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      Assessment of Overheating Risk in Gynaecology Scanning Rooms during Near-Heatwave Conditions: A Case Study of the Royal Berkshire Hospital in the UK

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          Abstract

          Hospital buildings in the UK are at particular risk to rising summer temperatures associated with climate change. Balancing the thermal needs of patients, staff, and visitors is a challenging, complex endeavour. A case study of the ultrasound area of the Royal Berkshire Hospital’s Maternity and Gynaecology building is presented, where temperatures were measured for 35 days in waiting areas, staff offices, and ultrasound scanning rooms, aiming to assess the overheating risk posed to occupants. Local external temperature measurements were used for comparison whereby determining the indoor-outdoor environmental connection. Results show that most rooms had already breached standard overheating thresholds within the study period. Anthropogenic and waste heat from equipment has a noticeable effect on indoor temperatures. Local air-conditioning helped reduce the peaks in temperature seen between 14:00 and 17:00 for similar scanning rooms but is in contradiction to the National Health Service’s sustainability plans. Several low-level solutions such as improved signage, access to water, and the allocation of vulnerable patients to morning clinics are suggested. Barriers to solutions are also discussed and the requirement of sufficient maintenance plans for cooling equipment is empathised. These solutions are likely to be applicable to other hospital buildings experiencing similar conditions.

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          Most cited references32

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          Workplace heat stress, health and productivity – an increasing challenge for low and middle-income countries during climate change

          Background Global climate change is already increasing the average temperature and direct heat exposure in many places around the world. Objectives To assess the potential impact on occupational health and work capacity for people exposed at work to increasing heat due to climate change. Design A brief review of basic thermal physiology mechanisms, occupational heat exposure guidelines and heat exposure changes in selected cities. Results In countries with very hot seasons, workers are already affected by working environments hotter than that with which human physiological mechanisms can cope. To protect workers from excessive heat, a number of heat exposure indices have been developed. One that is commonly used in occupational health is the Wet Bulb Globe Temperature (WBGT). We use WBGT to illustrate assessing the proportion of a working hour during which a worker can sustain work and the proportion of that same working hour that (s)he needs to rest to cool the body down and maintain core body temperature below 38°C. Using this proportion a ‘work capacity’ estimate was calculated for selected heat exposure levels and work intensity levels. The work capacity rapidly reduces as the WBGT exceeds 26–30°C and this can be used to estimate the impact of increasing heat exposure as a result of climate change in tropical countries. Conclusions One result of climate change is a reduced work capacity in heat-exposed jobs and greater difficulty in achieving economic and social development in the countries affected by this somewhat neglected impact of climate change.
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            Effects of heat stress on cognitive performance: the current state of knowledge.

            This paper discusses the current state of knowledge on the effects of heat stress on cognitive performance. Although substantial research has been performed, it has proven difficult to describe the literature findings in a systematic manner. This is due to the large number of factors that come into play, such as task type, exposure duration, skill and acclimatization level of the individual and due to the absence of a concise theory on which experimental work can be based. However, two trends have been identified. First, heat stress affects cognitive performance differentially, depending on the type of cognitive task. Secondly, it appears that a relationship can be established between the effects of heat stress and deep body temperature. A number of exposure limits have been proposed during the last decades. These limits are summarized in this paper, with a special emphasis on the most recent one derived by Hancock and Vasmatzidis. This limit, which employs an attentional resource approach, defines exposure duration thresholds as parallel lines. Although this approach appears to be the most promising thus far, it is concluded that much remains to be understood before a limit becomes universally acceptable.
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              A meta-analysis of performance response under thermal stressors.

              Quantify the effect of thermal stressors on human performance. Most reviews of the effect of environmental stressors on human performance are qualitative. A quantitative review provides a stronger aid in advancing theory and practice. Meta-analytic methods were applied to the available literature on thermal stressors and performance. A total of 291 references were collected. Forty-nine publications met the selection criteria, providing 528 effect sizes for analysis. Analyses confirmed a substantial negative effect on performance associated with thermal stressors. The overall effect size for heat was comparable to that for cold. Cognitive performance was least affected by thermal stressors, whereas both psychomotor and perceptual task performance were degraded to a greater degree. Other variables were identified that moderated thermal effects. Results confirmed the importance of task type, exposure duration, and stressor intensity as key variables impacting how thermal conditions affect performance. Results were consistent with the theory that stress forces the individual to allocate attentional resources to appraise and cope with the threat, which reduces the capacity to process task-relevant information. This represents a maladaptive extension of the narrowing strategy, which acts to maintain stable levels of response when stress is first encountered. These quantitative estimates can be used to design thermal tolerance limits for different task types. Although results indicate the necessity for further research on a variety of potentially influential factors such as acclimatization, the current summary provides effect size estimates that should be useful in respect to protecting individuals exposed to adverse thermal conditions.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                11 September 2019
                September 2019
                : 16
                : 18
                : 3347
                Affiliations
                [1 ]Department of Meteorology, University of Reading, Reading RG66UR, UK
                [2 ]Royal Berkshire Hospital, Reading RG1 5AN, UK; Samuel.Faulknall-Mills@ 123456royalberkshire.nhs.uk
                [3 ]School of Civil Engineering, University of Leeds, Leeds LS6 1AN, UK; M.F.King@ 123456leeds.ac.uk
                [4 ]School of the Built Environment, University of Reading, Reading RG66UR, UK; z.luo@ 123456reading.ac.uk
                Author notes
                [* ]Correspondence: H.gough@ 123456reading.ac.uk
                Author information
                https://orcid.org/0000-0002-4693-5931
                https://orcid.org/0000-0001-7010-476X
                https://orcid.org/0000-0002-2082-3958
                Article
                ijerph-16-03347
                10.3390/ijerph16183347
                6765865
                31514270
                6c792eb4-8207-418b-afeb-1491e623e5e4
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 12 August 2019
                : 07 September 2019
                Categories
                Article

                Public health
                hospital,overheating,temperature,heatwave,climate,case study
                Public health
                hospital, overheating, temperature, heatwave, climate, case study

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