Effect of Indoor Temperature on Physical Performance in Older Adults during Days with Normal Temperature and Heat Waves

A holistic modeling framework for estimating the influence of climate change on indoor air quality

The IPCC 2021 report predicts rising global temperatures and more frequent extreme weather events in the future, which will have different effects on the regional climate and concentrations of ambient air pollutants. Consequently, changes in heat and mass transfer between the inside and outside of buildings will also have an increasing impact on indoor air quality. It is therefore surprising that indoor spaces and occupant well-being still play a subordinate role in the studies of climate change. To increase awareness for this topic, the Indoor Air Quality Climate Change (IAQCC) model system was developed, which allows short and long-term predictions of the indoor climate with respect to outdoor conditions. The IAQCC is a holistic model that combines different scenarios in the form of submodels: building physics, indoor emissions, chemical-physical reaction and transformation, mold growth, and indoor exposure. IAQCC allows simulation of indoor gas and particle concentrations with outdoor influences, indoor materials and activity emissions, particle deposition and coagulation, gas reactions, and SVOC partitioning. These key processes are fundamentally linked to temperature and relative humidity. With the aid of the building physics model, the indoor temperature and humidity, and pollutant transport in building zones can be simulated. The exposure model refers to the calculated concentrations and provides evaluations of indoor thermal comfort and exposure to gaseous, particulate, and microbial pollutants.

Temperature and indoor environments

From the thermodynamic perspective, the term temperature is clearly defined for ideal physical systems: A unique temperature can be assigned to each black body via its radiation spectrum, and the temperature of an ideal gas is given by the velocity distribution of the molecules. While the indoor environment is not an ideal system, fundamental physical and chemical processes, such as diffusion, partitioning equilibria, and chemical reactions, are predictably temperature-dependent. For example, the logarithm of reaction rate and equilibria constants are proportional to the reciprocal of the absolute temperature. It is therefore possible to have non-linear, very steep changes in chemical phenomena over a relatively small temperature range. On the contrary, transport processes are more influenced by spatial temperature, momentum, and pressure gradients as well as by the density, porosity, and composition of indoor materials. Consequently, emergent phenomena, such as emission rates or dynamic air concentrations, can be the result of complex temperature-dependent relationships that require a more empirical approach. Indoor environmental conditions are further influenced by the thermal comfort needs of occupants. Not only do occupants have to create thermal conditions that serve to maintain their core body temperature, which is usually accomplished by wearing appropriate clothing, but also the surroundings must be adapted so that they feel comfortable. This includes the interaction of the living space with the ambient environment, which can vary greatly by region and season. Design of houses, apartments, commercial buildings, and schools is generally utility and comfort driven, requiring an appropriate energy balance, sometimes considering ventilation but rarely including the impact of temperature on indoor contaminant levels. In our article, we start with a review of fundamental thermodynamic variables and discuss their influence on typical indoor processes. Then, we describe the heat balance of people in their thermal environment. An extensive literature study is devoted to the thermal conditions in buildings, the temperature-dependent release of indoor pollutants from materials and their distribution in the various interior compartments as well as aspects of indoor chemistry. Finally, we assess the need to consider temperature holistically with regard to the changes to be expected as a result of global emergencies such as climate change.

Gender-Specific Differences of Renal Heat Tolerance in Older Adults during Heat Waves

BACKGROUND

Heat waves are known to cause increased morbidity and mortality in susceptible populations like old and functionally impaired people. The objective of the study was to assess renal tubular stress, a predictor for development of acute kidney injury, during heat waves in Central Europe. As a marker of renal tubular stress tissue inhibitor of metalloproteinases-2 [TIMP-2]·insulin-like growth factor binding protein-7 [IGFBP7], a new FDA-cleared renal tubular stress biomarker, was used.

MATERIALS AND METHODS

68 residents from facilities of sheltered housing with urine samples collected at heat waves in 2015 and at control visits were included. Urinary [TIMP-2]·[IGFBP7] was compared between the heat waves and the control visits. Multivariate linear models were adjusted for age, frailty index, and functional comorbidity index.

RESULTS

The median age was 82.0 years, 82.3% were women. The percentage of elevated levels of urinary [TIMP-2]·[IGFBP7] (>0.3 [ng/mL]2/1,000) in the total study population was higher at the heat waves than at the control visits (25.0% vs. 17.7%). The effect of the heat waves on urinary [TIMP-2]·[IGFBP7] was stronger in men than in women: The percentage of elevated levels was 75.0% in men and 14.3% in women. In the multivariate analysis, the mean urinary [TIMP-2]·[IGFBP7] was 0.48 (95% CI 0.25; 0.70) (ng/mL)2/1,000 higher in men than in women. Except gender, a number of additional variables did not show an association with urinary [TIMP-2]·[IGFBP7] at the heat waves or the control visits.

CONCLUSIONS

At heat waves, urinary [TIMP-2]·[IGFBP7] was elevated and higher in men than in women. This suggests gender-specific differences in renal heat tolerance in older people.

The Role of Environmental Conditions on Master Marathon Running Performance in 1,280,557 Finishers the 'New York City Marathon' From 1970 to 2019

Aim: This study investigated the influence of weather conditions on running performance in female and male age group runners in the largest marathon in the world, the “New York City Marathon.”

Methods: The analysis included data from 1,280,557 finishers the “New York City Marathon” from the years 1970 to 2019. Linear mixed models for men and women finishers with race time (min) as dependent variable and 5-year age groups, temperature, wind and relative humidity tertiles (low, medium, high) as independent factors and finisher as random intercept was performed. Additional models with an interaction between age groups and one weather variable each were performed.

Results: Temperature was positively associated with race time while wind speed and humidity were negatively associated (p < 0.001). Men were significantly greater affected wind speed and humidity than women (p < 0.001 for interaction) but not by temperature (p = 0.17 for interaction). With an average of 8 min longer race time, high temperature had the greatest effect on race time. The effect of high humidity on race time was significantly increased in 40–59 years old men and 25–65 years old women. High temperatures had an increased effect on race time in 30–64 years old men and 40–64 years old women. The inverse association between race time and high wind speed was pronounced in finishers with younger age.

Conclusion: Performance was lower on days with high temperature, low humidity and low wind speed. Men seemed to benefit more from higher humidity and wind speed than women. Aged (70 +) finishers were not greater affected by high temperatures.

Indoor temperature and health: a global systematic review

OBJECTIVES

The objective of this study was to identify and appraise evidence on the direct and indirect impacts of high indoor temperatures on health; the indoor temperature threshold at which the identified health impacts are observed; and to summarise the evidence for establishing a maximum indoor temperature threshold for health.

STUDY DESIGN

This is a systematic literature review and narrative synthesis.

METHODS

A review of the published literature using MEDLINE, EMBASE, Global Health, PsycINFO, Maternity and Infant Care, Cochrane Library, CINAHL and GreenFILE databases was conducted. The search criteria were kept broad to capture evidence from all countries and contexts; no date or study design limits were applied, except English language limits. We included studies that specifically measured indoor temperature and examined its effect on physical or mental health outcomes. Evidence was graded using the National Institutes of Health framework.

RESULTS

Twenty-two articles were included in the review, including 11 observational, seven cross-sectional and three longitudinal cohort studies and one prospective case-control study. Eight main health effects were described: respiratory, blood pressure, core temperature, blood glucose, mental health and cognition, heat-health symptoms, physical functioning and influenza transmission. Five studies found respiratory symptoms worsened in warm indoor environments, with one reporting indoor temperatures higher than 26 °C, which was associated with increased respiratory distress calls being made to paramedics (odds ratio = 1.63, P = 0.056). Core symptoms of schizophrenia and dementia were found to be significantly exacerbated by indoor heat (the latter above a 26 °C cumulative exposure threshold). The absorption of insulin doses in people with type one diabetes was also significantly accelerated in hot indoor environments. Only five studies reported the temperatures at which health outcomes worsened, with thresholds ranging between 26 °C and 32 °C. However, owing to insufficient data and the heterogeneity of the included studies (design, population, setting, exposure measures, outcomes and location), meta-analysis and an upper threshold determination was not feasible.

CONCLUSIONS

High indoor temperatures affect aspects of human health, with the strongest evidence for respiratory health, diabetes management and core schizophrenia and dementia symptoms. Exacerbation of symptoms in warm indoor environments has clinical relevance to at-risk groups and those caring for them. Care staff and facility managers need to be vigilant of high temperatures in care environments and should incorporate indoor overheating into their risk management and sustainability and/or climate change adaptation plans. The indoor temperature threshold at which adverse effects begin to occur remains unclear as studies seldom report the exposure-response relationship over a temperature continuum. Until there is extensive scientific data to support a maximum indoor temperature threshold, 26 °C may be the most suitable indoor temperature for at-risk groups in keeping with the existing guidance documents.

Towards establishing evidence-based guidelines on maximum indoor temperatures during hot weather in temperate continental climates

Rising environmental temperatures represent a major threat to human health. The activation of heat advisories using evidence-based thresholds for high-risk outdoor ambient temperatures have been shown to be an effective strategy to save lives during hot weather. However, although the relationship between weather and human health has been widely defined by outdoor temperature, corresponding increases in indoor temperature during heat events can also be harmful to health especially in vulnerable populations. In this review, we discuss our current understanding of the relationship between outdoor temperature and human health and examine how human health can also be adversely influenced by high indoor temperatures during heat events. Our assessment of the existing literature revealed a high degree of variability in what can be considered an acceptable indoor temperature because there are differences in how different groups of people may respond physiologically and behaviorally to the same living environment. Finally, we demonstrate that both non-physiological (e.g., geographical location, urban density, building design) and physiological (e.g., sex, age, fitness, state of health) factors must be considered when defining an indoor temperature threshold for preserving human health in a warming global climate.