Turmeric essential oil improves intestinal integrity, immunological parameters, and performance of broiler chickens under cyclic heat stress.

This study aimed to examine whether dietary supplementation of broiler chickens with turmeric essential could mitigate the effects of cyclic heat stress conditions. Intestinal and immunological parameters and gene expression were evaluated during the grower phase. A total of 320 21-day-old male Cobb 500 broilers were distributed according to a completely randomized design with a 4 (diet) × 2 (environment) factorial arrangement and eight replications of five birds each. Dietary treatments consisted of a basal diet without essential oil (EO, negative control) and three diets containing low (100 mg kg-1), intermediate (200 mg kg-1), or high (300 mg kg-1) levels of turmeric EO. In the heat stress group, dietary supplementation with turmeric EO at 100 and 200 mg kg-1 improved body weight, feed conversion, breast yield, and relative liver weight. These supplementation levels reduced villus width, increased villus/crypt ratio, reduced the H/L ratio, and improved hepatic (HSP70 and SREBP1) and intestinal (OCLN) gene expression in birds under heat stress. These findings support the hypothesis that turmeric EO can be used to improve or restore intestinal integrity, modulate inflammation parameters, and, consequently, enhance the performance of broilers challenged by cyclic heat stress.

Terminalia bellirica and Andrographis paniculata dietary supplementation in mitigating heat stress-induced behavioral, metabolic and genetic alterations in broiler chickens.

BACKGROUND: Heat stress (HS) is one of the most significant environmental stressors on poultry production and welfare worldwide. Identification of innovative and effective solutions is necessary. This study evaluated the effects of phytogenic feed additives (PHY) containing Terminalia bellirica and Andrographis paniculata on behavioral patterns, hematological and biochemical parameters, Oxidative stress biomarkers, and HSP70, I-FABP2, IL10, TLR4, and mTOR genes expression in different organs of broiler chickens under chronic HS conditions. A total of 208 one-day-old Avian-480 broiler chicks were randomly allocated into four treatments (4 replicate/treatment, 52 birds/treatment): Thermoneutral control treatment (TN, fed basal diet); Thermoneutral treatment (TN, fed basal diet + 1 kg/ton feed PHY); Heat stress treatment (HS, fed basal diet); Heat stress treatment (HS, fed basal diet + 1 kg/ton feed PHY). RESULTS: The findings of the study indicate that HS led to a decrease in feeding, foraging, walking, and comfort behavior while increasing drinking and resting behavior, also HS increased red, and white blood cells (RBCs and WBCs) counts, and the heterophile/ lymphocyte (H/L) ratio (P < 0.05); while both mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH) were decreased (P < 0.05). In addition, HS negatively impacted lipid, protein, and glucose levels, liver and kidney function tests, and oxidative biomarkers by increasing malondialdehyde (MDA) levels and decreasing reduced glutathion (GSH) activity (P < 0.05). Heat stress (HS) caused the upregulation in HSP70, duodenal TLR4 gene expression, and the downregulation of I-FABP2, IL10, mTOR in all investigated tissues, and hepatic TLR4 (P < 0.05) compared with the TN treatment. Phytogenic feed additives (PHY) effectively mitigated heat stress's negative impacts on broilers via an improvement of broilers' behavior, hematological, biochemical, and oxidative stress biomarkers with a marked decrease in HSP70 expression levels while all tissues showed increased I-FABP2, IL10, TLR4, and mTOR (except liver) levels (P < 0.05). CONCLUSION: Phytogenic feed additives (PHY) containing Terminalia bellirica and Andrographis paniculata have ameliorated the HS-induced oxidative stress and improved the immunity as well as the gut health and welfare of broiler chickens.

Impact of heat stress during close-up dry period on performance, fertility and immunometabolic blood indices of dairy cows: prospective cohort study.

This study aimed to investigate whether heat stress, as defined by the temperature-humidity index (THI) during the close-up dry period, had any impact on the productive performance, fertility, and immunometabolic blood indices of dairy cows in the subsequent lactation. Lactation performance was associated with increasing THI values on - 21, - 14, and - 7 d before calving resulting in decreased milk yield by about 2.30, 2.60, and 2.90 kg, respectively. The THI on the - 7 d before the calving was negatively associated with fertility parameters such as delayed first estrus postpartum, an elongated calving interval by approximately 32 d, a higher number of services per conception by 1.00, and an elongated artificial insemination service period, days open, and inter-calving period by about 20, 52, and 52 d, respectively. The study found that the immunometabolic blood indices were associated with increasing THI values during the close-up dry period. The study showed that exposing dairy cows to close-up dry period heat stress had negative consequences on performance, fertility, and immunometabolic blood indices in the subsequent lactation. Therefore, it is recommended that herd management and barn microclimate changes be implemented earlier, starting from the late dry period, to mitigate the negative impact of heat stress.

The effect of alcohol consumption on human physiological and perceptual responses to heat stress: a systematic scoping review.

BACKGROUND: Ethyl alcohol (ethanol) consumption is ostensibly known to increase the risk of morbidity and mortality during hot weather and heatwaves. However, how alcohol independently alters physiological, perceptual, and behavioral responses to heat stress remains poorly understood. Therefore, we conducted a systematic scoping review to understand how alcohol consumption affects thermoregulatory responses to the heat. METHODS: We searched five databases employing the following eligibility criteria, studies must have: 1) involved the oral consumption of ethanol, 2) employed a randomized or crossover-control study design with a control trial consisting of a volume-matched, non-alcoholic beverage, 3) been conducted in healthy adult humans, 4) reported thermophysiological, perceptual, hydration status markers, and/or behavioral outcomes, 5) been published in English, 6) been conducted in air or water at temperatures of > 28°C, 7) involved passive rest or exercise, and 8) been published before October 4th, 2023. RESULTS: After removing duplicates, 7256 titles were screened, 29 papers were assessed for eligibility and 8 papers were included in the final review. Across the 8 studies, there were a total of 93 participants (93 male/0 female), the average time of heat exposure was 70 min and average alcohol dose was 0.68 g·kg1. There were 23 unique outcome variables analyzed from the studies. The physiological marker most influenced by alcohol was core temperature (lowered with alcohol consumption in 3/4 studies). Additionally, skin blood flow was increased with alcohol consumption in the one study that measured it. Typical markers of dehydration, such as increased urine volume (1/3 studies), mass loss (1/3 studies) and decreased plasma volume (0/2 studies) were not consistently observed in these studies, except for in the study with the highest alcohol dose. CONCLUSION: The effect of alcohol consumption on thermoregulatory responses is understudied, and is limited by moderate doses of alcohol consumption, short durations of heat exposure, and only conducted in young-healthy males. Contrary to current heat-health advice, the available literature suggests that alcohol consumption does not seem to impair physiological responses to heat in young healthy males.

Approach to heat-related illness.

OBJECTIVE: To describe heat-related illness and provide approaches for treatment in family practice. SOURCES OF INFORMATION: The MeSH terms heat-related illness and primary care were searched in PubMed. Clinical trials, practice reviews, and systematic reviews were included in this review. Reference lists were reviewed for additional articles. MAIN MESSAGE: Extreme heat events are increasing in frequency due to climate change and can directly result in heat exhaustion, heat stroke, or death. Exposure to extreme heat also exacerbates underlying health conditions. Patients may be at increased risk of heat-related illness because of underlying sensitivity to heat, increased exposure to heat, or barriers to resources. CONCLUSION: Family physicians can help prevent heat-related illness by identifying and counselling patients who are at increased risk and by advocating for interventions that reduce the chance of heat-related illness.

Aborder les troubles liés à la chaleur.

OBJECTIF: Décrire les troubles liés à la chaleur et présenter des stratégies de traitement en pratique familiale. SOURCES DE L'INFORMATION: Une recension à l'aide des expressions MeSH en anglais heat-related illness et primary care a été effectuée dans PubMed. Les essais cliniques, les évaluations de la pratique et les revues systématiques ont été inclus dans la présente révision. Les listes de références ont été examinées pour trouver des articles additionnels. MESSAGE PRINCIPAL: Les épisodes de canicule augmentent en fréquence en raison du changement climatique et peuvent directement causer un épuisement dû à la chaleur, un coup de chaleur ou la mort. L'exposition à la chaleur extrême peut aussi exacerber les problèmes de santé sous-jacents. Les patients peuvent être à risque accru d'un trouble lié à la chaleur à cause d'une sensibilité sous-jacente ou d'une plus grande exposition à la chaleur, ou encore en raison d'obstacles pour accéder aux ressources. CONCLUSION: Les médecins de famille peuvent aider à prévenir les troubles liés à la chaleur en identifiant les patients qui sont à risque plus élevé et en plaidant en faveur d'interventions qui réduisent le risque de tels troubles.

The health benefits of reducing micro-heat islands: A 22-year analysis of the impact of urban temperature reduction on heat-related illnesses in California's major cities.

This study investigates the relationship between temporal changes in temperatures characterizing local urban heat islands (UHIs) and heat-related illnesses (HRIs) in seven major cities of California. UHIs, which are a phenomenon that arises in the presence of impervious surfaces or the lack of green spaces exacerbate the effects of extreme heat events, can be measured longitudinally using satellite products. The two objectives of this study were: (1) to identify temperature trends in local temperatures to characterize UHIs across zip code tabulation areas (ZCTAs) in the seven observed cities over a 22-year period and (2) to use propensity score and inverse probability weighting to achieve exchangeability between different types of ZCTAs and assess the difference in hospital admissions recorded as HRIs attributable to temporal changes in UHIs. We use monthly land surface temperature data derived from MODIS Terra imagery from the summer months (June-September) from 2000 to 2022. We categorized ZCTAs (into three groups) based on their monthly land surface temperature trends. Of the 216 ZCTAs included in this study, the summertime land surface temperature trends of 43 decreased, while 161 remained unchanged, and 12 increased. Los Angeles had the greatest number of decreased ZCTAs, San Diego and San Jose had the highest number of increased ZCTAs. To analyze the number of monthly HRI attributable to changes in UHI, we used inverse probability of treatment weighting to analyze the difference in HRI between the years of 2006 and 2017 which were two major extreme heat events over the entire State. We observed an average reduction of 3.2 (95 % CI: 0.5; 5.9) HRIs per month and per ZCTAs in decreased neighborhoods as compared to unchanged. This study emphasizes the importance of urban climate adaptation strategies to mitigate the intensity and prevalence of UHIs to reduce health risks related to heat.

Relationship between metabolic indices and milk yield in Saanen goats exposed to heat stress in semi-tropical climates.

This study aimed to determine the effects of heat stress on 30 Saanen goats of different ages (young, middle-aged, and old). The average temperature and humidity values during the trial were 27.82 °C and 40.65%, respectively. Statistically significant differences in pulse rate (PR), respiratory rate (SS), and temperature humidity index (THI) were found between months (P < 0.05). Beta-hydroxybutyric acid (BHBA) values were found to be statistically significant in the young and middle-aged group (P < 0.05), with the highest in the middle-aged group obtained in June (0.65 mmol/L). Non-esterified fatty acids (NEFA) and urea (BUN) were significantly different (P < 0.05) in all age groups, whereas creatinine values showed no significant differences between groups. Significant positive relationships were found between body weight (BW) and body condition score (BCS), as well as pulse rate (PR) and daily average daily milk yield (DAMY) (P < 0.01). A positive correlation was also found between the respiratory rate (SS) and pulse rate (P < 0.01). As a result, although attempts have been made to prevent the decrease in productivity with applications for animals under heat stress, the optimal strategy may be to address the source of the problem. Issues that cause heat accumulation in the body should be identified and necessary arrangements should be made in the shelter to distribute heat to ensure that animals are less affected. Shaded areas should be provided in cases of stress caused by heat. An appropriate structural arrangement for temperature, humidification, and ventilation systems, as well as the provision of abundant fresh drinking water, would also be beneficial.

Review: Ruminant heat-stress terminology.

With increasing climate variability, there is a rise in the exposure to, and incidence of, ruminant heat stress (HS), increasing the requirement for focused research. As such, precise terminology is crucial to maintain effective communication and knowledge advancement. Despite this, several key terms are currently defined inconsistently, leading to confusion and misinterpretation. This paper examines the historical and contemporary use of the terms 'resistance', 'tolerance', 'resilience', and 'susceptibility' across various disciplines, revealing significant ambiguities that hinder both research and practice. Through this comprehensive review, we propose new definitions for each term as they are used relating to HS, with a focus on ruminant production. Proposed definitions align with current scientific understanding, providing a robust framework for future research and application. As further research is conducted, we hope these definitions can be improved through the inclusion of quantitative measures which align with these classifications. This present review provides definition clarity for common heat abatement terminology, enabling consistency and from this, progress in the field to ameliorate HS for ruminants.

Assessment of the effects of heat stress on the production of dairy cows by using two comfort thermal indices in Southern Chile.

Heat stress has been recognized as a serious problem in dairy farms around the world due to the increasing heat waves and higher genetic potential of dairy cows. In Chile, milk production is concentrated in the southern regions of the country, where animals graze all year around, consequently being exposed directly to environmental conditions. Nevertheless, there are few studies conducted in Chile that have evaluated at the commercial level the impact of heat stress on milk production. The aim of this study was to assess the effects of summer conditions, across periods, on the milk production of cows at different stages of lactation in a dairy farm located in Southern Chile. Daily meteorological and milk yield records of three summers from a dairy farm were collected to characterize the relationship between two thermal stress indices and milk yield. The thermal comfort indices used were the comprehensive climate index (CCI), and the adjusted temperature humidity index (THIadj). The average values of CCI and THIadj were dependent on the period (P < 0.0001) with maximum CCI of 40.2 °C, 31.7 °C, and 27.5 °C for the 2012-2013, 2015-2016, and 2016-2017 periods, respectively. A similar response was recorded when THIadj was used (85.5, 78.0, and 73.9, respectively). In the 2012-2013 summer, 44.4% of the days presented conditions of heat stress (CCI ≥23), a value that fell to 26.7% in the summer of 2015-2016 and only 5.6% in the 2016-2017. On the opposite, when the THIadj was used, these values were 50%, 48.9%, and 5.6%, respectively. In conclusion, both comfort thermal indices are good tools to determine the risk of thermal stress in dairy cows, with a large variation between the three summer periods but also between indices. Likewise, cows in the early and mid-lactation periods are more affected in terms of milk yield.

Betaine and feed restriction as potential mitigation strategies against heat stress in two strains of laying hens.

Climate change is increasingly manifesting in temperate regions. Laying hens are highly sensitive to heat stress and mitigation strategies should be implemented to reduce the negative effects. The goal of this experiment was to evaluate the effects of betaine in drinking water (0.55 g/L) and 4 h feed restriction during peak heat stress on laying performance, egg quality, blood gas parameters, body temperature (Tb), and oxidative stress in 2 different breeds of laying hens. Therefore, 448 ISA Brown hens (25 wk) and 448 Lohmann LSL classic laying hens (26 wk) were housed in 128 cages (7 hens/cage). Thermoneutral (TN) data was collected for 21 d before cyclic heat stress (HS) (21d; 32 ± 2°C; 6 h daily). During HS, hens were divided into 4 treatments: 1) feed restriction (FR), 2) betaine supplementation in drinking water (BET), 3) feed restriction and betaine supplementation in drinking water (FR-BET), or 4) control (CON). The effects were evaluated after 1 wk of HS (acute heat stress; AHS) and 3 wk of HS (chronic heat stress; CHS). Laying rate and egg mass (EM) diminished during CHS but decreased more in white than brown hens (2.78% and 1.94%; -1.57% and -0.81%, respectively; P = 0.004) and remained unaltered by BET or FR. During AHS, average daily feed intake (ADFI) increased compared to TN, but the increase was higher in white than brown hens (6.36% and 2.62%, respectively; P = 0.001). Egg shell quality deteriorated during AHS and CHS, but was most affected in white hens, FR or BET did not impact this. Blood pCO2, HCO3- and base excess significantly decreased during AHS and CHS, but pH and iCa were unaltered. Blood glucose increased in white hens during AHS compared to TN (P < 0.001), while plasma malondialdehyde increased in brown hens (P < 0.001). Results indicated that laying hens experienced HS, but breed differences were observed and white hens were generally most affected. FR affected feed conversion ratio negatively during CHS. However, FR and BET could not improve laying performance, egg quality, Tb, or blood parameters during HS.

A longitudinal assessment of heat exposure and biomarkers of kidney function on heat shock protein 70 and antibodies among agricultural workers.

BACKGROUND: Exposure to extreme heat impacts millions of people worldwide and outdoor workers are among the populations most affected by hot temperatures. Heat stress induces several biological responses in humans, including the production of heat shock proteins (HSP) and antibodies against HSP (anti-HSP) which may play a central role in the body's cellular response to a hot environment. OBJECTIVE: This longitudinal study investigated the impact of elevated temperatures and humidity on the presence of HSP70 and anti-HSP70 and examined relationships with markers of kidney function in an at-risk workforce under conditions of extreme heat and exertion in Guatemala. METHODS: We collected ambient temperature and relative humidity data as well as biomarkers and clinical data from 40 sugarcane workers at the start and the end of a 6-month harvest. We used generalized mixed-effects models to estimate temperature effects on HSP70 and anti-HSP70 levels. In addition, we examined trends between HSP70 and anti-HSP70 levels and markers of kidney function across the harvest. RESULTS: At the end of the harvest, temperatures were higher, and workers had, on average, higher levels of HSP70 and anti-HSP70 compared to the beginning of the season. We observed significant increasing trends with temperature indices, heat index, and HSP70 levels. Maximum temperature was associated with HSP70 increments after controlling for age, systolic and diastolic blood pressure (ß: 0.21, 95% Confidence Interval: 0.09, 0.33). Kidney function decline across the harvest was associated with both higher levels of anti-HSP70 levels at the end of the harvest as well as greater increases in anti-HSP70 levels across the harvest. CONCLUSIONS: These results suggest that workplace heat exposure may increase the production of HSP70 and anti-HSP70 levels and that there may be a relationship between increasing anti-HSP70 antibodies and the development of renal injury. HSP70 holds promise as a biomarker of heat stress in exposed populations.

Evaluating the Impact of Heat Stress on Placental Function: A Systematic Review.

Ambient heat stress poses a significant threat to public health, with rising temperatures exacerbating the risks associated with pregnancy. This systematic review examined the associations between heat stress exposure and placental function, synthesizing methodologies from the existing literature to inform future research approaches. Analyzing 24 articles, it explores various study designs, temperature exposure parameters, pregnancy windows, and placental outcome variables. Findings across human and animal studies reveal diverse effects on placental weight, efficiency, blood flow, anatomy, gene expression, and steroid levels under heat stress conditions. While animal studies primarily utilize randomized controlled trials, human research relies on observational methodologies due to ethical constraints. Both demonstrate alterations in placental morphology and function, underscoring the importance of understanding these changes for maternal and fetal health. The review underscores the urgent need for further research, particularly in human populations, to elucidate mechanisms and develop interventions mitigating heat stress's adverse effects on placental health. Ultimately, this synthesis contributes to understanding the complex interplay between environmental factors and pregnancy outcomes, informing strategies for maternal and fetal well-being amidst climate change challenges.

Heat vulnerability: health impacts of heat on older people in urban and rural areas in Europe.

Exposure to extreme heat is associated with both increased morbidity and mortality, especially in older people. Health burdens associated with heat include heat stroke, diabetes mellitus, hypertension, ischemic heart diseases, heart failure and arrhythmia, pulmonary diseases but also injuries, problems with activities of daily living, and mental disorders. In Europe, there are remarkable spatial differences in heat exposure between urban and less populated areas. In Austria, for example, there is a significant gradual association between population density and the number of heat days, where the gradient of urbanization also follows the gradient of sea level. The European population is continuously ageing, especially in rural areas. Older adults are especially vulnerable to negative health consequences resulting from heat exposure, due to a lack of physiological, social, cognitive, and behavioral resources. Older people living in urban areas are particularly at risk, due to the urban heat island effect, the heat-promoting interplay between conditions typically found in cities, such as a lack of vegetation combined with a high proportion of built-up areas; however, older people living in rural regions often have less infrastructure to cope with extreme heat, such as fewer cooling centers and emergency services. Additionally, older adults still engaged in agricultural or forestry activities may be exposed to high temperatures without adequate protection or hydration. More research is required to examine factors responsible for heat vulnerability in older adults and the interactions and possibilities for increasing resilience in older urban and rural populations to the health consequences of heat.

Effect of seven days heat stress on feed and water intake, milk characteristics, blood parameters, physiological indicators, and gene expression in Holstein dairy cows.

This study examined the effects of 7 days of heat stress on eight early lactating Holstein cows in climate-controlled chambers. The early lactating Holstein cows (42 ± 2 days in milk, 29.27 ± 0.38 kg/day milk yield, 1.21 ± 0.05 parity) were subjected to two 14-day periods, each consisting of 7 days of adaptation and 7 days of heat stress. Conditions were set to 22 °C and 50% humidity during adaptation, followed by heat stress periods with low-temperature, low-humidity (LTLH, 71 THI) and high-temperature, high-humidity (HTHH, 86 THI) treatments. Data from the last 7 days were analyzed using a mixed procedure in SAS. In the study, the HTHH group displayed marked physiological and biochemical changes on 14 days of heat stress exposure compared to the LTLH group. Firstly, the HTHH group's dry matter intake decreased by approximately 12% while their water intake increased by about 23%. Secondly, both milk yield and milk protein production in the HTHH group decreased by 10% and 20%, respectively. Thirdly, there was a reduction in white blood cells, hemoglobin, mean corpuscular hemoglobin, and platelets in the HTHH group, with concurrent increases in glucose, non-esterified fatty acids, and albumin concentrations. Additionally, the HTHH group exhibited elevated plasma concentrations of cortisol and haptoglobin. Moreover, the gene expression of heat shock protein 70 and heat shock protein 90 was significantly upregulated in the HTHH group's peripheral blood mononuclear cells. Lastly, key physiological indicators such as rectal temperature, heart rate, and skin temperature showed substantial elevations in the HTHH group. Considering the enormous negative effects observed in the analyzed blood metabolites, milk yield and compositions, and heat shock protein gene expression, early lactating Holstein cows were found to be more vulnerable to HTHH than LTLH over a 7 days exposure to heat stress.

Livestock-Forest integrated system attenuates deleterious heat stress effects in bovine oocytes.

Global warming poses significant challenges to the fertility of tropical dairy cattle. One promising approach to mitigate heat stress effects on reproductive function and reduce the carbon footprint is the use of integrated livestock-forest (ILF) systems. The aim of this study was to investigate the effects of two different systems, namely Full Sun (FS) and ILF, on maternal hyperthermia and oocyte quality of Holstein and Girolando heifers during the tropical summer season. The temperature-humidity index (THI) data revealed intense heat stress during the experiment. Both the system (P<0.01) and the breed (P<0.01) factors had a significant impact on vaginal temperature, being hyperthermia more pronounced in the FS system and in the Holstein breed. Over the five time points collected at a 33-day interval, we observed distinct patterns for ILF (P=0.65) and FS (P<0.001) systems, suggesting an adaptive response in animals kept in FS systems. Furthermore, oocyte quality assessment revealed an effect of the system for oocyte diameter (P<0.001) and levels of IGFBP2 (P<0.001), and caspase 3 levels showed a decrease in ILF compared to FS for both Holstein (P<0.001) and Girolando (P<0.001) breeds. Collectively, these parameters indicate that oocyte quality during the summer months was superior in animals maintained in the ILF system. In conclusion, the ILF system demonstrated promising results in attenuating maternal hyperthermia and mitigating its effects on oocyte quality. Additionally, our observations suggest that animals in the FS system may exhibit an adaptive response to heat stress.

Heat stress and the velocity-duration relationship in amateur runners.

Tolerance to high-intensity constant power exercise can be characterized by the hyperbolic power-duration (or velocity-duration) relationship. The hyperbola is defined by the asymptote (critical power or velocity) and the curvature constant (W' or D'). The effects of thermoregulatory stress on middle-distance running performance are equivocal-possibly due to the complexities of the hyperbolic velocity-duration relationship for these relatively short duration events. We aimed to measure the effects of heat stress on the velocity-duration relationship in amateur runners. Fifteen participants (23 ± 6 years) completed a series of constant-velocity running bouts to intolerance in three heat indices (MILD: 20°C, VERY HOT: 38°C, EXTREME: 55°C). Critical velocity (CV) in MILD (3.52 ± 0.86 m/s) was higher than VERY HOT (3.39 ± 0.82 m/s) and EXTREME (3.29 ± 1.05 m/s; F[2.28] = 3.80, p < 0.035) with no effect of thermal stress on D' (F[2.28] = 2.48, p = 0.11). In amateur competitive/recreational runners, heat stress of ≥38°C heat index negatively affected CV. Thus, even during relatively short events, such as middle-distance running where fluid loss is not a primary concern, heat stress may negatively impact performance.

Heat-related illness and dementia: a study integrating epidemiological and experimental evidence.

BACKGROUND: Heat-related illness (HRI) is commonly considered an acute condition, and its potential long-term consequences are not well understood. We conducted a population-based cohort study and an animal experiment to evaluate whether HRI is associated with dementia later in life. METHODS: The Taiwan National Health Insurance Research Database was used in the epidemiological study. We identified newly diagnosed HRI patients between 2001 and 2015, but excluded those with any pre-existing dementia, as the study cohort. Through matching by age, sex, and the index date with the study cohort, we selected individuals without HRI and without any pre-existing dementia as a comparison cohort at a 1:4 ratio. We followed each cohort member until the end of 2018 and compared the risk between the two cohorts using Cox proportional hazards regression models. In the animal experiment, we used a rat model to assess cognitive functions and the histopathological changes in the hippocampus after a heat stroke event. RESULTS: In the epidemiological study, the study cohort consisted of 70,721 HRI patients and the comparison cohort consisted of 282,884 individuals without HRI. After adjusting for potential confounders, the HRI patients had a higher risk of dementia (adjusted hazard ratio [AHR] = 1.24; 95% confidence interval [CI]: 1.19-1.29). Patients with heat stroke had a higher risk of dementia compared with individuals without HRI (AHR = 1.26; 95% CI: 1.18-1.34). In the animal experiment, we found cognitive dysfunction evidenced by animal behavioral tests and observed remarkable neuronal damage, degeneration, apoptosis, and amyloid plaque deposition in the hippocampus after a heat stroke event. CONCLUSIONS: Our epidemiological study indicated that HRI elevated the risk of dementia. This finding was substantiated by the histopathological features observed in the hippocampus, along with the cognitive impairments detected, in the experimental heat stroke rat model.