Firefighter uncompensable heat stress results in excessive upper body temperatures measured by infrared thermography: Implications for cooling strategies.

This research sought to evaluate the thermal zones of the upper body and firefighter personal protective equipment (PPE) immediately following uncompensable heat stress (0.03 °C increase/min). We hypothesized that the frontal portion of the head and the inside of the firefighter helmet would be the hottest as measured by infrared thermography. This hypothesis was due to previous research demonstrating that the head accounts for ∼8-10% of the body surface area, but it accounts for ∼20% of the overall body heat dissipation during moderate exercise. Twenty participants performed a 21-min graded treadmill exercise protocol (Altered Modified Naughton) in an environmental chamber (35 °C, 50 % humidity) in firefighter PPE. The body areas analyzed were the frontal area of the head, chest, abdomen, arm, neck, upper back, and lower back. The areas of the PPE that were analyzed were the inside of the helmet and the jacket. The hottest areas of the body post-exercise were the frontal area of the head (mean: 37.3 ± 0.4 °C), chest (mean: 37.5 ± 0.3 °C), and upper back (mean: 37.3 ± 0.4 °C). The coldest area of the upper body was the abdomen (mean: 36.1 ± 0.4 °C). The peak temperature of the inside of the helmet increased (p < 0.001) by 9.8 °C from 27.7 ± 1.6 °C to 37.4 ± 0.7 °C, and the inside of the jacket increased (p < 0.001) by 7.3 °C from 29.2 ± 1.7 °C to 36.5 ± 0.4 °C. The results of this study are relevant for cooling strategies for firefighters.

A single rapid heat stress episode does not result in prolonged elevations in salivary cortisol and C-reactive protein production in firefighters.

In the present experiment, we evaluated the impact of rapid heat stress (RHS) on salivary cortisol and C-reactive protein production pre-RHS, post-RHS, and 24 and 48 h post-RHS exposure among firefighters. Previous research has demonstrated that RHS increases salivary cortisol during RHS and immediately post-RHS exposure. However, no research has evaluated the duration necessary to return to baseline cortisol levels following RHS. Additionally, no studies have analyzed the impact of RHS on inflammatory biomarkers, such as C-reactive protein. This study hypothesized that salivary cortisol and C-reactive protein levels would increase following RHS and then return to pre-RHS levels within 24 h post-exposure. Twenty-four participants performed a steady-state treadmill protocol in an environmental chamber (35 °C; 45% humidity) in full firefighter personal protective equipment until reaching either a core temperature (Tc) of 39 °C or a volitional maximum. The subjects had their saliva collected via the passive drool protocol pre-RHS, post-RHS, and 24 and 48 h post-RHS. Pre-RHS of 0.23 ± 0.03 µg/dL increased post-RHS to 0.51 ± 0.06 µg/dL (p < 0.001). This finding supports previous literature demonstrating the immediate impact of RHS. There were no changes in C-reactive protein. The novel finding of this study is that salivary cortisol levels return to baseline in the 24 h post-RHS exposure. This indicates that 24 h is recommended to recover from RHS and should be applied to prevent the chronic stress response.

An assessment of the validity and reliability of the P022-P version of e-Celsius core temperature capsules.

Core temperature monitoring is a research tool used in many studies, though most popularly, heat strain. Ingestible core temperature capsules are a non-invasive and increasingly popular choice for measuring core body temperature, particularly considering the well-established validation of capsule systems. A newer version of the e-Celsius ingestible core temperature capsule has been released since the preceding validation study resulting in a paucity of validated research for the current version of capsules, P022-P, used by researchers. Using a 1:1 ratio of propylene glycol to water in a circulating water bath, and a reference thermometer with resolution and uncertainty of 0.01 °C, we assessed the validity and reliability of 24 P022-P e-Celsius capsules in three groups of eight, at seven temperature plateaus between 35 °C, and 42 °C in a test-retest format. The systematic bias of these capsules across all 3360 measurements was found to be -0.038 °C ± 0.086 °C (p < .001), The TEST-RETEST evaluation revealed excellent reliability by way of a minute overall mean difference of 0.0095 °C ± 0.048 °C (p < .001), and an intraclass correlation coefficient of 1.00 for each of TEST and RETEST conditions. Although quite small, differences in systematic bias across temperature plateaus were observed for both the OVERALL bias-between 0.00066 °C and 0.041°C-and TEST/RETEST bias-between 0.00010 °C and 0.016 °C. We found that the new capsule version outperforms manufacturer guarantees, with half of the systematic bias observed in a validation study of the previous capsule version. Though these capsules tend to slightly underestimate temperature, we find they possess excellent validity and reliability between 35 °C and 42 °C.

Firefighter pre-frontal cortex oxygenation and hemodynamics during rapid heat stress.

This study evaluated the impact of rapid heat stress on prefrontal cortex (PFC) oxygenation and hemodynamics. Previous work has demonstrated that heat stress affects cerebral oxygenation and hemodynamics. Fourteen male subjects performed a graded exercise test to a termination criterion (volitional maximum, core temperature = 39.5 °C, or a 2-hour time cap) with (GEAR) and without (NOGEAR) firefighting gear in a laboratory with an ambient temperature of 25-26 °C. Changes in oxyhemoglobin (O2Hb), total hemoglobin (tHb), and tissue oxygen saturation index (TSI %) were monitored in the left and right PFC using near-infrared spectroscopy (NIRS). Significant NIRS results were a plateau in the left-side O2Hb and tHb at 80 % of the time to termination (TTT) in NOGEAR, and 60 % of TTT in GEAR. These TTT points were when the subject's core temperature (Tc) was equal to 38 °C. Additionally, there was higher left-side PFC activation during GEAR, as indicated by a significant decrease in TSI % from start to end of exercise and double the reduction in TSI % per minute in PPE compared to NOGEAR. There were no significant differences during the NOGEAR session. These data suggest that a rapid heat stress scenario (GEAR) causes altered cerebral oxygenation and hemodynamic response in the left-side PFC. The left PFC could be working harder to prevent fatigue in GEAR. This could affect cognitive processes during or following exercise in the heat while wearing personal protective equipment. Our results also support previous research demonstrating that NIRS is a sensitive metric of fatigue.

Firefighter salivary cortisol responses following rapid heat stress.

This research evaluated the impact of rapid heat stress on the rate of salivary cortisol appearance. We hypothesized that rapid heat stress would result in an increased rate of salivary cortisol appearance. Fourteen adult male participants performed an incremental exercise test to a termination criterion (volitional maximum, core temperature = 39.5 °C, or a 2-h time maximum time) with or without firefighting gear in a laboratory with an ambient temperature of 25-26 °C. Salivary cortisol was collected at each 0.5 °C increase in core temperature. We observed a significant increase (p ≤ 0.01) in the rate of cortisol appearance when the subjects were wearing the firefighting gear; no change was observed without firefighting gear. Our results demonstrate that rapid heat stress and the resulting physiological stress cause a rapid increase in the rate of salivary cortisol appearance. Our results also support previous research demonstrating that cortisol is a sensitive strain metric of heat intolerance.