Document Type : Original Article

Authors

1 Department of Occupational Health Engineering, Faculty of Medicine, University of Tarbiat Modares

2 Department of Occupational Health Engineering, School of Health, Shahid Beheshti University of Medical Sciences, Tehran, I. R. Iran

3 Environment Research Center, School of Health, Isfahan University of Medical Sciences, Isfahan

Abstract

Background: In the hot weather, overweight and obesity are considered as significant risk
factors for the incidence of cardiac strain in workers. This study is aimed at comparing the
cardiac strain among overweight and normal‑weighted workers, in the hot, humid conditions
of the south of Iran. Materials and Methods: This cross‑sectional study was conducted
on 71 workers in the south of Iran, in the summer of 2010.The heart rate was measured at
rest and at actual work. Cardiac strain based on the working heart rate (WHR), the relative
cardiac cost (RCC), the net cardiac cost (NCC), the load relative cardiovascular (CVL), and
heart rate reduction were analyzed in 35 normal weight people (BMI <25) and 36 people who
were overweight (BMI >25), using descriptive statistics and t‑ tests. Results: In 42% of the
total workers, the body mass index was more than 25. The average temperature of the two
groups was not significantly different. The mean WHR in these two groups was 101 ± 20.3
and 112 ± 18.9, respectively (P = 0.026). Percentages that exceeded the acceptable limits
in parameters of NCC, RCC, WHR, CVL, and the Brouha index, were significantly higher in
overweight people than those in people with normal weight. Conclusions: Based on the study
results, the severity of cardiac strain was higher in overweight workers when compared with
normal weight workers. Hence, in order to decrease the cardiac strain, selecting overweight
individuals for these jobs should be avoided, as also some vital intervention for losing weight,
such as, nutrition education and encouraging them to increase their physical activity, should
be implemented.

Keywords

1. Kelly T, Yang W, Chen CS, Reynolds K, He J. Global burden
of obesity in 2005 and projections to 2030. Int J Obes (Lond)
2008;32:1431‑7.
2. Esteghamati A, Khalilzadeh O, MohammadK, Meysamie A, Rashidi A,
Kamgar M, et al. Secular trends of obesity in Iran between 1999
and 2007: National Surveys of Risk Factors of Non‑communicable
Diseases. Metab Syndr Relat Disord 2010;8:209‑13.
3. Janghorbani M, Amini M, Willett WC, Mehdi Gouya M, Delavari A,
Alikhani S, et al. First nationwide survey of prevalence of
overweight, underweight, and abdominal obesity in Iranian adults.
Obesity (Silver Spring) 2007;15:2797‑808.
4. Wyatt SB, Winters KP, Dubbert PM. Overweight and obesity:
Prevalence, consequences, and causes of a growing public health
problem. Am J Med Sci 2006;331:166‑74.
5. Miller AT Jr, Blyth CS. Lack of insulating effect of body fat during
exposure to internal and external heat loads. J Appl Physiol
1958;12:17‑9.
6. Soteriades ES, Hauser R, Kawachi I, Liarokapis D, Christiani DC,
Kales SN. Obesity and cardiovascular disease risk factors in
firefighters: A prospective cohort study. Obes Res 2005;13:1756‑63.
7. Lumingu HM, Dessureault P. Physiological responses to heat strain:
A study on personal monitoring for young workers. J Therm Biol
2009;34:299‑305.
8. Saha R, Dey NC, Samanta A, Biswas R. A comparison of cardiac
strain among drillers of two different age groups in underground
manual coal mines in India. J Occup Health 2008;50:512‑20.
9. Parsons K. Heat stress standard ISO 7243 and its global application.
Ind Health 2006;44:368‑79.
10. Budd GM. Wet‑bulb globe temperature (WBGT)–its history and its
limitations. J Sci Med Sport 2008;11:20‑32.
11. Saha R, Samanta A, Dey N. Cardiac workload of dressers in
underground manual coal mines. JIOM 2011;32:11‑7.
12. Motamedzade M, AzariR. Heat stress evaluation using environmental
and biological monitoring. Pak J Biol Sci 2006;9:457‑9.
13. Du Bois D, Du Bois EF. Clinical calorimetry: Tenth paper a formula
to estimate the approximate surface area if height and weight be
known. Arch Intern Med 1916;17:863.
14. Keys A, Fidanza F, Karvonen MJ, Kimura N, Taylor HL. Indices of
relative weight and obesity. J Chronic Dis 1972;25:329‑43.
15. Robergs RA, Landwehr R. The surprising history of the
“HRmax=220‑age” equation. JEP 2002;5:1‑10.
16. Biswas R, Samanta A. Assessment of physiological strain in inland
fishing activity. Indian J Occup Environ Med 2006;10:19.
17. Dey NC, Samanta A, Saha R. Cardiovascular load assessment of
coal mine shovelers in West Bengal, India: A comparison between
middle age groups. J Hum Ergol (Tokyo) 2006;35:41‑4.
18. Yoopat P. Cardiorespiratory capacity and strain of blue‑collar
workers in Thailand. Kuopio University Publications D. Med Sci
2002;27‑3019. Vanhees L, Lefevre J, Philippaerts R, Martens M, Huygens W,
Troosters T, et al. How to assess physical activity? How to assess
physical fitness? Eur J Cardiovasc Prev Rehabil 2005;12:102‑14.
20. Consultation W. Obesity: Preventing and managing the global
epidemic. World Health Organ Tech Rep Ser 2000:8.
21. Robinson S. The effect of body size upon energy exchange in work.
American Journal of Physiology–Legacy Content 1942;136:363‑5
22. Crezee J, Lagendijk J. Temperature uniformity during hyperthermia:
The impact of large vessels. Phys Med Biol 1992;37:1321‑37.
23. Kenny GP, Yardley J, Brown C, Sigal RJ, Jay O, Kenny G. Heat stress
in older individuals and patients with common chronic diseases.
CMAJ: Canadian Medical Association Journal. 2010;182:1053.
24. Vroman NB, Buskirk ER, Hodgson JL. Cardiac output and skin blood
flow in lean and obese individuals during exercise in the heat. J Appl
Physiol 1983;55:69‑74.
25. Gardner JW, Kark JA, Karnei K, Sanborn JS, Gastaldo E, Burr P,
et al. Risk factors predicting exertional heat illness in male Marine
Corps recruits. Med Sci Sports Exerc 1996;28:939‑44.
26. Donoghue AM, Bates GP. The risk of heat exhaustion at a deep
underground metalliferous mine in relation to body‑mass index
and predicted VO2 max. Occup Med (Lond) 2000;50:259‑63.
27. Buskirk E, Taylor H, Simonson E. Relationships between obesity
and the pulse rate at rest and during work in young and older men.
Eur J Appl Physiol Occup Physiol 1955;16:83‑9.
28. Chung NK, Pin CH. Obesity and the occurrence of heat disorders.
Mil Med 1996;161:739‑42.
29. Bar‑Or O, Lundegren HM, Buskirk E. Heat tolerance of exercising
obese and lean women. J Appl Physiol 1969;26:403‑9.
30. Epstein Y, Shapiro Y, Brill S. Role of surface area‑to‑mass ratio and
work efficiency in heat intolerance. J Appl Physiol 1983;54:831‑6.
31. Hayward JS, Eckerson JD, Dawson BT. Effect of mesomorphy on
hyperthermia during exercise in a warm, humid environment. Am
J Phys Anthropol 1986;70:11‑7.
32. Havenith G, van Middendorp H. The relative influence of physical
fitness, acclimatization state, anthropometric measures and gender
on individual reactions to heat stress. Eur J Appl Physiol Occup
Physiol 1990;61:419‑27.