Wrong Thermometry and Wrong Temperature Can Cause Social and Economic Turmoil During a Flu Pandemic
Online –?? In a just released report (October 17, 2009), according to Businesswire, a Yale University research group says:
As we head into a flu season where the 2009 H1N1 swine flu is expected to cause increased sickness, hospitalization and deaths across the U.S., something as simple as inaccurate body temperature measurements may lead to social and economic turmoil – and may cause many more deaths.
A new study from a research group at Yale University released today shows the reliability of temperature measurements from the body???s own natural temperature indicator using the Brain Temperature Tunnel (BTT), which transmits brain temperature to a small area of skin. The study, ???Infrared Thermographic Analysis of Temperature on the Face, Forehead, Neck and Supero-medial Orbit,??? is being presented today at the 2009 Annual Meeting of the American Society of Anesthesiologists in New Orleans, LA…
The article goes on to state:
CURRENT THERMOMETRY???S INABILITY TO OVERCOME THERMAL BARRIERS
As shown in this study, because the body???s fat layer provides insulation and prevents adequate thermal emission, the skin surface, such as the forehead and axila, cannot provide accurate thermal measurement. Forehead thermometers are thereby forced to rely on artificial calculations, which can lead to overestimation and underestimation. Ear canal thermometry also relies on artificial estimations, and numerous reports, including reports by the British Government, show the limitations and dangers of the errors caused by ear thermometers.
At the same time that reports estimate that half the U.S. population, or greater than 150 million people, may be affected by the flu this season and the Centers for Disease Control (CDC) recommends that people with influenza remains at home until at least 24 hours after they are free of fever, other reports have shown that approximately 40% of thermometer readings overestimate and 20% underestimate body temperature. The result is a perfect storm with 60% of Americans — or 90 million people ??? receiving the wrong temperature readings during the flu season.
Back in 2003, Yale researcher M. Marc Abreu, M.D., a member of the reporting team, identified an area of the brain he calls the brain temperature tunnel, which transmits brain temperature to an area of skin and has the potential to prevent death from heat stroke and hypothermia, and detect infectious diseases such as Severe Acute Respiratory Syndrome (SARS).
Now he and co-workers conclude it is the best indicator for human body temperature in cases of flu.
His original results are described in an online article: Yale University Research Study Shows Reliability Of Body Temperature Measurement Using Our Natural Temperature Indicator – The `Brain Temperature Tunnel`
In the article it says:
Abreu, a postdoctoral fellow in the Department of Ophthalmology at Yale School of Medicine, found that a small area of skin near the eyes and the nose is the point of entry for the brain temperature tunnel. His research shows that this area is connected to a thermal storage center in the brain, and the area has the thinnest skin and the highest amount of light energy. He has constructed patches and eyeglasses designed to continuously measure brain temperature at this entry point.
Also, the present report states:
In addition to Dr. Silverman and Dr. Abreu, other authors on the study included Ala S. Haddadin, M.D., F.C.C.P., Tyler Silverman, B.S., and William Amalu, Ph.D.
Under the leadership of Dr. Silverman, the team of Dr. Abreu, Dr. Haddadin and Mr. Silverman have presented three other studies on the BTT in the past three years. The Yale research group is in the process of submitting to a major scientific journal a multi-center investigation, which includes Dr. Ricardo L. Smith, Professor and Chairman, Department of Anatomy, School of Medicine of the Federal University of Sao Paulo, Sao Paulo, Brazil; Dr. Airdem Assis and Dr. Marcos Hott of Embrapa, National Cattle Research Center of the Brazilian Ministry of Agriculture and Livestock; Dr. Claudio Campi Castro, Chief, Magnetic Resonance Imaging Section, Heart Institute, University of Sao Paulo Medical School, Sao Paulo, Brazil; Roger Titone of Brain Tunnelgenix Technologies Corp., Tiffin, IA; and Dr. Michael F. Bergeron, Director, National Institute for Athletic Health & Performance, Sanford USD Medical Center, Sioux Falls, SD.
Additionally, BTT research has been carried out in collaboration with Dr. Robert Gochman and Dr. Alexander Arroyo, Department of Pediatrics and Emergency Medicine, Long Island Jewish Medical Center and Albert Einstein College of Medicine, New Hyde Park, NY, and Dr. Joseph McIsaac, Department of Anesthesiology, University of Connecticut School of Medicine, Hartford, CT.
We are aware of one publication from the UK on the calibration errors in some infrared ear thermometers. It is from the UK’s National Physical Laboratory (NPL):
Tympanic thermometer performance validation by use of a body temperature fixed point blackbody.
Machin, G, Simpson, R?? ( Proc. SPIE – Int. Soc. Opt. Eng., 2003, 5073, 51-)
The Center for Disease Control (CDC) database yields only one result in searches for “Ear Thermometer”
That publication provides the following list of related references with online links:
- Kaydos-Daniels SC, Olowokure B, Chang HJ, Barwick RS, Deng JF, Kuo SH, et al.; SARS International Field Team. Body temperature monitoring and SARS fever hotline. Emerg Infect Dis. 2004;10:373???6.
- Chng SY, Chia F, Leong KK, Kwang YPK, Ma S, Lee BW, et al. Mandatory temperature monitoring in schools during SARS. Arch Dis Child. 2004;89:738???9. PubMed DOI
- St John RK, King A, de Jong D, Brodie-Collins M, Squires SG, Tam TW. Border screening for SARS. Emerg Infect Dis. 2005;11:6???10.
- Hughes WT, Patterson GG, Thronton D, Williams BJ, Lott L, Dodge R. Detection of fever with infrared thermometry: a feasibility study. J Infect Dis. 1985;152:301???6.
- Ng EY, Kaw GJ, Chang WM. Analysis of IR thermal imager for mass blind fever screening. Microvasc Res. 2004;68:104???9. PubMed DOI
- Wong JJ. Non-contact infrared thermal images for mass fever screening???state of the art or myth? Hong Kong Med J. 2006;12:242???3.
- Erickson RS, Meyer LT. Accuracy of infrared ear thermometry and other temperature methods in adults. Am J Crit Care. 1994;3:40???54.
- Chamberlain JM, Terndrup TE, Alexander DT, Siverstone FA, Wolf-Klein G, O’Donnell R, et al. Determination of normal ear temperature with an infrared emission detection thermometer. Ann Emerg Med. 1995;25:15???20. PubMed DOI
- Rotello LC, Crawford L, Terndrup TE. Comparison of infrared ear thermometer derived and equilibrated rectal temperatures in estimating pulmonary artery temperatures. Crit Care Med. 1996;24:1501???6. PubMed DOI
- Ng DK, Chan CH, Chan EY, Kwok KL, Chow PY, Lau WF, et al. A brief report on the normal range of forehead temperature as determined by noncontact, handled, infrared thermometer. Am J Infect Control. 2005;33:227???9. PubMed DOI
- Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1:307???10.
- Degroot DW, Kenney WL. Impaired defense of core temperature in aged humans during mild cold stress. Am J Physiol Regul Integr Comp Physiol. 2007;292:R103???8. PubMed DOI
- Andersson SE, Edvinsson ML, Edvinsson L. Cutaneous vascular reactivity is reduced in aging and in heart failure: association with inflammation. Clin Sci. 2003;105:699???707. PubMed DOI