Polar Human Biology The Proceedings of the SCAR/IUPS/IUBS Symposium on Human Biology and Medicine in the Antarctic edited by O. G. Edholm & E. K. E. Gunderson WILLIAM HEINEMANN MEDICAL BOOKS LTD. First published 1973 © William Heinemann Medical Books Ltd., 1973 ISBN 0 433 08155 4 Printed and bound in Great Britain by R.J. Acford Ltd. Industrial Estate, Chichester, Sussex List of contributors T. R. Allen* 17 Green Sward, Stockton Lane, York Y03 OJE K. Asahina Department of Physiology, Toho University School of Medicine, Nishi 5-21, Omori, Ota-ku, Tokyo, Japan H. Bellamy Chronobiology Laboratories, University of Minnesota, USA A. D. Beynon*t Division of Human Physiology, National Institute for Medical Research, (Hampstead Laboratories), London NW3 6RB A. B. Blackburn Veterans Administration Hospital, 2002 Holcombe Blvd., Houston, Texas 77031, USA A. S. Bodey Assistant Pathologist, Mercy Maternity Hospital, Clarendon Street, East Melbourne, Australia 3002 J. Bohlen Chronobiology Laboratories, University of Minnesota, USA R. E. Brooks Veterans Administration Hospital, 921 NE 13th Street, Oklahoma City, Oklahoma 73104, USA J. Brotherhood* Laboratory for Field Physiology, National Institute for Medical Research, {Hampstead Laboratories), London NW3 6RB G. M. Budd School of Public Health and Tropical Medicine, Zone A27, University of Sydney, NSW, Australia 2006 * Denotes former medical officer or member of the British Antarctic Survey. t Present address : Department of Oral Anatomy, The Dental School, University of Newcastle upon Tyne, Newcastle upon Tyne NEI 8TA. ix X LIST OF CONTRIBUTORS G. Cazes DRME, 5 bis, av. de la Porte de Sèvres, Paris 15ème. L. Crocq DRME, 5 bis, av. de la Porte de Sèvres, Paris, 15ème. A. G. Davies* Department of Physiology, The Medical School, University of Birmingham, Birmingham B15 2TJ P. Doury Hôpital d? Instruction des Armées du Val de Grâce, 277 bis, rue Saint-Jacques, 75230—Paris Cedex 05 O. G. Edholm Division of Human Physiology, National Institute for Medical Research, {Hampstead Laboratories), London NW3 6RB R. Eide Institute of Psychology, University of Bergen, N-5001 Bergen, Norway A. J. Fry* Department of Clinical Biochemistry, Worthing Hospital, Lynd- hurst Road, Worthing, Sussex BN11 2DH G. Godin School of Hygiene, 150 College Street, University of Toronto, Toronto, Ontario M5S 1A1, Canada E. K. E. Gunderson Navy Medical Neuropsychiatrie Research Unit, San Diego, California 92152, USA F. Halberg Chronobiology Laboratories, University of Minnesota, USA M. J. Holmes* Clinical Research Centre, Watford Road, Harrow, Middlesex HAI 3UJ A. T. Joern Veterans Administration Hospital, 921 NE 13th Street, Oklahoma City, Oklahoma 73104, USA W. J. Klein (Lieutenant Commander, USN) Fellow in Operational and Research Psychiatry, Naval Hospital, Philadelphia, Pennsylvania 19145, USA * Denotes former medical officer or member of the British Antarctic Survey. LIST OF CONTRIBUTORS XI J. LeBlanc Laboratoire d'Endocrinologie Climatique, Faculté de Médecine, Université Laval, Québec, Canada I. Leith* Broomfield Hospital, Court Road, Chelmsford, Essex R. M. Lloyd* " ShackletorC\ Well Lane, Mollington, Nr. Chester Mary C. Lobban Division of Human Physiology, National Institute for Medical Research, (Hampstead Laboratories), London NW3 6RB D. J. Lugg Senior Medical Officer, Antarctic Division, Department of Science, 568 St. Kilda Road, Melbourne, Australia 3004 H. G. Muchmore Veterans Administration Hospital, 921 NE 13th Street, Oklahoma City, Oklahoma 73104, USA K. Natani Veterans Administration Hospital, 921 NE 13th Street, Oklahoma City, Oklahoma 73104, USA Y. Ohkubo Blood Transfusion Service, Tokyo Medical and Dental University Hospital, Tokyo, Japan S. Pattin Hôpital d'Instruction des Armées du Val de Grâce, 277 bis, rue Saint-Jacques, 75230—Paris Cedex 05 C. M. Pierce Veterans Administration Hospital, 921 NE 13th Street, Oklahoma City, Oklahoma 73104, USA J. Rivolier 195, rue de V Université, Paris 7ème A. Rode School of Hygiene, 150 College Street, University of Toronto, Toronto, Ontario M5S 1A1, Canada A. F. Rogers Department of Physiology, University of Bristol, The Medical School, University Walk, Bristol BS8 1TD Nan E. Scott Veterans Administration Hospital, 921 NE 13th Street, Oklahoma City, Oklahoma 73103, USA * Denotes former medical officer or member of the British Antarctic Survey. Xll LIST OF CONTRIBUTORS R. J. Shephard School of Hygiene, 150 College Street, University of Toronto, Toronto, Ontario M5S lAl, Canada J. T. Shurley Veterans Administration Hospital, 921 NE 13th Street, Oklahoma City, Oklahoma 73104, USA H. W. Simpson*t Chronobiology Laboratories, University of Minnesota, USA R. E. Strange (Captain, USN)t Chief, Neuropsychiatry Service, Naval Hospital, Philadelphia, Pennsylvania 19145, and Consultant, US Naval Support Force, Antarctica B. A. Tatem Chronobiology Laboratories, University of Minnesota, USA A. J. W. Taylor Psychology Department, Victoria University of Wellington, P.O. Box 196, Wellington, New Zealand I. I. Tikhomirov Soviet Committee on Antarctic Research, Academy of Sciences of the USSR, Ul. Vavilova 44, Building 2, Moscow B-333, USSR D. A. J. Tyrrell Clinical Research Centre, Watford Road, Harrow, Middlesex HAI 3UJ D. C. Wilkins* Department of Surgery, Addenbrooke's Hospital, Cambridge O. Wilson Institute of Aviation Medicine, Flight Test Centre, Fack, S-580 13 Linköping, Sweden R. A. Worley Veterans Administration Hospital, 921 NE 13th Street, Oklahoma City, Oklahoma 73104, USA H. Yoshimura Department of Physiology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan * Denotes former medical officer or member of the British Antarctic Survey. t Present address : Department of Pathology, Royal Infirmary, Glasgow, C4. t Present address : Bureau of Medicine and Surgery, Code 313, Department of the Navy, Washington, DC 20372, USA. O. G. Edholm Introduction This volume contains the majority of the papers delivered at the Symposium on Human Biology and Medicine in the Antarctic which was held at the Scott Polar Research Institute, Cambridge, England on September 19th-21st, 1972. The Symposium was organised under the auspices of the Scientific Committee on Antarctic Research (SCAR), the International Union of Physiological Sciences (IUPS) and the International Union of Biological Sciences (IUBS). The Subcommittee on Human Biology and Medicine in the Antarctic established by the SCAR Working Group on Biology was respon­ sible for the initiation and organisation of the Symposium; detailed planning was carried out by O. G. Edholm, E. K. E. Gunderson and R. Goldsmith. The Symposium was the first of its kind to be held, although at a meeting held in Paris in 1962 organised by the SCAR Working Group on Biology a number of papers dealing with human aspects had been included. It proved to be fortunate that at the Cambridge meeting there were contributions dealing with studies in the Arctic, hence the title of the present volume, indicating that the contents do not deal exclusively with Antarctic problems. At an informal discussion on Arctic/Antarctic co-operation, organised by R. Goldsmith, many speakers stressed the importance of linking work in the polar regions where there were common problems and common environmental conditions, but also some striking contrasts. The contents of this volume demonstrate the multidisciplinary aspects of the work carried out in both polar regions. A number who attended the meeting commented on the stimulus they had from the presentation and discussion of papers dealing with clinical, virological, physiological and psychological studies. Although there are evident beginnings of multidisciplinary work, it became clear as the meeting progressed that studies, particularly in the 1 2 POLAR HUMAN BIOLOGY Antarctic, not only needed to be developed on multidisciplinary lines but also that the Antarctic was peculiarly well-placed for such development. It became obvious that the interpretation of physiologi­ cal studies of the effects of cold on man would be greatly helped by a knowledge of the psychological effects of the polar situation, and conversely. Although it has now become fashionable to talk of the multidisciplinary approach and the need to study the totality of the situation, the practical difficulties are still so great that pro­ gress has been relatively slow. One of the most potent agencies in promoting such work has been the International Biological Pro­ gramme (IBP). The Human Adaptability section, under the vigor­ ous leadership of Professor J. S. Weiner, has sponsored hundreds of studies in nearly all regions of the world, and a significant pro­ portion of these has involved a number of disciplines. Geneticists, physiologists, clinicians, nutritionists and anthropologists have become accustomed to working together, at least to the extent that they study the same subjects and results are available to all the members of the team. The first attempt to co-ordinate Antarctic studies of human biology arose from the establishment of the IBP and to the decision to include Antarctica. The first Subcommittee of the SCAR Working Group on Biology brought together an inter­ national group of physiologists who recommended a variety of standardised techniques and measurements to be made on Antarctic personnel. The remoteness of Antarctica, the long time lags between planning, execution, analysis and publication of research made it difficult to achieve effective work co-ordinating research in different national bases. Nevetheless, the members of the Sub­ committee were able to inform each other and to learn something of the various national research characteristics. The full impact of the very considerable research effort was not appreciated until the Cambridge Symposium. Certainly, the majority, perhaps all, of those who attended were surprised to learn of the extent and breadth of research which has been rapidly developing over the last few years. It will be obvious that the published papers, substantial as they are, do not completely cover the work that has been accomplished. The Symposium was opened by Dr. Terence Armstrong, deputis­ ing for Dr. Gordon Robin, Director of the Scott Polar Research Institute and President of SCAR. The first speakers were Sir Vivian Fuchs and Mr. A. Stephenson who vividly described the INTRODUCTION 3 problems encountered by Antarctic expeditions in the 1930s and today. They were followed by Professor Asahina's account of the Japanese expedition to the Antarctic in 1911-12, at the same time as Amundsen's and Scott's expeditions. The report by Professor Asahina is the first paper in this volume and illustrates the tremendous changes in the way in which Antarctic expeditions operated then and now, changes implied in Professor Yoshimura's review of the studies carried out in the last 15 years at the Japanese base, Syowa. The next section consists of reviews of work at Australian, Japanese, French and Russian bases. No attempt has been made to impose uniformity of presentation either on the authors of review articles or of the subsequent papers; a number of different terms are used to describe similar situations or objects. The custom of the British Antarctic Survey is to describe their permanent or semi-permanent establishments as a 'base', but the majority of other countries use the term 'station' and some use both. The words used to describe people spending a year or, specifically, the winter in Antarctica include cwintering-over', 'winterers' and in contrast, rather pejor­ atively, 'summer visitors'. Other phrases have been used but 'winter­ ing-over' has been widely accepted. It may be asked why there is no review of either USA or UK work. Since the Symposium was held in the UK, it was relatively easy for those who had worked as medical officers of the British Antarctic Survey to present papers. In spite of distance, there was also excellent representation from the USA, and the important papers contributed to this volume describe their work. Following the review papers, medical and dental aspects are described, after which comes a small but important section on micro­ biology. This is a rapidly growing field and it is clear there are some exceptional advantages in Antarctica. The physiological papers include metabolism, nutrition, endocrinology and circadian rhy­ thms. Sleep can be considered a special example of such a rhythm and the exciting contributions made by Dr. J. T. Shurley and his colleagues are reported. Then comes the final section dealing with psychological and behavioural aspects, begun by a review written by my co-editor, Dr. E. K. E. Gunderson. He and his colleagues have been responsible for the important programme implemented at US bases in the Antarctic which has produced valuable practical results on selection techniques as well as many contributions to the study of the effects of isolation and the Antarctic environment. 4 POLAR HUMAN BIOLOGY Other countries have also investigated psychological aspects, includ­ ing France, Australia and New Zealand. Cultural patterns influence psychological responses of individuals to Antarctic conditions so there is a remarkable, indeed unique, opportunity to be able to compare the findings of psychologists working at different national bases. Nowhere else in the world is it possible to examine different national groups, isolated almost completely from each other but all exposed to the harsh Antarctic environment and a state of isola­ tion. Within each national base the culture of the parent country is dominant. Although there will be many difficult technical and procedural problems to solve, there could be exciting findings from the application of similar methods of assessing and measuring psychological and behavioural characteristics in the different national groups. National characteristics may not be responsible for some of the other differences evident in fields of work other than psychological. Obviously there is much repetition; the same problems have been studied in a number of different bases. There are also contrasts; the effects of ionisation of the atmosphere are discussed both by Dr. J. Rivolier (France) and by Dr. I. I. Tikhomirov (USSR), but so far other countries have not included this topic in their research programme. It would be excessive to attempt to review each paper in this book, but there are some general points and some special findings which should be emphasised. Dr. Tikhomirov points out most clearly that the Antarctic continent must not be thought of as uniform, and he differentiates three zones: coastal, where the temperature is greatly affected by the sea; the hinterland, with ground rising more or less gradually up to the third zone of the high altitude plateau. Here the effective altitude, as pointed out by Dr. Shurley, is consider­ ably higher than the geographical altitude above sea leavel, rising up to approximately 3500 m at Vostok, the USSR station near to the Pole of Inaccessibility. Tikhomirov emphasises, and the point needs emphasis, that it is rash to compare results obtained at, say, Vostok with other results obtained at a coastal station without taking into account the altitude difference. Some of the changes observed in men stationed at Vostok and reported by Tikhomirov are certainly due to the effects of altitude. The combination of very severe cold together with hypoxia provides an environmental stress of considerable intensity and is one of which we have relatively little