Cardiorespiratory effects of respiratory protective devices during exercise in well-trained men

The Impact of Firefighter Physical Fitness on Job Performance: A Review of the Factors That Influence Fire Suppression Safety and Success

Purpose: The objective of this review was to analyze the physiological impact of fire suppression on the human body. Design: The literature review included studies focused on workload requirements for common firefighting tasks, effect of health status on the firefighting profession, and attempts to establish a minimum physiological workload capacity for successful performance of firefighting. Findings: The existing literature provides evidence of the high degree of physiological stress that firefighters are under during fire suppression tasks and the great degree of maximal physical capacity that firefighting often requires. Firefighters often operate close to maximal aerobic capacity while performing tasks common to the profession. This is especially true due to the added physiological stress placed on the human body while wearing personal protective equipment during firefighting. Conclusions: Future investigations are necessary to further explore markers of physiological stress during firefighting and the impact that it may have on the ability to withstand the development of disease as well as fire suppression safety. Using completion time of fire suppression tasks as a criterion of success may be an important consideration in addition to the physiological requirements of the occupation when assessing the appropriateness of an individual to be a firefighter. An important future consideration is the effect that fire suppression activities may have on reaction time in critical situations in which life-and-death decisions must be made.

Impact of SCBA size and firefighting work cycle on firefighter functional balance

Slips, trips and falls are leading causes of fireground injuries. A functional balance test (FBT) was used to investigate the effects of self-contained breathing apparatus (SCBA) size and design, plus firefighting work cycle. During the FBT, subjects walked along a narrow platform and turned in defined spaces, with and without an overhead obstacle. Thirty firefighters wore three varying-sized standard SCBAs and a low-profile prototype SCBA during three simulated firefighting work/rest cycles. Firefighters were tested pre- and post-firefighting activity (one bout, two bouts with a 5-min break, or back-to-back bouts with no break). Subjects committed more errors and required longer completion times with larger SCBAs. Use of the prototype SCBA lead to lower times and fewer errors. Performing a second bout of firefighting increased completion time. Firefighters need to consider how SCBA and amount of physical activity on the fireground may influence balance in order to reduce the risk of injury.

Physiological response to firefighting activities of various work cycles using extended duration and prototype SCBA

Firefighters' self-contained breathing apparatus (SCBA) protects the respiratory system during firefighting but increases the physiological burden. Extended duration SCBA (>30 min) have increased air supply, potentially increasing the duration of firefighting work cycles. To examine the effects of SCBA configuration and work cycle (length and rest), 30 firefighters completed seven trials using different SCBA and one or two bouts of simulated firefighting following work cycles common in the United States. Heart rate, core temperature, oxygen consumption, work output and self-reported perceptions were recorded during all activities. Varying SCBA resulted in few differences in these parameters. However, during a second bout, work output significantly declined while heart rates and core temperatures were elevated relative to a single bout. Thirty seven per cent of the subjects were unable to complete the second bout in at least one of the two-bout conditions. These firefighters had lower fitness and higher body mass than those who completed all assigned tasks. Practitioner Summary: The effects of extended duration SCBA and work/rest cycles on physiological parameters and work output have not been examined. Cylinder size had minimal effects, but extended work cycles with no rest resulted in increased physiological strain and decreased work output. This effect was more pronounced in firefighters with lower fitness.

Respiratory Responses during Exercise in Self-contained Breathing Apparatus among Firefighters and Nonfirefighters

Background

Firefighters are required to use self-contained breathing apparatus (SCBA), which impairs ventilatory mechanics. We hypothesized that firefighters have elevated arterial CO₂ when using SCBA.

Methods

Firefighters and controls performed a maximal exercise test on a cycle ergometer and two graded exercise tests (GXTs) at 25%, 50%, and 70% of their maximal aerobic power, once with a SCBA facemask and once with protective clothing and full SCBA.

Results

Respiratory rate increased more in controls than firefighters. Heart rate increased as a function of oxygen consumption (V.O2) more in controls than firefighters. End-tidal CO₂ (ETCO₂) during the GXTs was not affected by work rate in either group for either condition but was higher in firefighters at all work rates in both GXTs. SCBA increased ETCO₂ in controls but not firefighters.

Conclusions

The present study showed that when compared to controls, firefighters’ hypoventilate during a maximal test and GXT. The hypoventilation resulted in increased ETCO₂, and presumably increased arterial CO₂, during exertion. It is proposed that firefighters have altered CO₂ sensitivity due to voluntary hypoventilation during training and work. Confirmation of low CO₂ sensitivity and the consequence of this on performance and long-term health remain to be determined.

The Effect of Inspiratory Resistance on Exercise Performance and Perception in Moderate Normobaric Hypoxia

Seo, Yongsuk, Jeremiah Vaughan, Tyler D. Quinn, Brittany Followay, Raymond Roberge, Ellen L. Glickman, and Jung-Hyun Kim. The effect of inspiratory resistance on exercise performance and perception in moderate normobaric hypoxia. High Alt Med Biol. 18:417-424, 2017.

PURPOSE

Respirators are simple and efficient in protecting workers against toxic airborne substances; however, their use may limit the physical performance of workers. The purpose of this study was to determine the effect of inspiratory resistance on physical performance and breathing perception in normobaric hypoxia.

METHOD

Nine healthy men wore a tight-fitting respiratory mask outfitted with one of four different inspiratory resistors (R) (0, 1.5, 4.5, 7.5 cm H2O/L/Sec) while exercising at normobaric hypoxia (17% O2) at submaximal exercise workloads of 50, 100, and 150 W on a cycle ergometer for 10 minutes each, followed by a maximal oxygen uptake (VO2max) test to exhaustion.

RESULTS

Maximal power output at R7.5 was significantly lower than R0 (p = 0.016) and R1.5 (p = 0.035). Respiration rate was significantly reduced at R4.5 (p = 0.011) and R7.5 (p ≤ 0.001) compared with R0. Minute ventilation was significantly decreased in R7.5 compared with R0 (p = 0.003), R1.5 (p = 0.010), and R4.5 (p = 0.016), whereas VO2 was not significantly changed. Breathing comfort (BC) and breathing effort (BE) were significantly impaired in R7.5 (BC: p = 0.025, BE: p = 0.001) and R4.5 (BC: p = 0.007, BE: p = 0.001) compared with R0, but rating of perceived exertion (RPE) remained unchanged.

CONCLUSIONS

Added inspiratory resistance limited maximal power output and increased perceptions of BC and BE in normobaric hypoxia. However, low-to-moderate inspiratory resistance did not have a deleterious effect on VO2 or RPE at submaximal or maximal exercise. Perceptual and physiological characteristics of respirators of varying inspiratory resistances should be considered by manufacturers and end users during design and respirator selection processes.

Cardiopulmonary fitness and respirator clearance: an update

This review addresses five key questions regarding respirator clearance: What is the efficacy of different methods of respirator clearance? Which diagnostic test is most predictive of cardiac event during respirator use? Is spirometry accurate in predicting respiratory distress/insufficiency during respirator use? Is exercise tolerance testing accurate in predicting cardiac injury during respirator use? Which periodicity of clearance evaluations is most protective against cardiac event during respirator use? The medical literature was searched using PubMed, the Cochrane Library, and Web of Science. Relevant articles were reviewed to assess current recommendations and practices in respirator clearance. Between the years 1970 and 2011, 144 articles were identified, and 21 were included in this review. Current recommendations for respirator clearance are based on consensus rather than outcome studies, and opinions differed between expert sources. Many authors observed the need for cost-effective respirator clearance, but none proposed evidence-based strategies. Prospective studies on respirator clearance that evaluate cardiac and pulmonary outcomes are necessary to establish an evidence base for improving the validity, efficiency, and consistency of respirator clearance testing.

Effect of respirator resistance on tolerant capacity during graded load exercise

Respirator breathing resistance impacts performance of wearers during constant work load. However, it is less clear as to how breathing resistance affects the tolerant capacity of users during graded work load. The present study investigated the tolerant capacity of 8 individuals during incremental work load. The 8 subjects were required to wear two matched respirators (respirators I and II which were designed to have different breathing resistances and the same dead space) respectively on separate days and then work to end points. Minute ventilation (V(E)), breathing frequency (BF), oxygen consumption (VO(2)) and heart rate (HR) were recorded during exercise, while tolerant time, response time and breathing discomfort were measured at the end of each test trial. The test variables were compared between the two respirators by using matched-pairs t-test. The results showed that the tolerant time was significantly reduced for the respirator I with higher level of breathing resistance when compared with its counterpart with lower breathing resistance (respirator II) (P<0.05). The same changes occurred for response time. Results also showed a significant increase in V(E) and BF for respirator I wearers when the work load was above 125 W. The O(2) consumption was similar under the two breathing resistance conditions. These findings suggested that the respiratory resistance caused by self-contained breathing apparatus (SCBA) has an impact on the tolerant capacity of users.

Field evaluation of a new prototype self-contained breathing apparatus

Firefighters are required to use a self-contained breathing apparatus (SCBA) for respiratory protection when engaged in a variety of firefighting duties. While the SCBA provides crucial respiratory support and protection, it is also cumbersome and heavy, thus adding to the physical work performed by the firefighter. The purpose of the present study was to evaluate and compare the low profile SCBA prototype to a standard SCBA, as assessed by the objective and subjective measures of mobility and comfort, time of donning/doffing, as well as by acquiring user feedback on SCBA design features during field activities. The results of the present study indicated that the prototype SCBA was rated as a significant improvement over the standard SCBA in the areas of range of motion (ROM), mobility, comfort, induction of fatigue, interaction with protective clothing, and operability when worn over a standard firefighter ensemble, while performing a series of International Association of Fire Fighters Fire Ground Survival Program training exercises. STATEMENT OF RELEVANCE: A prototype SCBA was evaluated and compared with a standard SCBA, focusing on the objective and subjective measures of mobility and comfort during field activities. Feedback from end users was collected during the evaluation. The findings of the present study can be used for improving the system design and overall performance of new prototype SCBAs.

Respirator physiologic impact in persons with mild respiratory disease

OBJECTIVE

To assess whether mild respiratory disease affects physiologic adaptation to respirator use.

METHODS

The study compared the respiratory effects of dual cartridge half face mask and filtering facepeice (N95) respirators while performing simulated-work tasks. Subjects with mild chronic obstructive pulmonary disease (n = 14), asthma (n = 42), chronic rhinitis (n = 17), and normal respiratory status (n = 24) were studied. Mixed model regression analyses determined the effects of respirator type, disease status, and the respirator-disease interactions.

RESULTS

Respirator type significantly affected several physiologic measures. Respirator type effects differed among disease categories as shown by statistically significant interaction terms. Respiratory timing parameters were more affected than ventilatory volumes. In general, persons with asthma showed greater respirator-disease interactions than chronic obstructive pulmonary disease, rhinitis, or healthy subjects.

CONCLUSIONS

The effects of respirator type differ according to the category of respiratory disease.

Respirator physiological effects under simulated work conditions

This study compared the physiological impacts of two respirator types in simulated work conditions. Fifty-six subjects included normal volunteers and persons with mild respiratory impairments (chronic rhinitis, mild COPD, and mild asthma). Respiratory parameters and electrocardiogram were measured using respiratory inductive plethysmography while performing eight work tasks involving low to moderate exertion using two respirators: (1) a dual cartridge half face mask (HFM) respirator, and (2) the N95. Mixed model regression analyses evaluating the effect of task and respirator type showed that task affected tidal volume, minute ventilation, breathing frequency and heart rate; all were greater in heavier tasks. Although respirator type did not affect respiratory volume parameters and flow rates, the HFM led to increase in the inspiratory time, reduction of the expiratory time, and increase in the duty cycle in comparison with the N95. The magnitude of differences was relatively small. The results suggest that most individuals, including persons with mild respiratory impairments, will physiologically tolerate either type of respirator at low to moderate exertion tasks. However, because effective protection depends on proper use, differences in subjective effect may have greater impact than physiological differences. Using respirators may be feasible on a widespread basis if necessary for maintaining essential services in the face of widespread concern about an infectious or terrorist threat.

Effect of wearing personal protective clothing and self-contained breathing apparatus on heart rate, temperature and oxygen consumption during stepping exercise and live fire training exercises

Fire fighter breathing apparatus instructors (BAIs) must possess the ability to respond to both the extrinsic stress of a high temperature environment and the intrinsic stress from wearing personal protective equipment (PPE) and self-contained breathing apparatus (SCBA), repeatedly and regularly, whilst training recruits in live fire training exercises (LFTEs). There are few previous investigations on BAIs in hot environments such as LFTEs, since the main research focus has been on regular fire fighters undertaking exercises in temperate or fire conditions at a moderate to high exercise intensity. In this study, the intrinsic cardiovascular stress effects of wearing PPE + SCBA were first investigated using a step test whilst wearing gym kit (control), weighted gym kit (a rucksack weighted to the equivalent of PPE + SCBA) and full PPE + SCBA (weight plus the effects of protective clothing). The extrinsic effects of the very hot environment were investigated in BIAs in LFTEs compared to mock fire training exercises (MFTEs), where the fire was not ignited. There was an increase in heart rate due to the modest workload imposed on the BAIs through carrying out the MFTEs (25.0 (18.7)%) compared to resting. However, when exposed to fire during the LFTEs, heat storage appears to be significant as the heart rate increased by up to 39.8 (+/-20.1)% over that of the mock LFTEs at temperate conditions. Thus, being able to dissipate heat from the PPE is particularly important in reducing the cardiovascular responses for BAIs during LFTEs.

Performance when breathing through different respirator inhalation and exhalation resistances during hard work

Respirator inspiratory and expiratory breathing resistances impact ventilation and performance when studied independently. However, it is less clear as to how various combinations of inhalation and exhalation resistance affect user performance. The present study investigated the performance of 11 individuals during constant load, demanding work to exhaustion while wearing respirators with eight different combinations of inhalation and exhalation resistance. Exercise performance time, performance rating, minute volume, and peak inspiratory and expiratory airflow were recorded at the end of each test trial, and independent correlations with inhalation resistance and exhalation resistance were assessed. The combined impacts of respirator inhalation and exhalation resistances were quantified as the total external work of breathing (WOB(tot)) and correlations between the test variables and WOB(tot) were also examined. Significantly linear decreases in performance were found with increased inhalation resistances independent of exhalation resistance (R(2) = 0.99; p < 0.001) and with increased WOB(tot) (R(2) = 0.92; p < 0.001). Performance also decreased with increased exhalation resistance but no significant relationships were found. Minute volume decreased linearly with increased inhalation resistance independent of exhalation resistance (R(2) = 0.99; p < 0.001), but the linear decrease observed between minute volume and WOB(tot) was weak (R(2) = 0.36; p < 0.05). These findings suggest that WOB(tot) serves as a reliable estimate of the combined impacts of respirator inhalation and exhalation resistances on user performance during hard work, but that inhalation resistance alone serves as a better predictor of ventilation during respirator wear.

The Influence of the Self-Contained Breathing Apparatus (SCBA) on Ventilatory Function and Maximal Exercise

Our previous work showed that breathing low density gases during exercise with the self-contained breathing apparatus (SCBA) improves maximal ventilation (VE) and maximal oxygen consumption [Formula: see text] This suggests that the SCBA limits exercise by adding a resistive load to breathing. In this study we compared [Formula: see text] with and without the various components comprising the SCBA to determine their impact on [Formula: see text] Twelve males performed 4 randomly ordered incremental exercise tests to exhaustion on a treadmill: (1) low-resistance breathing valve only (CON); (2) full SCBA (SCBA); (3) SCBA regulator only (REG); and (4) carrying the cylinder and harness assembly but breathing through a low-resistance breathing valve (PACK). Compared to CON, [Formula: see text] was reduced to a similar extent in the SCBA and REG trials (14.9% and 13.1%, respectively). The PACK condition also reduced [Formula: see text] but to a lesser extent (4.8 ± 5.3%). At [Formula: see text][Formula: see text] was decreased and expiratory mouth pressure and external breathing resistance (BR) were increased in both the SCBA and REG trials. There was a significant correlation between the change in maximal [Formula: see text] and [Formula: see text] with the SCBA. The results show that the SCBA reduces [Formula: see text] by limiting [Formula: see text] secondary to the increased BR of the SCBA regulator. Key words: ventilation, breathing resistance, expiratory flow limitation, [Formula: see text]

CO2 and O2 concentrations in integral motorcycle helmets

Inhaling air which contains excess CO2 and/or is oxygen-deficient is known to present health risks and to diminish human cognitive abilities. The average CO2 concentrations relevant to a motorcyclist wearing an integral helmet were measured 20 years ago and found to be alarmingly large. The purpose of the present study was to examine gas concentrations typically inhaled by a motorcyclist. Average concentrations of CO2 near the upper lip for persons (n = 4) wearing integral motorcycle helmets were measured in the laboratory and the field to facilitate comparison to previous work, and similarly high average concentrations were found: above 2% when stationary, well below 1% for speeds of 50 km/h or more. Very good agreement was obtained between laboratory and field measurements. Detailed measurements of the time-dependent CO2 concentrations passing through a mouthpiece for mouth-breathing showed inhaled levels slightly over half of the corresponding average concentrations, including 1.3+/-0.3% at standstill, though higher concentrations (4% or more) were inhaled at the beginning of each breath. Opening the visor at standstill had on average no effect. At a speed of 50 km/h the inhaled CO2 concentration resembles that for a person without a helmet in still air, at about 0.2%. The oxygen deficiency is generally equal to the CO2 concentration, and could also contribute negatively to a motorcyclist's cognitive abilities.

Respiratory demand during rigorous physical work in a chemical protective ensemble

Protection afforded by a respirator filter depends on many factors, among them chemical or biological agent and flow rate. Filtration mechanisms, such as chemical adsorption, depend on sufficient residence time for the filter media to extract noxious agents from the airstream. Consequently, filter efficiency depends on inspiratory air velocities, among other factors. Filter designs account for this by adjusting bed depth and cross-sectional area to anticipated flow rates. Many military and commercial filters are designed and tested at 32-40 L/min. The present study investigated respiratory demand while U.S. Marines (n=32) completed operationally relevant tasks in chemical protective ensembles, including M-40 masks and C2A1 filters. Respiratory demand greatly exceeded current test conditions during the most arduous tasks: minute ventilation=96.4+/-18.9 L/min (mean+/-SD) with a maximum of 131.7 L/min observed in one subject. Mean peak inspiratory flow rate (PIF) reached 238.7+/-34.0 L/min with maximum PIF often exceeding 300 L/min (maximum observed value=356.3 L/min). The observed respiratory demand was consistent with data reported in previous laboratory studies of very heavy workloads. This study is among the few to report on respiratory demand while subjects perform operationally relevant tasking in chemical protective ensembles. The results indicate that military and industrial filters will probably encounter higher flow rates than previously anticipated during heavy exertion.

Positive pressure breathing during rest and exercise

The requirements to maintain a positive pressure with respiratory protection during heavy exercise and the effects on ventilation and feelings of discomfort were investigated. Eight male subjects participated, using the respirator system during rest and exercise at about 80% of their individual maximum power. A blower was used at maximum and medium capacity and at two pressure levels (3 and 15 mbar). Additionally, the mouth pressure was used as a feedback for the blower. The blower decreased the fraction of the breathing cycle with negative pressures from 50% (SD 4%) to 15% (SD 10%) during exercise. Negative pressures occurred at all settings of the blower during exercise. Thus, the currently available commercial blower systems do not supply a sufficient airflow to maintain a positive pressure during heavy exercise. Positive pressure breathing did not affect the ventilation and the circulation. But the oxygen consumption was higher with the blower and respirator than without.

An evaluation of physiological demands and comfort between the use of conventional and lightweight self-contained breathing apparatus

The additional physiological strain associated with the use of self-contained breathing apparatus (SCBA) is mostly linked to the additional weight. Lightweight and conventional SCBA were assessed in a submaximal step test performed in full firekit (total weights 15 and 27 kg, respectively). Factors assessed were: comparative energy expenditure of the two sets, relationship between comparative energy expenditure and aerobic fitness and subjective discomfort. Measured variables were: oxygen consumption, heart rate, estimated VO2max and subjective discomfort (body part discomfort scale). The lightweight SCBA displayed a significant oxygen consumption benefit, which was independent of dynamic workrate and valued at 0.2561 min(-1). Mean heart rate responses were significantly lower with the light set. No relationship was found between comparative energy expenditure and aerobic fitness. The light set was rated as significantly more comfortable than the heavy. Further research is required to assess the extent of the energy consumption benefit in realistic fire suppression protocols and the contribution of ergonomic factors to the energy and comfort benefits.

Anaesthesia and critical care considerations in nerve agent warfare trauma casualties

Nerve agents (NA) (tabun, sarin, suman, VX) have been stocked around the world for some time and still present a major threat to civilian as well as to military populations. Since NA can be delivered through both an aerial spray system and a ballistic system, victims could suffer both NA intoxication and multiple trauma necessitating urgent surgical intervention followed by intensive care. These patients can be expected to be extremely precarious neurologically, respiratorily and haemodynamically. Moreover, their clinical signs can be misleading. Further exacerbating the problem is the fact that interactions of NA with the pharmacological agents used for resuscitation and/or during anaesthesia can aggravate organ instability even more and possibly cause systemic collapse. There are no protocols for perioperative critical care and early assessment or for the administration of anaesthesia for surgical interventions in such combined multiple trauma and intoxicated casualties. We propose a scheme for the administration of critical care and anaesthesia based on the scant anecdotal reports that have emerged after the occurrence of local accidents involving NA intoxication and on the neuropharmacological knowledge of the pesticide organophosphate poisoning database, these compounds being related chemical substances.

Cardiorespiratory and thermoregulatory response of working in fire-fighter protective clothing in a temperate environment

The cardiorespiratory and thermal responses of two intensities of treadmill exercise were compared for brief periods (12 min) in fire ensemble (FE) but without self contained breathing apparatus, and sports ensemble (SE), in a temperature environment. A further experiment explored the responses of subjects exercising in FE over a prolonged period (60 min). Eighteen male fire-fighters wearing either FE or SE walked on a level treadmill for 6 min at 5 km x h(-1) increasing to 7 km x h(-1) for 6 min. Following a recovery interval of 1 h, the exercise protocol was repeated in the second ensemble; the order of ensemble was balanced. Heart rate (HR), rectal temperature (Tre), VO2 max and rating of perceived exertion (RPE) were monitored continuously under both ensembles. At 7 km x h(-1), VO2 was significantly higher (p<0.05) in FE (36.1 and 39.9 ml x kg(-1) x min(-1)) than in SE and represented 74% VO2 max. There were no changes Tre. In experiment 2, following a rest interval of at least 36 h, eight subjects in FE walked on the treadmill at 6 km x h (gradient 10%) for 60 min also in temperate conditions, where HR, Tre and RPE were recorded at 10-min intervals. During the 60-min exercise in FE, HR reached 161 beats x min(-1) and Tre increased to 38.3 degrees C. Despite considerable subject discomfort, Tre remained below dangerous levels (38.4 degrees C). When RPE were compared with a physiological strain index (PSI) calculated from Tre and HR data over 60 min, there was no significant difference (p<0.05) with a correlation coefficient (r) of 0.98. The results suggest that RPE and PSI are closely related when exercise is sufficiently prolonged or intense to elevate Tre and HR in fire-fighters wearing FE in temperate conditions. If further investigation confirms this relationship for hot humid conditions in which fire-fighters operate, then with training, it may provide individuals with a valid measure of dangerous levels of perceived heat strain.

A thermal physiological comparison of two HAZMAT protective ensembles with and without active convective cooling

Wearing impermeable garments for hazardous materials (HAZMAT) cleanup can often present a health and safety problem for the wearer. Even short duration cleanup activities can produce heat-stress injuries in HAZMAT workers. It was hypothesized that an internal cooling system might increase worker productivity and decrease the likelihood of heat-stress injuries in typical HAZMAT operations. Two HAZMAT protective ensembles were compared during subjects' treadmill exercise. The different ensembles were created using two different suits: a Trelleborg vapor protective suit representative of current HAZMAT suits and a prototype suit developed by engineers at the National Aeronautics and Space Administration (NASA). The two life-support systems used were a current-technology Interspiro Spirolite breathing apparatus and a liquid air breathing system that also provided convective cooling. Twelve local members of a HAZMAT team served as test subjects. They were fully instrumented to allow a complete physiological comparison of their theramal responses to the different ensembles. Results showed that cooling from the liquid air system significantly decreased thermal stress. The results of the subjective evaluations of new design features in the prototype suit were also highly favorable. Incorporation of these new design features could lead to significant operational advantages in the future.

The effects of powered air supply to the respiratory protective device on respiration parameters during rest and exercise

The common chemical warfare protective masks impose an excessive respiratory load on the wearer due to elevated breathing resistance and increased dead space. For patients with severe respiratory disease, the excessive respiratory effort may be intolerable. Besides, the substantial negative pressure created within the mask during inspiration may result in an inward leakage in individuals having difficulties with proper facial fitting of the mask. The purpose of the current investigation was to evaluate the effects of a blower, actively driving air, through the mask's filter, at a flow (mean +/- SD) of 42 +/- 2 L/min, on respiratory parameters during rest and moderate exercise. Ten healthy subjects of either sex participated in two experimental sessions, wearing the mask with and without the blower. Each session included 6 min of sitting at rest and 6 min of walking on a treadmill (3.2 mph, and 10 percent grade). In nine of the subjects, the active air supply produced a positive inspiratory pressure at rest (5 +/- 4 vs -24 +/- 9 mm H2O peak inspiratory pressure with and without the blower, respectively, p < 0.0001). Inspiratory carbon dioxide concentration (FICO2) at rest was diminished (0.4 +/- 0.4 vs 1.3 +/- 0.7 percent with and without the blower, respectively; p < 0.01) while FIO2 increased from 19.5 +/- 0.7 percent to 20.6 +/- 0.4 percent with the device (p < 0.01). These changes were associated with a significant decrease in respiratory rate (15 +/- 2 vs 18 +/- 3 per minute, p < 0.01). During exercise the blower barely decreased the negative inspiratory pressures, had no effect on other respiratory parameters measured, but significantly shortened the inspiratory/cycle-length time ratio (0.46 +/- 0.03 vs 0.53 +/- 0.03, p < 0.005). The effects of active air supply were not different between male and female subjects. We conclude that the blower is expected to be a useful accessory to respiratory protective devices for patients with pulmonary disease.

Effects of industrial respirators on breathing pattern at different work levels

The effects of a filtering device and an air-line apparatus on breathing pattern were studied in healthy men with different physical characteristics and work capacity. The subjects comprised nine construction workers aged 35-44, and nine firemen aged 21-35. The construction workers' mean maximal oxygen consumption (VO2max) was 34.5 ml min-1 kg-1, the firemen's 66.9 ml min-1 kg-1. Breathing pattern was analyzed for its components, inspiratory time, expiratory time, breathing frequency, tidal volume, and pulmonary ventilation at rest, during two submaximal treadmill walks when the subjects' absolute work load was equal, and during recovery. Neither the filtering device nor the air-line apparatus had a significant effect on breathing pattern when compared with the control values measured twice with a low-resistance breathing valve. A significantly longer expiratory time, lower breathing frequency, and smaller pulmonary ventilation were found for the firemen with the breathing valve and the industrial respirators. The breathing pattern of the construction workers and the firemen differed, but the alterations were not induced by the use of the filtering device or the air-line apparatus when studied at aerobic work levels up to 60% VO2max.

Cardiorespiratory strain in jobs that require respiratory protection

Twenty-one workers in the construction, foundry, shipyard, and metal industries, and nine firemen were studied in jobs that require the regular use of various industrial respirators. The subjects' heart rates (HR) were continuously recorded during 1 to 2 workshifts or during special tasks. Their oxygen consumption (VO2) and ventilation rates were measured during main work phases. The subjects' VO2max were determined by a submaximal bicycle-ergometer test. In construction and industrial jobs, when a filtering device or an air-line apparatus was worn, the subjects' mean HR-values ranged from 66 to 132 beats min-1, which is equivalent to a relative aerobic strain of 12 to 57% VO2max. In smog-diving and repair and rescue tasks with self-contained breathing apparatus and protective clothing, the corresponding mean values were 142 to 160 beats min-1 and 54-74% VO2, respectively. The field results were compared with those measured in the laboratory with the same type of respirator. The suitability of different respirators in practical work situations was then evaluated, as were the physical qualifications required of the wearer.

Cardiorespiratory and thermal effects of wearing gas protective clothing

Six healthy men aged 25 to 37 walked on a treadmill at work levels of 21 and 41% of their VO2max for 25 to 30 min wearing gas protective clothing (GPC) consisting of an impermeable suit with a self-contained breathing apparatus (total weight 25 kg) or shorts (control tests, CT) in a temperate environment (ta 24.3 degrees C +/- 1.0 degrees C, rh 30-50%). When the GPC was worn at 21 and 41% VO2max, the most prominent increases, compared with the CT, were noted in the heart rate (means +/- SE, 120 +/- 5 vs 76 +/- 3 beats min-1 and 171 +/- 5 vs 103 +/- 3 beats min-1), mean skin temperature (36.1 +/- 0.2 vs 31.3 degrees C +/- 0.1 degree C and 36.9 +/- 0.3 vs 30.9 degrees C +/- 0.4 degrees C) and sweat rate (473 +/- 51 vs 70 +/- 23 g m-2 h-1 and 766 +/- 81 vs 135 +/- 18 g m-2 h-1) indicating a high cardiovascular and thermoregulatory strain, which was not decreased by ventilating the suit with an air flow of 281 min-1 at 41% VO2max. The ventilation, oxygen consumption and production of carbon dioxide increased in relation to the extra weight of the GPC, partly dependent on the dynamic work level. It was concluded that the increase in the physiological load caused by the GPC was so high that the work-rest regimens, workers' level of physical fitness, cardiovascular health and heat tolerance should be considered whenever gas protective clothing is used.

Reduction of isometric muscle endurance after wearing impermeable gas protective clothing

The isometric endurance of forearm muscles at 40% maximum voluntary contraction was measured in six healthy male subjects, after they had walked for 25-30 min on a treadmill while wearing an impermeable gas protective suit and a self-contained breathing apparatus at a light (21% VO2 max), and a moderate 41% VO2 max) work level. The mean endurance times were 12% (NS) and 24% (P less than 0.01) shorter than the average control value after exercise for the light and moderate work levels, respectively. These changes were accompanied by an increased heart rate, and rectal and skin temperatures. Ventilating the suit with an air flow of 181 . min-1 at the moderate work level did not significantly affect isometric endurance (decreased 27%), heart rate or body temperatures. It was concluded, that muscular performance capacity is reduced after wearing gas-protective clothing in a temperate environment, presumably due to the increased muscle temperature, and this should be considered in scheduling work times and rest periods.