The determinants of thermal comfort in cool water.

Water-based activities may result in the loss of thermal comfort (TC). We hypothesized that in cooling water, the hands and feet would be responsible. Supine immersions were conducted in up to five clothing conditions (exposing various regions), as well as investigations to determine if a "reference" skin temperature (Tsk) distribution in thermoneutral air would help interpret our findings. After 10 min in 34.5 °C water, the temperature was decreased to 19.5 °C over 20 min; eight resting or exercising volunteers reported when they no longer felt comfortable and which region was responsible. TC, rectal temperature, and Tsk were measured. Rather than the extremities, the lower back and chest caused the loss of overall TC. At this point, mean (SD) chest Tsk was 3.3 (1.7) °C lower than the reference temperature (P = 0.005), and 3.8 (1.5) °C lower for the back (P = 0.002). Finger Tsk was 3.1 (2.7) °C higher than the reference temperature (P = 0.037). In cool and cooling water, hands and feet, already adapted to colder air temperatures, will not cause discomfort. Contrarily, more discomfort may arise from the chest and lower back, as these regions cool by more than normal. Thus, Tsk distribution in thermoneutral air may help understand variations in TC responses across the body.