Identifying the Upper Environmental Limits of Thermal Compensation in Older Human Females Using a Rapid Humidity Ramp Protocol
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 12
- 试验地点
- 2
- 主要终点
- Rectal temperature rate of change
研究概览
简要总结
Climate change increases extreme heat events, elevating global heat-illness risk. Females have reduced heat loss capacity (~5%) compared to males, driven by differences in skin blood flow and sweating responses. While findings on sex-mediated mortality are mixed, some studies suggest older females (≥65 years), face higher heat-related mortality/morbidity risks, evidenced by disproportionate female deaths in the 2021 Western Heat Dome. The effects of extreme uncompensable heat on older females remain understudied.
Heat exposure initially causes net heat gain, raising core/skin temperatures and triggering heat-loss responses. Under compensable heat stress, heat loss balances gain, stabilizing core temperature. Uncompensable heat stress (exceeding maximal dissipation capacity) causes continuous core temperature rise, posing severe health risks. The specific temperature and relative humidity (RH) limits where compensability is lost are critical survival determinants, influenced by age and sex.
Ramping protocols identify these limits: participants face progressively increasing heat stress (e.g., staged humidity rises) while core temperature is monitored. Core temperature typically stabilizes initially, then exhibits an abrupt rapid increase at an inflection point, operationally defined as the limit of compensability. Despite increasing use, ramping protocol validity for accurately identifying this threshold remains unverified.
This project assesses ramping protocol validity for determining uncompensable conditions in older females and evaluates cumulative thermal and cardiovascular strain, as well as psychological and cognitive responses to both uncompensable and compensable heat. Participants will complete five trials. Trial 1 (Ramping): Rest at 42°C, 28% RH for 70min, then incremental RH increases (3% every 10min) to 70% RH. Individual core temperature (rectal) inflection points are identified from the ramping trial. Trials 2-5 (Fixed Conditions, Randomized): i) ~10% below inflection; ii) ~5% below inflection; iii) ~5% above inflection; iv) Thermo-neutral control (26°C, 45% RH). Comparing the rate of rectal temperature change and cumulative strain during prolonged fixed exposures (especially below vs. above inflection) will validate if the ramping inflection point represents the true limit of compensability for older females.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Basic Science
- 盲法
- Double (Participant, Outcomes Assessor)
入排标准
- 年龄范围
- 65 Years 至 85 Years(Older Adult)
- 性别
- Female
- 接受健康志愿者
- 是
入选标准
- •Non-smoking.
- •English or French speaking.
- •Ability to provide informed consent.
- •With or without a) chronic hypertension (elevated resting blood pressure; as defined by Heart and Stroke Canada and Hypertension Canada), b) type 2 diabetes as defined by Diabetes Canada, with at least 5 years having elapsed since time of diagnosis
排除标准
- •Episode(s) of severe hypoglycemia (requiring the assistance of another person) within the previous year, or inability to sense hypoglycemia (hypoglycemia unawareness).
- •Serious complications related to diabetes (gastroparesis, renal disease, uncontrolled hypertension, severe autonomic neuropathy).
- •Uncontrolled hypertension - BP >150 mmHg systolic or >95 mmHg diastolic in a sitting position.
- •Restrictions in physical activity due to disease (e.g. intermittent claudication, renal impairment, active proliferative retinopathy, unstable cardiac or pulmonary disease, disabling stroke, severe arthritis, etc.).
- •Use of or changes in medication judged by the patient or investigators to make participation in this study inadvisable.
- •Cardiac abnormalities identified during screening
研究组 & 干预措施
Humidity-ramp protocol
The humidity-ramp protocol will necessarily be performed first. The order of the fixed-condition exposures will be randomized.
干预措施: Humidity-Ramp Protocol (Other)
Below-inflection fixed-condition heat exposure (5%)
Participants will complete all exposures. The humidity-ramp protocol will necessarily be performed first. The order of the fixed-condition exposures will be randomized.
干预措施: Below-inflection fixed-condition exposure (5%) (Other)
Control fixed-condition heat exposure
Participants will complete all exposures. The humidity-ramp protocol will necessarily be performed first. The order of the fixed-condition exposures will be randomized.
干预措施: Control fixed-condition exposure (Other)
Below-inflection fixed-condition heat exposure (10%)
Participants will complete all exposures. The humidity-ramp protocol will necessarily be performed first. The order of the fixed-condition exposures will be randomized.
干预措施: Below-inflection fixed-condition exposure (10%) (Other)
Above-inflection fixed-condition heat exposure (5%)
Participants will complete all exposures. The humidity-ramp protocol will necessarily be performed first. The order of the fixed-condition exposures will be randomized.
干预措施: Above-inflection fixed-condition exposure (5%) (Other)
结局指标
主要结局
Rectal temperature rate of change
时间窗: End of fixed-condition heat exposure (hour 9 or termination)
Rate of change of rectal temperature measured over the final 2-hours of heat exposure
次要结局
- Number of participants unable to finish fixed-condition heat exposure(End of fixed-condition heat exposure (hour 9 or termination))
- Mean skin temperature rate of change(End of fixed-condition heat exposure (hour 9 or termination))
- Heart rate rate of change(End of fixed-condition heat exposure (hour 9 or termination))
- Heart rate (AUC)(End of fixed-condition heat exposure (hour 9 or termination))
- Thermal sensation(End of fixed-condition heat exposure (hour 9 or termination))
- Thermal comfort(End of fixed-condition heat exposure (hour 9 or termination))
- Sweat rate(End of fixed-condition heat exposure (hour 9 or termination))
- Net fluid loss(End of fixed-condition heat exposure (hour 9 or termination))
- Profiles of Mood States (POMS)(Prior to (hour 0) and at the end of fixed-condition heat exposure (hour 9 or termination))
- Environmental Symptoms Questionnaire (ESQ)(Prior to (hour 0) and at the end of fixed-condition heat exposure (hour 9 or termination))
- Core temperature (AUC)(End of fixed-condition heat exposure (hour 9 or termination))
- Predicted time until 40.2°C esophageal temperature(End of fixed-condition heat exposure (hour 9 or termination))
研究者
Glen P. Kenny
Full Professor
University of Ottawa
