title: Development and Validation of a Questionnaire for Preliminary Assessment of Heat Stress at Workplace.
abstract: BACKGROUND
  Current heat stress indices are not completely suitable for heat strain screening in developing countries due to their inherent and applied limitations. The aim of this study was development of a questionnaire method entitled "Heat Strain Score Index" (HSSI) in order to perform a preliminary assessment of heat stress at work.
  
  
  METHODS
  This research included six phases (i) Item generation (ii) Content validity (iii) Reliability analysis (iv)Structure validity (v) Concurrent validity and (vi) Classification of thermal risk level. In item generation phase, 40 items were identified to have impact on the heat strain. Content validity was evaluated by occupational health specialists.
  
  
  RESULTS
  In consistency assessment, Cronbach's coefficient (α) of items was 0.91. Exploratory factor analysis on items HSSI draft identified four subscales which explained 71.6% of the variance. Correlation between the HSSI score with aural temperature was 0.73. Cut-off point; sensitivity and specificity for upper no thermal strain zone were 13.5, 91% and 50%, respectively. Whereas Cut-off point, sensitivity and specificity for lower thermal strain zone were 18, 86% and 73%.
  
  
  CONCLUSIONS
  The results showed that 18 variables that were measurable through subjective judgment and observation in the HSSI scale covered heat stress key factors. This scale demonstrated reliability and initial validity in scale were suitable. Therefore HSSI scale for primary evaluation heat stress is appropriate.
authors.affiliation: Department of Occupational Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran. ha_dehghan@hlth.mui.ac.ir.
authors.forename: Habibollah
authors.initials: H
authors.lastname: Dehghan
authors.affiliation: Department of Occupational Health Engineering, School of Medicine, Tarbiat Modares University, Tehran, Iran.mortazavi@modares.ac.ir.
authors.forename: Seyed Bagher
authors.initials: SB
authors.lastname: Mortzavi
authors.affiliation: Department of Occupational Health Engineering, School of Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mohamad Javad
authors.initials: MJ
authors.lastname: Jafari
authors.affiliation: Environment Research Center and Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Mohamad Reza
authors.initials: MR
authors.lastname: Maracy
mesh_terms: D018882:Heat Stress Disorders / Q000175:diagnosis*; D006801:Humans; D016273:Occupational Exposure; D011795:Surveys and Questionnaires / Q000592:standards*
keywords: Aural Temperature; Heat Strain Score Index; Heat Stress Evaluation; Reliability; Validity