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PLoS One. 2015 Nov 17;10(11):e0143461. doi: 10.1371/journal.pone.0143461. eCollection 2015.

Ebola Response: Modeling the Risk of Heat Stress from Personal Protective Clothing.

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Biophysics and Biomedical Modeling Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts, 01760, United States of America.



A significant number of healthcare workers have responded to aid in the relief and containment of the 2013 Ebola virus disease (EVD) outbreak in West Africa. Healthcare workers are required to wear personal protective clothing (PPC) to impede the transmission of the virus; however, the impermeable design and the hot humid environment lead to risk of heat stress.


Provide healthcare workers quantitative modeling and analysis to aid in the prevention of heat stress while wearing PPC in West Africa.


A sweating thermal manikin was used to measure the thermal (Rct) and evaporative resistance (Ret) of the five currently used levels of PPC for healthcare workers in the West Africa EVD response. Mathematical methods of predicting the rise in core body temperature (Tc) in response to clothing, activity, and environment was used to simulate different responses to PPC levels, individual body sizes, and two hot humid conditions: morning/evening (air temperature: 25°C, relative humidity: 40%, mean radiant temperature: 35°C, wind velocity: 1 m/s) and mid-day (30°C, 60%, 70°C, 1 m/s).


Nearly still air (0.4 m/s) measures of Rct ranged from 0.18 to 0.26 m2 K/W and Ret ranged from 25.53 to 340.26 m2 Pa/W.


Biophysical assessments and modeling in this study provide quantitative guidance for prevention of heat stress of healthcare workers wearing PPC responding to the EVD outbreak in West Africa.

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