Human scalp hair as a thermoregulatory adaptation.

Humans are unique among mammals in having a functionally naked body with a hair-covered scalp. Scalp hair is exceptionally variable across populations within Homo sapiens. Neither the function of human scalp hair nor the consequences of variation in its morphology have been studied within an evolutionary framework. A thermoregulatory role for human scalp hair has been previously suggested. Here, we present experimental evidence on the potential evolutionary function of human scalp hair and variation in its morphology. Using a thermal manikin and human hair wigs at different wind speeds in a temperature and humidity-controlled environment, with and without simulated solar radiation, we collected data on the convective, radiative, and evaporative heat fluxes to and from the scalp in relation to properties of a range of hair morphologies, as well as a naked scalp. We find evidence for a significant reduction in solar radiation influx to the scalp in the presence of hair. Maximal evaporative heat loss potential from the scalp is reduced by the presence of hair, but the amount of sweat required on the scalp to balance the incoming solar heat (i.e., zero heat gain) is reduced in the presence of hair. Particularly, we find that hair that is more tightly curled offers increased protection against heat gain from solar radiation.

Optimal low-cost cooling strategies for infant strollers during hot weather.

The current study aimed to identity the optimal low-cost stroller cooling strategies for use in hot and moderately humid summer weather. A commercially available stroller was instrumented to assess the key parameters of the thermal environment. The cooling efficacy of eight different stroller configurations was examined in a counterbalanced order across 16 hot summer days (air temperature (Ta) = 33.3 ± 4.1 °C; relative humidity = 36.7 ± 15%; black globe temperature = 43.9 ± 4.6 °C). Compared with a standard-practice stroller configuration, combining a moist muslin draping with a battery-operated clip-on fan provided optimal in-stroller cooling, reducing the end-trial air temperature by 4.7 °C and the wet bulb globe temperature (WBGT) by 1.4 °C. In contrast, in-stroller temperatures were substantially increased by draping a dry muslin (Ta = +2.6 °C; WBGT = +0.9 °C) or flannelette (Ta = +3.7 °C; WBGT = +1.4 °C) cloth over the stroller carriage. These findings provide empirical evidence which may inform guidance aimed at protecting infants during hot weather.Practitioner summary: This study examined the efficacy of traditional and novel stroller cooling strategies for use in hot and moderately humid weather. Covering the carriage with a dry muslin cloth substantially increased stroller temperatures and should be avoided. Evaporative cooling methods reduced in-stroller temperatures. A moist muslin cloth draping combined with a fan provided optimal stroller cooling.

Retrofitting passive cooling strategies to combat heat stress in the face of climate change: A case study of a ready-made garment factory in Dhaka, Bangladesh.

The ready-made garment industry is critical to the Bangladesh economy. There is an urgent need to improve current working conditions and build capacity for heat mitigation as conditions worsen due to climate change. We modelled a typical, mid-sized, non-air-conditioned factory in Bangladesh and simulated how the indoor thermal environment is altered by four rooftop retrofits (1. extensive green roof, 2. rooftop shading, 3. white cool roof, 4. insulated white cool roof) on present-day and future decades under different climate scenarios. Simulations showed that all strategies reduce indoor air temperatures by around 2 °C on average and reduce the number of present-day annual work-hours during which wetbulb globe temperature exceeds the standardised limits for moderate work rates by up to 603 h - the equivalent of 75 (8 h) working days per year. By 2050 under a high-emissions scenario, indoor conditions with a rooftop intervention are comparable to present-day conditions. To reduce the growing need for carbon-intensive air-conditioning, sustainable heat mitigation strategies need to be incorporated into a wider range of solutions at the individual, building, and urban level. The results presented here have implications for factory planning and retrofit design, and may inform policies targeting worker health, well-being, and productivity.

Influence of sex and biological maturation on the sudomotor response to exercise-heat stress: are girls disadvantaged?

Both adult females and children have been reported to have a lower sweating capacity and thus reduced evaporative heat loss potential that may increase their susceptibility to exertional hyperthermia in the heat. Compared with males, females have a lower maximal sweat rate and thus a theoretically lower maximum skin wettedness due to a lower sweat output per gland. Similarly, children have been suggested to be disadvantaged in high ambient temperatures due to a lower sweat production and therefore reduced evaporative capacity, despite modifications of heat transfer due to physical attributes and possible evaporative efficiency. The reported reductions in the sudomotor activity of females and children suggest a lower sweating capacity in girls. However, because of the complexities of isolating sex and maturation from the confounding effects of morphological differences (e.g., body surface area-to-mass ratio) and metabolic heat production, limited evidence exists supporting whether children, and, more specifically, girls are at a thermoregulatory disadvantage. Furthermore, a limited number of child-adult comparison studies involve females and very few studies have directly compared regional and whole body sudomotor activity between boys and girls. This minireview highlights the exercise-induced sudomotor response of females and children, summarizes previous research investigating the sudomotor response to exercise in girls, and suggests important areas for further research.

Quantifying the impact of heat on human physical work capacity; part IV: interactions between work duration and heat stress severity.

High workplace temperatures negatively impact physical work capacity (PWC). Although PWC loss models with heat based on 1-h exposures are available, it is unclear if further adjustments are required to accommodate repeated work/rest cycles over the course of a full work shift. Therefore, we examined the impact of heat stress exposure on human PWC during a simulated work shift consisting of six 1-h work-rest cycles. Nine healthy males completed six 50-min work bouts, separated by 10-min rest intervals and an extended lunch break, on four separate occasions: once in a cool environment (15 °C/50% RH) and in three different air temperature and relative humidity combinations (moderate, 35 °C/50% RH; hot, 40 °C/50% RH; and very hot, 40 °C/70%). To mimic moderate to heavy workload, work was performed on a treadmill at a fixed heart rate of 130 beats·min-1. During each work bout, PWC was quantified as the kilojoules expended above resting levels. Over the shift, work output per cycle decreased, even in the cool climate, with the biggest decrement after the lunch break and meal consumption. Expressing PWC relative to that achieved in the cool environment for the same work duration, there was an additional 5(± 4)%, 7(± 6)%, and 16(± 7)% decrease in PWC when work was performed across a full work shift for the moderate, hot, and very hot condition respectively, compared with 1-h projections. Empirical models to predict PWC based on the level of heat stress (Wet-Bulb Globe Temperature, Universal Thermal Climate Index, Psychrometric Wet-Bulb Temperature, Humidex, and Heat Index) and the number of work cycles performed are presented.

Quantifying the impact of heat on human physical work capacity; part III: the impact of solar radiation varies with air temperature, humidity, and clothing coverage.

Heat stress decreases human physical work capacity (PWC), but the extent to which solar radiation (SOLAR) compounds this response is not well understood. This study empirically quantified how SOLAR impacts PWC in the heat, considering wide, but controlled, variations in air temperature, humidity, and clothing coverage. We also provide correction equations so PWC can be quantified outdoors using heat stress indices that do not ordinarily account for SOLAR (including the Heat Stress Index, Humidex, and Wet-Bulb Temperature). Fourteen young adult males (7 donning a work coverall, 7 with shorts and trainers) walked for 1 h at a fixed heart rate of 130 beats∙min-1, in seven combinations of air temperature (25 to 45°C) and relative humidity (20 or 80%), with and without SOLAR (800 W/m2 from solar lamps). Cumulative energy expenditure in the heat, relative to the work achieved in a cool reference condition, was used to determine PWC%. Skin temperature was the primary determinant of PWC in the heat. In dry climates with exposed skin (0.3 Clo), SOLAR caused PWC to decrease exponentially with rising air temperature, whereas work coveralls (0.9 Clo) negated this effect. In humid conditions, the SOLAR-induced reduction in PWC was consistent and linear across all levels of air temperature and clothing conditions. Wet-Bulb Globe Temperature and the Universal Thermal Climate Index represented SOLAR correctly and did not require a correction factor. For the Heat Stress Index, Humidex, and Wet-Bulb Temperature, correction factors are provided enabling forecasting of heat effects on work productivity.

Quantifying the impact of heat on human physical work capacity; part II: the observed interaction of air velocity with temperature, humidity, sweat rate, and clothing is not captured by most heat stress indices.

Increasing air movement can alleviate or exacerbate occupational heat strain, but the impact is not well defined across a wide range of hot environments, with different clothing levels. Therefore, we combined a large empirical study with a physical model of human heat transfer to determine the climates where increased air movement (with electric fans) provides effective body cooling. The model allowed us to generate practical advice using a high-resolution matrix of temperature and humidity. The empirical study involved a total of 300 1-h work trials in a variety of environments (35, 40, 45, and 50 °C, with 20 up to 80% relative humidity) with and without simulated wind (3.5 vs 0.2 m∙s-1), and wearing either minimal clothing or a full body work coverall. Our data provides compelling evidence that the impact of fans is strongly determined by air temperature and humidity. When air temperature is ≥ 35 °C, fans are ineffective and potentially harmful when relative humidity is below 50%. Our simulated data also show the climates where high wind/fans are beneficial or harmful, considering heat acclimation, age, and wind speed. Using unified weather indices, the impact of air movement is well captured by the universal thermal climate index, but not by wet-bulb globe temperature and aspirated wet-bulb temperature. Overall, the data from this study can inform new guidance for major public and occupational health agencies, potentially maintaining health and productivity in a warming climate.

Body mapping of sweating patterns of pre-pubertal children during intermittent exercise in a warm environment.

PURPOSE: To determine sweating responses of pre-pubertal children during intermittent exercise in a warm environment and create whole-body maps of regional sweat rate (RSRs) distribution across the body. METHODS: Thirteen pre-pubertal children; six girls and seven boys (8.1 ± 0.8 years) took part. Sweat was collected using the technical absorbent method in the last 5 min of a 30-min intermittent exercise protocol performed at 30 â„ƒ, 40% relative humidity and 2 m·s-1 frontal wind. RESULTS: Mean gross sweat loss (GSL) was 126 ± 47 g·m-2·h-1 and metabolic heat production was 278 ± 50 W·m2. The lower anterior torso area had the lowest RSR with a median (IQR) sweat rate (SR) of 40 (32) g·m-2·h-1. The highest was the forehead with a median SR of 255 (163) g·m-2·h-1. Normalised sweat maps (the ratio of each region's SR to the mean SR for all measured pad regions) showed girls displayed lower ratio values at the anterior and posterior torso, and higher ratios at the hands, feet and forehead compared to boys. Absolute SRs were similar at hands and feet, but girls sweated less in most other areas, even after correction for metabolic rate. CONCLUSION: Pre-pubertal children have different RSRs across the body, also showing sex differences in sweat distribution. Distributions differ from adults. Hands and feet RSR remain stable, but SR across other body areas increase with maturation. These data can increase specificity of models of human thermoregulation, improve the measurement accuracy of child-sized thermal manikins, and aid companies during product design and communication.

An advanced empirical model for quantifying the impact of heat and climate change on human physical work capacity.

Occupational heat stress directly hampers physical work capacity (PWC), with large economic consequences for industries and regions vulnerable to global warming. Accurately quantifying PWC is essential for forecasting impacts of different climate change scenarios, but the current state of knowledge is limited, leading to potential underestimations in mild heat, and overestimations in extreme heat. We therefore developed advanced empirical equations for PWC based on 338 work sessions in climatic chambers (low air movement, no solar radiation) spanning mild to extreme heat stress. Equations for PWC are available based on air temperature and humidity, for a suite of heat stress assessment metrics, and mean skin temperature. Our models are highly sensitive to mild heat and to our knowledge are the first to include empirical data across the full range of warm and hot environments possible with future climate change across the world. Using wet bulb globe temperature (WBGT) as an example, we noted 10% reductions in PWC at mild heat stress (WBGT = 18°C) and reductions of 78% in the most extreme conditions (WBGT = 40°C). Of the different heat stress indices available, the heat index was the best predictor of group level PWC (R2 = 0.96) but can only be applied in shaded conditions. The skin temperature, but not internal/core temperature, was a strong predictor of PWC (R2 = 0.88), thermal sensation (R2 = 0.84), and thermal comfort (R2 = 0.73). The models presented apply to occupational workloads and can be used in climate projection models to predict economic and social consequences of climate change.

Air speed and direction affect metabolic and thermoregulatory responses during walking and running in a temperate environment.

Revisiting classical experiments on the impact of air resistance on metabolic rate, we aimed to overcome limitations of previous research, notably: low participant numbers (n=1-3), highly turbulent wind, and confounding effects of rising body temperature. In a custom-built wind tunnel with reduced turbulence, 14 participants (8 males, 6 females) walked (5 km.h-1) and ran on a treadmill (70%V̇O2max) at 0, 2, 4 and 6 m.s-1 headwind or tailwind in a counterbalanced design, with rest-breaks between each exposure to avoid rises in body core temperature. Oxygen consumption (V̇O2) exhibited strong linear relationships versus wind direction, dynamic pressure and air speed squared(Vwr2), lower in magnitude for headwind than tailwind. A moderate linear relationship was observed between heart rate, wind direction, dynamic pressure and Vwr2. Below 4 m⸱s-1, the effect of wind was well within inter- and intra-individual variation and equipment uncertainty, and only at wind speeds ≥4 m⸱s-1 did the differences in physiological responses reach statistical significance. Our data indicate that at running speeds below 4 m⸱s-1 (14.4 km/h), indoor treadmill and outdoor running are comparable in terms of the metabolic impact of air movement relative to the person. However, this does not extend to the thermoregulatory effect of wind, with outdoor running providing a higher cooling rate due to the self-generated wind created during running. By removing the confounding impact of core temperature rises, the observed effects of headwind were lower and those of tailwind larger than observed previously. In the context of middle-distance running, headwind created by running at 21.5 km.h-1 would result in a 2.2% increase of V̇O2. A relative tailwind of the same speed would lead to a 3.1% reduction.

Comparing efficacy of different climate indices for predicting labor loss, body temperature, and thermal perception in a wide variety of warm and hot climates.

The purpose of this study was to investigate which climate/heat indices perform best in predicting heat-induced loss of physical work capacity (PWC-loss). Integrating data from earlier studies, data from 982 exposures (75 conditions) exercising at a fixed cardiovascular load of 130b.min-1, in varying temperatures (15-50°C), humidities (20-80%), solar radiation (0-800W.m-2), wind (0.2-3.5m.s-1) and two clothing levels, were used to model the predictive power of ambient temperature, Universal Thermal Climate Index (UTCI), Wet Bulb Globe Temperature (WBGT), Modified Equivalent Temperature (mPET), Heat Index, Apparent Temperature (AT), and Wet Bulb Temperature (Twb) for the calculation of PWC-loss, skin temperature (Tskin) and core-to-skin temperature gradient, and Thermal perception( TSV) in the heat. R2, RMSD and Akaike stats were used indicating model performance. Indices not including wind/radiation in their calculation (Ta, Heat Index, AT, Twb) struggled to provide consistent predictions across variables. For PWC-loss and TSV, UTCI and WBGT had the highest predictive power. For Tskin, and core-to-skin temperature gradient, the physiological models UTCI and mPET worked best in semi-nude conditions, but clothed, AT, WBGT and UTCI worked best. For all index predictions, Ta, vapor pressure and Twb were shown to be the worst heat strain predictors. While UTCI and WBGT had similar model performance using the full dataset, WBGT did not work appropriately in windy, hot-dry, conditions where WBGT predicted lower strain due to wind, whereas the empirical data, UTCI and mPET indicated that wind in fact increased the overall level of thermal strain. The findings of the current study highlight the advantages of using a physiological model-based index like UTCI when evaluating heat stress in dynamic thermal environments.

Quantifying Exercise Heat Acclimatisation in Athletes and Military Personnel: A Systematic Review and Meta-analysis.

BACKGROUND: Athletes and military personnel are often expected to compete and work in hot and/or humid environments, where decrements in performance and an increased risk of exertional heat illness are prevalent. A physiological strategy for reducing the adverse effects of heat stress is to acclimatise to the heat. OBJECTIVE: The aim of this systematic review was to quantify the effects of relocating to a hotter climate to undergo heat acclimatisation in athletes and military personnel. ELIGIBILITY CRITERIA: Studies investigating the effects of heat acclimatisation in non-acclimatised athletes and military personnel via relocation to a hot climate for < 6 weeks were included. DATA SOURCES: MEDLINE, SPORTDiscus, CINAHL Plus with Full Text and Scopus were searched from inception to June 2022. RISK OF BIAS: A modified version of the McMaster critical review form was utilised independently by two authors to assess the risk of bias. DATA SYNTHESIS: A Bayesian multi-level meta-analysis was conducted on five outcome measures, including resting core temperature and heart rate, the change in core temperature and heart rate during a heat response test and sweat rate. Wet-bulb globe temperature (WBGT), daily training duration and protocol length were used as predictor variables. Along with posterior means and 90% credible intervals (CrI), the probability of direction (Pd) was calculated. RESULTS: Eighteen articles from twelve independent studies were included. Fourteen articles (nine studies) provided data for the meta-analyses. Whilst accounting for WBGT, daily training duration and protocol length, population estimates indicated a reduction in resting core temperature and heart rate of - 0.19 °C [90% CrI: - 0.41 to 0.05, Pd = 91%] and - 6 beats·min-1 [90% CrI: - 16 to 5, Pd = 83%], respectively. Furthermore, the rise in core temperature and heart rate during a heat response test were attenuated by - 0.24 °C [90% CrI: - 0.67 to 0.20, Pd = 85%] and - 7 beats·min-1 [90% CrI: - 18 to 4, Pd = 87%]. Changes in sweat rate were conflicting (0.01 L·h-1 [90% CrI: - 0.38 to 0.40, Pd = 53%]), primarily due to two studies demonstrating a reduction in sweat rate following heat acclimatisation. CONCLUSIONS: Data from athletes and military personnel relocating to a hotter climate were consistent with a reduction in resting core temperature and heart rate, in addition to an attenuated rise in core temperature and heart rate during an exercise-based heat response test. An increase in sweat rate is also attainable, with the extent of these adaptations dependent on WBGT, daily training duration and protocol length. PROSPERO REGISTRATION: CRD42022337761.

Influence of Biological Sex and Fitness on Core Temperature Change and Sweating in Children Exercising in Warm Conditions.

PURPOSE: This study aimed to investigate the associations of biological sex and aerobic fitness (i.e., V̇O 2peak ) on the change in gastrointestinal temperature (∆ Tgi ) and whole-body sweat rate (WBSR) of children exercising in warm conditions. METHODS: Thirty-eight children (17 boys, mean ± SD = 13.7 ± 1.2 yr; 21 girls, 13.6 ± 1.8 yr) walked for 45 min at a fixed rate of metabolic heat production (8 W·kg -1 ) in 30°C and 40% relative humidity. Biological sex and relative V̇O 2peak were entered as predictors into a Bayesian hierarchical generalized additive model for Tgi . For a subsample of 13 girls with measured body composition, body fat percent was entered into a separate hierarchical generalized additive model for Tgi . Sex, V̇O 2peak , and the evaporative requirement for heat balance ( Ereq ) were entered into a Bayesian hierarchical linear regression for WBSR. RESULTS: The mean ∆ Tgi for boys was 0.71°C (90% credible interval = 0.60-0.82) and for girls 0.78°C (0.68-0.88). A predicted 20 mL·kg -1 ·min -1 higher V̇O 2peak resulted in a 0.19°C (-0.03 to 0.43) and 0.24°C (0.07-0.40) lower ∆ Tgi in boys and girls, respectively. A predicted ~13% lower body fat in the subsample of girls resulted in a 0.15°C (-0.12 to 0.45) lower ∆ Tgi . When Ereq was standardized to the grand mean, the difference in WBSR between boys and girls was -0.00 L·h -1 (-0.06 to 0.06), and a 20-mL·kg -1 ·min -1 higher predicted V̇O 2peak resulted in a mean difference in WBSR of -0.07 L·h -1 (-0.15 to 0.00). CONCLUSIONS: Biological sex did not independently influence ∆ Tgi and WBSR in children. However, a higher predicted V̇O 2peak resulted in a lower ∆ Tgi of children, which was not associated with a greater WBSR, but may be related to differences in body fat percent between high and low fitness individuals.

Biological sex does not independently influence core temperature change and sweating of children exercising in uncompensable heat stress.

The purpose of this study was to investigate the influence of biological sex, independent of differences in aerobic fitness and body fatness, on the change in gastrointestinal temperature (ΔTgi) and whole body sweat rate (WBSR) of children exercising under uncompensable heat stress. Seventeen boys (means ± SD; 13.7 ± 1.3 yr) and 18 girls (13.7 ± 1.4 yr) walked for 45 min at a fixed rate of metabolic heat production per kg body mass (8 W·kg-1) in 40°C and 30% relative humidity. Sex and peak oxygen consumption (V̇o2peak) were entered into a Bayesian hierarchical general additive model (HGAM) for Tgi. Sex, V̇o2peak, and the evaporative requirement for heat balance (Ereq) were entered into a Bayesian hierarchical linear regression for WBSR. For 26 (12 M and 14 F) of the 35 children with measured body composition, body fat percentage was entered in a separate HGAM and hierarchical linear regression for Tgi and WBSR, respectively. Conditional on sex-specific mean V̇o2peak, ΔTgi was 1.00°C [90% credible intervals (Crl): 0.84, 1.16] for boys and 1.17°C [1.01, 1.33] for girls, with a difference of 0.17°C [-0.39, 0.06]. When sex differences in V̇o2peak were accounted for, the difference in ΔTgi between boys and girls was 0.01°C [-0.25, 0.22]. The difference in WBSR between boys and girls was 0.03 L·h-1 [-0.02, 0.07], when isolated from differences in Ereq. The difference in ΔTgi between boys and girls was -0.10°C [-0.38, 0.17] when sex differences in body fat (%) were accounted for. Biological sex did not independently influence the ΔTgi and WBSR of children exercising under uncompensable heat stress.NEW & NOTEWORTHY Limited studies have investigated the thermoregulatory responses of boys and girls exercising under uncompensable heat stress. Boys and girls often differ in physiological characteristics other than biological sex, such as aerobic fitness and body fat percentage, which may confound interpretations. We investigated the influence of biological sex on exercise thermoregulation in children, independent of differences in aerobic fitness and body fatness.

Breaking Sitting Time with Physical Activity Increases Energy Expenditure but Does Not Alter Postprandial Metabolism in Girls.

PURPOSE: Young people spend a substantial proportion of their time at school sedentary; therefore, this setting represents an important target for interventions aimed at displacing sedentary time with physical activity. This study aimed to examine the postprandial metabolic effects of breaking sedentary time by accumulating walking and repeated bouts of nonambulatory standing during simulated school days in inactive adolescent girls. METHODS: Seventeen girls (mean ± SD = 12.8 ± 0.4 yr) completed two 3-d experimental conditions. On days 1 and 2 of the standing + walking (STD-WLK) experimental trial, participants interrupted sedentary time by completing 4 × 10 min bouts of self-paced walking and accumulated 18 × 5 min standing bouts during each simulated school day. On day 3 of STD-WLK, participants attended school as normal with no additional physical activity or standing prescribed. On all 3 d of the control condition (CON), participants attended school as normal with no physical activity intervention. On days 2 and 3 of both STD-WLK and CON, a baseline capillary blood sample was provided to determine fasting [TAG] and [glucose]. Participants then consumed a standardized breakfast (0 h) and lunch (4.7 h), and blood samples were provided postprandially at 2.7, 5.3, and 7.3 h for [TAG] and [glucose]. RESULTS: Energy expenditure was 28% (95% confidence interval = 8% to 52%) higher during school hours on day 1 and day 2 during STD-WLK compared with CON (2171 vs 1693 kJ; effect size = 0.89, P = 0.008). However, no reduction of fasting or postprandial [TAG] or [glucose] was observed on day 2 or day 3 ( P ≥ 0.245). CONCLUSIONS: Two consecutive days of breaking prolonged sitting with self-paced walking and intermittent standing had no meaningful effect on postprandial metabolism in adolescent girls.

Seasonal Heat Acclimatisation in Healthy Adults: A Systematic Review.

BACKGROUND: Physiological heat adaptations can be induced following various protocols that use either artificially controlled (i.e. acclimation) or naturally occurring (i.e. acclimatisation) environments. During the summer months in seasonal climates, adequate exposure to outdoor environmental heat stress should lead to transient seasonal heat acclimatisation. OBJECTIVES: The aim of the systematic review was to assess the available literature and characterise seasonal heat acclimatisation during the summer months and identify key factors that influence the magnitude of adaptation. ELIGIBILITY CRITERIA: English language, full-text articles that assessed seasonal heat acclimatisation on the same sample of healthy adults a minimum of 3 months apart were included. DATA SOURCES: Studies were identified using first- and second-order search terms in the databases MEDLINE, SPORTDiscus, CINAHL Plus with Full Text, Scopus and Cochrane, with the last search taking place on 15 July 2021. RISK OF BIAS: Studies were independently assessed by two authors for the risk of bias using a modified version of the McMaster critical review form. DATA EXTRACTION: Data for the following outcome variables were extracted: participant age, sex, body mass, height, body fat percentage, maximal oxygen uptake, time spent exercising outdoors (i.e. intensity, duration, environmental conditions), heat response test (i.e. protocol, time between tests), core temperature, skin temperature, heart rate, whole-body sweat loss, whole-body and local sweat rate, sweat sodium concentration, skin blood flow and plasma volume changes. RESULTS: Twenty-nine studies were included in this systematic review, including 561 participants across eight countries with a mean summer daytime wet-bulb globe temperature (WBGT) of 24.9 °C (range: 19.5-29.8 °C). Two studies reported a reduction in resting core temperature (0.16 °C; p < 0.05), 11 reported an increased sweat rate (range: 0.03-0.53 L·h-1; p < 0.05), two observed a reduced heart rate during a heat response test (range: 3-8 beats·min-1; p < 0.05), and six noted a reduced sweat sodium concentration (range: - 22 to - 59%; p < 0.05) following summer. The adaptations were associated with a mean summer WBGT of 25.2 °C (range: 19.6-28.7 °C). LIMITATIONS: The available studies primarily focussed on healthy male adults and demonstrated large differences in the reporting of factors that influence the development of seasonal heat acclimatisation, namely, exposure time and duration, exercise task and environmental conditions. CONCLUSIONS: Seasonal heat acclimatisation is induced across various climates in healthy adults. The magnitude of adaptation is dependent on a combination of environmental and physical activity characteristics. Providing environmental conditions are conducive to adaptation, the duration and intensity of outdoor physical activity, along with the timing of exposures, can influence seasonal heat acclimatisation. Future research should ensure the documentation of these factors to allow for a better characterisation of seasonal heat acclimatisation. PROSPERO REGISTRATION: CRD42020201883.

Caffeine alters thermoregulatory responses to exercise in the heat only in caffeine-habituated individuals: a double-blind placebo-controlled trial.

To assess the impact of acute caffeine ingestion on thermoregulatory responses during steady-state exercise under moderate heat stress conditions in caffeine-habituated and nonhabituated individuals. Twenty-eight participants [14 habituated (HAB) (4 females) and 14 nonhabituated (NHAB) (6 females)] cycled at a fixed metabolic heat production (7 W·kg-1) for 60 min on two separate occasions 1 h after ingesting 1) 5 mg·kg-1 caffeine (CAF) or 2) 5 mg·kg-1 placebo (PLA), in a double-blinded, randomized, and counterbalanced order. Environmental conditions were 30.6 ± 0.9°C, 31 ± 1% relative humidity (RH). The end-exercise rise in esophageal temperature (ΔTes) from baseline was greater with CAF in the HAB group (CAF = 0.88 ± 0.29°C, PLA = 0.62 ± 0.34°C, P < 0.001), but not in the NHAB group (CAF = 1.00 ± 0.42°C, PLA = 1.00 ± 0.39°C, P = 0.94). For a given change in mean body temperature, rises in % of maximum skin blood flow were attenuated with CAF on the forearm (P = 0.015) and back (P = 0.021) in the HAB group, but not in the NHAB group (P ≥ 0.65). Dry heat loss was similar in the HAB (CAF = 31 ± 5 W·m-2, PLA = 33 ± 7 W·m-2) and NHAB groups (CAF = 31 ± 3 W·m-2, PLA 30 ± 4 W·m-2) (P ≥ 0.37). There were no differences in whole body sweat losses in both groups (HAB: CAF = 0.59 ± 0.15 kg, PLA = 0.56 ± 0.17 kg, NHAB:CAF = 0.53 ± 0.19 kg, PLA 0.52 ± 0.19 kg) (P ≥ 0.32). As the potential for both dry and evaporative heat loss was uninhibited by caffeine, we suggest that the observed ΔTes differences with CAF in the HAB group were due to alterations in internal heat distribution. Our findings support the common practice of participants abstaining from caffeine before participation in thermoregulatory research studies in compensable conditions.NEW & NOTEWORTHY We provide empirical evidence that acute caffeine ingestion exerts a thermoregulatory effect during exercise in the heat in caffeine-habituated individuals but not in nonhabituated individuals. Specifically, caffeine habituation was associated with a greater rise in esophageal temperature with caffeine compared with placebo, which appears to be driven by a blunted skin blood flow response. In contrast, no thermoregulatory differences were observed with caffeine in nonhabituated individuals. Caffeine did not affect sweating responses during exercise in the heat.

Thermoregulation During Pregnancy: a Controlled Trial Investigating the Risk of Maternal Hyperthermia During Exercise in the Heat.

OBJECTIVES: Despite the well-established benefits of exercise, pregnant women are discouraged from physical activity in hot/humid conditions to avoid hyperthermia (core temperature (Tcore) ≥ 39.0 °C). Recent epidemiological evidence also demonstrates greater risk of negative birth outcomes following heat exposure during pregnancy, possibly due to thermoregulatory impairments. We aimed to determine (1) the risk of pregnant women exceeding a Tcore of 39.0 °C during moderate-intensity exercise in the heat; and (2) if any thermoregulatory impairments are evident in pregnant (P) versus non-pregnant (NP) women. METHODS: Thirty participants (15 pregnant in their second trimester or third trimester) completed two separate exercise-heat exposures in a climate chamber (32 °C, 45%RH). On separate occasions, each participant cycled on a semi-recumbent cycle ergometer for 45 min at a workload representative of a moderate-intensity (1) non-weight-bearing (NON-WB), or (2) weight-bearing (WB) activity. Thermoregulatory responses were monitored throughout. RESULTS: The highest rectal temperature observed in a pregnant individual was 37.93 °C. Mean end-exercise rectal temperature did not differ between groups (P:37.53 ± 0.22 °C, NP:37.52 ± 0.34 °C, P = 0.954) in the WB trial, but was lower in the P group (P:37.48 ± 0.25 °C, vs NP:37.73 ± 0.38 °C, P = 0.041) in the NON-WB trial. Whole-body sweat loss was unaltered by pregnancy during WB (P:266 ± 62 g, NP:264 ± 77 g; P = 0.953) and NON-WB P:265 ± 51 g, NP:300 ± 75 g; P = 0.145) exercise. Pregnant participants reported higher ratings of thermal sensation (felt hotter) than their non-pregnant counterparts in the WB trial (P = 0.002) but not in the NON-WB trial, (P = 0.079). CONCLUSION: Pregnant women can perform 45 min of moderate-intensity exercise at 32 °C, 45%RH with very low apparent risk of excessive maternal hyperthermia. No thermoregulatory impairments with pregnancy were observed.

Aerobic fitness as a parameter of importance for labour loss in the heat.

OBJECTIVES: To derive an empirical model for the impact of aerobic fitness (maximal oxygen consumption; V̇O2max in mL∙kg-1∙min-1) on physical work capacity (PWC) in the heat. DESIGN: Prospective, repeated measures. METHODS: Total work completed during 1 h of treadmill walking at a fixed heart rate of 130 b∙min-1 was assessed in 19 young adult males across a variety of warm and hot climate types, characterised by wet-bulb globe temperatures (WBGT) ranging from 12 to 40 °C. For data presentation and obtaining initial parameter estimates for modelling, participants were grouped into low (n = 6, 74 trials), moderate (n = 8, 76 trials), and high (n = 5, 29 trials) fitness, with group mean V̇O2max 42, 52, and 64 mL∙kg-1∙min-1, respectively. For the heated conditions (WBGT 18 to 40 °C), we calculated PWC% by expressing total energy expenditure (kJ above resting) in each trial relative to that achieved in a cool reference condition (WBGT = 12 °C = 100% PWC). RESULTS: The relative reduction in energy expenditure (PWC%) caused by heat was significantly smaller by up to 16% for the fit participants compared to those with lower aerobic capacity. V̇O2max also modulated the relationship between sweat rate and body temperature changes to increasing WBGT. Including individual V̇O2max data in the PWC prediction model increased the predicting power by 4%. CONCLUSIONS: Incorporating individual V̇O2max improved the predictive power of the heat stress index WBGT for Physical Work Capacity in the heat. The largest impact of V̇O2max on PWC was observed at a WBGT between 25 and 35 °C.

Electric fans: A potential stay-at-home cooling strategy during the COVID-19 pandemic this summer?

Current public health guidance designed to protect individuals against extreme heat and the ongoing COVID-19 pandemic is seemingly discordant, yet during the northern hemisphere summer, we are faced with the imminent threat of their simultaneous existence. Here we examine the environmental limits of electric fan-use in the context of the United States summer as a potential stay-at-home cooling strategy that aligns with existing efforts to mitigate the spread of SARS-COV-2.