-h forecasts of WBGT are also available through a smartphone application. Additionally, as revealed when developing the occupational heat stress legislation in Cyprus and Qatar, crucial first steps are identifying the specific characteristics of worker exposure and the tripartite collaboration between employers, workers, and the State. Results: Evaluating the simplified WBGT forecasted values and the smartphone application estimates proved well-established. The sound scientific basis can be effectively combined with administrative measures based on the EU OHS legislative experience to produce practical solutions. Conclusions: As the climate crisis exacerbates, worker productivity and well-being will decline, underscoring the urgent need for an integrated protection framework. Such a framework is proposed here.


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1. European Commission (EC), ‘EU Strategic framework on health and safety at work 2021-2027’, COM(2021) 323 final, Brussels.
2. Flouris AD, Dinas PC, Ioannou LG, et al. Workers' health and productivity under occupational heat strain: a systematic review and meta-analysis. Lancet Planet Health. 2018;2(12):521-31. Doi: 10.1016/S2542-5196(18)30237-7. PMID: 30526938
3. Hellenic Ministry of Labour and Social Affairs. ‘Prevention of occupational heat stress during heatwave’. Circular 217464/6.7.2020 (reference in Greek).
4. Hellenic mining enterprises’ association. ‘Mining and quarry regulation’, 2011 (reference in Greek).
5. Health & Safety Executive (HSE), ‘Heat stress in the workplace, a brief guide’, INDG451, 2013.
6. Association of Farmworker Opportunity Programs, ‘TRAINER GUIDE AND WORK BOOK’, 2010 Occupa-tional Safety and Health Administration, U.S. Department of Labor.
7. Occupational Health and Safety Council of Ontario, ‘HEAT STRESS AWARENESS GUIDE, 2007, 5252A CSAO (04/07), Ontario, Canada.
8. Malaysian Department of Occupational Safety and Health, ‘GUIDELINES ON HEAT STRESS MANAGE-MENT AT WORKPLACE’, 2016, Ministry of Human Resources, Malaysia.
9. Ioannou LG, Dinas PC, Notley SR, et al. Indicators to assess physiological heat strain, part1: Systematic review, part2: Delphi exercise. Temp. 2022. Doi:
10. Flouris AD. Human thermoregulation. In Heat Stress in Sport and Exercise; Périard J. and Racinais S., Eds.; Springer Nature, UK, 2019.
11. Ioannou LG, Tsoutsoubi L, Mantzios K, et al. A free software to predict heat strain according to the ISO 7933:2018. Ind Health. 2019;29;57(6):711-720. Doi: 10.2486/indhealth.2018-0216. Epub 2019 Mar 27. PMID: 30918161; PMCID: PMC6885605.
12. ISO 7933. 2004, Ergonomics of the thermal environment—Analytical determination and interpretation of heat stress using the predicted heat strain model. International Organization for Standardization, Geneva.
13. Ioannou LG, Tsoutsoubi L, Mantzios K, et al. Indicators to assess physiological heat strain – Part 3: Mul-ti-country field evaluation and consensus recommendations. Temperature (Austin). 2022;9(3):274-291. Doi: 10.1080/23328940.2022.2044739. PMID: 36249710; PMCID: PMC9559325.
14. Ioannou LG, Dinas PC, Notley SR, et al. Indicators to assess physiological heat strain – Part 2: Delphi ex-ercise. Temperature (Austin). 2022;9(3):263-273. Doi: 10.1080/23328940.2022.2044738. PMID: 36211947; PMCID: PMC9542877.
15. ISO 7243: 2017, ‘Ergonomics of the thermal environment - Assessment of heat stress using the WBGT (wet bulb globe temperature) index’.
16. Georgoulias AK, Akritidis D, Kalisoras A, et al. Climate change projections for Greece in the 21st century from high-resolution EURO-CORDEX RCM simulations. Atmos Res. 2022;271.
17. Garcia-Leon D, Casanueva A, Standardi G, et al. Current and projected regional economic impacts of heatwaves in Europe. Nat Commun. 2021;5807(12). Doi:
18. Morabito M, Messeri A, Noti P, et al. An Occupational Heat-Health Warning System for Europe: The HEAT-SHIELD Platform. Int J Environ Res Public Health. 2019:13;16(16):2890. Doi: 10.3390/ijerph16162890. PMID: 31412559; PMCID: PMC6718993.
19. Hellenic Ministry of Labour and Social Affairs. ‘Handling occupational heat stress during summer’. Cir-cular 130427/26.6.1990 (reference in Greek).
20. Lemke B and Kjellstrom T. Calculating workplace WBGT from meteorological data: a tool for climate change. Ind Health. 2012;50(4), 267-78.
21. American College of Sports Medicine. Prevention of thermal injuries. Position stand. Med J Aust. 1984;141(12-13):876-9.
22. Liljegren JC, Carhart RA, Lawday P, et al. Modeling the wet bulb globe temperature using standard mete-orological measurements. J Occup Environ Hyg. 2008;5:645-655.
23. ISO 7726:1998. Ergonomics of the thermal environment — Instruments for measuring physical quanti-ties. International Organization for Standardization, Geneva.
24. ISO 7243:2017. Ergonomics of the thermal environment — Assessment of heat stress using the WBGT (wet bulb globe temperature) index. International Organization for Standardization, Geneva.
25. Gofa F, Pytharoulis I, Andreadis T, et al. Evaluation of the Operational Numerical Weather Forecasts of the Hellenic National Meteorological Service. 9th Conference of Meteorology, Climatology and Atmos-pheric Physics, 9th COMECAP, Thessaloniki, 28-31 May, 2008.
26. Ministry of Labour of Cyprus. Occupational Heat Stress. Nicosia 2014 (reference in Greek).
27. ILO. One is too many. The collection & analysis of data on occupational injuries in Qatar. Doha, Qatar 2021.
28. Gofa F, Nikas D, Gourzoulidis GA and Flouris AD. Measuring and predicting heat stress conditions with the WBGT index. 15th International Conference on Meteorology, Climatology and Atmospheric Physics - COMECAP 2021.
29. Directive 89/391/EEC, on the introduction of measures to encourage improvements in the safety and health of workers at work - "Framework Directive".
30. ACGIH. TLVs and BEIs based on the documentation of the threshold limit values for chemical substanc-es and physical agents. 2020. ISBN: 978-1-607261-12-4.
31. ISO 7243: 1989, ‘Hot environment – Estimation of the heat stress on working man, based on the WBGT (wet bulb globe temperature)’.
32. Hellenic Ministry of Labour and Social Affairs. ‘Handling occupational heat stress during summer’. Cir-cular 56163/15.6.2022 (reference in Greek).