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Thermoregulatory Responses to Acute Exercise‐Heat Stress and Heat Acclimation

Michael N. Sawka, C. Bruce Wenger, Kent B. Pandolf

10.1002/cphy.cp040109

Source: Supplement 14: Handbook of Physiology, Environmental Physiology

Originally published: 1996

Published online: January 2011

Full Article on Wiley Online Library



Abstract

The sections in this article are:

1 Heat Stress
2 Thermoregulatory Control
3 Core Temperature
3.1 Measurement of Core Temperature
3.2 Core Temperature Responses to Exercise
4 Metabolism
4.1 Metabolic Rate
4.2 Skeletal Muscle Metabolism
4.3 Acclimation
5 Heat Loss Mechanisms
5.1 Evaporation
5.2 Heat Loss and Skin Blood Flow
5.3 Cardiovascular Support for Thermoregulation and Exercise
6 Heat Acclimation
6.1 Induction and Decay
6.2 Underlying Mechanisms
6.3 Dry vs Humid Heat
7 Biomedical Factors Modifying Exercise‐Heat Performance
7.1 Aerobic Fitness
7.2 Dehydration
7.3 Circadian Patterns and Sleep Loss
7.4 Skin Disorders
7.5 Medications
8 Specific Populations
8.1 Women
8.2 Blacks
8.3 Children and Older Adults
8.4 Spinal Cord Injury
Figure 1. Figure 1.

Wet‐bulb globe temperature (WBGT) during July in the Northern Hemisphere 99.
Figure 2. Figure 2.

Relationships of back sweating rate 190, forearm blood flow 243, and forearm venous volume 241 to esophageal and mean skin temperatures (as presented in ref. 198).
Figure 3. Figure 3.

Schematic model of the control of human thermoregulatory effector responses 198.
Figure 4. Figure 4.

Heat‐exchange data averaged over 1 h of exercise at each ambient temperature for one subject performing exercise in a variety of environmental temperatures. The difference between metabolic rate and total heat loss is the sum of mechanical power (147 W) and mean rate of heat storage.

redrawn from Nielsen 141
Figure 5. Figure 5.

Relationship of steady‐state core‐temperature responses during exercise at three metabolic rates to the environmental conditions.

redrawn from Lind 116
Figure 6. Figure 6.

Relationship of steady‐state core‐temperature responses during exercise to relative exercise intensity (A) and the ambient temperature (B).

redrawn from Davies et al. 45. redrawn from Davies 43
Figure 7. Figure 7.

Total metabolic rate and percentage contribution of aerobic and anaerobic metabolism during exercise at different ambient temperatures.

drawn from data of Dimri et al. 46
Figure 8. Figure 8.

Day‐to‐day improvement in exercise‐heat tolerance of men participating in a dry‐heat acclimation program.

from Pandolf and Young 155
Figure 9. Figure 9.

Heart rate, rectal temperature, and mean skin temperature responses before and during exercise each day during a 10 day dry‐heat‐acclimation program. Each day's exercise consisted of five 10 min treadmill walks, separated by 2 min rests. Large circles show data before the start of exercise, small circles connected by solid lines show data at the end of successive walks, and dotted lines connect final values for each day.

redrawn from Eichna et al. 54
Figure 10. Figure 10.

Relationship between decrease in 4th‐h exercise heart rate and increase in resting plasma volume during humid heat acclimation.

from Senay et al. 204
Figure 11. Figure 11.

Relationship between sweat sodium concentration and back sweating rate before and after heat acclimation.

from Allan and Wilson 2
Figure 12. Figure 12.

Relationship between maximal oxygen uptake and rectal temperature (top) in a hot humid environment or between maximal oxygen uptake and the acclimatization day for a plateau in rectal temperature (bottom) during dry‐heat exposure.

from Armstrong and Pandolf 4
Figure 13. Figure 13.

Changing esophageal temperature at rest and esophageal temperature threshold for sweating and cutaneous vasodilation during exercise with the circadian period.

from Stephenson et al. 220


Figure 1.

Wet‐bulb globe temperature (WBGT) during July in the Northern Hemisphere 99.



Figure 2.

Relationships of back sweating rate 190, forearm blood flow 243, and forearm venous volume 241 to esophageal and mean skin temperatures (as presented in ref. 198).



Figure 3.

Schematic model of the control of human thermoregulatory effector responses 198.



Figure 4.

Heat‐exchange data averaged over 1 h of exercise at each ambient temperature for one subject performing exercise in a variety of environmental temperatures. The difference between metabolic rate and total heat loss is the sum of mechanical power (147 W) and mean rate of heat storage.

redrawn from Nielsen 141


Figure 5.

Relationship of steady‐state core‐temperature responses during exercise at three metabolic rates to the environmental conditions.

redrawn from Lind 116


Figure 6.

Relationship of steady‐state core‐temperature responses during exercise to relative exercise intensity (A) and the ambient temperature (B).

redrawn from Davies et al. 45. redrawn from Davies 43


Figure 7.

Total metabolic rate and percentage contribution of aerobic and anaerobic metabolism during exercise at different ambient temperatures.

drawn from data of Dimri et al. 46


Figure 8.

Day‐to‐day improvement in exercise‐heat tolerance of men participating in a dry‐heat acclimation program.

from Pandolf and Young 155


Figure 9.

Heart rate, rectal temperature, and mean skin temperature responses before and during exercise each day during a 10 day dry‐heat‐acclimation program. Each day's exercise consisted of five 10 min treadmill walks, separated by 2 min rests. Large circles show data before the start of exercise, small circles connected by solid lines show data at the end of successive walks, and dotted lines connect final values for each day.

redrawn from Eichna et al. 54


Figure 10.

Relationship between decrease in 4th‐h exercise heart rate and increase in resting plasma volume during humid heat acclimation.

from Senay et al. 204


Figure 11.

Relationship between sweat sodium concentration and back sweating rate before and after heat acclimation.

from Allan and Wilson 2


Figure 12.

Relationship between maximal oxygen uptake and rectal temperature (top) in a hot humid environment or between maximal oxygen uptake and the acclimatization day for a plateau in rectal temperature (bottom) during dry‐heat exposure.

from Armstrong and Pandolf 4


Figure 13.

Changing esophageal temperature at rest and esophageal temperature threshold for sweating and cutaneous vasodilation during exercise with the circadian period.

from Stephenson et al. 220
References
 1. Adolph, E. F. Life in deserts. In: Physiology of Man in the Desert, edited by E. F. Adolph et al. New York: Interscience, 1947, p. 326–341.
 2. Allan, J. R., and C. G. Wilson. Influence of acclimatization on sweat sodium concentration. J. Appl. Physiol. 30: 708–712, 1971.
 3. Anderson, R. K., and W. L. Kenney. Effect of age on heat‐activated sweat gland density and flow during exercise in dry heat. J. Appl. Physiol. 63: 1089–1094, 1987
 4. Armstrong, L. E., and K. B. Pandolf. Physical training, cardio‐respiratory physical fitness and exercise‐heat tolerance. In: Human Performance Physiology and Environmental Medicine at Terrestrial Extremes, edited by K. B. Pandolf, M. N. Sawka, and R. R. Gonzalez. Indianapolis, IN: Benchmark, 1988, p. 199–226.
 5. Åstrand, I. Aerobic work capacity in men and women. Acta Physiol. Scand. 49: (Suppl. 169): 64–73, 1960.
 6. Attia, M., and P. Engel. Thermoregulatory set‐point in paraplegics. Thermal Physiol. 9: 79–82, 1984.
 7. Aulick, L. H., S. Robinson, and S. Tzankoff. Arm and leg intravascular temperature of men during submaximal exercise. J. Appl. Physiol. 51: 1092–1097, 1981
 8. Avellini, B. A., E. Kamon, and J. T. Krajewski. Physiological responses of physically fit men and women to acclimation to humid heat. J. Appl. Physiol. 49: 254–261, 1980.
 9. Avellini, B. A., Y. Shapiro, S. M. Fortney, C. B. Wenger, and K. B. Pandolf. Effects on heat tolerance of physical training in water and on land. J. Appl. Physiol. 53: 1291–1298, 1982.
 10. Avellini, B. A., Y. Shapiro, K. B. Pandolf, N. A. Pimental, and R. F. Goldman. Physiological responses of men and women to prolonged dry heat exposure. Aviat. Space Environ. Med. 51: 1081–1085, 1980
 11. Baker, P. T. Racial differences in heat tolerance. Am. J. Anthropol. 16: 287–305, 1958.
 12. Bar‐Or, O. Temperature regulation during exercise in children and adolescents. In: Perspectives in Exercise Science and Sports Medicine. Youth, Exercise, and Sport, edited by C. V. Gisolfi, and D. R. Lamb. Indianapolis, IN: Benchmark 1989, vol. 2, p. 335–362.
 13. Bass, D. E. Thermoregulatory and circulatory adjustments during acclimatization to heat in man. In: Temperature, Its Measurement and Control in Science and Industry. Biology and Medicine, edited by J. D. Hardy. New York: Van Nostrand Reinhold, 1963, vol. 3, part 3, p. 299–305.
 14. Bass, D. E., and A. Henschel. Responses of body fluid compartments to heat and cold. Physiol. Rev. 36: 128–144, 1956.
 15. Bean, W. B., and L. W. Eichna. Performance in relation to environmental temperature. Reactions of normal young men to simulated desert environment. Federation Proc. 2: 144–158, 1943.
 16. Benedict, F. G., and E. P. Slack. A Comparative Study of Temperature Fluctuations in Different Parts of the Body. Washington, DC: Carnegie Institute, publication 155, 1911.
 17. Benzinger, T. H. Cranial measurements of internal temperature in man. In: Temperature, Its Measurement and Control in Science and Industry, edited by J. D. Hardy. New York: Van Nostrand Reinhold, 1963, vol. 3, part 3, p. 111–120.
 18. Blair, D. A., W. E. Glover, and I. C. Roddie. Vasomotor fibers to skin in the upper arm, calf and thigh. J. Physiol. (Lond.) 153: 232–238, 1960.
 19. Blair, D. A., W. E. Glover, and I. C. Roddie. Cutaneous vasomotor nerves to the head and trunk. J. Appl. Physiol. 16: 119–122, 1961.
 20. Bligh, J. The receptors concerned in the respiratory response to humidity in sheep at high ambient temperature. J. Physiol. (Lond.) 168: 747–763, 1963.
 21. Boulant, J. A. Hypothalamic control of thermoregulation. In: Handbook of the Hypothalamus. Behavioral Studies of the Hypothalamus, edited by P. J. Morgane, and J. Panksepp. New York: Marcel Dekker, 1980, vol. 3, Part A, p. 1–82.
 22. Brengelmann, G. L. Dilemma of body temperature measurement. In: Man in a Stressful Environment; Thermal and Work Physiology, edited by K. Shiraki, and M. K. Yousef. Springfield, IL: Thomas, 1987, p. 5–22.
 23. Brengelmann, G. L., P. D. Freund, L. B. Rowell, J. E. Olerud, and K. K. Kraning. Absence of active cutaneous vasodilation associated with congenital absence of sweat glands in humans. Am. J. Physiol. 240 (Heart Circ. Physiol. 11): H571–H575, 1981.
 24. Brouha, L., P. E. Smith, Jr., R. DeLanne, and M. E. Maxfield. Physiological reactions of men and women during muscular activity and recovery in various environments. J. Appl. Physiol. 16: 133–140, 1960.
 25. Brown, W. K., and F. Sargent. II. Hidromeiosis. Arch. Environ. Health 11: 442–453, 1965.
 26. Bullard, R. W., M. R. Banerjee, F. Chen, R. Elizondo, and B. A. MacIntyre. Skin temperature and thermoregulatory sweating: a control systems approach. In: Physiological and Behavioral Temperature Regulation, edited by J. D. Hardy, A. P. Gagge, and J. A.J. Stolwijk. Springfield, IL: Thomas, 1970, p. 597–610.
 27. Buskirk, E. R., P. F. Iampietro, and D. E. Bass. Work performance after dehydration: effects of physical conditioning and heat acclimation. J. Appl. Physiol. 12: 189–194, 1958.
 28. Cabanac, M. Keeping a cool head. News Physiol. Sci. 1: 41–44, 1986.
 29. Cabanac, M., and M. Caputa. Natural selective cooling of the human brain: evidence of its occurrence and magnitude. J. Physiol. (Lond.) 286: 255–264, 1979.
 30. Cadarette, B. S., M. N. Sawka, M. M. Toner, and K. B. Pandolf. Aerobic fitness and the hypohydration response to exercise‐heat stress. Aviat. Space Environ. Med. 55: 507–512, 1984.
 31. Candas, V., J. P. Libert, and J. J. Vogt. Sweating and sweat decline of resting men in hot humid environments. Eur. J. Appl. Physiol. 50: 223–234, 1983.
 32. Clark, W. G., and J. M. Lipton. Drug‐related heatstroke. Pharmacol. Ther. 26: 345–388, 1984.
 33. Cleland, T. S., S. M. Horvath, and M. Phillips. Acclimatization of women to heat after training. Int. Z. Angew. Physiol. 27: 15–24, 1969.
 34. Collins, K. J. Endocrine control of salt and water in hot conditions. Federation Proc. 22: 716–720, 1963.
 35. Collins, K. J. The action of exogenous aldosterone on the secretion and composition of drug‐induced sweat. Clin. Sci. 30: 207–221, 1966.
 36. Collins, K. J., G. W. Crockford, and J. S. Weiner. Sweat‐gland training by drugs and thermal stress. Arch. Environ. Health 11: 407–422, 1965.
 37. Collins, K. J., G. W. Crockford, and J. S. Weiner. The local training effect of secretory activity on the response of eccrine sweat glands. J. Physiol. (Lond.) 184: 203–214, 1966.
 38. Consolazio, C. F., L. O. Matoush, R. A. Nelson, J. A. Torres, and G. J. Isaac. Environmental temperature and energy expenditures. J. Appl. Physiol. 18: 65–68, 1963.
 39. Consolazio, C. F., R. Shapiro, J. E. Masterson, and P. S. L. McKinzie. Energy requirements of men in extreme heat. J. Nutr. 73: 126–134, 1961.
 40. Cooper, K. E., W. I. Cranston, and S. Snell. Temperature in the external auditory meatus as an index of central temperature changes. J. Appl. Physiol. 19: 1032–1035, 1964
 41. Cooper, K. E., and J. R. Kenyon. A comparison of temperature measured in the rectum, oesophagus and on the surface of the aorta during hypothermia in man. Br. J. Surg. 44: 616–619, 1957.
 42. Cunningham, D. J., J. A. J. Stolwijk, and C. B. Wenger. Comparative thermoregulatory responses of resting men and women. J. Appl. Physiol. 47: 908–915, 1978.
 43. Davies, C. T. M. Influence of skin temperature on sweating and aerobic performance during severe work. J. Appl. Physiol. 47: 770–777, 1979.
 44. Davies, C. T. M. Thermal responses to exercise in children. Ergonomics 24: 55–61, 1981.
 45. Davies, C. T. M., J. R. Brotherhood, and E. Zeidifard. Temperature regulation during severe exercise with some observations on effects of skin wetting. J. Appl. Physiol. 41: 772–776, 1976.
 46. Dimri, G. P., M. S. Malhotra, J. Sen Gupta, T. S. Kumar, and B. S. Aora. Alterations in aerobic–anaerobic proportions of metabolism during work in heat. Eur. J. Appl. Physiol. 45: 43–50, 1980.
 47. Docherty, D., J. D. Eckerson, and J. S. Hayward. Physique and thermoregulation in prepubertal males during exercise in a warm, humid environment. Am. J. Phys. Anthropol. 70: 19–26, 1986.
 48. Downey, J. A., R. F. Mottram, and G. W. Pickering. The location by regional cooling of central temperature receptors in the conscious rabbit. J. Physiol. (Lond.) 170: 415–441, 1964.
 49. Drinkwater, B. L., J. F. Bedi, A. B. Loucks, S. Roche, and S. M. Horvath. Sweating sensitivity and capacity of women in relation to age. J. Appl. Physiol. 53: 671–676, 1982.
 50. Drinkwater, B. L., and S. M. Horvath. Heat tolerance and aging. Med. Sci. Sports 11: 49–55, 1979.
 51. Drinkwater, B. L., and S. M. Horvath. Physiological adaptation of women to heat stress. In: Terminal Progress Report of National Institute for Occupational Safety and Health. Cincinnati, OH: NIOSH, 1983.
 52. Drinkwater, B. L., I. C. Kupprat, J. E. Denton, J. L. Christ, and S. M. Horvath. Response of prepubertal girls and college women to work in the heat. J. Appl. Physiol. 43: 1046–1053, 1977
 53. Eichna, L. W., W. B. Bean, W. F. Ashe, and N. Nelson. Performance in relation to environmental temperature. Reactions of normal young men to hot, humid (simulated jungle) environment. Bull. Johns Hopkins Hosp. 76: 25–58, 1945.
 54. Eichna, L. W., C. R. Park, N. Nelson, S. M. Horvath, and E. D. Palmes. Thermal regulation during acclimatization in a hot, dry (desert type) environment. Am. J. Physiol. 163: 585–597, 1950.
 55. Ekblom, B., C. J. Greenleaf, J. E. Greenleaf, and L. Hermansen. Temperature regulation during exercise dehydration in man. Acta Physiol. Scand. 79: 475–583, 1970.
 56. Elizondo, R. S., and G. S. Johnson. Peripheral effector mechanisms of temperature regulation. In: Advances in Physiological Sciences. Contributions to Thermal Physiology, edited by Z. Szelenyi, and M. Szekely. New York: Pergamon, 1980, p. 397–408.
 57. Falk, B., O. Bar‐Or, and J. D. MacDougall. Thermoregulatory responses of pre‐, mid‐, and late‐pubertal boys to exercise in dry heat. Med. Sci. Sports Exerc. 24: 313–319, 1992.
 58. Fink, W. J., D. L. Costill, and W. J. Van Handel. Leg muscle metabolism during exercise in the heat and cold. Eur. J. Appl. Physiol. 34: 183–190, 1975.
 59. Fitzgerald, P. I., D. A. Sedlock, and R. G. Knowlton. Circulatory and thermal adjustments to prolonged exercise in paraplegic women. Med. Sci. Sports Exerc. 22: 629–635, 1990.
 60. Folk, G. E. Textbook of Environmental Physiology. Philadelphia: Lea and Febiger, 1974, p. 220–227.
 61. Fortney, S. M., E. R. Nadel, C. B. Wenger, and J. R. Bove. Effect of acute alterations of blood volume on circulatory performance in humans. J. Appl. Physiol. 50: 292–298, 1981.
 62. Fortney, S. M., E. R. Nadel, C. B. Wenger, and J. R. Bove. Effect of blood volume on sweating rate and body fluids in exercising humans. J. Appl. Physiol. 51: 1594–1600, 1981.
 63. Fortney, S. M., C. B. Wenger, J. R. Bove, and E. R. Nadel. Effect of hyperosmolality on control of blood flow and sweating. J. Appl. Physiol. 57: 1688–1695, 1984.
 64. Fox, R. H., R. Goldsmith, I. F. G. Hampton, and T. J. Hunt. Heat acclimatization by controlled hyperthermia in hot‐dry and hot‐wet climates. J. Appl. Physiol. 22: 39–46, 1967.
 65. Fox, R. H., R. Goldsmith, I. F. G. Hampton, and H. E. Lewis. The nature of the increase in sweating capacity produced by heat acclimatization. J. Physiol. (Eond.) 171: 368–376, 1964.
 66. Fox, R. H., R. Goldsmith, and D. J. Kidd. Cutaneous vasomotor control in the human head, neck and upper chest. J. Physiol. (Eond.) 161: 298–312, 1962.
 67. Fox, R. H., R. Goldsmith, D. J. Kidd, and H. E. Lewis. Acclimatization to heat in man by controlled elevation of body temperature. J. Physiol. (Lond.) 166: 530–547, 1963.
 68. Fox, R. H., R. Goldsmith, D. J. Kidd, and H. E. Lewis. Blood flow and other thermoregulatory changes with acclimatization to heat. J. Physiol. (Lond.) 166: 548–562, 1963.
 69. Fox, R. H., and S. M. Hilton. Bradykinin formation in human skin as a factor in heat vasodilatation. J. Physiol. (Lond.) 142: 219–232, 1958.
 70. Francesconi, R. P., M. N. Sawka, and K. B. Pandolf. Hypohydration and heat acclimation: plasma renin and aldosterone during exercise. J. Appl. Physiol. 55: 1790–1794, 1983.
 71. Freund, P. R., G. L. Brengelmann, L. B. Rowell, and E. Halar. Attenuated skin blood flow response to hyperthermia in paraplegic men. J. Appl. Physiol. 56: 1104–1109, 1984.
 72. Frye, A. J., and E. Kamon. Responses to dry heat of men and women with similar aerobic capacities. J. Appl. Physiol. 50: 65–70, 1980.
 73. Frye, A. J., and E. Kamon. Sweating efficiency in acclimated men and women exercising in humid and hot dry heat. J. Appl. Physiol. 54: 972–977, 1983.
 74. Gisolfi, C. V. Work‐heat tolerance derived from interval training. J. Appl. Physiol. 35: 349–354, 1973.
 75. Gisolfi, C. V., and J. S. Cohen. Relationships among training, heat acclimation, and heat tolerance in men and women: the controversy revisited. Med. Sci. Sports. 11: 56–59, 1979.
 76. Gisolfi, C. V., and S. Robinson. Relations between physical training, acclimatization, and heat tolerance. J. Appl. Physiol. 26: 530–534, 1969.
 77. Gisolfi, C. V., and C. B. Wenger. Temperature regulation during exercise: old concepts, new ideas. In: Exercise and Sport Sciences Reviews, edited by R. L. Terjung. Lexington, MA: Collamore, 1984, p. 339–372.
 78. Goetz, R. H. Effect of changes in posture on peripheral circulation, with special reference to skin temperature readings and the plethysmogram. Circulation 1: 56–75, 1950.
 79. Gonzalez, R. R., K. B. Pandolf, and A. P. Gagge. Heat acclimation and decline in sweating during humidity transients. J. Appl. Physiol. 36: 419–425, 1974.
 80. Greenleaf, J. E., and B. L. Castle. External auditory canal temperature as an estimate of core temperature. J. Appl. Physiol. 32: 194–198, 1972.
 81. Greenleaf, J. E., C.J. Greenleaf, D. H. Card, and B. Saltin. Exercise‐temperature regulation in man during acute exposure to simulated altitude. J. Appl. Physiol. 26: 290–296, 1969.
 82. Hardy, J. D. Physiology of temperature regulation. Physiol. Rev. 41: 521–606, 1961.
 83. Harrison, M. H. Effects of thermal stress and exercise on blood volume in humans. Physiol. Rev. 65: 149–209, 1985.
 84. Haymes, E. M., R. J. McCormick, and E. R. Buskirk. Heat tolerance of exercising lean and heavy prepubertal girls. J. Appl. Physiol. 36: 566–571, 1974.
 85. Hellekant, G. Circulation of the tongue. In: Oral Physiology, edited by N. Emmelin, and Y. Zotterman. London: Pergamon, 1972, p. 127–137.
 86. Hellon, R. F., and A. R. Lind. Observations on the activity of sweat glands with special reference to the influence of ageing. J. Physiol. (Land.) 133: 132–144, 1956.
 87. Hellon, R. F., and A. R. Lind. The influence of age on peripheral vasodilatation in a hot environment. J. Physiol. (Lond.) 141: 262–272, 1958.
 88. Hellon, R. F., A. R. Lind, and J. S. Weiner. The physiological reactions of men of two age groups to a hot environment. J. Physiol. (Lond.) 133: 118–131, 1956.
 89. Henane, R., R. Flandrois, and J. P. Charbonnier. Increase in sweat sensitivity by endurance conditioning in men. J. Appl. Physiol. 43: 822–828, 1977.
 90. Hensel, H. Temperature receptors in the skin. In: Physiological and Behavioral Temperature Regulation, edited by J. D. Hardy, A. P. Gagge, and J. A. J. Stolwijk. Springfield, IL: Thomas, 1970, p. 442–453.
 91. Hertzman, A. B., W. C. Randall, C. N. Peiss, and R. Seckendorf. Regional rates of evaporation from the skin at various environmental temperatures. J. Appl. Physiol. 5: 153–161, 1952.
 92. Hessemer, V., and K. Brück. Influence of menstrual cycle on shivering, skin blood flow, and sweating responses measured at night. J. Appl. Physiol. 59: 1902–1910, 1985
 93. Höfler, W. Changes in regional distribution of sweating during acclimatization to heat. J. Appl. Physiol. 25: 503–506, 1968.
 94. Hopman, M. T. E., B. Oeseburg, and R. A. Binkhorst. Cardiovascular responses in persons with paraplegia to prolonged arm exercise and thermal stress. Med. Sci. Sports Exerc. 25: 577–583, 1993.
 95. Horvath, S. M., and W. B. Shelley. Acclimatization to extreme heat and its effect on the ability to work in less severe environments. Am. J. Physiol. 146: 336–343, 1946.
 96. Inbar, O. Acclimatization to dry and hot environment in young adults and children 8‐ to 10‐years‐old. (Ed. D. diss. Columbia University, 1978).
 97. Janssens, W. J., and P. M. Vanhoutte. Instantaneous changes of alpha‐adrenoceptor affinity caused by moderate cooling in canine cutaneous veins. Am. J. Physiol. 234 (Heart Circ. Physiol. 5): H330–H337, 1978.
 98. Jessen, C., and G. Kuhnen. No evidence for brain stem cooling during face fanning in humans. J. Appl. Physiol. 72: 664–669, 1992.
 99. John B. Stennis. Space Center. Global Climatology for the Wet Bulb Globe Temperature (WBGT) Heat Stress Index. Bay St. Louis, Miss.: Gulf Weather, 1989.
 100. Jooste, P. L., and N. B. Strydom. Improved mechanical efficiency derived from heat acclimation. S. Afr. J. Res. Sport, Phys. Ed. Rec. 2: 45–53, 1979.
 101. Karlberg, P. The significance of depth of insertion of the thermometer for recording rectal temperature. Acta Paediatr. Scand. 38: 359–366, 1949.
 102. Kenney, W. L. Control of heat‐induced cutaneous vasodilatation in relation to age. Eur. J. Appl. Physiol. 57: 120–125, 1988.
 103. Kenney, W. L., and J. M. Johnson. Control of skin blood flow during exercise. Med. Sci. Sports Exerc. 24: 303–312, 1992.
 104. King, D. S., D. L. Costill, W. J. Fink, M. Hargreaves, and R. A. Fielding. Muscle metabolism during exercise in the heat in unacclimatized and acclimatized humans. J. Appl. Physiol. 59: 1350–1354, 1985.
 105. Kirby, C. R., and V. A. Convertino. Plasma aldosterone and sweat sodium concentrations after exercise and heat acclimation. J. Appl. Physiol. 61: 967–970, 1986.
 106. Kirwan, J. P., D. L. Costill, H. Kuipers, M. J. Burrell, W. J. Fink, J. E. Kovaleski, and R. A. Fielding. Substrate utilization in leg muscle of men after heat acclimation. J. Appl. Physiol. 63: 31–35, 1987.
 107. Klausen, K., D. B. Dill, E. E. Phillips, and D. McGregor. Metabolic reactions to work in the desert. J. Appl. Physiol. 22: 292–296, 1967.
 108. Kolka, M. A., and L. A. Stephenson. Cutaneous blood flow and local sweating after systemic atropine administration. Pflügers Arch. 410: 524–529, 1987.
 109. Kolka, M. A., and L. A. Stephenson. Exercise thermoregulation after prolonged wakefulness. J. Appl. Physiol. 64: 1575–1579, 1988.
 110. Kolka, M. A., L. A. Stephenson, P. B. Rock, and R. R. Gonzalez. Local sweating and cutaneous blood flow during exercise in hypobaric environments. J. Appl. Physiol. 62: 2224–2229, 1987.
 111. Kraning, K. K., P. A. Lehman, R. G. Gano, and T. S. Weller. A non‐invasive dose‐response assay of sweat gland function and its application in studies of gender comparison, heat acclimation, and anticholinergic potency. In: Thermal Physiology 1989, edited by J. B. Mercer. Amsterdam: Elsevier, 1989, p. 301–307.
 112. Laaser, U. Physiologische Reaktionen während eines fünfwöchigen Daueraufenthaltes in einem künstlichen feuchtheissen Klima. Int. Z. Angew. Physiol. 25: 279–302, 1968.
 113. Ladell, W. S. S. Acquired heat tolerance of temperate climate men living in the tropics. In: Abstracts, XVII International Physiological Congress. Copenhagen, 1950, p. 320–322.
 114. Ladell, W. S. S. Inherent acclimatization of indigenous West Africans [Abstract]. J. Physiol. (Lond.) 112: 15P–16P, 1951.
 115. Leithead, C. S., and A. R. Lind. Thermal limits for different types of occupations. In: Heat Stress and Heat Disorders. Philadelphia: Davis, 1964, p. 79–107.
 116. Lind, A. R. A physiological criterion for setting thermal environmental limits for everyday work. J. Appl. Physiol. 18: 51–56, 1963.
 117. Lind, A. R. Physiologic responses to heat. In: Medical Climatology, edited by S. Licht. New Haven, CT: Elizabeth Licht, 1964, p. 164–195.
 118. Lind, A. R., and D. E. Bass. Optimal exposure time for development of acclimatization to heat. Federation Proc. 22: 704–708, 1963.
 119. Lind, A. R., P. W. Humphreys, K. J. Collins, K. Foster, and K. F. Sweetland. Influence of age and daily duration of exposure on responses of men to work in the heat. J. Appl. Physiol. 28: 50–56, 1970.
 120. Love, A. H. G., and R. G. Shanks. The relationship between the onset of sweating and vasodilatation in the forearm during body heating. J. Physiol. (Lond.) 162: 121–128, 1962.
 121. Lundberg, J. M., A. Änggård, J. Fahrenkrug, T. Hökfelt, and V. Mutt. Vasoactive intestinal polypeptide in cholinergic neurons of exocrine glands: functional significance of coexisting transmitters for vasodilation and secretion. Proc. Natl. Acad. Sci. USA 77: 1651–1655, 1980.
 122. Machle, W., and T. F. Hatch. Heat: man's exchanges and physiological responses. Physiol. Rev. 27: 200–227, 1947.
 123. Macpherson, R. K. Acclimatization status of temperate‐zone man. Nature 182: 1240–1241, 1958.
 124. Marcus, P. Some effects of cooling and heating areas of the head and neck on body temperature measurements at the ear. Aerospace Med. 44: 397–402, 1973.
 125. Marcus, P. Some effects of radiant heating of the head on body temperature measurement at the ear. Aerospace Med. 44: 403–406, 1973.
 126. McCaffrey, T. V., R. D. McCook, and R. D. Wurster. Effect of head skin temperature on tympanic and oral temperature in man. J. Appl. Physiol. 39: 114–118, 1975.
 127. Molnar, G. W., and R. C. Read. Studies during open‐heart surgery on the special characteristics of rectal temperature. J. Appl. Physiol. 36: 333–336, 1974.
 128. Montain, S. J., and E. F. Coyle. The influence of graded dehydration on hyperthermia and cardiovascular drift during exercise. J. Appl. Physiol. 73: 1340–1350, 1992.
 129. Nadel, E. R. (ed). Problems with Temperature Regulation During Exercise. New York: Academic, 1977.
 130. Nadel, E. R., R. W. Bullard, and J. A. J. Stolwijk. Importance of skin temperature in the regulation of sweating. J. Appl. Physiol. 31: 80–87, 1971.
 131. Nadel, E. R., S. M. Fortney, and C. B. Wenger. Effect of hydration on circulatory and thermal regulation. J. Appl. Physiol. 49: 715–721, 1981.
 132. Nadel, E. R., and S. M. Horvath. Comparison of tympanic membrane and deep body temperatures in man. Life Sci. 9: 869–875, 1970.
 133. Nadel, E. R., J. W. Mitchell, B. Saltin, and J. A. J. Stolwijk. Peripheral modifications to the central drive for sweating. J. Appl. Physiol. 31: 828–833, 1971.
 134. Nadel, E. R., K. B. Pandolf, M. F. Roberts, and J. A. J. Stolwijk. Mechanisms of thermal acclimation to exercise and heat. J. Appl. Physiol. 37: 515–520, 1974.
 135. Nadel, E. R., and J. A. J. Stolwijk. Effect of skin wettedness on sweat gland response. J. Appl. Physiol. 35: 689–694, 1973.
 136. National Institute for Occupational Safety and Health. Occupational Exposure to Hot Environments. Washington, DC: Department of Health and Human Services, publication DHHS 86–113, 1986.
 137. Newman, R. W. Why man is such a sweaty and thirsty naked animal: a speculative review. Hum. Biol. 42: 7–27, 1970.
 138. Nielsen, B. Thermoregulation during work in carbon monoxide poisoning. Acta Physiol. Scand. 82: 98–106, 1971.
 139. Nielsen, B., and M. Nielsen. Body temperature during work at different environmental temperatures. Acta Physiol. Scand. 56: 120–129, 1962.
 140. Nielsen, B., G. Savard, E. R. Richter, M. Hargreaves, and B. Saltin. Muscle blood flow and muscle metabolism during exercise and heat stress. J. Appl. Physiol. 69: 1040–1046, 1990
 141. Nielsen, M. Die Regulation der Körpertemperatur bei Muskelarbeit. Skand. Arch. Physiol. 79: 193–230, 1938.
 142. Normell, L. A. Distribution of impaired cutaneous vasomotor and sudomotor function in paraplegic man. Scand. J. Clin. Lab. Invest. 33 (Suppl. 138): 25–41, 1974.
 143. Ogawa, T., and M. Asayama. Quantitative analysis of the local effect of skin temperature on sweating. Jpn. J. Physiol. 36: 417–422, 1986.
 144. Oyono‐Enguelle, S. A. Heitz, J. Marbach, C. Ott, A. Pape, and H. Freund. Heat stress does not modify lactate exchange and removal abilities during recovery from short exercise. J. Appl. Physiol. 74: 1248–1255, 1993.
 145. Pandolf, K. B. Effects of physical training and cardiorespiratory physical fitness on exercise‐heat tolerance: recent observations. Med. Sci. Sports 11: 60–65, 1979.
 146. Pandolf, K. B. Importance of environmental factors for exercise testing and exercise prescription. In: Exercise Testing and Exercise Prescription for Special Cases, edited by J. S. Skinner. Philadelphia: Lea and Febiger, 1987, p. 77–98.
 147. Pandolf, K. B. Aging and heat tolerance at rest or during work. Exp. Aging Res. 17: 189–204, 1991.
 148. Pandolf, K. B., R. L. Burse, and R. F. Goldman. Role of physical fitness in heat acclimatisation, decay and reinduction. Ergonomics 20: 399–408, 1977.
 149. Pandolf, K. B., B. S. Cadarette, M. N. Sawka, A. J. Young, R. P. Francesconi, and R. R. Gonzalez. Thermoregulatory responses of middle‐aged and young men during dry‐heat acclimation. J. Appl. Physiol. 65: 65–71, 1988.
 150. Pandolf, K. B., R. W. Gange, W. A. Latzka, I. H. Blank, K. K. Kraning, and R. R. Gonzalez. Human thermoregulatory responses during heat exposure after artificially induced sunburn. Am. J. Physiol. 262 (Regulatory Integrative Comp. Physiol. 31): R610–R616, 1992.
 151. Pandolf, K. B., R. W. Gange, W. A. Latzka, I. H. Blank, A. J. Young, and M. N. Sawka. Human thermoregulatory responses during cold‐water immersion after artificially induced sunburn. Am. J. Physiol. 262 (Regulatory Integrative Comp. Physiol. 31): R617–R623, 1992.
 152. Pandolf, K. B., T. B. Griffin, E. H. Munro, and R. F. Goldman. Persistence of impaired heat tolerance from artificially induced miliaria rubra. Am. J. Physiol. 239 (Regulatory Integrative Comp. Physiol. 10): R226–R232, 1980.
 153. Pandolf, K. B., T. B. Griffin, E. H. Munro, and R. F. Goldman. Heat intolerance as a function of percent of body surface involved with miliaria rubra. Am. J. Physiol. 239 (Regulatory Integrative Comp. Physiol. 10): R233–R240, 1980.
 154. Pandolf, K. B., L. A. Stroschein, L. L. Drolet, R. R. Gonzalez, and M. N. Sawka. Prediction modeling of physiological responses and human performance in the heat. Comput. Biol. Med. 16: 319–329, 1986.
 155. Pandolf, K. B., and A. J. Young. Environmental extremes and performance. In: Endurance in Sport, edited by R. J. Shephard, and P. O. Åstrand. Oxford: Blackwell, 1992, p. 270–282.
 156. Peiss, C. N., W. C. Randall, and A. B. Hertzman. Hydration of the skin and its effect on sweating and evaporative water loss. J. Invest. Dermatol. 26: 459–470, 1956.
 157. Petersen, E. S., and H. Vejby‐Christensen. Effect of body temperature on steady‐state ventilation and metabolism in exercise. Acta Physiol. Scand. 89: 342–351, 1973.
 158. Piironen, P. Sinusoidal signals in the analysis of heat transfer in the body. In: Physiological and Behavioral Temperature Regulation, edited by J. D. Hardy, A. P. Gagge, and J. A. J. Stolwijk. Springfield, IL: Thomas, 1970, p. 358–366.
 159. Piwonka, R. W., and S. Robinson. Acclimatization of highly trained men to work in severe heat. J. Appl. Physiol. 22: 9–12, 1967.
 160. Piwonka, R. W., S. Robinson, V. L. Gay, and R. S. Manalis. Preacclimatization of men to heat by training. J. Appl. Physiol. 20: 379–384, 1965.
 161. Roberts, M. F., C. B. Wenger, J. A. J. Stolwijk, and E. R. Nadel. Skin blood flow and sweating changes following exercise training and heat acclimatization. J. Appl. Physiol. 43: 133–137, 1977.
 162. Robinson, S., H. S. Belding, F. C. Consolazio, S. M. Horvath, and E. S. Turrell. Acclimatization of older men to work in heat. J. Appl. Physiol. 20: 583–586, 1965.
 163. Robinson, S., D. B. Dill, J. W. Wilson, and M. Nielsen. Adaptation of white men and Negroes to prolonged work in humid heat. Am. J. Trop. Med. 21: 261–287, 1941.
 164. Robinson, S., and A. H. Robinson. Chemical composition of sweat. Physiol. Rev. 34: 202–220, 1954.
 165. Robinson, S., E. S. Turrell, H. S. Belding, and S. M. Horvath. Rapid acclimatization to work in hot climates. Am. J. Physiol. 140: 168–176, 1943.
 166. Roddie, I. C., J. T. Shepherd, and R. F. Whelan. The contribution of constrictor and dilator nerves to the skin vasodilatation during body heating. J. Physiol. (Lond.) 136: 489–497, 1957.
 167. Rowell, L. B. Cardiovascular adjustments to thermal stress. In: Handbook of Physiology. The Cardiovascular System. Peripheral Circulation and Organ Blood Flow, edited by J. T. Shepherd, and F. M. Abboud. Bethesda, MD: Am. Physiol. Soc., 1983, p. 967–1023.
 168. Rowell, L. B. Human Circulation: Regulation During Physical Stress. New York: Oxford University Press, 1986.
 169. Rowell, L. B., J. R. Blackmon, R. H. Martin, J. A. Mazzarella, and R. A. Bruce. Hepatic clearance of indocyanine green in man under thermal and exercise stresses. J. Appl. Physiol. 20: 384–394, 1965.
 170. Rowell, L. B., G. L. Brengelmann, J. B. Blackmon, R. D. Twiss, and F. Kusumi. Splanchnic blood flow and metabolism in heat‐stressed man. J. Appl. Physiol. 24: 475–484, 1968.
 171. Rowell, L. B., G. L. Brengelmann, J. A. Murray, K. K. Kraning, and F. Kusumi. Human metabolic responses to hyperthermia during mild to maximal exercise. J. Appl. Physiol. 26: 395–402, 1969.
 172. Rowell, L. B., P. R. Freund, and G. L. Brengelmann. Cutaneous vascular response to exercise and acute hypoxia. J. Appl. Physiol. 53: 920–924, 1982.
 173. Rowell, L. B., K. K. Kraning, II, J. W. Kennedy, and T. O. Evans. Central circulatory responses to work before and after acclimatization. J. Appl. Physiol. 22: 509–518, 1967.
 174. Rowell, L. B., H. J. Marx, R. A. Bruce, R. D. Conn, and F. Kusumi. Reductions in cardiac output, central blood volume and stroke volume with thermal stress in normal men during exercise. J. Clin. Invest. 45: 1801–1816, 1966.
 175. Saltin, B., A. P. Gagge, U. Bergh, and J. A. J. Stolwijk. Body temperatures and sweating during exhaustive exercise. J. Appl. Physiol. 32: 635–643, 1972.
 176. Saltin, B., A. P. Gagge, and J. A. J. Stolwijk. Body temperatures and sweating during thermal transients caused by exercise. J. Appl. Physiol. 28: 318–327, 1970.
 177. Saltin, B., and L. Hermansen. Esophageal, rectal and muscle temperature during exercise. J. Appl. Physiol. 21: 1757–1762, 1966.
 178. Sato, K. The physiology, pharmacology and biochemistry of the eccrine sweat gland. Rev. Physiol. Biochem. Pharmacol. 79: 51–131, 1977.
 179. Sato, K., and R. L. Dobson. Regional and individual variations in the function of the human eccrine sweat gland. J. Invest. Dermatol. 54: 443–449, 1970.
 180. Sato, K., and F. Sato. Cyclic AMP accumulation in the beta adrenergic mechanism of eccrine sweat secretion. Pflügers Arch. 390: 49–53, 1981.
 181. Sato, K., and F. Sato. Pharmacologic responsiveness of isolated single eccrine sweat glands. Am. J. Physiol. 240 (Regulatory Integrative Comp. Physiol. 11): R44–R51, 1981.
 182. Sato, K., and F. Sato. Role of calcium in cholinergic and adrenergic mechanisms of eccrine sweat secretion. Am. J. Physiol. 241 (Cell Physiol. 9): C113–C120, 1981.
 183. Savage, M. V., G. L. Brengelmann, A. M. J. Buchan, and P. D. Freund. Cystic fibrosis, vasoactive intestinal polypeptide and active cutaneous vasodilation. J. Appl. Physiol. 69: 2149–2154, 1990.
 184. Savard, G. K., B. Nielsen, J. Laszczynska, B. E. Larson, and B. Saltin. Muscle blood flow is not reduced in humans during moderate exercise and heat stress. J. Appl. Physiol. 64: 649–657, 1988.
 185. Sawka, M. N. Body fluid responses and hypohydration during exercise‐heat stress. In: Human Performance Physiology and Environmental Medicine at Terrestrial Extremes, edited by K. B. Pandolf, M. N. Sawka, and R. R. Gonzalez. Indianapolis, IN: Benchmark, 1988, p. 227–266.
 186. Sawka, M. M. Physiological consequences of hypohydration: exercise performance and thermoregulation. Med. Sci. Sports Exerc. 24: 657–670, 1992.
 187. Sawka, M. N., R. C. Dennis, R. R. Gonzalez, A. J. Young, S. R. Muza, J. W. Martin, C. B. Wenger, R. P. Francesconi, K. B. Pandolf, and C. R. Valeri. Influence of polycythemia on blood volume and thermoregulation during exercise‐heat stress. J. Appl. Physiol. 62: 912–918, 1987.
 188. Sawka, M. N., R. P. Francesconi, N. A. Pimental, and K. B. Pandolf. Hydration and vascular fluid shifts during exercise in the heat. J. Appl. Physiol. 56: 91–96, 1984.
 189. Sawka, M. N., R. R. Gonzalez, L. L. Drolet, and K. B. Pandolf. Heat exchange during upper‐ and lower‐body exercise. J. Appl. Physiol. 57: 1050–1054, 1984
 190. Sawka, M. N., R. R. Gonzalez, and K. B. Pandolf. Effects of sleep deprivation on thermoregulation during exercise. Am. J. Physiol. 246 (Regulatory Integrative Comp. Physiol. 15): R72–R77, 1984.
 191. Sawka, M. N., R. R. Gonzalez, A. J. Young, R. C. Dennis, C. R. Valeri, and K. B. Pandolf. Control of thermoregulatory sweating during exercise in the heat. Am. J. Physiol. 257 (Regulatory Integrative Comp. Physiol. 26): R311–R316, 1989.
 192. Sawka, M. N., R. R. Gonzalez, A. J. Young, S. M. Muza, K. B. Pandolf, W. A. Latzka, R. C. Dennis, and R. C. Valeri. Polycythemia and hydration: effects on thermoregulation and blood volume during exercise‐heat stress. Am. J. Physiol. 255 (Regulatory Integrative Comp. Physiol. 24): R456–R463, 1988.
 193. Sawka, M. N., R. G. Knowlton, and J. B. Critz. Thermal and circulatory responses to repeated bouts of prolonged running. Med. Sci. Sports. 11: 177–180, 1979.
 194. Sawka, M. N., W. A. Latzka, and K. B. Pandolf. Temperature regulation during upper body exercise: able‐bodied and spinal cord injured. Med. Sci. Sports Exerc. 21: S132–S140, 1989.
 195. Sawka, M. N., and K. B. Pandolf. Effects of body water loss on exercise performance and physiological function. In: Perspectives in Exercise Science and Sports Medicine. Fluid Homeostasis During Exercise, edited by C. V. Gisolfi, and D. R. Lamb. Indianapolis, IN: Benchmark, 1990, vol. 3, p. 1–38.
 196. Sawka, M. N., K. B. Pandolf, B. A. Avellini, and Y. Shapiro. Does heat acclimation lower the rate of metabolism elicited by muscular exercise? Aviat. Space Environ. Med. 54: 27–31, 1983.
 197. Sawka, M. N., M. M. Toner, R. P. Francesconi, and K. B. Pandolf. Hypohydration and exercise: effects of heat acclimation, gender and environment. J. Appl. Physiol. 55: 1147–1153, 1983.
 198. Sawka, M. N., and C. B. Wenger. Physiological responses to acute exercise‐heat stress. In: Human Performance Physiology and Environmental Medicine at Terrestrial Extremes, edited by K. B. Pandolf, M. N. Sawka, and R. R. Gonzalez. Indianapolis, IN: Benchmark, 1988, p. 97–151.
 199. Sawka, M. N., A. J. Young, B. S. Cadarette, L. Levine, and K. B. Pandolf. Influence of heat stress and acclimation on maximal aerobic power. Eur. J. Appl. Physiol. 53: 294–298, 1985.
 200. Sawka, M. N., A. J. Young, R. P. Francesconi, S. R. Muza, and K. P. Pandolf. Thermoregulatory and blood volume responses during exercise at graded hypohydration levels. J. Appl. Physiol. 59: 1394–1401, 1985.
 201. Sawka, M. N., A. J. Young, W. A. Latzka, P. D. Neufer, M. D. Quigley, and K. B. Pandolf. Human tolerance to heat strain during exercise: influence of hydration. J. Appl. Physiol. 72: 368–375, 1992.
 202. Senay, L. C. Temperature regulation and hypohydration: a singular view. J. Appl. Physiol. 47: 1–7, 1979.
 203. Senay, L. C., and R. Kok. Effects of training and heat acclimatization on blood plasma contents of exercising men. J. Appl. Physiol. 43: 591–599, 1977.
 204. Senay, L. C., D. Mitchell, and C. H. Wyndham. Acclimatization in a hot, humid environment: body fluid adjustments. J. Appl. Physiol. 40: 786–796, 1976.
 205. Sen Gupta, J., P. Midri, and M. S. Malhotra. Metabolic responses of Indians during sub‐maximal and maximal work in dry and humid heat. Ergonomics 20: 33–40, 1977.
 206. Shapiro, Y., R. W. Hubbard, C. M. Kimbrough, and K. B. Pandolf. Physiological and hematologic responses to summer and winter dry‐heat acclimation. J. Appl. Physiol. 50: 792–798, 1981.
 207. Shapiro, Y., K. B. Pandolf, B. A. Avellini, N. A. Pimental, and R. F. Goldman. Physiological responses of men and women to humid and dry heat. J. Appl. Physiol. 49: 1–8, 1980.
 208. Shiraki, K., N. Konda, and S. Sagawa. Esophageal and tympanic temperature responses to core blood temperature changes during hyperthermia. J. Appl. Physiol. 61: 98–102, 1986.
 209. Shiraki, K., S. Sagawa, T. Tajima, A. Yokota, M. Hashimoto, and G. L. Brengelmann. Independence of brain and tympanic temperatures in an unanesthetized human. J. Appl. Physiol. 65: 482–486, 1988.
 210. Shoenfeld, Y., R. Udassin, Y. Shapiro, A. Ohir, and E. Sohar. Age and sex difference in response to short exposure to extreme dry heat. J. Appl. Physiol. 44: 1–4, 1978.
 211. Shvartz, E., A. Bhattacharya, S. J. Sperinde, P. J. Brock, D. Sciaraffa, and W. Van Beaumont. Sweating responses during heat acclimation and moderate conditioning. J. Appl. Physiol. 46: 675–680, 1979.
 212. Shvartz, E., E. Saar, N. Meyerstein, and D. Benor. A comparison of three methods of acclimatization to dry heat. J. Appl. Physiol. 34: 214–219, 1973.
 213. Shvartz, E., Y. Shapiro, A. Magazanik, A. Meroz, H. Birnfeld, A. Mechtinger, and S. Shibolet. Heat acclimation, physical fitness, and responses to exercise in temperate and hot environments. J. Appl. Physiol. 43: 678–683, 1977.
 214. Shvartz, E., N. B. Strydom, and H. Kotze. Orthostatism and heat acclimation. J. Appl. Physiol. 39: 590–595, 1975.
 215. Speckman, K. L., A. E. Allan, M. N. Sawka, A. J. Young, S. R. Muza, and K. B. Pandolf. Perspectives in microclimate cooling involving protective clothing in hot environments. Int. J. Indust. Erg. 3: 121–147, 1988.
 216. Stephenson, L. A., and M. A. Kolka. Effect of gender, circadian period and sleep loss on thermal responses during exercise. In: Human Performance Physiology and Environmental Medicine at Terrestrial Extremes, edited by K. B. Pandolf, M. N. Sawka, and R. R. Gonzalez. Indianapolis, IN: Benchmark, 1988, p. 267–304.
 217. Stephenson, L. A., and M. A. Kolka. Acetylcholinesterase inhibitor, pyridostigmine bromide, reduces skin blood flow in humans. Am. J. Physiol. 258 (Regulatory Integrative Comp. Physiol. 27): R951–R957, 1990.
 218. Stephenson, L. A., and M. A. Kolka. Sleep deprivation affects the onset of cutaneous vasodilation by disrupting circadian timing [Abstract]. Physiologist 33: A50, 1990.
 219. Stephenson, L. A., and M. A. Kolka. Thermoregulation in women. In: Exercise and Sport Sciences Reviews, edited by J. O. Holloszy. Baltimore: Williams & Wilkins, 1993, p. 231–262.
 220. Stephenson, L. A., C. B. Wenger, B. H. O'Donovan, and E. R. Nadel. Circadian rhythm in sweating and cutaneous blood flow. Am. J. Physiol. 246 (Regulatory Integrative Comp. Physiol. 15): R321–R324, 1984.
 221. Stolwijk, J. A. J., B. Saltin, and A. P. Gagge. Physiological factors associated with sweating during exercise. Aerospace Med. 39: 1101–1105, 1968.
 222. Strydom, N. B., J. F. Morrison, J. Booyens, and J. Peter. Comparison of oral and rectal temperatures during work in heat. J. Appl. Physiol. 8: 406–408, 1956.
 223. Strydom, N. B., and C. G. Williams. Effect of physical conditioning on state of heat acclimatization of Bantu laborers. J. Appl. Physiol. 27: 262–265, 1969.
 224. Strydom, N. B., C. H. Wyndham, C. G. Williams, J. F. Morrison, G. A. G. Bredell, A. J. S. Benade, and M. Von Rahden. Acclimatization to humid heat and the role of physical conditioning. J. Appl. Physiol. 21: 636–642, 1966.
 225. Strydom, N. B., C. H. Wyndham, C. G. Williams, J. F. Morrison, G. A. G. Bredell, and A. Joffe. Oral/rectal temperature difference during work and heat stress. J. Appl. Physiol. 20: 283–287, 1965.
 226. Tabor, M. W., D. M. Blaho, and W. R. Schriver. Tympanic membrane perforation: complication of tympanic thermometry during general anesthesia. Oral Surg. 51: 581–583, 1981.
 227. Tam, H. S., R. C. Darling, H. Y. Chen, and J. A. Downey. Sweating response: a means of evaluating the set‐point theory during exercise. J. Appl. Physiol. 45: 451–458, 1978.
 228. Tankersley, C. G., W. C. Nicholas, D. R. Deaver, D. Makita, and W. L. Kenney. Estrogen replacement in middle‐aged women: thermoregulatory responses to exercise in the heat. J. Appl. Physiol. 73: 1238–1245, 1992.
 229. Tankersley, C. G., J. Smolander, W. L. Kenney, and S. M. Fortney. Sweating and skin blood flow during exercise: effects of age and maximal oxygen uptake. J. Appl. Physiol. 71: 236–242, 1991.
 230. Tankersley, C. G., D. H. Zappe, T. G. Meister, and W. L. Kenney. Hypohydration affects forearm vascular conductance independent of heart rate during exercise. J. Appl. Physiol. 73: 1232–1237, 1992.
 231. Thauer, R. Thermosensitivity of the spinal cord. In: Physiological and Behavioral Temperature Regulation, edited by J. D. Hardy, A. P. Gagge, and J. A. J. Stolwijk. Springfield, IL: Thomas, 1970, p. 472–492.
 232. Vaalasti, A., H. Tainio, and L. Rechardt. Vasoactive intestinal polypeptide (VIP)‐like immunoreactivity in the nerves of human axillary sweat glands. J. Invest. Dermatol. 85: 246–248, 1985.
 233. Van Beaumont, W., and R. W. Bullard. Sweating: its rapid response to muscular work. Science 141: 643–646, 1963.
 234. Wagner, J. A., S. Robinson, S. P. Tzankoff, and R. P. Marino. Heat tolerance and acclimatization to work in the heat in relation to age. J. Appl. Physiol. 33: 616–622, 1972.
 235. Wallace, C. T., W. E. Marks, W. Y. Adkins, and J. E. Mahaffey. Perforation of the tympanic membrane, a complication of tympanic thermometry during anaesthesia. Anesthesiology 41: 290–291, 1974.
 236. Webb‐Peploe, M. M., and J. T. Shepherd. Response of dogs' cutaneous veins to local and central temperature changes. Circ. Res. 23: 693–699, 1968.
 237. Webb‐Peploe, M. M., and J. T. Shepherd. Response of large hindlimb veins of the dog to sympathetic nerve stimulation. Am. J. Physiol. 215: 299–307, 1968.
 238. Weinman, K. P., Z. Slabochova, E. M. Bernauer, T. Morimoto, and F. Sargent. II. Reactions of men and women to repeated exposure to humid heat. J. Appl. Physiol. 22: 533–538, 1967.
 239. Wenger, C. B. Heat of evaporation of sweat: thermodynamic considerations. J. Appl. Physiol. 32: 456–459, 1972.
 240. Wenger, C. B. Human heat acclimation. In: Human Performance Physiology and Environmental Medicine at Terrestrial Extremes, edited by K. B. Pandolf, M. N. Sawka, and R. R. Gonzalez. Indianapolis, IN: Benchmark, 1988, p. 153–197.
 241. Wenger, C. B., and M. F. Roberts. Control of forearm venous volume during exercise and body heating. J. Appl. Physiol. 48: 114–119, 1980.
 242. Wenger, C. B., M. F. Roberts, E. R. Nadel, and J. A. J. Stolwijk. Thermoregulatory control of finger blood flow. J. Appl. Physiol. 38: 1078–1082, 1975
 243. Wenger, C. B., M. F. Roberts, J. A. J. Stolwijk, and E. R. Nadel. Forearm blood flow during body temperature transients produced by leg exercise. J. Appl. Physiol. 38: 58–63, 1975.
 244. Wenger, C. B., L. A. Stephenson, and M. A. Durkin. Effect of nerve block on response of forearm blood flow to local temperature. J. Appl. Physiol. 61: 227–232, 1986.
 245. Williams, C. G., G. A. G. Bredell, C. H. Wyndham, N. B. Strydom, J. F. Morrison, J. Peter, P. W. Fleming, and J. S. Ward. Circulatory and metabolic reactions to work in heat. J. Appl. Physiol. 17: 625–638, 1962.
 246. Williams, C. G., C. H. Wyndham, and J. F. Morrison. Rate of loss of acclimatization in summer and winter. J. Appl. Physiol. 22: 21–26, 1967.
 247. Wood, J. E., and D. E. Bass. Responses of the veins and arterioles of the forearm to walking during acclimatization to heat in man. J. Clin. Invest. 39: 825–833, 1960.
 248. Wyndham, C. H. Effect of acclimatization on circulatory responses to high environmental temperatures. J. Appl. Physiol. 4: 383–395, 1951.
 249. Wyndham, C. H. The physiology of exercise under heat stress. Ann. Rev. Physiol. 35: 193–220, 1973.
 250. Wyndham, C. H., A. J. A. Benade, C. G. Williams, N. B. Strydom, A. Goldin, and A. J. A. Heyns. Changes in central circulation and body fluid spaces during acclimatization to heat. J. Appl. Physiol. 25: 586–593, 1968.
 251. Wyndham, C. H., W. v.d.M. Bouwer, M. G. Devine, and H. E. Patterson. Physiological responses of African laborers at various saturated air temperatures, wind velocities and rates of energy expenditure. J. Appl. Physiol. 5: 290–298, 1952.
 252. Wyndham, C. H., G. G. Rogers, L. C. Senay, and D. Mitchell. Acclimatization in a hot, humid environment: cardiovascular adjustments. J. Appl. Physiol. 40: 779–785, 1976.
 253. Wyndham, C. H., N. B. Strydom, J. F. Morrison, C. G. Williams, G. A. G. Bredell, M. J. E. Von Rahden, L. D. Holdsworth, and A. Munro. Heat reactions of Caucasian and Bantu in South Africa. J. Appl. Physiol. 19: 598–606, 1964.
 254. Young, A. J. Energy substrate utilization during exercise in extreme environments. In: Exercise and Sport Sciences Reviews, edited by K. B. Pandolf. Baltimore: Williams and Wilkins, 1990, p. 65–117.
 255. Young, A. J., M. N. Sawka, L. Levine, B. S. Cadarette, and K. B. Pandolf. Skeletal muscle metabolism during exercise is influenced by heat acclimation. J. Appl. Physiol. 59: 1929–1935, 1985
 256. Young, A. J., M. N. Sawka, M. D. Quigley, B. S. Cadarette, P. D. Neufer, R. C. Dennis, and C. R. Valeri. Role of thermal factors on aerobic capacity improvements with endurance training. J. Appl. Physiol. 75: 49–54, 1993.
 257. Yousef, M. K., D. B. Dill, T. S. Vitez, S. D. Hillyard, and A. S. Goldman. Thermoregulatory responses to desert heat: age, race and sex. J. Gerontol. 39: 406–414, 1984.

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Article Title: Thermoregulatory Responses to Acute Exercise‐Heat Stress and Heat Acclimation
 

How to Cite

Michael N. Sawka, C. Bruce Wenger, Kent B. Pandolf. Thermoregulatory Responses to Acute Exercise‐Heat Stress and Heat Acclimation. Compr Physiol 2011, Supplement 14: Handbook of Physiology, Environmental Physiology: 157-185. First published in print 1996. doi: 10.1002/cphy.cp040109