q-6 1Q AI{ATOMY OF A GROUP IN AI{TARCTICA TTIESIS ON TTIE PHYSIOTOGICAL ADAPTATION AÌ{D HEALTH OF Ai\ EXPEDITION IN AÌ{TARCTICA' WTTH COI\4MENT ON BEHAVIOURAT ADAPTATION SUBMITTED FOR THE DEGREE OF DOCTOR OF MEDICINE IN THE UNIVERSITY OF ADELAIDE, SOUT}I AUSTRALIA by DESI\OND JAN{ES LUGG, M.8., B.S. L973 FRONTISPIECE Davis from the sea ice, Septenber 1,963. (ANARE photograph by B.Eyre) CONTENTS 1 SUMMARY 1V DECLARATION V ACKNOWLEDGEMENTS PART I - INTRODUCTION Chapter 1 The Antarctic L2 Chapter 2 Medical Practice and Research in Antarctica L775-L962 33 Chapter 3 The Present StudY PART II - THE ENVIRONMENT Chapter 4 Davis Station 4L 44 Chapter 5 The L963 Expedition Chapter 6 Expedition Prograrune 52 55 Chapter 7 Clinatic Factors PART III - SYSTEMATIC INVESTIGATIONS 58 Chapter 8 Monthly Physiological Measurements 73 Chapter 9 Field Studies Chapter 10 Cold Exposure and Activity 91 Chapter 11 Therrnal Confort Studies LO7 PART IV - CLINICAL AI.{D PSYCHOLOGI CAL OBSERVATIONS L24 Cl.apter L2 Health of the Expedition Chapter 15 Psychological AdaPtation t44 PART V - AI\TARCTIC EPIDEMIOLOGY Cxtapter L4 Morbidity and MortaLity at AI'{ARE L63 Stations L947-1972 178 Chapter 15 Conparison with other Antarctic Expeditions PART VI - SYNTHESIS Chapter 16 Conclusions 794 202 APPENDICES 22L BIBLIOGRAPHY 1 SUMMARY Antarctica is the harshest and rnost isolated continent, and nembers of the Australian National Antarctic Research Expeditions (ANARE), who corne from densely populated tenperate and tropical regions, form an ideal population in which to study hulnan adaptability. In this age of space exploration and the current evaluation of mants irnpact on the world and of the world on himself, medical research on smal1 groups in Antarctica is appropriate as hunan adaptation is the central problem in environmental ePideniologY. The study which is described in this thesis consists of a nurnber of interrelated observations on physioL.ogy, thermal comfort, cold exposure, activity, health and behaviour of a níne- nan expedition at Davis, Antarctica, in 1963, and a health survey of the Australian Expeditions L947-L972. Medical practice and research in Antarctica are reviewed, and a description of the environment, cold exposure experienced, expedition organisation and progranme is given. This is irnportant not only for an understanding of the present study but also enables comparisons to be rnade with expeditions of other nations ' ThemenWereexposedtothemeteorologicalclirnatefor 20 per cent of their tine. However, adapftation was influenced by behavioural lesponse as the exposure climate was found to be 1_1 L2-2BoC above the meteorological clirnate and independent of it. At all dry-bulb tenperatures between 5.6oC and 27.zo; all men were comfortable, but the preferred indoor temperature h¡a5 14.zoc. The results are conpared with those for tropical and tenperate regions. The absence of thernal disconfort and the low value of the preferred tenperature are shown to be due to adjustments in clothing, clothing being shown to play a Lurger part in determin- ing the thermal sensation than the indoor air tenperature. The amount of clothing worn outdoors did not increase as winter approached, yet the nen naintained a higher level of thernal confort. A comparison of the thernal confort and the clothing worn, both indoors and outdoors, in periods before and after midwinter strongly suggests that acclímatizatíon to cold had occurred. Throughout the whole year there was a high degree of activity which was reflected in an absence of seasonal weight changes. The human adaptation is related to changes in the physiological variables although the biological significance of a number of these changes is not clear. Observations of men on field traverses showed a complex interaction between activ:ity, calorie intake and energy expenditure, with dehydration being considered the most important factor that influenced the sub- stantial weight losses that occurred. The group adjusted readily to the clinate, isolation, work, stress and each other. This is ernphasized by the low incidence of mental illness. Cornment on the behaviouraL adaptat- ion is made. Although physiological adaptation in the forn of 111- acclinati zalcíon to cold is suggested by the Davis study, it is concluded that overall adaptation of the group is more influenced by behavioural than by physiological factors ' The ability of the men to function effectively is shown by the low incidence of illness, for the rnaintenance of health irnplies adaptation to manrs envitonment. An analysis of the health, including noltality and nedical evacuations, of 60 Australian Expeditions shows the Davis gloup to be a typica]- expedition. Factors influencing health are discussed. It is believed that this thesis contributes to the knowledge of man in polar regions and human adaptabllity in Antarctica in the aïeas of local acclirnatization, thermal corn- fort, health, morbidity, medical practice and behaviour, all of which are basic to a complete understanding of Antarctic environmental ePidenio logY. 1V DECLARATION I declare that this thesis is a true record of a study conducted at Davis Station, Antarctica by rnyself* dur- ing 1965-64 while a mernber of the Australian National Antarctic Research Expedition (AI'{ARE) . It is also a record of work done subsequentLy at the Antarctic Division, Melbourne, ffid school of Public Health and Tropical Medicine, university of sydney. This thesis contains no material which has been accepted for the award of any other Degree or Diploma in any University. Furthermore, to the best of ny knowledge and belief, it contains no material previously published or written by another person, except when due reference is nade in the text of the thesis. * The author ü¡as also Leader and Medical Officer of the Prince Charles Mountains Surveys: December 1969-March L970, December tr97O-March L97L. V ACKNOWLEDGEMENTS It is inevitable that a study of this nature cannot be undertaken without a great deat of assistance from many sources. It is a pleasure to acknowledge the help received. The study was done under the supervision of Professor R.K. Macpherson, Principal, School of Public Health and Tropical Medicine, University of Sydney, to whon I an particularly indebted for his interest, encouragement, guidance and valuable assistance throughout the study. I gratefully acknowledge the opportunity afforded ne by the Antarctic Division, Department of Sciencex, to carry out the work, and the assistance of Dr P.G..Law, who was Director, and Dr F. Jacka (now Director of the Mawson Institute, University of Adelaide) who was Assistant Director (Scientific) at the conmencement of this study. The unfailing co-operation of the Officer-in-Charge, W.F. Young, and the willing participation of all nenbers of the L965 Davis Expedition in the study are greatly appreciated. ú The Antarctic Division was in the Depaîtment of External Affairs fron its inception until 1968 when it was transferred to the Departnent of Supply. Recently the Division was transferred to the Department of Science. V1 I an indebted to the late Director, Antarctic Division, Mr Bryan Rofe, for his encouragement and permission to analyse all Divisional records and publish these findings, the final drafts of which were not conpleted before his untirnely death. Other members of the Antarctic Division who have assisted greatly are: Dr R. Garrod, Director; P.H. Sulzberger, Assistant Director (Scientific) ; G.W. McKinnon, Geographical Officer; B. Hill, Drafting Assistant; Mrs J. Hosel and R. Reeves, Photographic Section; M. Millett, Publications Officer; Mrs I. McMahon, Librarian; F. Bond, Physicist; Misses E. Chipnan and K. Carrnody and other secretarial staff. I thank Dr K. Hicks of the School of Public Health and Tropical Medicine for his advice, computation of some of the data and helpful criticism of the text, and Dr G.M. Budd for assistance in preparing sections of the physiology prograrrne and for helpful advice in the analyses of these sections. Many doctors, who have served one or more years at AI\iARE stations and have provided the excellent rnedical service for the expeditions, gave me valuable data from their reports and in personal discwsions, and to these I an much indebted; especially to Dr J. Boyd for pernission to publish sone of his findings. I am grateful to the people who read and cornmented on rnany parts of this thesis during its preparation; Professor J.P. Masterton, Associate Professor of Surgery, Monash University, Melbourne; Professor R;E. Johnson, Department of Physiology and Biophysics, University of Illinois, Urbana, U.S.A.; Professor vr-1 W.V. Macfarlane, Professor of Aninal Physiology, University of Adelaide; Professor I. Pilowsky, Professor of Mental Health, university of Adelaide; Dr s. Preston, cornrnonwealth Department of Health, Melboume. In addition, I am most grateful to the following who provided nuch helpful and informative naterial and suggestions during personal discussions: Sir Vivian Fuchs, Director, British Antarctic Survey, London; Dr O. Wilson, Director, Institute of Aviation Medicine, Sweden; Dr. J. Rivolier, Chef de Médecin, Territoire Des Terres Australes et Antarctiques Francaise, Paris; Dr E.K.E. Gunderson, Head, Operational Psychiatry Division, Navy Medical Neuropsychiatric Research unit, San Diego, U.S.A.; Dr R.E. Strange, Neuropsychiatry Service, U.S. Naval Hospital, Philadelphia, U;S.4.; Professor J.T. shurley, Research Professor of Psychiatry and Adjunct professor of Hunan Ecology, University of Oklahorna, U.S.A.; Captain S.A. Youngman, U.S. Naval Support Force Antarctica, Washington D.C.; Dr A.F. Rogers, Department of Physiology, University of Bristol, U.K.; H.G.R. King, Librarian, Scott Polar Research Institute, Cambridge, U.K. PART I - INTRODUCTION CHAPTER I THE ANTARCTIC History of ErpLoratíon and. S cienti fi. c Erp e&Ltions Ancient Greek philosophers speculated on the existence of a southern continent about the fourth century B.C. Thelr lik- ing for order and synrnetry in nature led then to place a land mass in the south to balance the known lands of the Northern Henisphere.