Skin sites to predict deep-body temperature while wearing firefighters’ personal protective equipment during periodical changes in air temperature

The aim of this study was to investigate stable and valid measurement sites of skin temperatures as a non-invasive variable to predict deep-body temperature while wearing firefighters’ personal protective equipment (PPE) during air temperature changes. Eight male firefighters participated in an experiment which consisted of 60-min exercise and 10-min recovery while wearing PPE without self-contained breathing apparatus (7.75 kg in total PPE mass). Air temperature was periodically fluctuated from 29.5 to 35.5 °C with an amplitude of 6 °C. Rectal temperature was chosen as a deep-body temperature, and 12 skin temperatures were recorded. The results showed that the forehead and chest were identified as the most valid sites to predict rectal temperature (R² = 0.826 and 0.824, respectively) in an environment with periodically fluctuated air temperatures. This study suggests that particular skin temperatures are valid as a non-invasive variable when predicting rectal temperature of an individual wearing PPE in changing ambient temperatures.

Practitioner Summary: This study should offer assistance for developing a more reliable indirect indicating system of individual heat strain for firefighters in real time, which can be used practically as a precaution of firefighters’ heat-related illness and utilised along with physiological monitoring.     

The hybrid personal cooling system (PCS) could effectively reduce the heat strain while exercising in a hot and moderate humid environment

This study aimed to examine the effectiveness of a hybrid personal cooling system (PCS) in mitigating body heat stain while exercising in a hot environment. Eight subjects underwent two trials: PCS and CON (i.e. no cooling). All trials were conducted at an air temperature of 36 ± 0.5 °C and RH = 59 ± 5%. The key findings demonstrated that the PCS could significantly reduce the core temperature, mean skin temperature, heart rate and physiological strain index during both exercise and recovery periods (p < 0.05). Subjective perceptions were also significantly alleviated in PCS at the end of the exercise and during the recovery (p < 0.05). Besides, the PCS could also bring remarkable benefits in lowering local skin temperatures and in improving perceptual sensations in both upper and lower body during both exercise and recovery periods (p < 0.05). It was thus concluded that the hybrid PCS is effective in mitigating body heat strain while exercising in a hot environment.

Practitioner Summary: In hot and humid environments, body heat dissipation through sweating is greatly restricted. Our newly developed hybrid PCS could effectively alleviate heat strain while exercising in hot environments. The findings contribute to the body of knowledge in improving the health and well-being of sportsmen while exercising in hot environments.     

Thermal response to firefighting activities in residential structure fires: impact of job assignment and suppression tactic

Firefighters’ thermal burden is generally attributed to high heat loads from the fire and metabolic heat generation, which may vary between job assignments and suppression tactic employed. Utilising a full-sized residential structure, firefighters were deployed in six job assignments utilising two attack tactics (1. Water applied from the interior, or 2. Exterior water application before transitioning to the interior). Environmental temperatures decreased after water application, but more rapidly with transitional attack. Local ambient temperatures for inside operation firefighters were higher than other positions (average ~10–30 °C). Rapid elevations in skin temperature were found for all job assignments other than outside command. Neck skin temperatures for inside attack firefighters were ~0.5 °C lower when the transitional tactic was employed. Significantly higher core temperatures were measured for the outside ventilation and overhaul positions than the inside positions (~0.6–0.9 °C). Firefighters working at all fireground positions must be monitored and relieved based on intensity and duration.

Practitioner Summary: Testing was done to characterise the thermal burden experienced by firefighters in different job assignments who responded to controlled residential fires (with typical furnishings) using two tactics. Ambient, skin and core temperatures varied based on job assignment and tactic employed, with rapid elevations in core temperature in many roles.     

The effect of flexible body armour on pulmonary function

The additional mass and fit of current military in-service body armour (ISBA) can reduce pulmonary function in a way that is characteristic of a restrictive respiratory impairment. This could ultimately impair exercise capacity and military performance. This study compared pulmonary function (forced vital capacity [FVC] and forced expiratory volume in 1 s [FEV₁]) in UK ISBA (15.3 kg) and three flexible body armours (BAs) (FA1: 10 kg; FA2: 7.8 kg; FA3: 10 kg) in eight male soldiers. The design of the ballistic plates differed between the BAs to improve the flexibility. FVC and FEV₁ were reduced by 4–6%, without reduction in FEV₁/FVC for ISBA, FA2 and FA3, when compared to NoBA (p < 0.05). No difference was observed between FA1 and NoBA. As expected, wearing BA caused a mild restrictive ventilatory impairment; however, modifications to BA design can reduce the degree of this impairment.

Practitioner Summary: This study showed that wearing body armour caused a mild restrictive ventilatory impairment. However, the design of the armour can be modified to reduce the degree of this impairment. This may lead to improvements in soldier performance during tasks that require body armour.     

A comfort assessment of existing cervical orthoses

Purpose: Identify location and intensity of discomfort experienced by healthy participants wearing cervical orthoses.

Method: Convenience sample of 34 healthy participants wore Stro II, Philadelphia, Headmaster, and AspenVista^® cervical orthoses for four-hour periods. Participants reported discomfort level (scale 0–6) and location.

Results: Participants reported mean discomfort for all orthoses over the four-hour test between ‘a little discomfort’ and ‘very uncomfortable’ (mean discomfort score = 1.64, SD = 1.50). Seven participants prematurely stopped tests due to pain and six reported maximum discomfort scores. Significant linear increase in discomfort with duration of wear was found for all orthoses. Significantly less discomfort was reported with Stro II than Headmaster and Philadelphia. Age correlated with greater perceived discomfort. Orthoses differed in the location discomfort was experienced.

Conclusion: Existing cervical orthoses cause discomfort influenced by design and duration of wear with orthoses’ design the more significant factor. This work informed the design of a new orthosis and future orthoses developments.

Practitioner Summary: The purpose of this study was to gain greater knowledge about the discomfort caused by wearing of existing neck orthoses in order to inform the design and development of a new neck orthosis. This study gathers empirical data from a surrogate population and concludes that orthosis design is more influential than the duration of wear.     

A shirt containing multistage phase change material and active cooling components was associated with increased exercise capacity in a hot,humid environment

Recent advances in clothing design include the incorporation of phase change materials (PCM) and other active cooling components (ACC) to provide better body heat dissipation. The purpose of this study was to determine the effect of wearing a shirt containing multistage PCM/ACC on exercise capacity at low (5.0), moderate–high (7.5) and extreme (9.0) levels of the physiological strain index (PSI). Fourteen individuals tested two shirts (control vs. cooling) during 45-min of interval running in a hot, humid (35 ± 1 °C; 55 ± 6% RH) environment. The cooling shirt resulted in an 8% improvement in exercise capacity at a PSI of 7.5 (p < 0.05). The observed increase in exercise capacity would likely translate to a significant improvement in exercise performance. More research is needed to determine a best practice approach for the use of cooling clothing as a counter to exercise-induced heat exposure.

Practitioner Summary: In this report, we demonstrate that when forced to exercise in a hot, humid environment, an individual’s exercise capacity may increase by as much as 8% when wearing a shirt composed of multistage phase change material and active cooling components.     

Thermal and cardiovascular strain imposed by motorcycle protective clothing under Australian summer conditions

Motorcycle protective clothing can be uncomfortably hot during summer, and this experiment was designed to evaluate the physiological significance of that burden. Twelve males participated in four, 90-min trials (cycling 30 W) across three environments (25, 30, 35 °C [all 40% relative humidity]). Clothing was modified between full and minimal injury protection. Both ensembles were tested at 25 °C, with only the more protective ensemble investigated at 30 and 35 °C. At 35 °C, auditory canal temperature rose at 0.02 °C min^?1 (SD 0.005), deviating from all other trials (p < 0.05). The thresholds for moderate (>38.5 °C) and profound hyperthermia (>40.0 °C) were predicted to occur within 105 min (SD 20.6) and 180 min (SD 33.0), respectively. Profound hyperthermia might eventuate in ~10 h at 30 °C, but should not occur at 25 °C. These outcomes demonstrate a need to enhance the heat dissipation capabilities of motorcycle clothing designed for summer use in hot climates, but without compromising impact protection.

Practitioner’s Summary:

Motorcycle protective clothing can be uncomfortably hot during summer. This experiment was designed to evaluate the physiological significance of this burden across climatic states. In the heat, moderate (>38.5 °C) and profound hyperthermia (>40.0 °C) were predicted to occur within 105 and 180 min, respectively.     

Integrating a hip belt with body armour reduces the magnitude and changes the location of shoulder pressure and perceived discomfort in soldiers*

Soldiers carry heavy loads that may cause general discomfort, shoulder pain and injury. This study assessed if new body armour designs that incorporated a hip belt reduced shoulder pressures and improved comfort. Twenty-one Australian soldiers completed treadmill walking trials wearing six different body armours with two different loads (15 and 30 kg). Contact pressures applied to the shoulders were measured using pressure pads, and qualitative assessment of comfort and usability were acquired from questionnaires administered after walking trials. Walking with hip belt compared to no hip belt armour resulted in decreased mean and maximum shoulder pressures (p < 0.005), and 30% fewer participants experiencing shoulder discomfort (p < 0.005) in best designs, although hip discomfort did increase. Laterally concentrated shoulder pressures were associated with 1.34-times greater likelihood of discomfort (p = 0.026). Results indicate body armour and backpack designs should integrate a hip belt and distribute load closer to shoulder midline to reduce load carriage discomfort and, potentially, injury risk.

Practitioner Summary: Soldiers carry heavy loads that increase their risk of discomfort and injury. New body armour designs are thought to ease this burden by transferring the load to the hips. This study demonstrated that designs incorporating a hip belt reduced shoulder pressure and shoulder discomfort compared to the current armour design.     

Layering garments during rest and exercise in the cold (8°C): wearer responses and comparability with selected fabric properties

How garments contribute to performance of the clothing system during wear is of interest, as is understanding the value of using fabric properties to inform end-use characteristics. To investigate the influences of layering upper-body garments, four fabrics were used to construct two first-layer garments (wool and polyester) and two outer-layer garments (wool and membrane laminate). Over six sessions, 10 moderately trained males wore each first-layer garment as a single layer and in combination with each outer-layer garment while resting, running and walking in cold environmental conditions (8 ± 1°C, 81 ± 4% RH). Here, the type of garment arrangement worn (fabric type or number of layers) had little influence on heart rate, core body temperature and change in body mass. Weighted mean covered skin temperature was warmer and weighted mean next-to-skin vapour pressure was typically higher (following the onset of exercise) with two layers versus one. Differences among fabrics for individual properties were typically overstated compared to differences among corresponding garments for physiological and psychophysical variables under the conditions of this study. These findings inform the interpretation of particular fabric properties and highlight issues to be acknowledged during development/refinement of fabric test methods.

Practitioner Summary: We examined the way in which selected fibre, fabric and garment (layering) characteristics contribute to performance of the clothing system during wear under cold conditions. Selected properties of the constituent fabrics were found to provide limited insight into how garments perform during wear under the conditions of this study.     

The ageing Australian firefighter: an argument for age-based recruitment and fitness standards for urban fire services

Currently, there is no enforcement of physical standards within Australian fire services post-recruitment, possibly leading to inappropriate fitness and body composition. This study evaluated the impacts of ageing on physical standards of Australian firefighters. Seventy-three firefighters from three different 10-year age groups [25–34 years (n = 27), 35–44 years (n = 27), 45–54 years (n = 19)] volunteered for physical testing using dual-energy X-ray analysis and existing fitness tests used for recruitment by an Australian fire service. Older (45–54 years) participants demonstrated significantly poorer physical standards compared with younger participants including cardiovascular fitness (p < 0.05), strength (p = 0.001) and simulated operational power testing tasks (p < 0.001). Age-related body composition changes were also observed independent of body mass index. Minimum recruitment standards and fitness programs need to account for age-related declines in physical capabilities to ensure that the minimum standard is maintained regardless of age.

Practitioner Summary: Using dual-energy X-ray analysis and established fitness testing protocols, this study aimed to gain an appreciation of the current standards of body composition and fitness of Australian firefighters and the effects of ageing on their physical abilities post-recruitment. The study demonstrated a significant decline in physical standards due to age.     

The effect of age on in-vivo spine stiffness,postures and discomfort responses during prolonged sitting exposures

Many industrialised working populations are ageing and prolonged sitting exposures are prevalent across occupational sectors. The purpose of this work was to determine the effect of age and sex on passive spine stiffness, postures and discomfort in response to seated work. A total of 34 participants were recruited, with 17 older adults with an average age of (standard deviation) 63.7 (±3.9) years and 17 younger adults aged 23.8 (±5.0) years. Participants were asked to sit continuously for 90?min while typing. Baseline passive spine stiffness was higher in older adults at 40% flexion compared to younger adults (p?=?.0233). Older adults sat in less normalised flexion, at 33.4% (±16.4) compared to 60.9% (±20.2) in the younger group (p?=?.0003). Discomfort was higher among older adults in the neck, right shoulder and middle back regions (p?<?.0086). An understanding of age-specific responses to workplace exposures is essential to determine whether age-specific interventions are warranted.

 

Practitioner summary: Older adults had higher passive spine stiffness and sat with less flexion during prolonged sitting. Discomfort was higher among older adults and occurred earlier in the simulation compared to younger participants, indicating that interventions, such as walking breaks may need to be implemented earlier during sitting for aged workers.     

Association between objectively measured static standing and low back pain – a cross-sectional study among blue-collar workers*

This study aims to investigate the cross-sectional association between objectively measured total time and temporal patterns of static standing (short bouts: 0–5 min; moderate bouts: >5–10 min; and long bouts: >10 min) during work and leisure and low back pain (LBP) among 698 blue-collar workers. Workers reported LBP on a 0–10 scale. The association between time spent on static standing and LBP was tested with linear regression. A positive association with LBP intensity was found for long bouts of static standing (β = 0.27) during total day (work + leisure), and total static standing time at leisure (β = 0.12). No significant associations were found for static standing during work and LBP intensity. These findings indicate that particularly long bouts of static standing over the entire day contribute to LBP in blue-collar workers.

Practitioner Summary: The association between LBP and static standing time was investigated. This study indicates that prolonged time standing during total day and standing during leisure are positively associated with LBP among blue-collar workers. Therefore, practitioners should consider long periods of standing as a potential risk factor for LBP.     

Predictive discomfort of supine humans in whole-body vibration and shock environments

This work presents a predictive model to evaluate discomfort associated with supine humans during transportation, where whole-body vibration and repeated shock are predominant. The proposed model consists of two parts: (i) static discomfort resulting from body posture, joint limits and ambient discomfort; and (ii) dynamic discomfort resulting from the relative motion between the body segments as a result of transmitted vibration. Twelve supine subjects were exposed to single and 3D random vibrations and 3D shocks mixed with vibrations. The subjects’ reported discomfort and biodynamic response were analysed under different support conditions, including a rigid surface, a stretcher and a stretcher with a spinal backboard. The results demonstrated good correlations between the predictive discomfort and the reported discomfort for the different conditions under consideration, with R² = 0.69–0.94 for individual subjects and R² = 0.94 for the group mean. The results also indicated a strong relationship between the head-neck and trunk angular velocities and discomfort during supine transportation.

Practitioner Summary: The quantification of discomfort of supine humans under vibration and shocks by using a predictive model is an important contribution to this field, whereby the efficacy of different transport systems can be compared. The predictive discomfort model can be used as design criteria for ergonomic enhancement in supine transportation of humans.     

The effects of military body armour on trunk and hip kinematics during performance of manual handling tasks*

Musculoskeletal injuries are reported as burdening the military. An identified risk factor for injury is carrying heavy loads; however, soldiers are also required to wear their load as body armour. To investigate the effects of body armour on trunk and hip kinematics during military-specific manual handling tasks, 16 males completed 3 tasks while wearing each of 4 body armour conditions plus a control. Three-dimensional motion analysis captured and quantified all kinematic data. Average trunk flexion for the weightiest armour type was higher compared with control during the carry component of the ammunition box lift (p?<?0.001) and sandbag lift tasks (p?<?0.001). Trunk rotation ROM was lower for all armour types compared with control during the ammunition box place component (p?<?0.001). The altered kinematics with body armour occurred independent of armour design. In order to optimise armour design, manufacturers need to work with end-users to explore how armour configurations interact with range of personal and situational factors in operationally relevant environments.

Practitioner Summary: Musculoskeletal injuries are reported as burdening the military and may relate to body armour wear. Body armour increased trunk flexion and reduced trunk rotation during military-specific lifting and carrying tasks. The altered kinematics may contribute to injury risk, but more research is required.     

Normative data on the one-handed static pull strength of a Chinese population and a comparison with American data

We assess the one-handed static pull strength of a Chinese population and compare it to that of an American sample. Fifty men and 50 women in five age groups were asked to exert their maximum one-handed pull strength in three pulling directions (across, front and side) and from four pulling heights (61 cm, 76 cm, waist height and above-shoulder height). The results showed that women had less pull strength than men under all of the conditions tested. The front and side pulling resulted in the greatest pull strength, with a decrease detected when the pulling height was increased. The American sample exhibited greater strength than the Chinese. Body mass and men’s handgrip force were also associated with the pull strength. These variables should be taken into account in the development of tasks related to one-handed pulling.

Practitioner summary:

In this paper, we report a laboratory-based experiment conducted to assess the one-handed static pull strength of a Chinese population and compare the results with those of an American population. The variables associated with pull strength included gender, pulling direction, pulling height, race, body mass and men’s handgrip force.     

Can an off-the-rack orthotic stiletto alter pressure and comfort scores in the forefoot,arch and heel?

The study sought to investigate whether an orthotic stiletto could modulate the pressure and comfort under the forefoot, arch and heel that stiletto wearers experience. Twenty-two women participated. We measured the peak pressure and pressure-time integral for orthotic stilettos with built-in metatarsal pad, heel cup and arch support; standard stilettos without inlays; and trainers. Comfort was recorded during 3 × 3 working days. The orthotic stiletto exhibited lower metatarsal head1 (MTH) and MTH2+3 and heel pressures than the standard stiletto (p < .01), and a long second metatarsal increased MTH2+3 pressure (p < .01). The comfort in the forefoot and heel was higher in the orthotic stiletto than in the standard one (p < .01), and comfort in the forefoot was correlated to the pressure-time integral of MTH2+3 (p = .03) and not peak pressure. Off-the-rack orthotic stilettos can notably reduce plantar pressures and improve forefoot and heel comfort during everyday use.

Practitioner Summary: Off-the-rack orthotic stilettos with built-in metatarsal pad, arch support and heel caps can lower the pressure under the heel and forefoot in comparison with a standard stiletto and can improve comfort during everyday use. Having a long second metatarsal is a risk factor for increased forefoot pressure.     

A detailed description of the short-term musculoskeletal and cognitive effects of prolonged standing for office computer work

Due to concerns about excessive sedentary exposure for office workers, alternate work positions such as standing are being trialled. However, prolonged standing may have health and productivity impacts, which this study assessed. Twenty adult participants undertook two hours of laboratory-based standing computer work to investigate changes in discomfort and cognitive function, along with muscle fatigue, movement, lower limb swelling and mental state. Over time, discomfort increased in all body areas (total body IRR [95% confidence interval]: 1.47[1.36–1.59]). Sustained attention reaction time (β = 18.25[8.00–28.51]) deteriorated, while creative problem solving improved (β = 0.89[0.29–1.49]). There was no change in erector spinae, rectus femoris, biceps femoris or tibialis anterior muscle fatigue; low back angle changed towards less lordosis, pelvis movement increased, lower limb swelling increased and mental state decreased. Body discomfort was positively correlated with mental state. The observed changes suggest replacing office work sitting with standing should be done with caution.

Practitioner Summary: Standing is being used to replace sitting by office workers; however, there are health risks associated with prolonged standing. In a laboratory study involving 2 h prolonged standing discomfort increased (all body areas), reaction time and mental state deteriorated while creative problem-solving improved. Prolonged standing should be undertaken with caution.     

Prevalence of work-related musculoskeletal and non-musculoskeletal injuries in health care workers: the implications for work disability management

To compare the prevalence of musculoskeletal and non-musculoskeletal injuries in a cohort of workers in Manitoba health care sector, who made injury claims between 2002 and 2012. A retrospective study, using secondary data from WCB Manitoba. Logistic regression was used to determine odds ratios for nature of work-related injuries among different groups of workers. Idiopathic work-related musculoskeletal disorders (WMSD) constituted 74.6% of all the injury claims. Injury risks varied between worker groups, and a significant difference was found within the female group, χ² = 13.4, p = 0.0094, but not among the males. Compared to the married, single workers were more likely to experience traumatic than idiopathic injuries (OR = 1.72, CI, 1.28, 2.29), and much higher risk of traumatic injuries than non-WMSD (OR = 1.93, CI, 1.31, 2.84). Work-related injury risks vary significantly across occupations and worker groups, with idiopathic injuries being higher in high physical tasks.

Practitioner Summary: To compare musculoskeletal and non-musculoskeletal injuries among workers in health care sector, and explore the implications for work disability management. Retrospective study, using workers’ compensation claims data. The risk of idiopathic work-related musculoskeletal disorders continue to be high compared to traumatic and non-musculoskeletal disorders, particularly in tasks that involved high physical activities.     

Distress and worry as mediators in the relationship between psychosocial risks and upper body musculoskeletal complaints in highly automated manufacturing

As a result of changes in manufacturing including an upward trend in automation and the advent of the fourth industrial revolution, the requirement for supervisory monitoring and consequently, cognitive demand has increased in automated manufacturing. The incidence of musculoskeletal disorders has also increased in the manufacturing sector. A model was developed based on survey data to test if distress and worry mediate the relationship between psychosocial factors (job control, cognitive demand, social isolation and skill discretion), stress states and symptoms of upper body musculoskeletal disorders in highly automated manufacturing companies (n = 235). These constructs facilitated the development of a statistically significant model (RMSEA 0.057, TLI 0.924, CFI 0.935). Cognitive demand was shown to be related to higher distress in employees, and distress to a higher incidence of self-reported shoulder and lower back symptoms. The mediation model incorporating stress states (distress, worry) as mediators is a novel approach in linking psychosocial risks to musculoskeletal disorders.

Practitioners’ Summary

With little requirement for physical work in many modern automated manufacturing workplaces, there is often minimal management focus on Work-Related Musculoskeletal Disorders (WRMSDs) as important occupational health problems. Our model provides evidence that psychosocial factors are important risk factors in symptoms of WRMSD and should be managed.     

Associations between firefighters’ physical activity across multiple shifts of wildfire suppression

The aim of this study was to examine the associations between firefighters’ physical activity levels across consecutive wildfire suppression shifts and to determine whether sleep duration moderated these associations. Forty volunteer firefighters (31 males, 9 females) wore an activity monitor to concurrently measure physical activity and sleep duration. Sedentary time and time spent in light- (LPA), moderate- (MPA), and vigorous-intensity physical activity (VPA) during each shift were determined using monitor-specific cut points. During any given shift, every additional 60 min spent in LPA was associated with 7.2 min more LPA and 27.6 min MPA the following shift. There were no other significant positive or negative associations. No significant moderating effect of total sleep time was observed. Firefighters are able to maintain and/or increase their physical activity intensity between consecutive shifts. Further research is needed to understand firefighters pacing and energy conservation strategies during emergency wildfire deployments.

Practitioner Summary: To examine associations between firefighters’ physical activity levels across consecutive shifts during a multi-day emergency wildfire and determine whether sleep duration moderated these associations. Firefighters are able to maintain and/or increase their physical activity intensity between consecutive shifts. No significant moderating effect of total sleep time was observed.