The physiological strain index applied to heat-stressed rats.
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A physiological strain index (PSI) based on heart rate (HR) and rectal temperature (Tre) was recently suggested to evaluate exercise-heat stress in humans. The purpose of this study was to adjust PSI for rats and to evaluate this index at different levels of heat acclimation and training. The corrections of HR and Tre to modify the index for rats are as follows: PSI = 5 (Tre t - Tre 0). (41.5 - Tre 0)-1 + 5 (HRt - HR0). (550 - HR0)-1, where HRt and Tre t are simultaneous measurements taken at any time during the exposure and HR0 and Tre 0 are the initial measurements. The adjusted PSI was applied to five groups (n = 11-14 per group) of acclimated rats (control and 2, 5, 10, and 30 days) exposed for 70 min to a hot climate [40 degrees C, 20% relative humidity (RH)]. A separate database representing two groups of acclimated or trained rats was also used and involved 20 min of low-intensity exercise (O2 consumption approximately 50 ml. min-1. kg-1) at three different climates: normothermic (24 degrees C, 40% RH), hot-wet (35 degrees C, 70% RH), and hot-dry (40 degrees C, 20% RH). In normothermia, rats also performed moderate exercise (O2 consumption approximately 60 ml. min-1. kg-1). The adjusted PSI differentiated among acclimation levels and significantly discriminated among all exposures during low-intensity exercise (P < 0.05). Furthermore, this index was able to assess the individual roles played by heat acclimation and exercise training. (+info)
Heat exhaustion in a deep underground metalliferous mine.
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OBJECTIVES: To examine the incidence, clinical state, personal risk factors, haematology, and biochemistry of heat exhaustion occurring at a deep underground metalliferous mine. To describe the underground thermal conditions associated with the occurrence of heat exhaustion. METHODS: A 1 year prospective case series of acute heat exhaustion was undertaken. A history was obtained with a structured questionnaire. Pulse rate, blood pressure, tympanic temperature, and specific gravity of urine were measured before treatment. Venous blood was analysed for haematological and biochemical variables, during the acute presentation and after recovery. Body mass index (BMI) and maximum O2 consumption (VO2 max) were measured after recovery. Psychrometric wet bulb temperature, dry bulb temperature, and air velocity were measured at the underground sites where heat exhaustion had occurred. Air cooling power and psychrometric wet bulb globe temperature were derived from these data. RESULTS: 106 Cases were studied. The incidence of heat exhaustion during the year was 43.0 cases/million man-hours. In February it was 147 cases/million man-hours. The incidence rate ratio for mines operating below 1200 m compared with those operating above 1200 m was 3.17. Mean estimated fluid intake was 0.64 l/h (SD 0.29, range 0.08-1.50). The following data were increased in acute presentation compared with recovery (p value, % of acute cases above the normal clinical range): neutrophils (p < 0.001, 36%), anion gap (p < 0.001, 63%), urea (p < 0.001, 21%), creatinine (p < 0.001, 30%), glucose (p < 0.001, 15%), serum osmolality (p = 0.030, 71%), creatine kinase (p = 0.002, 45%), aspartate transaminase (p < 0.001, 14%), lactate dehydrogenase (p < 0.001, 9.5%), and ferritin (p < 0.001, 26%). The following data were depressed in acute presentation compared with recovery (p value, % of acute cases below the normal clinical range): eosinophils (p = 0.003, 38%) and bicarbonate (p = 0.011, 32%). Urea and creatinine were significantly increased in miners with heat cramps compared with miners without this symptom (p < 0.001), but there was no significant difference in sodium concentration (p = 0.384). Mean psychrometric wet bulb temperature was 29.0 degrees C (SD 2.2, range 21.0-34.0). Mean dry bulb temperature was 37.4 degrees C (SD 2.4, range 31.0-43.0). Mean air velocity was 0.54 m/s (SD 0.57, range 0.00-4.00). Mean air cooling power was 148 W/m2 (SD 49, range 33-290) Mean psychrometric wet bulb globe temperature was 31.5 degrees C (SD 2.0, range 25.2-35.3). Few cases (< 5%) occurred at psychrometric wet bulb temperature < 25.0 degrees C, dry bulb temperature < 33.8 degrees C, air velocity > 1.56 m/s, air cooling power > 248 W/m2, or psychrometric wet bulb globe temperature < 28.5 degrees C. CONCLUSION: Heat exhaustion in underground miners is associated with dehydration, neutrophil leukocytosis, eosinopenia, metabolic acidosis, increased glucose and ferritin, and a mild rise in creatine kinase, aspartate transaminase, and lactate dehydrogenase. Heat cramps are associated with dehydration but not hyponatraemia. The incidence of heat exhaustion increases during summer and at depth. An increased fluid intake is required. Heat exhaustion would be unlikely to occur if ventilation and refrigeration achieved air cooling power > 250 W/m2 at all underground work sites. (+info)
Heat illness: tips for recognition and treatment.
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Heat stroke, an acute, life-threatening emergency, results from an overload or impairment of heat-dissipating mechanisms. At risk are the elderly, infants, the obese, people with hyperthyroidism, and those taking certain drugs. Early recognition and rapid cooling are essential--the more rapid the cooling, the lower the mortality. (+info)
Presence of antibody against the inducible Hsp71 in patients with acute heat-induced illness.
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Antibodies against heat shock or stress proteins (Hsps) have been reported in a number of diseases in which they may be involved in the pathogenesis of the disease or may be of use for prognosis. Heat-induced diseases, such as heat cramps, heat exhaustion, or heat stroke, are frequent in hot working or living environments. There are still few investigations on the presence and possible significance of autoantibodies against Hsps in heat-induced illnesses. Using an immunoblotting technique with recombinant human Hsps, we analyzed the presence and titers of antibodies against Hsp60, Hsp71, and Hsp90alpha, and Hsp90beta in a group of 42 young male patients who presented with acute heat-induced illness during training. We also examined the presence of antibody against Hsp71 in a second group of 57 patients with acute heat-induced illness and measured the changes in titers of anti-Hsp71 antibodies in 9 patients hospitalized by emergency physicians. In the first group of young persons exercising in a hot environment, the occurrence of antibodies against Hsp71 and Hsp90alpha was significantly higher among individuals with symptoms of heat-induced illness (P < 0.05) than in the matched group of nonaffected exercising individuals. Moreover titers of antibody against Hsp71 were higher in individuals of the severe and mild heat-induced illness groups, the highest titer being found in the most severe cases. The results from the second group of 57 heat-affected patients exposed to extreme heat were similar. Again, patients with the more severe heat-induced symptoms showed a significantly higher incidence of antibodies to Hsp71 than controls and the titer of anti-Hsp71 was higher in the severely affected group. Finally, in a study of 9 patients, it was observed that the titer of anti-Hsp71 decreased during recovery from severe heat symptoms. These results suggest that measurement of antibodies to Hsps may be useful in assessing how individuals are responding to abnormal stress within their living and working environment and may be used as one biomarker to evaluate their susceptibility to heat-induced diseases. (+info)
Heat wave morbidity and mortality, Milwaukee, Wis, 1999 vs 1995: an improved response?
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OBJECTIVES: This study examined whether differences in heat alone, as opposed to public health interventions or other factors, accounted for the reduction in heat-related deaths and paramedic emergency medical service (EMS) runs between 1995 and 1999 during 2 heat waves occurring in Milwaukee, Wis. METHODS: Two previously described prediction models were adapted to compare expected and observed heat-related morbidity and mortality in 1999 based on the city's 1995 experience. RESULTS: Both models showed that heat-related deaths and EMS runs in 1999 were at least 49% lower than levels predicted by the 1995 relation between heat and heat-related deaths or EMS runs. CONCLUSIONS: Reductions in heat-related morbidity and mortality in 1999 were not attributable to differences in heat levels alone. Changes in public health preparedness and response may also have contributed to these reductions. (+info)
Type A lactic acidosis in occupational heat exhaustion.
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BACKGROUND: This paper presents a further analysis of biochemical data collected during a 1 year prospective study of 106 cases of heat exhaustion at a deep underground metalliferous mine. RESULTS: Multiple regression analysis results indicate that the haemoglobin, serum creatinine and plasma lactate concentrations are statistically significant predictors of the anion gap. Together, they explain 65% of the variance in the anion gap (R(2) = 0.650). Spearman's rho correlation results also confirm that haemoglobin, creatinine and lactate are each statistically significantly correlated with the anion gap (P < 0.001). CONCLUSIONS: These results indicate that dehydration and lactate are important determinants of the metabolic acidosis previously observed in occupational heat exhaustion. It is likely that dehydration in these workers has resulted in poor muscle perfusion, anaerobic conditions and elevated lactate. This constitutes Type A lactic acidosis. Creatine kinase is not a statistically significant predictor of the anion gap in multiple regression (P = 0.956). Furthermore, the Spearman's rho correlation coefficient for creatine kinase versus the anion gap is weak (r(s) = 0.175) and is not statistically significant (P = 0.073). These results suggest that there was no rhabdomyolysis contributing to the metabolic acidosis. (+info)
Distribution and mitogen response of peripheral blood lymphocytes after exertional heat injury.
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To determine whether immune disturbances during exertional heat injury (EHI) could be distinguished from those due to exercise (E), peripheral lymphocyte subset distributions and phytohemagglutinin-stimulated CD69 mitogen responses as discriminated by flow cytometry were studied in military recruits [18.7 +/- 0.3 (SE) yr old] training in warm weather. An E group (3 men and 3 women) ran 1.75-2 miles. During similar E, 11 recruits (10 men and 1 woman) presented with suspected EHI. EHI (40.4 +/- 0.3 degrees C) vs. E (38.6 +/- 0.2 degrees C) body temperature was significantly elevated (P < 0.05). Heat illness was largely classified as EHI, not heatstroke, because central nervous system manifestations were generally mild. Blood was collected at E completion or EHI onset (0 h) and 2 and 24 h later. At 0 h (EHI vs. E), suppressor, natural killer, and total lymphocyte counts were significantly elevated, helper and B lymphocyte counts remained similar, and the helper-to-suppressor ratio was significantly depressed. By 2 h, immune cell dynamics between groups were similar. From 0 to 24 h, T lymphocyte subsets revealed significantly reduced phytohemagglutinin responses (percent CD69 and mean CD69 fluorescent intensity) in EHI vs. E. Thus immune cell dynamics with EHI were distinguishable from E. Because heat stress as reported in exercise or heatstroke is associated with similar immune cell disturbances, these findings in EHI contributed to the suggestion that heat stress of varying severity shares a common pathophysiological process influencing the immune system. (+info)
Postexercise protein supplementation improves health and muscle soreness during basic military training in Marine recruits.
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Elevated postexercise amino acid availability has been demonstrated to enhance muscle protein synthesis acutely, but the long-term impact of postexercise protein supplementation on variables such as health, muscle soreness, and function are unclear. Healthy male US Marine recruits from six platoons (US Marine Corps Base, Parris Island, SC; n = 387; 18.9 +/- 0.1 yr, 74.7 +/- 1.1 kg, 13.8 +/- 0.4% body fat) were randomly assigned to three treatments within each platoon. Nutrients supplemented immediately postexercise during the 54-day basic training were either placebo (0 g carbohydrate, 0 g protein, 0 g fat), control (8, 0, 3), or protein supplement (8, 10, 3). Subjects and observers making measurements and data analysis were blinded to subject groupings. Compared with placebo and control groups, the protein-supplemented group had an average of 33% fewer total medical visits, 28% fewer visits due to bacterial/viral infections, 37% fewer visits due to muscle/joint problems, and 83% fewer visits due to heat exhaustion. Recruits experiencing heat exhaustion had greater body mass, lean, fat, and water losses. Muscle soreness immediately postexercise was reduced by protein supplementation vs. placebo and control groups on both days 34 and 54. Postexercise protein supplementation may not only enhance muscle protein deposition but it also has significant potential to positively impact health, muscle soreness, and tissue hydration during prolonged intense exercise training, suggesting a potential therapeutic approach for the prevention of health problems in severely stressed exercising populations. (+info)