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Hot air sauna burns
Abstract
Our cases and the described evaluation of nationwide cases show that, although hot air sauna burns are rare, they do occur. In most cases, as emphasized by the survey, those burns occur alongside a loss of consciousness. Finally, the diminished perfusion of the skin leads to a disturbance of the cutaneous heat exchange. As a result, the heat effects accumulate on the highest exposed body parts and cause the described "Apex Burns". In conclusion, we found the damage to the skin is usually deeper (deep second- and third-degree burns) than first expected and generally the injuries require excisions at facial level or even amputation of limbs. Sauna-related burns induced by hot air in connection with a loss of consciousness, need a specific intensive medical and surgical therapy in a specialised centre.
... Finland has a population of 5.2 million, and 2 BioMed Research International nearly 2 million Finns use saunas regularly, whilst other Scandinavians also take sauna baths at least once a week for health improvement [2,3]. In addition, growing numbers of people install saunas at home or use different types of sauna (dry, steam, or infrared) in SPA centers [4]. Historically, saunas were popularized by Finnish athletes during the Olympic Games of 1936; consequently, sauna baths have been introduced to training programs in many sport disciplines [5]. ...
... In respondents who visited a sauna before EIMD, thermal treatment reduced sensory impairment (PF-ROM and PE-ROM) and improved muscle functions (GS and WES) in wrist extensor muscles [21]. Thermal treatment and rapid cooling after sauna were also found to exert a complex and positive effect on vascular and cardiac functions [4,22], including arterial stiffness, BP, and some blood-based biomarkers [23]. ...
... Dry sauna leads to changes in physiological parameters as well as body composition. Sauna bathing induces sweating, which promotes passive dehydration and leads to hyperthermia [18], mainly due to the evaporation of sweat and enhanced blood circulation in the skin, the main cooling mechanism in the body [4]. Uncontrolled sweating leads to body mass loss (0.1-1.0 kg), and fluid loss can reach up to 13 liters under extreme circumstances, such as sauna competitions [38]. ...
Background:
The effect of thermal stress on the physiological parameters of young overweight and sedentary men who sporadically use the sauna remains insufficiently investigated.
Aim:
The aim of the study was to determine the effect of sauna bathing on the physiological parameters of young overweight, physically inactive men and to test the correlations between physiological parameters versus anthropometric features and body composition parameters.
Materials and methods:
Forty-five overweight and sedentary men aged 20.76±2.4 y were exposed to four sauna sessions of 10 minutes each (temperature: 90-91°C; relative humidity: 14-16 %) with four 5-minute cool-down breaks. Body composition was determined before sauna, and body mass and blood pressure were measured before and after sauna. Physiological parameters were monitored during four 10-minute sauna sessions.
Results:
A significant (p<0.0001) increase in all analyzed physiological parameters was observed during four successive 10-minute sauna sessions. Heart rate, energy expenditure, blood pressure, and body mass loss were most strongly correlated with anthropometric parameters (body mass, body mass index, and body surface area) and body composition parameters (percent body fat, body fat mass, and visceral fat level). The 60-minute treatment resulted in a significant reduction in body mass (0.65 kg).
Conclusions:
Repeated use of Finnish sauna induces significant changes in the physiological parameters of young sedentary overweight men, and these changes are intensified during successive treatments. Deleterious cardiovascular adaptations were most prevalent in men characterized by the highest degree of obesity and the largest body size.
... ескую травму чрезвычайно сложного комплексного характера, когда поражение всех слоев кожи сочетается с поражением глубоких тканей. В шести последующих случаях ОГВС, все больные были обнаружены лежащими без сознания в сауне. На этот момент время пребывания в парной составляло от 30 до 60 мин.; такое же время регистрируется немецкими исследователями (Ghods, Corterier и др. 2008). Ни один из пациентов не был в контакте с горячей плитой и не имел ран или кровоподтеков, свидетельствующих о падении (Koski, Koljonen и др. 2005). ...
... Ghods с соавторами собрал сведения о немецких пациентах с ОГВС в период с 1999 по 2005.Их статья указывает на незначительное преобладание женщин (9F/7M), и только у двух пациентов был зарегистрирован повышенный уровень алкоголя(Ghods, Corterier и др. 2008).ОГВС -«небольшие» ожоги. В литературе указывают на поражение от 3 до 32% площади поверхности тела(Koski, Koljonen и др. 2005; Garcia-Tutor и Koljonen 2007;Koljonen 2007). ...
... атуры. Несмотря на то, что воздух обладает пониженной теплоемкостью, кожа в данных обстоятельствах чрезвычайно уязвима, и одновременная неподвижность способствует возникновению ожога за сравнительно короткое время.Обожженные горячим воздухом участки тела -всегда наиболее высоко расположенные(Koski, Koljonen и др. 2005; Garcia-Tutor и Koljonen 2007;Ghods, Corterier и др. 2008).Периферийные части тела, особенно пальцы на руках и ногах, представляются особо чувствительными к воздействию горячего воздуха, поскольку находящиеся там кровеносные сосуды уже, а кожный покров тоньше. Такой отчетливый характер термических поражений побудил Ghods с соавторами в своей недавней статье(Ghods, Corterier и др. 2008) предложи ...
... ihon kaikkien kerrosten tuhoutuminen ja ihonalaiskudoksen kuolio. Koski ym. (2005) julkaisivat kuuden potilaan sarjan, jonka potilaat oli löydetty tajuttomina saunasta aikaisintaan 30 minuutin ja viimeistään tunnin kuluttua altistumisen alusta. Yhtä lyhyitä vaikeaan palovammaan johtaneita altistusaikoja on todettu myös saksalaisessa tutkimuksessa (Ghods ym. 2008). Kellään näiden aineistojen potilaista ei todettu kiukaan aiheuttamaa kontaktipalovammaa tai muita vammoja, kuten ruhjeita, jotka viittaisivat esimerkiksi liukastumistapaturmaan. ...
... a saunailmapalovammasarjoissa on miesten osuus ollut jopa 80 % potilaista (Koski ym. 2005, Garcia-Tutor ym. 2007). Veren keskimääräinen alkoholipitoisuus oli Kosken ym. (2005) pienessä aineistossa 2,23 ‰ (1,5-3,5 ‰), mikä tuntuu sopivan suomalaiseen saunakulttuuriin: miehet saunovat naisia enemmän ja käyttävät tässä yhteydessä runsaasti alkoholia. Ghods ym. (2008) analysoivat saksalaisia saunailmapalovammatapauksia vuosilta 1999-2005. Yllättäen heidän 16 potilaan aineistossaan oli hieman enemmän naisia kuin miehiä ja ainoastaan kahdella potilaalla todettiin alkoholia verestä. ...
... Saunailmapalovammat ovat pienehköjä, mutta suomalaisissa aineistoissa palovamma on kattanut ihon pinta-alasta laajimmillaan jopa 32 % (Koski ym. 2005, Garcia-Tutor ja Koljonen 2007, Koljonen 2008. Saksalaisten tutkimuksessa laajin palovamma-alue oli 25 % ja keskimääräinen pinta-ala 14 % (Ghods ym. 2008). Saunailmapalovamman saaneilla on todettu suhteessa suurempi kuolevuus kuin samankokoisen liekkivamman saaneilla (Koski ym. 2005). Kuvantamistutkimuksista suositellaan pään kerroskuvausta, jos tajuttomuuden syy jää anamneesin perusteella epäselväksi. Neurologiset tutkimukset voidaan suorittaa myöhemmin, kun potilas on vieroitettu hengit ...
Burn injuries caused by hot air sauna burns constitute a Finnish burn rarity. The patients are usually middle-aged men having passed out on the sauna benches under the influence of alcohol. Sauna air causes a deep injury penetrating all layers of the skin, accompanied with necrosis of the subcutaneous tissue and consequent rhabdomyolysis. The initially harmless-looking erythema of the skin rapidly transforms into a third-degree burn. Therapy includes the prevention of kidney damage and surgery. Local flaps are recommended for the treatment of tissue defects caused by destruction of deep tissues and amputations.
... In a series of six patients with HASBs, all patients were found unconscious in the sauna after 30 minutes to 1 hour, a time period that has also been recorded in a German study. 3 None of those patients were in contact with the hot stove or had wounds or bruises that could be caused by an accidental fall. 1 Dehydration caused by enhanced perspiration (0.5-1.0 kg loss of body weight) and reduced vascular resistance produce reduction of the blood volume. 4,5 To balance this, the heart rate increases, together with the high risk of arrhythmia and vascular deregulation. ...
... In their article, there was a slight female predominance (9 F/7 M), and only two of the patients had elevated blood alcohol levels. 3 HASBs are small injuries. The %TBSA varied between 3 and 32% in the published series. ...
... The burned areas are always those areas exposed at the highest level. 1,3 This has been verified from the ambulance documents reporting the patient's original position in the sauna. 1 The pattern of the burned areas leaves the contralateral side of the body part intact. ...
Hot air sauna burns (HASBs) are rare but potentially fatal injuries with simultaneous rhabdomyolysis. The mechanism of HASBs involves prolonged exposure to hot air because of immobility. The burned areas are on the parts of the body that are directly exposed to hot air. This type of heat exposure results in a complex injury, in which full-thickness skin damage occurs concurrently with deeper tissue destruction. Sauna bathing is becoming more and more a popular recreational activity around the world. The objective of this review article is to familiarize burn care specialists on this unique and clinically challenging type of burn injury and to illustrate our department's long experience in treating patients with HASBs. A thorough review of the current literature with PubMed interface using the key word "hot air sauna burn" was performed. Six articles were found under this topic, with 42 patients being recorded. Therapy for rhabdomyolysis and aggressive early operative treatment are the cornerstones of hot air sauna burn treatment and lifesaving actions. Treatment of HASBs differs from the more common flame and scald burns. Hot air sauna burn patients require early and aggressive surgical intervention to treat the rhabdomyolysis. Amputations and excision of the affected muscles are common. Contrary to other types of burn injuries, these patients need flap coverage during the acute surgery phase. Microvascular free flaps usually perish because of damage of vascular structures deeper to the visible burned cutaneous areas. Pedicled flaps are the treatment of choice.
... Fortunately, hot air sauna burns are relatively rare, even among the avid sauna bathing Finnish population [2]. The mechanism of hot air sauna burns involves prolonged exposure to hot air, due of immobility or loss of consciousness [1,3]. If the victim is found lying on left side, the burned areas are typically on the contralateral side of the body, thus leaving the other side unaffected. ...
... If the victim is found lying on left side, the burned areas are typically on the contralateral side of the body, thus leaving the other side unaffected. The burned areas are always those areas exposed at the highest level [1,3]. Therefore, Ghods et al. suggested the term ''Apex burns'' when referring to the hot air sauna burns. ...
... They reported two hot air sauna burn victims, whose lower extremity hot air sauna injuries, after depridement resulted in exposed bone. In both cases the free flaps perished due to thrombosis [3]. On admission, these patients need fasciotomies in addition to escharotomies [1]. ...
... Repeated sauna bathing influences endogenous regulatory mechanisms, mainly acute and transient cardiovascular and hormonal changes, by maintaining a balance between fluid composition and the distribution of circulating blood [1]. Uncontrolled sauna bathing poses various health risks, such as severe dehydration, heat exhaustion, stroke or burns [9,22,31]. ...
... The loss of bodily fluids corresponding to 1% body mass can reduce endurance by 4 to 6%, strength by 4 to 7% and coordination and concentration by 8% [30]. Sweat evaporation and blood circulation in the skin are the main cooling mechanisms in the body [9]. Uncontrolled sweating leads to the loss of body mass (0.5-1.0 kg) [22]. ...
The aim of this study was to evaluate the relationship between basic somatic features (body mass and height) and body mass loss in physically inactive young women and men exposed to thermal stress in a dry sauna.
: The research was conducted in 2015 on 685 first-year full-time students (333 women, 352 men), aged 19–20 years old. Nude body mass was measured after the students dried off before and after using the sauna.
: An analysis of regression equations indicated that an increase in the body mass of women and men leads to a significant increase in sauna-induced body mass loss. On the other hand, body mass loss decreased with an increase in height in women and men, but to a smaller extent. From among the tested somatic features, body height and body mass, body mass had a decisive influence on body mass loss. Body height had a minimal and statistically non-significant impact on body mass loss.
: The results of this study indicate that heavier individuals have an increased risk of dehydration and hyperthermia. Therefore, they should pay close attention to replenishing fluids lost in the sauna. The determination of body mass loss values after a visit to a dry sauna has practical significance because it supports the estimation of the fluid volume required for the maintenance of correct water balance.
... Growing levels of awareness about health and the benefits of a healthy lifestyle have contributed to the popularity of sauna bathing in recent years [1]. Sauna is an ancient traditional form of whole-body heat therapy that relies on contrast thermal effects. ...
Simple Summary
It is important to determine the effects of thermal stress on the physiological parameters of obese persons. The aim of this study was to analyze the influence of sauna bathing on obese and non-obese physically inactive men. Sixty volunteers aged 18–24 years were divided into two groups (group I—normal body mass, group II—class 1 obesity). Their physiological parameters were monitored before and during the sauna session. The average values of body mass, body mass index, body surface area, and weight-to-height ratio were significantly higher in obese men than in the normal weight group. The values of physiological parameters were also significantly higher in obese individuals. However, the observed changes remained within the norm, which indicates that a 10 min sauna session is safe for young men regardless of their body fat levels.
Abstract
The effects of thermal stress on the physiological parameters of obese subjects remain insufficiently researched. The objective of this study was to determine the influence of sauna bathing on the physiological parameters of obese and non-obese physically inactive men. Sixty volunteers aged 18–24 years (20.85 ± 1.46) were divided into two groups (group I—normal body mass, group II—class 1 obesity) for a comparative analysis. Somatic features and body composition were determined before sauna, and blood pressure was measured before and after sauna. Physiological parameters were monitored before and during the sauna session. The average values of body mass, body mass index, body surface area, and weight-to-height ratio were significantly higher (p < 0.001) in obese men (by 28.39 kg, 8.7 kg/m², 0.34 m², and 0.13, respectively) than in the normal weight group. Similar observations were made in an analysis of the remaining body composition parameters. The values of physiological parameters (heart rate, systolic and diastolic blood pressure, energy expenditure, oxygen uptake, excess post-exercise oxygen consumption, respiratory rate) were significantly (p < 0.001) higher in obese subjects. However, the observed physiological changes were within the expected norm; therefore, a 10 min sauna session is safe for young men regardless of their body fat levels.
... This type of heat exposure results in a complex injury, in which full-thickness skin damage occurs concurrently with deeper tissue destruction and rhabdomyolysis. [8][9][10] Under normal conditions, the body is cooled by the evaporation of sweat and by blood circulation in the skin. That way, temperatures up to 120°C in dry, hot air do not cause any damage to the skin, an effect caused by the low thermal capacity of air. ...
Sudden death during or after sauna bathing is a rare event. When occurring accidentally, it is often caused or contributed by consumption of ethanol. To accidentally burn to death because of hot air is highly uncommon without some contributing factor that lowers the person's consciousness. Hot air burns have been reported to develop in 20 to 60 minutes. We present a case of sudden death of a healthy man with rare and extensive hot air burns that developed in less than 10 minutes in the sauna. Ethanol was not a contributing factor. Substantial injuries were found at the autopsy, both external and internal, for instance, small hemorrhages in the stomach mucosa, indicating a heavy antemortem stress reaction. The most probable reason for the extensive scalds was concluded to be, apart from the high temperature, the high degree of relative humidity in the sauna.
... Sauna is used in sports to maximize the athletes' physical and psychological recovery [10,11]. Despite the above, uncontrolled sauna bathing could pose a risk of various disorders, such as severe dehydration, heat exhaustion, stroke, and burn [12][13][14]. ...
The aim of the study was to evaluate the relationship between body mass index (BMI) and body mass loss (BML) induced by thermal stress in a dry sauna. The study was conducted on a group of 674 sedentary students, 326 women and 348 men aged 19-20. The correlations between BMI scores and BML were determined. The subjects were placed in supine position in a dry sauna for two sessions of 10 minutes each with a 5-minute break. The influence of BMI on the amount of BML in the sauna was determined by nonlinear stepwise regression. The smallest BML was noted in underweight subjects; students with normal weight lost more weight, whereas the greatest BML was reported in overweight and obese subjects. Persons with a high BMI are at higher risk of dehydration, and they should pay particular attention to replenishing fluids during a visit to the sauna. The proposed equations for calculating BML based on a person's BMI can be useful in estimating the amount of fluids that should be replenished by both men and women during a visit to a dry sauna.
... Sauna is used in sports to maximize the athletes' physical and psychological recovery [10,11]. Despite the above, uncontrolled sauna bathing could pose a risk of various disorders, such as severe dehydration, heat exhaustion, stroke, and burn [12][13][14]. ...
The aim of the study was to evaluate the relationship between body mass index (BMI) and body mass loss (BML) induced by thermal stress in a dry sauna. The study was conducted on a group of 674 sedentary students, 326 women and 348 men aged 19-20. The correlations between BMI scores and BML were determined. The subjects were placed in supine position in a dry sauna for two sessions of 10 minutes each with a 5-minute break. The influence of BMI on the amount of BML in the sauna was determined by nonlinear stepwise regression. The smallest BML was noted in underweight subjects; students with normal weight lost more weight, whereas the greatest BML was reported in overweight and obese subjects. Persons with a high BMI are at higher risk of dehydration, and they should pay particular attention to replenishing fluids during a visit to the sauna. The proposed equations for calculating BML based on a person's BMI can be useful in estimating the amount of fluids that should be replenished by both men and women during a visit to a dry sauna.
... La survenue de brûlures lors du sauna a été rapportée pour la première fois en 1978 (13). Depuis, les cas sont, sans surprise, rapportés majoritairement en Finlande, mais également en Allemagne (14)(15)(16)(17)(18)(19). L'incidence des brûlures lors de saunas est estimée à 7/100 000 habitants en Finlande, et une brûlure liée au sauna par jour nécessiterait une hospitalisation, selon une étude rétrospective réalisée dans un centre universitaire de grands brûlés (14). ...
... The mechanism of hot air sauna burns involves prolonged exposure to hot air, due of immobility or loss of consciousness. This type of heat exposure results in a complex injury in which fullthickness skin damage occurs concurrently with deeper tissue destruction frequently affecting the muscles [21,22]. ...
Despite the diagnostic advancements, some clinically important diagnoses remain undetected during intensive care in burn patients. The aim of this study was to compare the premortem clinical diagnoses and autopsy findings.
A retrospective review of all burn deaths during 1995-2005 was conducted. The clinical diagnoses and autopsy reports were reviewed, and diagnostic discrepancies were classified into four categories, according to the impact on the treatment.
Overall mortality during the study period was 5.4%. Altogether 74 deaths were recorded, of which 71 were included in the study. Typical patient was a 58-year-old male with flame burn of %TBSA 49, ABSI 10. Clinical diagnostic discrepancies were found in 14.1% of the patients; one diagnostic discrepancy was recorded in each of the patients. Of these diagnostic discrepancies, 8.5% were considered major, and 5.6% would have altered the clinical outcome or therapy, if known at the time. Diagnostic discrepancies consisted of one cardiovascular, seven respiratory and two gastrointestinal missed diagnosis. The most common missed diagnosis was pneumonia.
This study emphasizes the usefulness of autopsies to provide valuable clinical data for the treatment of burn patients. It also highlights the few missed diagnoses which may occur in burn patients.
Background
Many individuals who use the sauna at a temperature of 120°C of higher are not aware of the negative consequences of extreme thermal stress. Despite extensive research into sauna use, the impact of extreme thermal stress on the physiological and psychological characteristics of sauna users have not been examined to date.
Aim
The aim was to determine the effect of 20 min sauna sessions with a temperature of 80°C and 120°C on the physiological and psychological characteristics of women who sporadically visit the sauna.
Methods
The study was conducted on 22 full-time female university students. Physical activity (PA) levels were evaluated with the Polish short version of the International Physical Activity Questionnaire (IPAQ). Anthropometric characteristics were measured before the first sauna session by the InBody270 body composition analyzer. Physiological parameters, including heart, energy expenditure, physical effort, and blood pressure (systolic blood pressure – SBP, and diastolic blood pressure – DBP), were assessed indirectly using Polar V800 heart rate monitors and the Omron M6 Comfort blood pressure monitor. The participants’ wellbeing was assessed with the Profile of Mood States (POMS) questionnaire. The presence of significant correlations between heat exhaustion and heat stress variables and syncope during the second sauna session was examined with the use of classification and regression trees (CRT) and the cross-validation technique.
Results
Twenty-minute sauna sessions with a temperature of 80°C and 120°C induced a significant (p < 0.001) decrease in the values of SBP (excluding the temperature of 120°C), DBP, and body mass, as well as a significant increase in HR and forehead temperature. Exposure to a temperature of 80°C led to a significant (p < 0.001) increase in vigor with a simultaneous decrease in tension, depression, anger, fatigue, and confusion. In turn, sauna bathing at a temperature of 120°C had an opposite effect on the above mood parameters. Vomiting and confusion were the main predictors of syncope that occurred in some of the surveyed women.
Conclusion
Excessive air temperature can induce symptoms characteristic of heat exhaustion and heat stress nausea, heavy sweating, fast weak or strong HR, high body temperature, and confusion. Therefore, sauna bathing at a temperature of 80°C can be recommended to women who sporadically use the sauna, whereas exposure to a temperature of 120°C is not advised in this group of sauna users. The present findings provide highly valuable inputs for managing wellness and SPA centers.
Simple Summary
In response to disease outbreaks or other urgent circumstances, an increasing number of farm animals in the United States (US) are being killed en masse by depopulation. In the past few years, depopulation methods that rely on heatstroke as the mechanism of killing have been used with increasing frequency to kill birds and pigs raised for food production. While they are defended as expedient and faster to implement, heatstroke-based methods severely compromise animal welfare and there is a prolonged period prior to the animals losing consciousness. The US veterinary profession is entrusted with an ethical responsibility to protect and advance animal welfare, yet its classification of the heatstroke-based depopulation method Ventilation Shutdown Plus is used to justify this method’s widespread use. Numerous strategies are suggested for how the US veterinary profession, including the American Veterinary Medical Association, can encourage the use of more humane methods when depopulations are performed.
Abstract
Depopulation of food-producing animals is becoming increasingly common in response to both disease outbreaks and supply chain disruptions. In 2019, the American Veterinary Medical Association released depopulation guidelines classifying certain heatstroke-based killing methods as “permitted in constrained circumstances”, when circumstances of the emergency constrain reasonable implementation of “preferred” methods. Since then, tens of millions of birds and pigs have been killed by such methods, termed ventilation shutdown (VSD) Plus Heat and VSD Plus High Temperature and Humidity. While no research using validated measures of animal welfare assessment has been performed on these methods, their pathophysiology suggests that animals are likely to experience pain, anxiety, nausea, and heat distress prior to loss of consciousness. Heatstroke-based methods may result in prolonged suffering and often do not achieve 100% mortality. Potential and available alternative depopulation methods are briefly reviewed. The veterinary profession’s ethical obligation to protect animal welfare in the context of depopulations is discussed.
The health benefits of sauna baths are attracting ever-increasing interest. Therefore, the purpose of this study was to evaluate the effects of 12 high-temperature (100 °C) sauna baths on body composition of 23 healthy young men, divided into a control group (CG) and a sauna group (SG). Both groups were initially evaluated by dual-energy X-ray absorptiometry (DXA), after which the SG experienced 12 sessions of sauna baths at high temperatures (100 °C). Initial measurements were carried out after the sauna sessions and after two weeks of decay in both groups. The muscle mass of the right leg (pre vs. decay: 9.50 (5.59) vs. 10.52 (5.15); p < 0.05; Δ 1.07%), bone mineral density (pre vs. post: 1.221 (0.35) vs. 1.315 (0.45); p < 0.05; Δ 7.7%) and bone mineral content (pre vs. post: 0.470 (0.21) vs. 0.499 (0.22); p < 0.05; Δ 6.17%) of the left leg increased in the SG after the sauna baths. It seems that exposure to heat at high temperatures could produce improvements in bone and muscle mass.
COVID-19 is a new contagious disease caused by a new coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 is a disease that has reached every continent in the world; it has overloaded the medical system worldwide and it has been declared a pandemic by the World Health Organization. Currently there is no definite treatment for COVID-19. We realize that host immunity is a critical factor in the outcome of coronavirus 2 infection. Here, however, we review the pathophysiology of the disease with a focus on searching for what we can do to combat this new disease. From this, we find that coronavirus is sensitive to heat. We have thus focused on this area of vulnerability of the virus. The emphasis of this hypothesis is on the action of body heat—internal (fever) and external (heat treatment)—in activating the immune system and its antiviral activities, and specifically related to the coronavirus. We hypothesize from this review that heat treatments has the potential to prevent COVID-19 and to decrease the severity of mild and moderate cases of Coronavirus. We propose heat treatments for this uncontrolled worldwide coronavirus pandemic while studies are being done to test the effectiveness of heat treatments in the prevention and treatment of COVID-19.
As the “baby boom population” in North America ages, one of the populations at greatest risk of thermal injury continues to expand. According to the US Census Bureau in 2000, the population of US citizens who are 75 years and older was 16,548,000 (6.0 %). In 2010 this figure was projected to be 19,101,000 (6.4 %), and by 2050 it is expected to exceed 54, 094,000 (13.4 %) (Lionelli et al., Burns 31:958–963, 2005). In the United States and Canada, 1.25 million people suffer burn injuries annually (Burn Foundation. Burn incidence and treatment in the United States 1999 Fact Sheet. Philadelphia). Populations identified at increased risk of burns include infants and young children, older adults, and people with any type of disability (Redlick et al., Burn Care Rehabil 23:351–356, 2002; Baptiste and Feck, Am J Public Health 70:727–729, 1980; Petro et al., Geriatrics 44(3):25–48, 1989; Stassen et al., Am Surg. 2001;67:704–708). Many of the burns reported are from scalds. Scald injuries are painful, require prolonged treatment, and may result in lifelong scarring and even death. Most burn injuries happen in the home with tap water scalds occurring in the bathroom or kitchen (Redlick et al., Burn Care Rehabil 23:351–356, 2002; American Burn Association (2000) Scalds: a burning issue. A campaign kit for burn awareness week; Bull and Lawrence, Fire Mater 3(2):100–105, 1979). Burns can also be caused by therapies in medical treatment facilities (Barillo et al., J Burn Care Rehabil 21:269–273, 2000) or from therapeutic use of heat in the home. This premise is supported by a jointly issued public health advisory in 1995 by the United States Food and Drug Administration and the Consumer Products Safety Commission on electric heating pads. This advisory reported approximately 1,600 heating pad burns treated in the emergency room annually and that approximately 45 % of those patients were over 65 years of age (Burlington DB, Brown A (1995) FDA/CPSC public health advisory: hazards associated with the use of electric heating pads. pp 1–3.
As the “baby boom population” in North America ages, one of the populations at greatest risk of thermal injury continues to expand. According to the US Census Bureau in 2000, the population of US citizens who are 75 years and older was 16,548,000 (6.0 %). In 2010 this figure was projected to be 19,101,000 (6.4 %), and by 2050 it is expected to exceed 54, 094,000 (13.4 %) (Lionelli et al., Burns 31:958–963, 2005). In the United States and Canada, 1.25 million people suffer burn injuries annually (Burn Foundation. Burn incidence and treatment in the United States 1999 Fact Sheet. Philadelphia). Populations identified at increased risk of burns include infants and young children, older adults, and people with any type of disability (Redlick et al., Burn Care Rehabil 23:351–356, 2002; Baptiste and Feck, Am J Public Health 70:727–729, 1980; Petro et al., Geriatrics 44(3):25–48, 1989; Stassen et al., Am Surg. 2001;67:704–708). Many of the burns reported are from scalds. Scald injuries are painful, require prolonged treatment, and may result in lifelong scarring and even death. Most burn injuries happen in the home with tap water scalds occurring in the bathroom or kitchen (Redlick et al., Burn Care Rehabil 23:351–356, 2002; American Burn Association (2000) Scalds: a burning issue. A campaign kit for burn awareness week; Bull and Lawrence, Fire Mater 3(2):100–105, 1979). Burns can also be caused by therapies in medical treatment facilities (Barillo et al., J Burn Care Rehabil 21:269–273, 2000) or from therapeutic use of heat in the home. This premise is supported by a jointly issued public health advisory in 1995 by the United States Food and Drug Administration and the Consumer Products Safety Commission on electric heating pads. This advisory reported approximately 1,600 heating pad burns treated in the emergency room annually and that approximately 45 % of those patients were over 65 years of age (Burlington DB, Brown A (1995) FDA/CPSC public health advisory: hazards associated with the use of electric heating pads. pp 1–3.
We have studied the effect of a short period of exposure to the intense heat of a sauna bath on the electrocardiogram and plasma catecholamine, free fatty acid, and triglyceride concentrations in 17 subjects with apparently normal hearts and 18 persons with coronary heart disease. Similar observations were made on 11 of the 17 normal subjects and on 7 of the persons with coronary heart disease in response to exercise.Exposure to heat was associated with an increase in plasma adrenaline with no change in noradrenaline, free fatty acid, or triglyceride concentrations. Exercise was associated with the expected increase in both plasma noradrenaline and adrenaline concentrations. A heart rate up to 180 beats/min was observed in response to both heat and exercise. Apart from the ST-T changes inherent to sinus tachycardia, ST-T segment abnormalities were frequent in response to heat in both the subjects with normal and abnormal hearts, but little change occurred in the ST-T configuration when the subjects were exercised to produce comparable heart rates. Ectopic beats, sometimes numerous and multifocal, were observed in some subjects of both groups in response to heat, but not to exercise. It seems likely that the net unbalanced adrenaline component of the increased plasma catecholamine concentrations (which is also seen in certain emotional stress situations) is predominantly responsible for ischaemic-like manifestations of the electrocardiogram in susceptible subjects. The observations provide further validation for previously reported studies that it is the increased plasma noradrenaline in response to emotional stress that is associated with the release of free fatty acids and ultimate hypertriglyceridaemia, of probable importance in the aetiology of atheroma.
Systemic thermal therapy, such as taking a warm-water bath and sauna, induces systemic vasodilation. It was found that repeated sauna therapy (60 degrees C for 15 min) improved hemodynamic parameters, clinical symptoms, cardiac function, and vascular endothelial function in patients with congestive heart failure. Vascular endothelial function is impaired in subjects with lifestyle-related diseases, such as hypertension, hyperlipidemia, diabetes mellitus, obesity, and smoking. Sauna therapy also improved endothelial dysfunction in these subjects, suggesting a preventive role for atherosclerosis. In animal experiments, sauna therapy increases mRNA and protein levels of endothelial nitric oxide synthase (eNOS) in aortas. In normal-weight patients with appetite loss, repeated sauna therapy increased plasma ghrelin concentrations and daily caloric intake and improved feeding behavior. In obese patients, the body weight and body fat significantly decreased after 2 weeks of sauna therapy without increase of plasma ghrelin concentrations. On the basis of these data, sauna therapy may be a promising therapy for patients with lifestyle-related diseases.
Alcohol-related minor accidents such as sprains and burns are common in sauna, but more serious accidents also take place--head contusions, heat stroke after passing out in sauna and drownings while swimming. The exact number of these accidents is not known, but in Finland (population 4.8 million) the consumption of alcohol has been estimated to be a contributing factor in some 20 to 25 sauna-related deaths every year. The scientific information on the interaction of sauna and alcohol on human physiology is totally lacking. Thus our discussion on the physiological and medical consequences of this interaction relies merely on presumptions. Ingestion of large amounts of alcohol while sauna bathing may affect the body's ability to maintain blood pressure. In particular, the risk of an orthostatic hypotensive reaction is increased with concomitant faintings and accidents. Alcohol intoxication and particularly the hangover phase exposes a person to cardiac arrhythmias, and sauna may further increase the arrhythmia-risk due to enhanced adrenergic activity. Sauna bathing and heavy drinking, and also sauna bathing during hangover phase undoubtedly create real health risks.
158 sudden and unexpected natural and non-natural deaths, which occurred in the province of Uusimaa (population 1.1 million) in 1976-1983, and in which the corpse was found in the sauna or in the adjacent rooms were the material of this study. The protocol of the police and that of the medicolegal autopsy of these cases were analysed. Most of the deaths occurred on Friday or Saturday nights in the steam room of the sauna in association to bathing; the proportion of males was 80% of all cases; most of the cases belonged to older age groups; and skilled and non-skilled workers were the largest occupational groups. Coronary atherosclerosis or acute myocardial infarct were the underlying cause of death in 78% of all natural deaths (46% of the whole material), whereas effects of heath - stroke or burns - (36%), hanging (18%) and alcohol intoxication (13%) were the largest non-natural groups of deaths (54%). Ingestion of alcohol was found to be a significant condition contributing to the death in 30% of all deaths of males from cardiovascular diseases and in 52% of all non-natural deaths of males.
Effects of thermal dehydration without exercise on leukocyte differentials, serum protein fractions, and other hematologic characteristics were studied in six healthy subjects. Both leukocyte and serum total protein levels increased beyond that predicted by hemoconcentration alone. Eosinophil counts decreased significantly, although other leukocyte counts tended to increase. Serum globulin concentrations tended to increase, but the albumin level did not change. Serum K+ concentration was elevated, but Na+ and Cl- were unaffected. It is suggested that thermal dehydration affects blood leukocyte composition and protein metabolism in many of the same ways as physical exercise.
Bathing in sauna has been customary for Finnish people for centuries. However, there are no actual reviews on sauna-related burns in the literature. This 7-year retrospective analyses of 598 burn patients treated in Kuopio University Hospital Burn Unit revealed that every fourth burn in our unit was sauna-related, giving a total of 154 cases. Most of these burns were minor but 54% required operative treatment. A total of 71% of patients were male and 40% of all patients were under the influence of alcohol. The incidence of sauna-related burns in Finland according to our material is 7/100,000, giving a total of 357 patients annually. Hence, there is one sauna-related burn per day requiring hospitalization in Finland.
The purpose of this study was to determine the mechanism by which 60 degrees C sauna treatment improves cardiac function in patients with chronic heart failure (CHF).
We have previously reported that repeated 60 degrees C sauna treatment improves hemodynamic data and clinical symptoms in patients with CHF. We hypothesized that the sauna restores endothelial function and then improves cardiac function.
Twenty patients (62 plus minus 15 years) in New York Heart Association (NYHA) functional class II or III CHF were treated in a dry sauna at 60 degrees C for 15 min and then kept on bed rest with a blanket for 30 min, daily for two weeks. Ten patients with CHF, matched for age, gender and NYHA functional class, were placed on a bed in a temperature-controlled (24 degrees C) room for 45 min as the nontreated group. Using high-resolution ultrasound, we measured the diameter of the brachial artery at rest and during reactive hyperemia (percent flow-mediated dilation, %FMD: endothelium-dependent dilation), as well as after sublingual administration of nitroglycerin (%NTG: endothelium-independent dilation). Cardiac function was evaluated by measuring the concentrations of plasma brain natriuretic peptide (BNP).
Clinical symptoms were improved in 17 of 20 patients after two weeks of sauna therapy. The %FMD after two-week sauna treatment significantly increased from the baseline value, whereas the %NTG-induced dilation did not. Concentrations of BNP after the two-week sauna treatment decreased significantly. In addition, there was a significant correlation between the change in %FMD and the percent improvement in BNP concentrations in the sauna-treated group. In contrast, none of the variables changed at the two-week interval in the nontreated group.
Repeated sauna treatment improves vascular endothelial function, resulting in an improvement in cardiac function and clinical symptoms.
Sauna-related burns are rare, even in Finland where sauna bathing is a popular leisure pastime. Burns induced by hot air are even more rare and constitute a very small subgroup of all sauna burns. Hot air burns are characterised by a combination of full thickness skin damage with deep tissue destruction. We report here on six consecutive patients suffering from hot air sauna burns with rhabdomyolysis. All six patients were middle-aged, the majority of them men. Acute excessive consumption of alcohol exacerbated by a hot environment resulted in dehydration and loss of consciousness. Immobility and prolonged exposure to hot, dry air resulted in third degree regional burns with 5-32% TBSA. Rhabdomyolysis was evident on admission. The laboratory values of plasma creatine kinase (P-CK), plasma myoglobin (PM), blood pH, and serum potassium (S-K) during the first five days were evaluated. Aggressive fluid management and correction of acidosis and myoglobinuria were started on admission. Surgical management consisted of early, aggressive excision at fascial level, in some patients involving sacrifice of the upper layers of muscle. Even so, mortality in this small series was 50%. The best indicator of poor prognosis was a highly elevated CK value on the second post-injury day.
Saunawirkung auf Hä modynamik und myokardiale Leistungsfä higkeit
- P Baumgartl
- E Knapp
- A Aigner
Baumgartl P, Knapp E, Aigner A, Raas E. Saunawirkung auf Hä modynamik und myokardiale Leistungsfä higkeit. Mü nch Med Wochenschr 1972;114:479–83.
Saunomisen hemodynaamiset vaikutukset
- Vuori
Vuori I, Oja P. Saunomisen hemodynaamiset vaikutukset. Suom Lä a ¨ kä ril 1987;21:1976–82.
Saunawirkung auf Hämodynamik und myokardiale Leistungsfähigkeit
- Baumgartl
Unerwartete und plötzliche Tode in der finnischen Sauna
- Penttilä