Thermal Comfort and the Heat Stress Indices
Open accessAbstract
Thermal stress is an important factor in many industrial situations, athletic events and military scenarios. It can seriously affect the productivity and the health of the individual and diminish tolerance to other environmental hazards. However, the assessment of the thermal stress and the translation of the stress in terms of physiological and psychological strain is complex. For over a century attempts have been made to construct an index, which will describe heat stress satisfactorily. The many indices that have been suggested can be categorized into one of three groups: "rational indices", "empirical indices", or "direct indices". The first 2 groups are sophisticated indices, which integrate environmental and physiological variables; they are difficult to calculate and are not feasible for daily use. The latter group comprises of simple indices, which are based on the measurement of basic environmental variables. In this group 2 indices are in use for over four decades: the "wet-bulb globe temperature" (WBGT) index and the "discomfort index" (DI). The following review summarizes the current knowledge on thermal indices and their correlates to thermal sensation and comfort. With the present knowledge it is suggested to adopt the DI as a universal heat stress index.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
DI correlates well with WBGT (R2 = 0.95 in the range of 15-33 °C of WBGT index, n = 108).
“Nevertheless, the authors found that DI correlates well with WBGT (R2 = 0.95 in the range of 15–33 °C of WBGT index, n = 108).”
From Occupational heat stress assessment and protective strategies in the context of climate change (2018) · cites this paper as Epstein and Moran 2006
The discomfort-index section reports that DI and WBGT were highly correlated (r² = 0.9466), and the Summary identifies 108 observations for their correlation. Our copy does not specify that the WBGT values ranged from 15 to 33 °C, so that qualifier is unsupported. (LLM, conf=0.88)
Experimental — accuracy not yet measuredAppropriate assessment of occupational heat stress requires consideration of six factors: four thermal climate factors, metabolic heat production, and clothing properties.
“Any comprehensive thermal stress index will need to consider all the six factors outlined for appropriate assessment of occupational heat stress (Parsons 2014; Epstein and Moran 2006).”
From Occupational heat stress assessment and protective strategies in the context of climate change (2018) · cites this paper as Epstein and Moran 2006
Local workplace environmental conditions such as local heat sources, metabolic heat production within the human body, and clothing properties all affect the exchange of heat between the body and the environment.
“In addition, local workplace environmental conditions such as local heat sources, metabolic heat production within the human body, and clothing properties, all affect the exchange of heat between the body and the environment.”
From Occupational heat stress assessment and protective strategies in the context of climate change (2018) · cites this paper as Epstein and Moran 2006
The WBGT index can function as a screening tool for the assessment of heat stress.
“The WBGT index can function as a screening tool for the assessment of heat stress (Parsons 2013; Epstein and Moran 2006).”
From Occupational heat stress assessment and protective strategies in the context of climate change (2018) · cites this paper as Epstein and Moran 2006
An applicable heat stress index must meet four criteria: feasible and accurate at relevant range of environmental and metabolic conditions; considers all six factors; measurement should reflect worker's exposure; exposure limits should be reflected by physiological and/or psychological responses.
“Epstein and Moran (2006) emphasized that an applicable heat stress index must meet the following criteria: 1) feasible and accurate at relevant range of environmental and metabolic conditions, 2) considers all six factors, 3) the measurement should reflect worker’s exposure, 4) exposure limits should be reflected by physiological and/or psychological responses.”
From Occupational heat stress assessment and protective strategies in the context of climate change (2018) · cites this paper as Epstein and Moran 2006
More than 30 heat indexes have been developed, differing in input variables and parameterization.
“More than 30 heat indexes have been developed (20), differing both in the input variables they use and in the way their effects are parameterized.”
From Heat, Human Performance, and Occupational Health: A Key Issue for the Assessment of Global Climate Change Impacts (2016) · cites this paper as [20]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Thermal Environmental Conditions for Human Occupancy
Ashrae, S. (1992) · Medical Entomology and Zoology · Cited by 6,092 · see citing works
Thom, E. C. (1959) · Weatherwise · doi:10.1080/00431672.1959.9926960 · Cited by 1,527 · see citing works
A standard predictive index of human response to the thermal environment
Gagge, A. P., Fobelets, A. P. R., & Berglund, L. G. (1986) · ASHRAE winter conference papers · Cited by 1,063 · see citing works
An Effective Temperature Scale Based on a Simple Model of Human Physiological Regulatory Response
Gagge, A. P. (1971) · ASHRAE winter conference papers · Cited by 799 · see citing works
Glossary of terms for thermal physiology.
Bligh, J., & Johnson, K. (1973) · Journal of Applied Physiology · doi:10.1152/jappl.1973.35.6.941 · Cited by 740 · see citing works
Thermoreception and temperature regulation
Hensel, H. (1991) · General Pharmacology The Vascular System · doi:10.1016/0306-3623(91)90495-r · Cited by 630 · see citing works
A physiological strain index to evaluate heat stress
Moran, D. S., Shitzer, A., & PANDOLF, K. B. (1998) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.1998.275.1.r129 · Cited by 623 · see citing works
Self-citationAn Effective Temperature Scale Based on a Simple Model of Human Physiological Regulatiry Response
Gagge, A. P., Stolwijk, J. A. J., & Nishi, Y. (1972) · Hokkaido University Collection of Scholarly and Academic Papers (Hokkaido University) · Cited by 461 · see citing works
Parsons, K. (2014) · CRC Press eBooks · doi:10.1201/b16750-10 · Cited by 412 · see citing works
Physiology of Man in the Desert
Adolph, E. F. (1969) · Medical Entomology and Zoology · Cited by 372 · see citing works
The stress of hot environments.
Dm, K. (1972) · PubMed · Cited by 338 · see citing works
Index for evaluating Heat Stress in Terms of resulting Physiological Strains.
Belding, H. S., & Hatch, T. F. (1955) · Heating, piping and air conditioning · Cited by 281 · see citing works
Predicting rectal temperature response to work, environment, and clothing.
Givoni, B., & Goldman, R. F. (1972) · Journal of Applied Physiology · doi:10.1152/jappl.1972.32.6.812 · Cited by 268 · see citing works
The Influence of High Air Temperatures No. I
Haldane, J. S. (1905) · Epidemiology and Infection · doi:10.1017/s0022172400006811 · Cited by 243 · see citing works
Field and clinical observations of exertional heat stroke patients
Shapiro, Y., & Seidman, D. S. (1990) · Medicine & Science in Sports & Exercise · doi:10.1249/00005768-199002000-00003 · Cited by 210 · see citing works
Shibolet, S., Lancaster, M. C., & Danon, Y. (1976) · PubMed · Cited by 208 · see citing works
Gonzalez, R. R., Nishi, Y., & Gagge, A. P. (1974) · International Journal of Biometeorology · doi:10.1007/bf01450660 · Cited by 199 · see citing works
An environmental stress index (ESI) as a substitute for the wet bulb globe temperature (WBGT)
Moran, D. S., PANDOLF, K. B., Shapiro, Y., Heled, Y., Shani, Y., Mathew, W. T., & Gonzalez, R. R. (2001) · Journal of Thermal Biology · doi:10.1016/s0306-4565(01)00055-9 · Cited by 186 · see citing works
Self-citationPredicting sweat loss response to exercise, environment and clothing
Shapiro, Y., PANDOLF, K. B., & Goldman, R. F. (1982) · European Journal of Applied Physiology · doi:10.1007/bf00421168 · Cited by 158 · see citing works
American College of Sports Medicine position stand. Heat and cold illnesses during distance running.
Armstrong, L. E., Epstein, Y., GREENLEAF, J. E., Haymes, E. M., Hubbard, R. W., Roberts, W. O., & Thompson, P. D. (1996) · PubMed · Cited by 115 · see citing works
Self-citationThe Influence of the Humidity of the Air on Capacity for Work at High Temperatures
Vernon, H. M., & Warner, C. G. (1932) · Journal of Hygiene · doi:10.1017/s0022172400018167 · Cited by 107 · see citing works
The Warmth Factor in Comfort at Work. A Physiological Study of Heating and Ventilation.
Bedford, T. (1936) · Cited by 103 · see citing works
The Effects of Continuous Hot Weather Training on Risk of Exertional Heat Illness
Wallace, R. F., Kriebel, D., Punnett, L., et al. (2005) · Medicine & Science in Sports & Exercise · doi:10.1249/01.mss.0000150018.90213.aa · Cited by 98 · see citing works
PHYSIOLOGICALLY EQUIVALENT CONDITIONS OF AIR TEMPERATURE AND HUMIDITY
Robinson, S., TURRELL, E. S., & Gerking, S. D. (1945) · American Journal of Physiology-Legacy Content · doi:10.1152/ajplegacy.1945.143.1.21 · Cited by 91 · see citing works
The nature of thermal comfort for sedentary man.
Rohles, F., & Nevins, R. G. (1971) · Cited by 87 · see citing works
Psychomotor deterioration during exposure to heat.
Epstein, Y., Keren, G., Moisseiev, J., Gasko, O., & Yachin, S. (1980) · PubMed · Cited by 83 · see citing works
Self-citationPredicting heart rate response to work, environment, and clothing.
Givoni, B., & Goldman, R. F. (1973) · Journal of Applied Physiology · doi:10.1152/jappl.1973.34.2.201 · Cited by 82 · see citing works
Physiological, Comfort, Performance, and Social Effects of Heat Stress
Bell, P. A. (1981) · Journal of Social Issues · doi:10.1111/j.1540-4560.1981.tb01058.x · Cited by 80 · see citing works
Indices of thermoregulatory strain for moderate exercise in the heat
Gonzalez, R. R., Berglund, L. G., & Gagge, A. P. (1978) · Journal of Applied Physiology · doi:10.1152/jappl.1978.44.6.889 · Cited by 67 · see citing works
Hill, L., Griffith, O. W., & Flack, M. (1916) · Philosophical Transactions of the Royal Society of London Series B Containing Papers of a Biological Character · doi:10.1098/rstb.1916.0005 · Cited by 59 · see citing works
Upper thermal tolerance limits for unimpaired mental performance.
Jf, W. (1965) · PubMed · Cited by 59 · see citing works
A Wet Globe Thermometer for Environmental Heat Measurement
Botsford, J. H. (1971) · American Industrial Hygiene Association Journal · doi:10.1080/0002889718506400 · Cited by 56 · see citing works
ACSM Position Stand: The Female Athlete Triad: Heat and Cold Illnesses During Distance Running
Armstrong, L. E., Epstein, Y., GREENLEAF, J. E., Haymes, E. M., Hubbard, R. W., Roberts, W. O., & Thompson, P. D. (1996) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-199610000-00050 · Cited by 54 · see citing works
Self-citationThe Effects of Core Temperature Elevation and Thermal Sensation on Performance
ALLNUTT, M. F., & ALLAN, J. R. (1973) · Ergonomics · doi:10.1080/00140137308924495 · Cited by 43 · see citing works
Assessment of Physiological Severity of Hot Climates
LIND, A. R., & Hellon, R. F. (1957) · Journal of Applied Physiology · doi:10.1152/jappl.1957.11.1.35 · Cited by 42 · see citing works
The Effective Radiant Field and Operative Temperature Necessary for Comfort with Radiant Heating
Gagge, A. P. (1967) · ASHRAE winter conference papers · Cited by 41 · see citing works
Wet bulb globe temperature (WBGT)--to what extent is GT essential?
Moran, D. S., & PANDOLF, K. B. (1999) · PubMed · Cited by 40 · see citing works
Self-citationSOHAR, E., TENNENBAUM, J., & ROBINSON, N. (1962) · Biometeorology · doi:10.1016/b978-0-08-009683-4.50052-8 · Cited by 39 · see citing works
Effect of individual variation on upper limit of prescriptive zone of climates.
LIND, A. R. (1970) · Journal of Applied Physiology · doi:10.1152/jappl.1970.28.1.57 · Cited by 37 · see citing works
Physiological index of strain and body heat storage in hyperthermia
Hall, J. F., & Polte, J. W. (1960) · Journal of Applied Physiology · doi:10.1152/jappl.1960.15.6.1027 · Cited by 33 · see citing works
Physical indices of the thermal environment
Gagge, A. P., & Nishi, Y. (1976) · OSTI OAI (U.S. Department of Energy Office of Scientific and Technical Information) · Cited by 32 · see citing works
Dufton, A. F. (1929) · Journal of Scientific Instruments · doi:10.1088/0950-7671/6/8/303 · Cited by 32 · see citing works
Physiological reactions and sensations of pleasantness under varying atmospheric conditions
Winsløw, C. (1939) · Medical Entomology and Zoology · Cited by 25 · see citing works
Environmental physiology and indoor climate — Thermoregulation and thermal comfort
Shapiro, Y., & Epstein, Y. (1984) · Energy and Buildings · doi:10.1016/0378-7788(84)90043-4 · Cited by 22 · see citing works
Self-citation[The physiologial significance of the cumulative discomfort index (Cum.D.I.)].
TENNENBAUM, J., SOHAR, E., Adar, R., et al. (1961) · PubMed · Cited by 20 · see citing works
Fighter index of thermal stress (FITS): guidance for hot-weather aircraft operations.
Nunneley, S. A., & Stribley, R. F. (1979) · PubMed · Cited by 16 · see citing works
Effective heat strain index using pocket computer
Kamon, E., & Ryan, C. (1981) · American Industrial Hygiene Association Journal · doi:10.1080/15298668191420369 · Cited by 16 · see citing works
A MODIFIED DISCOMFORT INDEX (MDI) AS A SUBSTITUTE FOR THE WET BULB GLOBE TEMPERATURE (WBGT)
Moran, D. S., Laor, A., Epstein, Y., et al. (1998) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-199805001-01614 · Cited by 13 · see citing works
Self-citationSOHAR, E. (1982) · Energy and Buildings · doi:10.1016/0378-7788(82)90040-8 · Cited by 7 · see citing works
Environmental limits, their prescription and proscription
Goldman, R. F. (1973) · International Journal of Environmental Studies · doi:10.1080/00207237308709609 · Cited by 7 · see citing works
Thermal Comfort in an Era of Energy Shortage
Goldman, R. F. (1982) · doi:10.1520/stp30088s · Cited by 1 · see citing works
Flagged first, then by citations
Research works printed but not linked: 11
- [9]9. Fanger PO (1970) Thermal comfort, Danish Technical Press, Copenhgen.
- [10]10. Goldman RF (2001) Introduction to heat-related problems in military operations. In: Textbook of military medicine: medical aspects of harsh environments Vol. 1, Pandolf KB, Burr RE (Eds.), 3-49, Office of the Surgeon General, Department of the Army, Washington DC. 11)
- [15]15. Goldman RF (1988) Standards for human exposure to heat. In: Environmental ergonomics, Mekjavic IB, Banister EW, Morrison JB (Eds.), 99-138, Taylor & Francis, Philadelphia.
- [20]20. Belding HS (1970) The search for a universal heat stress index. In: Physiological and behavioral temperature regulation, Hardy JD, Gagge AP, Stolwijk JAJ (Eds.), 193- 202, Charles C Thomas, Springfield. 21
- [29]29. US Department of Labor (1999) OSHA Technical manual (OTM) (TED 01-00-015), section III chapter 4: heat stress, US Department of Labor, Washington DC.
- [32]32. Department of the Army (1980) Prevention, treatment, and control of heat injury, 1-21, Technical Bulletin No TB Med 507, Department of the Army, Washington DC.
- [40]40. Sohar E (1979) Man in the desert. In: Arid zone settlement planning-the Israeli experience, Golani G (Ed.), 477-518, Pergamon Press, New York.
- [42]42. Epstein Y, Moran DS (2004) Extremes of temperature and hydration. In: Travel Medicine, Keystone JS, Kozarsky PE, Freedman DO, Nothdurft HD, Conner BA (Eds.), 383-92, Mosbey, Edinburgh.
- [58]58. Givoni B (1962) The influence of work and environmental conditions on the physiological responses and thermal equilibrium of man. In: Proceedings of UNESCO Symposium on Environmental Physiology and Psychology in Arid Conditions, 199-204, Lucknow.
- [67]67. Kerslake DM (1972) The stress of hot environment. Cambridge University Press, Cmbridge.
- [76]76. Frank A, Moran D, Epstein Y, Belokopytov M, Shapiro Y (1996) The estimation of heat tolerance by a new cumulative heat strain index. In: Environmental Ergonomics: Recent progress and new frontiers, Shapiro Y, Moran D, Epstein Y (Eds.), 194-7, Freund Pub House, London.
Cited by
Sorted by citations
Wet-bulb globe temperature (WBGT)—its history and its limitations
Budd, G. M. (2008) · Journal of Science and Medicine in Sport · doi:10.1016/j.jsams.2007.07.003 · Cited by 783 · see citing works
Deadly heat waves projected in the densely populated agricultural regions of South Asia
Im, E.-S., Pal, J. S., & Eltahir, E. A. B. (2017) · Science Advances · doi:10.1126/sciadv.1603322 · Cited by 673 · see citing works
Reductions in labour capacity from heat stress under climate warming
Dunne, J. P., Stouffer, R. J., & John, J. G. (2013) · Nature Climate Change · doi:10.1038/nclimate1827 · Cited by 660 · see citing works
Kjellstrom, T., Briggs, D., Freyberg, C., Lemke, B., Otto, M., & Hyatt, O. (2016) · Annual Review of Public Health · doi:10.1146/annurev-publhealth-032315-021740 · Cited by 617 · see citing works
Mental health effects of climate change
Padhy, S., Sarkar, S., Panigrahi, M., & Paul, S. (2015) · Indian Journal of Occupational and Environmental Medicine · doi:10.4103/0019-5278.156997 · Cited by 238 · see citing works
Occupational heat stress assessment and protective strategies in the context of climate change
Gao, C., Kuklane, K., Östergren, P.-O., & Kjellstrom, T. (2018) · International Journal of Biometeorology · doi:10.1007/s00484-017-1352-y · Cited by 198 · see citing works
“The development of a heat stress index as Ba single value that integrates the effects of the basic parameters in any human thermal environment such that its value will vary with the thermal strain experienced by the individual^ (Epstein and Moran 2006) has been fraught with difficulties.”
BackgroundMethodInfluentialMaloney, S. K., & Forbes, C. F. (2011) · International Journal of Biometeorology · doi:10.1007/s00484-010-0320-6 · Cited by 96 · see citing works
Heat stress within energy efficient dwellings in Australia
Ren, Z., Wang, X., & Chen, D. (2014) · Architectural Science Review · doi:10.1080/00038628.2014.903568 · Cited by 60 · see citing works
Heat stress and occupational health and safety – spatial and temporal differentiation
Błażejczyk, K., Baranowski, J., & Błażejczyk, A. (2014) · Miscellanea Geographica - Regional Studies on Development · doi:10.2478/mgrsd-2014-0011 · Cited by 39 · see citing works
Practical on-site measurement of heat strain with the use of a perceptual strain index
Chan, A. P. C., & Yang, Y. (2016) · International Archives of Occupational and Environmental Health · doi:10.1007/s00420-015-1073-7 · Cited by 27 · see citing works
Borzino, N., Otto, M., Kjellstrom, T., & Kai Wei Lee, J. (2026) · Environmental Research: Climate · doi:10.1088/2752-5295/ae8320
- Authors
- EPSTEIN, Y., & MORAN, D. S.
- Affiliations
- Tel Aviv University (IL)
- Venue
- Industrial Health
- Published
- 2006
- Volume
- 44
- Issue
- 3
- Pages
- 388-398
- ISSN
- 0019-8366 (ISSN-L)
- 1880-8026
- OpenAlex
- W2058120680
- Cited by
- 920
- References
- 52
- Citations by year
- 2026: 59 · 2025: 74 · 2024: 62 · 2023: 78 · 2022: 84 · 2021: 75 · 2020: 71 · 2019: 64 · 2018: 70 · 2017: 55 · 2016: 54 · 2015: 37 · 2014: 43 · 2013: 42 · 2012: 19
- FWCI
- 1.33
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Industrial Health (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Thermoregulation and physiological responses
- Physical Sciences › Engineering › Building and Construction › Building Energy and Comfort Optimization
- Life Sciences › Agricultural and Biological Sciences › Animal Science and Zoology › Effects of Environmental Stressors on Livestock
- Keywords
- heat stress, thermal comfort, heat stress indices, wet bulb globe temperature, discomfort index, thermal sensation, occupational heat exposure
- MeSH terms
- Adaptation, Physiological, Humans, Israel, Temperature, Risk Assessment, Heat Stress Disorders
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review