Ice and cold water) ingestion seems to yield greater increases in body heat content during exercise in hot (34 C) and dry (20 RH) conditions compared to thermoneutral fluid.49 In view of the much greater latent heat of vaporization of water (2430 J�g?) relative to specific heat capacity, greater cooling may actually be achieved by dampening the skin surface with water (particularly when accompanied by additional air flow).52 Only if work is carried out in hot/humid conditions whereby cold fluid ingestion will reduce the amount of sweat that drips off the body without impacting skin surface evaporation, may the ingestion of colder water confer a clear thermoregulatory advantage. In most hot occupational environments, workers should therefore consider dampening their skin with water (with a sponge or water spray) in addition to ingesting water at a temperature that is most palatable.Skin temperatureSkin temperature data among the studies captured by the present review were sparse, however those that did include this measure often reported values of 35 C or greater (Table 4) which is to be expected from the known associations between skin temperature and the thermal environment. While changes in skin temperature have been demonstrated to be a poor correlate of body heat storage,54 mean skin temperature determines the temperature gradient for skin surface dry heat exchange for a given set of environmental conditions, and is traditionally viewed as the driver for internal heat transfer from deeper body tissues to the body shell.55 It follows that the drive for both internal and external convective/conductive heat loss would have been compromised in most of the studies reporting skin temperature, with skin surface evaporation responsible for almost all heat dissipation. High skin temperatures have also been shown in the athletic arena to compromise physical performance.56-58 Such observations are likely only relevant in the present review to activities with high rate of metabolic energy expenditure (i.e., military-related, fire Aprotinin biological activity fighting and Tasigna web search and rescue activities).Thermal comfort/sensationreported subjective thermal votes of workers in hot Australian workplaces (Table 4). Nonetheless it is reasonable to assume that most workers in the reported conditions would feel warm to hot, and often uncomfortably so. Given the importance of subjective variables on worker performance and health and safety (from a perspective of both decision making and the ability to focus on the task at hand) such a paucity of data is surprising. Studies that did include such measures reported thermal sensations that included discomfort. Search and rescue workers and zinc cathode strippers appeared to experience the greatest levels of thermal discomfort, however the studies that reported the greatest levels of workplace hyperthermia did not measure subjective responses. Modest rises in deep core temperature can compromise the performance of cognitive tasks,59 however studies examining the relationship between environmental heat stress and cognitive functioning have been far from conclusive. In some cases heat stress was detrimental60,61 while others have reported enhanced arousal/concentration.62,63 Despite subjective sensations of warmth and discomfort ?which often give cause for concern or alarm – the accompanying physiological responses of core temperature and sweat rate were generally well within tolerable levels.Health impacts of occupational heat stress in Aus.Ice and cold water) ingestion seems to yield greater increases in body heat content during exercise in hot (34 C) and dry (20 RH) conditions compared to thermoneutral fluid.49 In view of the much greater latent heat of vaporization of water (2430 J�g?) relative to specific heat capacity, greater cooling may actually be achieved by dampening the skin surface with water (particularly when accompanied by additional air flow).52 Only if work is carried out in hot/humid conditions whereby cold fluid ingestion will reduce the amount of sweat that drips off the body without impacting skin surface evaporation, may the ingestion of colder water confer a clear thermoregulatory advantage. In most hot occupational environments, workers should therefore consider dampening their skin with water (with a sponge or water spray) in addition to ingesting water at a temperature that is most palatable.Skin temperatureSkin temperature data among the studies captured by the present review were sparse, however those that did include this measure often reported values of 35 C or greater (Table 4) which is to be expected from the known associations between skin temperature and the thermal environment. While changes in skin temperature have been demonstrated to be a poor correlate of body heat storage,54 mean skin temperature determines the temperature gradient for skin surface dry heat exchange for a given set of environmental conditions, and is traditionally viewed as the driver for internal heat transfer from deeper body tissues to the body shell.55 It follows that the drive for both internal and external convective/conductive heat loss would have been compromised in most of the studies reporting skin temperature, with skin surface evaporation responsible for almost all heat dissipation. High skin temperatures have also been shown in the athletic arena to compromise physical performance.56-58 Such observations are likely only relevant in the present review to activities with high rate of metabolic energy expenditure (i.e., military-related, fire fighting and search and rescue activities).Thermal comfort/sensationreported subjective thermal votes of workers in hot Australian workplaces (Table 4). Nonetheless it is reasonable to assume that most workers in the reported conditions would feel warm to hot, and often uncomfortably so. Given the importance of subjective variables on worker performance and health and safety (from a perspective of both decision making and the ability to focus on the task at hand) such a paucity of data is surprising. Studies that did include such measures reported thermal sensations that included discomfort. Search and rescue workers and zinc cathode strippers appeared to experience the greatest levels of thermal discomfort, however the studies that reported the greatest levels of workplace hyperthermia did not measure subjective responses. Modest rises in deep core temperature can compromise the performance of cognitive tasks,59 however studies examining the relationship between environmental heat stress and cognitive functioning have been far from conclusive. In some cases heat stress was detrimental60,61 while others have reported enhanced arousal/concentration.62,63 Despite subjective sensations of warmth and discomfort ?which often give cause for concern or alarm – the accompanying physiological responses of core temperature and sweat rate were generally well within tolerable levels.Health impacts of occupational heat stress in Aus.