Physiological strain and countermeasures with firefighting

Protective clothing is integral to the task of firefighting, but at the same time can increase physiological strain and impair work capacity. Encapsulation of the head and the high thermal resistance and/or low water vapor permeability of the clothing ensemble impede evaporative heat dissipation, thus elevating the rate of heat storage and creating a state of uncompensable heat stress (UHS). In addition, the additional weight from carrying a supplemental air supply and the greater respiratory work of breathing through a regulator can create a negative spiral of thermal hyperpnea from greater respiratory demands and metabolic heat production. The elevated respiratory demands also increase cardiac strain and potentially the risk for myocardial events. Tolerance time during UHS is determined by three factors: the core temperature at the beginning of the heat stress exposure, the core temperature that can be tolerated before exhaustion or collapse ensues, and the rate of increase in core temperature from the beginning to end of the heat stress exposure. Protective clothing is often employed in highly dynamic environments, making portability, longevity and integration with the task requirements and clothing critical design characteristics for countermeasures. To date, most countermeasures have been relatively indirect in nature, primarily with alterations in work scheduling along with physiological manipulations such as cooling manipulations during recovery periods. Advances are required in materials science to develop lighter and less restrictive protective equipment, concurrent with cooling strategies that target specific regions or which can be effectively implemented during exercise.

[1]  Tom M. McLellan,et al.  The Thermophysiology of Uncompensable Heat Stress , 2000, Sports medicine.

[2]  Lucy E. Dorman,et al.  The effects of protective clothing on energy consumption during different activities , 2008, European Journal of Applied Physiology.

[3]  D L Smith,et al.  Physiological, psychophysical, and psychological responses of firefighters to firefighting training drills. , 1996, Aviation, space, and environmental medicine.

[4]  F. Esposito,et al.  Theeffects ofbreathing He-02mixtures onmaximaloxygen consumption innormoxic andhypoxic men , 2013 .

[5]  R F Goldman,et al.  Increased energy cost with multiple clothing layers. , 1972, Journal of applied physiology.

[6]  F. N. Craig,et al.  Efficiency of evaporative cooling from wet clothing. , 1974, Journal of applied physiology.

[7]  D L Smith,et al.  The effects of different thermal environments on the physiological and psychological responses of firefighters to a training drill. , 1997, Ergonomics.

[8]  I Kuorinka,et al.  Firefighters' reaction to alarm, an ECG and heart rate study. , 1981, Journal of occupational medicine. : official publication of the Industrial Medical Association.

[9]  M. L. Riedesel,et al.  Pre-Exercise Glycerol Hydration Improves Cycling Endurance Time , 1996, International journal of sports medicine.

[10]  L D Cady,et al.  Energy costs of simulated stair climbing as a job-related task in fire fighting. , 1986, Journal of occupational medicine. : official publication of the Industrial Medical Association.

[11]  M. Sawka,et al.  Effects of dehydration, hypohydration, and hyperhydration on tolerance during uncompensable heat stress. , 1999, Canadian journal of applied physiology = Revue canadienne de physiologie appliquee.

[12]  N. Gledhill,et al.  Development and validation of a fitness screening protocol for firefighter applicants. , 1992, Canadian journal of sport sciences = Journal canadien des sciences du sport.

[13]  S. Shirreffs,et al.  Cold drink ingestion improves exercise endurance capacity in the heat. , 2008, Medicine and science in sports and exercise.

[14]  Christian F. Bulcao,et al.  Relative contribution of core and cutaneous temperatures to thermal comfort and autonomic responses in humans. , 1999, Journal of applied physiology.

[15]  T M McLellan,et al.  Heat acclimation, aerobic fitness, and hydration effects on tolerance during uncompensable heat stress. , 1998, Journal of applied physiology.

[16]  N. Eves,et al.  Submaximal exercise with self-contained breathing apparatus: the effects of hyperoxia and inspired gas density. , 2003, Aviation Space and Environmental Medicine.

[17]  T M McLellan,et al.  Physical Work Limits for Toronto Firefighters in Warm Environments , 2004, Journal of occupational and environmental hygiene.

[18]  Olli Korhonen,et al.  Cardiorespiratory effects of respiratory protective devices during exercise in well-trained men , 2004, European Journal of Applied Physiology and Occupational Physiology.

[19]  W R Santee,et al.  A proposed model for load carriage on sloped terrain. , 2001, Aviation, space, and environmental medicine.

[20]  V Louhevaara,et al.  Effects of an SCBA on breathing pattern, gas exchange, and heart rate during exercise. , 1985, Journal of occupational medicine. : official publication of the Industrial Medical Association.

[21]  C. Roussos,et al.  Respiratory Muscle Energetics , 2011 .

[22]  Ingvar Holmér,et al.  Classification of metabolic and respiratory demands in fire fighting activity with extreme workloads. , 2007, Applied ergonomics.

[23]  S. Petersen,et al.  Oxygen cost of the CF-DND fire fit test in males and females. , 2007, Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme.

[24]  Jay R. Hoffman,et al.  Physiological and biomechanical analysis of treadmill walking up various gradients in men and women , 2002, European Journal of Applied Physiology.

[25]  M. White Components and mechanisms of thermal hyperpnea. , 2006, Journal of applied physiology.

[26]  Lemon Pw,et al.  The human energy cost of fire fighting , 1977 .

[27]  D. Montgomery,et al.  Physiological profile of fire fighters compared to norms for the Canadian population. , 1993, Canadian journal of public health = Revue canadienne de sante publique.

[28]  B. Bone,et al.  Selected physiological and psychobiological responses to physical activity in different configurations of firefighting gear , 1995 .

[29]  I. Mekjavic,et al.  Temperature and humidity within the clothing microenvironment. , 1992, Aviation, space, and environmental medicine.

[30]  Bruce D. Johnson,et al.  Influence of expiratory loading and hyperinflation on cardiac output during exercise. , 2004, Journal of applied physiology.

[31]  J E Manning,et al.  Heart rates in fire fighters using light and heavy breathing equipment: similar near-maximal exertion in response to multiple work load conditions. , 1983, Journal of occupational medicine. : official publication of the Industrial Medical Association.

[32]  Randy W. Dreger,et al.  Effects of the self-contained breathing apparatus and fire protective clothing on maximal oxygen uptake , 2006, Ergonomics.

[33]  J L Bilzon,et al.  Characterization of the metabolic demands of simulated shipboard Royal Navy fire-fighting tasks , 2001, Ergonomics.

[34]  M. L. Riedesel,et al.  Effects of glycerol-induced hyperhydration prior to exercise in the heat on sweating and core temperature. , 1990, Medicine and science in sports and exercise.

[35]  Sarah A Nunneley Design and Evaluation of Clothing for Protection from Heat Stress: An Overview , 1986 .

[36]  N. Eves,et al.  Hyperoxia improves maximal exercise with the self-contained breathing apparatus (SCBA) , 2002, Ergonomics.

[37]  N. Eves,et al.  Work of breathing is increased during exercise with the self-contained breathing apparatus regulator. , 2006, Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme.

[38]  Cady Ld,et al.  Energy costs of simulated stair climbing as a job-related task in fire fighting. , 1986 .

[39]  G P Kenny,et al.  Effect of water temperature on cooling efficiency during hyperthermia in humans. , 2003, Journal of applied physiology.

[40]  Horowitz Mr,et al.  Physiological profile of fire fighters compared to norms for the Canadian population. , 1993 .

[41]  A. Keefe,et al.  Respiratory heat loss during work at various ambient temperatures. , 1990, Respiration physiology.

[42]  D L Smith,et al.  Selected physiological and psychological responses to live-fire drills in different configurations of firefighting gear. , 1998, Ergonomics.

[43]  J. Medbø,et al.  Physiological responses of firefighters and performance predictors during a simulated rescue of hospital patients , 2006, Ergonomics.

[44]  Richard L. Jones,et al.  Impaired exercise ventilatory mechanics with the self-contained breathing apparatus are improved with heliox , 2007, European Journal of Applied Physiology.

[45]  K B Pandolf,et al.  Mechanisms of thermal acclimation to exercise and heat. , 1974, Journal of applied physiology.

[46]  T K Hodous,et al.  Reduced work tolerance associated with wearing protective clothing and respirators. , 1987, American Industrial Hygiene Association journal.

[47]  K. Kelly,et al.  Impact of a design modification in modern firefighting uniforms on burn prevention outcomes in New York City firefighters. , 2000, Journal of occupational and environmental medicine.

[48]  N. Eves,et al.  The influence of the self-contained breathing apparatus (SCBA) on ventilatory function and maximal exercise. , 2005, Canadian journal of applied physiology = Revue canadienne de physiologie appliquee.

[49]  Effects of the self-contained breathing apparatus on left-ventricular function at rest and during graded exercise. , 2009, Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme.

[50]  M. Haykowsky,et al.  Effects of self-contained breathing apparatus on ventricular function during strenuous exercise. , 2009, Journal of applied physiology.

[51]  R. F. Goldman,et al.  Predicting rectal temperature response to work, environment, and clothing. , 1972, Journal of applied physiology.

[52]  M. Llewellyn,et al.  Effect of backpack fit on lung function , 2004, Ergonomics.

[53]  K. Kelly,et al.  Effects of fire fighting uniform (modern, modified modern, and traditional) design changes on exercise duration in New York City Firefighters. , 1999, Journal of occupational and environmental medicine.

[54]  S. Reis,et al.  The effect of hyperhydration on physiological and perceived strain during treadmill exercise in personal protective equipment , 2009, European Journal of Applied Physiology.

[55]  A. Rosengart,et al.  Simple intravenous fluid regimens to control fever in hospitalized stroke patients: A theoretical evaluation , 2009, Journal of Clinical Neuroscience.

[56]  R. Meeusen,et al.  Alteration in sympathoadrenergic activity at rest and during intense exercise despite normal aerobic fitness in late pubertal adolescent girls with type 1 diabetes. , 2007, Diabetes & metabolism.

[57]  McLellan Tm,et al.  Work performance at 40 degrees C with Canadian Forces biological and chemical protective clothing. , 1993 .

[58]  R. Eston,et al.  A single 10-min bout of cold-water immersion therapy after strenuous plyometric exercise has no beneficial effect on recovery from the symptoms of exercise-induced muscle damage , 2009, Ergonomics.

[59]  M S Sothmann,et al.  Heart rate response of firefighters to actual emergencies. Implications for cardiorespiratory fitness. , 1992, Journal of occupational medicine. : official publication of the Industrial Medical Association.

[60]  S. Powers,et al.  Effects of Breathing a Normoxic He-O2 Gas Mixture on Exercise Tolerance and V̇O2 max , 1986, International journal of sports medicine.

[61]  K. Kelly,et al.  Impact of a modern firefighting protective uniform on the incidence and severity of burn injuries in New York City firefighters. , 1999, Journal of occupational and environmental medicine.

[62]  Cooling hyperthermic firefighters by immersing forearms and hands in 10 degrees C and 20 degrees C water. , 2007, Aviation, space, and environmental medicine.

[63]  Tom M. McLellan,et al.  Influence of hydration status and fluid replacement on heat tolerance while wearing NBC protective clothing , 1997, European Journal of Applied Physiology and Occupational Physiology.

[64]  D. Abe,et al.  Effects of load carriage, load position, and walking speed on energy cost of walking. , 2004, Applied ergonomics.

[65]  J. Baker,et al.  Cardiorespiratory and thermoregulatory response of working in fire-fighter protective clothing in a temperate environment , 2000, Ergonomics.

[66]  T. McLellan,et al.  Active Versus Passive Cooling During Work in Warm Environments While Wearing Firefighting Protective Clothing , 2004, Journal of occupational and environmental hygiene.

[67]  H. Welch,et al.  Metabolic and cardiorespiratory responses to He-O2 breathing during exercise. , 1983, Journal of applied physiology: respiratory, environmental and exercise physiology.

[68]  T M McLellan,et al.  The impact of various rehydration volumes for firefighters wearing protective clothing in warm environments , 2006, Ergonomics.

[69]  N Gledhill,et al.  Characterization of the physical demands of firefighting. , 1992, Canadian journal of sport sciences = Journal canadien des sciences du sport.

[70]  S. Cheung,et al.  Effects of metabolic rate and ambient vapour pressure on heat strain in protective clothing , 2006, European Journal of Applied Physiology and Occupational Physiology.

[71]  P. Lemon,et al.  The human energy cost of fire fighting. , 1977, Journal of occupational medicine. : official publication of the Industrial Medical Association.

[72]  Rodrigo Villar,et al.  Physiological demands of the firefighter Candidate Physical Ability Test. , 2009, Medicine and science in sports and exercise.

[73]  J. Dempsey,et al.  Expiratory threshold loading impairs cardiovascular function in health and chronic heart failure during submaximal exercise. , 2006, Journal of applied physiology.

[74]  N. Gill,et al.  Effect of cold water immersion on repeat cycling performance and thermoregulation in the heat , 2008, Journal of sports sciences.

[75]  A Duggan,et al.  Energy cost of stepping in protective clothing ensembles. , 1988, Ergonomics.

[76]  G. Skrinar,et al.  Hyperhydration: tolerance and cardiovascular effects during uncompensable exercise-heat stress. , 1998, Journal of applied physiology.

[77]  John Frim,et al.  Physiological responses to fire fighting activities , 2004, European Journal of Applied Physiology and Occupational Physiology.

[78]  S. Goodall,et al.  The influence of cold water immersions on adaptation following a single bout of damaging exercise , 2009, European Journal of Applied Physiology.

[79]  R. Maly,et al.  Augmented hyperventilation via normoxic helium breathing does not prevent exercise-induced hypoxemia. , 1996, Canadian journal of applied physiology = Revue canadienne de physiologie appliquee.

[80]  M. Kivimäki,et al.  Physiological responses of firefighting students during simulated smoke-diving in the heat. , 1993, American Industrial Hygiene Association journal.

[81]  Markus Amann,et al.  Respiratory system determinants of peripheral fatigue and endurance performance. , 2008, Medicine and science in sports and exercise.