Human Physiology in Extreme Environments

325 Pages·2014·64.469 MB·English

by  Hanns-Christian Gunga

Human Physiology in Extreme
Environments
Human Physiology in
Extreme Environments
Hanns-Christian Gunga
Professor
Center for Space Medicine and
Extreme Environments
Institute of Physiology
CharitéCrossOver (CCO)
Charité University Medicine Berlin
Berlin
Germany
With contributions from
Oliver Opatz Alexander Christoph Stahn
Postdoctoral Research Associate Postdoctoral Research Associate
Center for Space Medicine and Center for Space Medicine and
Extreme Environments Extreme Environments
Institute of Physiology Institute of Physiology
CharitéCrossOver (CCO) CharitéCrossOver (CCO)
Charité University Medicine Berlin Charité University Medicine Berlin
Berlin Berlin
Germany Germany
Mathias Steinach
Postdoctoral Research Associate
Center for Space Medicine and
Extreme Environments
Institute of Physiology
CharitéCrossOver (CCO)
Charité University Medicine Berlin
Berlin
Germany
AMSTERDAM (cid:127) BOSTON (cid:127) HEIDELBERG (cid:127) LONDON
NEW YORK (cid:127) OXFORD (cid:127) PARIS (cid:127) SAN DIEGO
SAN FRANCISCO (cid:127) SINGAPORE (cid:127) SYDNEY (cid:127) TOKYO
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Cover artwork created by Dr. Mathias Steinach MD (Center for Space Medicine and Extreme
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Dedication
This book is dedicated to Luise, Leonard, Maxim, and Arthur.
Berlin, May 2014
Preface
This book deals with humans in extreme environments. It originated from talks
and field studies with my academic teacher Prof. K. Kirsch in the gold mines
of Tarkwa in Ghana’s tropical rain forest more than 20 years ago. The con-
tents of the book are based on lectures and seminars to medical students at
the Institute of Physiology at the Free University of Berlin1 at the beginning
of the 1980s. Meanwhile, additional courses were given with support of the
Deutschen Akademischen Austauschdienst (DAAD, Germany) and the State
Administration of Foreign Experts (China) at the Faculdad de Medicina de
Chile (Santiago, Chile) and at the Key Laboratory for Space Biosciences and
Biotechnology at the Northwestern Polytechnical University (Xi’an, China),
respectively. Our experience is based on numerous studies in the laboratory
and the field, including studies conducted in Africa, North and South America,
Antarctica, and in space.
Several different kinds of books on this topic have been published during
the last decades [1–3]. However, some cover only one topic, such as Edholm’s
Man: Hot and Cold [1]. Other excellent books are extremely comprehensive,
such as volumes I/II of the Handbook of Physiology: Environmental Physiology
[4], Pandolf’s “Human performance physiology and environmental medicine
at terrestrial extremes” [5], or Auerbach’s outstanding handbook Wilderness
Medicine [6]. Therefore, we felt that the present book should be “as broad as
possible and as focused as necessary” [7],2 aiming primarily at medical students
and interested laymen. Thus, our work follows most closely of Edgar Folk’s
classical Textbook of Environmental Physiology in its second edition [8] or more
recently the publications by Piantadosi [9] “The biology of human survival life
and death in extreme environments” and Cheung’s “Advanced environmental
exercise physiology” [10]. However, we thought that for an initial introduction
to the topic some additional aspects should be addressed such as evolutionary,
anthropological, and methodological issues.
1. In 2003 the Medical Faculty of the Free University of Berlin and the former Medical Faculty
of the Humboldt University, the Charité, were unified under the common name Charité University
Medicine Berlin.
2. It would seem that Arnold Schönberg faced similar problems when he tried to summarize the his-
torical and aesthetic developments of music in the last centuries, guided by the captivating principle
that “a universal education should be another virtue of the specialist” [7, p. 7].
xi
xii Preface
FIGURE 1 Nathan Zuntz (1847-1920) at his office in Berlin at the Königlich Landwirtschaftliche
Hochschule around 1915. Courtesy Institute of Physiology, Charité University Medicine Berlin.
In an era when knowledge is expanding at an ever-increasing pace and in-
struction increasingly takes place in the form of modules that actually demand a
considerable basis of theoretical knowledge, an integrative approach to observ-
ing fundamental physiological processes is even more critical to avoid getting
lost in details and losing sight of the larger picture. This integrative a pproach, a
working philosophy of not relying on “armchair postulation” [11], but instead
testing and verifying laboratory results in the field, as well as the research on
humans in extreme environments, is not new for us in Berlin. One hundred
years ago, Nathan Zuntz (1847-1920) was already a key figure in the history
of research on the physiology of humans in extreme environments (Figure 1).
His books Höhenklima und Bergwanderungen in ihrer Wirkung auf den
Menschen (The Effect of High-Altitude Climate and Mountain Hiking on Human
Beings) [12] as well as Studien zu einer Physiologie des Marsches (Studies on the
Physiology of Marching) [13] must be considered classic publications in the his-
tory of applied physiological sciences and on a par with Paul Bert’s La pression
barométrique (Barometric pressure) [14] and Adolph’s Man in the Desert [11].3
Adolph (1895-1986) led the Rochester Desert Unit in the United States and con-
ducted several studies of water requirements and thermoregulation in humans un-
der contract with the Office of Scientific Research and Development in the United
States in close cooperation with the famous Harvard Fatigue Laboratory [19]. The
latter was conceived by Lawrence J. Henderson in 1926, started operating in the
fall of 1927 under the directorate of David Bruce Dill, and became a leading center
3. For further details, please compare Refs. [15–18].
Preface xiii
FIGURE 2 Otto Gauer (1909-1979) at the age of 65 in Berlin. Courtesy Institute of Physiology,
Charité University Medicine Berlin.
of human adaptation to extreme environments dealing with exercise, exhaustion,
heat, cold, and high altitude adaptation [20]. Otto Gauer (1907-1979) (Figure 2), the
famous gravitational physiologist and former director of the Institute of Physiology
of Berlin, was fascinated by this kind of research.
He obviously developed a deep familiarity with it, especially during his time
at Brooks Air Force Base in the United States during the 1950s and early 1960s,
where he personally met and worked with members of these two i mportant re-
search schools and laboratories. This collaboration definitely paved his way to
studies of humans in extreme environments (Figure 3).
Gauer taught the scholars K. Kirsch (1938-) and L. Röcker (1940-) in
Berlin, who continued and broadened this research, especially in the fields
of cardiovascular, blood, exercise, and space physiology. This kind of re-
search has been and remains primarily a domain of English-language scholar-
ship, as recently documented by Tipton’s (History of) Exercise Physiology [17].
In Germany, this field of study does not enjoy the same level of recogni-
tion among physiologists, in spite of the fact that the research field “extreme
environments” is distinguished by an entertainment value that should not be
discounted. This is no small advantage, even, or perhaps especially, with regard
to university-level education. The lack of recognition may result from the fact
that research on human adaptation to extreme environments is often inherently
limited to descriptive work, without the possibility of providing concrete ex-
planations. What some fail to recognize, however, is that over the long term,
research that initially provided purely descriptive observations of humans under
extreme conditions has since resulted in significant new approaches and ways
of thinking that are of essential importance to research. One outstanding current
example of this process is the research on non-osmotic storage of Na+, primarily
in the skin, conducted as a part of the investigations into the effects of long-term
xiv Preface
FIGURE 3 Certificate verifying that Otto Gauer is an honorary member of the gravitational stress
panel dated January 11, 1965. Courtesy Institute of Physiology, Charité University Medicine Berlin.
isolation on humans to prepare for space missions [21]. Furthermore, work-
ing in extreme environments, especially when conducting physiological studies
in the field, usually requires high-performance, miniaturized, noninvasive, and
easy-to-use devices. The potential applications for such devices are not limited
to extreme environments; rather, they offer great utility in the many various
everyday applications on earth. For several decades, our working group has
devoted considerable attention to the development of miniaturized, noninvasive
tools and procedures for human physiological measurements in close coopera-
tion with companies active in this field. These technological developments are
possible only thanks to substantial and, most importantly, continuous financial
support provided to our research projects by the Deutsches Zentrum für Luft-
und Raumfahrt (DLR, German Aerospace Center) in Bonn-Oberkassel, namely
Dr. P. Preu, Prof. G. Ruyters, Dr. P. Gräf, and Dr. H.-U. Hoffmann. We must
also not forget that it was small to mid-sized industrial firms as well as major
corporations that created the conditions for this research institution to continue
its work over the long-term in Berlin by establishing and funding the Nathan
Zuntz Professorship for Space Medicine and Extreme Environments at the Freie
Universität Berlin in 2003 and currently the Nathan-Zuntz-Förderkreis e.V. In
addition, we received financial support from the Deutsche Gesellschaft für
Technologische Zusammenarbeit (GTZ, Eschborn) and the Bundesministerium
für Bildung und Forschung (BMBF, Bonn).
Preface xv
In summary, this book was enabled by work done in the following three
major areas: (i) classical education and teaching at a major German university,
including the history of science; (ii) planning, implementation, and evaluation
of our own research in human physiology under sometimes extreme conditions
in the field and the laboratory, including research conducted with German and
international partners; and (iii) close cooperation with small and mid-sized
corporations in planning, developing, and producing new tools and processes.
Therefore, some of the material in following chapters is based on or complied
from previous manuscripts or publications that have been published in seminar
handouts (scripts) of regular courses given at the Charité, published separately
in journals, derived from works on guidelines by expert councils, or have been
the essence of long-lasting research groups, such as the DFG Research Group
533 as well as material from classical text [22–24] and handbook chapters
[25,26] written by the authors in previous years.
Finally, this book would not have been possible without the continuous
support of L. Roecker and K. Kirsch and my scientific team members at the
Department, namely Dr. O. Opatz, Dr. A. Stahn, and Dr. M. Steinach, co-a uthors
of some chapters, and Dr. A. Werner, S. Thomas, as well as the large techni-
cal support by B. Bünsch, B. Himmelsbach, E. Hofmann, F. Kern, and finally
A. Sommer, who prepared with great long-lasting enthusiasm the illustrations
for this book. Thanks to all of them.
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xvi Preface
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