Performance requirements of physically strenuous occupations: validating minimum standards for muscular strength and endurance.

Employment rights legislative mandates passed in the USA over the last three decades emphasize the importance of validating performance standards for physically strenuous occupations. This study validated minimally acceptable standards for the muscular strength and endurance necessary to perform fire suppression activities. Incumbent firefighters (n=153) selected for key demographic characteristics completed a simulated set of firefighting tasks (Fire Suppression Evolution) and then a Predictor Test Battery of physical abilities tests. Regression analysis revealed that three predictor test items (hose drag/high rise pack carry; arm lift; arm endurance) combined to significantly predict performance time of the Fire Suppression Evolution (p < or =0.01). Firefighters (n=41) rating videotaped performance times of the Fire Suppression Evolution determined that more than one-half a standard deviation slower than the mean time established by the incumbents reflected unacceptable performance. Approximately 80% of incumbent firefighters passed the minimally acceptable performance standard. Use of the 3-predictor test battery would correctly identify 89% of successful performers and 72% of unsuccessful performers. This study demonstrates that validation of minimal physical performance standards will identify a cohort of individuals with a high probability of not being able to perform critical fire suppression activities. This finding has important implications for examining the relationship between physical performance standards and medical and economic outcomes.

Brain norepinephrine changes with simulated weightlessness and relation to exercise training.

Maintenance of nervous system function during periods of a deconditioning syndrome is important to prevent diminished psychological/behavioral, and physiological function observed during periods of bed rest, physical inactivity, and weightlessness. A main neurotransmitter is norepinephrine (NE), and its regulation yields insight into nervous system function. This research tested the hypotheses that, 1) deconditioning syndrome induced by simulated weightlessness of 9 days via the head-down tilt (HDT) model results in a blunted noradrenergic turnover rate in selected brain tissue and, 2) that exercise training acts as a countermeasure for these changes in noradrenergic activity. Male Sprague-Dawley rats (3 months, n = 60) were divided into either a HDT (HDT, n = 20), cage control (CAGE-CN, n = 20) or an exercise trained HDT (HDT-EX, n = 20) group. Each group was further subdivided into a saline (n = 10) or alpha-methyl-tyrosine (AM, n = 10) (200 mg/kg) injected subgroup. Animals in the HDT groups were tail suspended in a 30 degrees head-down tilt position for 9 days. Norepinephrine turnover was determined 3 h following administration of saline or alpha-methyl-para-tyrosine. The NE turnover rate (ng gm(-1) x h(-1)) for the CN, HDT, and HDT-EX groups, respectively, were as follows: locus coeruleus, 63 +/- 33, *134 +/- 65, 85 +/- 61; hypothalamus, 195 +/- 50, *47 +/- 47; *93 +/- 34; cerebellum, 10 +/- 18, *65 +/- 15, *53 +/- 19; cerebral cortex, 6 +/- 20, *28 +/- 15, *68 +/- 22. (*Denotes significant difference from the control group at the p < or = 0.05 level of significance; +denotes significant difference from the HDT group at the p < or = 0.05 level of significance.) These findings suggest that: 1) norepinephrine turnover rate adapts in a tissue-specific manner following a 9-day tail suspension, 2) increased norepinephrine turnover rates and norepinephrine tissue content in the HDT group are consistent with neural adaptation to a chronic stress response.

Simulated weightlessness to induce chronic hypoactivity of brain norepinephrine for exercise and stress studies.

Although research on the relationship between exercise training and physiological stress reactivity is increasing, we know little about the involvement of brain neurochemistry. Moreover, the few studies that have been performed have concentrated on animals with normally functioning neurochemistry exposed to an acute stressor. Biomedical research is drawing an association between hypoactivation of the physiological stress response and certain medical conditions. As such, there is a need for an animal model that manifests a chronic hypoactivity of the stress system. In this report we describe the results from studies on norepinephrine changes with actual and simulated weightlessness in animals and humans. There is consistent evidence with rats that 14 d of simulated weightlessness produces reduced norepinephrine turnover in selected brainstem nuclei and peripheral tissue mediating the physiological stress response. Little is known about other brain regions, particularly the hypothlamus. These preliminary data suggest that simulated weightlessness is one method by which a chronic hypoactivity of norepinephrine biosynthesis or release might be induced to study exercise training as an intervention.

Changes in the growth hormone axis due to exercise training in male and female rats: secretory and molecular responses.

GH secretion is altered by exercise in humans. In an attempt to investigate the underlying mechanisms, we developed a rodent model. GH secretion was assayed in male and female rats that were sedentary (not exercised), acutely exercised, and chronically exercised. Sedentary males showed typical pulsatile GH secretion. The acutely exercised males had low GH concentrations during the exercise bout, but showed partial recovery of GH pulses during the 5.5-h postexercise period. GH secretion in the chronically exercised males was low during both the exercise and postexercise periods. Sedentary females displayed the typical pattern of GH secretion for this sex. The acutely exercised females had low GH concentrations during the exercise period; the pulsatile pattern of GH secretion did not return during the postexercise period. In contrast, the chronically exercising females had suppressed GH secretion during the exercise bout, but concentrations immediately returned to normal during the postexercise bout. The effects of exercise on GH, GH-releasing hormone (GHRH), and somatostatin messenger RNA (mRNA) levels using Northern and slot blot analyses were also determined. Acutely and chronically exercised male rats had decreased levels of GH mRNA compared to sedentary male rats. The acutely exercised female rats had increased levels of GH mRNA compared to the sedentary females, whereas the chronically exercised females had decreased levels. GHRH mRNA levels in acutely exercising male rats was decreased and in chronically exercising male rats was increased compared to those in the sedentary controls. The pattern of GHRH mRNA in female rats was the opposite of this. Somatostatin mRNA levels decreased in acutely exercised male rats and were not affected in chronically exercised male rats. This signal increased in both acute and chronically exercised female rats. These studies suggest that GH secretion is suppressed in response to exercise in the rat. This contrasts with the increase observed after exercise in humans.

Selected psychophysiological stress responses in men with high and low body fatness.

Previous research on catecholamine (CA) response to exercise has linked heightened adiposity to a hypostress syndrome. In the present study a cognitive/psychomotor stressor was employed to determine whether this association exists during less metabolically challenging tasks. Moreover, because stress is manifested in a multidimensional manner, measures of behavior and perceived distress were analyzed in addition to the physiological response. Men were selectively recruited for two body fatness groups (low, 12 +/- 4%, N = 9; high, 27 +/- 2%, N = 10) while being matched on age, lean weight, and peak absolute oxygen consumption. All men performed a modified Stroop task for 12 min to induce a psychophysiological stress response. Physiological changes included significant increases in heart rate, venous plasma norepinephrine, and epinephrine. Cognitive/psychomotor responses indicated no change in reaction time during the task but significant cognitive fatigue as indicated by post-task anagram performance. Perceived distress was suggested by elevated state anxiety. The high and low adiposity groups were similar on all measures of the psychophysiological stress response. These findings suggest that elevated adiposity is not characterized by a hypostress state during the relatively low metabolic challenge of a cognitive/psychomotor stressor.

Molecular analysis of mutations in the gene FMR-1 segregating in fragile X families.

Molecular genetic analysis of the transmission of mutations in 73 families with fragile X (one of the largest samples evaluated so far) has confirmed previous hypotheses that the fragile X syndrome results from two consecutive mutational steps, designated "premutation" and "full fragile X mutation". These mutations give rise to expansions of restriction fragments, most probably by amplification of the FMR-1 CGG repeat. Premutations are identified by small expansions that apparently have no effect on either the clinical or the cellular phenotype. Full mutations are reflected by large expansions and hypermethylation of the expanded gene region. All males showing large expansions were affected. Individuals with full mutations also expressed the fragile X, with only one exception. An affected "mosaic" male, showing a predominance of premutated fragments in his leukocytes, was shown to be fragile-X-negative on different occasions. About 50% of heterozygotes with full mutations were reported by clinicians to be mentally retarded. Conversion of the premutation to the full mutation may occur at oogenesis, as previously suggested, or after formation of a zygote at an early transitional stage in development when the CGG repeat behaves as a mitotically unstable element on maternally derived/imprinted X chromosomes carrying a premutation of sufficient repeat length.

Young and old subjects matched for aerobic capacity have similar noradrenergic responses to exercise.

Sympathetic nervous system activity as indicated by circulating norepinephrine has been demonstrated to increase with advancing chronological age both at rest and during submaximal exercise. Much of the earlier work investigating this aging phenomenon used a younger group that had a higher peak oxygen consumption (VO2) than did the older group, which made comparisons difficult. In the present study, young [n = 7, 36 +/- 1.0 (SE) yr] and old subjects (n = 8, 61 +/- 1.2 yr) were matched on peak VO2 and then exercised at approximately the same relative submaximal VO2 (75%) and power output on a cycle ergometer for 21 min. Blood samples were collected at rest and in the 7th, 14th, and last minute of a 21-min exercise bout via an indwelling catheter in an antecubital vein. The norepinephrine responses for the young and old groups, respectively, were as follows: rest, 486 +/- 111 vs. 673 +/- 108; 7 min, 1,258 +/- 255 vs. 1,185 +/- 172; 14 min, 1,639 +/- 316 vs. 1,528 +/- 288; and 21 min, 2,038 +/- 488 vs. 1,936 +/- 453 pg/ml. These responses were not significantly different between the groups at any time period. The epinephrine values for the age groups were not statistically different: rest, 115 +/- 60 vs 88 +/- 51; 7 min, 140 +/- 18 vs. 326 +/- 88; 14 min, 216 +/- 33 vs. 366 +/- 104; and 21 min, 324 +/- 100 vs. 447 +/- 113 pg/ml.(ABSTRACT TRUNCATED AT 250 WORDS)

Heart rate response of firefighters to actual emergencies. Implications for cardiorespiratory fitness.

Heart rate (HR) and oxygen consumption (VO2) responses during actual fire-suppression emergencies were monitored in 10 male firefighters. These firefighters worked at 157 +/- 8 beats per minute (bpm) for 15 +/- 7 minutes. This was 88 +/- 6% of their previously determined HR max. Based on treadmill testing, the HR x VO2 relationship was established for each firefighter. The predicted VO2 derived from HR monitoring in actual emergencies was 25.6 +/- 8.7 mL.kg-1.min-1 or 63 +/- 14% of VO2 max (40.0 +/- 6.5 mL.kg-1.min-1). These values on the cardiorespiratory response to actual emergencies are very similar to results derived from studies employing fire-suppression simulations. Recommendations for the VO2 max of firefighters ranging from 33.5 to 42.0 mL.kg-1.min-1 that have been generated from simulation testing appear appropriate given the cardiorespiratory responses to actual emergencies.

Sympathetic nervous system and behavioral responses to stress following exercise training.

This study tests the hypothesis that a short-term (16 weeks) exercise program modifies sympathetic nervous system (SNS) and selected behavioral responses to acute psychological stress. Twenty-four previously sedentary middle-aged men with maximal aerobic capacity (VmaxO2) values less than 40 ml.kg-1.min-1 were assigned to experimental (n = 12) and control (n = 12) groups. All subjects performed a modified Stroop test (18 min) at pre- and postexercise training during which intravenous blood samples were drawn at three time intervals for plasma catecholamine (CA) determination. Motor performance was continuously recorded for assessment of premotor (PMT) and motor (MOT) components of reactions time. A set of anagrams were administered immediately following the modified Stroop to determine the level of cognitive fatigue induced. At both pre- and postexercise intervention, the total group (n = 24) manifested significant (p less than or equal to 0.05) elevations in state anxiety, heart rate, and plasma norepinephrine. No significant changes occurred over time on PMT or MOT. There were significantly (p less than or equal to 0.01) lengthened anagram performance scores poststress compared to nonstress values. The experimental group exercise trained 3 days/week for 16 weeks, resulting in a 20% increase in VO2max. However, there were no group differences on the CA or behavioral responses to the modified Stroop at pre- or postintervention. These findings do not support the hypothesis that short-term aerobic training significantly alters SNS activity or behavioral measures of central processing in middle-aged men exposed to an acute psychological challenge.

Age as a bona fide occupational qualification for firefighting. A review on the importance of measuring aerobic power.

Recent federal and judicial initiatives have led to controversy over the justification of mandatory retirement policies applied to public safety occupations. The Equal Employment Opportunity Commission has been mandated to study this issue, and a critical element of that study will be to determine the types of tests to be employed as substitutes for a mandatory retirement age. In this review, a rationale is presented for the measurement of aerobic power (VO2max) as a predictor of the physical performance capability of firefighters. We conclude that task simulations rarely replicate the environmental conditions present at structural fires that stress the cardiorespiratory capability of firefighters. VO2max is an important predictor of performance effectiveness of firefighters to be used in conjunction with task-specific testing.

Oxygen consumption during fire suppression: error of heart rate estimation.

Ten male firefighters were tested on a treadmill to determine their heart rate (HR) x oxygen consumption (VO2) relationship. These men then performed a simulated fire suppression protocol during which HR and VO2 were measured simultaneously by a portable physiological monitoring system. Average VO2 in the simulated setting was 31.0 +/- 7.0 ml.kg-1.min-1 at a HR of 176 +/- 9 bpm. This VO2 was significantly (p less than or equal to 0.05) less than the VO2 that would have been predicted by treadmill testing (38.9 +/- 5.0 ml.kg-1.min-1) at a corresponding HR. Fifty-nine per cent of this variability could be accounted for by regression analysis. Firefighters worked on average at 73 +/- 10% VO2 max with a range of 54% to 88%. There was a significant (-0.82; p less than or equal to 0.05) inverse relationship between performance time of the fire suppression protocol and the relative intensity of VO2 max at which the firefighters worked. These findings indicate that the prediction of energy expenditure from HR is not straightforward in fire suppression settings. Furthermore, the relative intensity of work firefighters self-select is variable and should be considered as an additional physiological determinant of work behaviour.

Aging and the fitness of fire fighters: the complex issues involved in abolishing mandatory retirement ages.

This study presents an assessment of the cardiorespiratory health and physical fitness of fire fighters of different ages with the aim of addressing several questions currently being debated on a national level. These include how fire fighters differ across age groups in their health and physical fitness, and what would be the impact on the existing work force of implementing minimum fitness standards as an alternative to mandatory retirement ages. Fire fighters aged 20-65 years were found to be similar in their cardiorespiratory health and physical fitness to the sedentary segment of the general population of the same age. Particularly worrisome, however, is the low maximal aerobic capacity (31, 28, 26 ml/kg/min), high percent body fat (26, 29, 30), and high resting blood pressure (136/86, 140/90, 143/93 mm Hg) observed in the 40-45-, 50-55-, and 60-65-year-old fire fighters, respectively. In fact, 66%, 83%, and 93% of the fire fighters in these three age groups, respectively, fall below the lowest published recommendations for maximal aerobic capacity in this profession. These data underscore the need to establish minimum health and physical performance standards for fire fighters and demonstrate the profound impact such minimum standards will have on the existing work force.

Relationship of regional fat distribution and obesity to electrocardiographic parameters in healthy premenopausal women.

Abdominal obesity is an independent cardiovascular risk factor. The coexistence of abdominal obesity and electrocardiographic abnormalities may facilitate the development of cardiac arrhythmias and sudden death. We determined the relationship of body fat distribution and obesity to ECG indices in 27 obese premenopausal women on an isocaloric diet. Intra-abdominal fat distribution was assessed by computerized tomography, and obesity was assessed by hydrostatic weighing. The PR, QRS, and QTc intervals, the P and QRS axes, and the P-QRS angle were determined from a resting electrocardiogram. Cardiovascular risk profile was assessed by systolic and diastolic blood pressure and plasma cholesterol and triglyceride levels. Increased deposition of intra-abdominal fat was significantly associated with prolongation of the QTc interval independent of obesity and other cardiovascular risk factors. The prolongation of the QTc interval seen with increasing intra-abdominal fat distribution may enhance susceptibility to cardiac arrhythmias. These subjects should have electrocardiographic monitoring during periods of weight loss achieved by intensive regimens.

Plasma catecholamine response to acute psychological stress in humans: relation to aerobic fitness and exercise training.

Existing cross-sectional studies on plasma catecholamine activity provide no support for the concept that a markedly high level of aerobic fitness modifies sympathoadrenal response to an acute psychological challenge in humans. In contrast, compromised sympathetic nervous system activity has been observed in individuals with low aerobic fitness and the relationship probably reflects a global deconditioning syndrome involving both psychological and physiological processes. The relationship between low levels of fitness and plasma norepinephrine may appear as a blunted or augmented response depending upon the nature of the task. Short-term (3-4 months) exercise training studies conducted with humans have not indicated a substantial adaptation in the relative plasma catecholamine change from a preexisting baseline during exposure to acute psychological stress. Exercise training can lower basal circulating plasma norepinephrine, resulting in lower absolute concentrations during an acute challenge, but the studies in this area lack consistency and the absolute change tends to be modest. There is no evidence that fitness or exercise training is significantly associated with plasma epinephrine activity during short-term psychological stress.

Plasma free and sulfoconjugated catecholamines during sustained exercise.

Previous research established a relationship between circulating sulfoconjugated norepinephrine (NE-SO4) and oxygen consumption at various exercise intensities. In this study, the stability of the NE-SO4 response was examined during sustained exercise at a constant relative intensity. Seven trained men bicycled at 78 +/- 3% of their maximal O2 consumption for 28 min and then rested on the ergometer for a comparable duration. After a 30-min rest, plasma samples were collected through an indwelling catheter at 7-min intervals during the exercise and recovery periods. Free NE and epinephrine increased sixfold during exercise. These changes were accompanied by increases in sulfoconjugated catecholamines, but only NE-SO4 achieved statistical significance (rest, 712 +/- 602; exercise, 1,329 +/- 1,163 pg/ml). This occurred at three collection periods (14, 21, and 28 min). Approximately 35, 52, and 95% of NE, epinephrine, and dopamine, respectively, existed as sulfoconjugated during exercise. Subject variation was present in the sulfoconjugated catecholamine response that could not be attributed to corresponding differences in circulating free catecholamine release. These findings implicate blood flow as a factor in the sulfoconjugation of NE, but not epinephrine or dopamine.

Impact of exercise training on plasma adrenocorticotropin response to a well-learned vigilance task.

Plasma adrenocorticotropin hormone (ACTH), cortisol, heart rate, self-reported state anxiety and total reaction time responses in physically active (n = 8) and sedentary (n = 11) middle-aged men were compared during performance of a well-learned, psychologically challenging task. The groups were similar in age (active: 39.9 +/- 8.4 yr vs. sedentary: 44.4 +/- 7.2 yr) and trait anxiety (29.4 +/- 5.2 vs. 34.5 +/- 12.6), but they had different maximal oxygen consumption relative to lean body weight (68.6 +/- 7.1 vs. 44.7 +/- 4.6 ml.kg(-1).min(-1)). During performance of the psychological protocol, the total group had significant increases in heart rate and state anxiety, whereas both ACTH and cortisol remained near baseline levels. ACTH and cortisol were not different between the groups. The sedentary group exercise trained for 4 mo, which resulted in an 18% improvement in maximal aerobic capacity (vO2 max). Exercise intervention did not significantly alter the neuroendocrine response compared to pre-training values or compared to a corresponding control group. These findings suggest that enhanced cardiovascular fitness resulting from exercise training does not affect anterior pituitary-adrenocortical activity during performance of a practiced vigilance task.

The relationship of insulin to sex hormone-binding globulin: role of adiposity.

The role of adiposity in the relationship of insulin to sex hormone-binding globulin (SHBG) concentration was examined in 31 healthy premenopausal women of varying body weight. Fat mass was estimated by hydrostatic weighing. Concentrations of SHBG and testosterone (T) and cumulative insulin response during an oral glucose tolerance test were measured. The cumulative insulin response was inversely related to SHBG (r = -0.56, P less than 0.01). The relationship between SHBG and cumulative insulin response remained significant (r = -0.47, P less than 0.01) after adjusting for fat mass and T. The fat mass correlated significantly with SHBG (r = -0.51, P less than 0.01). The relationship of SHBG to fat mass remained significant after adjusting for T (r = -0.45, P less than 0.01). However, the relationship between fat mass and SHBG was no longer significant (r = -0.34, P greater than 0.05) after adjusting for cumulative insulin response. Hyperinsulinemia may play an important role in the progressive reduction of SHBG observed with increasing adiposity.