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 O₂ 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.     

Effects of the self-contained breathing apparatus and fire protective clothing on maximal oxygen uptake

To examine the effects of firefighting personal protective ensemble (PPE) and self-contained breathing apparatus (SCBA) on exercise performance, 12 males completed two randomly ordered, graded exercise treadmill tests (GXT_PPE and GXT_PT). Maximal oxygen consumption (VO_2max) during GXT_PPE was 17.3% lower than the GXT_PT in regular exercise clothing (43.0 ± 5.7 vs. 52.4 ± 8.5 ml/kg per min, respectively). The lower VO_2max during the PPE condition was significantly related (r = 0.81, p < 0.05) to attenuated peak ventilation (142.8 ± 18.0 vs. 167.1 ± 15.6 l/min), which was attributed to a significant reduction in tidal volume (2.6 ± 10.4 vs. 3.2 ± 0.4 l). Breathing frequency at peak exercise was unchanged (55 ± 7 vs. 53 ± 7 breaths/min). The results of this investigation demonstrate that PPE and the SCBA have a negative impact on VO_2max. These factors must be considered when evaluating aerobic demands of fire suppression work and the fitness levels of firefighters.     

Oxygen uptake and muscle activity limitations during stepping on a stair machine at three different climbing speeds

Abstract

This laboratory study examined human stair ascending capacity and constraining factors including legs’ local muscle fatigue (LMF) and cardiorespiratory capacity. Twenty-five healthy volunteers, with mean age 35.3 years, maximal oxygen uptake (VO_2max) of 46.7?mL·min^?1·kg^?1 and maximal heart rate (HR) of 190 bpm, ascended on a stair machine at 60 and 75% (3?min each) and 90% of VO_2max (5?min or until exhaustion). The VO₂, maximal heart rate (HR_max) and electromyography (EMG) of the leg muscles were measured. The average VO_2highest reached 43.9?mL·min^?1·kg^?1, and HR_highest peaked at 185 bpm at 90% of VO_2max step rate (SR). EMG amplitudes significantly increased at all three levels, p?<?.05, and median frequencies decreased mostly at 90% of VO_2max SR evidencing leg LMF. Muscle activity interpretation squares were developed and effectively used to observe changes over time, confirming LMF. The combined effects of LMF and cardiorespiratory constraints reduced ascending tolerance and constrained the duration to 4.32?min.

Practitioner Summary: To expedite ascending evacuation from high-rise buildings and deep underground structures, it is necessary to consider human physical load. This study investigated the limiting physiological factors and muscle activity rate changes (MARC) used in the muscle activity interpretation squares (MAIS) to evaluate leg local muscle fatigue (LMF). LMF and cardiorespiratory capacity significantly constrain human stair ascending capacities at high, constant step rates.     

Effect of load position on physiological and perceptual responses during load carriage with an internal frame backpack

The purpose of this study was to determine the effect of load position in an internal frame backpack on physiological and perceptual variables. Ten female participants walked on a level treadmill for 10?min carrying 25% of their body weight in a high, central, or low position. The variables measured included oxygen consumption (VO₂), heart rate (HR), respiratory exchange ratio (R), respiratory rate (RR), minute ventilation (VE), and rating of perceived exertion (RPE). VO₂, VE, and RPE were significantly lower in the high position (18.6?±?2.3?ml/kg/min, 31.7?±?5.0?l/min, 2.8?±?0.8, respectively) compared to the low position (22.2?±?3.0?ml/kg/min, 38.6?±?7.5?l/min, 3.7?±?1.0, respectively). HR, R, and RR did not change significantly as the load was moved from the high (129.8?±?16.8, 0.89?±?0.06, 30.3?±?4.2, respectively) to the low position (136.0?±?25.3, 0.92?±?0.04, 33.8?±?5.2, respectively). The results of this study suggest that load placement is an important factor in the physiological and perceptual responses to load carriage, and that packing heavy items high in the backpack may be the most energy efficient method of carrying a load on the back.     

The physical and physiological workload of refuse collectors

In order to secure a safer and healthy work situation, the heavy physical loads imposed on 23 refuse collectors (aged 26-54) working in the city of Haarlem, in The Netherlands, were studied in a series of three experiments between 1984 and 1987. The aims were respectively (1) to study the load for workers collecting dustbins or polythene bags; (2) to introduce changes to reduce the load to avoid exceeding the overload criteria by individual refuse collectors; and (3) to investigate the effects of interventions to improve the efficiency of refuse collecting. The maximal isometric lifting force (F_max) and the maximal aerobic power( [Vdot]O_2max of 23 refuse collectors were measured in the laboratory. F_max was measured with an isometric dynamometer pulling with one arm from the floor; the mean value was 912 (± 127)N. VO_2max was measured running on a treadmill; the mean value was 43-3 (±0-8) ml O₂ per kg body mass per min. The physical load on the oxygen transport system was measured through work analysis and by a continuous registration of the heart rate over three working days. Criteria for overload were set at a mean external load of 20% Fm? and a mean energy expenditure of 30% VO_2max and an energy expenditure of 50% VO_2max or more for a maximum of 60 min per day. Replacement of dustbins by polythene bags resulted in a 70% increase in the total amount of refuse collected, an increase in throwing frequency, but a lower mean load per throw, and no significant differences in the mean heart rate over the working day. When polythene bags were used the mean values did not exceed the overload criteria, but 39% of the individual collectors did have a workload that was too high with respect to one of the criteria. In the last experiment the collectors were advised to reduce their work load by (a) lifting no more than two bags at a time; (b) reducing their walking pace; and (c) taking more breaks. Although compliance with the recommendations was good, and the weight lifted and the walking speed decreased, the physiological load remained the same. This may have been caused by a 15% increase in the total amount of refuse that had to be collected at that time.     

Metabolic demands of law enforcement personal protective equipment during exercise tasks

Many occupations require the use of personal protective equipment (PPE) but the added metabolic demands are unknown for certain professions. The purpose of this study was to quantify metabolic and perceptual differences between activity with and without the PPE ensemble required for police officers. Twelve participants were asked to complete experimental and control exercise sessions consisting of three modes of exercise (walking, jogging and stepping). A significant main effect (p < 0.01) for gear was found for heart rate (beats per minute) and VO₂ (L/min) between conditions. Dependent t-tests revealed significant differences for perceived effort, discomfort and session rating of perceived exertion between trials. Medium to large effect sizes for all variables with significant main effects between modes (p < 0.01, η² = 0.51–0.96, 1–β = 0.98–1.0, d = 0.42–2.7) were observed. These findings help to increase awareness of how PPE affects metabolic demands and perception of discomfort during exercise.     

Ergonomics diary

Physiological, perceptual and physical responses to a typical circuit weight-training (CWT) regimen were recorded in two studies. The aims were to assess the intensity of exercise during CWT; and to determine whether physical responses as evaluated by spinal shrinkage were related to physiological and perceptual responses to CWT. In the first study (n = 10) heart rate (HR), oxygen consumption (VO), ventilation (VE), blood lactate (La) and perceived exertion (RPE) were measured in response to CWT. Mean ( ± SD) time to complete three circuits of CWT was 17.8 (± 1-4) min. The HR max, VO₂max and peak La, measured first during an incremental treadmill test, were 195 (±13) beats.min ^?159-7 (±4-8) ml.kg^?1.min^?1 and 14-3 (±3-5) mM respectively. Mean HR and vO₂ during CWT were 69% and 50% of the respective maximal values. The HR-VO₂ ratio observed on the treadmill was elevated during CWT, with VO₂ being lowered relative to HR. Mean VE and La values were 52-7 (± 14-5) l.min^?1 and 6-9 ( ± 3-6) mM. The effect of the same CWT regimen on spinal loading as indicated by change in stature (shrinkage) was investigated in a second study (n = 8). The mean ( ± SD) time taken to complete the circuit was 17-4 ( ± 1-3) min. Mean shrinkage due to CWT (2-5 ± 1 -5?mm) was unrelated to the time taken to complete the circuits, to HR, RPE or to low back pain ratings (p > 0-05). Observations suggest that CWT as represented in these studies engages anaerobic as well as aerobic mechanisms but the exercise intensity may not provide sufficient stimulation for aerobic training. The physical load on the spine indicated by spinal shrinkage was not related to the physiological or perceptual strain.     

Increasing surfboard volume reduces energy expenditure during paddling

Abstract

The purpose of this study was to investigate how altering surfboard volume (BV) affects energy expenditure during paddling. Twenty surfers paddled in a swim flume on five surfboards in random order twice. All surfboards varied only in thickness and ranged in BV from 28.4 to 37.4 L. Measurements of heart rate (HR), oxygen consumption (VO₂), pitch angle, roll angle and paddling cadence were measured. VO₂ and HR significantly decreased on thicker boards [VO₂: r = ?0.984, p = 0.003; HR: r = ?0.972, p = 0.006]. There was also a significant decrease in pitch and roll angles on thicker boards [Pitch: r = ?0.995, p < 0.001; Roll: r = ?0.911, p = 0.031]. Results from this study suggest that increasing BV reduces the metabolic cost of paddling as a result of lower pitch and roll angles, thus providing mechanical evidence for increased paddling efficiency on surfboards with more volume.

Practioner Summary: This study investigated the impact of surfboard volume on energy expenditure during paddling. Results from this study suggest that increasing surfboard volume reduces the metabolic cost of paddling as a result of lower pitch and roll angles, thus providing mechanical evidence for increased paddling efficiency on surfboards with more volume.     

Muscular,cardiorespiratory and thermal strain of mast and pole workers

This field study evaluated the level of muscular, cardiorespiratory and thermal strain of mast and pole workers. We measured the muscular strain using electromyography (EMG), expressed as a percentage in relation to maximal EMG activity (%MEMG). Oxygen consumption (VO₂) was indirectly estimated from HR measured during work and expressed as a percentage of maximum VO₂ (%VO₂max). Skin and deep body temperatures were measured to quantify thermal strain. The highest average muscular strain was found in the wrist flexor (24 ± 1.5%MEMG) and extensor (21 ± 1.0%MEMG) muscles, exceeding the recommendation of 14%MEMG. Average cardiorespiratory strain was 48 ± 3%VO₂max. Nearly half (40%) of the participants exceeded the recommended 50%VO₂max level. The core body temperature varied between 36.8°C and 37.6°C and mean skin temperature between 28.6°C and 33.4°C indicating possible occasional superficial cooling. Both muscular and cardiorespiratory strain may pose a risk of local and systemic overloading and thus reduced work efficiency. Thermal strain remained at a tolerable level.     

Metabolic and cardiovascular responses to exercise with caffeine

The effect of caffeine on circulation and metabolism was studied during a discontinuous maximal oxygen uptake (VO₂ max) test on a bicycle ergometer. Eight male subjects were chosen for their minimal use of caffeine of which six normally did not ingest caffeinated beverages. Two caffeinated and two decaffeinated (control) trials were administered to each subject following double-blind and counterbalanced testing procedures. One hour before exercise, subjects ingested decaffeinated coffee with or without 350 mg of caffeine anhydrous added. Cardiac output (Q) was measured by a C0₂ rebreathing technique. Compared to control trials, caffeine increased the VO₂ max by an average of 140ml min?¹ (p <0-0·5)l. In addition, during caffeine trials, the average maximal heart rate (HR max) was elevated by 5 beats min^?1 (p<0·01). There were no other statistically significant changes in metabolic (VO₂ and R) and cardiovascular (Q, HR, SV and (a-v) 0₂ diff) variables during either submaximal or maximal exercise. Performance, as measured by total exercise time on the VO₂ max test, was not significantly different (p>0·05). It was concluded that caffeine has a small physiological but a statistically significant effect on VQ₂ max and HR max. During submaximal exercise, caffeine did not significantly effect the cardiovascular system.     

Reducing heat stress under thermal insulation in protective clothing: microclimate cooling by a ‘physiological’ method

Heat stress caused by protective clothing limits work time. Performance improvement of a microclimate cooling method that enhances evaporative and to a minor extent convective heat loss was tested. Ten male volunteers in protective overalls completed a work-rest schedule (130 min; treadmill: 3 × 30 min, 3 km/h, 5% incline) with or without an additional air-diffusing garment (climatic chamber: 25°C, 50% RH, 0.2 m/s wind). Heat loss was supported by ventilating the garment with dry air (600 l/min, ?5% RH, 25°C). Ventilation leads (M ± SD, n = 10, ventilated vs. non-ventilated) to substantial strain reduction (max. HR: 123 ± 12 b/min vs. 149 ± 24 b/min) by thermal relief (max. core temperature: 37.8 ± 0.3°C vs. 38.4 ± 0.4°C, max. mean skin temperature: 34.7 ± 0.8°C vs. 37.1 ± 0.3°C) and offers essential extensions in performance and work time under thermal insulation.     

Application of thermoregulatory modeling to predict core and skin temperatures in firefighters

The purpose of the study was to compare body temperature responses from subjects who exercised while wearing firefighter clothing to predictive data from a real-time thermoregulatory model that had been initially developed and validated for use in the military. Data from two firefighter studies, firefighter study 1 (FFS1: 7 males and 3 females, continuous treadmill exercise at 50% VO_2max, 25 °C, 50% RH) and firefighter study 2 (FFS2: 6 males, intermittent treadmill exercise at 75% VO_2max, 35 °C, 50% RH), were utilized for the thermoregulatory modeling and comparison. The results showed that prediction error (RMSD) of the model for core and skin temperatures was 0.33 and 0.65 °C in FFS1 and 0.39 and 0.86 °C in FFS2, respectively. While the real-time thermoregulatory model tested in the present study showed the potential for providing a means for reasonably accurate prediction of body temperature responses in firefighters, further development on the model's metabolism algorithms to include adjustments for protective clothing, options to facilitate external work, inclusions of cooling effects are suggested.Relevance to industryFirefighters exposed to thermal extremes experience physiological strain, but direct monitoring of physiological variables is not always practical. Thermoregulatory models can simulate the thermal responses reasonably accurately by applying known thermo-physiological mechanisms together with heat loss mechanisms related to clothing and environment in an effort to improve firefighter safety.     

Air management and physiological responses during simulated firefighting tasks in a high-rise structure

Air consumption, oxygen uptake (VO₂), carbon dioxide output (VCO₂) and respiratory exchange ratio (RER = VCO₂/VO₂) were measured directly from the self-contained breathing apparatus (SCBA) as 36 professional firefighters (three women) completed scenarios of high-rise stair climbing and fifth floor search and rescue. During stair climbing VO₂ was 75 ± 8% VO_2max (mean ± SD), RER = 1.10 ± 0.10, and heart rate = 91 ± 3% maximum (based on maximum treadmill data). Firefighters stopped climbing on consuming 55% of the air cylinder then descended. In the fifth floor search and rescue VO₂ was slightly lower than stair climbing but RER remained elevated (1.13 ± 0.12) reflecting high anaerobic metabolism. The first low air alarm sounded, indicating 25% of the air remaining in a “30-min cylinder”, during the stair climb at 8 min with 19 of 36 sounding before 12 min. Aggressive air management strategies are required for safety in high-rise firefighting.     

A comparison of two physical ability tests for firefighters

Smoke diving is physically demanding, and firefighters must therefore meet certain minimum physical requirements. The aim of this study was to compare the physiological demands of two fire fitness tests: a test of 8-min treadmill walking approved by the Norwegian Labour Inspection Authority (NLIA) (a laboratory test) and a Canadian test consisting of 10 firefighting specific tasks carried out in sequence (an applied field test). If the Canadian field test is as physically demanding as the NLIA-approved laboratory test, it may be suitable for testing Norwegian firefighters. Twenty-two male professional firefighters were tested on separate days. In both tests, the subjects wore a complete firefighting outfit including a breathing apparatus. The test durations were 8 min (NLIA test) versus approximately 6 min (Canadian test). Neither the peak O₂ uptake (VO₂) of approximately 45 ml kg ^? 1 min ^? 1 nor the blood lactate concentration (BLC) at test termination ( ≈ 9 mmol L ^? 1) differed between the two tests. Rating of perceived exertion (RPE_CR-10) was lower for the Canadian test than for the Norwegian test (5.2 ± 1.5 vs. 7.0 ± 2.0, respectively), and the exercise time at a high VO₂ was also shorter. In conclusion, the Canadian test appeared to be almost as physically demanding as the NLIA-approved test, having equal peak VO₂ and BLC, but shorter time at a high VO₂ and shorter duration. It might thus be a suitable alternative to the NLIA test with some modifications. The advantage of the Canadian field test is the inclusion of specific firefighting-like tasks that are not part of the NLIA test.     

Physiological responses of fire-fighter instructors during training exercises

Thirteen male instructors were monitored during a total of 44 live fire training exercises (ambient temperature 74?±?42°C). Exposure time during the ‘Hot Fire’ (HF), ‘Fire Behaviour’ and ‘Fire Attack’ exercises was 33.0?±?7.9?min (n?=?30); 26.3?±?5.5?min (n?=?6); and 7.3?±?2.6?min (n?=?8) respectively. At the end of the exercises, mean core temperature (t_core) was 38.5?±?0.9°C (n?=?32), however eight instructors had a t_core above 39°C. The mean maximum temperature under the fire hood was 41.2?±?4.6°C (n?=?40). Mean maximum heart rate (HR) was 138?±?26 bpm (n?=?34) however, in five exercises, HR exceeded 90% of the instructors' HR reserve. Mean fluid deficit was 0.62?±?0.6?l (n?=?30) at the end of the HF exercises, the maximum being 2.54?l. Four instructors doubted their ability to perform a rescue at the end of the exercise. The energy cost of performing simulated rescues of a 50?kg dummy in the cool was investigated in a pilot study. Mean HR during the rescues was 79?±?7% of the instructors' HR reserve and it was estimated that this could increase t_core by 0.4 to 0.6°C. The physiological responses to the fire-fighting exercises varied considerably and reflected the differences in work performed and external heat load. The results obtained from some individuals give cause for concern, and signs of heat strain were seen in at least two individuals.     

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.     

Optimization of load carriage at desert environment

The present study was undertaken to assess the effect of different magnitudes of load on physiological responses of soldiers in desert terrain and also to estimate an optimum load that can be carried comfortably at specific walking speed. Nine infantry male soldiers of SHAPE-I standard with age 25.22 ± 1.02 years, height 170.78 ± 0.95 cm and weight 66.56 ± 2.38 Kg volunteered in this study. All participants were marched at speed of 6.13 ± 0.40 Km h⁻¹ in desert terrain with 10.7 Kg (16.07% BW) and 21.4 Kg (32.15% BW) load and without load. Heart rate (HR), respiratory frequency (RF), oxygen consumption (VO₂), minute ventilation (VE), energy expenditure (EE) and relative work load (RWL) were recorded by using K4b² system. During carrying of 10.7 Kg load HR, VO₂, EE, RF, VE and RWL (%VO₂max) were increased 13.88, 18.20, 20.16, 7.86, 19.30 and 23.71% respectively in comparison to no load. Similarly, during 21.4 Kg load, physiological responses viz.; HR, VO₂, EE, RF, VE and RWL (%VO₂max) were increased 24.84, 36.98, 33.68, 21.24, 38.25 and 40.64% respectively in comparison to no load. The observation of this study stated that 6.27 Kg (9.42%BW, 50% RWL), 13.7 Kg (20.58%BW, 60%RWL) and 24.86 Kg (37.35%BW, 75% RWL) can be recommended for 8 h, 2 h and for 30 min respectively.Relevance to industryMost of the countries do not have their own database for load carriage in specific environmental conditions. Result of this study will be helpful to the similar kind of population working under specified conditions.     

Physiological strain of next generation combat uniforms with chemical and biological protection: importance of clothing vents

This study examined whether vents in the arms, legs and chest of new protective assault uniforms (PTAU) reduced heat strain at 35°C during a low dressed state (DS_low), and subsequently improved tolerance time (TT) after transitioning to DS_high compared with the battle dress uniform and overgarment (BDU+O). Small but significant reductions in rectal temperature (T _re), heart rate and vapour pressures over the thigh and shin were observed during DS_low with vents open (37.9 ± 0.2°C, 120 ± 10 b/min, 3.7 ± 0.4 and 3.5 ± 1.0 kPa) versus closed (38.0 ± 0.1°C, 127 ± 5 b/min, 4.3 ± 0.3 and 4.6 ± 0.5 kPa). During DS_high T _re was reduced and TT increased significantly with the PTAUs (1.1 ± 0.2°C/h and 46 ± 24 min) versus BDU+O (1.6 ± 0.2°C/h and 33 ± 16 min). The vents marginally reduced heat strain during DS_low and extended TT during DS_high compared with BDU+O.

Practitioner Summary: Clothing vents in chemical and biological protective uniforms can assist with heat transfer in situations where the uniforms must be worn for extended periods prior to exposure to a hazardous condition. Once the vents are closed, exposure time is increased and the increase in body temperature reduced.     

Hyperoxia improves maximal exercise with the self-contained breathing apparatus (SCBA)

The effects of hyperoxia on maximal exercise while breathing from a self-contained breathing apparatus (SCBA) were studied in 25 males. Each participant completed three graded exercise tests (GXT) for the assessment of maximal oxygen uptake (Vdot;O _2max): two with 20.95 ± 0.28% O₂ and the third (GXT₄₀) while breathing hyperoxia (40.64 ± 1.29% O₂). No significant differences were found between the two normoxic tests, except for a 16W increase in maximal power output (PO_max) in the second trial (GXT₂₁). Compared to GXT₂₁, hyperoxia significantly increased Vdot;O _2max and PO_max by 10.0 ± 3.8% and 10.2 ± 7.1%, respectively. This was likely due to an increase in O₂ delivery as suggested by the significantly higher oxyhemoglobin saturation. The increase in Vdot;O _2max with hyperoxia was similar to the increase in carbon dioxide production (9.3 ± 6.5%). No other significant differences were found at maximal exercise. However, at the intensity that elicited Vdot;O _2max in GXT₂₁, pulmonary ventilation and SCBA mask pressure were significantly lower during GXT₄₀, suggesting a decrease in the work of breathing. These findings could have significant implications for occupations that involve heavy work with SCBA.