Physiological and subjective responses to standing showers, sitting showers, and sink baths

Clinical Characteristics of Stroke Occurring while Bathing

BACKGROUND

Stroke can occur during any human activity. Although cardiac arrests or drowning accidents while bathing have been studied extensively, there are few studies focusing on stroke occurring while bathing. The objectives of this study were to evaluate the clinical characteristics of stroke occurring while bathing and the association between stroke and drowning accidents.

METHODS

Clinical data prospectively acquired between January 2011 and December 2015 on 1939 patients with stroke (1224 cerebral infarctions [CIs], 505 intracerebral hemorrhages [ICHs], and 210 subarachnoid hemorrhages [SAHs]) were reviewed to identify patients who sustained a stroke while bathing. The ratio of bathing-related strokes to strokes occurring during other activities was evaluated. Moreover, the demographics of these 2 groups were compared in each stroke type.

RESULTS

Among the 1939 patients, 78 (CI, 32; ICH, 28; and SAH, 18) sustained a stroke while bathing. The ratio of bathing to other activities in the SAH group was the highest (8.6%), followed by the ICH group (5.5%), whereas that in the CI group was the lowest (2.6%). Regardless of stroke type, only a minority of patients were found to have collapsed inside the bathtub.

CONCLUSIONS

The higher ratio of bathing in hemorrhagic strokes may indicate that there is a small risk of hemorrhagic stroke while bathing in vulnerable subjects. This retrospective study did not establish a causal relationship between bathing and stroke nor identify risk factors, which means that future prospective studies are warranted. The finding that the great majority of bathing-related stroke patients were found to have collapsed outside the bathtub suggests that the involvement of stroke in drowning accidents in the bathtub may be small.

Verification of impact of morning showering and mist sauna bathing on human physiological functions and work efficiency during the day

Recently, a growing number in Japan are switching to taking baths in the morning (morning bathing). However, the effects of the morning bathing on human physiological functions and work efficiency have not yet been revealed. Then, we hypothesized that the effect of morning bathing on physiological functions would be different from those of night bathing. In this study, we measured the physiological functions and work efficiency during the day following the morning bathing (7:10-7:20) including showering, mist sauna bathing, and no bathing as a control. Ten male healthy young adults participated in this study as the subjects. We evaluated the rectal temperature (Tre), skin temperature (Tsk), heart rate (HR), heart rate variability (HRV), blood pressure (BP), the relative power density of the alpha wave (α-wave ratio) of electroencephalogram, alpha attenuation coefficient (AAC), and the error rate of the task performance. As a result, we found that the HR after the mist sauna bathing was significantly lower than those after no bathing rest 3 (11:00). Furthermore, we verified that the α-wave ratio of the Pz after the mist sauna bathing was significantly lower than those after no bathing during the task 6 (15:00). On the other hand, the α-wave ratio of the Pz after the mist sauna bathing was significantly higher than those after showering during the rest 3 (11:00). Tsk after the mist sauna bathing was higher than those after the showering at 9:00 and 15:00. In addition, the error rate of the task performance after the mist sauna bathing was lower than those after no bathing and showering at 14:00. This study concludes that a morning mist sauna is safe and maintains both skin temperature compared to other bathing methods. Moreover, it is presumed that the morning mist sauna bathing improves work efficiency comparing other bathing methods during the task period of the day following the morning bathing.

A case-control study of maternal bathing habits and risk for birth defects in offspring

BACKGROUND

Nearly all women shower or take baths during early pregnancy; however, bathing habits (i.e., shower and bath length and frequency) may be related to the risk of maternal hyperthermia and exposure to water disinfection byproducts, both of which are suspected to increase risk for multiple types of birth defects. Thus, we assessed the relationships between bathing habits during pregnancy and the risk for several nonsyndromic birth defects in offspring.

METHODS

Data for cases with one of 13 types of birth defects and controls from the National Birth Defects Prevention Study delivered during 2000-2007 were evaluated. Logistic regression analyses were conducted separately for each type of birth defect.

RESULTS

There were few associations between shower frequency or bath frequency or length and risk for birth defects in offspring. The risk for gastroschisis in offspring was increased among women who reported showers lasting ≥15 compared to <15 minutes (adjusted odds ratio: 1.43, 95% confidence interval: 1.18-1.72). In addition, we observed modest increases in the risk for spina bifida, cleft lip with or without cleft palate, and limb reduction defects in offspring of women who showered ≥15 compared to <15 minutes. The results of comparisons among more specific categories of shower length (i.e., <15 minutes versus 15-19, 20-29, and ≥ 30 minutes) were similar.

CONCLUSIONS

Our findings suggest that shower length may be associated with gastroschisis, but the modest associations with other birth defects were not supported by analyses of bath length or bath or shower frequency. Given that showering for ≥15 minutes during pregnancy is very common, further evaluation of the relationship between maternal showering habits and birth defects in offspring is worthwhile.

Physiological functions of the effects of the different bathing method on recovery from local muscle fatigue

BACKGROUND

Recently, mist saunas have been used in the home as a new bathing style in Japan. However, there are still few reports on the effects of bathing methods on recovery from muscle fatigue. Furthermore, the effect of mist sauna bathing on human physiological function has not yet been revealed. Therefore, we measured the physiological effects of bathing methods including the mist sauna on recovery from muscle fatigue.

METHODS

The bathing methods studied included four conditions: full immersion bath, shower, mist sauna, and no bathing as a control. Ten men participated in this study. The participants completed four consecutive sessions: a 30-min rest period, a 10-min all out elbow flexion task period, a 10-min bathing period, and a 10-min recovery period. We evaluated the mean power frequency (MNF) of the electromyogram (EMG), rectal temperature (Tre), skin temperature (Tsk), skin blood flow (SBF), concentration of oxygenated hemoglobin (O2Hb), and subjective evaluation.

RESULTS

We found that the MNF under the full immersion bath condition was significantly higher than those under the other conditions. Furthermore, Tre, SBF, and O2Hb under the full immersion bath condition were significantly higher than under the other conditions.

CONCLUSIONS

Following the results for the full immersion bath condition, the SBF and O2Hb of the mist sauna condition were significantly higher than those for the shower and no bathing conditions. These results suggest that full immersion bath and mist sauna are effective in facilitating recovery from muscle fatigue.

Prediction of human thermophysiological responses during shower bathing

This study develops a model to predict the thermophysiological response of the human body during shower bathing. Despite the needs for the quantitative evaluation of human body response during bathing for thermal comfort and safety, the complicated mechanisms of heat transfer at the skin surface, especially during shower bathing, have disturbed the development of adequate models. In this study, an initial modeling approach is proposed by developing a simple heat transfer model at the skin surface during shower bathing applied to Stolwijk's human thermal model. The main feature of the model is the division of the skin surface into three parts: a dry part, a wet part without water flow, and a wet part with water flow. The area ratio of each part is decided by a simple formula developed from a geometrical approach based on the shape of the Stolwijk's human thermal model. At the same time, the convective heat transfer coefficient between the skin and the flowing water is determined experimentally. The proposed model is validated by a comparison with the results of human subject experiments under controlled and free shower conditions. The model predicts the mean skin temperature during shower fairly well both for controlled and free shower bathing styles.

Bath-Related Thunderclap Headache: A Study of 21 Consecutive Patients

We consecutively recruited 21 patients (all women, mean 54 ± 8 years) with bath-related thunderclap headache (BRTH). Thirteen of them were in menopause, two had just ceased hormonal therapy, and one was at 3 months postpartum. Bathing was the initial trigger for thunderclap headaches in nine patients (43%). Many patients ( n = 15, 71%) had other non-bath-related attacks. Most patients ( n = 18, 86%) reported that the headache occurred immediately when water was sprayed over their body, with warm water (52%) as the most common. During the disease course [mean 14 days (6-34)], the mean number of BRTH was 5.1 ± 3.6 attacks. Nineteen patients (90%) changed bathing habits to prevent attacks. Thirteen patients (62%) had magnetic resonance angiography vasoconstrictions, and two of them (15%) developed reversible posterior encephalopathy. None of the patients without vasoconstrictions had this complication. Nimodipine was effective in stopping further attacks in 84% (16/19) treated patients. No relapse was reported at a mean follow-up of 30 months. BRTH occurred exclusively in women and predominantly in middle age. Deficiency or fluctuation of female sex hormones may play a role. About 60% patients showed cerebral vasospasms, fulfilling the diagnosis of reversible cerebral vasoconstriction syndrome and indicating a risk of posterior encephalopathy.

Effects of room temperature on physiological and subjective responses during whole-body bathing, half-body bathing and showering

The effects of bathroom thermal conditions on physiological and subjective responses were evaluated before, during, and after whole-body bath (W-bath), half-body bath (H-bath) and showering. The air temperature of the dressing room and bathroom was controlled at 10 degrees C, 17.5 degrees C, and 25 degrees C. Eight healthy males bathed for 10 min under nine conditions on separate days. The water temperature of the bathtub and shower was controlled at 40 degrees C and 41 degrees C, respectively. Rectal temperature (Tre), mean skin temperature (Tsk), blood pressure (BP), heart rate (HR), body weight loss and blood characteristics (hematocrit: Hct, hemoglobin: Hb) were evaluated. Also, thermal sensation (TS), thermal comfort (TC) and thermal acceptability (TA) were recorded. BP decreased rapidly during W-bath and H-bath compared to showering. HR during W-bath was significantly higher than for H-bath and showering (p < 0.01). The double products due to W-bath during bathing were also greater than for H-bath and showering (p < 0.05). There were no distinct differences in Hct and Hb among the nine conditions. However, significant differences in body weight loss were observed among the bathing methods: W-bath > H-bath > showering (p < 0.001). W-bath showed the largest increase in Tre and Tsk, followed by H-bath, and showering. Significant differences in Tre after bathing among the room temperatures were found only at H-bath. The changes in Tre after bathing for H-bath at 25 degrees C were similar to those for W-bath at 17.5 degrees C and 10 degrees C. TS and TC after bathing significantly differed for the three bathing methods at 17.5 degrees C and 10 degrees C (TS: p < 0.01 TC: p < 0.001). Especially, for showering, the largest number of subjects felt "cold" and "uncomfortable". Even though all of the subjects could accept the 10 degrees C condition after W-bath, such conditions were intolerable to half of them after showering. These results suggested that the physiological strains during H-bath and showering were smaller than during W-bath. However, colder room temperatures made it more difficult to retain body warmth after H-bath and created thermal discomfort after showering. It is particularly important for H-bath and showering to maintain an acceptable temperature in the dressing room and bathroom, in order to bathe comfortably and ensure warmth.