Reprinted Jrorn Jounlrl on t\pplrun Pslsrorocl Vol. 16, No.

1, ,luly, 19ii1

Printt:rtinL..S.A. Hefti-g,

BfuCe

4.,

MafVln

Sweating in hot baths.

L.

Riedesel and llarwood S" Belding. 1961. J. App. Phrrsjol_. 16: 647*657
z

Sweatirg in hot baths'''"

[, trf ,fbJ:ieJ,lg: G,/

1, s-t.

BRUCE A. HERTIG, MAR\IIN L. RIEDESEL,3 AND HAR\\'OOD S. BELDING, Ig G i ,

Department of OccuJtational Health, Graduate Sc/tool of Public Health, Llniu er sity of Pitt s b ur g h, Pi t t s b ur g h, P ennsy I u ani a

647-65r. 196r.-Sweating of human volunteers immersed to the neck in hot water declined markedly after reaching a
peak in the Ist hr of exposure. This decline always occurred in fresh water regardless of level of thermal stress. Sweating in the 3rd hr of exposure was about the same whether the water r'vas hot in the rst z hr (sweat glands active) or cool (sweat glands inactive). Thus "fatigue" was not responsible for the decline. It is suggested that observations of decline of sweating in rvarm-humid air environments, attributed to "sweat gland fatigue," in reality may have been owing to soaking of the skin with sweat. The mechanism of suppression appears more complex than blockage of the sweat ducts by swelling of the corneum. Rather, there is an association between the amount of decline and conditions favoring diffusion of water to deeper strata of thc skin. For example, adding salt tc the r.,'ater reduced the decline; no decline occurred in 1516 NaCl.

Honrrc, Bnucr, A., Me.nvrN L. Rreonsnr-, eNo H,qpwooo S. Brr-orNc. Sueating in hot baths. J Appl Physiol. r6(4):

manded assessment of mean skin temperatures with greater accuracy than is possible in an air environment with currently available techniques. Such accuracy can be achieved in the bath; the surface temperature of an immersed bodv differs from that of the . water by a

negligiblv smali amount, owing to the high thermal conductivitv of r'vell-stirred water (3). It soon became apparent that thermal stress was not the onlv factor influencing sweat rate. Further exploration of this finding led to the discoverv that immersion, per se, progressivelv inhibits sweating. 'Ihis paper describes our observations and discusses mechanisms possiblv responsible for the decline.
METHODS

Healthv voung men were immersed to the neck in a large tank located within a constant temperature
chamber. Recirculation of the water through a heat exchanger provided regulation of the water temperature to within o.o2 C. The water was stirred with a battervpowered outboard motor. Several leveis of activit\' \vere achieved bv varying the "stroke" rate on a rowing machine. Ambient air temperatures in the test chamber were maintained at q5C D.B. and z4 C W.B., corresponding to a water vapor pressure of r 7 mm Hg. Body and water temperatures were measured with thermistor devices. Heart rate was follor,r'ed by palpation at the radial arterv. Metabolic heat production was estimated from oxygen consumprion. Subjects were encouraged to drink r'vater equal to the

T r,ttru quANTirATrvE TNFoRMATToN is available on su'eat production in hot baths. Apparentlv sweatinq was measured in onlv two studies where full body immersions
Iasted an hour or longer. Whitehouse, Hancock, and Haldane (r) reported weight losses of about r,ooo g after 5 hr in fresh w'ater and about z,Boo g in rB% salt water (NaCl). Bazett (:) stated that loss ol water bv sweating "occurred as freelv in the bath as in a hot room," with rates reported as high as t.67" body wt/hr. The uselessness of sweat produced under water for cooling the body presumablv accounts for the lack of attention to this parameter in the numerous studies of thermal effects of
baths.

We undertook bath studies because investigation of the relationship between sweating and skin temperature deI{eceived for publication 6 March r96I. 1 This study was partially supported by Research Grant RG-4347 from the National Institutes of Health, and partially by a contract between the U. S. Army Medical Research and Development Command and the University of Pittsburgh. 2 This paper is an abridgment of the thesis submitted by Bruce A. Hertig to the Faculty of the Graduate School of Public Health, Unir.ersity of Pittsburgh, in partial fuifillment of the requirements for the degree of Doctor of Science in Hygiene. 3 Present address: Dept. of Biology, University of New Mexico, Albuquerque, N. M.
6q'i

amount lost b,v sweating. Although complete rvater balance couid not be maintained under ali conditions, dehvdration cannot account for the decreased sweating
observed (see orscussroN).

Sweat rate was determined br'' observation of bodv rveight loss at intervals. Transfer of the subject from the water to a scale placed beside the tank was controlled to allow for uniform run-off prior to weighing. A towel on the scale caught the $.ater dripping from the subject. Weighings bv this procedure were reproducible to within zo g and required less than a minute to complete. To determine whether loss of weight bv sweating was confounded with uptake ol water from the bath, observations r'r'ere made in neutral baths of 30 33 C. At these

6+B

HERTIG, RIEDESEL AND BELDING SUBJECT TM

g/hr. Inasmuch

BATH:

36.7 "C 7.5 STROKES,/MIN

as estimated gains from the bath about equaled estimated losses from the lungs, observed weight Ioss, corrected only for urine passed and water ingested, was accepted as sweating.

rr-

0.4

(,
Y

activitv (sitting at rest, and rowing at 6 and at 716 strokes/min). Metabolic rates for these activities were approximately 5o, 95, and ro5 kcal/hr-m2, respectiveiY. The effects of acclimatization, hours of "presoakins" in thermally neutral water and salinity of the water were
also investigated.

Time course of sweating was followed at three levels each of bath temperature (36.o, 36.7, and 37.2 C) and

z
o =

E o.z UJ

Most of the data included in this report were collected in 5i 3-hr exposures on 3 subjects. The same kinds of responses were seen in work with five other volunteers in
exposures at temperatures as high as 38 C and durations

up to 4 hr.

or23
lrc. r. Time
3 levels of course of sweating in bath. Representative data for activity at intermediate bath temperature (:6.2 C).

RESULTS

temperatures the subjects were "comfortable" or "cool" and no active sr,r'eating u'as observed on the head. We noted a gain of about 30 g within the first 3o min, probablr' representing storage in the stratural corneum. No subsequent uptake was detectable thereafter within the error of measurement. These figures are in reasonable

agreement

with other fuii-bocir- immersion

stuciies.

Bazett's subjects gained 5o-roo g, all in the first 3o min (r). Whitehouse et al. (r) observed no more than 16 g gain, and up to 27 g loss. Data of Mali (4) and Buettner

(5), when extrapolated to rvhole man, indicate that in-

'nvard transfer

bt'diffusion may occur at the rate of z-ro

SYMEOL x

In fresh water, we found that s"veating reached a peak during the r st hr of exposure, then declined markedlv (Fig. r). Peak rates were much less than we have seen at these skin temperatures in air environments. Temperature and actiaiQ. Sweating in response to heat stress is shown on semilog coordinates in Fig. s. Plotted in this fashion, parallel straight lines mav be fitted to describe the decline regardless of the level or modalitv of the stress. Total sweat output at 36.o C rvas substantiallv les-" before acclimatization, but it cieciineci simiiariv. There were no consistent relationships between the time course of sweating and the time course of other phvsiologic parameters (Fig. :). Heart rate adjusted rapidly to a value dependent on the demands of heat and work and then remained essentially constant throughout
SYMEOL

TEMP

ACTIVITY

TEMP
6.O 3 6.O
3 3

ACTIVITY

t
o

36.o'c 6 sPM' 36.0 6 SPM 36,7 6 SPM 36.7 REST 36.0 r.5 SPM 36.7 7.5 SPM 36.0 REST 37- I 7-5 SPM
6
SPM

I o o A

6.7

6 6 6
R

TEMP.

ACTIVITY

SPM
SPM SPM

36.7
36.O

EST
SPM SPM SPM

6.0 36.0 36 0
3 3
3 3

.I
F

J6.7

tl.z

E6.7

7.5 7.5 6 6

6.7

6.7 6.7

6 6 6 6 7.5

SPM

SPII
SPM
S PM

SPU

REST

SPf{

E 3

0.5

o.s

k F

L J

\:-_

\q

-\r '\J---,-

t\

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(9

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z
tr
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6 =

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F

o.o5

SUBJECT

JS

oouf

SUBJECT

TM

SUEJECT

AW

+ STROXES PER MINUTE o.orL

o
F'IG.

I I
0.0r L

.TrME ,OF EX.POSUBE

t2 z. Time course of sweating in bath at

t2

HR

-'-0

several levels

of bath temperature and activity. (o : exposures before acclimatization.)

SWEATING IN HOT BATHS

6+g

t20

q F

f o
c
t.

roo

gland activitv, the subjects were immersed in thermallv neutral water for r or z hr before exposure to warm water. During presoaking thev rested; after presoaking thev
exercised at a rate of 6 strokes/min in 36.7 C water. Sweat rates were about the same at the same point in time, regardless of the quantity of sweat which had been secreted in the earlv part of the exposure (Fig. 4). As
RECTAL

o
E E
I

decline was independent of prior activity ol the sweat glands, fatigue could not have been a major factor in the
RECTAL

l
SKIN (. EATH
)

f F

1..

E
F

lsu u
o.5 E

l l
I

(sKlN . 35.0 rlrl

oC)

3 o

5
!

SUBJECT PM A.5 STROKES/MIN

o.e SUBJECT
AW

decline. Salt water. Concentrations of 5 and roTo salt (NaCl) reduced the extent to which sweating declined; in t5Ta there was no decline at all. These curves extrapolate back to about the same value of sweat rate at "time zero," as does the curve for ordinary water (Fig. 5). This extrapolated level of r,6oo g/[p corresponds with sweat rates observed in this and other laboratories for similar skin temperatures and levels of activitv, suggesting that the salt did not serve as a stimulus for sweating, but rather served to remove an inhibitorv influence.
DISCUSSION

x z

This study has demonstrated that immersion in fresh water exerts an important influence on sweating in man. Leads suggested

o E o.. u o

STROKES/ MIN

by the literature (e.g., sweat gland

'

TIIIE OF

EXPOSURE- HOURS

ot20t2
sweating whether

rrc. 3. Data of z representative exposures illustrating decline of initial sweat rate was high or low, and whether

rectai temperature was rising or remained steady.

the exposure. Deep bodv temperature variouslv rose moderately to a steadv level, rose continuously over the entire exposure, or fell to a steadv level. Presoaking. To dissociate time of immersion and sweat

fatigue) were pursued, but none adequately explained the phenomenon. Those that seemed to offer the most promise are presented here in the form of hvpotheses: r. Receptors for sweating adapt to the uniform thermal stimulus of the water. Temperature control in salt water exposures was just as precise as in fresh, yet sweating did not decline as much. -2. Decline of sweating results from progressive loss of body water (6). The largest water deficit in this study (z% of body wt.) was recorded for subject -IS in r5 % salt water. Sweating did not decline at all in this exposure. 3. Thermal conductance of the stratum corneum is increased by hydration, thereby permitting the temperature to decline at a site critical for sr,r'eating. Regardless of

the amount of water absorbed, the conductivity could

E,

o u
J I
(9

=
o.4

'\* /\ 'i\\
TM
.- x ..

)\-'., \".
i \
SUsJECT JS \

.!
2

o.

U
an

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OF
EX

Ji

---

TIME OF EXPOSURE-HR

r23
rrc. 4. Time course of sweating in bath (26.2 C,6 strokes/min) after o, I, and s hr ofpresoaking at rest in thermally neutral water
and AW, g+.+ C; J,S, 33.9 C) Time of exposure includes presoaking time.

(TM

65o

HERTIG. RIEDESEL AND BELDING

t\
t.6

.t'

,o-

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ta,

\
t.2
R0Btils0tl's sljEJEcT xs
t{R

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I

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lli-

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(cLorHEo)
ll0TIAR

15% Noc

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I

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D,3 ].0 08,32.1'C lI8'

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tL

TAP WATER

a =
TIME OF EXPOSUREHR

24
SUBJECT J S ACTIVITY: 6 STROKES/MIN BATH: 3 6.7 'C
roo 80 60

.Y
I

(,

(9

k
:B

tr

z
a =

.uJ

40
20 TIME OF EXPOSURE

HR

"rNDEx oF wETNE

-300
nrc. 5. Time course of sweating in salt baths (NaCl) of various
concentrations.

-200

-loo

+50

heat load minus evaporatir.e capacity of environment, Kcal/hr.

Decrease in sweating is expressed as:

of sweating in hot-dry and warm-humid environments. (From Gerking and Robinson (rI); used by per-

rrc. 6. Time

course

initial sweat rate - 6th hr sweat rate

mission. )

iritiul .*..1 *1.

too

nrc. 7. Relationship between per cent decrease of sweating and an arbitrary index of skin wetness. "Index of Wetness" : total

Calculations are based on data of Robinson, Turrell, and Gerking (r o), and Gerking and Robinson (r r ).

not exceed that of water, a maximum possible increase of about twofoid. Because of the thinness of the hornv Iayer, its thermal conductance is normallv verv large; doubling it would reduce the temperature gradient bv less than o. r C, hardiv suflicient a change to influence
sr,r'eating so profoundlv.

tively, reabsorption from the ducts would have had to occur much more rapidlt' than is norv thought possible
(B)

blocks the outpouring of sweat (7). This is the most readiiv- acceptable hypothesis, -vet there are several inconsistencies.

4. Swelling of the stratum corneum mechanicallvUptake of water b)' the corneum appar-

entlv was completed before sweating had reached a maximum. Postulation of an accelerated failure of the glands because of increased resistance to secretion fails
to account for the reduced peaks after presoaking. Had the glands continued to secrete uniformlv and had srveat been prevented from reaching the surface, rve should have seen miliaria; we observed none. Alterna-

To recapitulate, the evidence suggests that sweating declined because the glands became progressivelv less active; the decreased activity was not related to functional impairment of the glands attributable to excessive activitv, and adding salt to the water reduced the decline. This last point is considered next. Buettner (s) and others found that 2 r,r of various solutes prevented water from diffusing inward through
the skin of hands and feet. Diffusion through skin of other areas was prevented bv raising the concentration to 3 r,r.

A 3-u soiution of NaCl is 15% by weight, the amount

which we found eliminated the decline of srveating. The high resistance to diffusion imposed by the skin's barrier zone would be expected to delay diffusive equiiibrium

SWEATING IN HOT BATHS betu'een tissue that was between the barrier zone and the water, in keeping with the observed semilogarithmic time course of decline. How a few grams of water might so profoundly affect sweating we can onlv guess. Could storage of water in the

65t
decline and skin wetncss (FiS. Z). Thaysen and Schrvartz (rz) observed "fatigue of the sweat glands" in environments permitting evaporation of onlv roo-3co g,/hr of

prickle cell la1'er (cited because of its location immediately behind the barrier zone and its small total mass) have rendered local receptors for thermal regulation less
responsive? Reduced ionic concentrations of perfusing media have been shown by Diamond, Gray, and Inman (g) to decrease the amplitude and rate of response of

the 5oo Boo g/hr of swear produced. The decreased sweating rvhich Ladell (r.t) attributed to rise of rectal

Pacinian corpuscles. We see a parallei in the decline of sweating in the bath and the declines observed in severely stressful air environmcnts where high humiditv restricted evaporation (e.g., Fig. 6). Calculations based on data of Robinson's group (Io, rr) show an association between the percentage of
REFERENCES

temperature above a critical level was recorded in ncarly saturatcd environments. What he referred to as "quasifatigue" (lessened sweat rate for a standard task when q hr of rest in the heat preceded the task) developed under conditions analogous to those of presoaking in this study. The concept of "sweat gland fatigue" needs re-examination in light of the apparent association between decline of sweating and skin wetness. This effect should be considered when sweat rates are determined by coilection in an arm bag or other reservoirs r,vhich restrict
evaporation.

r.

z. Brzrtr, H. C. Am. J. Physiol. 7o:412, rg24. 3. BunroN, A. C., airn H. C. Beznrr. Am. J. Plrysiol.
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E. S. Tunnarr-, eno S. D. GnnrrNc.,4m. J. r43:2i,1945. rr. Gen<rNc, S. D., aNo S. RoerNsoN. Am. J. Phy.riol. 147:3jo,
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r

382, rg5B.

B.

rz.

TH.+vsr:N,J. H., ewn

955. 957.

RoHnnn, eNo A. L. KuNz. J. Appl. Physiol. B : 6 r 5, r 956. 7. ReNoer-r, W. C., eNo C. N. Parss. J. Inuest. Dermatol. zB:435, IgsJ.

I. L. Scrrwarrz. J.

Clin. Inrest.34: r7rg,

13. Leonu., W. S. S. 7-rans. Roy. ,\oc. 7'rop. Med.

r

Hyg.5r:

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