Whole Body Immersion

There is an extensive literature on the body's response to submersion in activities such as self-contained underwater breating apparatus (SCUBA) diving. There are a whole host of physiologic changes that take place due to pressure, the work of breathing, and the gas mixture breathed. The main issue is heat transfer because water conducts heat at a rate 200 times that of air. Thus changes in core temperature are more rapid and more difficult to control when the person is immersed or submerged. Even in tropical water, the temperature is typically below that of air so there is a net cooling effect.

Situations may also arise where the issue is net heat flow into the body raising the core temperature. This might take place in a heated body of water, in farm effluent, or in a processing plant. Another example of potential hyper-thermia in submersion is with the use of hot tubs or Jacuzzis where a drop in blood pressure and syncope have been reported (38-40).

In addition to the conduction effects of fluids, there can be local effects. Prolonged or repeated exposure to water, especially if combined with agents that replace oils of the skin, can result in dyshidrosis. The skin develops a rash of small papules or blisters that can crack and become infected. Typically the hands are involved, but the same process can occur in the feet. Exposure to mud or sludge has been associated with skin disease that may be from bacterial, viral, or parasitic infections. The condition is made worse if there are abrasions of the skin (41,42).

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