A real-time heat strain risk classifier using heart rate and skin temperature

Heat injury is a real concern to workers engaged in physically demanding tasks in high heat strain environments. Several real-time physiological monitoring systems exist that can provide indices of heat strain, e.g. physiological strain index (PSI), and provide alerts to medical personnel. However, these systems depend on core temperature measurement using expensive, ingestible thermometer pills. Seeking a better solution, we suggest the use of a model which can identify the probability that individuals are 'at risk' from heat injury using non-invasive measures. The intent is for the system to identify individuals who need monitoring more closely or who should apply heat strain mitigation strategies. We generated a model that can identify 'at risk' (PSI ≥ 7.5) workers from measures of heart rate and chest skin temperature. The model was built using data from six previously published exercise studies in which some subjects wore chemical protective equipment. The model has an overall classification error rate of 10% with one false negative error (2.7%), and outperforms an earlier model and a least squares regression model with classification errors of 21% and 14%, respectively. Additionally, the model allows the classification criteria to be adjusted based on the task and acceptable level of risk. We conclude that the model could be a valuable part of a multi-faceted heat strain management system.