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Factors Associated With Heat Strain Among Workers at an Aluminum Smelter in Texas

Dang, Bich N. MD; Dowell, Chad H. MS, CIH

Journal of Occupational & Environmental Medicine:
doi: 10.1097/JOM.0000000000000095
Original Articles

Objectives: To determine the prevalence of heat strain and factors associated with heat strain among workers at an aluminum smelter in Texas.

Methods: Continuous core body temperature (Tc), heart rate, and pre- and postshift serum electrolytes, and urine specific gravity were measured, and symptom questionnaires were administered.

Results: Most participants (54%) had 1 or more signs of heat strain. Unacclimatized participants were significantly more likely to exceed the American Conference of Governmental Industrial Hygienists–recommended Tc than acclimatized participants (88% vs 20%; P < 0.01). Participants who exceeded the Tc for their acclimatization status and/or exceeded the recommended sustained peak HR had a significantly lower body mass index than those who did not (27.6 vs 31.8 and 28.4 vs 32.4, respectively; P = 0.01).

Conclusions: Employees and management need to strictly adhere to a heat stress management program to minimize heat stress and strain.

Author Information

From the Centers for Disease Control and Prevention (Dr Dang and LCDR Dowell), National Institute for Occupational Safety and Health, Division of Surveillance, Hazard Evaluations and Field Studies, Cincinnati, Ohio. LCDR Dowell is currently working at the Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Office of the Director, Atlanta, Georgia. Dr Dang is currently working at Baylor College of Medicine, Department of Medicine, Houston, Texas, and the Michael E. DeBakey Veterans Affairs Medical Center, Center for Innovations in Quality, Effectiveness and Safety, Houston, Texas.

Address correspondence to: Chad H. Dowell, MS, CIH, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, 1600 Clifton Road NE, Atlanta, Georgia 30333 (

The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the National Institute for Occupational Safety and Health.

The authors declare no conflicts of interest.

Copyright © 2014 by the American College of Occupational and Environmental Medicine