Physiological responses of firefighters and performance predictors during a simulated rescue of hospital patients

There is incomplete information about how physically demanding rescue work may be. The aim therefore of this paper was to examine the physiological responses of firefighters during a simulated rescue of hospital patients and to relate the firefighters' performance to their endurance, strength and working technique. Fourteen part-time male firefighters with a maximal oxygen uptake (VO(2max)) of 4.4 +/- 0.3 l/min (mean +/- SD) served as subjects in this study. First, each firefighter ascended six floors (a 20.5 m vertical ascent) carrying tools, wearing protective clothing and a breathing apparatus, an extra mass of 37 kg. He thereafter 'rescued' six persons by dragging each person on a fire-sheet on a flat floor. The technique used was recorded and the O(2) uptake and the heart rate were measured continuously during the whole operation. The blood lactate concentration and the subjective rating of perceived exertion were measured during and just after the rescue. The VO(2max) and the muscle strength were measured in the laboratory. The whole operation was carried out in the course of 5-9 min. The operation was a virtual all-out effort and the peak blood lactate concentration was 13 +/- 3 mmol/l. The peak oxygen uptake was 3.7 +/- 0.5 l/min (84% of the VO(2max)) during the operation. Large and heavy firefighters carried out the task faster than smaller ones. The VO(2max) in absolute terms and the dragging technique used were both related to the rescue performance. Rescuing patients at a hospital was physically very demanding and the time needed to complete the task depended on the VO(2max) in absolute values and the working technique used. A minimum VO(2max) of 4 l/min for firefighters was recommended.     

Adaptation of performance during a week of simulated night work

This study aimed to provide a comparative index of the performance impairment associated with the fatigue levels frequently experienced in workplaces that require night work. To do this, we equated fatigue-related impairment with the impairment resulting from varying levels of alcohol intoxication. Fifteen young individuals participated in two counterbalanced conditions which required them to (1) ‘work’ seven consecutive 8-h night shifts, and (2) consume an alcoholic beverage at hourly intervals until their blood alcohol concentration (BAC) reached 0.10%. In each condition, performance was measured at hourly intervals using a 10-min psychomotor vigilance task (PVT). Analysis indicated that as BAC increased, performance impairment significantly increased. Similarly, response times significantly increased during the first six simulated night-shifts, and lapse frequency significantly increased during the first two shifts. Equating the two conditions indicated that the first simulated night shift was associated with the greatest degree of performance impairment. In general, the impairment at the end of this shift was greater than that observed at a BAC of 0.10%. During the second and third simulated night shifts, the performance impairment was less than on the first night, but greater than that observed at a BAC of 0.05%. For the final four nights, the performance decrements generally did not exceed those observed at a BAC of 0.05%. This suggests that during a week of consecutive night shifts, adaptation of performance occurs.     

Cardiorespiratory responses of firefighters to a computerized fire strategies and tactics drill during physical activity

Firefighters are subjected to a combination of physical and mental challenges in the course of their occupational responsibilities. However, due to the ecological factors involved with firefighting, it makes it extremely difficult to examine physiological and psychological changes that occur as a result of these combined challenges. The purpose of this study was to examine the efficacy of a computer-based Fire Strategies and Tactics Drill (FSTD) in eliciting psychological and physiological measures of stress in professional firefighters. In one session, participants exercised at 60% VO_2max for 37 min (exercise alone condition, EAC), and in the other session the firefighter exercised for an equal amount of time and responded to the FSTD (dual challenge condition; DCC) while exercising. Cardiorespiratory (heart rate [HR], respiration rate [RR], minute ventilation [V_E], oxygen consumption [VO₂], ventilatory efficiency [V_E/VO₂], and respiratory exchange ratio [RER]) and psychometric measures (State Anxiety Inventory [SAI] and Ratings of Perceived Exertion [RPE]) were obtained throughout the experimental protocols. The NASA Task Load Index was used to assess perceived physical and mental load during each condition. The results demonstrated that the participants perceived overall workload to be higher in the DCC. Repeated measures ANOVAs revealed no differences between the EAC and DCC for VO₂ or RER, but the DCC did elicit significantly greater elevations in HR, RR, V_E, and V_E/VO₂ compared to the EAC. These results suggest that the FSTD utilized in this study provides an effective method for examining the physiological and psychological responses of firefighters in a research laboratory environment.     

Cardiovascular state changes during performance of a simulated ambulance dispatchers' task: Potential use for adaptive support

Adaptive support has the potential to keep the operator optimally motivated, involved, and able to perform a task. In order to use such support, the operator's state has to be determined from physiological parameters and task performance measures. In an environment where the task of an ambulance dispatcher was simulated, two studies have been carried out to evaluate the feasibility of using cardiovascular measures for adaptive support. During performance of this 2–3 h lasting planning task, a pattern of results is found that can be characterized by an initial increase of blood pressure and heart rate and a decrease of heart rate variability (defense reaction pattern) followed by an ongoing increase of blood pressure counteracted by a decrease in heart rate. This pattern can be explained by an augmented short-term blood pressure control (baroreflex), which is reflected in an increase of baroreflex sensitivity. Additionally, in this latter phase heart rate variability (HRV) increases as a function of time, while blood pressure variability decreases. In the two studies performed, the baroreflex pattern was consistent for all the relevant variables.In both studies there were periods with high and low workload. Effects of task load are mainly reflected in the variability measures, while in the second study, additionally, blood pressure level was higher during periods with high task demands.The conclusion of the studies is that consistent cardiovascular response patterns can be recognized during this semi-realistic planning task, where variability measures are most sensitive to task demand changes, while blood pressure and baroreflex sensitivity are most informative with respect to cardiovascular state changes. These findings can be seen as a great potential benefit for future use in adaptive support applications.     

Work content influences on cognitive task load,emotional state and performance during a simulated 520-days' Mars mission

In high-risk domains such as human space flight, cognitive performances can be negatively affected by emotional responses to events and conditions in their working environment (e.g., isolation and health incidents). The COgnitive Performance and Error (COPE) model distinguishes effects of work content on cognitive task load and emotional state, and their effect on the professional's performance. This paper examines the relationships between these variables for a simulated Mars-mission. Six volunteers (well-educated and -motivated men) were isolated for 520 days in a simulated spacecraft in which they had to execute a (virtual) mission to Mars. As part of this mission, every other week, several computer tasks were performed. These tasks consisted of a negotiation game, a chat-based learning activity and an entertainment game. Before and after these tasks, and after post-task questionnaires, the participants rated their emotional state consisting of arousal, valence and dominance, and their cognitive task load consisting of level of information processing, time occupied and task-set switches. Results revealed significant differences between cognitive task load and emotional state levels when work content varied. Significant regression models were also found that could explain variation in task performance. These findings contribute to the validation of the COPE model and suggest that differences in appraisals for tasks may bring about different emotional states and task performances.     

The utility of heart rate and minute ventilation as predictors of whole-body metabolic rate during occupational simulations involving load carriage

The utility of cardiac and ventilatory predictors of metabolic rate derived under temperate and heated laboratory conditions was evaluated during three fire-fighting simulations (70-mm hose drag, Hazmat recovery, bushfire hose drag; N = 16 per simulation). The limits of agreement for cardiac (temperate: ? 0.54 to 1.77; heated: ? 1.39 to 0.80 l min^? 1) and ventilatory surrogates (temperate: ? 0.19 to 1.27; heated: ? 0.26 to 1.16 l min^? 1) revealed an over-estimation of oxygen consumption that exceeded the acceptable limits required by occupational physiologists (N = 25; ± 0.24 l min^? 1). Although ventilatory predictions offered superior precision during low-intensity work (P < 0.05), a cardiac prediction was superior during more demanding work (P < 0.05). Deriving those equations under heated conditions failed to improve precision, with the exception of the cardiac surrogate during low-intensity work (P < 0.05). These observations imply that individualised prediction curves are necessary for valid estimations of metabolic demand in the field.     

Effects of tactile cueing on concurrent performance of military and robotics tasks in a simulated multitasking environment

This study examined the concurrent performance of military gunnery, robotics control and communication tasks in a simulated environment. More specifically, the study investigated how aided target recognition (AiTR) capabilities (delivered either through tactile or tactile + visual cueing) for the gunnery task might benefit overall performance. Results showed that AiTR benefited not only the gunnery task, but also the concurrent robotics and communication tasks. The participants' spatial ability was found to be a good indicator of their gunnery and robotics task performance. However, when AiTR was available to assist their gunnery task, those participants of lower spatial ability were able to perform their robotics tasks as well as those of higher spatial ability. Finally, participants' workload assessment was significantly higher when they teleoperated (i.e. remotely operated) a robot and when their gunnery task was unassisted. These results will further understanding of multitasking performance in military tasking environments. These results will also facilitate the implementation of robots in military settings and will provide useful data to military system designs.     

Reliability of physiological and subjective responses to physical and psychosocial exposures during a simulated manufacturing task

Responses to physical and psychosocial exposures can be measured using diverse methods, but their reliability, particularly under multiple exposures, is largely unknown. Five classes of methods were used to assess physiological and subjective responses among 24 participants to four combinations of physical and psychosocial exposures while performing two identical sessions of a simulated overhead manufacturing task. As an exploratory analysis, test–retest reliability was quantified using intraclass correlation coefficients (ICC) and coefficients of variation (CV). Discomfort ratings were reliable under less favorable exposures, and ratings of the psychosocial environment were most reliable under favorable social support. Workload ratings were most reliable with high physical exposure and favorable social support, and task performance was reliable overall. EMG and heart rate had relatively low reliability. Slightly less than half of the variables were considered reliable, but reliability depended on exposure conditions.Relevance to industry: The study provides information on the reliability of commonly used exposure measurement methods. The results can guide the selection of physiological and psychological work outcome measurements in future studies and work evaluations.     

Effects of setting up of humidifiers on thermal conditions and subjective responses of patients and staff in a hospital during winter

The purpose of this survey was to measure the thermal environment in a hospital during winter, and to investigate the subjective responses of patients and staff via a questionnaire. The air temperature and humidity in the sickrooms and nurse stations were measured for 3 months during winter. After 2 months, we introduced humidifiers into about half of the rooms and nurse stations as a method of improving the environment, and evaluated the effects of the installed humidifiers on the thermal conditions. In all, 36 patients and 45 staff members were asked once a week about subjective symptoms (dry and itchy skin, thirst, etc.). Before setting up the humidifiers, the existence of a low-humidity environment in the hospital during winter was confirmed, with the levels of relative humidity and humidity ratio reaching under 50% and 5g/kg DA, respectively, which is known to promote the spread of influenza viruses. However, the introduction of the humidifiers increased the relative humidity in sickrooms from 32.8% to 43.9% on average, and the air humidity in sickrooms thus almost reached the optimum range suggested by the Hospital Engineering Association of Japan (HEAJ). Additionally, complaints of thermal discomfort and dryness of air decreased among the staff, though not among the patients, after the humidifiers were installed. These results suggest that introducing humidifiers into a hospital during winter is an effective method of improving the low-humidity environment and relieving the discomfort of staff members.     

The effect of a passive trunk exoskeleton on metabolic costs during lifting and walking

The objective of this study was to assess how wearing a passive trunk exoskeleton affects metabolic costs, movement strategy and muscle activation during repetitive lifting and walking. We measured energy expenditure, kinematics and muscle activity in 11 healthy men during 5?min of repetitive lifting and 5?min of walking with and without exoskeleton. Wearing the exoskeleton during lifting, metabolic costs decreased as much as 17%. In conjunction, participants tended to move through a smaller range of motion, reducing mechanical work generation. Walking with the exoskeleton, metabolic costs increased up to 17%. Participants walked somewhat slower with shortened steps while abdominal muscle activity slightly increased when wearing the exoskeleton. Wearing an exoskeleton during lifting decreased metabolic costs and hence may reduce the development of fatigue and low back pain risk. During walking metabolic costs increased, stressing the need for a device that allows disengagement of support depending on activities performed.

Practitioner summary: Physiological strain is an important risk factor for low back pain. We observed that an exoskeleton reduced metabolic costs during lifting, but had an opposite effect while walking. Therefore, exoskeletons may be of benefit for lifting by decreasing physiological strain but should allow disengagement of support when switching between tasks.

Abbreviations: COM: centre of mass; EMG: electromyography; LBP: low back pain; MVC: maximum voluntary isometric contraction; NIOSH: National Institute for Occupational Safety and Health; PLAD: personal lift augmentation device; PWS: preferred walking speed without exoskeleton; PWSX: preferred walking speed with exoskeleton; ROM: range of motion; RER: respiratory exchange ratio; V ?O2max: maximum rate of oxygen consumption     

Evaluation of performance and load in simulated rescue tasks for a novel design SCBA: effect of weight,volume and weight distribution

A self-contained breathing apparatus (SCBA) with an innovative rucksack shape that provides a better distribution of its weight over the middle and lower parts of the back (device C: 6l, 13.7 kg) was compared with two conventional SCBA which differed from each other in volume and weight (A: 6l, 15 kg, B: 6.8l, 11.7 kg). Twelve fire-fighters (27-49 yr) performed three exercises while using the three SCBA in a systematically permuted sequence. The exercises consisted of simulated rescue work under natural climatic conditions in a dwelling on the second floor and several typical elements of severe fire-fighting actions. Duration, heart rate, breathing frequency, rectal temperature, and sweat loss were recorded. Perceived exertion was rated and the carrying features of the SCBA were subjectively evaluated. The exercise was executed faster with the rucksack device, heart rates were then lower and the carrying features were evaluated as better. Thus, the weight of the SCBA was shown to be less important than its distribution.     

The effects of a self-selected nap opportunity on the psychophysiological,performance and subjective measures during a simulated industrial night shift regimen

This study compared the effects of a 1 h self-selected recovery period to those of a standard night shift arrangement (with a total break time of 1-h) over a simulated three-day night shift schedule in a laboratory setting. Results showed that the inclusion of the flexible nap scheme resulted in higher performance output, improvements in physiological strain responses and reduced sleepiness during each night shift and generally over the three-night cycle. Certain variables also revealed the impact of napping compared with the standard rest break condition on the circadian rhythm. The sleep diary records show that the inclusion of the current intervention did not significantly reduce daytime recovery sleep. The results suggest that the potential benefits of flexible napping may outweigh the logistical effort it requires in a workplace environment.

Practitioner summary: Consensus on appropriate napping strategies for shift work remains a challenge. This simulated night shift laboratory study sought to determine the effects of a 1-h self-selected nap opportunity relative to a normal shift set-up. The nap improved performance and decreased sleepiness, without affecting daytime sleep.     

Effect of body-borne equipment on injury of military pilots and aircrew during a simulated helicopter crash

Military helicopter pilots are expected to wear a variety of items of body-borne equipment during flight so as to be prepared for any situation that may arise in combat. Helicopter seats are designed to a specified weight range for an occupant with equipment. This paper investigates how distributing the equipment on the body affects injury potential during a helicopter crash. A finite element model representing a helicopter seat with a fully deformable 50th percentile Hybrid III carrying equipment was developed. The model was subjected to a standard military certification crash test. Various equipment configurations were investigated and analysed to determine its influence on the risk of injury. It was found that placing the equipment low on the torso, i.e. near the thighs, not only reduces the likelihood of injury in the lumbar, spinal region but also provides favourable results in neck and head injury risk when compared to other configurations investigated. In contrast, placing equipment high on the torso, i.e. close to the chin, increases the lumbar load and implicitly, the risk of head injury. A statistical analysis is carried out using the Wilcoxon Signed Rank Test to deliver probability of loads experienced within a certain interval. This study recommends an equipment configuration that improves survivability for an occupant seated on a fixed load energy absorbing seat which is subjected to Military Standard 58095A Test 4.