The effect of improving the thermal quality of cold housing on blood pressure and general health: a research note

OBJECTIVE

To examine the effect of improving the thermal quality of housing on blood pressure (BP) and general health.

DESIGN

A before and after study comparing the changes of the intervention with controls.

SETTING

Four blocks of flats in the Easthall area of Easterhouse in Glasgow.

PARTICIPANTS

Residents of the four blocks who agreed to participate.

INTERVENTION

Two blocks of flats were upgraded from being cold, damp and mouldy to being comfortably warm, dry and mould free throughout.

MAIN OUTCOME MEASURES

Changes in BP, general health and financial status.

RESULTS

In the intervention subjects, systolic and diastolic blood pressures fell very significantly (p<0.000). There was also an improvement in general health as reported subjectively, and as indicated by a reduction in the use of medication and in hospital admissions. In addition, there was a markedly reduced expenditure on heating costs and other previous expenses. There were no changes in the control subjects in any of these measures.

CONCLUSION

Improving the thermal quality of housing to eliminate damp and mould and produce a comfortable temperature throughout the house has a major impact on the health of the residents. There are also financial benefits for the residents, and indirectly for the NHS.

Accidental hypothermia

Hypothermia and its management are examined and logical explanations are given for discarding many traditional views. Hypothermia is classified according to physiological changes, and a practical approach is suggested for management.

ABC of sports medicine. Temperature and performance--II: Heat

Images

ABC of sports medicine. Temperature and performance. I: Cold

Images

The cause of death after rescue

It is recognized that some people die from hypothermia even though they are alive and uninjured when rescued. The traditional explanation is that this is due to ventricular fibrillation resulting from the afterdrop of core temperature. This hypothesis was based on inadequate measurement and failure to consider the physiology of cold. It should now be discarded. Most deaths after rescue occur through an imbalance between the active vascular capacity and the circulating fluid volume i.e. relative hypovolaemia or fluid overload. The actual mechanism in any individual case depends both on the history of the cooling and the method of rewarming used. Some deaths will however occur due to continued cooling of the body or to ventricular fibrillation precipitated by rough handling.

The role of cold in ischaemic heart disease: a review

A review of the literature suggests that the geographical and social class distribution of ischaemic heart disease (IHD) could be partly explained by variations in degrees of cold exposure, which includes wind and rain as well as temperature, with frequent exposure to cold being more harmful than steady exposure. Blood pressure (BP) and serum cholesterol are raised in response to acute and chronic exposure to cold. Smoking and cold produce similar physiological changes which increase the risk of IHD, while regular exercise blunts the physiological effects of cold and other stresses. There are many acute responses to cold which could trigger a myocardial infarction (MI) and therefore cold is probably a major precipitating factor in many cases of MI. Public health measures to improve domestic housing and the working environment may produce a significant impact on the incidence of IHD.

Hypothesis: temperature recommendations for elderly people: are we wrong?

By concentrating housing recommendations purely on temperature, particularly of the living room, the medical profession may be doing a disservice to the elderly and may be causing increased numbers of cold-related deaths through attempting to reduce the far fewer cases of hypothermia. The best advice may be to avoid having one room significantly warmer than the rest of the house, to prewarm the bed and bedroom at night, to wear adequate clothing, eat adequate food, and take some exercise.

The effects of sera from Ra dial painters on the mitogenic responses of normal human lymphocytes

Sera from former Ra workers were incubated with normal human lymphocytes and the effects produced in stimulation assays with specific mitogens were compared with those observed with incubation using normal human sera. The sera from the Ra workers with high residual body burdens (greater than 0.1 muCi 226Ra) inhibited normal control lymphocytes stimulated with Con A and PHA when compared with control homologous sera. Although a significant suppression was not obtained between high- and low-body-burden groups a trend was indicated. Sera from the highest body-burden worker (0.58 muCi) was inhibitory to all normal lymphocyte populations tested regardless of the mitogen stimulant employed.

Measurement of lymphoblastogenic activity from thorium workers

Mitogenic stimulation of peripheral blood lymphocyte cultures obtained from 36 thorium workers was studied to determine whether the response of these cells was affected by the individuals' occupational exposure to alpha irradiation. The standard assay involved incubating 2 X 10(5) lymphocytes per test well for 72 hours in the presence of phytohemagglutinin (PHA), concanavalin A (Con A) or pokeweed mitogen (PWM). The results showed that there was a significant decrease in lymphocyte responsiveness of former thorium workers grouped by decade of life when compared with controls of the same decade of life for each mitogen tested with the exceptions of PHA in the 41-50 age group and PWM in the 51-60 age group. We are unable to correlate the decreased response observed with the measured body burdens, external gamma exposure, or thoron exhalation rates in these thorium cases. However, other occupational exposures (i.e., various chemicals used in processing thorium) cannot be eliminated as a possible cause.

Cells at risk for the production of bone tumors in radium exposed individuals: an electron microscope study

The endosteal cells of bone from a 75-yr-old woman who had acquired radium internally, as a consequence of her previous employment as a radium dial painter, are documented here for the first time by electron microscopy. As a result of amputation for a fibrosarcoma in the region of the right knee joint, fresh samples of bone and tumor tissue from the femur were made available. A sample of bone, also obtained at amputation from an unirradiated control patient, age 65, was examined from the same site in the femur. A comparison of the bone-marrow interface from the two patients showed that, unlike the control bone where cells were seen close to bone mineral a fibrotic layer was interposed between the marrow cells and the bone mineral in the bone from the radium case. This layer varied in thickness up to 50 microns and was often acellular, although cell remnants and cells, which appeared viable, were sometimes seen within this layer. It is suggested that irradiation of those cells proliferating within, and at the edge of, this replacement fibrotic layer may be the most important in the induction of bone tumors rather than the original cells lying within the 0-10 microns range from bone mineral which has previously been supposed. The nuclear dimensions of the endosteal bone lining cells and their distance from bone mineral have been measured in the bones from the radium and control cases. These dimensions are important not only in understanding the mechanisms by which bone tumors arise but in developing models of carcinogenic risks of other alpha-particle emitting isotopes such as plutonium.

A rational regimen for perioperative steroid supplements and a clinical assessment of the requirement

Sixty-one patients with rheumatoid arthritis on long-term corticosteroid treatment were managed for 107 orthopaedic procedures using a flexible method of supplementary steroid cover. It was found that the amount actually required was surprisingly small and in 78% of the operations no postoperative supplements were given. There were no consistent factors which would predict a requirement for supplementary steroids in any particular individual.

Transformation of mammalian cells by alpha particles

Mammalian cells in culture have been shown here for the first time to be transformed by alpha irradiation. Mouse embryo (C3H 10T1/2) cells were transformed with 5.6 MeV alpha particles from a Tandem Van de Graaff machine. Malignant tumours were induced following inoculation of the transformed cells into syngeneic hosts. Unirradiated control cells failed to produce tumours. The morphology of the transformed foci was similar to that obtained by X-rays and chemicals but different from virally transformed cells. The transformation frequency increased approximately as the cube of the dose to a maximum of about 4 per cent ofthe surviving cells which occurred between 1.5 and 2.5 x 10(7) alpha particles per cm2 (205-342 rad). It appears that alpha particle irradiation may exert a direct effect on the genome of the cell to produce malignancy without any external immunological or hormonal influences.

Cell survival following multiple-track alpha particle irradiation

In experiments in which mammalian cells were irradiated with 5 . 6 MeV alpha particles from a Tandem Van de Graaff machine, we have confirmed the finding of others that the mean lethal dose (Do) is about 60 rad. However, on measuring the area of the nuclei of the flattened cells as they were irradiated, we found that this mean lethal dose corresponds to the passage of not one or two alpha particles per cell nucleus as expected but to between 10 and 20 particles. This allows for the possibility that the direct action of alpha particles on the nucleus may be the important event in carcinogenesis.