Heat stress and protective clothing: an emerging approach from the United States.

There is little doubt that heat stress affects many workers adversely and that protective clothing generally adds to the burden. The ACGIH threshold limit value for heat stress is the guiding document for evaluation of heat stress in the United States. Adjustment factors have been used to reflect the change in heat stress imposed by different clothing ensembles. While the first proposed factors started with limited experimental data and professional judgment, heat balance methods in the laboratory have yielded better estimates of adjustment factors and for a wider selection of ensembles. These same experiments have provided the starting point to accounting for nonporous clothing in heat balance evaluation schemes such as required sweat rate. Proposed changes to the ACGIH TLV have been mentioned and a framework for thinking about controls presented.