DESIGN RESOURCES

DR - 0 7 P r o t e c t i v e Wi n t e r Cl o t h i n g
C e n t e r f o r I n c l u s i v e D e s i g n a n d E n v i r o n m e n t a l A c c e s s
1

ProtectiveWinterClothing
YueLi,PhD
1
,JenniferHsu,PhD
1,2
,GeoffFernie,BSc,PhD,MIMechE,CEng,PEng,CCE
1,2

1
TorontoRehabilitationInstitute;
2
UniversityofToronto

IssueandItsImportancetoUniversalDesignandtoStakeholders

Winterisassociatedwithincreasedmortalityratesofabout30%abovethoseexperiencedthe
restoftheyear.Thetwopopulationgroupswhoaremostheavilyrepresentedinthis
demographicareseniorsandthosewithchronicillnessesasaresultofoutdoorexposuretothe
cold.Properoutdoorclothing,togetherwithadequateindoorheating,canpreventmuchofthe
excesswintermortality.Therefore,itisimportanttoprovidepublichealthadvisorswithmore
robustevidenceonthebenefitsofincreasedoutdoorclothingforreducingexcesswinter
mortality.Ontheotherhand,wintercoatsposeaproblemformanyolderadultswho
experiencefunctionallimitations.Thedexterity,strengthandflexibilityrequirementsfor
puttingonawintercoatareforsomeolderadultsenoughofareasontoavoidgoingoutinthe
winter.Inestablishingguidelinesforuniversallydesignedwinterclothing,weneedtoidentify
populationswithspecificrequirementsandtoensurethatthethermalprotectionpropertyand
usabilityofthewinterclothingwillsatisfytheirneeds.

ExistingResearch/Evidence

Indoorclothinginthewinter:TheWorldHealthOrganizationrecommendsaminimalindoor
temperatureof18C(65F)anda23C(6870F)warmerminimaltemperatureforrooms
occupiedbysedentaryelderly,youngchildrenandpersonswithadisability(Collins,1986).Healy
andPepterClinchconductedanationalhouseholdsurveyinIrelandandfoundthattwothirds
offuelpoorhouseholdersdemonstratecoldstrain,andoverhalfofelderlyhouseholdsendure
inadequateambienthouseholdtemperaturesduringwinter(Healy&Peter,2002).Anincrease
inbloodpressureforelderlywasobservedwhentheairtemperaturewas15C
(59F)(Hashiguchietal.,2004).WebbandParsoncomparedresponsesofthermalcomfortof
peoplewithphysicaldisabilitieswiththoseofpeoplewithoutphysicaldisabilities(Webb&
Parsons,1998).Theyfoundthattherearefewgroupdifferencesbetweenthermalcomfort
requirementsofpeoplewithandwithoutphysicaldisabilities.Therangeofresponsesforpeople
withphysicaldisabilitiesismuchgreaterthanthatofpeoplewithoutphysicaldisabilities.

Outdoorclothinginthewinter:Improvementsincentralindoorheatingarenotconsistently
associatedwithareductioninseasonaldifferencesinmortalityfromcardiovasculardisease
(Keatingeetal.,1989;Wilkinsonetal.,2004;Barnettetal.,2005).Therefore,Keatingeand
colleaguesplacemoreemphasisonpersonalbehavioursandhavearguedthatmanyexcess
wintermortalitiesarerelatedtoexposuretocoldfrombriefexcursionsoutdoorsratherthanto
lowindoortemperatures(Keatingeetal.,1989;Keatinge,1997).Donaldsonetal.foundthat
regionalvariationsinthermalinsulationandnumberofitemsworn,afterallowancefor
differencesinclimateandbehaviour,wereassociatedwithgeographicaldifferencesinexcess
wintermortality(Donaldsonetal.,2001).Theauthorsthereforeconcludedthatthereisa
potentialtoincreaseclothing,particularlybywearinglongunderpantsortightswithtrousers,
underskirtswithskirts,jacketswithovercoats,orallthreeofhat,scarforgloves.Theuseof
extraclothingwould,however,havetobebalancedagainstthepracticalitiesofremovingexcess
clothingwhenindoors.
2

Insulationrequirementsforwinterclothing:Althoughinvestigationsoneffectsofoccupational
protectiveclothingonthewearerhavebeenundertakenfordecades,studiesofclothing
specificallyfordailyoutdooractivitiesaremuchlesscommon(Holmer,1988;Rissanen&
Rintamaki,2007).Foroccupationalcoldprotectiveclothing,ISO11079presentsamethodfor
evaluationofwholebodyheatbalance.Onthebasisofclimateandactivity,arequiredclothing
insulation(IREQ)forheatbalanceisdetermined.Forclothingwithknowninsulationvaluean
exposuretimelimitiscalculated(Holmer,1988).Severalinvestigatorshavehighlightedthatthe
outdoorclothingchoiceandhumancomfortleveldependsnotonlyonairtemperatureand
windspeedbutalsoonothermeteorologicalparameterssuchasrelativehumidityandsolar
radiationaswellasindividualcharacteristicssuchasactivitylevels,age,gender,originand
acclimatizationetc.(Stathopoulosetal.,2004;Nikolopoulou&Lykoudis,2006;Nagaraetal.,
1996;Givonietal.,2003;Metjeetal.,2008).Furthermore,insulationprovidedbyclothingisa
dynamicpropertywhichvariesduetobodyposture,intensityandtypeofactivity,moisture
content,andwind(Holmer,1988;Nielsenetal.1985).Duringthecourseofaday,peoplecan
experienceconsiderabletemperaturechangeandthetypeandintensityoftheiractivities
changealso.Thereisnoguidelinetoinformthegeneralpublicaboutthelevelofcoldstressthat
theymightexperiencebasedontheirclothingandactivitiesunderdefinedweatherconditions.

Effectofaging:Itisgenerallybelievedthatolderpersonsarelessabletomaintaincore
temperatureduringacoldchallengethanyoungerpersons(Smolander,2002).Thegreaterdrop
incoretemperatureintheolderpersonsseemstobepartlyduetolowerheatproductionand
partlyduetohigherheatloss.Whenatrestinthecold,olderpersonshavealowermetabolic
rateandahigherskinthermalconductance(indexofskinbloodflow)(Falketal.,1994).

Increasedheatloss:Underthermoneutralambientconditionstheskintemperatureat
theextremitiesislowerinolderpeople,whichisindicativeofenhancedbaseline
vasoconstriction(Rasmussenetal.,2001).However,duringcoldexposurebothin
laboratoryandoutdoorsituations,elderlyshowanattenuatedefficiencyindiverting
bloodfromtheskintohelpconservebodyheatandconsequentlytheskinremains
relativelywarm(Collinsetal.,1977;Khanetal.,1992;Ohnakaetal.,1994;Ballester&
Harchelroad,1999;Kajietal.,2000;Tochihara,2000).Thisagerelatedchangeislikelyto
bethemostimportantfactorinvolvedinpoorcolddefence(FlorezDuquet&McDonald,
1998).Themechanismunderlyingthedecreasedcoldinducedvasoconstrictionismost
likelyincreasedarterialwallstiffness(VanSomerrnetal.,2002).Insummary,the
delayedandslowerevolvingvasoconstrictiveresponsetoacoolenvironmentwill
contributetoalowerandmorevariablebodytemperature.

Decreasedheatproduction:Mostoftheavailablestudiesindicatethatcoldstress
producesasmallerriseinmetabolicrateinolderthaninyoungerpersons(Bernsteinet
al.,1956;Falketal.,1994;Horvathetal.,1955;Krag&Kountz,1950;Wagneretal.,
1974).Somestudieshavefoundnodifference,andsomestudiesevenagreaterincrease
inmetabolicrateinolderindividuals(OHanlon&Horvath,1970;Wagner&Horvath,
1985;Inoueetal.,1992;Mathewetal.,1986).Thelowercoldinducedincreasein
metabolicrateinolderpersonsmayberelatedtotheagerelateddecreaseinmuscle
mass,whichreducesbasalandrestingmetabolicratesby20%fromtheage30to70
(Poehlmanetal.,1994).Thesechangesmayalsoreduceshiveringthermogenesis
Kenney&Buskirk,1995).
3

Attenuatedthermalperception:Neurophysiologicalstudies,utilizinglocalheatingand
coolingofsmallskinareas,indicatethatagingisassociatedwithadecreasedcutaneous
thermalsensitivity(Stevens&Choo,1998;Merchut&Cone,1990;Lautenbacher&
Strain,1991;Heftetal.,1996).Duringdaytime,olderpeopleregulatetheirindoor
ambienttemperaturelesspreciselyandtoleratelargerdeviationsfromthecomfortable
averagebeforeactionisundertaken,indicatingadecreasedsubjectivethermal
perception(VanSomerenetal.,2002).Thereisthehighriskofdecreaseindeepbody
temperatureandrapidincreaseinbloodpressureinolderpeople,withoutthe
consciousnessofcold(Yochiharaetal.,1993).Therefore,itisnecessarytopayaspecial
attentiontotheelderlyincoldastheymaynotbeabletoadjusttheirthermal
conditionsagainstthecoldbywearingthickclothesorheatingtheroom.

Usabilityissue:Manyolderindividualshavetroubleputtingonwintercoatsbecausethe
garmentsaretypicallyheavyandrequireflexibility,dexterityandstrengthlevelsthatexceed
theirown.Thesedifficultiesaresoproblematicforsomethattheyareoftenenoughtokeep
themfromgoingoutside(Row,Paul,McKeeverandFernie,2005;Row,Paul&Fernie,2004).The
fewtechnologicalwinterapparelitemsthatofferactiveheatingcomponentsorsafetyadditions
havebeendesignedforthesportingandmilitarymarkets,andarethereforeoutofscopeand
pricerangeforfunctionallylimitedolderadultsandarenotuniversalsolutions.

DesignGuidelines

Determiningtheneedsofindoorclothing:Whereashealthyolderpeoplecompensatefor
feelingcoldbyturningupthethermostatandaddingextraclothing,frailerolderpeoplewith
impairedenvironmentalawareness,physicalabilities,andcommunicationmaybedependenton
caregiversorintelligentenvironmentalcontrols.Thereisaneedfortheinclusionofinformation
onthephysiologicresponsetocoldinuniversaldesignguidelinesinordertoinformpolicy,
educationalprogramcontentanddesignersofintelligentenvironmentalcontrolsystems.

Determiningthethermalprotectionpropertyofwinterclothing:Therequiredclothing
insulationcanbecalculatedforparticularoutdooractivitiesandenvironmentalconditions
(OLeary&Parsons,1994).However,therearenouniversalguidelinesthatcanbeusedbythe
consumersorbydesignersofwinterclothing.Internationalstandardsexistforevaluationof
coldworkplaces(seeTable1).Thethermalinsulationvalueofclothingensemblesismeasured
accordingtoISO15831.Inpractice,thethermalinsulationisestimatedusingtablesinISO11079
orusinganyofthemethodsproposedinISO9920.ISO11079recommendswithdrawingfrom
coldexposurewhenthereisadropinmeanskintemperaturebyabout3C(5F)startingfrom
comfortlevel(about34C,or93F).ISO11079alsorecommendsfrequentcontroloffinger
temperaturesintheworkplaceandsuggestthatfingertemperaturesshouldbehigherthan24C
(75F)forpreservationofgoodhandfunction.Occasionally,fingertemperaturesdownto15C
(50F)maybeacceptable,butdexterity,strengthandcoordinationsufferandpersonsmay
complainaboutpainsensations.Inhalationofcoldairmayprovokerespiratorydistress
symptoms,inparticularinpersonswithasthmaorotherdiseases.Alsohealthypersonsmay
developadverseeffectsonlungtissueswhenalargevolumeofverycoldairisinhaled,for
exampleduringheavyworkorathleticeventsattemperaturesbelow15to20C(5to4F).It
isrecommendedtoprotecttheairwaysbyreducingworkrateorexposureorbyprewarmingair
byabreathingmaskorsimilar(Holmer,2009).

4

Determiningtheusabilityofwinterclothing:Atpresentthereexistsnospecificguidanceonthe
usabilityofwinterclothing.Werecommendthatthedesignofwinterclothingforolderadults
shouldcompensateforchangesinbodyshapeandphysiologyaswellasincreasedfunctional
limitations.

SummaryofRelatedNewResearchAccomplishedbyRERCUD

Lietal.investigatedtheeffectofoutdoorclothingandrepeatedcoldexposureonblood
pressure,heartrate,skintemperature,andthermalsensationinnormotensiveparticipants(Li
etal.,2009).Fourwinterclothingensembleswereused:regularwinterclothingwithoutahat,
withahat,withanextrapairofpants,andwithahatandanextrapairofpants.Theparticipants
wereexposedfourtimesto5C(23F)for15minuteswearingdifferentclothingensemblesin
counterbalancedorderandeachcoldexposurewasfollowedby25minutesofrewarmingat
25C(77F).Theresultsshowedthatsystolicanddiastolicbloodpressureincreasedincoldand
increasedmorewhenahatwasnotused.Wearinghatsnotonlyreducedthebloodpressure
responseduringcoldexposurebutalsopromotedfasterrecoveryofforeheadskintemperature
andbloodpressure.Thesefindingsareencouragingandwarrantfurtherinvestigationstobetter
understandthebenefitsofwearingappropriateclothinginthewinter,especiallyamongolder
peopleandpeoplewithcardiovasculardiseases.

Researchneeds(Whatstillneedstobedone)

Indoorclothingforpeoplewithimpairmentincognitionormobility:Itisunknownwhetherthe
preferenceforseeminglyuncomfortableconditionsstemsfromphysiologicalchanges
associatedwithdementia,orstemsfromtheinabilitytocontroltheenvironmentandthe
passiveacceptancethereof(VanHoofetal.,2010).Anintelligentbodytemperaturemonitoring
andenvironmenttemperaturecontrollingsystemcouldbeintegratedintoindoorclothingfor
peoplewithimpairmentincognitionormobility.

Outdoorclothing:Morestudiesofthermalcomfortincoldenvironmentsareneededinorderto
revealthecomplexinteractionofperceptionandheatexchange(Holmer,2004).Dataon
baselinemetabolicrateandotherphysiologicalresponsesatdifferenttemperatureswearing
regularwinterclothingforallagegroupsarestillverylimitedandscattered.Acollaborative
effortshouldbeputtogethertoestablishadatabaseinthisarea.

Transitionbetweenindoorandoutdoorenvironments:Itissuggestedthatthesteadystate
modelsforthermalcomfortsuchasthePredictedMeanVote(PMV)indexmaynotbe
appropriatefortheassessmentofshorttermoutdoorthermalcomfort,mainlybecausetheyare
unabletoanalysetransientexposure(Thorssonetal.2004).Apreviousstudydiscoveredthat
lowerforeheadtemperaturesresultedinlowercomfortvaluesnearlyindependentofthe
meteorologicalparameters(Metjeetal.,2008).Therefore,theskintemperaturemaybeusedas
anobjectiveparametertodeterminehumanoutdoorindoortransientstresslevelsandfurther
testswillbeneeded.

Coldstressduringdifferentdailyactivities:Coldstressandclothinginsulationarestatic
parametersinISO7730.Inrealitytheyaredynamicvariablesthatchangeaccordingtoprevailing
airvelocitiesandtypeofactivity(Holmer,2004).Therefore,thereisaneedforstudiesthat
5

documentthecoldstressandclothinsulationvalueswhileyoung,olderandpeoplewith
disabilitiesparticipatingindifferentdailyactivities(Figure1).

Figure1Illustrationofaconceptualwinterjacketthatcanmonitorandcontrolthemicroenvironment
undertheclothing.(IllustrationbyStevenPong,M.Des)

Impactofcoldexposureduration:AccordingtoISO11079,requiredclothinginsulation(IREQ)is
calculatedforthegivenclimaticconditionsandactivityatworkplaces.Theinsulationvalueof
thegivenclothingensembleisdeterminedandcomparedwithIREQ.Iftheinsulationvalueis
lessthanIREQthenbodycoolingmayresultandasupplementarymethodcalculatesa
recommendedexposuretime(DLE=durationlimitedexposure)basedonasmalldropinbody
heatcontent.However,theinsulationvaluesprovidedbymostoftheregularwinterensembles
arelessthanIREQevenforayounghealthyperson.Forthegeneralpublic,especiallyfrailolder
people,arecommendedexposuretimeshouldbeestablishedbasedontheirthermo
physiologicalresponsesduringoutdoorcoldexposurewearingtheirregularwinterclothingand
moreresearchisneededtoestablishthisuniversalguideline.

Usabilityandsafety:Moreeffortsareneededtodevelopwintercoatsthatcanbeusedby
everyoneincludingolderadultswithfunctionallimitations.Thesedesignswill:1)reducethe
physicalchallengeofdonningthecoat,2)reducetherestrictionsonmovementandsafe
ambulation,and3)reducethelikelihoodofinjuryfromafall.

6

Table1:InternationalStandardsforEvaluationofColdWorkplaces

ISOStandard/ASTM/ANSI/ASHRAE/EN

ISOThermalcomfortandthermalenvironmentstandards

ISO15743:2008:ErgonomicsofthethermalenvironmentColdworkplacesRisk
assessmentandmanagement

ISO15831:2004ClothingPhysiologicaleffectsMeasurementofthermalinsulationby
meansofathermalmanikin

ISO11079:2007ErgonomicsofthethermalenvironmentDeterminationand
interpretationofcoldstresswhenusingrequiredclothinginsulation(IREQ)andlocal
coolingeffects.

ISO9920:2007ErgonomicsofthethermalenvironmentEstimationofthermalinsulation
andwatervapourresistanceofaclothingensemble.

ISO/TS14415:2005ErgonomicsofthethermalenvironmentApplicationofInternational
Standardstopeoplewithspecialrequirements

ISO8996:2004ErgonomicsofthethermalenvironmentDeterminationofmetabolicrate.

ISO7726:1998ErgonomicsofthethermalenvironmentInstrumentsformeasuring
physicalquantities.

ISO137323:2005ErgonomicsofthethermalenvironmentMethodsfortheassessment
ofhumanresponsestocontactwithsurfacesPart3:Coldsurfaces

ISO9886:2004ErgonomicsEvaluationofthermalstrainbyphysiologicalmeasurements.

ISO7730:2005.ErgonomicsofthethermalenvironmentAnalyticaldeterminationand
interpretationofthermalcomfortusingcalculationofthePMVandPPDindicesandlocal
thermalcomfortcriteria.

ISO10551:1995ErgonomicsofthethermalenvironmentAssessmentoftheinfluenceof
thethermalenvironmentusingsubjectivejudgementscales.

ASTMF273209StandardPracticeforDeterminingtheTemperatureRatingsforCold
WeatherProtectiveClothing

ANSI/ASHRAE552004Thermalenvironmentalconditionsforhumanoccupancy.

EN342ProtectiveclothingEnsemblesandGarmentsforprotectionagainstcold.

EN511Protectiveglovesagainstcold

7

Acknowledgements
ThispaperwasdevelopedinpartwithfundingfromtheNationalInstituteonDisabilityand
RehabilitationResearch(NIDRR),U.S.DepartmentofEducation,throughtheRehabilitation
EngineeringResearchCenteronUniversalDesignandtheBuiltEnvironment(RERCUD),a
partnershipbetweentheCenterforInclusiveDesignandEnvironmentalAccess(IDeA)andthe
OntarioRehabilitationTechnologyConsortium(ORTC).

References

BarnettA,DobsonA,McElduffP,SalomaaV,KuulasmaaK,SansS.Coldperiodsandcoronary
events:Ananalysisofpopulationsworldwide.JournalofEpidemiologyandCommunityHealth.
2005;59(7):551557.

BernsteinL,JohnstonL,RyanR,InoyeT,HickF.Bodycompositionasrelatedtoheatregulation
inwomen.JournalofAppliedPhysiology.1956;9(2):241256.

CollinsK.Lowindoortemperaturesandmorbidityintheelderly.AgeandAgeing.
1986;15(4):212220.

DonaldsonG,RintamkiH,NyhS.Outdoorclothing:Itsrelationshiptogeography,climate,
behaviourandcoldrelatedmortalityinEurope.InternationalJournalofBiometeorology.
2001;45(1):4551.

FalkB,BarOrO,SmolanderJ,FrostG.Responsetorestandexerciseinthecold:Effectsofage
andaerobicfitness.JournalofAppliedPhysiology.1994;76(1):7278.

GivoniB,NoguchiM,SaaroniH,PochterO,YaacovY,FellerN,etal.Outdoorcomfortresearch
issues.EnergyandBuildings.2003;35(1):7786.

HashiguchiN,TochiharaY,OhnakaT,TsuchidaC,OtsukiT.Physiologicalandsubjective
responsesintheelderlywhenusingfloorheatingandairconditioningsystems.Journalof
PhysiologicalAnthropologyandAppliedHumanScience.2004;23(6):205213.

HealyJ,PeterClinchJ.Fuelpoverty,thermalcomfortandoccupancy:Resultsofanational
householdsurveyinIreland.AppliedEnergy.2002;73(34):329343.

HeftM,CooperB,O'BrienK,HempE,O'BrienR.Agingeffectsontheperceptionofnoxiousand
nonnoxiousthermalstimuliappliedtotheface.AgingClinicalandExperimentalResearch.
1996;8(1):3541.

HolmrI.AssessmentofcoldstressintermsofrequiredclothinginsulationIREQ.International
JournalofIndustrialErgonomics.1988;3(2):159166.

HolmrI.ColdbutcomfortableApplicationofcomfortcriteriatocoldenvironments.IndoorAir,
Supplement.2004;14(SUPPL.7):2731.

8

HolmrI.Evaluationofcoldworkplaces:Anoverviewofstandardsforassessmentofcoldstress.
IndustrialHealth.2009;47(3):228234.

HorvathS,RadcliffeC,HuttB,SpurrG.Metabolicresponsesofoldpeopletoacoldenvironment.
JournalofAppliedPhysiology.1955;8(2):145148.

InoueY,NakaoM,ArakiT,UedaH.Thermoregulatoryresponsesofyoungandoldermentocold
exposure.EuropeanJournalofAppliedPhysiologyandOccupationalPhysiology.1992;65(6):492
498.

KeatingeW,ColeshawS,HolmesJ.Changesinseasonalmortalitieswithimprovementinhome
heatinginEnglandandWalesfrom1964to1984.InternationalJournalofBiometeorology.
1989;33(2):7176.

KeatingeW.Coldexposureandwintermortalityfromischaemicheartdisease,cerebrovascular
disease,respiratorydisease,andallcausesinwarmandcoldregionsofEurope.Lancet.
1997;349(9062):13411346.

KenneyW,BuskirkE.Functionalconsequencesofsarcopenia:Effectsonthermoregulation.
JournalsofGerontologySeriesABiologicalSciencesandMedicalSciences.1995;50(SPEC.
ISSUE):7885.

KragC,KountzW.Stabilityofbodyfunctionintheaged.I.Effectofthebodytocold.Journalof
Gerontology.1950;5(3):227235.
MetjeN,SterlingM,BakerC.Pedestriancomfortusingclothingvaluesandbodytemperatures.
JournalofWindEngineeringandIndustrialAerodynamics.2008;96(4):412435.

LautenbacherS,StrianF.Similaritiesinagedifferencesinheatpainperceptionandthermal
sensitivity.FunctionalNeurology.1991;6(2):129135.

LiY,AlshaerH,FernieG.Bloodpressureandthermalresponsestorepeatedwholebodycold
exposure:effectofwinterclothing.EuropeanJournalofAppliedPhysiology.2009;107(6):673
685.

MathewL,PurkayasthaS,SinghR,SenGuptaJ.Influenceofaginginthethermoregulatory
efficiencyofman.InternationalJournalofBiometeorology.1986;30(2):137145.

MerchutM,ConeToleikisS.Agingandquantitativesensorythresholds.Electromyographyand
ClinicalNeurophysiology.1990;30(5):293297.

NagaraK,ShimodaY,MizunoM.Evaluationofthethermalenvironmentinanoutdoor
pedestrianspace.AtmosphericEnvironment.1996;30(3):497505.

NielsenR,OlesenB,FangerP.Effectofphysicalactivityandairvelocityonthethermal
insulationofclothing.Ergonomics.1985;28(12):16171631.

NikolopoulouM,LykoudisS.Thermalcomfortinoutdoorurbanspaces:Analysisacrossdifferent
Europeancountries.BuildingandEnvironment.2006;41(11):14551470.
9

O'HanlonJr.J,HorvathS.Changingphysiologicalrelationshipsinmenunderacutecoldstress.
CanadianJournalofPhysiologyandPharmacology.1970;48(1):110.

O'LearyC,ParsonsK.TheroleoftheIREQindexinthedesignofworkingpracticesforcold
environments.AnnalsofOccupationalHygiene.1994;38(5):705719.

PoehlmanE,ArcieroP,GoranM.Enduranceexerciseinaginghumans:effectsonenergy
metabolism.ExerciseandSportSciencesReviews.1994;22:251284.

RissanenS,RintamkiH.Coldandheatstrainduringcoldweatherfieldtrainingwithnuclear,
biological,andchemicalprotectiveclothing.MilitaryMedicine.2007;172(2):128132.

RowB,PaulJ,FernieG.WhatisKeepingOlderAdultsShutInduringtheWinter?In:
GerontologicalSocietyofAmericaannualmeeting.WashingtonD.C.:2004.

RowB,PaulJ,McKeeverP,FernieG.WinterPresentsBarrierstoPhysicalandSocialActivityin
FunctionallyImpairedOlderAdults.In:AmericanCollegeofSportsMedicineAnnualMeeting.
Nashville,TN.:2005.

SmolanderJ.Effectofcoldexposureonolderhumans.InternationalJournalofSportsMedicine.
2002;23(2):8692.

StathopoulosT,WuH,ZachariasJ.Outdoorhumancomfortinanurbanclimate.Buildingand
Environment.2004;39(3):297305.

StevensJ,ChooK.Temperaturesensitivityofthebodysurfaceoverthelifespan.Somatosensory
andMotorResearch.1998;15(1):1328.

ThorssonS,LindqvistM,LindqvistS.Thermalbioclimaticconditionsandpatternsofbehaviourin
anurbanparkinGteborg,Sweden.InternationalJournalofBiometeorology.2004;48(3):149
156.

VanHoofJ,KortH,HensenJ,DuijnsteeM,RuttenP.Thermalcomfortandtheintegrateddesign
ofhomesforolderpeoplewithdementia.BuildingandEnvironment.2010;45(2):358370.

VanSomerenE,RaymannR,ScherderE,DaanenH,SwaabD.Circadianandagerelated
modulationofthermoreceptionandtemperatureregulation:Mechanismsandfunctional
implications.AgeingResearchReviews.2002;1(4):721778.

WagnerJ,RobinsonS,MarinoR.Ageandtemperatureregulationofhumansinneutralandcold
environments.JournalofAppliedPhysiology.1974;37(4):562565.

WagnerJ,HorvathS.Influencesofageandgenderonhumanthermoregulatoryresponsesto
coldexposures.JournalofAppliedPhysiology.1985;58(1):180186.

WebbLH,ParsonsKC.Casestudiesofthermalcomfortforpeoplewithphysicaldisabilities.In:
ASHRAETransactions.1998.p.883895.
10

WilkinsonP,PattendenS,ArmstrongB,FletcherA,KovatsR,MangtaniP,etal.Vulnerabilityto
wintermortalityinelderlypeopleinBritain:Populationbasedstudy.BritishMedicalJournal.
2004;329(7467):647651.

YochiharaY,OhnakaT,NagaiY,TokudaT,KawashimaY.Physiologicalresponsesandthermal
sensationsoftheelderlyincoldandhotenvironments.JournalofThermalBiology.1993;18(5
6):355361.
DESIGN RESOURCES
2010 Center for Incl usi ve Desi gn and Envi ronmental Access
University at Buffalo
School of Architecture and Planning
378 Hayes Hall
3435 Main Street
Buffalo, NY 14214-3087
Phone: (716) 829.3485 x329 | TTY (716) 829.3758
Email: ap-idea@buffalo.edu
Fax: +1 (716) 829.3861
DR-07 Protecti ve Wi nter Cl othi ng