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Coehoorn CJ, St Martin P, Teran J, Cowart H, Waite L, Newman S. Firefighter uncompensable heat stress results in excessive upper body temperatures measured by infrared thermography: Implications for cooling strategies. APPLIED ERGONOMICS 2024; 120:104342. [PMID: 38959633 DOI: 10.1016/j.apergo.2024.104342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 06/26/2024] [Accepted: 06/28/2024] [Indexed: 07/05/2024]
Abstract
This research sought to evaluate the thermal zones of the upper body and firefighter personal protective equipment (PPE) immediately following uncompensable heat stress (0.03 °C increase/min). We hypothesized that the frontal portion of the head and the inside of the firefighter helmet would be the hottest as measured by infrared thermography. This hypothesis was due to previous research demonstrating that the head accounts for ∼8-10% of the body surface area, but it accounts for ∼20% of the overall body heat dissipation during moderate exercise. Twenty participants performed a 21-min graded treadmill exercise protocol (Altered Modified Naughton) in an environmental chamber (35 °C, 50 % humidity) in firefighter PPE. The body areas analyzed were the frontal area of the head, chest, abdomen, arm, neck, upper back, and lower back. The areas of the PPE that were analyzed were the inside of the helmet and the jacket. The hottest areas of the body post-exercise were the frontal area of the head (mean: 37.3 ± 0.4 °C), chest (mean: 37.5 ± 0.3 °C), and upper back (mean: 37.3 ± 0.4 °C). The coldest area of the upper body was the abdomen (mean: 36.1 ± 0.4 °C). The peak temperature of the inside of the helmet increased (p < 0.001) by 9.8 °C from 27.7 ± 1.6 °C to 37.4 ± 0.7 °C, and the inside of the jacket increased (p < 0.001) by 7.3 °C from 29.2 ± 1.7 °C to 36.5 ± 0.4 °C. The results of this study are relevant for cooling strategies for firefighters.
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Affiliation(s)
| | | | | | | | - Landon Waite
- Louisiana State University Health Shreveport, USA
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2
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Maroli G, Rosati G, Suárez-García S, Bedmar-Romero D, Kobrin R, González-Laredo Á, Urban M, Alvárez-Diduk R, Ruiz-Molina D, Merkoçi A. Wearable, battery-free, wireless multiplexed printed sensors for heat stroke prevention with mussel-inspired bio-adhesive membranes. Biosens Bioelectron 2024; 260:116421. [PMID: 38838572 DOI: 10.1016/j.bios.2024.116421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 05/16/2024] [Accepted: 05/22/2024] [Indexed: 06/07/2024]
Abstract
Wearable technologies are becoming pervasive in our society, and their development continues to accelerate the untapped potential of continuous and ubiquitous sensing, coupled with big data analysis and interpretation, has only just begun to unfold. However, existing wearable devices are still bulky (mainly due to batteries and electronics) and have suboptimal skin contact. In this work, we propose a novel approach based on a sensor network produced through inkjet printing of nanofunctional inks onto a semipermeable substrate. This network enables real-time monitoring of critical physiological parameters, including temperature, humidity, and muscle contraction. Remarkably, our system operates under battery-free and wireless near-field communication (NFC) technology for data readout via smartphones. Moreover, two of the three sensors were integrated onto a naturally adhesive bioinspired membrane. This membrane, developed using an eco-friendly, high-throughput process, draws inspiration from the remarkable adhesive properties of mussel-inspired molecules. The resulting ultra-conformable membrane adheres effortlessly to the skin, ensuring reliable and continuous data collection. The urgency of effective monitoring systems cannot be overstated, especially in the context of rising heat stroke incidents attributed to climate change and high-risk occupations. Heat stroke manifests as elevated skin temperature, lack of sweating, and seizures. Swift intervention is crucial to prevent progression to coma or fatality. Therefore, our proposed system holds immense promise for the monitoring of these parameters on the field, benefiting both the general population and high-risk workers, such as firefighters.
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Affiliation(s)
- Gabriel Maroli
- Catalan Institute of Nanoscience and Nanotechnology, BIST, and CSIC, Edifici ICN2 Campus UAB, 08193, Bellaterra, Barcelona, Spain; Instituto de Investigaciones en Ingeniería Eléctrica Alfredo Desages (IIIE), Universidad Nacional del Sur - CONICET, Argentina
| | - Giulio Rosati
- Catalan Institute of Nanoscience and Nanotechnology, BIST, and CSIC, Edifici ICN2 Campus UAB, 08193, Bellaterra, Barcelona, Spain.
| | - Salvio Suárez-García
- Catalan Institute of Nanoscience and Nanotechnology, BIST, and CSIC, Edifici ICN2 Campus UAB, 08193, Bellaterra, Barcelona, Spain.
| | - Daniel Bedmar-Romero
- Catalan Institute of Nanoscience and Nanotechnology, BIST, and CSIC, Edifici ICN2 Campus UAB, 08193, Bellaterra, Barcelona, Spain
| | - Robert Kobrin
- Catalan Institute of Nanoscience and Nanotechnology, BIST, and CSIC, Edifici ICN2 Campus UAB, 08193, Bellaterra, Barcelona, Spain; Joint Department of Biomedical Engineering, NC State & UNC Chapel Hill, USA
| | - Álvaro González-Laredo
- Catalan Institute of Nanoscience and Nanotechnology, BIST, and CSIC, Edifici ICN2 Campus UAB, 08193, Bellaterra, Barcelona, Spain
| | - Massimo Urban
- Catalan Institute of Nanoscience and Nanotechnology, BIST, and CSIC, Edifici ICN2 Campus UAB, 08193, Bellaterra, Barcelona, Spain
| | - Ruslan Alvárez-Diduk
- Catalan Institute of Nanoscience and Nanotechnology, BIST, and CSIC, Edifici ICN2 Campus UAB, 08193, Bellaterra, Barcelona, Spain
| | - Daniel Ruiz-Molina
- Catalan Institute of Nanoscience and Nanotechnology, BIST, and CSIC, Edifici ICN2 Campus UAB, 08193, Bellaterra, Barcelona, Spain
| | - Arben Merkoçi
- Catalan Institute of Nanoscience and Nanotechnology, BIST, and CSIC, Edifici ICN2 Campus UAB, 08193, Bellaterra, Barcelona, Spain; Catalan Institution for Research and Advanced Studies (ICREA), Passeig de Lluís Companys, 23, Barcelona, 08010, Spain.
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Gibb K, Beckman S, Vergara XP, Heinzerling A, Harrison R. Extreme Heat and Occupational Health Risks. Annu Rev Public Health 2024; 45:315-335. [PMID: 38166501 DOI: 10.1146/annurev-publhealth-060222-034715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
Climate change poses a significant occupational health hazard. Rising temperatures and more frequent heat waves are expected to cause increasing heat-related morbidity and mortality for workers across the globe. Agricultural, construction, military, firefighting, mining, and manufacturing workers are at particularly high risk for heat-related illness (HRI). Various factors, including ambient temperatures, personal protective equipment, work arrangements, physical exertion, and work with heavy equipment may put workers at higher risk for HRI. While extreme heat will impact workers across the world, workers in low- and middle-income countries will be disproportionately affected. Tracking occupational HRI will be critical to informing prevention and mitigation strategies. Renewed investment in these strategies, including workplace heat prevention programs and regulatory standards for indoor and outdoor workers, will be needed. Additional research is needed to evaluate the effectiveness of interventions in order to successfully reduce the risk of HRI in the workplace.
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Affiliation(s)
- Kathryn Gibb
- Occupational Health Branch, California Department of Public Health, Richmond, California, USA;
| | - Stella Beckman
- Occupational Health Branch, California Department of Public Health, Richmond, California, USA;
| | | | - Amy Heinzerling
- Occupational Health Branch, California Department of Public Health, Richmond, California, USA;
| | - Robert Harrison
- Occupational Health Branch, California Department of Public Health, Richmond, California, USA;
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Vaidyanathan A, Gates A, Brown C, Prezzato E, Bernstein A. Heat-Related Emergency Department Visits - United States, May-September 2023. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2024; 73:324-329. [PMID: 38635484 PMCID: PMC11037437 DOI: 10.15585/mmwr.mm7315a1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
Unprecedented heat waves can affect all persons, but some are more sensitive to the effects of heat, including children and adults with underlying health conditions, pregnant women, and outdoor workers. Many regions of the United States experienced record-breaking high temperatures in 2023, with populations exposed to extremely high temperatures for prolonged periods. CDC examined emergency department (ED) visits associated with heat-related illness (HRI) from the National Syndromic Surveillance Program and compared daily HRI ED visit rates during the warm-season months (May-September) of 2023 with those during 2018-2022. In the 2023 warm-season months, daily HRI ED visit rates peaked in several regions and remained elevated for a prolonged duration. More males than females sought care in EDs for HRI, especially males aged 18-64 years. CDC issued multiple public health alerts using the Epidemic Information Exchange system to bring attention to increases in ED utilization for HRI. Deaths and illnesses associated with heat exposure are a continuing public health concern as climate change results in longer, hotter, and more frequent episodes of extreme heat. Near real-time monitoring of weather conditions and adverse health outcomes can guide public health practitioners' timing of risk communication and implementation of prevention measures associated with extreme heat.
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Agostinelli PJ, Linder BA, Frick KA, Bordonie NC, Neal FK, Sefton JM. Validity of heart rate derived core temperature estimation during simulated firefighting tasks. Sci Rep 2023; 13:22503. [PMID: 38110650 PMCID: PMC10728086 DOI: 10.1038/s41598-023-49929-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 12/13/2023] [Indexed: 12/20/2023] Open
Abstract
Rectal core temperature monitoring can help fire services mitigate heat injury but can be invasive and impractical. EQ02 + LifeMonitor provides a non-invasive estimation of core temperature. Therefore, the primary purpose of this study was to determine the validity of the EQ02 + LifeMonitor compared to the gold standard rectal thermometer core temperature assessment, as well as the potential influence of turnout gear on the estimated and physiological strain experienced during these activities. Thirteen participants completed simulated firefighting tasks with and without turnout gear, involving four rounds of a 5-min walk on a treadmill at 2.8 mph/2.5% grade and 20 deadlifts over 5 min in an environmental chamber set to 40.6 °C; 50% humidity. During each trial participants wore both an EQ02 + LifeMonitor and DataTherm II rectal thermometer. The results from the devices were statistically equivalent (p < 0.001), yet there was a statistically significant difference in the value (~ 0.1 °C; p < 0.001). There was a significant effect of devices [p < 0.001] and time [p < 0.001], but no interaction effect [p = 0.70] on core temperature drift. Estimated core temperature was marginally different from that measured via the DataTherm II. The EQ02 on average overestimated core temperature. Heart rate, rating of perceived exertion, and area under the curve of core temperature were significantly elevated due to turnout gear [ps < 0.025], but not core temperature skin temperature, or ventilatory rate [ps > 0.372]. These results suggest the EQ02 + LifeMonitor may be a viable, non-invasive alternative for assessing core temperature compared to rectal temperature monitoring, especially during rigorous, intermittent activities. Turnout gear does however increase heart rate, cumulative core temperature, and perceived exertion. Additionally, the validity of the estimated core temperature is not impacted by the use turnout gear. This is likely due to significant changes in heart rate, which allowed the heart-rate derived estimate of core temperature to remain consistent with changes in DataTherm II rectal temperatures.
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Affiliation(s)
- Philip J Agostinelli
- Warrior Research Center, School of Kinesiology, Auburn University, 301 Wire Road, Auburn, AL, 38632, USA
| | - Braxton A Linder
- Neurovascular Physiology Lab, School of Kinesiology, Auburn University, 301 Wire Road, Auburn, AL, USA
| | - Katherine A Frick
- Warrior Research Center, School of Kinesiology, Auburn University, 301 Wire Road, Auburn, AL, 38632, USA
| | - Nicholas C Bordonie
- Warrior Research Center, School of Kinesiology, Auburn University, 301 Wire Road, Auburn, AL, 38632, USA
| | - Frances K Neal
- Warrior Research Center, School of Kinesiology, Auburn University, 301 Wire Road, Auburn, AL, 38632, USA
| | - JoEllen M Sefton
- Warrior Research Center, School of Kinesiology, Auburn University, 301 Wire Road, Auburn, AL, 38632, USA.
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Lu H, Aratake S, Naito H, Nogawa M, Nemoto T, Togawa T, Tanaka S. Development of a Core Body Thermometer Applicable for High-Temperature Environment Based on the Zero-Heat-Flux Method. SENSORS (BASEL, SWITZERLAND) 2023; 23:1970. [PMID: 36850568 PMCID: PMC9959565 DOI: 10.3390/s23041970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/04/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
Monitoring core body temperature (CBT) allows observation of heat stress and thermal comfort in various environments. By introducing a Peltier element, we improved the zero-heat-flux core body thermometer for hot environments. In this study, we performed a theoretical analysis, designed a prototype probe, and evaluated its performance through simulator experiments with human subjects. The finite element analysis shows that our design can reduce the influence of external temperature variations by as much as 1%. In the simulator experiment, the prototype probe could measure deep temperatures within an error of less than 0.1 °C, regardless of outside temperature change. In the ergometer experiment with four subjects, the average difference between the prototype probe and a commercial zero-heat-flux probe was +0.1 °C, with a 95% LOA of -0.23 °C to +0.21 °C. In the dome sauna test, the results measured in six of the seven subjects exhibited the same trend as the reference temperature. These results show that the newly developed probe with the Peltier module can measure CBT accurately, even when the ambient temperature is higher than CBT up to 42 °C.
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Affiliation(s)
- Hanzi Lu
- Graduate School of Natural Science & Technology, Kanazawa University, Kanazawa 920-1164, Japan
| | - Shun Aratake
- Graduate School of Natural Science & Technology, Kanazawa University, Kanazawa 920-1164, Japan
| | - Hisashi Naito
- Institute of Science and Engineering, Kanazawa University, Kanazawa 920-1164, Japan
| | - Masamichi Nogawa
- Faculty of Health Sciences, Komatsu University, Komatsu 923-0961, Japan
| | - Tetsu Nemoto
- Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-0942, Japan
| | - Tatsuo Togawa
- Advanced Research Center for Human Sciences, Waseda University, Tokorozawa 359-1192, Japan
| | - Shinobu Tanaka
- Institute of Science and Engineering, Kanazawa University, Kanazawa 920-1164, Japan
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Kuklane K, Eggeling J, Kemmeren M, Heus R. A Database of Static Thermal Insulation and Evaporative Resistance Values of Dutch Firefighter Clothing Items and Ensembles. BIOLOGY 2022; 11:biology11121813. [PMID: 36552322 PMCID: PMC9775573 DOI: 10.3390/biology11121813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/02/2022] [Accepted: 12/06/2022] [Indexed: 12/15/2022]
Abstract
The rescue operations' environment can impair firefighters' performance and increase the risk of injuries, e.g., burns and hyperthermia. The bulk and carried weight of heavy protection contributes to lower physical performance, higher metabolic load and internal body heat production. For recommending optimal protection for the tasks and incident scenarios, knowledge of clothing thermal properties is needed. However, detailed data on firefighter protective clothing systems are not available. The aim of the study was to provide scientific background and a dataset that would allow for validation of thermo-physiological models for task-specific conditions of rescue work. Thermal insulation of 37 single items and their variations and 25 realistic protective clothing ensembles were measured on a thermal manikin. Twelve (12) ensembles that evenly covered the whole insulation range were selected for evaporative resistance testing. The equations for summing up individual item's insulation to ensemble insulation and calculating clothing area factor were derived from the dataset. The database of a firefighter clothing system was created. In addition, the local and regional thermal properties of the clothing ensembles were provided for use in future validation of advanced thermo-physiological models for rescue worker exposure predictions and for designing decision aid tools.
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Affiliation(s)
- Kalev Kuklane
- Team Fire Service Science, Netherlands Academy of Crisis Management and Fire Service Science, Netherlands Institute for Public Safety, Zilverstraat 91, 2718 RP Zoetermeer, The Netherlands
| | - Jakob Eggeling
- Division of Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, Box 118, 22100 Lund, Sweden
| | - Maurice Kemmeren
- Team COLS, Netherlands Institute for Public Safety, Zilverstraat 91, 2718 RP Zoetermeer, The Netherlands
| | - Ronald Heus
- Team Fire Service Science, Netherlands Academy of Crisis Management and Fire Service Science, Netherlands Institute for Public Safety, Zilverstraat 91, 2718 RP Zoetermeer, The Netherlands
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Carballo-Leyenda B, Villa-Vicente JG, Delogu GM, Rodríguez-Marroyo JA, Molina-Terrén DM. Perceptions of Heat Stress, Heat Strain and Mitigation Practices in Wildfire Suppression across Southern Europe and Latin America. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12288. [PMID: 36231589 PMCID: PMC9566145 DOI: 10.3390/ijerph191912288] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/20/2022] [Accepted: 09/23/2022] [Indexed: 06/16/2023]
Abstract
This study aimed to assess current perceptions of heat stress, heat strain, acclimatisation and recovery practices in wildland fire suppression. A total of 1459 wildfire and structural firefighters, all involved in wildland fire suppression, completed an 18-question survey. Most participants (81.3%) reported heat strain as one of the main risks faced during wildland firefighting. Thermal strain is considered an important risk for health and safety in wildland firefighting. The best-valued heat strain mitigation strategies were those traditionally recommended in wildland fire suppression: (i) an adequate work/rest ratio (79.0%), (ii) acclimatisation (71.6%), (iii) enhancing body ventilation by opening protective clothing or removing helmets or gloves (63.5%), and (iv) drinking water and food supplementation (52.1%). Despite these results, only 22% of the participants reported carrying out acclimatisation in the workplace. The vast majority of the respondents (87.4%) consider active cooling strategies (i.e., ice slurry ingestion, ice vests, etc.) impractical in combating heat strain during wildfire suppression. We identified a gap between knowledge about heat strain, its mitigation strategies and the level of actual implementation of these practices in the workplace. Our results highlight the need to improve heat strain management and implement operational directives for acclimatisation and active cooling interventions.
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Affiliation(s)
- Belén Carballo-Leyenda
- VALFIS Research Group, Department of Physical Education and Sports Sciences, Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain
| | - José Gerardo Villa-Vicente
- VALFIS Research Group, Department of Physical Education and Sports Sciences, Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain
| | - Giuseppe M. Delogu
- Department of Science for Nature and Environmental Resources (DipNeT), University of Sassari, Sardinia, 07100 Sassari, Italy
| | - Jose A. Rodríguez-Marroyo
- VALFIS Research Group, Department of Physical Education and Sports Sciences, Institute of Biomedicine (IBIOMED), University of León, 24071 León, Spain
| | - Domingo M. Molina-Terrén
- Department of Crops and Forest Sciences, School of Agrifood and Forestry Science and Engineering, University of Lleida, 25198 Lleida, Spain
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Viera E, Kaschel H, Valencia C. Heart Rate Variability Control Using a Biofeedback and Wearable System. SENSORS (BASEL, SWITZERLAND) 2022; 22:7153. [PMID: 36236257 PMCID: PMC9572135 DOI: 10.3390/s22197153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 06/16/2023]
Abstract
Heart rate variability is an important physiological parameter in medicine. This parameter is used as an indicator of physiological and psychological well-being and even of certain pathologies. Research on biofeedback integrates the fields of biological application (physiological behavior), system modeling, and automated control. This study proposes a new method for modeling and controlling heart rate variability as heart rate acceleration, a model expressed in the frequency domain. The model is obtained from excitation and response signals from heart rate variability, which through the instrumental variables method and the minimization of a cost function delivers a transfer function that represents the physiological phenomenon. This study also proposes the design of an adaptive controller using the reference model. The controller controls heart rate variability based on the light actuators designed here, generating a conditioned reflex that allows individuals to self-regulate their state through biofeedback, synchronizing this action to homeostasis. Modeling is conducted in a target population of middle-aged men who work as firefighters and forest firefighters. This study validates the proposed model, as well as the design of the controllers and actuators, through a simple experiment based on indoor cycling. This experiment has different segments, namely leaving inertia, non-controlled segment, and actively controlled segment.
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Kim DH, Kim S, Lee JY. An empirical investigation of firefighting personal protective equipment and burn injuries in Korea. INDUSTRIAL HEALTH 2022; 60:2-15. [PMID: 34615835 PMCID: PMC8826033 DOI: 10.2486/indhealth.2021-0068] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 05/20/2021] [Indexed: 06/13/2023]
Abstract
This study aimed to investigate the current situation of firefighting burn injuries and personal protective equipment (PPE) in Korea using a questionnaire. A questionnaire was constructed and then distributed to fire stations via the Fire & Disaster Headquarters of Korea. Responses from a total of 536 firefighters who were currently responsible for suppressing fire or doing rescue work were analysed (39.2 ± 8.58 y in age, 173.8 ± 5.0 cm in height, 73.4 ± 8.9 kg in body weight). The results showed that 22% of firefighters had experienced burns but of these 93% of were burns of less than 1% of total body surface area. The most common body site of burn injury was the hands (37%) and the head (face and neck) (34%). There were significant relationships between PPE non-compliance and career years, especially for the hood and boots. According to firefighters their gloves were the most vulnerable part of their PPE. We also elucidated relationships between the body sites most vulnerable to burn injuries and PPE wear compliance by item. The present results suggest that officially-undisclosed minor burn injuries but prevailing among firefighters can be reduced through improving firefighters' protective helmet, hoods and gloves.
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Affiliation(s)
- Do-Hee Kim
- Research Institute for Human Ecology, Seoul National University, Republic of Korea
| | - Siyeon Kim
- Reliability Assessment Center, FITI Testing & Research Institute, Republic of Korea
| | - Joo-Young Lee
- Research Institute for Human Ecology, Seoul National University, Republic of Korea
- Department of Textiles, Merchandising and Fashion Design, Seoul National University, Republic of Korea
- Graphene Research Center for Convergence Technology, Advanced Institute of Convergence Technology, Republic of Korea
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Fullagar HHK, Schwarz E, Richardson A, Notley SR, Lu D, Duffield R. Australian firefighters perceptions of heat stress, fatigue and recovery practices during fire-fighting tasks in extreme environments. APPLIED ERGONOMICS 2021; 95:103449. [PMID: 34015663 DOI: 10.1016/j.apergo.2021.103449] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/21/2021] [Accepted: 04/19/2021] [Indexed: 06/12/2023]
Abstract
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.
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Affiliation(s)
- Hugh H K Fullagar
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Australia.
| | - Edgar Schwarz
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Australia; Institute of Sports and Preventive Medicine, Saarland University, Campus, Geb. B8 2, 66123, Saarbrücken, Germany. https://twitter.com/edgarschwarz
| | | | - Sean R Notley
- Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Canada. https://twitter.com/seannotley
| | - Donna Lu
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Australia
| | - Rob Duffield
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Australia
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Morrissey MC, Casa DJ, Brewer GJ, Adams WM, Hosokawa Y, Benjamin CL, Grundstein AJ, Hostler D, McDermott BP, McQuerry ML, Stearns RL, Filep EM, DeGroot DW, Fulcher J, Flouris AD, Huggins RA, Jacklitsch BL, Jardine JF, Lopez RM, McCarthy RB, Pitisladis Y, Pryor RR, Schlader ZJ, Smith CJ, Smith DL, Spector JT, Vanos JK, Williams WJ, Vargas NT, Yeargin SW. Heat Safety in the Workplace: Modified Delphi Consensus to Establish Strategies and Resources to Protect the US Workers. GEOHEALTH 2021; 5:e2021GH000443. [PMID: 34471788 PMCID: PMC8388206 DOI: 10.1029/2021gh000443] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/08/2021] [Accepted: 06/11/2021] [Indexed: 06/04/2023]
Abstract
The purpose of this consensus document was to develop feasible, evidence-based occupational heat safety recommendations to protect the US workers that experience heat stress. Heat safety recommendations were created to protect worker health and to avoid productivity losses associated with occupational heat stress. Recommendations were tailored to be utilized by safety managers, industrial hygienists, and the employers who bear responsibility for implementing heat safety plans. An interdisciplinary roundtable comprised of 51 experts was assembled to create a narrative review summarizing current data and gaps in knowledge within eight heat safety topics: (a) heat hygiene, (b) hydration, (c) heat acclimatization, (d) environmental monitoring, (e) physiological monitoring, (f) body cooling, (g) textiles and personal protective gear, and (h) emergency action plan implementation. The consensus-based recommendations for each topic were created using the Delphi method and evaluated based on scientific evidence, feasibility, and clarity. The current document presents 40 occupational heat safety recommendations across all eight topics. Establishing these recommendations will help organizations and employers create effective heat safety plans for their workplaces, address factors that limit the implementation of heat safety best-practices and protect worker health and productivity.
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Affiliation(s)
- Margaret C. Morrissey
- Department of KinesiologyKorey Stringer InstituteUniversity of ConnecticutMansfieldCTUSA
| | - Douglas J. Casa
- Department of KinesiologyKorey Stringer InstituteUniversity of ConnecticutMansfieldCTUSA
| | - Gabrielle J. Brewer
- Department of KinesiologyKorey Stringer InstituteUniversity of ConnecticutMansfieldCTUSA
| | - William M. Adams
- Department of KinesiologyUniversity of North Carolina at GreensboroGreensboroNCUSA
| | - Yuri Hosokawa
- Faculty of Sports SciencesWaseda UniversitySaitamaJapan
| | | | | | - David Hostler
- Department of Exercise and Nutrition SciencesCenter for Research and Education in Special EnvironmentsBuffaloNYUSA
| | - Brendon P. McDermott
- Department of Health, Human Performance and RecreationUniversity of ArkansasFayettevilleARUSA
| | | | - Rebecca L. Stearns
- Department of KinesiologyKorey Stringer InstituteUniversity of ConnecticutMansfieldCTUSA
| | - Erica M. Filep
- Department of KinesiologyKorey Stringer InstituteUniversity of ConnecticutMansfieldCTUSA
| | - David W. DeGroot
- Fort Benning Heat CenterMartin Army Community HospitalFort BenningGAUSA
| | | | - Andreas D. Flouris
- Department of Exercise ScienceFAME LaboratoryUniversity of ThessalyTrikalaGreece
| | - Robert A. Huggins
- Department of KinesiologyKorey Stringer InstituteUniversity of ConnecticutMansfieldCTUSA
| | | | - John F. Jardine
- Department of KinesiologyKorey Stringer InstituteUniversity of ConnecticutMansfieldCTUSA
| | - Rebecca M. Lopez
- School of Physical Therapy & Rehabilitation SciencesMorsani College of MedicineUniversity of South FloridaTampaFLUSA
| | | | - Yannis Pitisladis
- Collaborating Centre of Sports MedicineUniversity of BrightonBrightonUK
| | - Riana R. Pryor
- Department of Exercise and Nutrition SciencesCenter for Research and Education in Special EnvironmentsBuffaloNYUSA
| | - Zachary J. Schlader
- Department of KinesiologySchool of Public HealthIndiana UniversityBloomingtonIAUSA
| | - Caroline J. Smith
- Department of Health and Exercise ScienceAppalachian State UniversityBooneNCUSA
| | - Denise L. Smith
- Department of Health and Human Physiological SciencesFirst Responder Health and Safety LaboratorySkidmore CollegeSaratoga SpringsNYUSA
| | - June T. Spector
- Department of Environmental and Occupational Health SciencesSchool of Public HealthUniversity of WashingtonSeattleWAUSA
| | | | - W. Jon Williams
- Centers for Disease Control and Prevention (CDC)National Personal Protective Technology Laboratory (NPPTL)National Institute for Occupational Safety and Health (NIOSH)PittsburghPAUSA
| | - Nicole T. Vargas
- Faculty of Health SciencesUniversity of SydneySydneyNSWAustralia
| | - Susan W. Yeargin
- Department of Exercise ScienceArnold School of Public HealthUniversity of South CarolinaColumbiaSCUSA
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13
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Taylor NAS, Lee JY, Kim S, Notley SR. Physiological interactions with personal-protective clothing, physically demanding work and global warming: An Asia-Pacific perspective. J Therm Biol 2021; 97:102858. [PMID: 33863427 DOI: 10.1016/j.jtherbio.2021.102858] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/07/2021] [Accepted: 01/13/2021] [Indexed: 01/03/2023]
Abstract
The Asia-Pacific contains over half of the world's population, 21 countries have a Gross Domestic Product <25% of the world's largest economy, many countries have tropical climates and all suffer the impact of global warming. That 'perfect storm' exacerbates the risk of occupational heat illness, yet first responders must perform physically demanding work wearing personal-protective clothing and equipment. Unfortunately, the Eurocentric emphasis of past research has sometimes reduced its applicability to other ethnic groups. To redress that imbalance, relevant contemporary research has been reviewed, to which has been added information applicable to people of Asian, Melanesian and Polynesian ancestry. An epidemiological triad is used to identify the causal agents and host factors of work intolerance within hot-humid climates, commencing with the size dependency of resting metabolism and heat production accompanying load carriage, followed by a progression from the impact of single-layered clothing through to encapsulating ensembles. A morphological hypothesis is presented to account for inter-individual differences in heat production and heat loss, which seems to explain apparent ethnic- and gender-related differences in thermoregulation, at least within thermally compensable states. The mechanisms underlying work intolerance, cardiovascular insufficiency and heat illness are reviewed, along with epidemiological data from the Asia-Pacific. Finally, evidence-based preventative and treatment strategies are presented and updated concerning moisture-management fabrics and barriers, dehydration, pre- and post-exercise cooling, and heat adaptation. An extensive reference list is provided, with >25 recommendations enabling physiologists, occupational health specialists, policy makers, purchasing officers and manufacturers to rapidly extract interpretative outcomes pertinent to the Asia-Pacific.
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Affiliation(s)
- Nigel A S Taylor
- Research Institute of Human Ecology, College of Human Ecology, Seoul National University, Seoul, Republic of Korea.
| | - Joo-Young Lee
- Research Institute of Human Ecology, College of Human Ecology, Seoul National University, Seoul, Republic of Korea
| | - Siyeon Kim
- Human Convergence Technology R&D Department, Korea Institute of Industrial Technology, Ansan, Republic of Korea
| | - Sean R Notley
- School of Human Kinetics, University of Ottawa, Ottawa, Canada
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14
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Williams A, McDonogh‐Wong L, Spengler JD. The Influence of Extreme Heat on Police and Fire Department Services in 23 U.S. Cities. GEOHEALTH 2020; 4:e2020GH000282. [PMID: 33204929 PMCID: PMC7648134 DOI: 10.1029/2020gh000282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/11/2020] [Accepted: 08/12/2020] [Indexed: 06/11/2023]
Abstract
Recent research suggests that extreme heat affects the demand for emergency services, including police and fire department incidents. Yet there is limited understanding of impacts across U.S. cities, with varying population sizes, and between different climates. This study sought to examine the daily utilization of police and fire department services, during hot days in 23 U.S. cities representing six climate zones using relative risk (RR) and time series analyses of daily police and fire department incidents. The warm season analyses utilized three temperature metrics: daily maximum temperature (TMAX), daily maximum heat index (HIMAX), and the preceding daily minimum temperature (TMIN). Across these cities, the RR of police department incidents on days where TMAX was at or above the 95th percentile significantly increased within a range from 3% (95% confidence interval [CI]: 0.3%, 6.3%) to 57% (95% CI: 24.5%, 89.7%), compared with a nonhot day. At the same temperature thresholds, the RR of fire department dispatches increased from 6% (95% CI: 3.0%, 8.6%) to 18% (95% CI: 15.2%, 21.6%). These results remained consistent across temperature metrics and consecutive days of extreme heat. The estimated effects of daily maximum temperature, daily maximum heat index, and daily minimum temperature were nonlinear for police and fire department incidents across all cities. These findings inform climate change adaptation strategies, preparing budgets and personnel for emergency agencies to ensure resilience as periods of extreme heat increase in frequency, severity, and duration.
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Affiliation(s)
- Augusta Williams
- Department of Environmental HealthHarvard T.H. Chan School of Public HealthBostonMAUSA
- Center for Climate, Health, and the Global EnvironmentHarvard T.H. Chan School of Public HealthBostonMAUSA
| | - Larissa McDonogh‐Wong
- Department of Environmental HealthHarvard T.H. Chan School of Public HealthBostonMAUSA
- Center for Climate, Health, and the Global EnvironmentHarvard T.H. Chan School of Public HealthBostonMAUSA
| | - John D. Spengler
- Department of Environmental HealthHarvard T.H. Chan School of Public HealthBostonMAUSA
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15
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Safety and Efficacy of CarbonCool Half-Body Vest for HAZMAT Decontamination Crews Wearing Personal Protective Equipment: A Pilot Study. Prehosp Disaster Med 2020; 35:645-650. [PMID: 32928328 DOI: 10.1017/s1049023x20001144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Personal protective equipment (PPE) are essential for medical personnel responding to hazardous materials (HAZMAT) incidents. However, their impermeable design causes increased physiological strain and reduced thermoregulation, limiting work times and causing heat-related illnesses (HRI). Use of wearable cooling devices slow heat accumulation and have been shown to reduce thermal and cardiovascular strain in such situations. METHODS This was a prospective clinical evaluation to determine the tolerability and effectiveness of the CarbonCool cooling system - a half-body cooling vest - in participants undergoing a HAZMAT decontamination recertification. Physiological measurements (heart rate [HR], weight, temperature, and blood pressure) and participant feedback were obtained. The main outcome of interest was participants' tolerability of the cooling vest. RESULTS A total of 23 healthy participants were recruited, with 10 randomized to the intervention group and 13 in the control group. Mean age in the control and intervention group was 35.5 years old (SD = 7.8) and 30.0 years old (SD = 6.2), respectively. Qualitative feedback obtained from participants regarding safety, mobility, and cooling efficacy was largely positive. Difference of before-after temperature and HR was 0.3°C (SD = 0.8) and 11.5bpm (SD = 13.6) in the control group compared to 0.0°C (SD = 0.5) and 0.0bpm (SD = 6.4) for the intervention group. CONCLUSION This clinical evaluation showed that the CarbonCool cooling vest is safe and tolerable in participants wearing PPE. Further trials with sample size powered to detect physiological outcomes are needed to assess the effect of the cooling vest on a subject's endurance to heat stress.
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