Simulated Firefighting Task Performance and Physiology Under Very Hot Conditions

Firefighter Health: A Narrative Review of Occupational Threats and Countermeasures

Structural firefighters are responsible for protecting properties and saving lives during emergency operations. Despite efforts to prepare firefighters for these hazardous occupational demands, the unfortunate reality is that the incidence of health morbidities is increasing within the fire service. Specifically, cardiovascular disease, cancer, and mental health disorders are among the most documented morbidities in firefighters. Pubmed and Google Scholar search engines were used to identify peer-reviewed English language manuscripts that evaluated firefighters' occupational health threats, allostatic factors associated with their occurrence, and evidence-based strategies to mitigate their impact. This narrative review provides fire departments, practitioners, and researchers with evidence-based practices to enhance firefighters' health.

An Examination of Subjective and Objective Measures of Stress in Tactical Populations: A Scoping Review

Persons working in tactical occupations are often exposed to high-stress situations. If this stress is to be measured, an understanding of the stress outcomes used in these occupations is needed. The aim of this review was to capture and critically appraise research investigating subjective and objective outcome measures of physiological stress in tactical occupations. Several literature databases (PubMed, EMBASE, EBsco) were searched using key search words and terms. Studies meeting inclusion criteria were critically evaluated and scored by two authors using the Joanne Briggs Institute (JBI) critical appraisal tool. Of 17,171 articles, 42 studies were retained. The Cohen's Kappa agreement between authors was 0.829 with a mean JBI Score of included studies of 8.1/9 ± 0.37 points. Multiple subjective and objective measures were assessed during a variety of high-stress tasks and environments across different occupations, including police officers, emergency service personnel, firefighters, and soldiers in the military. Common objective outcomes measures were heart rate, cortisol, and body temperature, and subjective measures were ratings of perceived exertion, and the Self Trait Anxiety Inventory. Often used in combination (i.e., subjective and objective), these outcome measures can be used to monitor stressors faced by tactical personnel undergoing on-the-job training.

Nanoscale chemical analysis of 2D molecular materials using tip-enhanced Raman spectroscopy

Two-dimensional (2D) molecular materials have attracted immense attention due to their unique properties, promising a wide range of exciting applications. To understand the structure-property relationship of these low-dimensional materials, sensitive analytical tools capable of providing structural and chemical characterisation at the nanoscale are required. However, most conventional analytical techniques fail to meet this challenge, especially in a label-free and non-destructive manner under ambient conditions. In the last two decades, tip-enhanced Raman spectroscopy (TERS) has emerged as a powerful analytical technique for nanoscale chemical characterisation by combining the high spatial resolution of scanning probe microscopy and the chemical sensitivity and specificity of surface-enhanced Raman spectroscopy. In this review article, we provide an overview of the application of TERS for nanoscale chemical analysis of 2D molecular materials, including 2D polymers, biomimetic lipid membranes, biological cell membranes, and 2D reactive systems. The progress in the structural and chemical characterisation of these 2D materials is demonstrated with key examples from our as well as other laboratories. We highlight the unique information that TERS can provide as well as point out the common pitfalls in experimental work and data interpretation and the possible ways of averting them.

Stress Response and Safe Driving Time of Bus Drivers in Hot Weather

PURPOSE

To evaluate the impact of high-temperature environments on bus drivers' physiology and reaction times, and to provide a basis for driver occupational health management.

METHODS

The physiological and reaction indexes of 24 bus drivers under different temperatures were investigated. The statistical analysis method was used to analyze the changes in drivers' physiological stress, the relationship between stress and response ability, and a safe driving time. The Kaplan-Meier survival function was used to analyze the survival rate of bus drivers under different temperatures and driving times.

RESULTS

The results showed that body temperature, heart rate, physiological strain index (PSI), and reaction ability were significantly different among different compartment temperatures. PSI was positively correlated with reaction ability. The safe driving time was 80 min, 73 min, and 53 min, respectively, at 32 °C, 36 °C, and 40 °C. The survival rate decreased to less than 60% at 36 °C when driving continuously for 73 min; it decreased to 20% at 40 °C when driving for 53 min, and it was 0 for 75 min.

CONCLUSIONS

High-temperature environments lead to heat stress of bus drivers, physiological indexes have changed significantly, and behavioral ability is also decreased. The higher the temperature, the lower the survival rate. Improvement measures can be taken from the aspects of convection, conduction, and behavior to ensure the bus driver's physiological health and driving safety under high temperatures and to improve the survival rate.

Australian firefighters perceptions of heat stress, fatigue and recovery practices during fire-fighting tasks in extreme environments

OBJECTIVES

The aim of this study was to assess current perceptions of heat stress, fatigue and recovery practices during active duty in Australian firefighters.

DESIGN

Prospective survey.

METHODS

473 firefighters from Fire and Rescue New South Wales completed a two-part, 16-item survey. Questions included perceptions of the operational activities and body areas associated with the most heat stress, the most mentally and physically demanding activities, and levels of fatigue felt. Further questions focussed on the use and importance of recovery practices, effectiveness of currently used heat-mitigation strategies and additional cooling strategies for future use.

RESULTS

Around a third of firefighters (62%) reported structural fire-fighting as the hottest operational activities experienced, followed by bushfire-fighting (51%) and rescue operations (38%). The top three responses for which body-parts get the hottest ranked as 'the head' (58%), 'the whole body' (54%) and 'the upper back' (40%), respectively. The majority of firefighters (~90%) stated they always or sometimes use the opportunity to recover at an incident, with the top three being 'sit in the shade' (93%), 'cold water ingestion (drinking)' (90%) and 'removing your helmet, flash hood and jacket' (89%). Firefighters reported higher usefulness for more easily deployed strategies compared to more advanced strategies. Limited age and gender differences were found, although location of active service differences were present.

CONCLUSION

These findings may inform future research, and translation to operational directives for recovery interventions; including exploration of protective gear and clothing, education, resources and provision of cooling methods, as well as recovery aid development.

Heart Rate Responses during Simulated Fire Ground Scenarios among Full-Time Firefighters

Simulated fire ground scenarios (SFGS) provide firefighters with an opportunity to maintain skills, receive feedback, and optimize performance. Although there is extensive research on heart rate (HR) changes in the firefighter population, few examine the differences between positions. Firefighters are primarily responsible for fire suppression and control (23), officers for emergency operations and organizational management, paramedics for providing on-scene emergency medical care, and drivers are responsible for driving the fire apparatus. Utilizing HR analysis to quantify the physical demands of SFGS among firefighting crews by position. Sixty-seven male (age: 38.97 ± 9.17; ht: 177.99 ± 6.45 cm. wt: 88.83 ± 13.55 kg) firefighters (FF) participated in this investigation. FF crews performed two SFGS involving the suppression and control of a structural fire. Participants were outfitted with heart rate (HR) monitors and average heart rate (HRavg) and maximum heart rate (HRmax) data were collected for each of the two SFGS. Significant differences were observed for Age (P = 0.01), APMHR (P = 0.01), HRmax1 (P = 0.04), and HRmax2 (P = 0.04) in which firefighters had higher values for Age-predicted maximal heart rate (APMHR), HRmax1, HRmax2 compared to the officers. SFGS can be very physically demanding events that may elicit maximal or near maximal HR responses regardless of position. Based on the metabolic demands of these events and the individual firefighter's capabilities, this information can be used to develop resistance training and conditioning programs that optimize performance at maximal or near maximal heart rates.

Indices of physiological strain for firefighters of the Australian Defence Forces

High levels of exertion and physiological strain are the leading cause of fireground injuries. The Physiological Strain Index (PSI) provides a rating of strain based on body core temperature and heart rate; however, it may underestimate the strain of workers in protective clothing as skin temperature may be elevated. This study aimed to examine the relationship between the PSI and an Adaptive Physiological Strain Index (aPSI) that incorporates skin temperature, among firefighters wearing protective clothing. Nine male firefighters of the Australian Defence Force volunteered to participate. Participants conducted scenario-based activities while wearing turnout gear and breathing apparatus. Working in teams of four, participants would respond to a situation around and within a small building with several rooms that could be filled with smoke, however, no live fire was present. Heart rate, gastrointestinal temperature, and skin temperature were monitored throughout work and rehabilitation. Physiological strain was estimated via the PSI and aPSI. Absolute peak PSI and aPSI ratings were significantly different during work (PSI: 7.3 ± 1.6; aPSI 8.2 ± 2.0; p < 0.001). The aPSI produced higher ratings of physiological strain, >0.5 above PSI, progressively from a moderate level of strain (>6). The aPSI may provide a more accurate indication of a level of "maximal strain" for encapsulated workers than the original PSI, coincident with the occupational limits for body core temperature of 38.0 °C for general occupational groups, or 38.5 °C for selected and acclimatised personnel.

Salivary cortisol profiles of on-call from home fire and emergency service personnel

Working on-call with a night call resulted in a depressed (lower) cortisol awakening response (CAR) peak and post-awakening cortisol area under the curve with respect to ground (AUC_G) the following day compared to when off-call. This may be due to exposure to noise, physical exertion, and stressful events during night callouts. There was no anticipatory effect to working on-call in any of the cortisol measures examined. This study, of male fire and emergency service workers who operate on-call from home, had two aims: (1) examine CAR and diurnal cortisol profile following a night on-call with a call, on-call without a call, and off-call; and, (2) explore whether there is an anticipatory effect of working on-call from home on diurnal cortisol profiles. Participants wore activity monitors, completed sleep and work diaries and collected seven saliva samples a day (0 min, 30 min, 60 min, 3 h, 6 h, 9 h, and 12 h after final awakening) for one week. CAR peak, reactivity and area under the curve with respect to increase (AUC_I), post-awakening cortisol AUC_G, diurnal cortisol slope and AUC_G, and mean 12-h cortisol concentrations were calculated. The final analysis included 26 participants for Aim 1 (22 off-call nights, 68 nights on-call without a call, and 20 nights on-call with a call) and 14 participants for Aim 2 (25 days leading up to a night off-call and 92 days leading up to a night on-call). Generalized estimating equations models were constructed for each variable of interest. Aim 1: CAR peak and post-awakening cortisol AUC_G were 8.2 ± 3.4 nmol/L and 5.7 ± 2.4 units lower, respectively, following a night on-call with a call compared to an off-call night. Aim 2: the day before a night on-call was not a significant predictor in any model. The lower CAR peak and post-awakening cortisol AUC_G following a night on-call with a call compared to following an off-call night may be due to exposure to noise, physical exertion, and stressful events during night callouts. The lack of difference between the day before a night on-call and the day before an off-call night suggests there may not be an anticipatory effect on cortisol when on-call from home.

Fractional Contribution of Wildland Firefighters' Personal Protective Equipment on Physiological Strain

Activities performed by wildland firefighters are carried out wearing a personal protective equipment (PPE). Although the PPE protects workers from a wide variety of hazards, it may increase their physiological response and limit their performance. The aim of this study was to analyze the effect of the protective clothing (PPC) and the rest of the PPE elements (i.e., helmet, neck shroud, gloves, goggles, and mid-calf leather boots) on the wildland firefighters' thermophysiological response during a moderate-intense exercise. Six male wildland firefighters performed, in a counterbalanced order, a 120 min graded exercise test wearing three different clothing configurations: (i) a traditional short sports gear (SG), (ii) a PPC, and (iii) a complete firefighters' PPE. Trials were conducted on separate days at the same time of the day (12:00-15:00 h) and under climate-controlled conditions (∼30°C and ∼30% relative humidity). Heart rate, respiratory gas exchange, gastrointestinal and skin temperature, blood lactate concentration were recorded throughout the tests. Additionally, parameters of heat balance were estimated. Exercise time was shorter (p < 0.001) wearing the PPE (62.4 ± 13.3 min) than with the PPC (115.5 ± 5.0 min) and SG (118.2 ± 20.7 min). The increment of gastrointestinal temperature with the PPE (1.8 ± 0.3°C) was greater (p < 0.05) than the observed in PPC (1.2 ± 0.6°C) and SG (1.0 ± 0.2°C). The use of PPC increased (p < 0.05) subjects' metabolic demand and skin temperature versus SG during the last 20 min of the test. The sweat retention in the PPE (1,045.7 ± 214.7 g) and PPC (978.3 ± 330.6 g) was significantly higher than that obtained in the SG (510.0 ± 210.0 g). Sweat efficiency decreased (p < 0.05) in the following order: PPE (45.6 ± 18.3%), PPC (64.3 ± 7.8%), and SG (79.3 ± 7.0%). These results highlight the importance of the PPE elements in the subjects' thermal strain. The reduction in the sweat evaporation produced by the PPE, together with the ensemble mass caused a substantial increase in the subjects' thermophysiological response. As a consequence the performance was reduced by ∼50%.

Salivary alpha amylase in on-call from home fire and emergency service personnel

The effect of working on-call from home on the sympatho-adrenal medullary system activity is currently unknown. This study had two aims, Aim 1: examine salivary alpha amylase awakening response (AAR) and diurnal salivary alpha amylase (sAA) profile in fire and emergency service workers who operate on-call from home following a night on-call with a call (NIGHT-CALL), a night on-call without a call (NO-CALL) and an off-call night (OFF-CALL), and Aim 2: explore whether there was an anticipatory effect of working on-call from home (ON) compared to when there was an off-call (OFF) on the diurnal sAA profile. Participants wore activity monitors, completed sleep and work diaries and collected seven saliva samples a day for one week. AAR area under the curve with respect to ground (AUC_G), AAR area under the curve with respect to increase (AUC_I), AAR reactivity, diurnal sAA slope, diurnal sAA AUC_G and mean 12-h sAA concentrations were calculated. Separate generalised estimating equation models were constructed for each variable of interest for each aim. For Aim 1, there were no differences between NIGHT-CALL or NO-CALL and OFF-CALL for any response variable. For Aim 2, there was no difference between any response variable of interest when ON the following night compared to when OFF the following night (n = 14). These findings suggest that there is no effect of working on-call from home on sAA, but should be interpreted with caution, as overnight data were not collected. Future research, using overnight heart rate monitoring, could help confirm these findings.

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.

Physiological Responses to Firefighting in Extreme Temperatures Do Not Compare to Firefighting in Temperate Conditions

Purpose: The aim of this study was to examine physiological responses to two different simulated firefighting exercises: a firefighting exercise with flashovers, smoke, poor visibility and extreme temperatures (300°) in a burning container and a standard firefighting exercise in temperate conditions. Furthermore, a second purpose of the study was to find out if the contribution of strength and endurance capacities to firefighting performance changes when the demands of the firefighting exercise change.

Methods: Sixteen professional firefighters performed a maximum treadmill test, strength testing, a standard simulated firefighting exercise (SFE) without heat and flashovers and a firefighting exercise with a simulation of the flashover phenomenon in a burning container (FOT). The treadmill testing was used to determine peak oxygen uptake (VO_2peak), ventilatory threshold (VT1) and respiratory compensation point (RCP). Three intensity zones were identified according to heart rate (HR) values corresponding to VT1 and RCP: zone 1–HR below VT1, zone 2-HR between VT1 and RCP, zone 3–HR above RCP. Firefighting performance was determined by a simple time-strain-air depletion model (TSA) taking the sum of z-transformed parameters of time to finish the exercise, strain in terms of mean heart rate, and air depletion from the breathing apparatus. Correlations were then established between TSA based firefighting performance parameters and fitness variables representing strength and endurance.

Results: HR was significantly lower during SFE (79.9 ± 6.9%HR_max) compared to FOT (85.4 ± 5.2%HR_max). During SFE subjects spent 24.6 ± 30.2% of time in zone 1, 65.8 ± 28.1% in zone 2 and 9.7 ± 16.6% in zone 3. During FOT subjects spent 16.3 ± 12.8% in zone 1, 50.4 ± 13.2% in zone 2 and 33.3 ± 16.6% in zone 3. Out of all correlations, relative VO_2peak showed the highest relation to mean HR during SFE (−0.593) as well as FOT (−0.693).

Conclusions: Endurance in terms of VO_2peak is an important prerequisite for both firefighting exercises. However, for standard simulated firefighting exercises it is important to work below VT1. For firefighting exercises in extreme temperatures with smoke, poor visibility and unexpected flashovers a high fitness level is required in order to keep the time spent above RCP as short as possible.

The Systematic Bias of Ingestible Core Temperature Sensors Requires a Correction by Linear Regression

An accurate measure of core body temperature is critical for monitoring individuals, groups and teams undertaking physical activity in situations of high heat stress or prolonged cold exposure. This study examined the range in systematic bias of ingestible temperature sensors compared to a certified and traceable reference thermometer. A total of 119 ingestible temperature sensors were immersed in a circulated water bath at five water temperatures (TEMP A: 35.12 ± 0.60°C, TEMP B: 37.33 ± 0.56°C, TEMP C: 39.48 ± 0.73°C, TEMP D: 41.58 ± 0.97°C, and TEMP E: 43.47 ± 1.07°C) along with a certified traceable reference thermometer. Thirteen sensors (10.9%) demonstrated a systematic bias > ±0.1°C, of which 4 (3.3%) were > ± 0.5°C. Limits of agreement (95%) indicated that systematic bias would likely fall in the range of −0.14 to 0.26°C, highlighting that it is possible for temperatures measured between sensors to differ by more than 0.4°C. The proportion of sensors with systematic bias > ±0.1°C (10.9%) confirms that ingestible temperature sensors require correction to ensure their accuracy. An individualized linear correction achieved a mean systematic bias of 0.00°C, and limits of agreement (95%) to 0.00–0.00°C, with 100% of sensors achieving ±0.1°C accuracy. Alternatively, a generalized linear function (Corrected Temperature (°C) = 1.00375 × Sensor Temperature (°C) − 0.205549), produced as the average slope and intercept of a sub-set of 51 sensors and excluding sensors with accuracy outside ±0.5°C, reduced the systematic bias to < ±0.1°C in 98.4% of the remaining sensors (n = 64). In conclusion, these data show that using an uncalibrated ingestible temperature sensor may provide inaccurate data that still appears to be statistically, physiologically, and clinically meaningful. Correction of sensor temperature to a reference thermometer by linear function eliminates this systematic bias (individualized functions) or ensures systematic bias is within ±0.1°C in 98% of the sensors (generalized function).