Milder form of heat-related symptoms and thermal sensation: a study in a Mediterranean climate.

Mild heat-related health effects and their potential association with meteorological and personal parameters in relation to subjective and objective thermal sensation were investigated. Micrometeorological measurements and questionnaire surveys were conducted in an urban Mediterranean environment during a warm, cool, and a transitional season. The participants were asked to indicate their thermal sensation based on a seven-point scale and report whether they were experiencing any of the following symptoms: headache, dizziness, breathing difficulties, and exhaustion. Two thermal indices, Actual Sensation Vote (ASV) and Universal Thermal Climate Index (UTCI), were estimated in order to obtain an objective measure of individuals' thermal sensation. Binary logistic regression was applied to identify risk parameters while cluster analysis was used to determine thresholds of air temperature, ASV and UTCI related to health effects. Exhaustion was the most frequent symptom reported by the interviewees. Females and smokers were more likely to report heat-related symptoms than males and nonsmokers. Based on cluster analysis, 35 °C could be a cutoff point for the manifestation of heat-related symptoms during summer. The threshold for ASV was 0.85 corresponding to "warm" thermal sensation and for UTCI was about 30.85 °C corresponding to "moderate heat stress" according to the Mediterranean assessment scale.