Physiological responses to treadmill exercise in size- and fitness-matched male and female firefighter applicants.

Physiological responses during a standardised treadmill test for structural firefighting employment were compared in 41 pairs of size-matched, male and female applicants. Applicants wore personal exercise clothing, running shoes, and fire protective ensemble with self-contained breathing apparatus (added mass 21.2 ± 1.0 kg). Applicants walked at 1.56 m·s-1, completing a 5-min warm-up, 8-min at 10% grade, and then, progressive 1-min stages to exhaustion. The cut-score required completion of 13-min of exercise. Up to the cut-score, no differences in heart rate, oxygen uptake or minute ventilation were detected between sexes. At time 12:30-13:00 min, V̇O2 was 45.7 ± 0.6 vs. 44.2 ± 0.5 mL·kg-1·min-1 (body mass) for males and females, respectively. Despite similar physiological responses at minute 13, females worked at higher fractions of peak than males (p < 0.05). A second analysis compared a subset of 27 fitness-matched (V̇O2peak) male-female pairs. Fitness-matching further reduced or eliminated most observed differences in physiological responses, except small differences in breathing pattern. Practitioner Summary: Physiological responses during a standardised treadmill test for firefighter applicants were investigated in male and female applicants matched on size and fitness. Absolute responses to exercise were the same for both sexes when size-matched, but relative intensity was higher for females. Fitness-matching reduced or eliminated most previously observed differences. Abbreviations: NFPA: National Fire Protection Association; V̇O2: rate of oxygen consumption; V̇O2peak: rate of oxygen consumption at peak exercise; PAR-Q+: Physical Activity Readiness Questionnaire Plus; SCBA: self-contained breathing apparatus; ANOVA: analysis of variance; V̇E: minute ventilation; V̇Epeak: minute ventilation at peak exercise; V̇E/V̇O2: ventilatory equivalent for oxygen.

The Validity and Reliability of a Treadmill Test for Structural Firefighter Applicants.

OBJECTIVE: This 2-part study evaluated validity and reliability of a treadmill test for structural firefighters. METHODS: Wearing fire protective ensemble, 260 participants walked at 1.56 m·s-1, completing a 5-min warm-up, an 8-min stage at a 5.71° incline, then graded stages to exhaustion. In Part 2, 21 participants completed the test on 3 separate days under standardized conditions. RESULTS: Average (±SD) oxygen uptake () during minutes 1-13 was similar to reported values for simulated fire-rescue work. During the 13th min, was consistent with recommendations for firefighters. in Part 2, exercise duration increased between trials 1 and 2 before stabilizing but was consistent. CONCLUSIONS: Congruence with reported during simulated firefighting and recommendations for confirmed validity. Acceptable test-retest reliability was demonstrated. We conclude that the test is valid and reliable for evaluating cardiorespiratory endurance for firefighting.

Evidence for Validity and Reliability, and Development of Performance Standards and Cut-Scores for Job-Related Tests of Physical Aptitude for Structural Firefighters.

OBJECTIVE: This multi-part study aimed to revise an existing battery of physical aptitude tests for firefighter applicants. Test validity and reliability were evaluated and performance thresholds were determined. METHODS: In Part I, 49 structural firefighters rated the similarity between the physical demands of the tests and corresponding work activities. In Part II, 23 participants completed the tests on 3 separate days. In Part III, cut-scores were determined using the Bookmark method by an expert panel of 25 firefighter supervisors. RESULTS: Analysis revealed high levels of validity and reliability. The expert panel provided invaluable direction through a combination of independent and group work, leading to consensus on acceptable completion times. CONCLUSION: Rigorous processes established scientific credibility for the revised battery of tests. Expert knowledge from firefighter supervisors contributed to determining cut-scores following established scientific methods.

The effect of general duty police ensemble on graded exercise and simulated work performance.

This 2-part study examined the impact of general duty police ensemble on selected cardiopulmonary responses during incremental treadmill exercise and on simulated work performance in 25 healthy young male and female participants. Part I comprised randomly ordered treadmill tests in 2 experimental conditions: physical training (PT; undergarments, shorts, t-shirt, and running shoes) and police duty ensemble (PDE; undergarments, body armour, patrol uniform, boots, duty belt with required equipment, radio, and weapons). The PDE added 10.3 kg (SD 0.4) or 14% (SD 2) body mass. Participants walked at 5.6 km·h-1, starting at 0% grade with 2% increases in grade every 2 min. The 4% stage was 6 min in duration to achieve physiological steady state. Subsequently, the 2-min increments continued to exhaustion. Part II evaluated performance time on a recognized job-related work simulation circuit, in 3 experimental conditions: (i) PT, (ii) weighted belt (WB; PT plus a 7.5 kg weighted belt), and (iii) PDE. In Part I, physiological responses (e.g., oxygen uptake, ventilation, heart rate) were elevated (p < 0.05) with PDE during submaximal exercise but peak values were unchanged. Test duration and peak power output were significantly reduced with PDE. In Part II, circuit completion time was increased in PDE but not WB when compared with PT (p < 0.05). Heart rate and perceived exertion were similar in all conditions and perceived dyspnea was higher in PDE. Novelty Police duty ensemble negatively affected exercise performance more than would be expected due to load mass alone. Specificity must be considered when simulating occupational load carriage.

Ventilatory responses in males and females during graded exercise with and without thoracic load carriage.

PURPOSE AND METHODS: To compare the effects of thoracic load carriage on the ventilatory and perceptual responses to graded exercise, 14 pairs of height-matched, physically active males and females completed randomly ordered modified Balke treadmill exercise tests with and without a correctly sized and fitted 20.4 kg backpack and work clothing. Subjects walked at 1.56 m.s- 1 while grade was increased by 2% every 2 min until exhaustion. Ventilatory responses were measured with open circuit spirometry and perceptual responses were evaluated using the modified Borg scale. Inspiratory capacity maneuvers were performed to calculate operating lung volumes. RESULTS: Despite height matching, males had significantly greater lung volumes and peak oxygen uptake ([Formula: see text]O2peak). Peak [Formula: see text]O2 and ventilation ([Formula: see text]E) were lower (p < 0.05) for all subjects under load. Throughout exercise, the ventilatory equivalents for [Formula: see text]O2 and carbon dioxide production were significantly higher in females, independent of condition. At similar relative submaximal intensities (%[Formula: see text]O2peak), there was no difference in [Formula: see text]E between conditions in either group, however, all subjects adopted a rapid and shallow breathing pattern under load with decreased tidal volume secondary to lower end-inspiratory lung volume. The relative changes in breathing pattern and operating lung volume between unloaded and loaded conditions were similar between males and females. Females reported significantly higher dyspnea ratings for a given [Formula: see text]E compared to males; however, the relationship between dyspnea and [Formula: see text]E was unaffected by load carriage. CONCLUSION: The relative response patterns for ventilatory and perceptual responses to graded exercise with thoracic loading were similar in males and females.

Influence of work clothing on physiological responses and performance during treadmill exercise and the Wildland Firefighter Pack Test.

This study investigated physiological responses and performance during three separate exercise challenges (Parts I, II, and III) with wildland firefighting work clothing ensemble (boots and coveralls) and a 20.4 kg backpack in four conditions: U-EX (no pack, exercise clothing); L-EX (pack, exercise clothing); U-W (no pack, work clothing); and, L-W (pack and work clothing). Part I consisted of randomly-ordered graded exercise tests, on separate days, in U-EX, L-EX and L-W conditions. Part II consisted of randomly-ordered bouts of sub-maximal treadmill exercise in the four conditions. In Part III, subjects completed, in random-order on separate days, 4.83 km Pack Tests in L-EX or L-W conditions. In Part I, peak oxygen uptake was reduced (p < .05) in L-W. In Part II, mass-specific oxygen uptake was significantly higher in both work clothing conditions. In Part III, Pack Test time was slower (p < .05) in L-W. These results demonstrate the negative impact of work clothing and load carriage on physiological responses to exercise and performance.

The Influence of Body Mass on Physical Fitness Test Performance in Male Firefighter Applicants.

OBJECTIVE: The influence of body mass on test performance was investigated in 414 male firefighter applicants who completed a maximal treadmill test and five task-simulation tests while dressed in fire protective ensemble. METHODS: Subjects were assigned to six mass categories from less than 70 kg to more than 110 kg, in 10 kg increments (n = 69 in each). RESULTS: Treadmill performance was lower (P < 0.05) in the two heaviest groups. Charged hose advance time was slower in the two lightest groups. The lightest group had slower times for weighted sled pull, forcible entry, and victim rescue tests. The heaviest group was slower on the ladder climb test. CONCLUSION: Lighter subjects had a small advantage in endurance-oriented tests while higher mass appeared to improve performance slightly in strength-oriented tests. However, mass explained only 4% to 19% of the variance in performance.

The impact of thoracic load carriage up to 45 kg on the cardiopulmonary response to exercise.

PURPOSE: The purposes of this experiment were to, first, document the effect of 45-kg thoracic loading on peak exercise responses and, second, the effects of systematic increases in thoracic load on physiological responses to submaximal treadmill walking at a standardized speed and grade. METHODS: On separate days, 19 males (age 27 ± 5 years, height 180.0 ± 7.4 cm, mass 86.9 ± 15.1 kg) completed randomly ordered graded exercise tests to exhaustion in loaded (45 kg) and unloaded conditions. On a third day, each subject completed four randomly ordered, 10-min bouts of treadmill walking at 1.34 m s(-1) and 4 % grade in the following conditions: unloaded, and with backpacks weighted to 15, 30, and 45 kg. RESULTS: With 45-kg thoracic loading, absolute oxygen consumption ([Formula: see text]), minute ventilation, power output, and test duration were significantly decreased at peak exercise. End-inspiratory lung volume and tidal volume were significantly reduced with no changes in end-expiratory lung volume, breathing frequency, and the respiratory exchange ratio. Peak end-tidal carbon dioxide and the ratio of alveolar ventilation to carbon dioxide production were similar between conditions. The reductions in peak physiological responses were greater than expected based on previous research with lighter loads. During submaximal treadmill exercise, [Formula: see text] increased (P < 0.05) by 11.0 (unloaded to 15 kg), 14.5 (15-30 kg), and 18.0 % (30-45 kg) showing that the increase in exercise [Formula: see text] was not proportional to load mass. CONCLUSION: These results provide further insight into the specificity of physiological responses to different types of load carriage.

Physiological and performance consequences of heavy thoracic load carriage in females.

The purposes of this experiment were to study physiological responses to graded exercise to exhaustion (Part I) and ventilatory responses during 45 min of exercise (Part II) with and without a 25-kg backpack. In Part I, on separate days, 24 females completed randomly ordered modified Balke treadmill tests. Analysis revealed significant decreases in absolute peak oxygen uptake (3.5%), peak power output (20%), and test duration (40%) under load. There was a significant but modest negative relationship between body mass and the change in test duration between conditions (r = -0.44). While physiological responses to peak exercise were similar, exercise performance was negatively impacted under load. On separate days in Part II, 14 females completed randomly ordered, loaded and unloaded exercise challenges of submaximal treadmill walking at matched oxygen demands. Under load, breathing frequency, dead space, and minute ventilation were increased by 19.9%, 29.8%, and 11.6% (P < 0.05), respectively, while tidal volume and end-inspiratory lung volume decreased by 13.6% and 6.0% (P < 0.05), respectively. After loaded exercise, maximal inspiratory pressure was decreased by 11.5% (P < 0.05) with no changes in maximal expiratory pressure in either condition. Despite matched oxygen uptake between loaded and unloaded exercise challenges, perceived exertion and breathing discomfort were higher (P < 0.05) under load. With heavy load carriage, the altered breathing pattern led to increased dead space and minute ventilation, which likely contributed to higher perceptions of exercise stress and breathing discomfort. These results are similar to previous research in males and underscore the impact of heavy load carriage during exercise.

Load carriage, human performance, and employment standards.

The focus of this review is on the physiological considerations necessary for developing employment standards within occupations that have a heavy reliance on load carriage. Employees within military, fire fighting, law enforcement, and search and rescue occupations regularly work with heavy loads. For example, soldiers often carry loads >50 kg, whilst structural firefighters wear 20-25 kg of protective clothing and equipment, in addition to carrying external loads. It has long been known that heavy loads modify gait, mobility, metabolic rate, and efficiency, while concurrently elevating the risk of muscle fatigue and injury. In addition, load carriage often occurs within environmentally stressful conditions, with protective ensembles adding to the thermal burden of the workplace. Indeed, physiological strain relates not just to the mass and dimensions of carried objects, but to how those loads are positioned on and around the body. Yet heavy loads must be borne by men and women of varying body size, and with the expectation that operational capability will not be impinged. This presents a recruitment conundrum. How do employers identify capable and injury-resistant individuals while simultaneously avoiding discriminatory selection practices? In this communication, the relevant metabolic, cardiopulmonary, and thermoregulatory consequences of loaded work are reviewed, along with concomitant impediments to physical endurance and mobility. Also emphasised is the importance of including occupation-specific clothing, protective equipment, and loads during work-performance testing. Finally, recommendations are presented for how to address these issues when evaluating readiness for duty.

Towards best practice in physical and physiological employment standards.

While the scope of the term physical employment standards is wide, the principal focus of this paper is on standards related to physiological evaluation of readiness for work. Common applications of such employment standards for work are in public safety and emergency response occupations (e.g., police, firefighting, military), and there is an ever-present need to maximize the scientific quality of this research. Historically, most of these occupations are male-dominated, which leads to potential sex bias during physical demands analysis and determining performance thresholds. It is often assumed that older workers advance to positions with lower physical demand. However, this is not always true, which raises concerns about the long-term maintenance of physiological readiness. Traditionally, little attention has been paid to the inevitable margin of uncertainty that exists around cut-scores. Establishing confidence intervals around the cut-score can reduce for this uncertainty. It may also be necessary to consider the effects of practise and biological variability on test scores. Most tests of readiness for work are conducted under near perfect conditions, while many emergency responses take place under far more demanding and unpredictable conditions. The potential impact of protective clothing, respiratory protection, load carriage, environmental conditions, nutrition, fatigue, sensory deprivation, and stress should also be considered when evaluating readiness for work. In this paper, we seek to establish uniformity in terminology in this field, identify key areas of concern, provide recommendations to improve both scientific and professional practice, and identify priorities for future research.

Ventilatory responses to prolonged exercise with heavy load carriage.

PURPOSE: The purpose of this experiment was to study breathing pattern and operating lung volume during 45 min of exercise with a heavy backpack (25 kg) and examine the effect of this exercise on respiratory muscle strength. METHODS: Fifteen males completed randomly ordered graded exercise tests on a treadmill with and without a correctly sized and fitted 25 kg pack. Subsequently, each subject completed, in random order, on separate days, 45 min of treadmill walking with and without the pack. Oxygen demand was matched between conditions (loaded: 3.01 ± 0.11 and unloaded 3.02 ± 0.11 L min(-1)). RESULTS: With load, breathing frequency (f B) and minute ventilation increased by 21.7 and 15.1 % (P < 0.05), respectively, while tidal volume (V T) and end-inspiratory lung volume (EILV) were reduced by 6.3 and 6.4% (P < 0.05), respectively, compared to unloaded. Following loaded exercise, maximal inspiratory pressure decreased by 6.7% (P < 0.05) with no change in maximal expiratory pressure. No changes in maximal inspiratory or expiratory pressures were observed following unloaded exercise. Despite equivalent oxygen demand, perceived exercise stress and breathing discomfort was higher (P < 0.05) in the loaded condition. CONCLUSIONS: The mechanical disadvantage placed on the respiratory system during exercise with a heavy pack led to compensatory changes in breathing pattern and EILV, and a reduction in maximal inspiratory pressure post-exercise. We suggest that in an attempt to minimize the work of breathing, subjects adopted a shallow and frequent breathing pattern. However, this pattern increased deadspace and minute ventilation, which likely contributed to altered perceptions of exercise stress and breathing discomfort.

The effects of cranial cooling during recovery on subsequent uncompensable heat stress tolerance.

This study compared cranial (CC) with passive (CON) cooling during recovery on tolerance to subsequent exercise while wearing firefighting protective ensemble and self-contained breathing apparatus in a hot-humid environment. Eleven males (mean ± SD; age, 30.9 ± 9.2 years; peak oxygen consumption, 49.5 ± 5.1 mL · kg(-1) · min(-1)) performed 2 × 20 min treadmill walks (5.6 km · h(-1), 4% incline) in 35 °C and 60% relative humidity. During a 20-min recovery (rest), participants sat and removed gloves, helmets, and flash hoods but otherwise remained encapsulated. A close-fitting liquid-perfused hood pumped 13 °C water at ∼ 500 mL · min(-1) through the head and neck (CC) or no cooling hood was worn (CON). During rest, neck temperature was lower in CC compared with CON from 4 min (CC: 35.73 ± 3.28 °C, CON: 37.66 ± 1.35 °C, p = 0.025) until the end (CC: 33.06 ± 4.70 °C, CON: 36.85 ± 1.63 °C, p = 0.014). Rectal temperature rose in both CC (0.11 ± 0.19 °C) and CON (0.26 ± 0.15 °C) during rest, with nonsignificant interaction between conditions (p = 0.076). Perceived thermal stress was lower (p = 0.006) from 5 min of CC (median: 3 (quartile 1: 3, quartile 3: 4)) until the end of rest compared with CON (median: 4 (quartile 1: 4, quartile 3: 4)). However, there were no significant differences (p = 0.906) in tolerance times during the second exercise between CC (16.55 ± 1.14 min) and CON (16.60 ± 1.31 min), nor were there any difference in rectal temperature at the start (CC: 38.30 ± 0.40 °C, CON: 38.40 ± 0.16 °C, p = 0.496) or at the end (CC: 38.82 ± 0.23 °C, CON: 39.07 ± 0.22 °C, p = 0.173). With high ambient heat and encapsulation, cranial and neck cooling during recovery decreases physiological strain and perceived thermal stress, but is ineffective in improving subsequent uncompensable heat stress tolerance.

Modelling the physiological strain and physical burden of chemical protective coveralls.

This study determined the impact of selected chemical protective coveralls (CPC) on physiological responses and comfort sensations. Fifteen males exercised at approximately 6 METS in three CPC (Tyvek®, Gulf and Tychem®) and a control garment. Physiological strain was characterised by core and skin temperatures, heart rate, V̇O2, perceived exertion, hotness and wetness. Physical burden was characterised by restriction to movement, V̇O2 and RPE. The highest levels of physiological strain and physical burden were found in Tychem®, and the lowest in control. Seven statistical regression models were developed through correlation and multiple regression analyses between the human responses and the results from previously conducted fabric and garment property testing. These models showed that physical burden was increased by adding weight and/or restricting movement. Oxygen consumption was best predicted by clothing weight and fabric bending hysteresis. Fabric evaporative resistance and thickness were the two best predictors of physiological and perceptual responses. Practitioner Summary: Traditional evaluation of chemical protective coveralls (CPC) involves testing at the fabric and garment levels and rarely is based on human trials. This study integrates information from fabric, garment and human trials to better understand physiological strain and physical comfort during prolonged exercise in CPC.

Dopamine receptor blockade improves pulmonary gas exchange but decreases exercise performance in healthy humans.

Pulmonary gas exchange, as evaluated by the alveolar-arterial oxygen difference (A-aDO2), is impaired during intense exercise, and has been correlated with recruitment of intrapulmonary arteriovenous anastomoses (IPAVA) as measured by agitated saline contrast echocardiography. Previous work has shown that dopamine (DA) recruits IPAVA and increases venous admixture (Q̇s/Q̇t) at rest. As circulating DA increases during exercise, we hypothesized that A-aDO2 and IPAVA recruitment would be decreased with DA receptor blockade. Twelve healthy males (age: 25 ± 6 years, V̇O2 max : 58.6 ± 6.5 ml kg(-1) min(-1) ) performed two incremental staged cycling exercise sessions after ingestion of either placebo or a DA receptor blocker (metoclopramide 20 mg). Arterial blood gas, cardiorespiratory and IPAVA recruitment (evaluated by agitated saline contrast echocardiography) data were obtained at rest and during exercise up to 85% of V̇O2 max . On different days, participants also completed incremental exercise tests and exercise tolerance (time-to-exhaustion (TTE) at 85% of V̇O2 max ) with or without dopamine blockade. Compared to placebo, DA blockade did not change O2 consumption, CO2 production, or respiratory exchange ratio at any intensity. At 85% V̇O2 max , DA blockade decreased A-aDO2, increased arterial O2 saturation and minute ventilation, but did not reduce IPAVA recruitment, suggesting that positive saline contrast is unrelated to A-aDO2. Compared to placebo, DA blockade decreased maximal cardiac output, V̇O2 max and TTE. Despite improving pulmonary gas exchange, blocking dopamine receptors appears to be detrimental to exercise performance. These findings suggest that endogenous dopamine is important to the normal cardiopulmonary response to exercise and is necessary for optimal high-intensity exercise performance.

Variability in performance on a work simulation test of physical fitness for firefighters.

The Canadian Forces Firefighter Physical Fitness Maintenance Evaluation (FF PFME) requires firefighters in full fire-protective ensemble, including self-contained breathing apparatus, to correctly complete 10 work-related tasks on a measured and calibrated course. Fitness for duty is inferred from completion time of the course. We hypothesized that completion time may be dependent on pacing strategy and day-to-day fluctuations in biological function. To examine variability in performance, 20 females and 31 males (mean ± SD; age, 27.6 ± 10.5 years; height, 176.7 ± 8.3 cm; mass, 77.3 ± 13.4 kg) were familiarized with the FF PFME and then completed the test on 6 separate days. Pre-test behaviours (e.g., sleep, diet) and test conditions (e.g., calibration, time of day) were consistent. Repeated-measures ANOVA revealed a significant decrease in completion time between tests 1 and 6 (18.7%) and between all sequential pairs (e.g., tests 1 and 2). There was also a small but significant increase in the fraction of total test time for task completion and a corresponding decrease in the time to transition between tasks. The performance improvements cannot be explained by differences in effort (heart rate and perceived exertion). Coefficient of variation for tests 1, 2, and 3 was 7% and for tests 4, 5, and 6 was 2.6%. The results indicate the importance of practice on performance and the potential for false-positive or false-negative decision errors if biological variability is not taken into account.

Getting rhythm: how do babies do it?

OBJECTIVES: To investigate the emergence of biological rhythms in the first months of life in human infants, by measuring age-related changes in core body temperature during night-time sleep, hormones (cortisol and 6-sulfatoxymelatonin) and the expression of a clock-controlled gene H3f3b in oral epithelial cells. DESIGN: Observational longitudinal study. SETTING: We measured overnight core body temperature, actigraphy, day-night urinary cortisol and 6-sulfatoxymelatonin, as well as circadian gene expression, in infants at home from March 2007 to July 2008 in Leicester. PARTICIPANTS: We recruited 35 healthy Caucasian infants who were born at term. They were monitored from 6 to 18 weeks of age. RESULTS: At 8 weeks of age the day-night rhythm of cortisol secretion was the first to appear followed by 6-sulfatoxymelatonin 1 week later; at the same time that night-time sleep was established. At 10 weeks, the maximum fall in deep body temperature occurred with the onset of night-time sleep, followed at 11 weeks by the rhythmical expression of the H3f3b gene. CONCLUSIONS: In human infants, there is a clear sequential pattern for the emergence of diurnal biological rhythms between 6 and 18 weeks of postnatal age, led by the secretion of cortisol and linked with the establishment of consolidated night-time sleep. It is likely that this represents part of a maturation and adaption process as infants gain equilibrium with their external environment after birth.

Establishment of performance standards and a cut-score for the Canadian Forces firefighter physical fitness maintenance evaluation (FF PFME).

The bookmark method for setting cut-scores was used to re-set the cut-score for the Canadian Forces Firefighter Physical Fitness Maintenance Evaluation (FF PFME). The time required to complete 10 tasks that together simulate a first-response firefighting emergency was accepted as a measure of work capacity. A panel of 25 Canadian Forces firefighter supervisors set cut-scores in three rounds. Each round involved independent evaluation of nine video work samples, where the times systematically increased from 400 seconds to 560 seconds. Results for Round 1 were discussed before moving to Round 2 and results for Round 2 were discussed before moving to Round 3. Accounting for the variability among panel members at the end of Round 3, a cut-score of 481 seconds (mean Round 3 plus 2 SEM) was recommended. Firefighters who complete the FF PFME in 481 seconds or less have the physical capacity to complete first-response firefighting work.