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Yüksel S, Akıl M. Mild Dehydration Triggered by Exercise Reduces Cognitive Performance in Children, But Does Not Affect Their Motor Skills. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2024:1-9. [PMID: 38837125 DOI: 10.1080/27697061.2024.2362709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 05/28/2024] [Indexed: 06/06/2024]
Abstract
OBJECTIVE Children face the risk of dehydration in varying amounts during the day due to reasons such as physical activity, sweating, eating salty foods and drinking carbonated beverages. It is assumed that dehydration can lead to impaired motor skills and cognitive performance since it affects brain function. However, inconsistencies in study results, test times and problems caused by heat stress make new research mandatory. In our research, we examined the effects of exercise-induced mild dehydration on motor skills and cognitive performance in active/sedentary boys who do/do not do regular physical activities in their daily lives. METHODS The study included 112 boys who do regular physical activity (n:57; 12.40 ± 0.49age) and sedentary (n:55; 12.49 ± 0.50age). The children were given a 12-h hydration program. Mild dehydration was created by giving exercises after hydration measurements. In case of hydration and mild dehydration, Bruininks-Oseretsky Motor Proficiency and d2 attention test were applied to the children. For comparison, Repeated Measures ANOVA and Bonferroni post-hoc test was performed at the second level. RESULTS According to the hydration and mild dehydration comparison results, there was no difference in total score of Fine Motor Skill Sensitivity, Fine Motor Skill Integration, Hand Dexterity and Bidirectional Coordination, Balance, Running Speed and Agility, Hand-Arm Coordination, Strength, and BOT-2 in children. There was a decrease in both groups in terms of Focused Attention, Processing Speed, Accuracy, Concentration Performance and Attention Span. CONCLUSION As a result, mild dehydration is associated with daily physical activity in children (physical education classes, etc.) or it can easily occur due to food/beverage preferences. It may affect children's performance of school curriculum and extracurricular activities. It shows that maintaining optimal hydration is important.
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Affiliation(s)
- Sinem Yüksel
- Graduate Education Institute, Uşak University, Uşak, Türkiye
| | - Mustafa Akıl
- Faculty of Sport Sciences, Uşak University, Uşak, Türkiye
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Yin B, Fang W, Liu L, Guo Y, Ma X, Di Q. Effect of extreme high temperature on cognitive function at different time scales: A national difference-in-differences analysis. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 275:116238. [PMID: 38518609 DOI: 10.1016/j.ecoenv.2024.116238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 03/14/2024] [Accepted: 03/16/2024] [Indexed: 03/24/2024]
Abstract
BACKGROUND Mounting evidence has demonstrated that high temperature was associated with adverse health outcomes, especially morbidity and mortality. Nonetheless, the impact of extreme high temperature on cognitive performance, which is the fundamental capacity for interpreting one's surroundings, decision-making, and acquiring new abilities, has not been thoroughly investigated. METHODS We aimed to assess associations between extreme high temperature at different time scales and poor cognitive function. We used longitudinal survey data from the three waves of data from China Family Panel Study, providing an 8-year follow-up of 53,008 participants from China. We assessed temperature and extreme high temperature exposure for each participant based on the residential area and date of cognitive test. We defined the proportion of days/hours above 32 °C as the metric of the exposure to extreme high temperature. Then we used generalized additive model and difference-in-differences approach to explore the associations between extreme high temperature and cognitive function. RESULTS Our results demonstrated that either acute exposure or long-term exposure to extreme high temperature was associated with cognitive decline. At hourly level, 0-1 hour acute exposure to extreme high temperature would induce -0.93 % (95 % CI: -1.46 %, -0.39 %) cognitive change. At annual level, 10 percentage point increase in the hours proportion exceeding 32 °C in the past two years induced -9.87 % (95 % CI: -13.99 %, -5.75 %) cognitive change. Furthermore, subgroup analyses indicated adaptation effect: for the same 10 percentage increase in hours proportion exceeding 32 °C, people in warmer areas had cognitive change of -6.41 % (-11.22 %, -1.61 %), compared with -15.30 % (-21.07 %, -9.53 %) for people in cool areas. CONCLUSION Our results demonstrated that extreme high temperature was associated with reduced cognitive function at hourly, daily and annual levels, warning that people should take better measures to protect the cognitive function in the context of climate change.
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Affiliation(s)
- Bo Yin
- School of Medicine, Tsinghua University, Beijing 100084, China
| | - Wen Fang
- Division of Sports Science & Physical Education, Tsinghua University, Beijing 100084, China
| | - Linfeng Liu
- School of Medicine, Tsinghua University, Beijing 100084, China
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Xindong Ma
- Division of Sports Science & Physical Education, Tsinghua University, Beijing 100084, China; IDG/McGovern Institute for Brain Research, Tsinghua University, Beijing 100084, China
| | - Qian Di
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China; Institute for Healthy China, Tsinghua University, Beijing 100084, China.
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Taggart SM, Girard O, Landers GJ, Ecker UKH, Wallman KE. Impact of living and working in the heat on cognitive and psycho-physiological responses in outdoor fly-in fly-out tradesmen: a mining industry study. Front Physiol 2023; 14:1210692. [PMID: 37501924 PMCID: PMC10368878 DOI: 10.3389/fphys.2023.1210692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 06/30/2023] [Indexed: 07/29/2023] Open
Abstract
Objective: This study aimed to evaluate complex cognitive function, manual dexterity and psycho-physiological parameters in tradesmen working outdoors in the mining industry during summer and winter. Methods: Twenty-six males working in a mining village in the north-west of Australia were assessed pre- and post-an 11-h shift at the start, middle, and end of a 14-day swing in summer (average daily temperature: 33.9°C, 38% RH; n = 12) and winter (24.3°C, 36% RH; n = 14). Results: Working memory performance did not differ between seasons, over the swing or shift (p ≥ 0.053). Processing efficiency and manual dexterity performance did not differ between seasons (p ≥ 0.243), yet improved over the course of the swing (p ≤ 0.001) and shift (p ≤ 0.001). Core temperature, heart rate, thermal comfort, rating of perceived exertion and thermal sensation were not significantly different between seasons (p ≥ 0.076); however, average shift dehydration was greater in winter compared to summer (1.021 ± 0.005 vs. 1.018 ± 0.006; p = 0.014). Conclusion: The ability to self-regulate the intensity of activity likely helped outdoor workers to thermoregulate effectively, minimising thermal strain during their swings and shifts, in turn explaining unaltered cognitive function and manual dexterity performance between seasons. Regardless of season, workers should receive education on dehydration and workplace risks to protect their health.
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Affiliation(s)
- Sarah M. Taggart
- School of Human Sciences, The University of Western Australia, Crawley, WA, Australia
| | - Olivier Girard
- School of Human Sciences, The University of Western Australia, Crawley, WA, Australia
| | - Grant J. Landers
- School of Human Sciences, The University of Western Australia, Crawley, WA, Australia
| | - Ullrich K. H. Ecker
- School of Psychological Science, The University of Western Australia, Crawley, WA, Australia
| | - Karen E. Wallman
- School of Human Sciences, The University of Western Australia, Crawley, WA, Australia
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Water intake, hydration status and 2-year changes in cognitive performance: a prospective cohort study. BMC Med 2023; 21:82. [PMID: 36882739 PMCID: PMC9993798 DOI: 10.1186/s12916-023-02771-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 02/06/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Water intake and hydration status have been suggested to impact cognition; however, longitudinal evidence is limited and often inconsistent. This study aimed to longitudinally assess the association between hydration status and water intake based on current recommendations, with changes in cognition in an older Spanish population at high cardiovascular disease risk. METHODS A prospective analysis was conducted of a cohort of 1957 adults (aged 55-75) with overweight/obesity (BMI between ≥ 27 and < 40 kg/m2) and metabolic syndrome from the PREDIMED-Plus study. Participants had completed bloodwork and validated, semiquantitative beverage and food frequency questionnaires at baseline, as well as an extensive neuropsychological battery of 8 validated tests at baseline and 2 years of follow-up. Hydration status was determined by serum osmolarity calculation and categorized as < 295 mmol/L (hydrated), 295-299.9 mmol/L (impending dehydration), and ≥ 300 mmol/L (dehydrated). Water intake was assessed as total drinking water intake and total water intake from food and beverages and according to EFSA recommendations. Global cognitive function was determined as a composite z-score summarizing individual participant results from all neuropsychological tests. Multivariable linear regression models were fitted to assess the associations between baseline hydration status and fluid intake, continuously and categorically, with 2-year changes in cognitive performance. RESULTS The mean baseline daily total water intake was 2871 ± 676 mL/day (2889 ± 677 mL/day in men; 2854 ± 674 mL/day in women), and 80.2% of participants met the ESFA reference values for an adequate intake. Serum osmolarity (mean 298 ± 24 mmol/L, range 263 to 347 mmol/L) indicated that 56% of participants were physiologically dehydrated. Lower physiological hydration status (i.e., greater serum osmolarity) was associated with a greater decline in global cognitive function z-score over a 2-year period (β: - 0.010; 95% CI - 0.017 to - 0.004, p-value = 0.002). No significant associations were observed between water intake from beverages and/or foods with 2-year changes in global cognitive function. CONCLUSIONS Reduced physiological hydration status was associated with greater reductions in global cognitive function over a 2-year period in older adults with metabolic syndrome and overweight or obesity. Future research assessing the impact of hydration on cognitive performance over a longer duration is needed. TRIAL REGISTRATION International Standard Randomized Controlled Trial Registry, ISRCTN89898870. Retrospectively registered on 24 July 2014.
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Donnan KJ, Williams EL, Bargh MJ. The effectiveness of heat preparation and alleviation strategies for cognitive performance: A systematic review. Temperature (Austin) 2023; 10:404-433. [PMID: 38130656 PMCID: PMC10732620 DOI: 10.1080/23328940.2022.2157645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022] Open
Abstract
A range of occupational and performance contexts (e.g. military personnel operations, emergency services, sport) require the critical maintenance of cognitive performance in environmentally challenging environments. Several reviews exist which evaluate the effectiveness of heat preparation strategies to facilitate physical performance. To date, no review has explored the usefulness of heat preparation strategies for cognitive performance. Therefore, this systematic review aimed to evaluate a range of interventions for the maintenance of cognitive performance, during or following active or passive heat exposure. Studies to be included were assessed by two authors reviewing title, abstract, and full-text. Forty articles were identified which met the inclusion criteria. Interventions were categorised into chronic (i.e. acclimation/acclimatisation) and acute strategies (i.e. hydration, cooling, supplementation, psychological). The results indicate that medium-term consecutive heat acclimation may mitigate some cognitive deficits under heat stress, although heat acclimation effectiveness could be influenced by age. Further, pre-cooling appears the most effective cooling method for maintaining cognitive performance under heat stress, although results were somewhat ambiguous. The hydration literature showed that the most effective hydration strategies were those which individualised electrolyte fortified fluid volumes to match for sweat loss. Limited research exploring psychological interventions indicates that motivational self-talk could be facilitative for maintaining cognitive skills following exercise in hot conditions. These findings can be used to help inform strategies for maintaining critical cognitive and decision-making skills in hot environments.
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Affiliation(s)
- Kate J. Donnan
- Department of Sport, Exercise, and Rehabilitation Sciences, University of Hull, Hull, HU6 7RX, UK
| | - Emily L. Williams
- Centre for Human Performance, Carnegie School of Sport, Leeds Beckett University, Leeds, LS6 3QS, UK
| | - Melissa J. Bargh
- School of Sport and Exercise Science, College of Social Science of University of Lincoln, Lincoln, LN6 7TS, UK
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Tochihara Y, Wakabayashi H, Lee JY, Wijayanto T, Hashiguchi N, Saat M. How humans adapt to hot climates learned from the recent research on tropical indigenes. J Physiol Anthropol 2022; 41:27. [PMID: 35836266 PMCID: PMC9281079 DOI: 10.1186/s40101-022-00302-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 07/03/2022] [Indexed: 11/10/2022] Open
Abstract
AbstractThis review mainly aimed to introduce the findings of research projects comparing the responses of tropical and temperate indigenes to heat. From a questionnaire survey on thermal sensation and comfort of Indonesians and Japanese, we found that the thermal descriptor “cool” in tropical indigenes connotes a thermally comfortable feeling, suggesting that linguistic heat acclimatization exists on a cognitive level. Ten male students born and raised in Malaysia were invited to Fukuoka, Japan, and compared their responses with 10 Japanese male students with matched physical fitness and morphological characteristics. Cutaneous thermal sensitivity: The sensitivities were measured at 28 °C. The forehead warm sensitivity was significantly blunted in Malaysians. The less sensitivity to the warmth of tropical indigenes is advantageous in respect to withstanding heat stress with less discomfort and a greater ability to work in hot climates. Passive heat stress: Thermoregulatory responses, especially sweating, were investigated, during the lower leg hot bathing (42 °C for 60 min). The rectal temperature at rest was higher in Malaysians and increased smaller during immersion. There was no significant difference in the total amount of sweating between the two groups, while the local sweating on the forehead and thighs was lesser in Malaysians, suggesting distribution of sweating was different from Japanese. Exercise: Malaysian showed a significantly smaller increase in their rectal temperature during 55% maximal exercise for 60 min in heat (32 °C 70% relative humidity), even with a similar sweating and skin blood flow response in Japanese. The better heat tolerance in Malaysians could be explained by the greater convective heat transfer from the body core to the skin due to the greater core-to-skin temperature gradient. In addition, when they were hydrated, Malaysian participants showed better body fluid regulation with smaller reduction in plasma volume at the end of the exercise compared to the non-hydrated condition, whereas Japanese showed no difference between hydration conditions. We further investigated the de-acclimatization of heat adaptation by longitudinal observation on the heat tolerance of international students who had moved from tropical areas to Fukuoka for several years.
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Morrison SA. Moving in a hotter world: Maintaining adequate childhood fitness as a climate change countermeasure. Temperature (Austin) 2022; 10:179-197. [PMID: 37332309 PMCID: PMC10274554 DOI: 10.1080/23328940.2022.2102375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 07/09/2022] [Accepted: 07/12/2022] [Indexed: 10/16/2022] Open
Abstract
Children cope with high temperatures differently than adults do, largely because of slight alterations in their body proportions and heat loss mechanisms compared to fully mature humans. Paradoxically, all current tools of assessing thermal strain have been developed on adults. As the Earth's warming continues to accelerate, children are set to bear the health risk brunt of rising global temperatures. Physical fitness has a direct impact on heat tolerance, yet children are less fit and more obese than ever before. Longitudinal research reveals that children have 30% lower aerobic fitness than their parents did at the same age; this deficit is greater than can be recovered by training alone. So, as the planet's climate and weather patterns become more extreme, children may become less capable of tolerating it. This comprehensive review provides an outline of child thermoregulation and assessment of thermal strain, before moving to summarize how aerobic fitness can modulate hyperthermia, heat tolerance, and behavioral thermoregulation in this under-researched population. The nature of child physical activity, physical fitness, and one's physical literacy journey as an interconnected paradigm for promoting climate change resilience is explored. Finally, future research foci are suggested to encourage continued exploration of this dynamic field, notable since more extreme, multifactorial environmental stressors are expected to continue challenging the physiological strain of the human population for the foreseeable future.
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Ioannou LG, Foster J, Morris NB, Piil JF, Havenith G, Mekjavic IB, Kenny GP, Nybo L, Flouris AD. Occupational heat strain in outdoor workers: A comprehensive review and meta-analysis. Temperature (Austin) 2022; 9:67-102. [PMID: 35655665 PMCID: PMC9154804 DOI: 10.1080/23328940.2022.2030634] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/11/2022] [Accepted: 01/13/2022] [Indexed: 12/29/2022] Open
Abstract
The present comprehensive review (i) summarizes the current knowledge on the impacts of occupational heat stress on outdoor workers, (ii) provides a historical background on this issue, (iii) presents a meta-analysis of published data, (iv) explores inter-individual and intra-individual factors, (v) discusses the available heat mitigation strategies, (vi) estimates physical work capacity, labour productivity, and metabolic rate for the year 2030, and (vii) provides an overview of existing policy and legal frameworks on occupational heat exposure. Meta-analytic findings from 38 field studies that involved monitoring 2,409 outdoor workers across 41 jobs in 21 countries suggest that occupational heat stress increases the core (r = 0.44) and skin (r = 0.44) temperatures, as well as the heart rate (r = 0.38) and urine specific gravity (r = 0.13) of outdoor workers (all p < 0.05). Moreover, it diminishes the capacity of outdoor workers for manual labour (r = -0.82; p < 0.001) and is responsible for more than two thirds of the reduction in their metabolic rate. Importantly, our analysis shows that physical work capacity is projected to be highly affected by the ongoing anthropogenic global warming. Nevertheless, the metabolic rate and, therefore, labour productivity are projected to remain at levels higher than the workers' physical work capacity, indicating that people will continue to work more intensely than they should to meet their financial obligations for food and shelter. In this respect, complementary measures targeting self-pacing, hydration, work-rest regimes, ventilated garments, and mechanization can be adopted to protect outdoor workers.
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Affiliation(s)
- Leonidas G. Ioannou
- FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Josh Foster
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas and University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Nathan B. Morris
- Department of Human Physiology & Nutrition, University of Colorado, Springs, Colorado, USA
| | - Jacob F. Piil
- Department of Nutrition, Exercise and Sports, August Krogh Building, University of Copenhagen, Copenhagen, Denmark
| | - George Havenith
- Environmental Ergonomics Research Centre, Loughborough Design School, Loughborough University, Loughborough, UK
| | - Igor B. Mekjavic
- Department of Automation, Biocybernetics and Robotics, Jozef Stefan Institute, Ljubljana, Slovenia
| | - Glen P. Kenny
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Lars Nybo
- Department of Nutrition, Exercise and Sports, August Krogh Building, University of Copenhagen, Copenhagen, Denmark
| | - Andreas D. Flouris
- FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
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Huang JH, Lin CI, Liao CY, Hsieh MH, Lin HS, Chang CK. Intermittent Cooling Reduces Perceived Exertion but Has No Effect on Baseball Hitting or Defense Performance in a Hot Environment. J Sports Sci Med 2022; 21:137-144. [PMID: 35250344 PMCID: PMC8851114 DOI: 10.52082/jssm.2022.137] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 02/08/2022] [Indexed: 06/14/2023]
Abstract
Hot environments can impair the complex cognitive functions that are crucial to baseball hitting and defense. This study investigated the effects of intermittent forehead and neck cooling on the hitting and reactive agility of baseball players in hot environments. Ten male collegiate baseball players played 7-inning intrasquad games in a hot environment (31.1°C - 33.4°C), completing one cooling and one control trial in a randomized crossover design. In the cooling trial, the participants placed ice-cold towels on their forehead and neck for 3 min during offensive half innings. Hitting and reactive agility tests, a go/no-go task, and the Stroop Color and Word Test were administered before and after each game. The games in the hot environment significantly increased rectal temperatures to the same level in the control (38.15°C ± 0.31°C, p < 0.001) and cooling (38.08°C ± 0.24°C, p < 0.001) trials. Intermittent cooling significantly reduced forehead and tympanic temperatures, perceived exertion, and thermal sensation during the game. Swing power significantly increased after the game, but the exit velocity of batted balls did not significantly differ in both trials. Reactive agility was significantly impaired after the game in the control trial (before: 0.367 ± 0.109 s, after: 0.491 ± 0.212 s, p = 0.008) but displayed a trend of decrease in the cooling trial (before: 0.390 ± 0.183 s, after: 0.518 ± 0.282 s, p = 0.066). The game and cooling intervention had no significant effects on the reaction time or error rate in the go/no-go task and Stroop Color and Word Test. The results showed that intermittent cooling during a baseball game in a hot environment reduces perceived exertion and thermal sensation but has no significant effect on hitting, defense performance, or cognitive function.
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Affiliation(s)
- Jyh-How Huang
- Department of Sport Information and Communication, National Taiwan University of Sport, Taichung, Taiwan
| | - Chung-I Lin
- Department of Ball Sport, National Taiwan University of Sport, Taichung, Taiwan
| | - Chih-Yang Liao
- Department of Sport Performance, National Taiwan University of Sport, Taichung, Taiwan
| | - Meng-Hung Hsieh
- Department of Sport Performance, National Taiwan University of Sport, Taichung, Taiwan
| | - Han-Szu Lin
- Graduate Institute of Sport Coaching Science, Chinese Culture University, Taipei, Taiwan
| | - Chen-Kang Chang
- Department of Sport Performance, National Taiwan University of Sport, Taichung, Taiwan
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Schultz Martins R, Wallace PJ, Steele SW, Scott JS, Taber MJ, Hartley GL, Cheung SS. The Clamping of End-Tidal Carbon Dioxide Does Not Influence Cognitive Function Performance During Moderate Hyperthermia With or Without Skin Temperature Manipulation. Front Psychol 2021; 12:788027. [PMID: 35002880 PMCID: PMC8730541 DOI: 10.3389/fpsyg.2021.788027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 11/26/2021] [Indexed: 11/13/2022] Open
Abstract
Increases in body temperature from heat stress (i.e., hyperthermia) generally impairs cognitive function across a range of domains and complexities, but the relative contribution from skin versus core temperature changes remains unclear. Hyperthermia also elicits a hyperventilatory response that decreases the partial pressure of end-tidal carbon dioxide (PetCO2) and subsequently cerebral blood flow that may influence cognitive function. We studied the role of skin and core temperature along with PetCO2 on cognitive function across a range of domains. Eleven males completed a randomized, single-blinded protocol consisting of poikilocapnia (POIKI, no PetCO2 control) or isocapnia (ISO, PetCO2 maintained at baseline levels) during passive heating using a water-perfused suit (water temperature ~ 49°C) while middle cerebral artery velocity (MCAv) was measured continuously as an index of cerebral blood flow. Cognitive testing was completed at baseline, neutral core-hot skin (37.0 ± 0.2°C-37.4 ± 0.3°C), hot core-hot skin (38.6 ± 0.3°C-38.7 ± 0.2°C), and hot core-cooled skin (38.5 ± 0.3°C-34.7 ± 0.6°C). The cognitive test battery consisted of a detection task (psychomotor processing), 2-back task (working memory), set-shifting and Groton Maze Learning Task (executive function). At hot core-hot skin, poikilocapnia led to significant (both p < 0.05) decreases in PetCO2 (∆−21%) and MCAv (∆−26%) from baseline, while isocapnia clamped PetCO2 (∆ + 4% from baseline) leading to a significantly (p = 0.023) higher MCAv (∆−18% from baseline) compared to poikilocapnia. There were no significant differences in errors made on any task (all p > 0.05) irrespective of skin temperature or PetCO2 manipulation. We conclude that neither skin temperature nor PetCO2 maintenance significantly alter cognitive function during passive hyperthermia.
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Affiliation(s)
- Ricardo Schultz Martins
- Environmental Ergonomics Laboratory, Department of Kinesiology, Brock University, St. Catharines, ON, Canada
| | - Phillip J. Wallace
- Environmental Ergonomics Laboratory, Department of Kinesiology, Brock University, St. Catharines, ON, Canada
| | - Scott W. Steele
- Environmental Ergonomics Laboratory, Department of Kinesiology, Brock University, St. Catharines, ON, Canada
| | - Jake S. Scott
- Environmental Ergonomics Laboratory, Department of Kinesiology, Brock University, St. Catharines, ON, Canada
| | - Michael J. Taber
- Environmental Ergonomics Laboratory, Department of Kinesiology, Brock University, St. Catharines, ON, Canada
- NM Consulting Inc., St. Catharines, ON, Canada
| | - Geoffrey L. Hartley
- Department of Physical and Health Education, Nipissing University, North Bay, ON, Canada
| | - Stephen S. Cheung
- Environmental Ergonomics Laboratory, Department of Kinesiology, Brock University, St. Catharines, ON, Canada
- *Correspondence: Stephen S. Cheung,
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James CA, Willmott AG, Dhawan A, Stewart C, Gibson OR. Increased air temperature decreases high-speed, but not total distance, in international field hockey. Temperature (Austin) 2021; 9:357-372. [PMCID: PMC9629124 DOI: 10.1080/23328940.2021.1997535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
This study investigated the effect of heat stress on locomotor activity within international field hockey at team, positional and playing-quarter levels. Analysis was conducted on 71 matches played by the Malaysia national men’s team against 24 opponents. Fixtures were assigned to match conditions, based on air temperature [COOL (14 ± 3°C), WARM (24 ± 1°C), HOT (27 ± 1°C), or VHOT (32 ± 2°C), p < 0.001]. Relationships between locomotor metrics and air temperature (AIR), absolute and relative humidity, and wet bulb globe temperature (WBGT) were investigated further using correlation and regression analyses. Increased AIR and WBGT revealed similar correlations (p < 0.01) with intensity metrics; high-speed running (AIR r = −0.51, WBGT r = −0.45), average speed (AIR r = −0.48, WBGT r = −0.46), decelerations (AIR r = −0.41, WBGT r = −0.41), sprinting efforts (AIR r = −0.40, WBGT r = −0.36), and sprinting distance (AIR r = −0.37, WBGT r = −0.29). In comparison to COOL, HOT, and VHOT matches demonstrated reduced high-speed running intensity (−14–17%; p < 0.001), average speed (−5-6%; p < 0.001), sprinting efforts (−17%; p = 0.010) and decelerations per min (−12%; p = 0.008). Interactions were found between match conditions and playing quarter for average speed (+4-7%; p = 0.002) and sprinting distance (+16-36%; p < 0.001), both of which were higher in the fourth quarter in COOL versus WARM, HOT and VHOT. There was an interaction for “low-speed” (p < 0.001), but not for “high-speed” running (p = 0.076) demonstrating the modulating effect of air temperature (particularly >25°C) on pacing within international hockey. These are the first data demonstrating the effect of air temperature on locomotor activity within international men’s hockey, notably that increased air temperature impairs high-intensity activities by 5–15%. Higher air temperatures compromise high-speed running distances between matches in hockey.
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Affiliation(s)
- Carl A James
- Institut Sukan Negara (National Sports Institute), National Sports Complex, Kuala Lumpur, Malaysia
- Environmental Extremes Laboratory, University of Brighton, Eastbourne, UK
| | - Ashley G.B. Willmott
- Environmental Extremes Laboratory, University of Brighton, Eastbourne, UK
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | | | - Craig Stewart
- CS Performance, Clontarf Hockey Club, Dublin, Ireland
| | - Oliver R Gibson
- Centre for Human Performance, Exercise and Rehabilitation (CHPER), Division of Sport, Health and Exercise Sciences, Brunel University London, Uxbridge, UK
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Girard O, Gaoua N, Grantham J, Knez W, Walsh A, Racinais S. Effects of living and working in a hot environment on cognitive function in a quiet and temperature-controlled room: An oil and gas industry study. Temperature (Austin) 2021; 8:372-380. [PMID: 34901319 DOI: 10.1080/23328940.2021.1959289] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
We investigate the effects of seasonal heat stress on cognitive function in outdoor workers. Thirty-nine workers from an oil and gas industry in the Middle-East volunteered for cognitive testing before (5.30 to 7.00 am) and after (3.30 to 5.00 pm) their daily work-shift in hot (August - average daily temperature: ~41°C) and temperate (January - average daily temperature: ~22°C) seasons. While physical activity was reduced in hot compared to temperate season (average normalized acceleration: 96 ± 33 vs. 112 ± 31 × 10-3 g; -12.5 ± 4.7%; P = 0.010), the average core temperature during the work-shift was higher in the hot season (37.4 ± 0.2 vs. 37.2 ± 0.2°C; P = 0.002). Peak core temperature was 38.0 ± 0.1°C and 37.8 ± 0.1°C in hot and temperate seasons, respectively. Cognitive performance did not differ between seasons for tests of recognition memory (P = 0.169), working memory (P = 0.797) and executive function (P = 0.145), independent of testing time. Whereas there was no significant main effect of testing time for tests of recognition memory (P = 0.503) and working memory (P = 0.849), the number of problems solved on the first choice for the executive function test was lower in the afternoon than the morning (-9.2 ± 5.3%; P = 0.039). There was no season × testing time interaction for any cognitive tests (P ≥ 0.145). In the absence of hyperthermia, living and working in a hot environment does not alter cognitive function in oil and gas industry workers tested in a quiet and temperature-controlled room, with reduced clothing encumbrance (relative to work). Conclusions should not be extrapolated to more stressful situations (i.e., thermal stressor present, pronounced dehydration, noise).
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Affiliation(s)
- Olivier Girard
- School of Human Sciences (Exercise and Sport Science), The University of Western Australia, Crawley, Western Australia, Australia.,Research and Scientific Support Department, Aspetar Orthopaedic and Sport Medicine Hospital, Doha, Qatar
| | - Nadia Gaoua
- Research and Scientific Support Department, Aspetar Orthopaedic and Sport Medicine Hospital, Doha, Qatar.,Sport and Exercise Science Research Centre (SESRC), London South Bank University, London, UK
| | - Justin Grantham
- Research and Scientific Support Department, Aspetar Orthopaedic and Sport Medicine Hospital, Doha, Qatar.,RelatePerform, Relate Perform Ltd, Hong Kong
| | - Wade Knez
- Research and Scientific Support Department, Aspetar Orthopaedic and Sport Medicine Hospital, Doha, Qatar
| | - Andrew Walsh
- Research and Scientific Support Department, Aspetar Orthopaedic and Sport Medicine Hospital, Doha, Qatar.,Brisbane Lions Football Club, Brisbane, Queensland, Australia
| | - Sebastien Racinais
- Research and Scientific Support Department, Aspetar Orthopaedic and Sport Medicine Hospital, Doha, Qatar
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13
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Schlader ZJ, Schwob J, Hostler D, Cavuoto L. Simultaneous assessment of motor and cognitive tasks reveals reductions in working memory performance following exercise in the heat. Temperature (Austin) 2021; 9:344-356. [PMID: 36339090 PMCID: PMC9629122 DOI: 10.1080/23328940.2021.1992239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
This study tested the hypothesis that, following exercise in the heat, motor task performance will be impaired when assessed simultaneously with a cognitive task. In a randomized, crossover and counterbalanced design, twelve healthy adults (23 ± 2 years, 5 women) completed four 10-minute exercise circuits involving upper and lower body exercise in a moderate (18.1 ± 1.7°C, 38 ± 10% relative humidity) and a hot (40.3 ± 1.1°C, 26 ± 5% relative humidity) environment. Experimental testing was completed in a temperate thermal environment before exercise (~25°C) and in either the moderate or hot environment following exercise. The 3 Back test (a test of working memory) was used as the cognitive task and postural sway was used as the motor task. Cognitive and motor task performance assessments were conducted both individually (solo) and simultaneously (dual). At the end of exercise, core temperature (by 0.4 ± 0.3°C, P < 0.001), heart rate (by 12 ± 18 bpm, P = 0.025), and mean skin temperature (by 7.6 ± 0.8°C, P < 0.001) were higher in the Hot trial compared to Moderate. During solo testing, postural sway increased from pre- to post-exercise in the Hot (P ≤ 0.028), but not the Moderate (P ≥ 0.261) trial. During dual testing, postural sway did not differ between trials (P ≥ 0.065) or over time (P ≥ 0.094). During solo testing, 3 Back performance did not differ between trials (P = 0.810) or over time (P = 0.707), but during dual testing 3 Back performance following exercise was reduced in the Hot compared to the Moderate trial (P = 0.028). Simultaneous assessment of motor and cognitive tasks reveals that motor performance is reduced following exercise in the heat. .
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Affiliation(s)
- Zachary J. Schlader
- Center for Research and Education in Special Environments, Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, USA,Department of Kinesiology, School of Public Health, Indiana University, Bloomington, USA
| | - Jacqueline Schwob
- Center for Research and Education in Special Environments, Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, USA
| | - David Hostler
- Center for Research and Education in Special Environments, Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, USA,Department of Emergency Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, USA
| | - Lora Cavuoto
- Department of Industrial and Systems Engineering, School of Engineering and Applied Sciences, University at Buffalo, Buffalo, USA,CONTACT Lora Cavuoto
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14
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Ward MK, Yam CMH, Palejwala Z, Wallman K, Taggart SM, Wood FM, Parker SK. An Experimental Simulation of Heat Effects on Cognition and Workload of Surgical Team Members. Ann Surg 2021; 274:e395-e402. [PMID: 33196490 DOI: 10.1097/sla.0000000000004598] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To isolate heat exposure as a cause of cognitive impairment and increased subjective workload in burns surgical teams. SUMMARY OF BACKGROUND DATA Raising ambient temperature of the operating room can improve burns patient outcomes, but risks increased cognitive impairment and workload of surgical team members. Prior research indicates ambient heat exposure depletes physiological and cognitive resources, but these findings have not been studied in the context of burns surgical teams. METHODS Seventeen surgical team members completed 2 surgery simulations of similar complexities in a hot and in a normothermic operating room. During each simulation, participants completed multiple cognitive tests to assess cognitive functioning and the SURG-TLX to self-assess workload. Order effects, core body temperature changes due to menstruation, and circadian rhythms were controlled for in the experimental design. Descriptive statistics, correlations, and mixed ANOVAs were performed to assess relationships between ambient heat exposure with cognitive functioning and perceived workload. RESULTS Heat had a main effect on executive functioning and verbal reasoning. Duration of heat exposure (heat ∗ time) increased response times and negatively impacted executive functioning, spatial planning, and mental rotation. Perceived workload was higher in the hot condition. CONCLUSIONS We provide causal evidence that over time, heat exposure impairs cognitive speed and accuracy, and increases subjective workload. We recommend building on this study to drive best-practices for acute burns surgery and design work to enable burns teams to maintain their cognitive stamina, lower their workload, and improve outcomes for patients and surgeons.
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Affiliation(s)
- Mary K Ward
- Curtin University, Faculty of Business and Law, Future of Work Institute, Perth, Australia
| | - Cheryl M H Yam
- Curtin University, Faculty of Business and Law, Future of Work Institute, Perth, Australia
| | - Zehra Palejwala
- The University of Western Australia, School of Human Sciences, Perth, Australia
| | - Karen Wallman
- The University of Western Australia, School of Human Sciences, Perth, Australia
| | - Sarah M Taggart
- The University of Western Australia, School of Human Sciences, Perth, Australia
| | - Fiona M Wood
- Burn Injury Research Unit, University of Western Australia, and Burn Service of WA South Metropolitan Health Service, Perth, Australia
| | - Sharon K Parker
- Curtin University, Faculty of Business and Law, Future of Work Institute, Perth, Australia
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15
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Piil JF, Kingma B, Morris NB, Christiansen L, Ioannou LG, Flouris AD, Nybo L. Proposed framework for forecasting heat-effects on motor-cognitive performance in the Summer Olympics. Temperature (Austin) 2021; 8:262-283. [PMID: 34485620 PMCID: PMC8409751 DOI: 10.1080/23328940.2021.1957367] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Heat strain impairs performance across a broad spectrum of sport disciplines. The impeding effects of hyperthermia and dehydration are often ascribed to compromised cardiovascular and muscular functioning, but expert performance also depends on appropriately tuned sensory, motor and cognitive processes. Considering that hyperthermia has implications for central nervous system (CNS) function and fatigue, it is highly relevant to analyze how heat stress forecasted for the upcoming Olympics may influence athletes. This paper proposes and demonstrates the use of a framework combining expected weather conditions with a heat strain and motor-cognitive model to analyze the impact of heat and associated factors on discipline- and scenario-specific performances during the Tokyo 2021 games. We pinpoint that hyperthermia-induced central fatigue may affect prolonged performances and analyze how hyperthermia may impair complex motor-cognitive performance, especially when accompanied by either moderate dehydration or exposure to severe solar radiation. Interestingly, several short explosive performances may benefit from faster cross-bridge contraction velocities at higher muscle temperatures in sport disciplines with little or no negative heat-effect on CNS fatigue or motor-cognitive performance. In the analyses of scenarios and Olympic sport disciplines, we consider thermal impacts on “motor-cognitive factors” such as decision-making, maximal and fine motor-activation as well as the influence on central fatigue and pacing. From this platform, we also provide perspectives on how athletes and coaches can identify risks for their event and potentially mitigate negative motor-cognitive effects for and optimize performance in the environmental settings projected.
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Affiliation(s)
- Jacob Feder Piil
- Department of Nutrition, Exercise and Sports, Section for Integrative Physiology, University of Copenhagen, Copenhagen N, Copenhagen, Denmark
| | - Boris Kingma
- Department of Mechanical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.,TNO, the Netherlands Organization for Applied Scientific Research, Unit Defense, Safety & Security, Soesterberg, The Netherlands
| | - Nathan B Morris
- Department of Nutrition, Exercise and Sports, Section for Integrative Physiology, University of Copenhagen, Copenhagen N, Copenhagen, Denmark
| | - Lasse Christiansen
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
| | - Leonidas G Ioannou
- FAME Laboratory, School of Exercise Science, University of Thessaly, Thessaly, Greece
| | - Andreas D Flouris
- FAME Laboratory, School of Exercise Science, University of Thessaly, Thessaly, Greece
| | - Lars Nybo
- Department of Nutrition, Exercise and Sports, Section for Integrative Physiology, University of Copenhagen, Copenhagen N, Copenhagen, Denmark
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16
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Ebi KL, Capon A, Berry P, Broderick C, de Dear R, Havenith G, Honda Y, Kovats RS, Ma W, Malik A, Morris NB, Nybo L, Seneviratne SI, Vanos J, Jay O. Hot weather and heat extremes: health risks. Lancet 2021; 398:698-708. [PMID: 34419205 DOI: 10.1016/s0140-6736(21)01208-3] [Citation(s) in RCA: 298] [Impact Index Per Article: 99.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 12/15/2020] [Accepted: 05/20/2021] [Indexed: 01/18/2023]
Abstract
Hot ambient conditions and associated heat stress can increase mortality and morbidity, as well as increase adverse pregnancy outcomes and negatively affect mental health. High heat stress can also reduce physical work capacity and motor-cognitive performances, with consequences for productivity, and increase the risk of occupational health problems. Almost half of the global population and more than 1 billion workers are exposed to high heat episodes and about a third of all exposed workers have negative health effects. However, excess deaths and many heat-related health risks are preventable, with appropriate heat action plans involving behavioural strategies and biophysical solutions. Extreme heat events are becoming permanent features of summer seasons worldwide, causing many excess deaths. Heat-related morbidity and mortality are projected to increase further as climate change progresses, with greater risk associated with higher degrees of global warming. Particularly in tropical regions, increased warming might mean that physiological limits related to heat tolerance (survival) will be reached regularly and more often in coming decades. Climate change is interacting with other trends, such as population growth and ageing, urbanisation, and socioeconomic development, that can either exacerbate or ameliorate heat-related hazards. Urban temperatures are further enhanced by anthropogenic heat from vehicular transport and heat waste from buildings. Although there is some evidence of adaptation to increasing temperatures in high-income countries, projections of a hotter future suggest that without investment in research and risk management actions, heat-related morbidity and mortality are likely to increase.
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Affiliation(s)
- Kristie L Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, WA, USA.
| | - Anthony Capon
- Monash Sustainable Development Institute, Monash University, Melbourne, VIC, Australia; Sydney School of Public Health, Sydney, NSW, Australia
| | - Peter Berry
- Faculty of Environment, University of Waterloo, Waterloo, ON, Canada
| | - Carolyn Broderick
- School of Medical Sciences, UNSW Sydney, NSW, Australia; The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Richard de Dear
- Indoor Environmental Quality Laboratory, School of Architecture, Design, and Planning, Sydney, NSW, Australia; The University of Sydney, Sydney, NSW, Australia
| | - George Havenith
- Environmental Ergonomics Research Centre, School of Design and Creative Arts, Loughborough University, Loughborough, UK
| | - Yasushi Honda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - R Sari Kovats
- NIHR Health Protection Research Unit in Environmental Change and Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Wei Ma
- School of Public Health and Climate Change and Health Center, Shandong University, Jinan, China
| | - Arunima Malik
- Discipline of Accounting, Business School, Sydney, NSW, Australia; School of Physics, Faculty of Science, ISA, Sydney, NSW, Australia
| | - Nathan B Morris
- Thermal Ergonomics Laboratory, Sydney, NSW, Australia; Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Lars Nybo
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Sonia I Seneviratne
- Institute for Atmospheric and Climate Science, ETH Zurich, Zurich, Switzerland
| | - Jennifer Vanos
- School of Sustainability, Arizona State University, Tempe, AZ, USA
| | - Ollie Jay
- Thermal Ergonomics Laboratory, Sydney, NSW, Australia; Sydney School of Health Sciences, Sydney, NSW, Australia; Sydney School of Public Health, Sydney, NSW, Australia; Faculty of Medicine and Health, Charles Perkins Centre, Sydney, NSW, Australia
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17
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Morris NB, Piil JF, Morabito M, Messeri A, Levi M, Ioannou LG, Ciuha U, Pogačar T, Kajfež Bogataj L, Kingma B, Casanueva A, Kotlarski S, Spirig C, Foster J, Havenith G, Sotto Mayor T, Flouris AD, Nybo L. The HEAT-SHIELD project — Perspectives from an inter-sectoral approach to occupational heat stress. J Sci Med Sport 2021; 24:747-755. [DOI: 10.1016/j.jsams.2021.03.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 02/11/2021] [Accepted: 03/01/2021] [Indexed: 02/07/2023]
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18
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Castillo F, Mora AM, Kayser GL, Vanos J, Hyland C, Yang AR, Eskenazi B. Environmental Health Threats to Latino Migrant Farmworkers. Annu Rev Public Health 2021; 42:257-276. [PMID: 33395542 PMCID: PMC8168948 DOI: 10.1146/annurev-publhealth-012420-105014] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Approximately 75% of farmworkers in the United States are Latino migrants, and about 50% of hired farmworkers do not have authorization to work in the United States. Farmworkers face numerous chemical, physical, and biological threats to their health. The adverse effects of these hazards may be amplified among Latino migrant farmworkers, who are concurrently exposed to various psychosocial stressors. Factors such as documentation status, potential lack of authorization to work in the United States, and language and cultural barriers may also prevent Latino migrants from accessing federal aid, legal assistance, and health programs. These environmental, occupational, and social hazards may further exacerbate existing health disparities among US Latinos. This population is also likely to be disproportionately impacted by emerging threats, including climate change and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Latino migrant farmworkers are essential to agriculture in the United States, and actions are needed to protect this vulnerable population.
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Affiliation(s)
- Federico Castillo
- Department of Environmental Science, Policy and Management, University of California, Berkeley, California 94720, USA;
| | - Ana M Mora
- Center for Environmental Research and Children's Health, School of Public Health, University of California, Berkeley, California 94720, USA; , ,
- Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional, Heredia 86-3000, Costa Rica
| | - Georgia L Kayser
- Health Sciences, University of California, San Diego, California 92093, USA; ,
| | - Jennifer Vanos
- School of Sustainability, Arizona State University, Tempe, Arizona 85287, USA;
| | - Carly Hyland
- Center for Environmental Research and Children's Health, School of Public Health, University of California, Berkeley, California 94720, USA; , ,
| | - Audrey R Yang
- Health Sciences, University of California, San Diego, California 92093, USA; ,
| | - Brenda Eskenazi
- Center for Environmental Research and Children's Health, School of Public Health, University of California, Berkeley, California 94720, USA; , ,
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19
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Gibbons TD, Ainslie PN, Thomas KN, Wilson LC, Akerman AP, Donnelly J, Campbell HA, Cotter JD. Influence of the mode of heating on cerebral blood flow, non-invasive intracranial pressure and thermal tolerance in humans. J Physiol 2021; 599:1977-1996. [PMID: 33586133 DOI: 10.1113/jp280970] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 02/01/2021] [Indexed: 12/22/2022] Open
Abstract
KEY POINTS The human brain is particularly vulnerable to heat stress; this manifests as impaired cognition, orthostatic tolerance, work capacity and eventually, brain death. The brain's limitation in the heat is often ascribed to inadequate cerebral blood flow (CBF), but elevated intracranial pressure is commonly observed in mammalian models of heat stroke and can on its own cause functional impairment. The CBF response to incremental heat strain was dependent on the mode of heating, decreasing by 30% when exposed passively to hot, humid air (sauna), while remaining unchanged or increasing with passive hot-water immersion (spa) and exercising in a hot environment. Non-invasive intracranial pressure estimates (nICP) were increased universally by 18% at volitional thermal tolerance across all modes of heat stress, and therefore may play a contributing role in eliciting thermal tolerance. The sauna, more so than the spa or exercise, poses a greater challenge to the brain under mild to severe heating due to lower blood flow but similarly increased nICP. ABSTRACT The human brain is particularly vulnerable to heat stress; this manifests as impaired cognitive function, orthostatic tolerance, work capacity, and eventually, brain death. This vulnerability is often ascribed to inadequate cerebral blood flow (CBF); however, elevated intracranial pressure (ICP) is also observed in mammalian models of heat stroke. We investigated the changes in CBF with incremental heat strain under three fundamentally different modes of heating, and assessed whether heating per se increased ICP. Fourteen fit participants (seven female) were heated to thermal tolerance or 40°C core temperature (Tc ; oesophageal) via passive hot-water immersion (spa), passive hot, humid air exposure (sauna), cycling exercise, and cycling exercise with CO2 inhalation to prevent heat-induced hypocapnia. CBF was measured with duplex ultrasound at each 0.5°C increment in Tc and ICP was estimated non-invasively (nICP) from optic nerve sheath diameter at thermal tolerance. At thermal tolerance, CBF was decreased by 30% in the sauna (P < 0.001), but was unchanged in the spa or with exercise (P ≥ 0.140). CBF increased by 17% when end-tidal P C O 2 was clamped at eupnoeic pressure (P < 0.001). On the contrary, nICP increased universally by 18% with all modes of heating (P < 0.001). The maximum Tc was achieved with passive heating, and preventing hypocapnia during exercise did not improve exercise or thermal tolerance (P ≥ 0.146). Therefore, the regulation of CBF is dramatically different depending on the mode and dose of heating, whereas nICP responses are not. The sauna, more so than the spa or exercise, poses a greater challenge to the brain under equivalent heat strain.
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Affiliation(s)
- Travis D Gibbons
- University of Otago, 55/47 Union St. W, Dunedin, Otago, 9016, New Zealand
| | - Philip N Ainslie
- University of British Columbia, Okangan Campus, Kelowna, BC, V1V 1V7, Canada
| | - Kate N Thomas
- University of Otago, 55/47 Union St. W, Dunedin, Otago, 9016, New Zealand
| | - Luke C Wilson
- University of Otago, 55/47 Union St. W, Dunedin, Otago, 9016, New Zealand
| | | | | | - Holly A Campbell
- University of Otago, 55/47 Union St. W, Dunedin, Otago, 9016, New Zealand
| | - Jim D Cotter
- University of Otago, 55/47 Union St. W, Dunedin, Otago, 9016, New Zealand
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20
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Ashworth ET, Cotter JD, Kilding AE. Impact of elevated core temperature on cognition in hot environments within a military context. Eur J Appl Physiol 2021; 121:1061-1071. [PMID: 33426575 PMCID: PMC7797274 DOI: 10.1007/s00421-020-04591-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 12/17/2020] [Indexed: 01/31/2023]
Abstract
PURPOSE Cognition can be impaired during exercise in the heat, potentially contributing to military casualties. To our knowledge, the independent role of elevated core temperature during exercise has not been determined. The aim of the current study was to evaluate effects of elevated core temperature on cognition during physically encumbering, heated exercise, and to determine whether the perceptual cooling effects of menthol preserves cognition. METHODS Eight participants complete three trials in randomised order: one normothermic (CON) and two with elevated (38.5°C) core temperature, induced by prior immersion in neutral versus hot water The CON trial and one hot trial (HOT) used a water mouth-rinse following each cognitive task of the trial, (HOT) while the other used a menthol mouth-rinse (MENT). Participants walked in humid heat (33°C, 75% relative humidity) in military clothing, completing a cognitive battery of reaction time, perceptual processing, working memory, executive function, cognitive flexibility, vigilance, and declarative memory. RESULTS No differences in cognitive performance were observed between any conditions. Near-infrared spectroscopy showed greater oxygenated haemoglobin tissue content in HOT and MENT compared to CON (ΔO2Hb-deO2Hb: 2.3 ± 4.5 µM, p < .024), and lower deoxygenated haemoglobin in MENT than in CON or HOT (p = .017), suggesting higher brain metabolism during the more stressful conditions. CONCLUSION Moderately elevated core (38.5°C) and skin temperature does not appear to impair cognitive performance during exercise despite mildly elevated cerebral metabolism. The effects of menthol remain undetermined due to the lack of heat-mediated cognitive impairment.
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Affiliation(s)
- Edward Tom Ashworth
- Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, 17 Antares Place, Rosedale, Auckland, 0632, New Zealand.
| | - James David Cotter
- School of Physical Education, Sport and Exercise Sciences, University of Otago, 55/47 Union Street W, North Dunedin, Dunedin, 9016, New Zealand
| | - Andrew Edward Kilding
- Sports Performance Research Institute New Zealand (SPRINZ), Auckland University of Technology, 17 Antares Place, Rosedale, Auckland, 0632, New Zealand
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21
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Morris NB, Levi M, Morabito M, Messeri A, Ioannou LG, Flouris AD, Samoutis G, Pogačar T, Bogataj LK, Piil JF, Nybo L. Health vs. wealth: Employer, employee and policy-maker perspectives on occupational heat stress across multiple European industries. Temperature (Austin) 2020; 8:284-301. [PMID: 34485621 PMCID: PMC8409781 DOI: 10.1080/23328940.2020.1852049] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/12/2020] [Accepted: 11/13/2020] [Indexed: 01/16/2023] Open
Abstract
Successful implementation of cooling strategies obviously depends on identifying effective interventions, but in industrial settings, it is equally important to consider feasibility and economic viability. Many cooling interventions are available, but the decision processes affecting adoption by end-users are not well elucidated. We therefore arranged two series of meetings with stakeholders to identify knowledge gaps, receive feedback on proposed cooling interventions, and discuss factors affecting implementation of heat-health interventions. This included four meetings attended by employers, employees, and health and safety officers (n = 41), and three meetings attended primarily by policy makers (n = 74), with feedback obtained via qualitative and quantitative questionnaires and focus group discussions. On a 10-point scale, both employers and employees valued worker safety (9.1 ± 1.8; mean±SD) and health (8.5 ± 1.9) as more important than protecting company profits (6.3 ± 2.3). Of the respondents, 41% were unaware of any cooling strategies at their company and of those who were aware, only 30% thought the interventions were effective. Following presentation of proposed interventions, the respondents rated "facilitated hydration", "optimization of clothing/protective equipment", and "rescheduling of work tasks" as the top-three preferred solutions. The main barriers for adopting cooling interventions were cost, feasibility, employer perceptions, and legislation. In conclusion, preventing negative health and safety effects was deemed to be more important than preventing productivity loss. Regardless of work sector or occupation, both health and wealth were emphasized as important parameters and considered as somewhat interrelated. However, a large fraction of the European worker force lacks information on effective measures to mitigate occupational heat stress. List of abbreviations: OH-Stress: Occupational heat stress; WBGT: Wet Bulb Globe Temperature.
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Affiliation(s)
- Nathan B. Morris
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
- Centre for Technology Research and Innovation (CETRI), Lemesos, Cyprus
| | - Miriam Levi
- Epidemiology Unit, Department of Prevention, Local Health Authority Tuscany Center, Florence, Italy
| | - Marco Morabito
- Institute of Bioeconomy (IBE), National Research Council, Florence, Italy
- Center of Bioclimatology (CIBIC), University of Florence, Florence, Italy
| | - Alessandro Messeri
- Institute of Bioeconomy (IBE), National Research Council, Florence, Italy
- Center of Bioclimatology (CIBIC), University of Florence, Florence, Italy
| | - Leonidas G. Ioannou
- FAME Laboratory, Department of Exercise Science, University of Thessaly, Trikala, Greece
| | - Andreas D. Flouris
- FAME Laboratory, Department of Exercise Science, University of Thessaly, Trikala, Greece
| | | | - Tjaša Pogačar
- Department of Agronomy, Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Lučka Kajfež Bogataj
- Department of Agronomy, Biotechnical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Jacob F. Piil
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Lars Nybo
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
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22
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Byrne J, Ludington-Hoe SM. Theory of heat stress management: Development and application in the operating room. J Adv Nurs 2020; 77:1218-1227. [PMID: 33314328 DOI: 10.1111/jan.14668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/14/2020] [Accepted: 11/06/2020] [Indexed: 11/26/2022]
Abstract
AIM The Theory of Heat Stress Management addresses the phenomenon of occupational heat stress and applies the theory to surgical staff wearing personal protective equipment while performing surgery. This discussion paper relates development of the prescriptive middle range theory of heat stress management to inform and advance research and provide evidence to support new standards of care in clinical nursing practice. DESIGN The prescriptive middle range theory was developed by summarizing essential elements of the theory, describing the linkages among the dimensions of the theory, enumerating nursing interventions and physiological, psychological and cognitive outcomes, stating relevant assumptions, defining and identifying relationships between the concepts of heat stress management in observable and measurable terms. DATA SOURCES This discussion paper is based on the first author's experiences with occupational heat stress, observed improvements in surgical personnel's thermal comfort by using a cooling intervention and knowledge gained from an extensive integrated literature review and ongoing clinical research. IMPLICATIONS FOR NURSING The middle range theory was developed to create awareness of the impact heat stress has on the health and well-being of all healthcare personnel at risk for heat stress due to wearing personal protective equipment. Nurses need to recognize individuals in thermally stressful environments, evaluate and monitor individuals' physiological and psychological responses and promote comfort by providing interventions to alleviate occupational heat stress. CONCLUSION The Theory of Heat Stress Management combines dimensions specific to heat stress affecting surgical staff and provides a perspective that facilitates knowledge development, can enhance nursing practice and support exploration of the linkages and prescriptions of the theory through research. IMPACT The predictive middle-range Theory of Heat Stress Management will guide nurses to promote the health and well-being of healthcare workers and influence and improve clinical nursing practice, education, and research related to heat stress management.
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Affiliation(s)
- Jill Byrne
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, USA
| | - Susan M Ludington-Hoe
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, USA
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Perry BG, Mündel T. Lower body positive pressure affects systemic but not cerebral haemodynamics during incremental hyperthermia. Clin Physiol Funct Imaging 2020; 41:226-233. [PMID: 33238075 DOI: 10.1111/cpf.12682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 10/17/2020] [Accepted: 11/18/2020] [Indexed: 11/28/2022]
Abstract
Hyperthermia produces profound redistribution of blood and circulatory reflex function. We investigated the potential for lower body positive pressure (LBPP) to maintain or restore haemodynamics during graded hyperthermia. Eight healthy adults rested supine in a custom-made LBPP box, sealed distal to the iliac crest. Following 5 min of normothermic rest, 20 mmHg of LBPP was applied and repeated when core temperature (Tcore ) had increased passively by +0.5 and +1°C. Primary dependent variables included mean middle cerebral artery blood velocity (MCAvmean , transcranial Doppler), mean arterial blood pressure (MAP, finger photoplethysmography), heart rate (HR) and partial pressure of end-tidal carbon dioxide (PET CO2 ). The absolute increase in MAP during LBPP was lower at Tcore +1°C (2 ± 3 mmHg), compared with normothermia (7 ± 3 p = .01). The modest increase in MCAvmean was unchanged by Tcore (normothermia, 2 ± 3 cm/s; +0.5°C, 3 ± 3 cm/s and +1°C, 3 ± 4 cm/s, p = .74). By design, PET CO2 was unchanged in all conditions from normothermic baseline (42 ± 1, p = .81). LBPP-induced changes in HR were greater at +0.5°C (-13 ± 4 b/min) and +1°C (-12 ± 6 b/min) compared with normothermia (-3 ± 3 b/min, p = .01 and p = .01, respectively). These data indicate that despite a significant attenuation in MAP to LBPP with moderate hyperthermia, MCAvmean dynamics were unchanged among the thermal manipulations.
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Affiliation(s)
- Blake G Perry
- School of Health Sciences, Massey University, Wellington, New Zealand.,School of Sport, Exercise and Nutrition, Massey University, Palmerston North, New Zealand
| | - Toby Mündel
- School of Sport, Exercise and Nutrition, Massey University, Palmerston North, New Zealand
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Valenza A, Charlier H, Bianco A, Filingeri D. Independent and interactive effects of thermal stress and mental fatigue on manual dexterity. Am J Physiol Regul Integr Comp Physiol 2020; 319:R703-R711. [PMID: 33074012 DOI: 10.1152/ajpregu.00226.2020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Many occupations and sports require high levels of manual dexterity under thermal stress and mental fatigue. Yet, multistressor studies remain scarce. We quantified the interactive effects of thermal stress and mental fatigue on manual dexterity. Seven males (21.1 ± 1.3 yr) underwent six separate 60-min trials characterized by a combination of three air temperatures (hot, 37°C; neutral, 21°C; cold, 7°C) and two mental fatigue states (MF, mental fatigue induced by a 35-min cognitive battery; no-MF, no mental fatigue). Participants performed complex (O'Connor test) and simple (hand-tool test) manual tasks pre- and posttrial to determine stressor-induced performance changes. We monitored participants' rectal temperature and hand skin temperature (Thand) continuously and assessed the reaction time (hand-click test) and subjective mental fatigue (5-point scale). Thermal stress (P < 0.0001), but not mental fatigue (P = 0.290), modulated Thand (heat, +3.3°C [95% CI: +0.2, +6.5]; cold, -7.5°C [-10.7, -4.4]). Mental fatigue (P = 0.021), but not thermal stress (P = 0.646), slowed the reaction time (∼10%) and increased subjective fatigue. Thermal stress and mental fatigue had an interactive effect on the complex manual task (P = 0.040), with cold-no-MF decreasing the performance by -22% [-39, -5], whereas neutral-MF, cold-MF, and heat-MF by -36% [-53, -19], -34% [-52, -17], and -36% [-53, -19], respectively. Only mental fatigue decreased the performance in the simple manual task (-30% [-43, -16] across all thermal conditions; P = 0.002). Cold stress-induced impairments in complex manipulation increase with mental fatigue; yet combined stressors' effects are no greater than those of mental fatigue alone, which also impairs simple manipulation. Mental fatigue poses a greater challenge to manual dexterity than thermal stress.
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Affiliation(s)
- Alessandro Valenza
- THERMOSENSELAB, Environmental Ergonomics Research Centre, Loughborough University, Loughborough, United Kingdom.,Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Harry Charlier
- THERMOSENSELAB, Environmental Ergonomics Research Centre, Loughborough University, Loughborough, United Kingdom
| | - Antonino Bianco
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Davide Filingeri
- THERMOSENSELAB, Environmental Ergonomics Research Centre, Loughborough University, Loughborough, United Kingdom
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25
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Wallace PJ, Schultz Martins R, Scott JS, Steele SW, Greenway MJ, Cheung SS. The effects of acute dopamine reuptake inhibition on cognitive function during passive hyperthermia. Appl Physiol Nutr Metab 2020; 46:511-520. [PMID: 33232172 DOI: 10.1139/apnm-2020-0869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Dopamine activity can modulate physical performance in the heat, but less is known about its effects on cognition during thermal stress. Twelves males completed a randomized, double-blinded protocol consisting of oral ingestion of 20 mg of methylphenidate (MPH) or placebo (lactose pill) during passive heating using a water-perfused suit (water temperature ∼49 °C). To identify the impact of peripheral versus central thermal strain, a cognitive test battery was completed at 4 different thermal states: baseline (BASE; 37.2 ± 0.6 °C core, 32.9 ± 0.7 °C skin), neutral core-hot skin (NC-HS; 37.2 ± 0.3 °C, 37.4 ± 0.3 °C), hyperthermic core-hot skin (HC-HS; 38.7 ± 0.4 °C, 38.7 ± 0.2 °C), and hyperthermic core-cooled skin (HC-CS; 38.5 ± 0.4 °C, 35.1 ± 0.8 °C). The cognitive test battery consisted of the 2-back task (i.e., working memory), set-shifting (i.e., executive function), Groton Maze Learning Task (i.e., executive function) and detection task (i.e., psychomotor processing). MPH led to significantly higher heart rates (∼5-15 b·min-1) at BASE, NC-HS, and HC-HS (all p < 0.05). There were no significant differences in the number of errors made on each task (all p < 0.05). Participants were significantly faster (p < 0.05) on the set-shifting task in the HC-HS timepoint, irrespective of drug condition (p > 0.05). In summary, we demonstrated that 20 mg of MPH did not significantly alter cognitive function during either normothermia or moderate hyperthermia. Novelty: Twenty milligrams of MPH did not significantly alter cognitive function during passive heat stress. MPH led to significant higher heart rates (∼5-15 b·min-1) in thermoneutral and during passive heat stress. Future studies are needed to determine the mechanisms of why MPH improves physical but not cognitive performance during heat stress.
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Affiliation(s)
- Phillip J Wallace
- Environmental Ergonomics Laboratory, Department of Kinesiology, Brock University, St. Catharines, Ontario, Canada
| | - Ricardo Schultz Martins
- Environmental Ergonomics Laboratory, Department of Kinesiology, Brock University, St. Catharines, Ontario, Canada
| | - Jake S Scott
- Environmental Ergonomics Laboratory, Department of Kinesiology, Brock University, St. Catharines, Ontario, Canada
| | - Scott W Steele
- Environmental Ergonomics Laboratory, Department of Kinesiology, Brock University, St. Catharines, Ontario, Canada
| | - Mathew J Greenway
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Stephen S Cheung
- Environmental Ergonomics Laboratory, Department of Kinesiology, Brock University, St. Catharines, Ontario, Canada
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Morris NB, Piil JF, Christiansen L, Flouris AD, Nybo L. Prolonged facemask use in the heat worsens dyspnea without compromising motor-cognitive performance. Temperature (Austin) 2020; 8:160-165. [PMID: 33997114 PMCID: PMC8098073 DOI: 10.1080/23328940.2020.1826840] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background: Within the context of the COVID-19 pandemic, the WHO endorses facemask use to limit aerosol-spreading of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, concerns have been raised regarding facemask-associated dyspnea, thermal distress and self-reported impairment of cognition. Accordingly, we tested how facemask-use affects motor-cognitive performances of relevance for occupational safety. We hypothesized that mask use would affect cognitively dominated performances and thermal discomfort, but not alter whole-body thermal balance. Methods: Eight participants completed a facemask and a barefaced (control) trial, in a counterbalanced order, in 40°C and 20% humidity conditions. Motor-cognitive performance, physiological (rectal, mean skin and local facial temperatures) and perceptual (thermal comfort and dyspnea) measures were assessed at baseline and following 45 min of light work (100 W). Results: Perceived dyspnea was aggravated with prolonged facemask use (p = 0.04), resulting in 36% greater breathlessness compared to control. However, no other differences were observed in motor-cognitive performance, physiological strain, or thermal discomfort. Conclusions: Contradicting negative self-reported impacts of facemask-use, only dyspnea was aggravated in the present study, thereby reinforcing global recommendations of mask use, even in hot environments. (Funded by: European Union’s Horizon 2020 research and innovation program under the grant agreement No 668786).
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Affiliation(s)
- Nathan B Morris
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Jacob F Piil
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Lasse Christiansen
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - Andreas D Flouris
- FAME Laboratory, Department of Exercise Science, University of Thessaly, Trikala, Greece
| | - Lars Nybo
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
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27
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Morris NB, Jay O, Flouris AD, Casanueva A, Gao C, Foster J, Havenith G, Nybo L. Sustainable solutions to mitigate occupational heat strain - an umbrella review of physiological effects and global health perspectives. Environ Health 2020; 19:95. [PMID: 32887627 PMCID: PMC7487490 DOI: 10.1186/s12940-020-00641-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 08/12/2020] [Indexed: 05/19/2023]
Abstract
BACKGROUND Climate change is set to exacerbate occupational heat strain, the combined effect of environmental and internal heat stress on the body, threatening human health and wellbeing. Therefore, identifying effective, affordable, feasible and sustainable solutions to mitigate the negative effects on worker health and productivity, is an increasingly urgent need. OBJECTIVES To systematically identify and evaluate methods that mitigate occupational heat strain in order to provide scientific-based guidance for practitioners. METHODS An umbrella review was conducted in biomedical databases employing the following eligibility criteria: 1) ambient temperatures > 28 °C or hypohydrated participants, 2) healthy adults, 3) reported psychophysiological (thermal comfort, heart rate or core temperature) and/or performance (physical or cognitive) outcomes, 4) written in English, and 5) published before November 6, 2019. A second search for original research articles was performed to identify interventions of relevance but lacking systematic reviews. All identified interventions were independently evaluated by all co-authors on four point scales for effectiveness, cost, feasibility and environmental impact. RESULTS Following screening, 36 systematic reviews fulfilled the inclusion criteria. The most effective solutions at mitigating occupational heat strain were wearing specialized cooling garments, (physiological) heat acclimation, improving aerobic fitness, cold water immersion, and applying ventilation. Although air-conditioning and cooling garments in ideal settings provide best scores for effectiveness, the limited applicability in certain industrial settings, high economic cost and high environmental impact are drawbacks for these solutions. However, (physiological) acclimatization, planned breaks, shading and optimized clothing properties are attractive alternative solutions when economic and ecological sustainability aspects are included in the overall evaluation. DISCUSSION Choosing the most effective solution or combinations of methods to mitigate occupational heat strain will be scenario-specific. However, this paper provides a framework for integrating effectiveness, cost, feasibility (indoors and outdoor) and ecologic sustainability to provide occupational health and safety professionals with evidence-based guidelines.
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Affiliation(s)
- Nathan B. Morris
- Department of Nutrition, Exercise and Sports, Section for Integrative Physiology, University of Copenhagen, Copenhagen N, Denmark
| | - Ollie Jay
- Thermal Ergonomics Laboratory, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Andreas D. Flouris
- FAME Laboratory, School of Exercise Science, University of Thessaly, Thessaly, Greece
| | - Ana Casanueva
- Federal Office of Meteorology and Climatology, MeteoSwiss, Zurich Airport, Zurich, Switzerland
- Meteorology Group, Department of Applied Mathematics and Computer Sciences, University of Cantabria, Santander, Spain
| | - Chuansi Gao
- Thermal Environment Laboratory, Division of Ergonomics and Aerosol Technology, Department of Design Sciences, Faculty of Engineering, Lund University, Lund, Sweden
| | - Josh Foster
- Environmental Ergonomics Research Centre, Loughborough Design School, Loughborough University, Loughborough, UK
| | - George Havenith
- Environmental Ergonomics Research Centre, Loughborough Design School, Loughborough University, Loughborough, UK
| | - Lars Nybo
- Department of Nutrition, Exercise and Sports, Section for Integrative Physiology, University of Copenhagen, Copenhagen N, Denmark
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28
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Kingma BRM, Roijendijk LMM, Van Maanen L, Van Rijn H, Van Beurden MHPH. Time perception and timed decision task performance during passive heat stress. Temperature (Austin) 2020; 8:53-63. [PMID: 33553505 PMCID: PMC7849768 DOI: 10.1080/23328940.2020.1776925] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
This study investigates the hypotheses that during passive heat stress, the change in perception of time and change in accuracy of a timed decision task relate to changes in thermophysiological variables gastrointestinal temperature and heart rate (HR), as well as subjective measures of cognitive load and thermal perception. Young adult males (N = 29) participated in two 60-min head-out water immersion conditions (36.5°C-neutral and 38.0°C-warm). Cognitive task measurements included accuracy (judgment task), response time (judgment ask), and time estimation (interval timing task). Physiological measurements included gastrointestinal temperature and heart rate. Subjective measurements included cognitive task load (NASA-TLX), rate of perceived exertion, thermal sensation, and thermal comfort. Gastrointestinal temperature and HR were significantly higher in warm versus neutral condition (gastrointestinal temperature: 38.4 ± 0.2°C vs. 37.2 ± 0.2°C, p < 0.01; HR: 105 ± 8 BPM vs. 83 ± 9 BPM, p < 0.01). The change in accuracy was significantly associated with the change in gastrointestinal temperature, and attenuated by change in thermal sensation and change in HR (r2=0.40, p< 0.01). Change in response time was significantly associated with the change in gastrointestinal temperature (r2=0.26, p< 0.002), and change in time estimation was best explained by a change in thermal discomfort (r2=0.18, p< 0.01). Changes in cognitive performance during passive thermal stress are significantly associated with changes in thermophysiological variables and thermal perception. Although explained variance is low (<50%), decreased accuracy is attributed to increased gastrointestinal temperature, yet is attenuated by increased arousal (expressed as increased HR and warmth thermal sensation).
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Affiliation(s)
- Boris R M Kingma
- Department of Training and Performance Innovations, TNO, Netherlands Organization for Applied Scientific Research, Unit Defense Safety and Security, Soesterberg, The Netherlands.,Department of Nutrition, Exercise and Sports, Section for Integrative Physiology, University of Copenhagen, Copenhagen N, Denmark.,Department of Energy Technology, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Linsey M M Roijendijk
- Department of Training and Performance Innovations, TNO, Netherlands Organization for Applied Scientific Research, Unit Defense Safety and Security, Soesterberg, The Netherlands
| | - Leendert Van Maanen
- Department of Experimental Psychology & Helmholtz Institute, Faculty of Social and Behavioral Sciences, Utrecht University, Utrecht, The Netherlands
| | - Hedderik Van Rijn
- Department of Psychology, University of Groningen, Groningen, The Netherlands
| | - Maurice H P H Van Beurden
- Department of Training and Performance Innovations, TNO, Netherlands Organization for Applied Scientific Research, Unit Defense Safety and Security, Soesterberg, The Netherlands
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Piil JF, Christiansen L, Morris NB, Mikkelsen CJ, Ioannou LG, Flouris AD, Lundbye-Jensen J, Nybo L. Direct exposure of the head to solar heat radiation impairs motor-cognitive performance. Sci Rep 2020; 10:7812. [PMID: 32385322 PMCID: PMC7210303 DOI: 10.1038/s41598-020-64768-w] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 04/22/2020] [Indexed: 02/02/2023] Open
Abstract
Health and performance impairments provoked by thermal stress are societal challenges geographically spreading and intensifying with global warming. Yet, science may be underestimating the true impact, since no study has evaluated effects of sunlight exposure on human brain temperature and function. Accordingly, performance in cognitively dominated and combined motor-cognitive tasks and markers of rising brainstem temperature were evaluated during exposure to simulated sunlight (equal to ~1000 watt/m2). Acute exposure did not affect any performance measures, whereas prolonged exposure of the head and neck provoked an elevation of the core temperature by 1 °C and significant impairments of cognitively dominated and motor task performances. Importantly, impairments emerged at considerably lower hyperthermia levels compared to previous experiments and to the trials in the presents study without radiant heating of the head. These findings highlight the importance of including the effect of sunlight radiative heating of the head and neck in future scientific evaluations of environmental heat stress impacts and specific protection of the head to minimize detrimental effects.
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Affiliation(s)
- Jacob F Piil
- Department of Nutrition, Exercise and Sports, Section for integrative physiology, University of Copenhagen, 2200, Copenhagen N, Denmark.
| | - Lasse Christiansen
- Department of Nutrition, Exercise and Sports, Section for integrative physiology, University of Copenhagen, 2200, Copenhagen N, Denmark.,Danish Research Centre for Magnetic Resonance, Center for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, 2650, Hvidovre, Denmark
| | - Nathan B Morris
- Department of Nutrition, Exercise and Sports, Section for integrative physiology, University of Copenhagen, 2200, Copenhagen N, Denmark
| | - C Jacob Mikkelsen
- Department of Nutrition, Exercise and Sports, Section for integrative physiology, University of Copenhagen, 2200, Copenhagen N, Denmark
| | - Leonidas G Ioannou
- Department of Nutrition, Exercise and Sports, Section for integrative physiology, University of Copenhagen, 2200, Copenhagen N, Denmark.,FAME Laboratory, School of Exercise Science, University of Thessaly, Thessaly, Greece
| | - Andreas D Flouris
- FAME Laboratory, School of Exercise Science, University of Thessaly, Thessaly, Greece
| | - Jesper Lundbye-Jensen
- Department of Nutrition, Exercise and Sports, Section for integrative physiology, University of Copenhagen, 2200, Copenhagen N, Denmark
| | - Lars Nybo
- Department of Nutrition, Exercise and Sports, Section for integrative physiology, University of Copenhagen, 2200, Copenhagen N, Denmark
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30
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Kyle E. Clinical Issues-May 2020. AORN J 2020; 111:558-566. [PMID: 32343383 DOI: 10.1002/aorn.13036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Using Failure Modes and Effects Analysis to improve special-order implant procurement Key words: Failure Modes and Effects Analysis (FMEA), implant procurement, special-order implant, risk profile number (RPN), interdisciplinary teamwork. Heat stress among perioperative personnel Key words: heat stress, environmental conditions, task performance, surgical tasks, OR temperature. Venous thromboembolism prevention for bariatric surgery patients Key words: venous thromboembolism (VTE), prophylactic measures, bariatric surgery, risk factors, prevention protocol. Disinfecting case carts using ultraviolet light systems Key words: environmental cleaning, decontamination, case cart, ultraviolet (UV) light system, pulsed xenon.
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31
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Byrne J, Ludington‐Hoe SM, Voss JG. Occupational Heat Stress, Thermal Comfort, and Cognitive Performance in the OR: An Integrative Review. AORN J 2020; 111:536-545. [DOI: 10.1002/aorn.13009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Abstract
People undertaking prolonged vigorous exercise experience substantial bodily fluid losses due to thermoregulatory sweating. If these fluid losses are not replaced, endurance capacity may be impaired in association with a myriad of alterations in physiological function, including hyperthermia, hyperventilation, cardiovascular strain with reductions in brain, skeletal muscle and skin blood perfusion, greater reliance on muscle glycogen and cellular metabolism, alterations in neural activity and, in some conditions, compromised muscle metabolism and aerobic capacity. The physiological strain accompanying progressive exercise-induced dehydration to a level of ~ 4% of body mass loss can be attenuated or even prevented by: (1) ingesting fluids during exercise, (2) exercising in cold environments, and/or (3) working at intensities that require a small fraction of the overall body functional capacity. The impact of dehydration upon physiological function therefore depends on the functional demand evoked by exercise and environmental stress, as cardiac output, limb blood perfusion and muscle metabolism are stable or increase during small muscle mass exercise or resting conditions, but are impaired during whole-body moderate to intense exercise. Progressive dehydration is also associated with an accelerated drop in perfusion and oxygen supply to the human brain during submaximal and maximal endurance exercise. Yet their consequences on aerobic metabolism are greater in the exercising muscles because of the much smaller functional oxygen extraction reserve. This review describes how dehydration differentially impacts physiological function during exercise requiring low compared to high functional demand, with an emphasis on the responses of the human brain, heart and skeletal muscles.
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Gibbons TD, Tymko MM, Thomas KN, Wilson LC, Stembridge M, Caldwell HG, Howe CA, Hoiland RL, Akerman AP, Dawkins TG, Patrician A, Coombs GB, Gasho C, Stacey BS, Ainslie PN, Cotter JD. Global REACH 2018: The influence of acute and chronic hypoxia on cerebral haemodynamics and related functional outcomes during cold and heat stress. J Physiol 2020; 598:265-284. [PMID: 31696936 DOI: 10.1113/jp278917] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 10/28/2019] [Indexed: 11/08/2022] Open
Abstract
KEY POINTS Thermal and hypoxic stress commonly coexist in environmental, occupational and clinical settings, yet how the brain tolerates these multi-stressor environments is unknown Core cooling by 1.0°C reduced cerebral blood flow (CBF) by 20-30% and cerebral oxygen delivery (CDO2 ) by 12-19% at sea level and high altitude, whereas core heating by 1.5°C did not reliably reduce CBF or CDO2 Oxygen content in arterial blood was fully restored with acclimatisation to 4330 m, but concurrent cold stress reduced CBF and CDO2 Gross indices of cognition were not impaired by any combination of thermal and hypoxic stress despite large reductions in CDO2 Chronic hypoxia renders the brain susceptible to large reductions in oxygen delivery with concurrent cold stress, which might make monitoring core temperature more important in this context ABSTRACT: Real-world settings are composed of multiple environmental stressors, yet the majority of research in environmental physiology investigates these stressors in isolation. The brain is central in both behavioural and physiological responses to threatening stimuli and, given its tight metabolic and haemodynamic requirements, is particularly susceptible to environmental stress. We measured cerebral blood flow (CBF, duplex ultrasound), cerebral oxygen delivery (CDO2 ), oesophageal temperature, and arterial blood gases during exposure to three commonly experienced environmental stressors - heat, cold and hypoxia - in isolation, and in combination. Twelve healthy male subjects (27 ± 11 years) underwent core cooling by 1.0°C and core heating by 1.5°C in randomised order at sea level; acute hypoxia ( P ET , O 2 = 50 mm Hg) was imposed at baseline and at each thermal extreme. Core cooling and heating protocols were repeated after 16 ± 4 days residing at 4330 m to investigate any interactions with high altitude acclimatisation. Cold stress decreased CBF by 20-30% and CDO2 by 12-19% (both P < 0.01) irrespective of altitude, whereas heating did not reliably change either CBF or CDO2 (both P > 0.08). The increases in CBF with acute hypoxia during thermal stress were appropriate to maintain CDO2 at normothermic, normoxic values. Reaction time was faster and slower by 6-9% with heating and cooling, respectively (both P < 0.01), but central (brain) processes were not impaired by any combination of environmental stressors. These findings highlight the powerful influence of core cooling in reducing CDO2 . Despite these large reductions in CDO2 with cold stress, gross indices of cognition remained stable.
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Affiliation(s)
- T D Gibbons
- School of Physical Education, Sport & Exercise Science, University of Otago, 55/47 Union St W, Dunedin, 9016, New Zealand
| | - M M Tymko
- Centre for Heart, Lung and Vascular Health, University of British Columbia-Okanagan Campus, School of Health and Exercise Sciences, 3333 University Way, Kelowna, British Columbia, Canada, V1V 1V7
| | - K N Thomas
- Department of Surgical Sciences, University of Otago, 201 Great King St, Dunedin, 9016, New Zealand
| | - L C Wilson
- Department of Medicine, University of Otago, 201 Great King St, Dunedin, 9016, New Zealand
| | - M Stembridge
- Cardiff Centre for Exercise and Health, Cardiff Metropolitan University, Cyncoed Road, Cardiff, CF23 6XD, UK
| | - H G Caldwell
- Centre for Heart, Lung and Vascular Health, University of British Columbia-Okanagan Campus, School of Health and Exercise Sciences, 3333 University Way, Kelowna, British Columbia, Canada, V1V 1V7
| | - C A Howe
- Centre for Heart, Lung and Vascular Health, University of British Columbia-Okanagan Campus, School of Health and Exercise Sciences, 3333 University Way, Kelowna, British Columbia, Canada, V1V 1V7
| | - R L Hoiland
- Centre for Heart, Lung and Vascular Health, University of British Columbia-Okanagan Campus, School of Health and Exercise Sciences, 3333 University Way, Kelowna, British Columbia, Canada, V1V 1V7
| | - A P Akerman
- Faculty of Health Sciences, University of Ottawa, 125 University St, Ottawa, Ontario, Canada, K1N 6N5
| | - T G Dawkins
- Cardiff Centre for Exercise and Health, Cardiff Metropolitan University, Cyncoed Road, Cardiff, CF23 6XD, UK
| | - A Patrician
- Centre for Heart, Lung and Vascular Health, University of British Columbia-Okanagan Campus, School of Health and Exercise Sciences, 3333 University Way, Kelowna, British Columbia, Canada, V1V 1V7
| | - G B Coombs
- Centre for Heart, Lung and Vascular Health, University of British Columbia-Okanagan Campus, School of Health and Exercise Sciences, 3333 University Way, Kelowna, British Columbia, Canada, V1V 1V7
| | - C Gasho
- Division of Pulmonary, Critical Care, Hyperbaric and Sleep Medicine, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - B S Stacey
- Neurovascular Research Laboratory, Faculty of Life Sciences and Education, University of South Wales, UK
| | - P N Ainslie
- Centre for Heart, Lung and Vascular Health, University of British Columbia-Okanagan Campus, School of Health and Exercise Sciences, 3333 University Way, Kelowna, British Columbia, Canada, V1V 1V7
| | - J D Cotter
- School of Physical Education, Sport & Exercise Science, University of Otago, 55/47 Union St W, Dunedin, 9016, New Zealand
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BEJDER JACOB, BREENFELDT ANDERSEN ANDREAS, BONNE THOMASCHRISTIAN, PIIL JACOBFEDER, HAGEN LINNCAMILLAHAUAN, DEHNES YVETTE, EIBYE KASPERHVID, NYBO LARS, NORDSBORG NIKOLAIBAASTRUP. Tramadol Does Not Improve Performance or Impair Motor Function in Trained Cyclists. Med Sci Sports Exerc 2019; 52:1169-1175. [DOI: 10.1249/mss.0000000000002217] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Spector JT, Masuda YJ, Wolff NH, Calkins M, Seixas N. Heat Exposure and Occupational Injuries: Review of the Literature and Implications. Curr Environ Health Rep 2019; 6:286-296. [PMID: 31520291 PMCID: PMC6923532 DOI: 10.1007/s40572-019-00250-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE OF REVIEW The burden of heat-related adverse occupational health effects, as well as traumatic injuries, is already substantial. Projected increases in mean temperatures and extreme events may increase the risk of adverse heat health effects and enhance disparities among exposed workers. This article reviews the emerging literature on the relationship between heat exposure and occupational traumatic injuries and discusses implications of this work. RECENT FINDINGS A recent meta-analysis of three case-crossover and five time series studies in industrialized settings reported an association of increasing occupational injuries with increasing heat exposure, with increased effect estimates for male gender and age less than 25 years, although heterogeneity in exposure metrics and sources of bias were demonstrated to varying degrees across studies. A subsequent case-crossover study in outdoor construction workers reported a 0.5% increase in the odds of traumatic injuries per 1 °C increase in maximum daily humidex (odds ratio 1.005 [95% CI 1.003-1.007]). While some studies have demonstrated reversed U-shaped associations between heat exposure and occupational injuries, different risk profiles have been reported in different industries and settings. Studies conducted primarily in industrialized settings suggest an increased risk of traumatic injury with increasing heat exposure, though the exact mechanisms of heat exposure's effects on traumatic injuries are still under investigation. The effectiveness of heat-related injury prevention approaches has not yet been established. To enhance the effectiveness of prevention efforts, prioritization of approaches should take into account not only the hierarchy of controls, social-ecological models, community and stakeholder participation, and tailoring of approaches to specific local work settings, but also methods that reduce local and global disparities and better address the source of heat exposure, including conservation-informed land-use planning, built environment, and prevention through design approaches. Participation of occupational health experts in transdisciplinary development and integration of these approaches is needed.
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Affiliation(s)
- June T Spector
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, 1959 NE Pacific Street, Box 357234, Seattle, WA, 98195, USA.
- Department of Medicine, University of Washington, Seattle, WA, USA.
| | - Yuta J Masuda
- Global Science, The Nature Conservancy, Arlington, VA, USA
| | | | - Miriam Calkins
- Division of Field Studies and Engineering - Field Research Branch, National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Noah Seixas
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, 1959 NE Pacific Street, Box 357234, Seattle, WA, 98195, USA
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Heat Acclimation Does Not Protect Trained Males from Hyperthermia-Induced Impairments in Complex Task Performance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050716. [PMID: 30823366 PMCID: PMC6427404 DOI: 10.3390/ijerph16050716] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 02/22/2019] [Accepted: 02/25/2019] [Indexed: 01/01/2023]
Abstract
This study evaluated if adaptation to environmental heat stress can counteract the negative effects of hyperthermia on complex motor performance. Thirteen healthy, trained males completed 28 days of heat acclimation with 1 h daily exercise exposure to environmental heat (39.4 ± 0.3 °C and 27.0 ± 1.0% relative humidity). Following comprehensive familiarization, the participants completed motor-cognitive testing before acclimation, as well as after 14 and 28 days of training in the heat. On all three occasions, the participants were tested, at baseline (after ~15 min passive heat exposure) and following exercise-induced hyperthermia which provoked an increase in core temperature of 2.8 ± 0.1 °C (similar across days). Both cognitively dominated test scores and motor performance were maintained during passive heat exposure (no reduction or difference between day 0, 14, and 28 compared to cool conditions). In contrast, complex motor task performance was significantly reduced in hyperthermic conditions by 9.4 ± 3.4% at day 0; 15.1 ± 5.0% at day 14, and 13.0 ± 4.8% at day 28 (all p < 0.05 compared to baseline but not different across days). These results let us conclude that heat acclimation cannot protect trained males from being negatively affected by hyperthermia when they perform complex tasks relying on a combination of cognitive performance and motor function.
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Saldaris JM, Landers GJ, Lay BS, Zimmermann MR. Internal precooling decreases forehead and core temperature but does not alter choice reaction time during steady state exercise in hot, humid conditions. J Therm Biol 2019; 81:66-72. [PMID: 30975425 DOI: 10.1016/j.jtherbio.2019.02.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 02/12/2019] [Accepted: 02/19/2019] [Indexed: 01/03/2023]
Abstract
This study aimed to determine if precooling via crushed ice ingestion reduces forehead skin temperature (Thead) and core temperature (Tcore) during exercise in the heat and whether it has an effect on choice reaction time (CRT). Ten males commenced a 30 min precooling period, ingesting either 7 g kg-1 of crushed ice (ICE) or room temperature water (CON) prior to cycling 60 min at 55% V̇O2peak in hot, humid conditions (35.0 ± 0.3 °C, 50.2 ± 2.1% Relative Humidity). The CRT task was completed upon arrival and after the precooling period in the lab, then at 15 min intervals during exercise in the heat. Precooling reduced Thead and Tcore to a greater degree in ICE (Thead: -0.8 ± 0.31 °C; Tcore: -0.9 ± 0.3 °C) compared with CON (Thead: -0.2 ± 0.3 °C; Tcore: -0.2 ± 0.2 °C) (p ≤ 0.001). Choice reaction time performance improved throughout the cycle for both conditions (p ≤ 0.05). Ice ingestion lowered thermal sensation (p = 0.003) and skin temperature (d = 0.88; Tskin), while heart rate, ratings of perceived exertion and thirst were similar between conditions (p > 0.05). Precooling effectively reduced Thead and Tcore but did not provide additional improvement in CRT during moderate exercise in the heat. Further investigation is required to determine whether the lower central and peripheral temperature after ice ingestion is beneficial for tasks of greater cognitive effort.
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Affiliation(s)
- Jacinta M Saldaris
- The University of Western Australia, School of Human Sciences (Exercise and Sport Science), Western Australia, Australia.
| | - Grant J Landers
- The University of Western Australia, School of Human Sciences (Exercise and Sport Science), Western Australia, Australia
| | - Brendan S Lay
- The University of Western Australia, School of Human Sciences (Exercise and Sport Science), Western Australia, Australia
| | - Matthew R Zimmermann
- The University of Western Australia, School of Human Sciences (Exercise and Sport Science), Western Australia, Australia
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Piil JF, Lundbye-Jensen J, Christiansen L, Ioannou L, Tsoutsoubi L, Dallas CN, Mantzios K, Flouris AD, Nybo L. High prevalence of hypohydration in occupations with heat stress-Perspectives for performance in combined cognitive and motor tasks. PLoS One 2018; 13:e0205321. [PMID: 30356308 PMCID: PMC6200230 DOI: 10.1371/journal.pone.0205321] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 09/24/2018] [Indexed: 12/20/2022] Open
Abstract
Purpose To evaluate the prevalence of dehydration in occupational settings and contextualize findings to effects on performance in cognitively dominated tasks, simple and complex motor tasks during moderate and high heat stress. Methods The study included an occupational part with hydration assessed in five industries across Europe with urine samples collected from 139 workers and analyzed for urine specific gravity. In addition, laboratory experiments included eight male participants completing mild-intensity exercise once with full fluid replacement to maintain euhydration, and once with restricted water intake until the dehydration level corresponded to 2% bodyweight deficit. Following familiarization, euhydration and dehydration sessions were completed on separate days in random order (cross-over design) with assessment of simple motor (target pinch), complex motor (visuo-motor tracking), cognitive (math addition) and combined motor-cognitive (math and pinch) performance at baseline, at 1°C (MOD) and 2°C (HYPER) delta increase in body core temperature. Results The field studies revealed that 70% of all workers had urine specific gravity values ≥1.020 corresponding to the urine specific gravity (1.020±0.001) at the end of the laboratory dehydration session. At this hydration level, HYPER was associated with reductions in simple motor task performance by 4±1%, math task by 4±1%, math and pinch by 9±3% and visuo-motor tracking by 16±4% (all P<0.05 compared to baseline), whereas no significant changes were observed when the heat stress was MOD (P>0.05). In the euhydration session, HYPER reduced complex (tracking) motor performance by 10±3% and simple pinch by 3±1% (both P<0.05, compared to baseline), while performance in the two cognitively dominated tasks were unaffected when dehydration was prevented (P>0.05). Conclusion Dehydration at levels commonly observed across a range of occupational settings with environmental heat stress aggravates the impact of hyperthermia on performance in tasks relying on combinations of cognitive function and motor response accuracy.
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Affiliation(s)
- Jacob F. Piil
- Department of Nutrition, Exercise and Sports, Section for Integrative Physiology, University of Copenhagen, Copenhagen, Denmark
- * E-mail:
| | - Jesper Lundbye-Jensen
- Department of Nutrition, Exercise and Sports, Section for Integrative Physiology, University of Copenhagen, Copenhagen, Denmark
| | - Lasse Christiansen
- Department of Nutrition, Exercise and Sports, Section for Integrative Physiology, University of Copenhagen, Copenhagen, Denmark
| | - Leonidas Ioannou
- FAME Laboratory, Department of Exercise Science, University of Thessaly, Karies, Trikala, Greece
| | - Lydia Tsoutsoubi
- FAME Laboratory, Department of Exercise Science, University of Thessaly, Karies, Trikala, Greece
| | - Constantinos N. Dallas
- FAME Laboratory, Department of Exercise Science, University of Thessaly, Karies, Trikala, Greece
| | - Konstantinos Mantzios
- FAME Laboratory, Department of Exercise Science, University of Thessaly, Karies, Trikala, Greece
| | - Andreas D. Flouris
- FAME Laboratory, Department of Exercise Science, University of Thessaly, Karies, Trikala, Greece
| | - Lars Nybo
- Department of Nutrition, Exercise and Sports, Section for Integrative Physiology, University of Copenhagen, Copenhagen, Denmark
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Wittbrodt MT, Sawka MN, Mizelle JC, Wheaton LA, Millard‐Stafford ML. Exercise-heat stress with and without water replacement alters brain structures and impairs visuomotor performance. Physiol Rep 2018; 6:e13805. [PMID: 30136401 PMCID: PMC6105626 DOI: 10.14814/phy2.13805] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 06/26/2018] [Indexed: 01/08/2023] Open
Abstract
Effects of exercise-heat stress with and without water replacement on brain structure and visuomotor performance were examined. Thirteen healthy adults (23.6 ± 4.2 years) completed counterbalanced 150 min trials of exercise-heat stress (45°C, 15% RH) with water replacement (EHS) or without (~3% body mass loss; EHS-DEH) compared to seated rest (CON). Anatomical scans and fMRI Blood-Oxygen-Level-Dependent responses during a visuomotor pacing task were evaluated. Accuracy decreased (P < 0.05) despite water replacement during EHS (-8.2 ± 6.8% vs. CON) but further degraded with EHS-DEH (-8.3 ± 6.4% vs. EHS and -16.5 ± 10.2% vs. CON). Relative to CON, EHS elicited opposing volumetric changes (P < 0.05) in brain ventricles (-5.3 ± 1.7%) and periventricular structures (cerebellum: 1.5 ± 0.8%) compared to EHS-DEH (ventricles: 6.8 ± 3.4, cerebellum: -0.7 ± 0.7; thalamus: -2.7 ± 1.3%). Changes in plasma osmolality (EHS: -3.0 ± 2.1; EHS-DEH: 9.3 ± 2.1 mOsm/kg) were related (P < 0.05) to thalamus (r = -0.45) and cerebellum volume (r = -0.61) which, in turn, were related (P < 0.05) to lateral (r = -0.41) and fourth ventricle volume (r = -0.67) changes, respectively; but, there were no associations (P > 0.50) between structural changes and visuomotor accuracy. EHS-DEH increased neural activation (P < 0.05) within motor and visual areas versus EHS and CON. Brain structural changes are related to bidirectional plasma osmolality perturbations resulting from exercise-heat stress (with and without water replacement), but do not explain visuomotor impairments. Negative impacts of exercise-heat stress on visuomotor tasks are further exacerbated by dehydration.
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Affiliation(s)
| | - Michael N. Sawka
- School of Biological SciencesGeorgia Institute of TechnologyAtlantaGeorgia
| | - J. C. Mizelle
- Department of KinesiologyEast Carolina UniversityGreenvilleNorth Carolina
| | - Lewis A. Wheaton
- School of Biological SciencesGeorgia Institute of TechnologyAtlantaGeorgia
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