A three-compartment thermometry model for the improved estimation of changes in body heat content

A century of exercise physiology: concepts that ignited the study of human thermoregulation. Part 2: physiological measurements

In this, the second of four historical reviews on human thermoregulation during exercise, we examine the research techniques developed by our forebears. We emphasise calorimetry and thermometry, and measurements of vasomotor and sudomotor function. Since its first human use (1899), direct calorimetry has provided the foundation for modern respirometric methods for quantifying metabolic rate, and remains the most precise index of whole-body heat exchange and storage. Its alternative, biophysical modelling, relies upon many, often dubious assumptions. Thermometry, used for >300 y to assess deep-body temperatures, provides only an instantaneous snapshot of the thermal status of tissues in contact with any thermometer. Seemingly unbeknownst to some, thermal time delays at some surrogate sites preclude valid measurements during non-steady state conditions. To assess cutaneous blood flow, immersion plethysmography was introduced (1875), followed by strain-gauge plethysmography (1949) and then laser-Doppler velocimetry (1964). Those techniques allow only local flow measurements, which may not reflect whole-body blood flows. Sudomotor function has been estimated from body-mass losses since the 1600s, but using mass losses to assess evaporation rates requires precise measures of non-evaporated sweat, which are rarely obtained. Hygrometric methods provide data for local sweat rates, but not local evaporation rates, and most local sweat rates cannot be extrapolated to reflect whole-body sweating. The objective of these methodological overviews and critiques is to provide a deeper understanding of how modern measurement techniques were developed, their underlying assumptions, and the strengths and weaknesses of the measurements used for humans exercising and working in thermally challenging conditions.

Can the inner eye canthus temperature be used as an alternative method to measure core temperature in sleep-deprived individuals?

Core temperature is used in several situations, including studies on biological rhythms and circadian markers of physical performance. Measuring the inner eye canthus (Tco) temperature is a method proposed to identify core temperature, but it has shown little concordance in physical exercise situations and has not yet been used in studies with measurements taken throughout the day. The objective of this study was to compare the measurements and daily behavior of Tco obtained by infrared thermography with rectal temperature (Tre) during a prolonged waking protocol. Eleven male individuals participated in the study, who remained in the laboratory for at least 38 h using an actigraph to determine the wakefulness time and were monitored during the entire period. The Tre and Tco measurements were performed every 3 h. The ANOVA was used for repeated measurements followed by Bonferroni's post-hoc test to find the limits of concordance/proximity, while the Bland and Altman method and the Intraclass Correlation Coefficient were used to establish the reliability between the pairs. The significance level adopted was p < 0.05. The results demonstrate significant differences, low levels of concordance and unsatisfactory reliability levels between Tco and Tre at all 13 analyzed moments, in addition to not showing measurement reliability when all data are used together with the 143 temperature measurements. Daily behavior analysis shows moments with similar behavior with an increase in Tco and Tre, but at other times the behavior was the opposite, with a decrease in one measurement and an increase in the other. Based on the results presented, it is not recommended to use the inner eye canthus temperature as a substitute for rectal temperature for measuring core temperature at different times of the day or in sleep-deprived individuals.

Active warm-up and time-of-day effects on repeated-sprint performance and post-exercise recovery

PURPOSE

This study investigated the effects of both an active warm-up and the time-of-day variation on repeated-sprint performance. A second objective was to compare the post-exercise recovery between the experimental conditions.

METHODS

Eleven male participants performed ten maximal cycling sprints (6 s each, with a 30-s interval between them) in the morning and late afternoon, either after a warm-up or control condition. The warm-up consisted of cycling for 10 min at 50% of the peak aerobic power.

RESULTS

Rest measurements of rectal, muscle, and skin temperatures were higher in the afternoon compared to the morning (p < 0.05), with no significant differences in heart rate (p = 0.079) and blood lactate concentration (p = 0.300). Warm-up increased muscle temperature, heart rate, and lactate, and reduced skin temperature (all p < 0.001), though no significant differences were observed for rectal temperature (p = 0.410). The number of revolutions (p = 0.034, η_p² = 0.375), peak (p = 0.034, η_p² = 0.375), and mean (p = 0.037, η_p² = 0.365) power of the first sprint (not the average of ten sprints) were higher in the afternoon compared to the morning, regardless of warm-up. However, beneficial performance effects of warming up were evident for the first (p < 0.001) and the average of ten sprints (p < 0.05), regardless of time of day. More remarkable changes during the 60-min post-exercise were observed for rectal temperature (p = 0.005) and heart rate (p = 0.010) in the afternoon than in the morning.

CONCLUSION

Warming-up and time-of-day effects in enhancing muscular power are independent. Although warm-up ensured further beneficial effects on performance than the time-of-day variation, a faster post-exercise recovery was observed in the late afternoon.

Performance effects of internal pre- and per-cooling across different exercise and environmental conditions: A systematic review

Exercise in a hot and humid environment may endanger athlete's health and affect physical performance. This systematic review aimed to examine whether internal administration of ice, cold beverages or menthol solutions may be beneficial for physical performance when exercising in different environmental conditions and sports backgrounds. A systematic search was performed in PubMed, Web of Science, Scopus and SPORTDiscus databases, from inception to April 2022, to identify studies meeting the following inclusion criteria: healthy male and female physically active individuals or athletes (aged ≥18 years); an intervention consisting in the internal administration (i.e., ingestion or mouth rinse) of ice slush, ice slurry or crushed ice and/or cold beverages and/or menthol solutions before and/or during exercise; a randomized crossover design with a control or placebo condition; the report of at least one physical performance outcome; and to be written in English. Our search retrieved 2,714 articles in total; after selection, 43 studies were considered, including 472 participants, 408 men and 64 women, aged 18-42 years, with a VO2max ranging from 46.2 to 67.2 mL⋅kg-1⋅min-1. Average ambient temperature and relative humidity during the exercise tasks were 32.4 ± 3.5°C (ranging from 22°C to 38°C) and 50.8 ± 13.4% (varying from 20.0% to 80.0%), respectively. Across the 43 studies, 7 exclusively included a menthol solution mouth rinse, 30 exclusively involved ice slurry/ice slush/crushed ice/cold beverages intake, and 6 examined both the effect of thermal and non-thermal internal techniques in the same protocol. Rinsing a menthol solution (0.01%) improved physical performance during continuous endurance exercise in the heat. Conversely, the ingestion of ice or cold beverages did not seem to consistently increase performance, being more likely to improve performance in continuous endurance trials, especially when consumed during exercises. Co-administration of menthol with or within ice beverages seems to exert a synergistic effect by improving physical performance. Even in environmental conditions that are not extreme, internal cooling strategies may have an ergogenic effect. Further studies exploring both intermittent and outdoor exercise protocols, involving elite male and female athletes and performed under not extreme environmental conditions are warranted. Systematic review registration: [https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021268197], identifier [CRD42021268197].

Exertional heat stroke: nutritional considerations

NEW FINDINGS

What is the topic of this review? The potential role of nutrition in exertional heat stroke. What advances does it highlight? Certain nutritional and dietary strategies used by athletes and workers may exert a protective effect the pathophysiological processes of exertional heat stroke, whereas others may be detrimental. While current evidence suggests that some of these practices may be leveraged as a potential countermeasure to exertional heat stroke, further research on injury-related outcomes in humans is required.

ABSTRACT

Exertional heat stroke (EHS) is a life-threatening illness and an enduring problem among athletes, military servicemen and -women, and occupational labourers who regularly perform strenuous activity, often under hot and humid conditions or when wearing personal protective equipment. Risk factors for EHS and mitigation strategies have generally focused on the environment, health status, clothing, heat acclimatization and aerobic conditioning, but the potential role of nutrition is largely underexplored. Various nutritional and dietary strategies have shown beneficial effects on exercise performance and health and are widely used by athletes and other physically active populations. There is also evidence that some of these practices may dampen the pathophysiological features of EHS, suggesting possible protection or abatement of injury severity. Promising candidates include carbohydrate ingestion, appropriate fluid intake and glutamine supplementation. Conversely, some nutritional factors and low energy availability may facilitate the development of EHS, and individuals should be cognizant of these. Therefore, the aims of this review are to present an overview of EHS along with its mechanisms and pathophysiology, discuss how selected nutritional considerations may influence EHS risk focusing on their impact on the key pathophysiological processes of EHS, and provide recommendations for future research. With climate change expected to increase EHS risk and incidence in the coming years, further investigation on how diet and nutrition may be optimized to protect against EHS would be highly beneficial.

The specific heat of the human body is lower than previously believed: The journal Temperature toolbox

The specific heat capacity of the human body is an important value for heat balance analysis in thermoregulation and metabolism research. The widely used value of 3.47 kJ · kg-1· °C-1 was originally based on assumptions and was not measured or calculated. The purpose of this paper is to calculate the specific heat of the body, defined as the mass-weighted mean of the tissue specific heat. The masses of 24 body tissue types were derived from high-resolution magnetic resonance images of four virtual human models. The specific heat values of each tissue type were obtained from the published tissue thermal property databases. The specific heat of the entire body was calculated to be approximately 2.98 kJ · kg-1 · °C-1 and ranged from 2.44 to 3.39 kJ · kg-1 · °C-1 depending on whether min or max measured tissue values were used for the calculation. To our knowledge, this is the first time specific heat of the body has been calculated from the measured values of individual tissues. The contribution of the muscle to the specific heat of the body is approximately 47%, and the contribution of the fat and skin is approximately 24%. We believe this new information will improve the accuracy of calculations related to human heat balance in future studies of exercise, thermal stress, and related areas.

Exercise under heat stress: thermoregulation, hydration, performance implications, and mitigation strategies

A rise in body core temperature and loss of body water via sweating are natural consequences of prolonged exercise in the heat. This review provides a comprehensive and integrative overview of how the human body responds to exercise under heat stress and the countermeasures that can be adopted to enhance aerobic performance under such environmental conditions. The fundamental concepts and physiological processes associated with thermoregulation and fluid balance are initially described, followed by a summary of methods to determine thermal strain and hydration status. An outline is provided on how exercise-heat stress disrupts these homeostatic processes, leading to hyperthermia, hypohydration, sodium disturbances, and in some cases exertional heat illness. The impact of heat stress on human performance is also examined, including the underlying physiological mechanisms that mediate the impairment of exercise performance. Similarly, the influence of hydration status on performance in the heat and how systemic and peripheral hemodynamic adjustments contribute to fatigue development is elucidated. This review also discusses strategies to mitigate the effects of hyperthermia and hypohydration on exercise performance in the heat by examining the benefits of heat acclimation, cooling strategies, and hyperhydration. Finally, contemporary controversies are summarized and future research directions are provided.

Cockpit Temperature as an Indicator of Thermal Strain in Sports Car Competition

PURPOSE

This study aimed to evaluate the relationship between race car cockpit temperature and thermal strain indicators among race car drivers.

METHODS

Four male racing drivers' heart rate (HR), skin temperature (Tskin), and core temperature (Tcore) were measured continuously using the Equivital Life Monitor bio harness, and physiological strain index (PSI) was calculated during a hot (ambient temperature of 34.1°C ± 2.8°C) 6-h endurance race. Only data collected during green flag racing laps were analyzed.

RESULTS

Cross-sectional analyses showed that cockpit temperature did not have a significant relationship with percent of HRmax, Tskin, Tcore, or PSI (P > 0.05) during the race. Cockpit temperature decreased during driving time, whereas percent of HRmax, Tskin, Tcore, and PSI increased (P < 0.05).

CONCLUSION

Cockpit temperature does not correlate with measures of race car driver thermal strain. Therefore, metrics to determine driver thermal strain should include direct monitoring of the race car driver.

Individual Responses to Heat Stress: Implications for Hyperthermia and Physical Work Capacity

Background

Extreme heat events are increasing in frequency, severity, and duration. It is well known that heat stress can have a negative impact on occupational health and productivity, particularly during physical work. However, there are no up-to-date reviews on how vulnerability to heat changes as a function of individual characteristics in relation to the risk of hyperthermia and work capacity loss. The objective of this narrative review is to examine the role of individual characteristics on the human heat stress response, specifically in relation to hyperthermia risk and productivity loss in hot workplaces. Finally, we aim to generate practical guidance for industrial hygienists considering our findings. Factors included in the analysis were body mass, body surface area to mass ratio, body fat, aerobic fitness and training, heat adaptation, aging, sex, and chronic health conditions.

Findings

We found the relevance of any factor to be dynamic, based on the work-type (fixed pace or relative to fitness level), work intensity (low, moderate, or heavy work), climate type (humidity, clothing vapor resistance), and variable of interest (risk of hyperthermia or likelihood of productivity loss). Heat adaptation, high aerobic fitness, and having a large body mass are the most protective factors during heat exposure. Primary detrimental factors include low fitness, low body mass, and lack of heat adaptation. Aging beyond 50 years, being female, and diabetes are less impactful negative factors, since their independent effect is quite small in well matched participants. Skin surface area to mass ratio, body composition, hypertension, and cardiovascular disease are not strong independent predictors of the heat stress response.

Conclusion

Understanding how individual factors impact responses to heat stress is necessary for the prediction of heat wave impacts on occupational health and work capacity. The recommendations provided in this report could be utilized to help curtail hyperthermia risk and productivity losses induced by heat.

Partitional calorimetry

For thermal physiologists, calorimetry is an important methodological tool to assess human heat balance during heat or cold exposures. A whole body direct calorimeter remains the gold standard instrument for assessing human heat balance; however, this equipment is rarely available to most researchers. A more widely accessible substitute is partitional calorimetry, a method by which all components of the conceptual heat balance equation-metabolic heat production, conduction, radiation, convection, and evaporation-are calculated separately based on fundamental properties of energy exchange. Since partitional calorimetry requires relatively inexpensive equipment (vs. direct calorimetry) and can be used over a wider range of experimental conditions (i.e., different physical activities, laboratory or field settings, clothed or seminude), it allows investigators to address a wide range of problems such as predicting human responses to thermal stress, developing climatic exposure limits and fluid replacement guidelines, estimating clothing properties, evaluating cooling/warming interventions, and identifying potential thermoregulatory dysfunction in unique populations. In this Cores of Reproducibility in Physiology (CORP) review, we summarize the fundamental principles underlying the use of partitional calorimetry, present the various methodological and arithmetic requirements, and provide typical examples of its use. Strategies to minimize estimation error of specific heat balance components, as well as the limitations of the method, are also discussed. The goal of this CORP paper is to present a standardized methodology and thus improve the accuracy and reproducibility of research employing partitional calorimetry.

Does Cold Water or Ice Slurry Ingestion During Exercise Elicit a Net Body Cooling Effect in the Heat?

Cold water or ice slurry ingestion during exercise seems to be an effective and practical means to improve endurance exercise performance in the heat. However, transient reductions in sweating appear to decrease the potential for evaporative heat loss from the skin by a magnitude that at least negates the additional internal heat loss as a cold ingested fluid warms up to equilibrate with body temperature; thus explaining equivalent core temperatures during exercise at a fixed heat production irrespective of the ingested fluid temperature. Internal heat transfer with cold fluid/ice is always 100% efficient; therefore, when a decrement occurs in the efficiency that sweat evaporates from the skin surface (i.e. sweating efficiency), a net cooling effect should begin to develop. Using established relationships between activity, climate and sweating efficiency, the boundary conditions beyond which cold ingested fluids are beneficial in terms of increasing net heat loss can be calculated. These conditions are warmer and more humid for cycling relative to running by virtue of the greater skin surface airflow, which promotes evaporation, for a given metabolic heat production and thus sweat rate. Within these boundary conditions, athletes should ingest fluids at the temperature they find most palatable, which likely varies from athlete to athlete, and therefore best maintain hydration status. The cooling benefits of cold fluid/ice ingestion during exercise are likely disproportionately greater for athletes with physiological disruptions to sweating, such as those with a spinal cord injury or burn injuries, as their capacity for skin surface evaporative heat loss is much lower; however, more research examining these groups is needed.

Skin Temperature Measurement Using Contact Thermometry: A Systematic Review of Setup Variables and Their Effects on Measured Values

Background: Skin temperature (T_skin) is commonly measured using T_skin sensors affixed directly to the skin surface, although the influence of setup variables on the measured outcome requires clarification. Objectives: The two distinct objectives of this systematic review were (1) to examine measurements from contact T_skin sensors considering equilibrium temperature and temperature disturbance, sensor attachments, pressure, environmental temperature, and sensor type, and (2) to characterise the contact T_skin sensors used, conditions of use, and subsequent reporting in studies investigating sports, exercise, and other physical activity. Data sources and study selection: For the measurement comparison objective, Ovid Medline and Scopus were used (1960 to July 2016) and studies comparing contact T_skin sensor measurements in vivo or using appropriate physical models were included. For the survey of use, Ovid Medline was used (2011 to July 2016) and studies using contact temperature sensors for the measurement of human T_skinin vivo during sport, exercise, and other physical activity were included. Study appraisal and synthesis methods: For measurement comparisons, assessments of risk of bias were made according to an adapted version of the Cochrane Collaboration's risk of bias tool. Comparisons of temperature measurements were expressed, where possible, as mean difference and 95% limits of agreement (LoA). Meta-analyses were not performed due to the lack of a common reference condition. For the survey of use, extracted information was summarised in text and tabular form. Results: For measurement comparisons, 21 studies were included. Results from these studies indicated minor (<0.5°C) to practically meaningful (>0.5°C) measurement bias within the subgroups of attachment type, applied pressure, environmental conditions, and sensor type. The 95% LoA were often within 1.0°C for in vivo studies and 0.5°C for physical models. For the survey of use, 172 studies were included. Details about T_skin sensor setup were often poorly reported and, from those reporting setup information, it was evident that setups widely varied in terms of type of sensors, attachments, and locations used. Conclusions: Setup variables and conditions of use can influence the measured temperature from contact T_skin sensors and thus key setup variables need to be appropriately considered and consistently reported.

Skin Temperature Measurement Using Contact Thermometry: A Systematic Review of Setup Variables and Their Effects on Measured Values

Background: Skin temperature (Tskin) is commonly measured using Tskin sensors affixed directly to the skin surface, although the influence of setup variables on the measured outcome requires clarification. Objectives: The two distinct objectives of this systematic review were (1) to examine measurements from contact Tskin sensors considering equilibrium temperature and temperature disturbance, sensor attachments, pressure, environmental temperature, and sensor type, and (2) to characterise the contact Tskin sensors used, conditions of use, and subsequent reporting in studies investigating sports, exercise, and other physical activity. Data sources and study selection: For the measurement comparison objective, Ovid Medline and Scopus were used (1960 to July 2016) and studies comparing contact Tskin sensor measurements in vivo or using appropriate physical models were included. For the survey of use, Ovid Medline was used (2011 to July 2016) and studies using contact temperature sensors for the measurement of human Tskinin vivo during sport, exercise, and other physical activity were included. Study appraisal and synthesis methods: For measurement comparisons, assessments of risk of bias were made according to an adapted version of the Cochrane Collaboration's risk of bias tool. Comparisons of temperature measurements were expressed, where possible, as mean difference and 95% limits of agreement (LoA). Meta-analyses were not performed due to the lack of a common reference condition. For the survey of use, extracted information was summarised in text and tabular form. Results: For measurement comparisons, 21 studies were included. Results from these studies indicated minor (<0.5°C) to practically meaningful (>0.5°C) measurement bias within the subgroups of attachment type, applied pressure, environmental conditions, and sensor type. The 95% LoA were often within 1.0°C for in vivo studies and 0.5°C for physical models. For the survey of use, 172 studies were included. Details about Tskin sensor setup were often poorly reported and, from those reporting setup information, it was evident that setups widely varied in terms of type of sensors, attachments, and locations used. Conclusions: Setup variables and conditions of use can influence the measured temperature from contact Tskin sensors and thus key setup variables need to be appropriately considered and consistently reported.

Effects of 10 days of separate heat and hypoxic exposure on heat acclimation and temperate exercise performance

Adaptations to heat and hypoxia are typically studied in isolation but are often encountered in combination. Whether the adaptive response to multiple stressors affords the same response as when examined in isolation is unclear. We examined 1) the influence of overnight moderate normobaric hypoxia on the time course and magnitude of adaptation to daily heat exposure and 2) whether heat acclimation (HA) was ergogenic and whether this was influenced by an additional hypoxic stimulus. Eight males [V̇o2max = 58.5 (8.3) ml·kg−1·min−1] undertook two 11-day HA programs (balanced-crossover design), once with overnight normobaric hypoxia (HAHyp): 8 (1) h per night for 10 nights [[Formula: see text] = 0.156; SpO2 = 91 (2)%] and once without (HACon). Days 1, 6, and 11 were exercise-heat stress tests [HST (40°C, 50% relative humidity, RH)]; days 2–5 and 7–10 were isothermal strain [target rectal temperature (Tre) ~38.5°C], exercise-heat sessions. A graded exercise test and 30-min cycle trial were undertaken pre-, post-, and 14 days after HA in temperate normoxia (22°C, 55% RH; FIO2 = 0.209). HA was evident on day 6 (e.g., reduced Tre, mean skin temperature (T̄sk), heart rate, and sweat [Na+], P < 0.05) with additional adaptations on day 11 (further reduced T̄sk and heart rate). HA increased plasma volume [+5.9 (7.3)%] and erythropoietin concentration [+1.8 (2.4) mIU/ml]; total hemoglobin mass was unchanged. Peak power output [+12 (20) W], lactate threshold [+15 (18) W] and work done [+12 (20) kJ] increased following HA. The additional hypoxic stressor did not affect these adaptations. In conclusion, a separate moderate overnight normobaric hypoxic stimulus does not affect the time course or magnitude of HA. Performance may be improved in temperate normoxia following HA, but this is unaffected by an additional hypoxic stressor.

Increasing heat storage by wearing extra clothing during upper body exercise up-regulates heat shock protein 70 but does not modify the cytokine response

Plasma heat shock protein 70 (HSP70) concentrations rise during heat stress, which can independently induce cytokine production. Upper body exercise normally results in modest body temperature elevations. The aim of this study was to investigate the impacts of additional clothing on the body temperature, cytokine and HSP70 responses during this exercise modality. Thirteen males performed 45-min constant-load arm cranking at 63% maximum aerobic power (62 ± 7%V̇O_2peak) in either a non-permeable whole-body suit (intervention, INT) or shorts and T-shirt (control, CON). Exercise resulted in a significant increase of IL-6 and IL-1ra plasma concentrations (P < 0.001), with no difference between conditions (P > 0.19). The increase in HSP70 from pre to post was only significant for INT (0.12 ± 0.11ng∙mL^-1, P < 0.01 vs. 0.04 ± 0.18 ng∙mL^-1, P = 0.77). Immediately following exercise, T_core was elevated by 0.46 ± 0.29 (INT) and 0.37 ± 0.23ºC (CON), respectively (P < 0.01), with no difference between conditions (P = 0.16). The rise in mean T_skin (2.88 ± 0.50 and 0.30 ± 0.89ºC, respectively) and maximum heat storage (3.24 ± 1.08 and 1.20 ± 1.04 J∙g^-1, respectively) was higher during INT (P < 0.01). Despite large differences in heat storage between conditions, the HSP70 elevations during INT, even though significant, were very modest. Possibly, the T_core elevations were too low to induce a more pronounced HSP70 response to ultimately affect cytokine production.

The effect of passive heating on heat shock protein 70 and interleukin-6: A possible treatment tool for metabolic diseases?

Increasing physical activity remains the most widely publicized way of improving health and wellbeing. However, in populations that benefit most from exercise (EX), adherence is often poor and alternatives to EX are important to bring about health improvements. Recent work suggests a role for passive heating (PH) and heat shock proteins (HSP) in improving cardio-metabolic health. The aim of this study was to investigate the expression of HSP70 and interleukin-6 in response to either EX or PH and the subsequent effect on glucose control. Fourteen males volunteered and were categorized lean (BMI 23.5 ± 2.2 kg·m^-2) or overweight (29.2 ± 2.7 kg·m^-2) and completed 60 minutes of either moderate cycling at a fixed rate of metabolic heat production (EX) or warm water immersion in 40°C water (PH). Extracellular HSP70 increased from baseline in both conditions with no differences between PH (0.98 ± 1.1 ng·mL^-1) or EX (0.84 ± 1.0 ng·mL^-1, p = 0.814). IL-6 increased following both conditions with a two-fold increase after PH and four-fold after EX. Energy expenditure increased by 61.0 ± 14.4 kcal·h^-1 (79%) after PH. Peak glucose concentration after a meal immediately following PH was reduced when compared with EX (6.3 ± 1.4 mmol·L^-1 versus 6.8 ± 1.2 mmol·L^-1; p < 0.05). There was no difference in 24-hour glucose area under the curve (AUC) between conditions. These data indicate the potential for thermal therapy as an alternative treatment and management strategy for those at risk of developing metabolic disease where adherence, or ability to EX, may be compromised.

Individualising the exposure of -110°C whole body cryotherapy: The effects of sex and body composition

The purpose of this study was to investigate the effects of whole body cryotherapy (WBC) on a range of thermoregulatory measures. We also sought to examine the influence of sex and body composition. A convenience sample of 18 healthy participants (10 males and 8 females) (27±6yr) volunteered for this study. Temperature (core, tympanic, skin and mean body), heart rate, blood pressure, and thermal comfort and sensation were recorded pre- and post- (immediately and every 5min until 35min post) exposure to a single bout of WBC (30s at -60°C, 150s at 110°C). Anthropometric data (height, weight, body surface area, body mass index, fat mass and fat free mass) were also recorded. No significant differences in temperature (core, tympanic, skin and mean body), heart rate, blood pressure, or thermal comfort / sensation were observed between male and females at baseline. Immediately post WBC mean body (male:31.9±0.8°C; female:31.0±0.9°C; ∆ mean body temperature:0.9±0.1°C; P≤0.05, d=0.64) and mean skin (male:22.1±2.2°C; female:19.6±2.8°C; ∆ mean skin temperature:-2.5±0.6°C; d=0.99, P≤0.05) temperature was significantly different between sexes. Sex differences were also observed in regional skin temperature (male thigh, 20.8±1.1°C; female thigh, 16.7±1.1°C, ∆ mean thigh skin temperature:-4.1°C; d=3.72; male calf, 20.5±1.1°C; female calf, 18.2±1°C, ∆ mean calf skin temperature:-2.3±0.1°C; d=3.61; male arm, 21.7±1°C; female arm, 19±0.4°C, ∆ mean arm skin temperature: -2.7±0.3°C; d=3.54; P≤0.05). Mean arterial pressure was significantly different over time (P≤0.001) and between sexes (male 0mins:94±10mmHg; female 0mins:85±7mmHg; male 35mins:88±7mmHg; female 35mins:80±6mmHg; P≤0.05). Combined data set indicated a strong negative relationship between skin temperature and body fat percentage 35min' post WBC (r=-0.749, P≤0.001) and for core temperature and body mass index in males only (r=0.726, P≤0.05) immediately after WBC. There were no significant differences between sexes in any other variables (heart rate, tympanic and perceptual variables). We observed sex differences in mean skin and mean body temperature following exposure to whole body cryotherapy. In an attempt to optimise treatment, these differences should be taken into account if whole body cryotherapy is prescribed.

Hyperthermia and cardiovascular strain during an extreme heat exposure in young versus older adults

We examined whether older individuals experience greater levels of hyperthermia and cardiovascular strain during an extreme heat exposure compared to young adults. During a 3-hour extreme heat exposure (44°C, 30% relative humidity), we compared body heat storage, core temperature (rectal, visceral) and cardiovascular (heart rate, cardiac output, mean arterial pressure, limb blood flow) responses of young adults (n = 30, 19-28 years) against those of older adults (n = 30, 55-73 years). Direct calorimetry measured whole-body evaporative and dry heat exchange. Body heat storage was calculated as the temporal summation of heat production (indirect calorimetry) and whole-body heat loss (direct calorimetry) over the exposure period. While both groups gained a similar amount of heat in the first hour, the older adults showed an attenuated increase in evaporative heat loss (p < 0.033) in the first 30-min. Thereafter, the older adults were unable to compensate for a greater rate of heat gain (11 ± 1 ; p < 0.05) with a corresponding increase in evaporative heat loss. Older adults stored more heat (358 ± 173 kJ) relative to their younger (202 ± 92 kJ; p < 0.001) counterparts at the end of the exposure leading to greater elevations in rectal (p = 0.043) and visceral (p = 0.05) temperatures, albeit not clinically significant (rise < 0.5°C). Older adults experienced a reduction in calf blood flow (p < 0.01) with heat stress, yet no differences in cardiac output, blood pressure or heart rate. We conclude, in healthy habitually active individuals, despite no clinically observable cardiovascular or temperature changes, older adults experience greater heat gain and decreased limb perfusion in response to 3-hour heat exposure.

Separate and combined effects of exposure to heat stress and mental fatigue on endurance exercise capacity in the heat

PURPOSE

This study investigated the effects of exposure to pre-exercise heat stress and mental fatigue on endurance exercise capacity in a hot environment.

METHODS

Eight volunteers completed four cycle exercise trials at 80% maximum oxygen uptake until exhaustion in an environmental chamber maintained at 30 °C and 50% relative humidity. The four trials required them to complete a 90 min pre-exercise routine of either a seated rest (CON), a prolonged demanding cognitive task to induce mental fatigue (MF), warm water immersion at 40 °C during the last 30 min to induce increasing core temperature (WI), or a prolonged demanding cognitive task and warm water immersion at 40 °C during the last 30 min (MF + WI).

RESULTS

Core temperature when starting exercise was higher following warm water immersion (~38 °C; WI and MF + WI) than with no water immersion (~36.8 °C; CON and MF, P < 0.001). Self-reported mental fatigue when commencing exercise was higher following cognitive task (MF and MF + WI) than with no cognitive task (CON and WI; P < 0.05). Exercise time to exhaustion was reduced by warm water immersion (P < 0.001) and cognitive task (P < 0.05). Compared with CON (18 ± 7 min), exercise duration reduced 0.8, 26.6 and 46.3% in MF (17 ± 7 min), WI (12 ± 5 min) and MF + WI (9 ± 3 min), respectively.

CONCLUSIONS

This study demonstrates that endurance exercise capacity in a hot environment is impaired by either exposure to pre-exercise heat stress or mental fatigue, and this response is synergistically increased during combined exposure to them.

Ice Slurry Ingestion Leads to a Lower Net Heat Loss during Exercise in the Heat

PURPOSE

To compare the reductions in evaporative heat loss from the skin (Esk) to internal heat loss (Hfluid) induced by ice slurry (ICE) ingestion relative to 37 °C fluid and the accompanying body temperature and local thermoeffector responses during exercise in warm, dry conditions (33.5 °C ± 1.4 °C; 23.7% ± 2.6% relative humidity [RH]).

METHODS

Nine men cycled at approximately 55% VO2peak for 75 min and ingested 3.2 mL · kg(-1) aliquots of 37 °C fluid or ICE after 15, 30, and 45 min of exercise. Metabolic heat production (M-W), rectal temperature (Tre), mean skin temperature (Tsk), whole-body sweat loss (WBSL), local sweat rate (LSR), and skin blood flow (SkBF) were measured throughout. Net heat loss (HLnet) and heat storage (S) were estimated using partitional calorimetry.

RESULTS

Relative to the 37 °C trial, M-W was similar (P = 0.81) with ICE ingestion; however, the 200 ± 20 kJ greater Hfluid (P < 0.001) with ICE ingestion was overcompensated by a 381 ± 199-kJ lower Esk (P < 0.001). Net heat loss (HLnet) was consequently 131 ± 120 kJ lower (P = 0.01) and S was greater (P = 0.05) with ICE ingestion compared with 37 °C fluid ingestion. Concurrently, LSR and WBSL were lower by 0.16 ± 0.14 mg · min(-1) · cm(-2) (P < 0.01) and 191 ± 122 g (P < 0.001), respectively, and SkBF tended to be lower (P = 0.06) by 5.4%maxAU ± 13.4%maxAU in the ICE trial. Changes in Tre and Tsk were similar throughout exercise with ICE compared to 37 °C fluid ingestion.

CONCLUSIONS

Relative to 37 °C, ICE ingestion caused disproportionately greater reductions in Esk relative to Hfluid, resulting in a lower HLnet and greater S. Mechanistically, LSR and possibly SkBF were suppressed independently of Tre or Tsk, reaffirming the concept of human abdominal thermoreception. From a heat balance perspective, recommendations for ICE ingestion during exercise in warm, dry conditions should be reconsidered.

Conductive and evaporative precooling lowers mean skin temperature and improves time trial performance in the heat

Self-paced endurance performance is compromised by moderate-to-high ambient temperatures that are evident in many competitive settings. It has become common place to implement precooling prior to competition in an attempt to alleviate perceived thermal load and performance decline. The present study aimed to investigate precooling incorporating different cooling avenues via either evaporative cooling alone or in combination with conductive cooling on cycling time trial performance. Ten trained male cyclists completed a time trial on three occasions in hot (35 °C) ambient conditions with the cooling garment prepared by (a) immersion in water (COOL, evaporative); (b) immersion in water and frozen (COLD, evaporative and conductive); or (c) no precooling (CONT). COLD improved time trial performance by 5.8% and 2.6% vs CONT and COOL, respectively (both P < 0.05). Power output was 4.5% higher for COLD vs CONT (P < 0.05). Mean skin temperature was lower at the onset of the time trial following COLD compared with COOL and CONT (both P < 0.05) and lasted for the first 20% of the time trial. Thermal sensation was perceived cooler following COOL and COLD. The combination of evaporative and conductive cooling (COLD) had the greatest benefit to performance, which is suggested to be driven by reduced skin temperature following cooling.

Thermoregulatory responses in exercising rats: methodological aspects and relevance to human physiology

Rats are used worldwide in experiments that aim to investigate the physiological responses induced by a physical exercise session. Changes in body temperature regulation, which may affect both the performance and the health of exercising rats, are evident among these physiological responses. Despite the universal use of rats in biomedical research involving exercise, investigators often overlook important methodological issues that hamper the accurate measurement of clear thermoregulatory responses. Moreover, much debate exists regarding whether the outcome of rat experiments can be extrapolated to human physiology, including thermal physiology. Herein, we described the impact of different exercise intensities, durations and protocols and environmental conditions on running-induced thermoregulatory changes. We focused on treadmill running because this type of exercise allows for precise control of the exercise intensity and the measurement of autonomic thermoeffectors associated with heat production and loss. Some methodological issues regarding rat experiments, such as the sites for body temperature measurements and the time of day at which experiments are performed, were also discussed. In addition, we analyzed the influence of a high body surface area-to-mass ratio and limited evaporative cooling on the exercise-induced thermoregulatory responses of running rats and then compared these responses in rats to those observed in humans. Collectively, the data presented in this review represent a reference source for investigators interested in studying exercise thermoregulation in rats. In addition, the present data indicate that the thermoregulatory responses of exercising rats can be extrapolated, with some important limitations, to human thermal physiology.

Thermal Dynamics in Newborn and Juvenile Models Cooled by Total Liquid Ventilation

BACKGROUND

Total liquid ventilation (TLV) consists in filling the lungs with a perfluorocarbon (PFC) and using a liquid ventilator to ensure a tidal volume of oxygenated, CO 2 -free and temperature-controlled PFC. Having a much higher thermal capacity than air, liquid PFCs assume that the filled lungs become an efficient heat exchanger with pulmonary circulation.

OBJECTIVE

The objective of the present study was the development and validation of a parametric lumped thermal model of a subject in TLV.

METHODS

The lungs were modeled as one compartment in which the control volume varied as a function of the tidal volume. The heat transfer in the body was modeled as seven parallel compartments representing organs and tissues. The thermal model of the lungs and body was validated with two groups of lambs of different ages and weights (newborn and juvenile) undergoing an ultrafast mild therapeutic hypothermia induction by TLV.

RESULTS

The model error on all animals yielded a small mean error of -0.1 ±0.4  (°)C for the femoral artery and 0.0 ±0.1   (°)C for the pulmonary artery.

CONCLUSION

The resulting experimental validation attests that the model provided an accurate estimation of the systemic arterial temperature and the venous return temperature.

SIGNIFICANCE

This comprehensive thermal model of the lungs and body has the advantage of closely modeling the rapid thermal dynamics in TLV. The model can explain how the time to achieve mild hypothermia between newborn and juvenile lambs remained similar despite of highly different physiological and ventilatory parameters. The strength of the model is its strong relationship with the physiological parameters of the subjects, which suggests its suitability for projection to humans.

Exercise activates compensatory thermoregulatory reaction in rats: a modeling study

The importance of exercise is increasingly emphasized for maintaining health. However, exercise itself can pose threats to health such as the development of exertional heat shock in warm environments. Therefore, it is important to understand how the thermoregulation system adjusts during exercise and how alterations of this can contribute to heat stroke. To explore this we measured the core body temperature of rats (Tc) running for 15 min on a treadmill at various speeds in two ambient temperatures (Ta = 25°C and 32°C). We assimilated the experimental data into a mathematical model that describes temperature changes in two compartments of the body, representing the muscles and the core. In our model the core body generates heat to maintain normal body temperature, and dissipates it into the environment. The muscles produce additional heat during exercise. According to the estimation of model parameters, at Ta = 25°C, the heat generation in the core was progressively reduced with the increase of the treadmill speed to compensate for a progressive increase in heat production by the muscles. This compensation was ineffective at Ta = 32°C, which resulted in an increased rate of heat accumulation with increasing speed, as opposed to the Ta = 25°C case. Interestingly, placing an animal on a treadmill increased heat production in the muscles even when the treadmill speed was zero. Quantitatively, this "ready-to-run" phenomenon accounted for over half of the heat generation in the muscles observed at maximal treadmill speed. We speculate that this anticipatory response utilizes stress-related circuitry.

Blood temperature and perfusion to exercising and non-exercising human limbs

NEW FINDINGS

What is the central question of this study? Temperature-sensitive mechanisms are thought to contribute to blood-flow regulation, but the relationship between exercising and non-exercising limb perfusion and blood temperature is not established. What is the main finding and its importance? The close coupling among perfusion, blood temperature and aerobic metabolism in exercising and non-exercising extremities across different exercise modalities and activity levels and the tight association between limb vasodilatation and increases in plasma ATP suggest that both temperature- and metabolism-sensitive mechanisms are important for the control of human limb perfusion, possibly by activating ATP release from the erythrocytes. Temperature-sensitive mechanisms may contribute to blood-flow regulation, but the influence of temperature on perfusion to exercising and non-exercising human limbs is not established. Blood temperature (TB ), blood flow and oxygen uptake (V̇O2) in the legs and arms were measured in 16 healthy humans during 90 min of leg and arm exercise and during exhaustive incremental leg or arm exercise. During prolonged exercise, leg blood flow (LBF) was fourfold higher than arm blood flow (ABF) in association with higher TB and limb V̇O2. Leg and arm vascular conductance during exercise compared with rest was related closely to TB (r(2) = 0.91; P < 0.05), plasma ATP (r(2) = 0.94; P < 0.05) and limb V̇O2 (r(2) = 0.99; P < 0.05). During incremental leg exercise, LBF increased in association with elevations in TB and limb V̇O2, whereas ABF, arm TB and V̇O2 remained largely unchanged. During incremental arm exercise, both ABF and LBF increased in relationship to similar increases in V̇O2. In 12 trained males, increases in femoral TB and LBF during incremental leg exercise were mirrored by similar pulmonary artery TB and cardiac output dynamics, suggesting that processes in active limbs dominate central temperature and perfusion responses. The present data reveal a close coupling among perfusion, TB and aerobic metabolism in exercising and non-exercising extremities and a tight association between limb vasodilatation and increases in plasma ATP. These findings suggest that temperature and V̇O2 contribute to the regulation of limb perfusion through control of intravascular ATP.

An objective method for screening and selecting personal cooling systems based on cooling properties

A method is proposed for evaluation and selection of a personal cooling system (PCS) incorporating PCS, subject, and equipment weights; PCS run time; user task time; PCS cooling power; and average metabolic rate. The cooling effectiveness method presented is derived from first principles and allows those who select PCSs for specific applications to compare systems based on their projected use. This can lower testing costs by screening for the most applicable system. Methods to predict cooling power of PCSs are presented and are compared to data taken through standard manikin testing. The cooling effectiveness ranking is presented and validated against human subject test data. The proposed method provides significant insight into the application of PCS on humans. However, the interaction a humans with a PCS is complex, especially considering the range of clothing ensembles, physiological issues, and end use scenarios, and requires additional analysis.

Noninvasive assessment of muscle temperature during rest, exercise, and postexercise recovery in different environments

We introduced noninvasive and accurate techniques to estimate muscle temperature (Tm) of vastus lateralis (VL), triceps brachii (TB), and trapezius (TRAP) during rest, exercise, and postexercise recovery using the insulation disk (iDISK) technique. Thirty-six volunteers (24 men, 12 women; 73.0 ± 12.2 kg; 1.75 ± 0.07 m; 24.4 ± 5.5 yr; 49.2 ± 6.8 ml·kg(-1)·min(-1) peak oxygen uptake) underwent periods of rest, cycling exercise at 40% of peak oxygen uptake, and postexercise recovery in three environments: Normal (24°C, 56% relative humidity), Hot-Humid (30°C, 60% relative humidity), and Hot-Dry (40°C, 24% relative humidity). Participants were randomly allocated into the "model" and the "validation" groups. Results in the model group demonstrated that Tm (VL: 36.65 ± 1.27°C; TB: 35.76 ± 1.73°C; TRAP: 36.53 ± 0.96°C) was increased compared with iDISK (VL: 35.67 ± 1.71°C; TB: 34.77 ± 2.27°C; TRAP: 35.98 ± 1.34°C) across all environments (P < 0.001). Stepwise regression analysis generated models that accurately predicted Tm (predTm) of VL (R(2) = 0.73-0.91), TB (R(2) = 0.85-0.93), and TRAP (R(2) = 0.84-0.86) using iDISK and the difference between the current iDISK temperature and that recorded between 1 and 4 min before. Cross-validation analyses in the validation group demonstrated small differences (P < 0.05) of no physiological significance, small effect size of the differences, and strong associations (r = 0.85-0.97; P < 0.001) between Tm and predTm. Moreover, narrow 95% limits of agreement and low percent coefficient of variation were observed between Tm and predTm. It is concluded that the developed noninvasive, practical, and inexpensive techniques provide accurate estimations of VL, TB, and TRAP Tm during rest, cycling exercise, and postexercise recovery.

The Influence of Arc-Flash and Fire-Resistant Clothing on Thermoregulation during Exercise in the Heat

We evaluated the effect of arc-flash and fire-resistant (AFR) clothing ensembles (CE) on whole-body heat dissipation during work in the heat. On 10 occasions, 7 males performed four 15-min cycling bouts at a fixed rate of metabolic heat production (400 W) in the heat (35°C), each separated by 15-min of recovery. Whole-body heat loss and metabolic heat production were measured by direct and indirect calorimetry, respectively. Body heat storage was calculated as the temporal summation of heat production and heat loss. Responses were compared in a semi-nude state and while wearing two CE styles: (1) single-piece (coveralls) and (2) two-piece (workpant + long-sleeve shirt). For group 1, there was one non-AFR single-piece CE (CE1STD) and three single-piece CE with AFR properties (CE2AFR, CE3AFR, CE4AFR). For group 2, there was one non-AFR two-piece CE (CE5STD) and four two-piece CE with AFR properties (CE6AFR, CE7AFR, CE8AFR, CE9AFR). The workpants for CE6AFR were not AFR-rated, while a cotton undershirt was also worn for conditions CE8AFR and CE9AFR and for all single-piece CE. Heat storage for all conditions (CE1STD: 328 ± 55, CE2AFR: 335 ± 87, CE3AFR: 309 ± 95, CE4AFR: 403 ± 104, CE5STD: 253 ± 78, CE6AFR: 268 ± 89, CE7AFR: 302 ± 70, CE8AFR: 360 ± 36, CE9AFR: 381 ± 99 kJ) was greater than the semi-nude state (160 ± 124 kJ) (all p ≤ 0.05). No differences were measured between single-piece uniforms (p = 0.273). Among the two-piece uniforms, heat storage was greater for CE8AFR and CE9AFR relative to CE5STD and CE6AFR (all p ≤ 0.05), but not CE7AFR (both p > 0.05). Differences between clothing styles were measured such that greater heat storage was observed in both CE1STD and CE2-4AFR relative to CE5STD. Further, heat storage was greater in CE2AFR and CE4AFR relative to CE6AFR, while it was greater in CE4AFR compared to CE7AFR. Body heat storage during work in the heat was not influenced by the use of AFR fabrics in the single- or two-piece uniforms albeit less heat was stored in the two-piece uniforms when no undershirt was worn. However, heat storage was comparable between clothing styles when an undershirt was worn with the two-piece uniform.

Does type 1 diabetes alter post-exercise thermoregulatory and cardiovascular function in young adults?

Recent data demonstrated that individuals with type 1 diabetes mellitus (T1DM) exhibit impaired sweating and increased rectal temperature (i.e., heat storage) during exercise compared with healthy controls. Our purpose in this study was to investigate the consequences of T1DM on post-exercise thermal homeostasis. Sixteen participants (eight controls matched with eight T1DM) performed 90 min of cycling followed by 60 min of seated recovery. Esophageal and rectal temperatures, sweating (forearm, chest, and upper back), skin blood flow [forearm and upper back, presented as cutaneous vascular conductance (CVC)], and blood pressure [mean arterial pressure (MAP)] were measured at baseline and throughout recovery. Esophageal temperature was similar during baseline and recovery between groups (P = 0.88). However, rectal temperature was elevated in our T1DM group throughout recovery (P = 0.05). Sweating and CVC were similar between groups at all sites from 10-min post-exercise until the end of recovery (P ≥ 0.16). While absolute MAP was similar between groups (P = 0.43), the overall decrease in MAP post-exercise was greater in controls from 20 min (T1DM: - 8 ± 5 vs control: - 13 ± 6 mmHg, P = 0.03) until the end of recovery. We conclude that despite increased heat storage during exercise, individuals with T1DM exhibit a suppression in heat loss similar to their healthy counterparts during recovery.

Performance in the heat-physiological factors of importance for hyperthermia-induced fatigue

This article presents a historical overview and an up-to-date review of hyperthermia-induced fatigue during exercise in the heat. Exercise in the heat is associated with a thermoregulatory burden which mediates cardiovascular challenges and influence the cerebral function, increase the pulmonary ventilation, and alter muscle metabolism; which all potentially may contribute to fatigue and impair the ability to sustain power output during aerobic exercise. For maximal intensity exercise, the performance impairment is clearly influenced by cardiovascular limitations to simultaneously support thermoregulation and oxygen delivery to the active skeletal muscle. In contrast, during submaximal intensity exercise at a fixed intensity, muscle blood flow and oxygen consumption remain unchanged and the potential influence from cardiovascular stressing and/or high skin temperature is not related to decreased oxygen delivery to the skeletal muscles. Regardless, performance is markedly deteriorated and exercise-induced hyperthermia is associated with central fatigue as indicated by impaired ability to sustain maximal muscle activation during sustained contractions. The central fatigue appears to be influenced by neurotransmitter activity of the dopaminergic system, but inhibitory signals from thermoreceptors arising secondary to the elevated core, muscle and skin temperatures and augmented afferent feedback from the increased ventilation and the cardiovascular stressing (perhaps baroreceptor sensing of blood pressure stability) and metabolic alterations within the skeletal muscles are likely all factors of importance for afferent feedback to mediate hyperthermia-induced fatigue during submaximal intensity exercise. Taking all the potential factors into account, we propose an integrative model that may help understanding the interplay among factors, but also acknowledging that the influence from a given factor depends on the exercise hyperthermia situation.

Thermometry, calorimetry, and mean body temperature during heat stress

Heat balance in humans is maintained at near constant levels through the adjustment of physiological mechanisms that attain a balance between the heat produced within the body and the heat lost to the environment. Heat balance is easily disturbed during changes in metabolic heat production due to physical activity and/or exposure to a warmer environment. Under such conditions, elevations of skin blood flow and sweating occur via a hypothalamic negative feedback loop to maintain an enhanced rate of dry and evaporative heat loss. Body heat storage and changes in core temperature are a direct result of a thermal imbalance between the rate of heat production and the rate of total heat dissipation to the surrounding environment. The derivation of the change in body heat content is of fundamental importance to the physiologist assessing the exposure of the human body to environmental conditions that result in thermal imbalance. It is generally accepted that the concurrent measurement of the total heat generated by the body and the total heat dissipated to the ambient environment is the most accurate means whereby the change in body heat content can be attained. However, in the absence of calorimetric methods, thermometry is often used to estimate the change in body heat content. This review examines heat exchange during challenges to heat balance associated with progressive elevations in environmental heat load and metabolic rate during exercise. Further, we evaluate the physiological responses associated with heat stress and discuss the thermal and nonthermal influences on the body's ability to dissipate heat from a heat balance perspective.

The effect of ice ingestion on female athletes performing intermittent exercise in hot conditions

Studies have reported the benefits of pre-cooling prior to exercise in the heat for male athletes, but at this time no research has investigated female athletes. The aim of the following study was to test the effects of pre-cooling on female repeat sprint performance in hot, humid conditions; namely is ice ingestion effective in reducing core temperature (Tc) and does this reduced Tc lead to improved repeat sprint performance in female athletes? Nine female team sport athletes with mean age (21.0 ± 1.2 y), height (169.8 ± 4.1 cm) and body mass (62.3 ± 5.0 kg) participated in this study. Participants completed 72 min of an intermittent sprint protocol (ISP) consisting of 2 × 36 min halves in hot, humid conditions (33.1 ± 0.1 °C, 60.3 ± 1.5% RH) on a cycle ergometer. This was preceded by 30 min of either ice ingestion (ICE) or water consumption (CON) in a randomised order. At the end of the pre-cooling period, Tc significantly decreased following ICE (-0.7 ± 0.3 °C) compared to CON (-0.1 ± 0.2 °C; p = 0.001). Tc also remained lower in ICE compared to CON during the ISP (p = 0.001). Ratings of perceived thermal sensation were lower in ICE compared to CON (p = 0.032) at the beginning (p = 0.022) and mid-point (p = 0.035) of the second half. No differences in work, mean power, peak power, rating of perceived exertion, heart rate or sweat loss between conditions were recorded (p > 0.05). Ice ingestion significantly reduced female Tc prior to intermittent exercise in the heat and reduced thermal sensation; however, this did not coincide with improved performance.

Age-related decrements in heat dissipation during physical activity occur as early as the age of 40

Older adults typically experience greater levels of thermal strain during physical efforts in the heat compared to young individuals. While this may be related to an age-dependent reduction in whole-body sweating, no study has clearly delineated at what age this occurs. In the present study, we report direct measurements of human heat dissipation during physical activity in the heat in males ranging in age from 20–70 years. Eighty-five males performed four 15-min bouts of cycling separated by 15-min rest periods, in a calorimeter regulated to 35°C and 20% relative humidity. Direct calorimetry was used to measure total heat loss (whole-body evaporative heat loss and dry heat exchange). We also used indirect calorimetry as a continuous measure of metabolic heat production. Body heat storage was calculated as the temporal summation of heat production and total heat loss over the experimental session. Whole-body sweat rate (WBSR) was calculated from measurements of evaporative heat loss. Males were divided into five age categories for the analysis of WBSR and body heat storage: 20–31 years (n = 18), 40–44 years (n = 15), 45–49 years (n = 15), 50–55 years (n = 21) and 56–70 years (n = 16). Relative to young males, WBSR was reduced in males aged 56–70 during each exercise (all P<0.05), in males aged 50–55 during the second (P = 0.031) and third exercises (P = 0.028) and in males aged 45–49 during the final exercise bout (P = 0.046). Although not significantly different, 40–44 years old males also had a lower rate of heat loss compared to younger males. Over the sum of two hours, the change in body heat content was greater in males 40–70 years compared to young males (all P<0.05). Our findings suggest that middle-aged and older adults have impairments in heat dissipation when doing physical activity in the heat, thus possibly increasing their risk of heat-related illness under such conditions.

Skin temperature over the carotid artery provides an accurate noninvasive estimation of core temperature in infants and young children during general anesthesia

BACKGROUND

The accurate measurement of core temperature is an essential aspect of intraoperative management in children. Invasive measurement sites are accurate but carry some health risks and cannot be used in certain patients. An accurate form of noninvasive thermometry is therefore needed. Our aim was to develop, and subsequently validate, separate models for estimating core temperature using different skin temperatures with an individualized correction factor.

METHODS

Forty-eight pediatric patients (0-36 months) undergoing elective surgery were separated into a modeling group (MG, n = 28) and validation group (VG, n = 20). Skin temperature was measured over the carotid artery (Tsk_carotid ), upper abdomen (Tsk_abd ), and axilla (Tsk_axilla ), while nasopharyngeal temperature (Tnaso ) was measured as a reference.

RESULTS

In the MG, derived models for estimating Tnaso were: Tsk_carotid  + 0.52; Tsk_abd  + (0.076[body mass] + 0.02); and Tsk_axilla  + (0.081[body mass]-0.66). After adjusting raw Tsk_carotid, Tsk_abd , and Tsk_axilla values in the independent VG using these models, the mean bias (Predicted Tnaso - Actual Tnaso [with 95% confidence intervals]) was +0.03[+0.53, -0.50]°C, -0.05[+1.02, -1.07]°C, and -0.06[+1.21, -1.28°C], respectively. The percentage of values within ±0.5°C of Tnaso was 93.2%, 75.4%, and 66.1% for Tsk_carotid, Tsk_abd , and Tsk_axilla , respectively. Sensitivity and specificity for detecting hypothermia (Tnaso  < 36.0°C) was 0.88 and 0.91 for Tsk_carotid , 0.61 and 0.76 for Tsk_abd , and 0.91 and 0.73 for Tsk_axilla . Goodness-of-fit (R(2) ) relative to the line-of-identity was 0.74 (Tsk_carotid ), 0.34 (Tsk_abd ), and 0.15 (Tsk_axilla ).

CONCLUSIONS

Skin temperature over the carotid artery, with a simple correction factor of +0.52°C, provides a viable noninvasive estimate of Tnaso in young children during elective surgery with a general anesthetic.

Whole body heat loss is reduced in older males during short bouts of intermittent exercise

Studies in young adults show that a greater proportion of heat is gained shortly following the start of exercise and that temporal changes in whole body heat loss during intermittent exercise have a pronounced effect on body heat storage. The consequences of short-duration intermittent exercise on heat storage with aging are unclear. We compared evaporative heat loss (H E) and changes in body heat content (ΔHb) between young (20–30 yr), middle-aged (40–45 yr), and older males (60–70 yr) of similar body mass and surface area, during successive exercise (4 × 15 min) and recovery periods (4 × 15 min) at a fixed rate of heat production (400 W) and under fixed environmental conditions (35°C/20% relative humidity). H E was lower in older males vs. young males during each exercise (Ex1: 283 ± 10 vs. 332 ± 11 kJ, Ex2: 334 ± 10 vs. 379 ± 5 kJ, Ex3: 347 ± 11 vs. 392 ± 5 kJ, and Ex4: 347 ± 10 vs. 387 ± 5 kJ, all P < 0.02), whereas H E in middle-aged males was intermediate to that measured in young and older adults (Ex1: 314 ± 13, Ex2: 355 ± 13, Ex3: 371 ± 13, and Ex4: 365 ± 8 kJ). H E was not significantly different between groups during the recovery periods. The net effect over 2 h was a greater ΔHb in older (267 ± 33 kJ; P = 0.016) and middle-aged adults (245 ± 16 kJ; P = 0.073) relative to younger counterparts (164 ± 20 kJ). As a result of a reduced capacity to dissipate heat during exercise, which was not compensated by a sufficiently greater rate of heat loss during recovery, both older and middle-aged males had a progressively greater rate of heat storage compared with young males over 2 h of intermittent exercise.

Body heat storage during physical activity is lower with hot fluid ingestion under conditions that permit full evaporation

AIM

To assess whether, under conditions permitting full evaporation, body heat storage during physical activity measured by partitional calorimetry would be lower with warm relative to cold fluid ingestion because of a disproportionate increase in evaporative heat loss potential relative to internal heat transfer with the ingested fluid.

METHODS

Nine males cycled at 50% VO(2max) for 75 min at 23.6 ± 0.6 °C and 23 ± 11% RH while consuming water of either 1.5 °C, 10 °C, 37 °C or 50 °C in four 3.2 mL kg(-1) boluses. The water was administered 5 min before and 15, 30 and 45 min following the onset of exercise.

RESULTS

No differences in metabolic heat production, sensible or respiratory heat losses (all P > 0.05) were observed between fluid temperatures. However, while the increased internal heat loss with cold fluid ingestion was paralleled by similar reductions in evaporative heat loss potential at the skin (E(sk) ) with 10 °C (P = 0.08) and 1.5 °C (P = 0.55) fluid, the increased heat load with warm (50 °C) fluid ingestion was accompanied by a significantly greater E(sk) (P = 0.04). The resultant calorimetric heat storage was lower with 50 °C water ingestion in comparison to 1.5 °C, 10 °C and 37 °C (all P < 0.05). In contrast, heat storage derived conventionally using thermometry yielded higher values following 50 °C fluid ingestion compared to 1.5 °C (P = 0.025).

CONCLUSION

Under conditions permitting full sweat evaporation, body heat storage is lower with warm water ingestion, likely because of disproportionate modulations in sweat output arising from warm-sensitive thermosensors in the esophagus/stomach. Local temperature changes of the rectum following fluid ingestion exacerbate the previously identified error of thermometric heat storage estimations.

Relationship between mean body temperature calculated by two- or three-compartment models and active cutaneous vasodilation in humans: a comparison between cool and warm environments during leg exercise

The aim of this study was to assess whether the three-compartment model of mean body temperature (Tb3) calculated from the esophageal temperature (Tes), temperature in deep tissue of exercising muscle (Tdt), and mean skin temperature (Tsk) has the potential to provide a better match with the thermoregulatory responses than the two-component model of mean body temperature (Tb2) calculated from Tes and Tsk. Seven male subjects performed 40 min of a prolonged cycling exercise at 30% maximal oxygen uptake at 21°C or 31°C (50% relative humidity). Throughout the experiment, Tsk, Tb2, Tb3, and Tdt were significantly (P < 0.01) lower at 21°C than at 31°C temperature conditions, while Tes was similar under both conditions. During exercise, an increase in cutaneous vascular conductance (skin blood flow / mean arterial pressure) over the chest (%CVCc) was observed at both 21°C and 31°C, while no increase was observed at the forearm at 21°C. Furthermore, the Tb3 and Tdt threshold for the onset of the increase in %CVCc was similar, but the Tes and Tb2 threshold differed significantly (P < 0.05) between the conditions tested. These results suggest that active cutaneous vasodilation at the chest is related more closely to Tb3 or Tdt than that measured by Tes or Tb2 calculated by Tes and Tsk during exercise at both 21°C and 31°C.

A field evaluation of the physiological demands of miners in Canada's deep mechanized mines

This study was conducted to evaluate the physical/mechanical characteristics of typical selected mining tasks and the energy expenditure required for their performance. The study comprised two phases designed to monitor and record the typical activities that miners perform and to measure the metabolic energy expenditure and thermal responses during the performance of these activities under a non-heat stress environmental condition (ambient air temperature of 25.8°C and 61% relative humidity with a wet bulb globe temperature (WBGT) of 22.0°C). Six common mining jobs were evaluated in 36 miners: (1) production drilling (jumbo drill) (n = 3), (2) production ore transportation (load-haul dump vehicle) (n = 4), (3) manual bolting (n = 9), (4) manual shotcrete (wet/dry) (n = 3), (5) general services (n = 8) and, (6) conventional mining (long-hole drill) (n = 9). The time/motion analysis involved the on-site monitoring, video recording, and mechanical characterization of the different jobs. During the second trial, continuous measurement of oxygen consumption was performed with a portable metabolic system. Core (ingestible capsule) and skin temperatures (dermal patches) were recorded continuously using a wireless integrated physiological monitoring system. We found that general services and manual bolting demonstrated the highest mean energy expenditure (331 ± 98 and 290 ± 95 W, respectively) as well as the highest peak work rates (513 and 529 W, respectively). In contrast, the lowest mean rate of energy expenditure was measured in conventional mining (221 ± 44 W) and manual shotcrete (187 ± 77 W) with a corresponding peak rate of 295 and 276 W, respectively. The low rate of energy expenditure recorded for manual shotcrete was paralleled by the lowest work to rest ratio (1.8:1). While we found that production drilling had a moderate rate of energy expenditure (271 ± 11 W), it was associated with the highest work to rest ratio (6.7:1) Despite the large inter-variability in energy expenditure and work intervals among jobs, only small differences in average core temperature (average ranged between 37.20 ± 0.22 to 37.42 ± 0.18°C) were measured. We found a high level of variability in the duration and intensity of tasks performed within each mining job. This was paralleled by a large variation in the work to rest allocation and mean energy expenditure over the course of the work shift.

How to measure thermal effects of personal cooling systems: human, thermal manikin and human simulator study

Thermal effects, such as cooling power and thermophysiological responses initiated upon application of a personal cooling system, can be assessed with (i) humans, (ii) a thermal manikin and (iii) a thermophysiological human simulator. In order to compare these methods, a cooling shirt (mild cooling) and an ice vest (strong cooling) were measured using human participants and a thermal manikin. Under all conditions, cooling was provided for 45 min, while resting at a room temperature of 24.6-25.0 degrees C and a relative humidity of 22-24%. Subsequently, the thermophysiological human simulator was used under the same conditions to provide data on thermophysiological responses such as skin and rectal temperatures. The cooling power determined using the thermal manikin was 2 times higher for the cooling shirt and 1.5 times higher for the ice vest compared to the cooling power determined using human participants. For the thermophysiological human simulator, the cooling power of the cooling shirt was similar to that obtained using human participants. However, it was 2 times lower for the ice vest when using the thermophysiological human simulator. The thermophysiological human simulator is shown to be a useful tool to predict thermophysiological responses, especially upon application of mild cooling intensity. However, the thermophysiological human simulator needs to be further improved for strong cooling intensities under heterogeneous conditions.

Estimating changes in volume-weighted mean body temperature using thermometry with an individualized correction factor

This study investigated whether the estimation error of volume-weighted mean body temperature (DeltaT(b)) using changes in core and skin temperature can be accounted for using personal and environmental parameters. Whole body calorimetry was used to directly measure DeltaT(b) in an Experimental group (EG) of 36 participants (24 males, 12 females) and a Validation group (VG) of 20 (9 males, 11 females) throughout 90 min of cycle ergometry at 40 degrees C, 30% relative humidity (RH) (n = 9 EG, 5 VG); 30 degrees C, 30% RH (n = 9 EG, 5 VG); 30 degrees C, 60% RH (n = 9 EG, 5 VG); and 24 degrees C, 30% RH (n = 9 EG, 5 VG). The core of the two-compartment thermometry model was represented by rectal temperature and the shell by a 12-point mean skin temperature (DeltaT(sk)). The estimation error (X(0)) between DeltaT(b) from calorimetry and DeltaT(b) from thermometry using core/shell weightings of 0.66/0.34, 0.79/0.21, and 0.90/0.10 was calculated after 30, 60, and 90 min of exercise, respectively. The association between X(0) and the individual variation in metabolic heat production (M - W), body surface area (BSA), body fat percentage (%fat), and body surface area-to-mass ratio (BSA/BM) as well as differences in environmental conditions (Oxford index) in the EG data were assessed using stepwise linear regression. At all time points and with all core/shell weightings tested, M - W, BSA, and Oxford index independently correlated significantly with the residual variance in X(0), but %fat and BSA/BM did not. The subsequent regression models were used to predict the thermometric estimation error (X(0_pred)) for each individual in the VG. The value estimated for X(0_pred) was then added to the DeltaT(b) estimated using the two-compartment thermometry models yielding an adjusted estimation (DeltaT(b)_(adj)) for the individuals in the VG. When comparing DeltaT(b)_(adj) to the DeltaT(b) derived from calorimetry in the VG, the best performing model used a core/shell weighting of 0.66/0.34 describing 74%, 84%, and 82% of the variation observed in DeltaT(b) from calorimetry after 30, 60, and 90 min, respectively.