Abstract
CONTEXT: Many organizations associated with sports medicine recommend using wet-bulb globe temperature (WBGT)-based activity-modification guidelines that are uniform across the country. However, no consideration has been given to whether the WBGT thresholds are appropriate for different weather conditions, such as warm-humid (WH) relative to hot-dry (HD), based on known differences in physiological responses to these environments. OBJECTIVE: To identify if personnel in regions with drier conditions and greater evaporative cooling potential should consider using WBGT-based activity-modification thresholds that differ from those in more humid weather. DESIGN: Observational study. SETTING: Weather stations across the contiguous United States. MAIN OUTCOME MEASURE(S): A 15-year hourly WBGT dataset from 217 weather stations across the contiguous United States was used to identify particular combinations of globe temperature, wet-bulb temperature, and air temperature that produce WBGTs of 27.9°C, 30.1°C, and 32.3°C. A total of 71 302 observations were clustered into HD and WH environmental conditions. From these clusters, maximum heat-loss potential and heat-flux values were modeled at equivalent WBGT thresholds with various activity levels, clothing, and equipment configurations. RESULTS: We identified strong geographic patterns, with HD conditions predominant in the western half and WH conditions predominant in the eastern half of the country. Heat loss was systematically greater in HD than in WH conditions, indicating an overall less stressful environment, even at equivalent WBGT values. At a WBGT of 32.3°C, this difference was 11 W·m-2 at an activity velocity of 0.3 m·s-1, which doubled for an activity velocity of 0.7 m·s-1. The HD and WH difference increased with the WBGT value, demonstrating that evaporative cooling differences between HD and WH conditions were even greater at a higher, rather than lower, WBGT. CONCLUSIONS: Potential heat loss was consistently greater in HD than in WH environments despite equal WBGTs. These findings support the need for further clinical studies to determine the appropriate WBGT thresholds based on environmental and physiological limits to maximize safety while avoiding unnecessary limitations.