Heat Stress Management in the Military: Wet-Bulb Globe Temperature Offsets for Modern Body Armor Systems.

OBJECTIVE: The aim of this study was to model the effect of body armor coverage on body core temperature elevation and wet-bulb globe temperature (WBGT) offset. BACKGROUND: Heat stress is a critical factor influencing the health and safety of military populations. Work duration limits can be imposed to mitigate the risk of exertional heat illness and are derived based on the environmental conditions (WBGT). Traditionally a 3°C offset to WBGT is recommended when wearing body armor; however, modern body armor systems provide a range of coverage options, which may influence thermal strain imposed on the wearer. METHOD: The biophysical properties of four military clothing ensembles of increasing ballistic protection coverage were measured on a heated sweating manikin in accordance with standard international criteria. Body core temperature elevation during light, moderate, and heavy work was modeled in environmental conditions from 16°C to 34°C WBGT using the heat strain decision aid. RESULTS: Increasing ballistic protection resulted in shorter work durations to reach a critical core temperature limit of 38.5°C. Environmental conditions, armor coverage, and work intensity had a significant influence on WBGT offset. CONCLUSION: Contrary to the traditional recommendation, the required WBGT offset was >3°C in temperate conditions (<27°C WBGT), particularly for moderate and heavy work. In contrast, a lower WBGT offset could be applied during light work and moderate work in low levels of coverage. APPLICATION: Correct WBGT offsets are important for enabling adequate risk management strategies for mitigating risks of exertional heat illness.

Sex-based differences in body core temperature response across repeat work bouts in the heat.

OBJECTIVE: To investigate the effects of repeated work bouts in the heat on peak body core temperature and to explore sex-based differences in body core temperature responses. METHODS: Fourteen males and fifteen females performed four work bouts (two heavy and two moderate, alternating) in 32.5 °C Wet Bulb Globe Temperature (WBGT), each separated by 30-min seated rest in 28.0 °C WBGT. Participants wore a military combat uniform with body armour and helmet (10 kg load) during the work bouts, removing the vest and helmet during recovery periods. RESULTS: Body core temperature elevation over time was faster in the first compared with subsequent work bouts of each intensity. Body core temperature elevation was similar between males and females during the first heavy work bout, then remained significantly lower in females for the reminder of the trial. CONCLUSIONS: Contrary to the assumed progressive elevation in strain, but in agreement with recent literature, a gradual reduction in heat storage in subsequent exercise bouts prevented a cumulative increase in heat strain in the conditions tested.

Identifying Physically Demanding Tasks Performed by the Royal Australian Navy for the Development of a Physical Employment Standard.

OBJECTIVE: The aim of this study was to determine an appropriate method to characterize Royal Australian Navy intermittent intensity tasks. METHOD: Sixteen personnel performed four scenarios: (1) storing: repeatedly handle a 10 to 15 kg crate; (2) firefighting: walk 45 m wearing protective equipment and fighting a fire; (3) and (4) toxic hazard response: casualty evacuation tasks wearing protective equipment. Heart rate and oxygen consumption ((Equation is included in full-text article.)) were measured continuously. Mean and peak values and time spent in incremental zones were calculated. RESULTS: Scenario 2 elicited the highest oxygen cost (18.1 L, mean (Equation is included in full-text article.)1.5 L.min, time >2.5 L.min: 0.8%), yet scenario 4 elicited the highest mean (Equation is included in full-text article.)(1.8 L.min, oxygen cost 14.4 L), and participants spent a greater duration >2.5 L.min(Equation is included in full-text article.)(23.3% or 1 minute 55 seconds). CONCLUSIONS: A small difference (0.3 L.min) was observed between scenarios 2 and 4 for mean (Equation is included in full-text article.), yet (Equation is included in full-text article.)>2.5 L.min demonstrated scenario 4 had a higher metabolic demand.

The Effectiveness of Basic Military Training To Improve Functional Lifting Strength in New Recruits.

Australian Army recruits are required to meet the incumbent baseline physical employment standards (PES) during basic military training. A box lift and place (BLP) assessment is included in the PES, and it assesses the ability to perform essential muscular strength tasks. Therefore, basic military training must provide sufficient training stimulus to enable recruits to achieve the baseline BLP standard. A study was undertaken to investigate changes in the performance of 1-repetition maximum BLP in male (n = 154; age, 21.4 years) and female (n = 20; age, 23.1 years) recruits over the first 8 weeks of a 12-week basic military training course. Both male and female recruits showed modest improvements (2.2 ± 5.9 kg and 3.0 ± 3.1 kg, respectively; p ≤ 0.05) in maximal BLP performance, and there were no differences between genders. The female recruits showed greater relative improvements compared with the male recruits (14.7 ± 7.8% vs. 6.5 ± 2.3%). Despite the modest improvements in BLP performance, 70% of female and 100% of male recruits achieved the baseline BLP standard (25 kg) during week 8. The 30% failure rate for female recruits, however, suggests that the basic training program should be improved. A training program that yields greater gains in muscular strength would likely increase female recruit BLP pass rates. Augmented muscular strength would also likely increase the number of recruits capable of achieving higher BLP standards for more physically demanding employment categories. A training program that yields greater improvements in muscular strength may also enable lower entry standards, thereby increasing the recruit pool.

Health, fitness, and responses to military training of officer cadets in a Gulf Cooperation Council country.

OBJECTIVE: To quantify the health, fitness, and physiological responses to military training of Officer Cadets from a Gulf Cooperation Council country. METHODS: One hundred and nineteen Officer Cadets volunteered; body composition, core body temperature, aerobic fitness, hydration status (urine osmolality), cardiovascular strain, physical activity (3-dimensional accelerometry), and energy expenditure (doubly labelled water) were measured over 5-days of Basic Training (BT), Army Training (AT), Navy Training (NT), and Air Force Training (AFT). RESULTS: There were no differences between courses for body mass index (mean all courses: 24.1 +/- 4.1 kg x m2) or peak core body temperature (mean all courses: 38.1 +/- 0.4 degrees C) (p > 0.05). AT body fat (19.8 +/- 3.6%) and BT VO2 max (36.8 +/- 11.6 mL x kg(-1) x min(-1)) were lower than the other courses (BT, 26.1 +/- 8.1; NT, 26.0 +/- 6.0; AFT, 24.7 +/- 6.1%) and (AT, 44.8 +/- 9.6; NT, 45.0 +/- 7.5; AFT, 44.6 +/- 5.2 mL x kg(-1) x min(-1)), respectively (p < 0.05). NT urine osmolality (979 +/- 90 mOsmol x kg(-1)) was similar to BT (946 +/- 181 mOsmol x kg(-1) p > 0.05) but lower in AT (868 +/- 144 mOsmol x kg(-1), p < 0.05) and AFT (883 +/- 121 mOsmol x kg(-1), p < 0.05). Cardiovascular strain during NT (22 +/- 5% HRR) was lower than other courses (range, 25 +/- 4-29 +/- 3% Heart Rate Reserve) (p < 0.05). Physical activity level during AFT (1.70 +/- 0.18 AU) was lower than other courses (range, 1.86 +/- 0.21-1.92 +/- 0.18 AU) (p > 0.05). CONCLUSION: Positive developments were apparent from BT leading into other courses. Potential exists to increase physical training volume on all courses, which may improve participants' aerobic fitness, body composition, and health.

Influence of hydration volume and ambient temperature on physiological responses while wearing CBRN protective clothing.

This study examined a low (L; 5 ml/kg per h) and high (H, 10 ml/kg per h) rate of fluid replacement in moderate (18°C) and hot (30°C) conditions on physiological responses while wearing personal protective equipment (PPE). PPE included the gas-tight suit (GTS), the powered respirator protective suit (PRPS) and the civil responder 1 (CR1). Relative to the moderate condition, physiological responses were greater in the hot condition. The percentage change in body mass was different (p < 0.05) between L and H in the hot (L vs. H, GTS: -0.83 vs. -0.38%; PRPS: -1.18 vs. -0.71%; CR1: -1.62 vs. -0.57%) and moderate conditions, although in GTS and CR1 body mass increased (L vs. H, GTS: -0.48 vs. 0.06%; PRPS: -0.66 vs. -0.11%; CR1: -0.18 vs. 0.67%). Fluid replacement strategies for PPE should be adjusted for environmental conditions in order to avoid >1% body mass loss and/or net body mass gain. STATEMENT OF RELEVANCE: Currently, the UK Emergency Services do not have specific evidence-based fluid replacement guidelines to follow when wearing chemical, biological, radiological and/or nuclear (CBRN) PPE. Although ad libitum fluid replacement is encouraged (when breathing apparatus permits), recommendations from evidence-based findings specific to different PPE and to different environmental conditions are lacking. This study provides novel evidence supporting the need to develop fluid replacement strategies during CBRN deployments in both moderate and hot environmental conditions for CBRN PPE.

Plasma catecholamine and nephrine responses to brief intermittent maximal intensity exercise.

Catecholamines (noradrenaline, NA; adrenaline, AD; dopamine, DA) influence the metabolic and cardiovascular responses to exercise. However, changes in catecholamine metabolism during exercise are unclear. Plasma normetanephrine (NMET), metanephrine (MET) and catecholamine responses to a laboratory-based model of games-type exercise were examined. Twelve healthy men completed a resting control trial and a trial consisting of ten 6 s cycle ergometer sprints interspersed with 30 s recovery, in randomised order. Resting and post-sprint venous blood samples were taken. Plasma NA and AD increased after each sprint but DA was unaltered. Plasma nephrines increased significantly from sprint 4 onwards with peak NMET increasing 60% to 0.76 +/- 0.19 nmol l(-1) and MET 230% to 0.37 +/- 0.16 nmol l(-1) from resting values (P < 0.05). The results demonstrate increased catecholamine metabolism via elevated catechol-O-methyl transferase activity during intermittent sprinting. The results may aid regulation of the metabolic and cardiovascular responses to exercise by maintaining tissue adrenoceptor sensitivity to circulating catecholamines.

Quantification of the decay and re-induction of heat acclimation in dry-heat following 12 and 26 days without exposure to heat stress.

Compared with the induction of heat acclimation (HA), studies investigating the decay and re-induction of HA (RA) are relatively sparse and have yielded conflicting results. Therefore, 16 semi-nude men were acclimated to dry-heat by undertaking an exercise protocol in a hot chamber (dry-bulb temperature 46.1 +/- 0.1 degrees C; relative humidity 17.9 +/- 0.1%) on 10 consecutive days (HA1-10) in winter UK. Thereafter, the subjects were divided into two groups and re-exposed to the work-in-heat tests after 12 and 26 days until RA was attained (RA(12), n = 8; RA(26), n = 8). The exercise protocol consisted of 60 min of treadmill walking (1.53 m s(-1)) at an incline individually set to induce a rectal temperature (T (re)) of approximately 38.5 degrees C during HA1 (equating to 45 +/- 4% peak oxygen uptake), followed by 10 min of rest and 40 min of further treadmill exercise, the intensity of which was increased across HA to maintain T(re )at approximately 38.5 degrees C. T(re), mean skin temperature, heart rate and rate of total water loss measured at 60 min did not change after HA7, and HA was taken as the mean of the responses during HA8-10. For both groups, there was no decay in T(re) and for all measured variables RA was attained after 2 and 4 days in RA(12) and RA(26), respectively. It is concluded that once adaptation to heat has been attained, the time that individuals may spend in cooler conditions before returning to a hot environment could be as long as one month, without the need for extensive re-adaptation to heat.

Alkalosis and the plasma catecholamine response to high-intensity exercise in man.

PURPOSE: The aims of this study were to examine the plasma dopamine response to a controlled bout of short-duration high-intensity exercise and investigate the magnitude of the plasma dopamine (DA), norepinephrine (NE), and epinephrine (EPI) responses to this exercise after induced alkalosis. METHODS: Eight male subjects were given in randomized order either; PLAC 0.3 g.kg(-1) body mass CaCO3 + 1 g NaCl, 0.3CIT 0.3 g.kg(-1) or 0.5CIT 0.5 g.kg(-1) body mass tri-sodium citrate in 500 mL water. One hour after ingestion subjects performed a 2-min cycle test at a workload calculated to elicit 110% VO(2max). Plasma catecholamines were measured using high performance liquid chromatography with electrochemical detection. RESULTS: Antecubital venous blood pH and blood base excess (BBE) were significantly increased after ingestion of sodium citrate compared with placebo (P < 0.05). All postexercise sodium citrate blood pH and BBE values were significantly greater than placebo (P < 0.05). High-intensity exercise did not affect resting plasma DA concentrations. Peak plasma NE and EPI concentrations occurred immediately postexercise [NE PLAC 4.6 +/- 2.1 ES = 1.2, 0.3CIT 4.2 +/- 1.8 ES = 1.5, 0.5CIT 4.6 +/- 2.2 nmol.L(-1) ES = 1.2; EPI PLAC 0.6 +/- 0.3 ES = 1.3, 0.3CIT 0.5 +/- 0.2 ES = 1.3, 0.5CIT 0.5 +/- 0.3 nmol.L(-1) ES = 0.8] and were still elevated 5 min postexercise (P < 0.05). The magnitude of the plasma dopamine, norepinephrine and epinephrine response to exercise was unaltered with either 0.3CIT or 0.5CIT. CONCLUSION: This study has demonstrated that performance of a controlled bout of high-intensity exercise did not alter the plasma dopamine concentration. In addition, alterations in blood alkalosis did not influence the magnitude of the plasma dopamine, norepinephrine or epinephrine responses to exercise.