Skip to main content
SpringerLink
Log in

Outdoor Thermal Environment and Heat-Related Symptoms of Pedestrians: An Application of the UTCI for Health Risk Assessment

  • Chapter
  • First Online:
Applications of the Universal Thermal Climate Index UTCI in Biometeorology

Part of the book series: Biometeorology ((BIOMET,volume 4))

Abstract

Prolonged exposure to hot environments can cause adverse health effects ranging from thermal discomfort to heart disorders and heat stroke. Climate change and global warming increase people exposure to heat, posing a serious threat to human health. Adverse heat-related health impacts can be prevented by preparing public health systems to cope and address these threats. This study aims to examine the susceptibility of pedestrians to outdoor thermal environment. Micrometeorological conditions were monitored in urban public sites in Athens, Greece while data on individual's attributes and heat-related morbidity were collected with questionnaire-based field surveys. Participants were asked to report whether they were experiencing symptoms of heat-related illness during the field surveys. The symptoms included breathing difficulties, dizziness, headache and exhaustion. The thermal environment was assessed using the Universal Thermal Climate Index (UTCI). The relationship of experiencing or not heat-related symptoms with the UTCI was examined using logistic regression. Hierarchical clustering analysis was used to determine thresholds of the UTCI above which heat-related symptoms are expected to occur. A total of 2731 pedestrians participated in the surveys. Most of them were residents of the metropolitan area of Athens (94.2%), between 18 and 34 years old (44.8%), without a medical history of cardiovascular or respiratory disease (88.6%). Logistic regression showed that for one unit increase of the UTCI the odds of reporting heat-related symptoms increase by 4% (adjusted odds ratio (aOR) = 1.04, p-value < 0.001). The odds were increased to 6% in summer (aOR = 1.06, p-value < 0.012). The UTCI threshold for experiencing heat-related symptoms was 28.5 °C (moderate heat stress) for all seasons and 38.9 °C (very strong heat stress) for summer. These results could be used to strengthen public health capacities to protect population from heat exposure impacts.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 139.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Avalos LA, Chen H, Li DK, Basu R (2017) The impact of high apparent temperature on spontaneous preterm delivery: a case-crossover study. Environ Health 16(1):1–13

    Article  Google Scholar 

  • Basu R, Samet JM (2002) Relation between elevated ambient temperature and mortality: a review of the epidemiologic evidence. Epidemiol Rev 24(2):190–202

    Article  Google Scholar 

  • Basu R (2009) High ambient temperature and mortality: a review of epidemiologic studies from 2001 to 2008. Environ Health 8(1):1–13

    Article  Google Scholar 

  • Błażejczyk K, Błażejczyk M (2010) BioKlima© 2.6, Program komputerowy. http://www.igipz.pan.pl/Bioklima-zgik.html

  • Błażejczyk K, Jendritzky G, Bröde P, Fiala D, Havenith G, Epstein Y, Kampmann B (2013) An introduction to the universal thermal climate index (UTCI). Geogr Pol 86(1):5–10

    Article  Google Scholar 

  • Bröde P, Fiala D, Błażejczyk K, Holmér I, Jendritzky G, Kampmann B, Havenith G (2012) Deriving the operational procedure for the Universal Thermal Climate Index (UTCI). Int J Biometeorol 56(3):481–494

    Article  Google Scholar 

  • CDC (2020) Heat stress—heat related illness. https://www.cdc.gov/niosh/topics/heatstress/heatrelillness.html. Accessed 13 Mar 2020

  • Cui J, Sinoway LI (2014) Cardiovascular responses to heat stress in chronic heart failure. Curr Heart Fail Rep 11(2):139–145

    Article  Google Scholar 

  • Dehghan H, Mortazavi SB, Jafari MJ, Maracy MR (2013) Cardiac strain between normal weight and overweight workers in hot/humid weather in the Persian Gulf. Int J Prev Med 4(10):1147

    Google Scholar 

  • Di Napoli C, Pappenberger F, Cloke HL (2018) Assessing heat-related health risk in Europe via the Universal Thermal Climate Index (UTCI). Int J Biometeorol 62(7):1155–1165

    Article  Google Scholar 

  • ELSTAT (2020) Demographic characteristics/2011. https://www.statistics.gr/en/statistics/pop. Accessed 28 Sep 2020

  • Fouillet A, Rey G, Laurent F, Pavillon G, Bellec S, Guihenneuc-Jouyaux C, Hémon D (2006) Excess mortality related to the August 2003 heat wave in France. Int Arch Occup Environ Health 80(1):16–24

    Article  Google Scholar 

  • Gagnon D, Kenny GP (2012) Does sex have an independent effect on thermoeffector responses during exercise in the heat? J Physiol 590(23):5963–5973

    Article  Google Scholar 

  • Guyton AC, Hall JE (2006) Textbook of medical physiology, 11th edn. WB Sauders Co., Philadelphia

    Google Scholar 

  • Hajat S, Kosatky T (2010) Heat-related mortality: a review and exploration of heterogeneity. J Epidemiol Community Health 64(9):753–760

    Article  Google Scholar 

  • IPCC (2018) Global Warming of 1.5°C.https://www.ipcc.ch/sr15/. Accessed 15 Oct 2020

  • ISO 10551 (1995) Ergonomics of the physical environment—subjective judgement scales for assessing physical environments. Switzerland, Geneva

    Google Scholar 

  • ISO 7726 (2001) Ergonomics of the thermal environment—instruments for measuring physical quantities. Switzerland, Geneva

    Google Scholar 

  • ISO 8996 (2004) Ergonomics of the thermal environment—determination of metabolic rate. Switzerland, Geneva

    Google Scholar 

  • ISO 9920 (2007) Ergonomics—estimation of the thermal characteristics of a clothing ensemble. Switzerland, Geneva

    Google Scholar 

  • Kaciuba-Uscilko H, Grucza R (2001) Gender differences in thermoregulation. Curr Opin Clin Nutr Metab Care 4(6):533–536

    Article  Google Scholar 

  • Kenney WL, Craighead DH, Alexander LM (2014) Heat waves, aging, and human cardiovascular health. Med Sci Sports Exerc 46(10):1891

    Article  Google Scholar 

  • Kottek M, Grieser J, Beck C et al (2006) World Map of the Köppen-Geiger climate classification updated. Meteorol Z 15:259–263

    Article  Google Scholar 

  • Kuchcik M (2020) Mortality and thermal environment (UTCI) in Poland—long-term, multi-city study. Int J Biometeorol 1–13

    Google Scholar 

  • Lipman GS, Eifling KP, Ellis MA, Gaudio FG, Otten EM, Grissom CK (2013) Wilderness Medical Society practice guidelines for the prevention and treatment of heat-related illness. Wilderness Environ Med 24(4):351–361

    Article  Google Scholar 

  • Mora C, Counsell CW, Bielecki CR, Louis LV (2017) Twenty-seven ways a heat wave can kill you: deadly heat in the era of climate change. Circ Cardiovasc Qual Outcomes 10(11):e004233

    Google Scholar 

  • Murakami S, Miyatake N, Sakano N (2012) Changes in air temperature and its relation to ambulance transports due to heat stroke in all 47 prefectures of Japan. J Prev Med Public Health 45(5):309

    Article  Google Scholar 

  • Mutic AD, Mix JM, Elon L, Mutic NJ, Economos J, Flocks J, McCauley LA (2018) Classification of heat-related illness symptoms among Florida farmworkers. J Nurs Scholarsh 50(1):74–82

    Article  Google Scholar 

  • Nastos PT, Matzarakis A (2012) The effect of air temperature and human thermal indices on mortality in Athens. Greece Theor Appl Climatol 108(3):591–599

    Article  Google Scholar 

  • Näyhä S, Rintamäki H, Donaldson G, Hassi J, Jousilahti P, Laatikainen T, Ikäheimo TM (2017) The prevalence of heat-related cardiorespiratory symptoms: the vulnerable groups identified from the National FINRISK 2007 Study. Int J Biometeorol 61(4):657–668

    Article  Google Scholar 

  • Nikolopoulou M, Lykoudis S, Kikira M (2004) Thermal comfort models for open urban spaces. In: Nikolopoulou M (ed) Designing open spaces in the urban environment: a bioclimatic approach. Centre Renewable Energy Sources (C.R.E.S). http://alpha.cres.gr/ruros/desgui.htm. Accessed 15 Oct 2020

  • NOA-National Observatory of Athens (2020) Climatological bulletin. http://www.meteo.noa.gr/ENG/iersd_climatological.htm. Accessed 27 Sep 2020

  • Pantavou K, Theoharatos G, Nikolopoulos G, Katavoutas G, Asimakopoulos D (2008) Evaluation of thermal discomfort in Athens territory and its effect on the daily number of recorded patients at hospitals’ emergency rooms. Int J Biometeorol 52(8):773–778

    Article  Google Scholar 

  • Pantavou K, Theoharatos G, Santamouris M, Asimakopoulos D (2013) Outdoor thermal sensation of pedestrians in a Mediterranean climate and a comparison with UTCI. Build Environ 66:82–95

    Article  Google Scholar 

  • Pantavou KG, Lykoudis SP, Nikolopoulos GK (2016) Milder form of heat-related symptoms and thermal sensation: a study in a Mediterranean climate. Int J Biometeorol 60(6):917–929

    Article  Google Scholar 

  • Pantavou K, Giallouros G, Lykoudis S, Markozannes G, Constantinou E, Panagi A, Nikolopoulos GK (2020) Impact of heat exposure on health during a warm period in Cyprus. Euro-Mediterr J Environ Integr 5:1–12

    Article  Google Scholar 

  • Potchter O, Cohen P, Lin TP, Matzarakis A (2018) Outdoor human thermal perception in various climates: a comprehensive review of approaches, methods and quantification. Sci Total Environ 631:390–406

    Article  Google Scholar 

  • Seidell JC, Oosterlee A, Deurenberg P, Hautvast JG, Ruijs JH (1988) Abdominal fat depots measured with computed tomography: effects of degree of obesity, sex, and age. Eur J Clin Nutr 42(9):805–815

    Google Scholar 

  • Sherbakov T, Malig B, Guirguis K, Gershunov A, Basu R (2018) Ambient temperature and added heat wave effects on hospitalizations in California from 1999 to 2009. Environ Res 160:83–90

    Article  Google Scholar 

  • Son JY, Liu JC, Bell ML (2019) Temperature-related mortality: a systematic review and investigation of effect modifiers. Environ Res Lett 14(7):073004

    Google Scholar 

  • Song X, Wang S, Hu Y, Yue M, Zhang T, Liu Y, Shang K (2017) Impact of ambient temperature on morbidity and mortality: an overview of reviews. Sci Total Environ 586:241–254

    Article  Google Scholar 

  • Sugg MM, Konrad CE, Fuhrmann CM (2016) Relationships between maximum temperature and heat-related illness across North Carolina, USA. Int J Biometeorol 60(5):663–675

    Article  Google Scholar 

  • Sun Z, Chen C, Xu D, Li T (2018) Effects of ambient temperature on myocardial infarction: a systematic review and meta-analysis. Environ Pollut 241:1106–1114

    Article  Google Scholar 

  • Tseliou A, Tsiros IX, Nikolopoulou M, Papadopoulos G (2016) Outdoor thermal sensation in a Mediterranean climate (Athens): the effect of selected microclimatic parameters. Archit Sci Rev 59(3):190–202

    Article  Google Scholar 

  • UBiPlan (2020) Urban biometeorology and planning. https://ubiplanproject.wordpress.com/. Accessed 23 Feb 2020

  • Urban A, Kyselý J (2014) Comparison of UTCI with other thermal indices in the assessment of heat and cold effects on cardiovascular mortality in the Czech Republic. Int J Environ Res Public Health 11(1):952–967

    Article  Google Scholar 

  • Vaneckova P, Neville G, Tippett V, Aitken P, FitzGerald G, Tong S (2011) Do biometeorological indices improve modeling outcomes of heat-related mortality? J Appl Meteorol Climatol 50(6):1165–1176

    Article  Google Scholar 

  • Wang Y, Bobb JF, Papi B, Wang Y, Kosheleva A, Di Q, Dominici F (2016) Heat stroke admissions during heat waves in 1,916 US counties for the period from 1999 to 2010 and their effect modifiers. Environ Health 15(1):1–9

    Article  Google Scholar 

  • WHO-World Health Organization (2020) Information and public health advice: heat and health. https://www.who.int/globalchange/publications/heat-and-health/en/. Accessed 21 Sep 2020

  • Xu Y, Dadvand P, Barrera-Gómez J, Sartini C, Marí-Dell’Olmo M, Borrell C, Basagaña X (2013) Differences on the effect of heat waves on mortality by sociodemographic and urban landscape characteristics. J Epidemiol Commun Health 67(6):519–525

    Article  Google Scholar 

  • Xu Z, Hu W, Su H, Turner LR, Ye X, Wang J, Tong S (2014) Extreme temperatures and paediatric emergency department admissions. J Epidemiol Commun Health 68(4):304–311

    Article  Google Scholar 

  • Ye X, Wolff R, Yu W, Vaneckova P, Pan X, Tong S (2012) Ambient temperature and morbidity: a review of epidemiological evidence. Environ Health Perspect 120(1):19–28

    Article  Google Scholar 

Download references

Acknowledgements

I would like to thank Dr. Spyridon Lykoudis for his helpful comments and Emmanouil Melas for his support in the field surveys.

Funding

This project has received funding from the Hellenic Foundation for Research and Innovation (HFRI) and the General Secretariat for Research and Technology (GSRT), under grant agreement No. 146.

Author information

Authors and Affiliations

  1. Laboratory of General and Agricultural Meteorology, Agricultural University of Athens, Iera Odos 75, 118 55, Athens, Greece

    Katerina Pantavou

Authors
  1. Katerina Pantavou
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Katerina Pantavou .

Editor information

Editors and Affiliations

  1. Department of Civil Construction, Federal University of Technology, Curitiba - PR, Brazil

    Eduardo L. Krüger

Rights and permissions

Reprints and permissions

Copyright information

© 2021 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Pantavou, K. (2021). Outdoor Thermal Environment and Heat-Related Symptoms of Pedestrians: An Application of the UTCI for Health Risk Assessment. In: Krüger, E.L. (eds) Applications of the Universal Thermal Climate Index UTCI in Biometeorology. Biometeorology, vol 4. Springer, Cham. https://doi.org/10.1007/978-3-030-76716-7_7

Download citation

Publish with us

Policies and ethics

Search

Navigation