Heat strain models applicable for protective clothing systems: comparison of core temperature response

Modeling thermoregulatory responses during high-intensity exercise in warm environments

The six cylinder thermoregulatory model (SCTM) has been validated thoroughly for resting humans. This type of modeling is helpful to predict and develop guidance for safe performance of work and recreational activities. In the context of a warming global climate, updating the accuracy of the model for intense exercise in warm environments will help a wide range of individuals in athletic, recreational, and military settings. Three sets of previously collected data were used to determine SCTM accuracy. Dataset 1: two groups [large (LG) 91.5 kg and small (SM) 67.7 kg] of individuals performed 60 min of semirecumbent cycling in temperate conditions (25.1°C) at metabolic rates of 570-700 W. Dataset 2: two LG (100 kg) and SM (65.8 kg) groups performed 60 min of semirecumbent cycling in warm/hot environmental conditions (36.2°C) at metabolic rates of 590-680 W. Dataset 3: seven volunteers completed 8-km track trials (∼30 min) in cool (17°C) and warm (30°C) environments. The volunteers' metabolic rates were estimated to be 1,268 W and 1,166 W, respectively. For all datasets, SCTM-predicted core temperatures were found to be similar to the observed core temperatures. The root mean square deviations (RMSDs) ranged from 0.06 to 0.46°C with an average of 0.2°C deviation, which is less than the acceptance threshold of 0.5°C. Thus, the present validation shows that SCTM predicts core temperatures with acceptable accuracy during intense exercise in warm environments and successfully captures core temperature differences between large and small individuals.NEW & NOTEWORTHY The SCTM has been validated thoroughly for resting humans in warm and cold environments and during water immersion. The present study further demonstrated that SCTM predicts core temperatures with acceptable accuracy during intense exercise up to 1,300 W in temperate and warm environments and captures core temperature differences between large and small individuals. SCTM is potentially useful to develop guidance for safe operation in athletic, military, and occupational settings during exposure to warm or hot environments.

Use case for predictive physiological models: tactical insights about frozen Russian soldiers in Ukraine

Biomathematical models quantitatively describe human physiological responses to environmental and operational stressors and have been used for planning and real-time prevention of cold injury. These same models can be applied from a military tactical perspective to gain valuable insights into the health status of opponent soldiers. This paper describes a use case for predicting physiological status of Russian soldiers invading Ukraine using open-source information. In March 2022, media outlets reported Russian soldiers in a stalled convoy invading Ukraine were at serious risk of hypothermia and predicted these soldiers would be "freezing to death" within days because of declining temperatures (down to -20°C). Using existing Army models, clothing data and open-source intelligence, modelling and analyses were conducted within hours to quantitatively assess the conditions and provide science-based predictions. These predictions projected a significant increase in risks of frostbite for exposed skin and toes and feet, with a very low (negligible) risk of hypothermia. Several days later, media outlets confirmed these predictions, reporting a steep rise in evacuations for foot frostbite injuries in these Russian forces. This demonstrated what can be done today with the existing mathematical physiology and how models traditionally focused on health risk can be used for tactical intelligence.

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

OBJECTIVE

The aim of this study was to model the effect of body armor coverage on body core temperature elevation and wet-bulb globe temperature (WBGT) offset.

BACKGROUND

Heat stress is a critical factor influencing the health and safety of military populations. Work duration limits can be imposed to mitigate the risk of exertional heat illness and are derived based on the environmental conditions (WBGT). Traditionally a 3°C offset to WBGT is recommended when wearing body armor; however, modern body armor systems provide a range of coverage options, which may influence thermal strain imposed on the wearer.

METHOD

The biophysical properties of four military clothing ensembles of increasing ballistic protection coverage were measured on a heated sweating manikin in accordance with standard international criteria. Body core temperature elevation during light, moderate, and heavy work was modeled in environmental conditions from 16°C to 34°C WBGT using the heat strain decision aid.

RESULTS

Increasing ballistic protection resulted in shorter work durations to reach a critical core temperature limit of 38.5°C. Environmental conditions, armor coverage, and work intensity had a significant influence on WBGT offset.

CONCLUSION

Contrary to the traditional recommendation, the required WBGT offset was >3°C in temperate conditions (<27°C WBGT), particularly for moderate and heavy work. In contrast, a lower WBGT offset could be applied during light work and moderate work in low levels of coverage.

APPLICATION

Correct WBGT offsets are important for enabling adequate risk management strategies for mitigating risks of exertional heat illness.

Use of Thermoregulatory Models to Evaluate Heat Stress in Industrial Environments

Heat stress in many industrial workplaces imposes significant risk of injury to individuals. As a means of quantifying these risks, a comparison of four rationally developed thermoregulatory models was conducted. The health-risk prediction (HRP) model, the human thermal regulation model (HuTheReg), the SCENARIO model, and the six-cylinder thermoregulatory model (SCTM) each used the same inputs for an individual, clothing, activity rates, and environment based on previously observed conditions within the Portuguese glass industry. An analysis of model correlations was conducted for predicted temperatures (°C) of brain (TBrain), skin (TSkin), core body (TCore), as well as sweat evaporation rate (ER; Watts). Close agreement was observed between each model (0.81-0.98). Predicted mean ± SD of active phases of exposure for both moderate (TBrain 37.8 ± 0.25, TSkin 36.7 ± 0.49, TCore 37.8 ± 0.45 °C, and ER 207.7 ± 60.4 W) and extreme heat (TBrain 39.1 ± 0.58, TSkin, 38.6 ± 0.71, TCore 38.7 ± 0.65 °C, and ER 468.2 ± 80.2 W) were assessed. This analysis quantifies these heat-risk conditions and provides a platform for comparison of methods to more fully predict heat stress during exposures to hot environments.

A digital tool for prevention and management of cold weather injuries-Cold Weather Ensemble Decision Aid (CoWEDA)

This paper describes a Cold Weather Ensemble Decision Aid (CoWEDA) that provides guidance for cold weather injury prevention, mission planning, and clothing selection. CoWEDA incorporates current science from the disciplines of physiology, meteorology, clothing, and computer modeling. The thermal performance of a cold weather ensemble is defined by endurance times, which are the time intervals from initial exposure until the safety limits are reached. These safety limits correspond to conservative temperature thresholds that provide a warning of the approaching onset of frostbite and/or hypothermia. A validated six-cylinder thermoregulatory model is used to predict human thermal responses to cold while wearing different ensembles. The performance metrics, model, and a database of clothing properties were integrated into a user-friendly software application. CoWEDA is the first tool that allows users to build their own ensembles from the clothing menu (i.e., jackets, footwear, and accessories) for each body region (i.e., head, torso, lower body, hands, feet) and view their selections in the context of physiological strain and the operational consequences. Comparison of predicted values to skin and core temperatures, measured during 17 cold exposures ranging from 0 to -40°C, indicated that the accuracy of CoWEDA prediction is acceptable, and most predictions are within measured mean ± SD. CoWEDA predicts the risk of frostbite and hypothermia and ensures that a selected clothing ensemble is appropriate for expected weather conditions and activities. CoWEDA represents a significant enhancement of required clothing insulation (IREQ, ISO 11079) and wind chill index-based guidance for cold weather safety and survival.

Field validation of The Heat Strain Decision Aid during military load carriage

OBJECTIVES

We aimed to determine the agreement between actual and predicted core body temperature, using the Heat Strain Decision Aid (HSDA), in non-Ground Close Combat (GCC) personnel wearing multi terrain pattern clothing during two stages of load carriage in temperate conditions.

DESIGN

Cross-sectional.

METHODS

Sixty participants (men = 49, women = 11, age 31 ± 8 years; height 171.1 ± 9.0 cm; body mass 78.1 ± 11.5 kg) completed two stages of load carriage, of increasing metabolic rate, as part of the development of new British Army physical employment standards (PES). An ingestible gastrointestinal sensor was used to measure core temperature. Testing was completed in wet bulb globe temperature conditions; 1.2-12.6 °C. Predictive accuracy and precision were analysed using individual and group mean inputs. Assessments were evaluated by bias, limits of agreement (LoA), mean absolute error (MAE), and root mean square error (RMSE). Accuracy was evaluated using a prediction bias of ±0.27 °C and by comparing predictions to the standard deviation of the actual core temperature.

RESULTS

Modelling individual predictions provided an acceptable level of accuracy based on bias criterion; where the total of all trials bias ± LoA was 0.08 ± 0.82 °C. Predicted values were in close agreement with the actual data: MAE 0.37 °C and RMSE 0.46 °C for the collective data. Modelling using group mean inputs were less accurate than using individual inputs, but within the mean observed.

CONCLUSION

The HSDA acceptably predicts core temperature during load carriage to the new British Army non-GCC PES, in temperate conditions.

Comparison of two mathematical models for predicted human thermal responses to hot and humid environments

PURPOSE

We compared the accuracy and design of two thermoregulatory models, the US Army's empirically designed Heat Strain Decision Aid (HSDA) and the rationally based Health Risk Prediction (HRP) for predicting human thermal responses during exercise in hot and humid conditions and wearing chemical protective clothing.

METHODS

Accuracy of the HSDA and HRP model predictions of core body and skin temperature (Tc, Ts) were compared to each other and relative to measured outcomes from eight male volunteers (age 24 ± 6 years; height 178 ± 5 cm; body mass 76.6 ± 8.4 kg) during intermittent treadmill marching in an environmental chamber (air temperature 29.3 ± 0.1 °C; relative humidity 56 ± 1%; wind speed 0.4 ± 0.1 m∙s^-1) wearing three separate chemical protective ensembles. Model accuracies and precisions were evaluated by the bias, mean absolute error (MAE), and root mean square error (RMSE) compared to observed data mean ± SD and the calculated limits of agreement (LoA).

RESULTS

Average predictions of Tc were comparable and acceptable for each method, HSDA (Bias 0.02 °C; MAE 0.18 °C; RMSE 0.21 °C) and HRP (Bias 0.10 °C; MAE 0.25 °C; RMSE 0.34 °C). The HRP averaged predictions for Ts were within an acceptable agreement to observed values (Bias 1.01 °C; MAE 1.01 °C; RMSE 1.11 °C).

CONCLUSION

Both HSDA and HRP acceptably predict Tc and HRP acceptably predicts Ts when wearing chemical protective clothing during exercise in hot and humid conditions.

A canine thermal model for simulating temperature responses of military working dogs

Military working dogs (MWDs) are often required to operate in dangerous or extreme environments, to include hot and humid climate conditions. These scenarios can put MWD at significant risk of heat injury. To address this concern, a two-compartment (core, skin) rational thermophysiological model was developed to predict the temperature of a MWD during rest, exercise, and recovery. The Canine Thermal Model (CTM) uses inputs of MWD mass and length to determine a basal metabolic rate and body surface area. These calculations are used along with time series inputs of environmental conditions (air temperature, relative humidity, solar radiation and wind velocity) and level of metabolic intensity (MET) to predict MWD thermoregulatory responses. Default initial values of core and skin temperatures are set at neutral values representative of an average MWD; however, these can be adjusted to match known or expected individual temperatures. The rational principles of the CTM describe the heat exchange from the metabolic energy of the core compartment to the skin compartment by passive conduction as well as the application of an active control for skin blood flow and to tongue and lingual tissues. The CTM also mathematically describes heat loss directly to the environment via respiration, including panting. Thermal insulation properties of MWD fur are also used to influence heat loss from skin and gain from the environment. This paper describes the CTM in detail, outlining the equations used to calculate avenues of heat transfer (convective, conductive, radiative and evaporative), overall heat storage, and predicted responses of the MWD. Additionally, this paper outlines examples of how the CTM can be used to predict recovery from exertional heat strain, plan work/rest cycles, and estimate work duration to avoid overheating.

Heat strain in chemical protective ensembles: Effects of fabric thermal properties

An ongoing challenge in material science has been to reduce heat strain experienced by individuals wearing chemical protective ensembles. The objective of this study is to analyze the relationship between the thermal properties of eight chemical protective fabrics and heat strain in ten chemical protective ensembles constructed with those fabrics. The fabric samples were tested on a sweating guarded hot plate to measure fabric thermal and evaporative resistance. The ensembles were then tested on thermal manikins to measure ensemble thermal and evaporative resistance. An empirical thermoregulatory model, the Heat Strain Decision Aid (HSDA), was used to predict thermal responses of core temperature and endurance times. Model inputs included ensemble thermal and evaporative resistances, four environmental conditions and a metabolic rate of 400 W. The fabric intrinsic thermal and evaporative resistances ranged from 0.01 to 0.05 m² °C·W^-1 and from 5.9 to 12.82 m² Pa·W^-1, respectively. Ensemble intrinsic thermal and evaporative resistances ranged from 0.23 to 0.31 m² °C·W^-1 and 51.7-67.8 m² Pa·W^-1, respectively. Predicted endurance times varied from 170 to 300 min at 20 °C/50% RH/2 m s^-1 and 26 °C/55% RH/9 m s^-1 conditions, and varied from 91 to 98 min at 30 °C/75% RH/2 m s^-1 and 40 °C/20% RH/2 m s^-1 conditions. Improved fabric thermal properties reduced heat strain and extended endurance times, but the magnitude of the extended times is dependent on the environmental conditions. Consequently, the benefits of improved fabric thermal properties may only be observed under certain environmental conditions.

Design considerations for low-level risk personal protective clothing: a review

Personal protective clothing (PPC) is mandatory in hazardous industrial workplaces, but can increase thermophysiological strain, causing fatigue, reduced productivity, illness and injury. We systematically reviewed the literature on PPC and heat stress, focusing on research relating to working conditions of high temperature and humidity. PPC must protect industrial workers from a wide variety of hazards, including sun damage, abrasion, chemical spills and electrical burns; these competing demands inevitably compromise thermal performance. Fiber type, textile material construction and treatment need to be considered alongside garment fit and construction to design functional PPC providing wearers with adequate protection and comfort. Several approaches to materials and PPC testing-objective benchtop evaluation, mathematical modelling, and physiological testing-can be combined to provide high-quality thermal and vapor performance data. Our review provides a foundation and directions for further research in low-level risk PPC, where current research in fabrics and clothing in this category is very limited, and will help designers and manufacturers create industrial workwear with improved thermal management characteristics.

The Effects of Simulated Wildland Firefighting Tasks on Core Temperature and Cognitive Function under Very Hot Conditions

Background: The severity of wildland fires is increasing due to continually hotter and drier summers. Firefighters are required to make life altering decisions on the fireground, which requires analytical thinking, problem solving, and situational awareness. This study aimed to determine the effects of very hot (45°C; HOT) conditions on cognitive function following periods of simulated wildfire suppression work when compared to a temperate environment (18°C; CON). Methods: Ten male volunteer firefighters intermittently performed a simulated fireground task for 3 h in both the CON and HOT environments, with cognitive function tests (paired associates learning and spatial span) assessed at baseline (cog 1) and during the final 20-min of each hour (cog 2, 3, and 4). Reaction time was also assessed at cog 1 and cog 4. Pre- and post- body mass were recorded, and core and skin temperature were measured continuously throughout the protocol. Results: There were no differences between the CON and HOT trials for any of the cognitive assessments, regardless of complexity. While core temperature reached 38.7°C in the HOT (compared to only 37.5°C in the CON; p < 0.01), core temperature declined during the cognitive assessments in both conditions (at a rate of -0.15 ± 0.20°C·hr-1 and -0.63 ± 0.12°C·hr-1 in the HOT and CON trial respectively). Firefighters also maintained their pre-exercise body mass in both conditions, indicating euhydration. Conclusions: It is likely that this maintenance of euhydration and the relative drop in core temperature experienced between physical work bouts was responsible for the preservation of firefighters' cognitive function in the present study.

Heat strain imposed by personal protective ensembles: quantitative analysis using a thermoregulation model

The objective of this paper is to study the effects of personal protective equipment (PPE) and specific PPE layers, defined as thermal/evaporative resistances and the mass, on heat strain during physical activity. A stepwise thermal manikin testing and modeling approach was used to analyze a PPE ensemble with four layers: uniform, ballistic protection, chemical protective clothing, and mask and gloves. The PPE was tested on a thermal manikin, starting with the uniform, then adding an additional layer in each step. Wearing PPE increases the metabolic rates [Formula: see text], thus [Formula: see text] were adjusted according to the mass of each of four configurations. A human thermoregulatory model was used to predict endurance time for each configuration at fixed [Formula: see text] and at its mass adjusted [Formula: see text]. Reductions in endurance time due to resistances, and due to mass, were separately determined using predicted results. Fractional contributions of PPE's thermal/evaporative resistances by layer show that the ballistic protection and the chemical protective clothing layers contribute about 20 %, respectively. Wearing the ballistic protection over the uniform reduced endurance time from 146 to 75 min, with 31 min of the decrement due to the additional resistances of the ballistic protection, and 40 min due to increased [Formula: see text] associated with the additional mass. Effects of mass on heat strain are of a similar magnitude relative to effects of increased resistances. Reducing resistances and mass can both significantly alleviate heat strain.

Heat strain during military training activities: The dilemma of balancing force protection and operational capability

Military activities in hot environments pose 2 competing demands: the requirement to perform realistic training to develop operational capability with the necessity to protect armed forces personnel against heat-related illness. To ascertain whether work duration limits for protection against heat-related illness restrict military activities, this study examined the heat strain and risks of heat-related illness when conducting a military activity above the prescribed work duration limits. Thirty-seven soldiers conducted a march (10 km; ∼5.5 km h^-1) carrying 41.8 ± 3.6 kg of equipment in 23.1 ± 1.8°C wet-bulb globe temperature. Body core temperature was recorded throughout and upon completion, or withdrawal, participants rated their severity of heat-related symptoms. Twenty-three soldiers completed the march in 107 ± 6.4 min (Completers); 9 were symptomatic for heat exhaustion, withdrawing after 71.6 ± 10.1 min (Symptomatic); and five were removed for body core temperature above 39.0°C (Hyperthermic) after 58.4 ± 4.5 min. Body core temperature was significantly higher in the Hyperthermic (39.03 ± 0.26°C), than Symptomatic (38.34 ± 0.44°C; P = 0.007) and Completers (37.94 ± 0.37°C; P<0.001) after 50 min. Heat-related symptom severity was significantly higher among Symptomatic (28.4 ± 11.8) compared to Completers (15.0 ± 9.8, P = 0.006) and Hyperthermic (13.0 ± 9.6, P = 0.029). The force protection provided by work duration limits may be preventing the majority of personnel from conducting activities in hot environments, thereby constraining a commander's mandate to develop an optimised military force. The dissociation between heat-related symptoms and body core temperature elevation suggests that the physiological mechanisms underpinning exhaustion during exertional heat stress should be re-examined to determine the most appropriate physiological criteria for prescribing work duration limits.

Biophysical Assessment and Predicted Thermophysiologic Effects of Body Armor

INTRODUCTION

Military personnel are often required to wear ballistic protection in order to defend against enemies. However, this added protection increases mass carried and imposes additional thermal burden on the individual. Body armor (BA) is known to reduce combat casualties, but the effects of BA mass and insulation on the physical performance of soldiers are less well documented. Until recently, the emphasis has been increasing personal protection, with little consideration of the adverse impacts on human performance.

OBJECTIVE

The purpose of this work was to use sweating thermal manikin and mathematical modeling techniques to quantify the tradeoff between increased BA protection, the accompanying mass, and thermal effects on human performance.

METHODS

Using a sweating thermal manikin, total insulation (IT, clo) and vapor permeability indexes (im) were measured for a baseline clothing ensemble with and without one of seven increasingly protective U.S. Army BA configurations. Using mathematical modeling, predictions were made of thermal impact on humans wearing each configuration while working in hot/dry (desert), hot/humid (jungle), and temperate environmental conditions.

RESULTS

In nearly still air (0.4 m/s), IT ranged from 1.57 to 1.63 clo and im from 0.35 to 0.42 for the seven BA conditions, compared to IT and im values of 1.37 clo and 0.45 respectively, for the baseline condition (no BA).

CONCLUSION

Biophysical assessments and predictive modeling show a quantifiable relationship exists among increased protection and increased thermal burden and decreased work capacity. This approach enables quantitative analysis of the tradeoffs between ballistic protection, thermal-work strain, and physical work performance.

Thermoregulatory modeling use and application in the military workforce

Thermoregulatory models have been used in the military to quantify probabilities of individuals' thermal-related illness/injury. The uses of the models have diversified over the past decade. This paper revisits an overall view of selected thermoregulatory models used in the U.S. military and provides examples of actual practical military applications: 1) the latest military vehicle designed with armor and blast/bulletproof windows was assessed to predict crews' thermal strains levels inside vehicles under hot environment (air temperature [Ta]: 29-43 °C, dew point: 13 °C); 2) a military working dog (MWD) model was developed by modifying existing human thermoregulatory models with canine physical appearance and physiological mechanisms; 3) thermal tolerance range of individuals from a large military group (n = 100) exposed to 35 °C/40% relative humidity were examined using thermoregulatory modeling and multivariate statistical analyses. Model simulation results assist in the decisions for the strategic planning and preventions of heat stress.

Physiological cost and thermal envelope: a novel approach to cycle garment evaluation during a representative protocol

This study aimed to examine thermoregulation in different clothing assemblies during a representative cycling exercise protocol. Six men undertook cycling exercise simulating representative thermal exchange challenges while wearing low (LOW), intermediate (INT1 and INT2), or high (HI) amounts of clothing. Exercise was conducted at 14.5 °C, 46.8% relative humidity and included a "flat" [45 min at 35% peak power output (PPO), wind speed 8.3 m/s], "uphill" (30 min at 55% PPO, wind speed 3.6 m/s), and "downhill" (20 min at 50 W, wind speed 16.7 m/s) stage. Rectal temperature changed with the exercise stage and was independent of clothing assembly. In contrast, an "envelope" was evident for mean body temperature, resulting from differences in mean skin temperature between the LOW and HI conditions. The elevated mean body temperature in HI was associated with increased physiological "cost," in the form of increased sweat production and heart rate. Physiological cost provides a better index of clothing performance than deep body temperature in the "thermoregulatory zone," as a consequence sports clothing should attempt to optimize the balance between comfort and reduced physiological cost.

Encapsulated environment

In many occupational settings, clothing must be worn to protect individuals from hazards in their work environment. However, personal protective clothing (PPC) restricts heat exchange with the environment due to high thermal resistance and low water vapor permeability. As a consequence, individuals who wear PPC often work in uncompensable heat stress conditions where body heat storage continues to rise and the risk of heat injury is greatly enhanced. Tolerance time while wearing PPC is influenced by three factors: (i) initial core temperature (Tc), affected by heat acclimation, precooling, hydration, aerobic fitness, circadian rhythm, and menstrual cycle (ii) Tc tolerated at exhaustion, influenced by state of encapsulation, hydration, and aerobic fitness; and (iii) the rate of increase in Tc from beginning to end of the heat-stress exposure, which is dependent on the clothing characteristics, thermal environment, work rate, and individual factors like body composition and economy of movement. Methods to reduce heat strain in PPC include increasing clothing permeability for air, adjusting pacing strategy, including work/rest schedules, physical training, and cooling interventions, although the additional weight and bulk of some personal cooling systems offset their intended advantage. Individuals with low body fatness who perform regular aerobic exercise have tolerance times in PPC that exceed those of their sedentary counterparts by as much as 100% due to lower resting Tc, the higher Tc tolerated at exhaustion and a slower increase in Tc during exercise. However, questions remain about the importance of activity levels, exercise intensity, cold water ingestion, and plasma volume expansion for thermotolerance.

Prediction of the physiological response of humans wearing protective clothing using a thermophysiological human simulator

Most standards and devices for determining clothing properties ignore the physiological state of the wearer and are inadequate to evaluate the transient thermal properties of clothing ensembles. This study evaluated the physiological burden of different types of protective clothing and environmental conditions using the recently developed single-sector thermo-physiological human simulator and compared its performance with a thermal cylinder (without the physiological control model) and with an advanced physiological model (with a simple clothing model). A single-sector physiological simulator developed to simulate the dynamic thermal and perceptual behavior of humans over a wide range of environmental and personal conditions was successfully validated in this study through tests with clothed individuals exposed to hot and cold conditions. In comparative tests on water vapor permeable and impermeable clothing samples, the simulator provided a much more complete picture of actual clothing performance, for example, in terms of moisture retention within the clothing and the additional cooling due to the "heat pipe" effect in impermeable clothing.

Validation of the Fiala multi-node thermophysiological model for UTCI application

The important requirement that COST Action 730 demanded of the physiological model to be used for the Universal Thermal Climate Index (UTCI) was its capability of accurate simulation of human thermophysiological responses across a wide range of relevant environmental conditions, such as conditions corresponding to the selection of all habitable climates and their seasonal changes, and transient conditions representing the temporal variation of outdoor conditions. In the first part of this study, available heat budget/two-node models and multi-node thermophysiological models were evaluated by direct comparison over a wide spectrum of climatic conditions. The UTCI-Fiala model predicted most reliably the average human thermal response, as shown by least deviations from physiologically plausible responses when compared to other models. In the second part of the study, this model was subjected to extensive validation using the results of human subject experiments for a range of relevant (steady-state and transient) environmental conditions. The UTCI-Fiala multi-node model proved its ability to predict adequately the human physiological response for a variety of moderate and extreme conditions represented in the COST 730 database. The mean skin and core temperatures were predicted with average root-mean-square deviations of 1.35 ± 1.00°C and 0.32 ± 0.20°C, respectively.

Effect of temperature difference between manikin and wet fabric skin surfaces on clothing evaporative resistance: how much error is there?

Clothing evaporative resistance is one of the inherent factors that impede heat exchange by sweating evaporation. It is widely used as a basic input in physiological heat strain models. Previous studies showed a large variability in clothing evaporative resistance both at intra-laboratory and inter-laboratory testing. The errors in evaporative resistance may cause severe problems in the determination of heat stress level of the wearers. In this paper, the effect of temperature difference between the manikin nude surface and wet textile skin surface on clothing evaporative resistance was investigated by both theoretical analysis and thermal manikin measurements. It was found that the temperature difference between the skin surface and the manikin nude surface could lead to an error of up to 35.9% in evaporative resistance of the boundary air layer. Similarly, this temperature difference could also introduce an error of up to 23.7% in the real clothing total evaporative resistance (R ( et_real ) < 0.1287 kPa m(2)/W). Finally, it is evident that one major error in the calculation of evaporative resistance comes from the use of the manikin surface temperature instead of the wet textile fabric skin temperature.

Methods of evaluating protective clothing relative to heat and cold stress: thermal manikin, biomedical modeling, and human testing

Personal protective equipment (PPE) refers to clothing and equipment designed to protect individuals from chemical, biological, radiological, nuclear, and explosive hazards. The materials used to provide this protection may exacerbate thermal strain by limiting heat and water vapor transfer. Any new PPE must therefore be evaluated to ensure that it poses no greater thermal strain than the current standard for the same level of hazard protection. This review describes how such evaluations are typically conducted. Comprehensive evaluation of PPE begins with a biophysical assessment of materials using a guarded hot plate to determine the thermal characteristics (thermal resistance and water vapor permeability). These characteristics are then evaluated on a thermal manikin wearing the PPE, since thermal properties may change once the materials have been constructed into a garment. These data may be used in biomedical models to predict thermal strain under a variety of environmental and work conditions. When the biophysical data indicate that the evaporative resistance (ratio of permeability to insulation) is significantly better than the current standard, the PPE is evaluated through human testing in controlled laboratory conditions appropriate for the conditions under which the PPE would be used if fielded. Data from each phase of PPE evaluation are used in predictive models to determine user guidelines, such as maximal work time, work/rest cycles, and fluid intake requirements. By considering thermal stress early in the development process, health hazards related to temperature extremes can be mitigated while maintaining or improving the effectiveness of the PPE for protection from external hazards.

Sweat loss prediction using a multi-model approach

A new multi-model approach (MMA) for sweat loss prediction is proposed to improve prediction accuracy. MMA was computed as the average of sweat loss predicted by two existing thermoregulation models: i.e., the rational model SCENARIO and the empirical model Heat Strain Decision Aid (HSDA). Three independent physiological datasets, a total of 44 trials, were used to compare predictions by MMA, SCENARIO, and HSDA. The observed sweat losses were collected under different combinations of uniform ensembles, environmental conditions (15-40°C, RH 25-75%), and exercise intensities (250-600 W). Root mean square deviation (RMSD), residual plots, and paired t tests were used to compare predictions with observations. Overall, MMA reduced RMSD by 30-39% in comparison with either SCENARIO or HSDA, and increased the prediction accuracy to 66% from 34% or 55%. Of the MMA predictions, 70% fell within the range of mean observed value ± SD, while only 43% of SCENARIO and 50% of HSDA predictions fell within the same range. Paired t tests showed that differences between observations and MMA predictions were not significant, but differences between observations and SCENARIO or HSDA predictions were significantly different for two datasets. Thus, MMA predicted sweat loss more accurately than either of the two single models for the three datasets used. Future work will be to evaluate MMA using additional physiological data to expand the scope of populations and conditions.

Computer simulation of heat transfer in different tissue layers of body extremities under heat stress in deep anesthetic condition

Many mathematical models of thermoregulation in humans have been developed, so far. These models appeared to be very useful tools for studying temperature regulation in humans under adverse environmental conditions. However, no one discussed the heat transfer characteristics of denervated subjects. Thus, the present study is concerned with aspects of the passive system for denervated subjects: (1) modeling the human body extremities (2) modeling heat transport mechanism within the body and at its periphery. The present model was simulated using the software (Wintherm 8.0, Thermoanalytics, USA) for different body segments to predict the heat flow between body core and skin surface with changes in environmental temperature with fixed relative humidity and wind velocity. The simulated model for comparative study of internal temperature distribution of hand, arm, leg and feet segments yielded remarkably good results and observed to be in trends with previously cited work under ambient environmental condition and at controlled room temperature. Models could be used to measure the temperature distribution in human limbs during local hyperthermia and to investigate the interaction between limbs and the thermal environment.

The management of heat stress for the firefighter: a review of work conducted on behalf of the Toronto Fire Service

This report provides a summary of research conducted through a grant provided by the Workplace Safety Insurance Board of Ontario. The research was divided into two phases; first, to define safe work limits for firefighters wearing their protective clothing and working in warm environments; and, the second, to examine strategies to reduce the thermal burden and extend the operational effectiveness of the firefighter. For the first phase, subjects wore their protective ensemble and carried their self-contained breathing apparatus (SCBA) and performed very light, light, moderate or heavy work at 25 degrees C, 30 degrees C or 35 degrees C. Thermal and evaporative resistance coefficients were obtained from thermal manikin testing that allowed the human physiological responses to be compared with modeled data. Predicted continuous work times were then generated using a heat strain model that established limits for increases in body temperature to 38.0 degrees C, 38.5 degrees C and 39.0 degrees C. Three experiments were conducted for the second phase of the project. The first study revealed that replacing the duty uniform pants that are worn under the bunker pants with shorts reduced the thermal strain for activities that lasted longer than 60 min. The second study examined the importance of fluid replacement. The data revealed that fluid replacement equivalent to at least 65% of the sweat lost increased exposure time by 15% compared with no fluid replacement. The last experiment compared active and passive cooling. Both the use of a mister or forearm and hand submersion in cool water significantly increased exposure time compared with passive cooling that involved only removing most of the protective clothing. Forearm and hand submersion proved to be most effective and produced dramatic increases in exposure time that approximated 65% compared with the passive cooling procedure. When the condition of no fluid replacement and passive cooling was compared with fluid replacement and forearm and hand submersion, exposure times were effectively doubled with the latter condition. The heat stress wheel that was generated can be used by Commanders to determine safe work limits for their firefighters during activities that involve wearing their protective clothing and carrying their SCBA.

Physiologic tolerance to uncompensable heat: intermittent exercise, field vs laboratory

PURPOSE

This study determined whether exercise (30 min)-rest (10 min) cycles alter physiologic tolerance to uncompensable heat stress (UCHS) when outdoors in the desert. In addition, the relationship between core temperature and exhaustion from heat strain previously established in laboratory studies was compared with field studies.

METHODS

Twelve men completed four trials: moderate intensity continuous exercise (MC), moderate intensity exercise with intermittent rest (MI), hard intensity continuous exercise (HC), and hard intensity exercise with intermittent rest (HI). UCHS was achieved by wearing protective clothing and exercising (estimated at 420 W or 610 W) outdoors in desert heat.

RESULTS

Heat Stress Index values were 200%, 181%, 417%, and 283% for MC, MI, HC, and HI, respectively. Exhaustion from heat strain occurred in 36 of 48 trials. Core temperatures at exhaustion averaged 38.6 +/- 0.5 degrees, 38.9 +/- 0.6 degrees, 38.9 +/- 0.7 degrees, and 39.0 +/- 0.7 degrees C for MC, MI, HC, and HI, respectively. Core temperature at exhaustion was not altered (P > 0.05) by exercise intensity or exercise-rest cycles and 50% of subjects incurred exhaustion at core temperature of 39.4 degrees C. These field data were compared with laboratory and field data collected over the past 35 years. Aggregate data for 747 laboratory and 131 field trials indicated that 50% of subjects incurred exhaustion at core temperatures of 38.6 degrees and 39.5 degrees C, respectively. When heat intolerant subjects (exhaustion < 38.3 degrees C core temperature) were removed from the analysis, subjects from laboratory studies (who underwent short-term acclimation) still demonstrated less (0.8 degrees C) physiological tolerance than those from field studies (who underwent long-term acclimatization).

CONCLUSION

Exercise-rest cycles did not alter physiologic tolerance to UCHS. In addition, subjects from field studies demonstrate greater physiologic tolerance than subjects from laboratory studies.

Impact of fluid replacement on heat storage while wearing protective clothing

This study used partitional calorimetry to determine the influence of fluid replacement on heat storage during uncompensable heat stress. Eight males performed either light (L; level treadmill walking at 0.97 m x s(-1) (3.5 km x h(-1)) or heavy (H; 1.33 m x s(-1) (4.8 km x h(-1)) at a 4% grade) exercise at 40 degrees C and 30% relative humidity while wearing nuclear, biological and chemical (NBC) protective clothing. Subjects received either no fluid (NF), or 200 or 250 ml of fluid (F) as warm water at approximately 35 degrees C immediately before and every 15 min during the L and H trials respectively. Similar reductions in heart rate were observed at both metabolic rates with F but rectal temperature responses were not different between F and NF. Tolerance time was extended during L/F (106.5 +/- 22.1 min) compared with L/NF (93.1 +/- 20.8 min) but fluid replacement had no influence during H (59.8 +/- 9.5 min and 58.3 +/- 11.1 min for F and NF respectively). Fluid replacement also had no effect on the rate of heat storage during L (108.2 +/- 20.6 W x m(-2) and 111.0 +/- 22.6 W x m(-2) for F and NF respectively) and H (172.5 +/- 11.5 W x m(-2) and 182.1 +/- 15.8 W x m(-2) for F and NF respectively). However, heat storage expressed per unit of mass was significantly increased during L/F (18.5 +/- 4.0 kJ x kg(-1) ) compared with the other trials (16.3 +/- 4.8 kJ x kg(-1), 16.6 +/- 3.0 kJ x kg(-1) and 16.7 +/- 4.0 kJ x kg(-1) for L/NF, H/F and H/NF respectively). It was concluded that fluid replacement does not alter the rate of heat storage during uncompensable heat stress but does increase the heat storage capacity during light exercise when tolerance times are > 60 min.

The thermophysiology of uncompensable heat stress. Physiological manipulations and individual characteristics

In many athletic and occupational settings, the wearing of protective clothing in warm or hot environments creates conditions of uncompensable heat stress where the body is unable to maintain a thermal steady state. Therefore, special precautions must be taken to minimise the threat of thermal injury. Assuming that manipulations known to reduce thermoregulatory strain during compensable heat stress would be equally effective in an uncompensable heat stress environment is not valid. In this review, we discuss the impact of hydration status, aerobic fitness, endurance training, heat acclimation, gender, menstrual cycle, oral contraceptive use, body composition and circadian rhythm on heat tolerance while wearing protective clothing in hot environments. The most effective countermeasure is ensuring that the individual is adequately hydrated both before and throughout the exercise or work session. In contrast, neither short term aerobic training or heat acclimation significantly improve exercise-heat tolerance during uncompensable heat stress. While short term aerobic training is relatively ineffective, long term improvements in physical fitness appear to provide some degree of protection. Individuals with higher proportions of body fat have a lower heat tolerance because of a reduced capacity to store heat. Women not using oral contraceptives are at a thermoregulatory disadvantage during the luteal phase of the menstrual cycle. The use of oral contraceptives eliminates any differences in heat tolerance throughout the menstrual cycle but tolerance is reduced during the quasi-follicular phase compared with non-users. Diurnal variations in resting core temperature do not appear to influence tolerance to uncompensable heat stress.

Low doses of melatonin and diurnal effects on thermoregulation and tolerance to uncompensable heat stress

This study examined whether the reported hypothermic effect of melatonin ingestion increased tolerance to exercise at 40 degrees C, for trials conducted either in the morning or afternoon, while subjects were wearing protective clothing. Nine men performed four randomly ordered trials; two each in the morning (0930) and afternoon (1330) after the double-blind ingestion of either two placebo capsules or two 1-mg capsules of melatonin. Despite significant elevations in plasma melatonin to over 1,000 ng/ml 1 h after the ingestion of the first 1-mg dose, rectal temperature (T(re)) was unchanged before or during the heat-stress exposure. Also, all other indexes of temperature regulation and the heart rate response during the uncompensable heat stress were unaffected by the ingestion of melatonin. Initial T(re) was increased during the afternoon (37.1 +/- 0.2 degrees C), compared with the morning (36.8 +/- 0.2 degrees C) exposures, and these differences remained throughout the uncompensable heat stress, such that final T(re) was also increased for the afternoon (39.2 +/- 0.2 degrees C) vs. the morning (39.0 +/- 0.3 degrees C) trials. Tolerance times and heat storage were not different among the exposures at approximately 110 min and 16 kJ/kg, respectively. It was concluded that this low dose of melatonin had no impact on tolerance to uncompensable heat stress and that trials conducted in the early afternoon were associated with an increased T(re) tolerated at exhaustion that offset the circadian influence on resting T(re) and thus maintained tolerance times similar to those of trials conducted in the morning.

The physiological strain index applied to heat-stressed rats

A physiological strain index (PSI) based on heart rate (HR) and rectal temperature (Tre) was recently suggested to evaluate exercise-heat stress in humans. The purpose of this study was to adjust PSI for rats and to evaluate this index at different levels of heat acclimation and training. The corrections of HR and Tre to modify the index for rats are as follows: PSI = 5 (Tre t - Tre 0). (41.5 - Tre 0)-1 + 5 (HRt - HR0). (550 - HR0)-1, where HRt and Tre t are simultaneous measurements taken at any time during the exposure and HR0 and Tre 0 are the initial measurements. The adjusted PSI was applied to five groups (n = 11-14 per group) of acclimated rats (control and 2, 5, 10, and 30 days) exposed for 70 min to a hot climate [40 degrees C, 20% relative humidity (RH)]. A separate database representing two groups of acclimated or trained rats was also used and involved 20 min of low-intensity exercise (O2 consumption approximately 50 ml. min-1. kg-1) at three different climates: normothermic (24 degrees C, 40% RH), hot-wet (35 degrees C, 70% RH), and hot-dry (40 degrees C, 20% RH). In normothermia, rats also performed moderate exercise (O2 consumption approximately 60 ml. min-1. kg-1). The adjusted PSI differentiated among acclimation levels and significantly discriminated among all exposures during low-intensity exercise (P < 0.05). Furthermore, this index was able to assess the individual roles played by heat acclimation and exercise training.

A physiological strain index to evaluate heat stress

A physiological strain index (PSI), based on rectal temperature (Tre) and heart rate (HR), capable of indicating heat strain online and analyzing existing databases, has been developed. The index rates the physiological strain on a universal scale of 0-10. It was assumed that the maximal Tre and HR rise during exposure to exercise heat stress from normothermia to hyperthermia was 3 degrees C (36.5-39.5 degrees C) and 120 beats/min (60-180 beats/min), respectively. Tre and HR were assigned the same weight functions as follows: PSI = 5(Tret - Tre0) . (39.5 - Tre0)-1 + 5(HRt - HR0) . (180 - HR0)-1, where Tret and HRt are simultaneous measurements taken at any time during the exposure and Tre0 and HR0 are the initial measurements. PSI was applied to data obtained from 100 men performing exercise in the heat (40 degrees C, 40% relative humidity; 1.34 m/s at a 2% grade) for 120 min. A separate database representing seven men wearing protective clothing and exercising in hot-dry and hot-wet environmental conditions was applied to test the validity of the present index. PSI differentiated significantly (P < 0.05) between the two climates. This index has the potential to be widely accepted and to serve universally after extending its validity to women and other age groups.