Bioheat modeling of elderly and young for prediction of physiological and thermal responses in heat-stressful conditions

Exposure to hot and humid conditions results in physiological changes in metabolism, cardiac output and thermoregulation of the young adult and these changes deviate with elderly due to aging. The elderly population is more vulnerable than the healthy and young population due to age-weakened physiology and thermoregulatory functions. There are, however, limited bioheat models addressing such changes due to hot exposure in the young and the elderly. This paper develops robust bioheat models for young and elderly while incorporating the physiological changes under exposure to heat-stressful conditions for both age groups the age-related changes in physiology and thermoregulation to an elderly human. However, due to a large variability of thermoregulation among the elderly population, a sensitivity analysis revealed that the average elderly is characterized by metabolic rate and cardiac output, which are lower than those of the young by 21% and 14.4%, respectively. Moreover, the thresholds of the onset of vasodilation and sweating are delayed from those of young adults by 0.5 °C and 0.21 °C, respectively.The elderly and young bioheat models were validated with number of independent published experimental studies under hot exposures in steady and transient conditions. Model predictions of core and mean skin temperatures showed good agreement with published experimental data with a discrepancy of 0.1 °C and 0.5 °C, respectively.     

A new mathematical model to simulate AVA cold-induced vasodilation reaction to local cooling

The purpose of this work was to integrate a new mathematical model with a bioheat model, based on physiology and first principles, to predict thermoregulatory arterio-venous anastomoses (AVA) and cold-induced vasodilation (CIVD) reaction to local cooling. The transient energy balance equations of body segments constrained by thermoregulatory controls were solved numerically to predict segmental core and skin temperatures, and arterial blood flow for given metabolic rate and environmental conditions. Two similar AVA–CIVD mechanisms were incorporated. The first was activated during drop in local skin temperature (<32 °C). The second mechanism was activated at a minimum finger skin temperature, T _{CIVD, min}, where the AVA flow is dilated and constricted once the skin temperature reached a maximum value. The value of T _CIVD,min was determined empirically from values reported in literature for hand immersions in cold fluid. When compared with published data, the model predicted accurately the onset time of CIVD at 25 min and T _CIVD,min at 10 °C for hand exposure to still air at 0 °C. Good agreement was also obtained between predicted finger skin temperature and experimentally published values for repeated immersion in cold water at environmental conditions of 30, 25, and 20 °C. The CIVD thermal response was found related to core body temperature, finger skin temperature, and initial finger sensible heat loss rate upon exposure to cold fluid. The model captured central and local stimulations of the CIVD and accommodated observed variability reported in literature of onset time of CIVD reaction and T _CIVD,min.     

Computer prediction of human thermoregulatory and temperature responses to a wide range of environmental conditions

A mathematical model for predicting human thermal and regulatory responses in cold, cool, neutral, warm, and hot environments has been developed and validated. The multi-segmental passive system, which models the dynamic heat transport within the body and the heat exchange between body parts and the environment, is discussed elsewhere. This paper is concerned with the development of the active system, which simulates the regulatory responses of shivering, sweating, and peripheral vasomotion of unacclimatised subjects. Following a comprehensive literature review, 26 independent experiments were selected that were designed to provoke each of these responses in different circumstances. Regression analysis revealed that skin and head core temperature affect regulatory responses in a non-linear fashion. A further signal, i.e. the rate of change of the mean skin temperature weighted by the skin temperature error signal, was identified as governing the dynamics of thermoregulatory processes in the cold. Verification and validation work was carried out using experimental data obtained from 90 exposures covering a range of steady and transient ambient temperatures between 5°C and 50°C and exercise intensities between 46 W/m² and 600 W/m². Good general agreement with measured data was obtained for regulatory responses, internal temperatures, and the mean and local skin temperatures of unacclimatised humans for the whole spectrum of climatic conditions and for different activity levels. Received: 20 November 2000 / Revised: 24 April 2001 / Accepted: 14 May 2001     

Thermoregulatory consequences of long-term microwave exposure at controlled ambient temperatures

This study was designed to identify and measure changes in thermoregulatory responses, both behavioral and physiological, that may occur when squirrel monkeys are exposed to 2450-MHz continuous wave microwaves 40 hr/week for 15 weeks. Power densities of 1 or 5 mW/cm2 (specific absorption rate = 0.16 W/kg per mW/cm2) were presented at controlled environmental temperatures of 25, 30, or 35 degrees C. Standardized tests, conducted periodically, before, during, and after treatment, assessed changes in thermoregulatory responses. Dependent variables that were measured included body mass, certain blood properties, metabolic heat production, sweating, skin temperatures, deep body temperature, and behavioral responses by which the monkeys selected a preferred environmental temperature. Results showed no reliable alteration of metabolic rate, internal body temperature, blood indices, or thermoregulatory behavior by microwave exposure, although the ambient temperature prevailing during chronic exposure could exert an effect. An increase in sweating rate occurred in the 35 degrees C environment, but sweating was not reliably enhanced by microwave exposure. Skin temperature, reflecting vasomotor state, was reliably influenced by both ambient temperature and microwaves. The most robust consequence of microwave exposure was a reduction in body mass, which appeared to be a function of microwave power density.     

Temperatures of skin, subcutaneous tissue, muscle and core in resting men in cold, comfortable and hot conditions

To examine the core-shell model of temperature distribution and the possible role of subcutaneous temperature in heat regulation, comprehensive temperature measurements were made on six nude resting men exposed for 2-3 h to comfort (27 degrees C), cold (15 degrees C) and heat (45 degrees C). Cold produced strong shivering and heat caused heavy sweating. Temperatures were recorded every 10 min from: esophagus, rectum and auditory canal; back muscle and thigh muscle at 20 mm and 40 mm depths; 6 subcutaneous sites; and 16 skin sites. Average temperatures at these 29 sites were tabulated at the ends of comfort, hot and cold and the onsets of sweating and shivering. Body temperature changes were slow to develop, the skin temperatures being fastest, and successively deeper tissues progressively slower. There was occasional after-drop and after-rise. The data were consistent with the core-shell concept. The temperature gradient from subcutaneous tissue to skin, which differed substantially with comfort, the onset of shivering and the onset of sweating, could serve as a regulatory signal. The data are now in computer format and may be of interest to biothermal modelers.     

Neural control and mechanisms of eccrine sweating during heat stress and exercise.

In humans, evaporative heat loss from eccrine sweat glands is critical for thermoregulation during exercise and/or exposure to hot environmental conditions, particularly when environmental temperature is greater than skin temperature. Since the time of the ancient Greeks, the significance of sweating has been recognized, whereas our understanding of the mechanisms and controllers of sweating has largely developed during the past century. This review initially focuses on the basic mechanisms of eccrine sweat secretion during heat stress and/or exercise along with a review of the primary controllers of thermoregulatory sweating (i.e., internal and skin temperatures). This is followed by a review of key nonthermal factors associated with prolonged heat stress and exercise that have been proposed to modulate the sweating response. Finally, mechanisms pertaining to the effects of heat acclimation and microgravity exposure are presented.     

Physiological responses during continuous work in hot dry and hot humid environments in Indians

Studies have been conducted on six young healthy heat acclimatised Indians to determine the physiological changes in prolonged continuous work in thermally neutral and in hot dry and hot humid environments. Physiological responses in maximal efforts i.e. Vo₂ max, V_E max and Cf max were noted. In addition, duration in continuous work at three sub-maximal rate of work in three simulated environments were also noted. Physiological responses like Vo₂, V_E and Cf were noted every 15 minutes of work. Besides these responses, rectal temperature (Tre), mean skin temperature (T_s) and mean sweat rate were also recorded during continuous work.Results indicated a significant decrease in maximum oxygen uptake capacity (Vo₂ max) in heat with no change in maximum exercise ventilation (V_E max) and maximum cardiac frequency. However, the fall in Vo₂ max was more severe in the hot humid environment than in the hot dry climate. Cardiac frequency at fixed oxygen consumption of 1.0, 1.5 and 2.0 l/min was distinctly higher in the hot humid environment than in the hot dry and comfortable temperature. The duration in continuous physical effort in various grades of activities decreased in hot dry environment from that in the-comfortable climate and further decreased significantly in hot humid environment. The highest rate of sweating was observed during work in humid heat. The mean skin temperature (T_s) showed a fall in all the three rates of work in comfortable and hot dry conditions whereas in hot humid environment it showed a linear rise during the progress of work. The rectal temperature on the other hand maintained a near steady state while working at 65 and 82 watts in comfortable and hot dry environments but kept on rising during work in hot humid environment. At the highest work rate of 98 watts, the rectal temperature showed a steady increase even in the hot dry condition. It was thus concluded from the study that a hot humid climate imposes more constraints on the thermoregulatory system during work than in the hot dry condition because of less effective heat dissipation so resulting in reduced tolerance to work.     

Body Temperatures in the Elderly: A National Study of Physiological,Social, and Environmental Conditions

Two large-scale surveys of body temperatures in elderly people living at home were carried out in the winter of 1972. Most of the homes visited were cold with room temperatures below the minimum recommended by the Department of Health. Deep body temperatures below 35·5°C were found in 10% of those studied, and the difference between the skin temperature and the core temperature was also reduced in this group. Such individuals are at risk of developing hypothermia since they show evidence of some degree of thermoregulatory failure. Further research is needed, but meanwhile there are practical measures that could be taken to reduce the risk of hypothermia in the elderly.     

Seasonal changes in thermal responses of urban residents to cold exposure

To determine whether urban circumpolar residents show seasonal acclimatisation to cold, thermoregulatory responses and thermal perception during cold exposure were examined in young men during January-March (n=7) and August-September (n=8). Subjects were exposed for 24 h to 22 and to 10 degrees C. Rectal (T(rect)) and skin temperatures were measured throughout the exposure. Oxygen consumption (VO(2)), finger skin blood flow (Q(f)), shivering and cold (CDT) and warm detection thresholds (WDT) were assessed four times during the exposure. Ratings of thermal sensations, comfort and tolerance were recorded using subjective judgement scales at 1-h intervals. During winter, subjects had a significantly higher mean skin temperature at both 22 and 10 degrees C compared with summer. However, skin temperatures decreased more at 10 degrees C in winter and remained higher only in the trunk. Finger skin temperature was higher at 22 degrees C, but lower at 10 degrees C in the winter suggesting an enhanced cold-induced vasoconstriction. Similarly, Q(f) decreased more in winter. The cold detection threshold of the hand was shifted to a lower level in the cold, and more substantially in the winter, which was related to lower skin temperatures in winter. Thermal sensations showed only slight seasonal variation. The observed seasonal differences in thermal responses suggest increased preservation of heat especially in the peripheral areas in winter. Blunted vasomotor and skin temperature responses, which are typical for habituation to cold, were not observed in winter. Instead, the responses in winter resemble aggravated reactions of non-cold acclimatised subjects.     

Physiological interaction processes and radio-frequency energy absorption.

Because exposure to microwave fields at the resonant frequency may generate heat deep in the body, hyperthermia may result. This problem has been examined in an animal model to determine both the thresholds for response change and the steady-state thermoregulatory compensation for body heating during exposure at resonant (450 MHz) and supra-resonant (2,450 MHz) frequencies. Adult male squirrel monkeys, held in the far field of an antenna within an anechoic chamber, were exposed (10 min or 90 min) to either 450-MHz or 2,450-MHz CW fields (E polarization) in cool environments. Whole-body SARs ranged from 0-6 W/kg (450 MHz) and 0-9 W/kg (2,450 MHz). Colonic and several skin temperatures, metabolic heat production, and evaporative heat loss were monitored continuously. During brief RF exposures in the cold, the reduction of metabolic heat production was directly proportional to the SAR, but 2,450-MHz energy was a more efficient stimulus than was the resonant frequency. In the steady state, a regulated increase in deep body temperature accompanied exposure at resonance, not unlike that which occurs during exercise. Detailed analyses of the data indicate that temperature changes in the skin are the primary source of the neural signal for a change in physiological interaction processes during RF exposure in the cold.     

Effects of modafinil on heat thermoregulatory responses in humans at rest

The effects of modafinil on heat thermoregulatory responses were studied in 10 male subjects submitted to a sweating test after taking 200 mg of modafinil or placebo. Sweating tests were performed in a hot climatic chamber (45 degrees C, relative humidity <15%, wind speed = 0.8 m x s(-1), duration 1.5 h). Body temperatures (rectal (Tre) and 10 skin temperatures (Tsk)), sweat rate, and metabolic heat production (M) were studied as well as heart rate (HR). Results showed that modafinil induced at the end of the sweating test higher body temperatures increases (0.50 +/- 0.04 versus 0.24 +/- 0.05 degrees C (P < 0.01) for deltaTre and 3.64 +/- 0.16 versus 3.32 +/- 0.16 degrees C (P < 0.05) for deltaTsk (mean skin temperature)) and a decrease in sweating rate throughout the heat exposure (P < 0.05) without change in M, leading to a higher body heat storage (P < 0.05). AHR was also increased, especially at the end of the sweating test (17.95 +/- 1.49 versus 12.52 +/- 1.24 beats/min (P < 0.01)). In conclusion, modafinil induced a slight hyperthermic effect during passive dry heat exposure related to a lower sweat rate, probably by its action on the central nervous system, and this could impair heat tolerance.     

Physiological responses and thermal sensations of the elderly in cold and hot environments

1. 1. 10 elderly and 10 college-aged females served as subjects in cold and heat environments. The subjects changed into the standard clothing (0.63 clo), and stayed in the neutral environment (25°C) for 23 min, thereafter they were exposed to the cold (10°C) or hot (35°C) environment for 49 min.

2. 2. Then they returned to the neutral environment, and stayed there for 47 min. Oral temperature, skin temperatures at 10 sites, blood pressure and thermal sensation were measured during the experiments.

3. 3. In the cold environment, the elderly could not reduce heat loss by vasoconstriction as did young people, and their blood pressures increased more rapidly than in young people. In the hot environment, the elderly could not promote heat loss by vasodilation as did young people. Moreover, there is a delayed sensitivity to cold for the elderly. Therefore, in the houses of the elderly, it is important to have heating and cooling systems which also includes the areas where the people do not stay for a long period of time (e.g. toilet, passageways).

Thermoregulatory responses of middle-aged and young men during dry-heat acclimation

Thermoregulatory responses during heat acclimation were compared between nine young (mean age 21.2 yr) and nine middle-aged men (mean age 46.4 yr) who were matched (P greater than 0.05) for body weight, surface area, surface area-to-weight ratio, percent body fat, and maximal aerobic power. After evaluation in a comfortable environment (22 degrees C, 50% relative humidity), the men were heat acclimated by treadmill walking (1.56 m/s, 5% grade) for two 50-min exercise bouts separated by 10 min of rest for 10 consecutive days in a hot dry (49 degrees C ambient temperature, 20% relative humidity) environment. During the first day of heat exposure performance time was 27 min longer (P less than 0.05) for the middle-aged men, whereas final rectal and skin temperatures and heart rate were lower, and final total body sweat loss was higher (P less than 0.05) compared with the young men. These thermoregulatory advantages for the middle-aged men persisted for the first few days of exercise-heat acclimation (P less than 0.05). After acclimation no thermoregulatory or performance time differences were observed between groups (P greater than 0.05). Sweating sensitivity, esophageal temperature at sweating onset, and the sweating onset time did not differ (P greater than 0.05) between groups either pre- or postacclimatization. Plasma osmolality and sodium concentration were slightly lower for the young men both pre- and postacclimatization; however, both groups had a similar percent change in plasma volume from rest to exercise during these tests.(ABSTRACT TRUNCATED AT 250 WORDS)     

Preferred temperature of the elderly after cold and heat exposures determined by individual self-selection of air temperature

1. 1. The purpose of the study was to investigate the preferred temperature of the elderly after cold and heat exposures.

2. 2. Eight elderly and 9 young females wearing the same type of clothing were exposed to cold (10°C), moderate (25°C) or hot (35°C) environments for 30 min in the exposure room.

3. 3. Then they moved to the self-control room in which the temperature was set at 25°C, and the room temperature increased or decreased continuously by 0.4°C every minute.

4. 4. The subjects were instructed to operate the switch when they felt uncomfortably warm or cool during a 90-min period.

5. 5. In operating the switch, the changing in room temperature shifted to the opposite direction.

6. 6. The ambient temperature was recorded continuously and analyzed as the preferred temperature, which was defined as the midpoint temperature of the crest and trough of temperature records.

7. 7. The preferred temperatures after the cold exposure were significantly higher than those of other exposure conditions in the elderly.

8. 8. On the other hand, in the young, there was no significant difference in the preferred temperature among the exposure conditions.

9. 9. Although the effect of exposure to cold or hot environments decreased in the latter parts of self-control, the elderly still preferred the higher temperature after cold exposure.

Experimental and numerical study of physiological responses in hot environments

This paper proposed a multi-node human thermal model to predict human thermal responses in hot environments. The model was extended based on the Tanabe's work by considering the effects of high temperature on heat production, blood flow rate, and heat exchange coefficients. Five healthy men dressed in shorts were exposed in thermal neutral (29 °C) and high temperature (45 °C) environments. The rectal temperatures and skin temperatures of seven human body segments were continuously measured during the experiment. Validation of this model was conducted with experimental data. The results showed that the current model could accurately predict the skin and core temperatures in terms of the tendency and absolute values. In the human body segments expect calf and trunk, the temperature differences between the experimental data and the predicted results in high temperature environment were smaller than those in the thermally neutral environment conditions. The extended model was proved to be capable of predicting accurately human physiological responses in hot environments.     

Attenuated thermoregulatory sweating and cutaneous vasodilation after 14-day bed rest in humans.

We investigated the effect of head-down bed rest (HDBR) for 14 days on thermoregulatory sweating and cutaneous vasodilation in humans. Fluid intake was ad libitum during HDBR. We induced whole body heating by increasing skin temperature for 1 h with a water-perfused blanket through which hot water (42 degrees C) was circulated. The experimental room was air-conditioned (27 degrees C, 30-40% relative humidity). We measured skin blood flow (chest and forearm), skin temperatures (chest, upper arm, forearm, thigh, and calf), and tympanic temperature. We also measured sweat rate by the ventilated capsule method in which the skin area for measurement was drained by dry air conditioned at 27 degrees C under similar skin temperatures in both trials. We calculated cutaneous vascular conductance (CVC) from the ratio of skin blood flow to mean blood pressure. From tympanic temperature-sweat rate and -CVC relationships, we assessed the threshold temperature and sensitivity as the slope response of variables to a given change in tympanic temperature. HDBR increased the threshold temperature for sweating by 0.31 degrees C at the chest and 0.32 degrees C at the forearm, whereas it reduced sensitivity by 40% at the chest and 31% at the forearm. HDBR increased the threshold temperature for cutaneous vasodilation, whereas it decreased sensitivity. HDBR reduced plasma volume by 11%, whereas it did not change plasma osmolarity. The increase in the threshold temperature for sweating correlated with that for cutaneous vasodilation. In conclusion, HDBR attenuated thermoregulatory sweating and cutaneous vasodilation by increasing the threshold temperature and decreasing sensitivity. HDBR increased the threshold temperature for sweating and cutaneous vasodilation by similar magnitudes, whereas it decreased their sensitivity by different magnitudes.     

Altered thresholds for thermoregulatory sweating and vasodilatation in anorexia nervosa.

The changes in peripheral (hand) blood flow that occurred when deep body temperature was raised were measured in 13 patients with anorexia nervosa and 13 control subjects. The relation between blood flow and core temperature was shifted to the left in the patients with anorexia, with the onset of vasodilatation occurring at lower core and mean skin temperatures: no significant differences in the slopes of the responses were evident. The onset of thermal sweating occurred at lower core and mean skin temperatures in the patients with anorexia than in the controls. After ingestion of a high-energy liquid meal core temperature increased in the patients, and this was accompanied by a significant rise in peripheral blood flow in most cases. A similar meal in the normal subjects was followed by either no change in core temperature or a slight fall, and no consistent change in peripheral blood flow. These findings suggest that the lowering of thresholds for thermoregulatory sweating and vasodilatation may be a contributory factor to the abnormally low core temperature of patients with anorexia and may also explain some of their common complaints relating to feelings of warmth in the hands and feet after meals.     

Thermoregulation during rest and exercise in the cold in pre- and early pubescent boys and in young men.

Eight minimally dressed pre- and early pubescent boys (age 11-12 yr) and 11 young adult men (age 19-34 yr) rested for 20 min and exercised on a cycle ergometer for 40 min at approximately 30% of their maximum oxygen consumption (VO2max) at 5 degrees C. To quantify the added increase in metabolic rate because of cold, a separate test was carried out at 21 degrees C at rest and at equal work rates as in the cold. Both groups were similar in subcutaneous fat thickness and VO2max per kilogram body weight. Rectal temperature increased slightly during the exposure to the cold, but no significant difference was observed between the boys and men. In the cold, the boys had lower skin temperatures than the adults in their extremities but not in the trunk. The boys increased their metabolic rates in the cold more than did the men. As a result, the boys maintained their core temperature as effectively as the adults. Similar age-related differences in thermoregulatory responses to cold were observed when two boys and two men with equal body sizes were compared. Our results suggest that there may be maturation-related differences in thermoregulation in the cold between children and adults.     

Individual variability in the peripheral and core interthreshold zones

The purpose of the study was to investigate the degree of subject variability in the peripheral and core temperature thresholds of the onset of shivering and sweating. Nine healthy young male subjects participated in three trials. In the first two trials, wearing only shorts, they were exposed to air temperatures of 5 degrees C and 40 degrees C until the onset of shivering and sweating, respectively. In the second experiment, subjects wore a water perfused suit that was perfused with 25 degrees C water at a rate of 600 cc/min. They exercised on an ergometer at 50% of their maximum work rate for 10-15 min. At the onset of sweating, the exercise was terminated, and they remained seated until the onset of shivering, as reflected in oxygen uptake. In the first two trials, rectal temperature (Tre) was stable, despite displacements in skin temperature (Tsk), whereas in the third trial, Tsk (measured at four sites) was almost constant (30-32 degrees C), and the thermoregulatory responses were initiated due to changes in Tre alone. The results of the first two trials established the peripheral interthreshold zone, whereas the results of the third trial established the core interthreshold zone. The results demonstrated individual variability in the peripheral and core interthreshold zones, a proportional correlation between both zones (r=0.87), and a relatively higher contribution of adiposity in both zones as compared with those of other non-thermal factors such as height, weight, body surface area, surface area-to mass ratio, and the maximum work load.     

Decreased ability to cope with heat and cold linked to a dysfunction in a central dopaminergic pathway in elderly rats

Rectal and tail skin temperature was measured in lightly restrained rats aged 2 to 24 months after either drug injection or exposure to a hot or cold environment. At 18 months the rats were significantly less able to maintain their core temperature within the physiological range when subjected to a heat load, and this deficit was even more pronounced at 24 months, when an inability to maintain their core temperature in the cold was also evident. The hypothermic response of 24 month old rats to apomorphine and amphetamine was significantly less than that in 2 month old rats. In contrast, the elderly animals were more susceptible to the hypothermic effects of oxotremorine. These results suggest that a dysfunction in a dopaminergic pathway in the central nervous system can, at least in part, explain the inability of elderly rats to cope with heat stress.