The validity of mass body temperature screening with ear thermometers in a warm thermal environment

Identification of people who have a fever in public places during the occurrence of emerging infectious diseases is essential for controlling disease spread. The measurement of body temperature could identify infected persons. The environment affects body temperature, but little is known about the validity of measurements under different thermal environments. Therefore, the aim of this study was to determine the validity of measuring body temperature in cold and warm environments. We recruited 50 participants aged 18-69 years (26 males, 24 females) to measure body temperature using an axillary thermometer and an ear thermometer and by infrared thermal imaging (thermography). The body temperature obtained with an axillary thermometer was used as a reference; receiver operating characteristic (ROC) analysis was conducted to determine the validity of temperatures obtained by measurement with an ear thermometer and thermography at 36.7°C (median of the axillary body temperature). The area under the ROC curve (AUC) indicates the validity of measurements. The AUC for ear thermometers in a warm environment (mean temperature: 20.0°C) showed a fair accuracy (AUC: 0.74 [95% CI: 0.64-0.83]), while that (AUC: 0.62 [95% CI: 0.51-0.72]) in a cold environment (mean temperature: 12.6°C) and measurements with thermography used in both environments (AUC: 0.57 [95% CI: 0.45-0.68] in a warm environment and AUC: 0.65 [95% CI: 0.54-0.76] in a cold environment) showed a low accuracy. In conclusion, in a warm environment, measurement of body temperature with an ear thermometer is a valid procedure and effective for mass body temperature screening.