Wet Cloth Research Articles

Low back pain among mineworkers in relation to driving, cold environment and ergonomics

Objectives: We aimed to study the association between low back pain (LBP) and exposure to low temperature, wet clothes, heavy lifting and jobs that involve whole body vibration (WBV) in a population of miners. Methods: Health and personal data were collected in a population study by a questionnaire. A total of 3530 workers from four mines participated in the study. Results: 51% of the workers reported LBP within the last 12 months. The adjusted odds ratio for LBP was above unity for working with wet clothes (1.82), working in cold conditions (1.52), lifting heavy (1.54), having worked as a driver previously (1.79) and driving Toro400 (2.61) or train (1.69). Conclusion: Wet clothing, cold working conditions, heavy lifting, previous work as a driver and driving certain vehicles were associated with LBP, but vehicles with WBV levels above action value were not. For better prevention of LBP, improved cabin conditions and clothing should be emphasised.

Application of dissolving microneedles to glucose monitoring through dermal interstitial fluid.

Dissolving microneedles (DMs) were applied to glucose monitoring in the dermal interstitial fluid (ISF) of rats and their potential as an alternative blood glucose monitoring device was evaluated. Sodium chondroitin sulfate was used to prepare DM array chips, which consisted of 300 DMs/cm(2). The mean length of the DMs was 475±18 µm and the mean diameter of the basement was 278±8 µm. After DMs were inserted into the skin of the hair-removed rat abdomen, a wet unwoven cloth containing 10-30 µL of water was placed on the skin and ISF was extracted. By increasing the absorbed amount of water on the unwoven cloth from 10 to 30 µL, the extracted amount of glucose increased from 1.66±0.35 µg to 2.75±0.61 µg. Increasing the adhesion time of the wet unwoven cloth to the skin from 0.1 to 5.0 min, increased the amount of ISF glucose from 1.99±0.13 µg to 5.04±0.38 µg. The relation between the amount of glucose in ISF and blood glucose concentrations was examined. With increase in the adhesion time, the coefficient of determination, r(2), increased from 0.501 to 0.750. The number of DMs also affected the relationship and values of the coefficient of determinations, r(2) were: 0.340 (25 DMs), 0.758 (50 DMs), 0.763 (100 DMs), 0.774 (200 DMs), and 0.762 (300 DMs). These results indicate the usefulness of DMs as an alternative blood glucose monitoring device.

Practice for reducing contamination of controlled area under the influence of Fukushima nuclear accident

The Facility of Radiation Standards (FRS) of the Japan Atomic Energy Agency provides various radiation fields for calibration and testing. Radioactive materials discharged by the Fukushima nuclear accident contaminated around the FRS including inside radiation controlled areas, even though the FRS is located 120 km away from there. A month after the accident, the maximum contamination level in the controlled areas was 7.3 Bq/cm. Cs, Cs, I, Te and I were identified by γ-ray spectrometry. As for the FRS, practices for reducing contamination in the controlled areas were indispensable to keep the facility running under contaminated environment. The following two practices were found to be effective: 1) decontamination by wiping out with a wet cloth or steam cleaners, and 2) to prevent dust with contaminants from entering into the controlled areas. As a result, contamination inside the controlled areas decreased and was maintained to be dozens of times lower as compared with the outside.

A study of occupational health and safety measures in the Laundry Department of a private tertiary care teaching hospital, Bengaluru.

Introduction:The Laundry Department plays an important role in preventing the spread of infection and continuously supplying clean linen to various departments in any hospital.Objectives of the Study:To identify existing practices and occupational safety and health (OSH) measures in the Laundry Department and to assess the use of personal protective equipments (PPEs) among health care workers.Materials and Methods:A cross-sectional study was carried out in a private tertiary care teaching hospital. An observation checklist was developed, which was partially based on occupational hazard checklist of OSHA for Laundry Department. This was field tested and validated for applicability for this study.Results:The potential biological hazards are infections through exposure to aerosols, spills and splashes during various activities, fungal infection due to wet clothes and environment and infections through fomites. The potential physical hazards are injuries due to slips and falls, exposure to heat, humidity, dust, noise, and vibration. The potential chemical hazards are contact dermatitis and allergic asthma due to exposure to detergents, phenyl solution, bleaching powder, and soap oil solution. The potential ergonomic hazards are musculoskeletal diseases and repetitive stress injuries at the shoulder, elbow, and small joints of the hands. PPEs were not used consistently in most areas of the department.

The development and initial validation of a virtual dripping sweat rate and a clothing wetness ratio for use in predictive heat strain models

This paper applies the heat balance equation (HBE) for clothed subjects as a linear function of mean skin temperature (t sk ) by a new sweating efficiency (η sw ) and an approximation for the thermoregulatory sweat rate. The equation predicting t sk in steady state conditions was derived as the solution of the HBE and used for a predictive heat strain scale. The heat loss from the wet clothing (WCL) area was identified with a new variable of 'virtual dripping sweat rate VDSR' (S wdr ). This is a subject's un-evaporated sweat rate in dry clothing from the regional sweat rate exceeding the maximum evaporative capacity, and adds the moisture to the clothing, reducing the intrinsic clothing insulation. The S wdr allowed a mass balance analysis of the wet clothing area identified as clothing wetness (w cl ). The w cl was derived by combining the HBE at the WCL surface from which the evaporation rate and skin heat loss from WCL region are given. Experimental results on eight young male subjects wearing typical summer clothing, T-shirt and trousers verified the model for predicting t sk with WCL thermal resistance (R cl,w ) identified as 25 % of dry clothing (R cl,d ).

English

The present study aimed to establish the correlation between the external surface area of right frontal bone and crown rump length and hence predict the approximate fetal age from the crown rump length. Simultaneously growth pattern and rate of growth of frontal bone could be calculated. Fifty apparently normal fetuses ranging from 12 cm - 42 cm crown rump length of both sexes were obtained from the department of obstetrics and gynecology, Sassoon Hospital Pune. The foetuses were macerated to isolate the right frontal bone. The bone was subsequently cleaned and dried. The external surface area was measured. These measurements were tabulated and statistically analysed. A linear correlation was observed between the external surface of frontal bone & the crown rump length. INTRODUCTION: The skull is composed of the neurocranium which surrounds the brain, eyes and inner plus middle ears, and the viscerocranium which is derived from the frontonasal and first arch mesenchyme and forms the facial skeleton. The whole of the viscerocranium is neural crest-derived; the neurocranium (skull vault and the skull base) is derived from mesenchyme of both neural crest and mesodermal origin1. Apart from the classic work of Scammon and Calkins2 very few studies have been concerned specifically with human prenatal cephalometrics. Hence the study aimed at deriving a Regression equation to estimate the crown- rump length and the approximate age of foetus. MATERIAL AND METHODS: Human fetuses for the purpose of the present work were collected from the Department of obstetrics and gynecology in Sassoon Hospital, Pune. The fetuses were obtained from Medical Termination of Pregnancy done for various reasons. Fresh fetuses which appeared to be normal were selected for the present study. Skull bones from the fetuses were obtained after maceration, cleaning & drying. Wet thin cotton cloth was pasted on the external surface of individual skull bones. The cloth was accurately trimmed to the tune of the bone margins. The cloth was then detached from the bone and spread out on a graph paper. Then an outline was drawn along the margins of spread cotton piece over the graph paper. Area under the graph was then calculated

Don't give up on wound protectors yet

Dear Editor,IreadwithinterestthepaperpublishedbyDr.LauscherJCandcolleagues [1] reporting the results of randomized trial com-paring wound ring plastic drapes vs simple wet cloth towels toprevent surgical site infections (SSI) after laparoscopic colo-rectal surgery. The authors concluded that “ring drapes do notreduce the rate of SSIs in laparoscopic colorectal surgery”.Inmy opinion, the authors are wrong in drawing such a conclu-sion. Their trial had to be prematurely stopped due to recruit-ment problems, so it is clear that the results should beinterpretedwithcautionbecauseoflackofpower.Anyabsenceofstatisticallysignificantdifferencecanbetheoreticallyrelatedto a beta-error (concluding on a false equivalence). Further-more,insteadofdiscussinghowsurgeonscandecreasetherateofSSIswithothermeans,theauthorsshouldinfactdiscussthelimitations of their trial. Because of these flaws, the presenttrial does not involve any evidence allowing us to abandonwound protectors in our daily practice. Once again we arefacing in surgical literature a randomized trial which does notreach optimal quality to answer our questions in this field [2].Recently, a meta-analysis (published following the acceptanceofthepresentpaperforpublication)concludedthat(atleastforopen digestive surgery) wound protectors do reduce rates ofSSIs by half, the differences being significant with dual-ringimpervious plastic protectors [ 3]. The number needed to treatwas as low as ten patients to prevent one SSI. I do not thinklaparoscopicsurgeryshouldberegardeddifferentlyfromopensurgery concerning the preventive measures against the risk ofwound infection. From an ethical aspect and by taking intoaccount the results of the published meta-analysis [3] and theflaws of the present trial [1], we cannot give up yet woundprotectors whether in open or laparoscopic surgery.

Extreme weather-related health needs of people who are homeless

To identify the extreme weather-related health needs of homeless people and the response by homeless service providers in Adelaide, South Australia, a five-phased qualitative interpretive study was undertaken. (1) Literature review, followed by semi-structured interviews with 25 homeless people to ascertain health needs during extreme weather events. (2) Identification of homeless services. (3) Semi-structured interviews with 16 homeless service providers regarding their response to the health needs of homeless people at times of extreme weather. (4) Gap analysis. (5) Suggestions for policy and planning. People experiencing homelessness describe adverse health impacts more from extreme cold, than extreme hot weather. They considered their health suffered more, because of wet bedding, clothes and shoes. They felt more depressed and less able to keep themselves well during cold, wet winters. However, homeless service providers were more focussed on planning for extra service responses during times of extreme heat rather than extreme cold. Even though a city may be considered to have a temperate climate with a history of very hot summers, primary homeless populations have health needs during winter months. The experiences and needs of homeless people should be considered in extreme weather policy and when planning responses.

Do New Wipe Materials Outperform Traditional Lead Dust Cleaning Methods?

Government guidelines have traditionally recommended the use of wet mopping, sponging, or vacuuming for removal of lead-contaminated dust from hard surfaces in homes. The emergence of new technologies, such as the electrostatic dry cloth and wet disposable clothes used on mopheads, for removal of dust provides an opportunity to evaluate their ability to remove lead compared with more established methods. The purpose of this study was to determine if relative differences exist between two new and two older methods for removal of lead-contaminated dust (LCD) from three wood surfaces that were characterized by different roughness or texture. Standard leaded dust, <75 μm, was deposited by gravity onto the wood specimens. Specimens were cleaned using an automated device. Electrostatic dry cloths (dry Swiffer), wet Swiffer cloths, paper shop towels with non-ionic detergent, and vacuuming were used for cleaning LCD from the specimens. Lead analysis was by anodic stripping voltammetry. After the cleaning study was conducted, a study of the coefficient of friction was performed for each wipe material. Analysis of variance was used to evaluate the surface and cleaning methods. There were significant interactions between cleaning method and surface types, p = 0.007. Cleaning method was found be a significant factor in removal of lead, p <0.001, indicating that effectiveness of each cleaning methods is different. However, cleaning was not affected by types of surfaces. The coefficient of friction, significantly different among the three wipes, is likely to influence the cleaning action. Cleaning method appears to be more important than texture in LCD removal from hard surfaces. There are some small but important factors in cleaning LCD from hard surfaces, including the limits of a Swiffer mop to conform to curved surfaces and the efficiency of the wetted shop towel and vacuuming for cleaning all surface textures. The mean percentage reduction in lead dust achieved by the traditional methods (vacuuming and wet wiping) was greater and more consistent compared to the new methods (electrostatic dry cloth and wet Swiffer mop). Vacuuming and wet wiping achieved lead reductions of 92% ± 4% and 91%, ± 4%, respectively, while the electrostatic dry cloth and wet Swiffer mops achieved lead reductions of only 89 ± 8% and 81 ± 17%, respectively.

Image formation of the Turin Shroud: Hypothesis based on water vapor effects of light absorption

The Shroud of Turin displays a weak front and back body image which inter alia is very superficial and possesses three-dimensional properties. Up to now it has been impossible to reproduce all its characteristics at the same time albeit several attempts were made in many laboratories. But lately, coloration similar to that of the Shroud has been imprinted on dry linen cloths with a powerful VUV radiation of an excimer laser, which however does not exclude the fact that a different laser source could do the same. In fact, a new hypothesis is advanced here which is based on the irradiation of wet linen cloths with a short and powerful pulse of a CO2laser. Besides the well known features of pulsed IR laser, the hypothesis is based solely on the peculiar optical and thermal properties of water and vapor, and therein an experimental investigation is proposed to prove its validity. Key words: Body image, Shroud of Turin, light, lasers, heat, vapor.

Wischnewski spots and hypothermia: sensitive, specific, or serendipitous?

Hypothermia develops when regulatory mechanisms suchas vasoconstriction and heat production fail to compensatefor heat loss to the environment and the core temperature ofthe body falls below 35 C. Severe cases may be fatal withdeath resulting from myocardial ischemia and/or hypoxia,exacerbated by electrolyte abnormalities and elevated cat-echolamine levels. The mortality rate exceeds 70 % whenthe core temperature drops to 30 C, and reaches 90 % at26 C[1, 2].Causes of hypothermia include accidental exposure tolow environmental temperatures, either outdoors or inside,the latter occurring from inadequately heated houses. It hasbeen shown that hypothermic deaths may occur in areaswhere the external temperatures are not markedly lowered.Exacerbating factors include damp conditions, inadequateor wet clothing and air movement [3]. Individual suscep-tibility is increased by the ingestion of alcohol and certainprescribed or illicit drugs. In addition, low muscle mass,immobility, trauma, open injuries, and certain cardiovas-cular, neurological, endocrine and psychiatric disordersincrease the risk. An age-related susceptibility is alsofound, with children and the elderly being the most vul-nerable [1].The pathological diagnosis of hypothermia may be dif-ficult, as body temperatures at the time of death are usuallynot available at autopsy and so the circumstances of deathare of considerable importance in formulating the diagno-sis. In addition, morphological features are subtle and notwell understood. Characteristic findings that have beendescribed at autopsy include pinkish discoloration of theskin over the extensor surfaces of large joints, such as theelbows, knees and hips, acute pancreatic inflammation withfat necrosis, fatty change in cells of the heart, liver andkidneys, skeletal muscle hemorrhage, vacuolization ofrenal tubular cells, and superficial gastric lesions that havebeen called Wischnewski spots [1, 2, 4–7]. It is the latterfinding that we would like to examine in greater detail.In 1895 a Russian district medical officer, SM Wisch-newski, reported multiple superficial hemorrhagic lesionsof the gastric mucosa in 91 % of the cases of fatal hypo-thermia that he had examined. A contemporary translationof his original paper states: ‘‘On the mucous membrane ofthe stomach in humans who have died exclusively from theeffects of low temperatures, 5–100 hemorrhages areinvariably present. Their size ranges from 0.5 to 1.0 cm.They have a round to oval form. Sometimes they arepunctiform and lie about 1–2 inches apart. These hemor-rhages are raised slightly above the surface of the mucousmembrane, can be very easily scrapped (sic) away andleave behind nothing conspicuous on the gastric mucosa.’’[8] (Fig. 1). They have also been documented in ectopi-cally situated gastric mucosa [9].Although Wischnewski described raised hemorrhagicareas that could be easily removed from the mucosa, theywere subsequently considered to be ulcers or erosions[3, 10, 11]. In an immunohistochemical study by Tsokoset al. however it was proposed that the lesions resultedfrom the action of gastric acid on hemoglobin in areas ofinterstitial mucosal hemorrhage, and not from ulceration[7]. A photomicrograph in a chapter by Madea et al. [2](Fig. 1.4B) clearly demonstrates protrusion of one of thespots above the surface of the surrounding mucosa, and notulceration. Conversely, Hirvonen and Elfving reportedthat the erosions extended ‘‘halfway through the mucosa’’and that hemorrhage was ‘‘not always present’’ [12].

Ring drape do not protect against surgical site infections in colorectal surgery: a randomised controlled study

Surgical site infections (SSIs) remain a major problem in colorectal surgery. In this prospective, randomised study, we compared two kinds of wound protection, namely, "plastic ring drape" versus "standard cloth towels". One hundred one patients were randomised to the control group (wet cloth towels) and 98 to the study cohort (ring drape). SSIs were classified according to Centers for Disease Control and Prevention recommendations. In the control group, 30 patients had an SSI, whereas 20 did so in the study group. This difference was not significant (p = 0.131). Plastic ring drape for wound protection does not guard against SSIs in colorectal surgery.

Physical simulation of wet clothing for virtual humans

We present a technique that simulates wet garments for virtual humans with realistic folds and wrinkles. Our approach combines three new models to allow realistic simulation of wet garments: (1) a simplified saturation model that modifies the masses, (2) a nonlinear friction model derived from previously reported, real-world measurements, and (3) a wrinkle model based on imperfection sensitivity theory. In contrast to previous approaches to wet cloth, the proposed models are supported by the experimental results reported in the textile literature with parameters varying over the course of the simulation. As a result, the wet garment motions simulated by our method are comparable to that of real wet garments. Our approach recognizes the special, practical importance of contact models with human skin and provides a specific skin-cloth friction solution. We evaluate our approach by draping a rotating sphere and simulating a typical garment on a virtual human in the rain. Both of these examples are typical scenarios within computer graphics research.

Competence to Provide Urinary Incontinence Care in Taiwan's Nursing Homes

Nursing staff play an essential role in ensuring the quality of continence care in nursing homes. The purpose of this study was to describe the level of competence (knowledge, attitudes, and practice behaviors) of urinary incontinence (UI) care in nursing home staff in Taiwan. A cross-sectional postal survey was used to gather self-reported data from an island-wide sample of 195 nurses and 99 nurse assistants (NAs) in Taiwan. Participants completed the UI knowledge, the UI attitude, and the practice behaviors of UI care scales. The level of UI knowledge in nurses was higher than that of NAs, although nurses had less-positive attitudes than NAs. Reported practice behaviors of UI care did not differ between nurses and NAs. Changes of wet clothes, linens, and diapers were the most commonly reported practice behaviors. Information-gathering, physical examination, and pelvic floor muscle exercises were performed less commonly in nursing homes. Knowledge and positive attitudes regarding UI need to be improved in both nurses and NAs in nursing homes. Several deficits were found in practice behaviors of UI care. A competency-based education approach is suggested to enable awareness of UI and cultural changes on individual and institutional levels.

Protection against Cold in Prehospital Care: Evaporative Heat Loss Reduction by Wet Clothing Removal or the Addition of a Vapor Barrier—A Thermal Manikin Study

In the prehospital care of a cold and wet person, early application of adequate insulation is of utmost importance to reduce cold stress, limit body core cooling, and prevent deterioration of the patient's condition. Most prehospital guidelines on protection against cold recommend the removal of wet clothing prior to insulation, and some also recommend the use of a waterproof vapor barrier to reduce evaporative heat loss. However, there is little scientific evidence of the effectiveness of these measures. Using a thermal manikin with wet clothing, this study was conducted to determine the effect of wet clothing removal or the addition of a vapor barrier on thermal insulation and evaporative heat loss using different amounts of insulation in both warm and cold ambient conditions. A thermal manikin dressed in wet clothing was set up in accordance with the European Standard for assessing requirements of sleeping bags, modified for wet heat loss determination, and the climatic chamber was set to -15 degrees Celsius (°C) for cold conditions and +10°C for warm conditions. Three different insulation ensembles, one, two or seven woollen blankets, were chosen to provide different levels of insulation. Five different test conditions were evaluated for all three levels of insulation ensembles: (1) dry underwear; (2) dry underwear with a vapor barrier; (3) wet underwear; (4) wet underwear with a vapor barrier; and (5) no underwear. Dry and wet heat loss and thermal resistance were determined from continuous monitoring of ambient air temperature, manikin surface temperature, heat flux and evaporative mass loss rate. Independent of insulation thickness or ambient temperature, the removal of wet clothing or the addition of a vapor barrier resulted in a reduction in total heat loss of 19-42%. The absolute heat loss reduction was greater, however, and thus clinically more important in cold environments when little insulation is available. A similar reduction in total heat loss was also achieved by increasing the insulation from one to two blankets or from two to seven blankets. Wet clothing removal or the addition of a vapor barrier effectively reduced evaporative heat loss and might thus be of great importance in prehospital rescue scenarios in cold environments with limited insulation available, such as in mass-casualty situations or during protracted evacuations in harsh conditions.

Mine! by S. Crum

Crum, Shutta. Mine! Illus. Patrice Barton. New York: Alfred A. Knopf, 2011. Print. The dust jacket notes for Mine! tells us that it is about “two very young children and an adorable dog navigating the trials and triumphs of sharing.” In keeping with this theme, apart from a single “Woof?” barked by the dog, the only text is the word “mine” repeated ten times. However, when the pictures are left to tell the story, the text is really superfluous. Artist Patrice Barton has captured the chaos that happens when you put a baby, a toddler, a pile of toys, a dog, and a dog dish full of water all together in the same space without parental interference. The result is soaked children, water and wet toys thrown everywhere, and of course, a dripping dog. Children will love trying to find where all the different toys have gone from picture to picture. While the images are done in soft pastels, rather than the bright and bold colours we might expect to find in books for very young children, they are nonetheless engaging. Throughout, Barton manages to communicate movement in the images. Swoosh lines follow flying feet, jiggle lines show us the baby’s unsteady movement, and dashed lines show us where the balls or toys have flown or bounced. Over the course of the chaos, there is a delightful four page sequence where the baby stands up, totters across two pages and, overleaf, takes a flying leap, flattening the toddler, and sending the wet toys flying everywhere. That, of course, is the point where the adults reappear and begin picking up wet children and clothing. Because of all the wet and wild action in the book, the theme of sharing, or rather, not sharing, gets lost. So as a book with a message, Mine! does not work particularly well. However, both children and parents will enjoy the entertaining picture story. Recommendation: 3 stars out of 4 Reviewer: Sandy Campbell Sandy is a Health Sciences Librarian at the University of Alberta, who has written hundreds of book reviews across many disciplines. Sandy thinks that sharing books with children is one of the greatest gifts anyone can give.

Performance evaluation of an on‐site volume reduction system with synthetic urine using a water transport model

The parameters of a model of the transport of water from a wet cloth sheet to the air, developed for deionized water, to establish design procedures of an on‐site volume reduction system, were identified for high salt concentrations present in synthetic urine. The results showed that the water penetration was affected neither by the salts, urea or creatinine present in the synthetic urine nor by the salts accumulated on the surface of the vertical gauze sheet. However, the saturated vapour pressure decreased, leading to reduction in the evaporation rate, which occurred as a result of the salts accumulating on the surface of the vertical gauze sheet. Furthermore, a steady‐state evaporation condition was established, illustrating salts falling back to the tank from the vertical gauze sheet. Accordingly, the existing design procedure was amended by incorporating the calculation procedure for the saturated vapour pressure using Raoult's law. Subsequently, the effective evaporation area of the vertical gauze sheet was estimated using the amended deign procedures to assess feasibility. This estimation showed that the arid, tropical, temperate and cold climates are suitable for the operation of this system, which require requires a small place at household level for 80% volume reduction of 10 L of urine per day for 12 hours' operation in the daytime.

The perceived temperature – a versatile index for the assessment of the human thermal environment. Part A: scientific basics

The Perceived Temperature (PT) is an equivalent temperature based on a complete heat budget model of the human body. It has proved its suitability for numerous applications across a wide variety of scales from micro to global and is successfully used both in daily forecasts and climatological studies. PT is designed for staying outdoors and is defined as the air temperature of a reference environment in which the thermal perception would be the same as in the actual environment. The calculation is performed for a reference subject with an internal heat production of 135 W m(-2) (who is walking at 4 km h(-1) on flat ground). In the reference environment, the mean radiant temperature equals the air temperature and wind velocity is reduced to a slight draught. The water vapour pressure remains unchanged. Under warm/humid conditions, however, it is implicitly related to a relative humidity of 50%. Clothing is adapted in order to achieve thermal comfort. If this is impossible, cold or heat stress will occur, respectively. The assessment of thermal perception by means of PT is based on Fanger's Predicted Mean Vote (PMV) together with additional model extensions taking account of stronger deviations from thermal neutrality. This is performed using a parameterisation based on a two-node model. In the cold, it allows the mean skin temperature to drop below the comfort value. In the heat, it assesses additionally the enthalpy of sweat-moistened skin and of wet clothes. PT has the advantages of being self-explanatory due to its deviation from air temperature and being--via PMV--directly linked to a thermo-physiologically-based scale of thermal perception that is widely used and has stood the test of time. This paper explains in detail the basic equations of the human heat budget and the coefficients of the parameterisations.

One Final Sip

The patient was in his 70s but appeared much older. Speaking in broken sentences, he nervously stated that he could not breathe. With each exhalation there were discomforting squeaks and whistles; with each intake of breath his nostrils widened, the muscles on his neck contracted, and his belly moved down towards his torso, making shallow craters in his abdominal wall. His lips had a bluish hue, and he said in barely discernible speech, “I have cancer.” There was guilt in his voice. “I’m so sorry,” he said, “I’m so sorry.” The physician grabbed the man’s cool and clammy fingers, and rested them firmly against the palms of his hands while his internal autopilot shouted audible orders. “I need 125 milligrams of Solumedrol. He’s tiring out. I need 40 milligrams of Lasix. Someone get him a breathing treatment!”

Core Temperature Response to Alternating Sedentary Water Immersion and Wet Clothing Air Exposure

Hypothermia incurred during training exposure to cold leads to lost training time and possible injury or death. Certain exercises do not occur in particularly cold atmospheres; however, they may involve water immersion and time out of water in wet clothing. Wet clothing results in greater conductive, convective, and evaporative heat loss than dry clothing. This may contribute to hypothermia. PURPOSE: To observe trainee gastro-intestinal temperature (TGI) responses that occur in different water and air conditions and how these responses may be helpful to monitor trainees' safety. METHODS: TGI responses were measured on three occasions (E1, E2, and E3) using an ingestible thermistor consumed > 4hr prior to the first measurement. Group characteristics are as follows: E1 - N=30, height 177 ± 5 cm, body mass 77 ± 7 kg; E2 - N=20, height 177 ± 5 cm, body mass 75 ± 6 kg; E3 - N=69, height 178 ± 7 cm; body mass 77 ± 8 kg. Ambient air temperature (Ta), wind velocity (Vw) and water temperature (Tw) were: E1 14.6°C, 3.3 m·s-1, 15.6°C; E2 14.5°C, 1.0 m·s-1, 17.2°C; E3 19.9°C, 0.5 m·s-1, 18.3°C. The duration of immersion and time on shore in wet clothing were; 38 min, 21 min; 25 min, 12 min; and 33 min, 22min, respectively for E1, E2, and E3. RESULTS: In all exercises mean TGI significantly decreased from the start of the exercise to the end; E1 37.4 ± 0.4°C to 35.3 ± 0.7°C (p<0.01); E2 37.7 ± 0.4°C to 36.5 ± 0.8°C (p<0.01); E3 37.2 ±.04°C to 36.6 ± 0.5°C (p<0.01). Significantly different mean rates of TGI decrease were observed between E1 (-0.04 ± 0.01 °C·min-1) and E3 (-0.01 ± 0.01 °C·min-1) (p<0.01) as well as between E2 (-0.03 ± 0.02 °C·min-1) and E3 (-0.01 ± 0.01 °C·min-1) (p<0.01). E1 and E2 rates of decrease did not differ. CONCLUSION: Although the temperatures experienced by the trainees may be considered moderate, rapid cooling rates were observed. Significantly different rates of TGI decrease between E2 and E3 despite experiencing similar Tw emphasizes that immersion is not the only aspect of body temperature drop during these exercises. Therefore in order to minimize hypothermic risk and potentially lost training time, exposure guidance for exercises that occur in water as well as on land in wet clothing should incorporate Tw, Ta, and Vw as all these factors may affect the rate of body temperature drop.