Search

Introduction: During heatwaves, it is important to monitor workers' cardiovascular health since 35% of those working in hot environments experience symptoms of heat strain. Wearable technology has been popularized for monitoring heart rate (HR) during recreational activities, but it can also be used to monitor occupational heat strain based on core and skin temperatures and HR. To our knowledge, no devices estimate the cardiovascular strain directly based on stroke volume (SV) or cardiac output (CO). In addition to the hardware, there are limitations regarding the lack of suitable algorithms that would provide such an index based on relevant physiological responses. The validation of the formulae already existing in literature was the principle aim of the present study., Methods: We monitored the cardiovascular responses of our participants to a supine and 60° head-up tilt at the same time each day. During the test, we measured blood pressure derived by finger photoplethysmography, which also provided beat-by-beat measures of SV and CO. Afterwards, we compared the SV derived from the photoplethysmography with the one calculated with the different equations that already exist in literature., Results: The evaluation of the formulae was based on comparing the error of prediction. This residual analysis compared the sum of the squared residuals generated by each formula using the same data set., Conclusion: Our findings suggest that estimating SV with existing formulae is feasible, showing a good correlation and a relatively small bias. Thus, simply measuring workers' blood pressure during breaks could estimate their cardiac strain., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Tsoutsoubi, Ioannou, Ciuha, Fisher, Possnig, Simpson, Flouris, Lawley and Mekjavic.)

This study compared the joint kinematics between the front squat (FS) conducted in the upright (natural gravity) position and in the supine position on a short arm human centrifuge (SAHC). Male participants (N = 12) with no prior experience exercising on a centrifuge completed a FS in the upright position before (PRE) and after (POST) a FS exercise conducted on the SAHC while exposed to artificial gravity (AG). Participants completed, in randomized order, three sets of six repetitions with a load equal to body weight or 1.25 × body weight for upright squats, and 1 g and 1.25 g at the center of gravity (COG) for AG. During the terrestrial squats, the load was applied with a barbell. Knee (left/right) and hip (left/right) flexion angles were recorded with a set of inertial measurement units. AG decreased the maximum flexion angle (MAX) of knees and hips as well as the range of motion (ROM), both at 1 and 1.25 g. Minor adaptation was observed between the first and the last repetition performed in AG. AG affects the ability to FS in naïve participants by reducing MAX, MIN and ROM of the knees and hip., (© 2024 The Author(s). Physiological Reports published by Wiley Periodicals LLC on behalf of The Physiological Society and the American Physiological Society.)

This study investigated the impact of a multiday heatwave on nocturnal physiology, behavior, and sleep under controlled conditions with comprehensive monitoring of environmental factors and participant activities. Seven young healthy males were confined for ten days in controlled conditions that ranged between hot-to-warm (day:35.4°C, night:26.3°C) during nights 4-6 and temperate (day:25.4°C, night:22.3°C) before (nights 1-3) and after (nights 7-10) the heatwave. Measurements included core and skin temperatures, heart rate, sympathovagal balance, vasomotion indicators, urine samples, blanket coverage, subjective sleep assessments, and partial polysomnography. The average nocturnal core temperature was 0.2°C higher during and after the heatwave compared to the pre-heatwave period, with this difference being more pronounced (+0.3°C) in the first two hours of sleep (p<0.001). For every 0.1°C rise in overnight core temperature, the total sleep time decreased by 14 minutes (pseudo-R2=0.26, p=0.01). The elevated core temperatures occurred despite the participants exhibiting evident thermoregulatory behavior, as they covered 30% less body surface during the heatwave compared to pre- and post-heatwave periods (p<0.001). During the heatwave, mean skin temperature at bedtime was 1.3°C higher than pre-heatwave and 0.8°C higher than post-heatwave periods (p<0.001). No differences in other responses, including heart rate and vasomotion indicators, were observed. The paper details a 20-minute sleepwalking episode that was coupled with marked changes in sleepwalker's thermophysiological responses. In conclusion, the simulated heatwave resulted in higher overnight core temperature which was associated with reduced total sleep time. Behavioral thermoregulation during sleep may serve as a defense against these effects, though more research is needed.

Introduction: This study examined the impact of different upper-torso sportswear technologies on the performance and physiological heat strain of well-trained and national-level athletes during prolonged running in moderately hot conditions., Methods: A randomized crossover design was employed in which 20 well-trained (n = 16) and national-level (n = 4) athletes completed four experimental trials in moderately hot conditions (35°C, 30% relative humidity). In each trial, participants ran at 70% of their peak oxygen uptake (70% V̇O 2peak ) for 60 min, while wearing a different upper-body garment: cotton t-shirt, t-shirt with sweat-wicking fabric, compression t-shirt, and t-shirt with aluminum dots lining the inside of the upper back of the garment. Running speed was adjusted to elicit the predetermined oxygen consumption associated with 70% V̇O 2peak . Physiological (core and skin temperatures, total body water loss, and urine specific gravity) and perceptual (thermal comfort and sensation, ratings of perceived exertion, and garment cooling functionality) parameters along with running speed at 70% V̇O 2peak were continuously recorded., Results: No significant differences were observed between the four garments for running speed at 70% V̇O 2peak , physiological heat strain, and perceptual responses (all p > 0.05). The tested athletes reported larger areas of perceived suboptimal cooling functionality in the cotton t-shirt and the t-shirt with aluminum dots relative to the sweat-wicking and compression t-shirts (d: 0.43-0.52)., Conclusion: There were not differences among the tested garments regarding running speed at 70% V̇O 2peak , physiological heat strain, and perceptual responses in well-trained and national-level endurance athletes exercising in moderate heat., (© 2023 The Authors. Scandinavian Journal of Medicine & Science In Sports published by John Wiley & Sons Ltd.)

In October 2022, the Human Factors and Medicine (HFM) panel of the NATO Science and Technology Organization convened a review of progress in military biomedical research for cold weather operations. This paper represents a summary of the research presentations and future directions. The importance of realistic training was an overarching theme. Many reported studies took advantage of cold weather training exercises to monitor soldiers' health and performance; these are valuable data, using winter exercises as a platform to gain further knowledge regarding human performance in the cold and represent an excellent extension of controlled laboratory studies. Topics also included prevention of Cold Weather Injuries (CWI); effects of cold weather stressors on cognitive function; field treatment of freezing cold injuries (FCI); and new consideration to injury and trauma care in the cold. Future work programmes re-emphasise development of cold weather training and establishment of consensus diagnostic criteria and treatments for FCI and non-FCI. CWI prevention should take advantage of biomathematical models that predict risk of CWI and provide guidance regarding optimal clothing and equipment and move from group averages to personalised predictions. The publication of selected presentations from the symposium in this special issue increases attention to military cold weather research.

Purpose: This study examined physiological and perceptual parameters related to cold-induced vasodilation (CIVD) in the fingers and toes of people with paraplegia and compared them with responses observed in able-bodied individuals., Methods: Seven participants with paraplegia and seven able-bodied individuals participated in a randomized matched-controlled study involving left-hand and -foot immersion in cold water (8 ± 1 °C) for 40 min during exposure to cool (16 ± 1 °C), thermoneutral (23 ± 1 °C), and hot (34 ± 1 °C) ambient conditions., Results: Similar CIVD occurrence was observed in the fingers in the two groups. In toes, three of the seven participants with paraplegia revealed CIVDs: one in cool, two in thermoneutral, and three in hot conditions. No able-bodied participants revealed CIVDs in cool and thermoneutral conditions, while four revealed CIVDs in hot conditions. The toe CIVDs of paraplegic participants were counterintuitive in several respects: they were more frequent in cool and thermoneutral conditions (compared to the able-bodied participants), emerged in these conditions despite lower core and skin temperatures of these participants, and were evident only in cases of thoracic level lesions (instead of lesions at lower spinal levels)., Conclusion: Our findings demonstrated considerable inter-individual variability in CIVD responses in both the paraplegic and able-bodied groups. While we observed vasodilatory responses in the toes of participants with paraplegia that technically fulfilled the criteria for CIVD, it is unlikely that they reflect the CIVD phenomenon observed in able-bodied individuals. Taken together, our findings favor the contribution of central over peripheral factors in relation to the origin and/or control of CIVD., (© 2023. The Author(s).)

Physical inactivity increases cardiometabolic risk through a variety of mechanisms, among which alterations of immunological, metabolic, and autonomic control systems may play a pivotal role. Physical inactivity is frequently associated with other factors that may further worsen prognosis. The association between physical inactivity and hypoxia is particularly interesting and characterizes several conditions-whether physiological (e.g., residing or trekking at high altitude and space flights) or pathological (e.g., chronic cardiopulmonary diseases and COVID-19). In this randomized intervention study, we investigated the combined effects of physical inactivity and hypoxia on autonomic control in eleven healthy and physically active male volunteers, both at baseline (ambulatory) conditions and, in a randomized order, hypoxic ambulatory, hypoxic bedrest, and normoxic bedrest (i.e., a simple experimental model of physical inactivity). Autoregressive spectral analysis of cardiovascular variabilities was employed to assess cardiac autonomic control. Notably, we found hypoxia to be associated with an impairment of cardiac autonomic control, especially when combined with bedrest. In particular, we observed an impairment of indices of baroreflex control, a reduction in the marker of prevalent vagal control to the SA node, and an increase in the marker of sympathetic control to vasculature.

Introduction: Technological advances have made high-altitude ski slopes easily accessible to skiers of all ages. However, research on the effects of hypoxia experienced during excursions to such altitudes on physiological systems, including the ocular system, in children is scarce. Retinal vessels are embryologically of the same origin as vessels in the brain, and have similar anatomical and physiological characteristics. Thus, any hypoxia-related changes in the morphology of the former may reflect the status of the latter. Objective: To compare the effect of one-day hypoxic exposure, equivalent to the elevation of high-altitude ski resorts in North America and Europe (∼3,000 m), on retinal vessel diameter between adults and children. Methods: 11 adults (age: 40.1 ± 4.1 years) and 8 children (age: 9.3 ± 1.3 years) took part in the study. They spent 3 days at the Olympic Sports Centre Planica (Slovenia; altitude: 940 m). During days 1 and 2 they were exposed to normoxia (F i O 2 = 0.209), and day 3 to normobaric hypoxia (F i O 2 = 0.162 ± 0.03). Digital high-resolution retinal fundus photographs were obtained in normoxia (Day 2) and hypoxia (Day 3). Central retinal arteriolar equivalent (CRAE) and venular equivalents (CRVE) were determined using an Automated Retinal Image Analyser. Results: Central retinal arteriolar and venular equivalents increased with hypoxia in children (central retinal arteriolar equivalent: 105.32 ± 7.72 µm, hypoxia: 110.13 ± 7.16 µm, central retinal venular equivalent: normoxia: 123.39 ± 8.34 µm, hypoxia: 130.11 ± 8.54 µm) and adults (central retinal arteriolar equivalent: normoxia: 105.35 ± 10.67 µm, hypoxia: 110.77 ± 8.36 µm; central retinal venular equivalent: normoxia: 126.89 ± 7.24 µm, hypoxia: 132.03 ± 9.72 µm), with no main effect of group or group*condition interaction. A main effect of condition on central retinal arteriolar and venular equivalents was observed (central retinal arteriolar equivalent:normoxia: 105.34 ± 9.30 µm, hypoxia: 110.50 ± 7.67 µm, p < 0.001; central retinal venular equivalent: normoxia: 125.41 ± 7.70 µm, hypoxia: 131.22 ± 9.05 µm, p < 0.001). Conclusion: A 20-hour hypoxic exposure significantly increased central retinal arteriolar and venular equivalents in adults and children. These hypoxia-induced increases were not significantly different between the age groups, confirming that vasomotor sensitivity of the retinal vessels to acute hypoxia is comparable between adults and prepubertal children., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Mlinar, Debevec, Kapus, Najdenov, McDonnell, Ušaj, Mekjavic and Jaki Mekjavic.)

Introduction: A wide range of cooling vests for heat-strain mitigation purposes during physical work are available on the market. The decision regarding the optimal cooling vest/concept for a specific environment can be challenging by relying solely on the information provided by the manufacturers. The aim of this study was to investigate how different types of cooling vests would manifest/perform in a simulated industrial setting, in a warm and moderately humid environment with low air velocity., Methods: Ten young males completed six experimental trials, including a control trial (no vest) and five trials with vests of different cooling concepts. Once entering the climatic chamber (ambient temperature: 35 °C, relative humidity: 50 %), participants remained seated for 30 min to induce passive heating, after which they donned a cooling vest and started a 2.5-h of walk at 4.5 km·h -1 . During the trial, torso skin temperature (T sk ), microclimate temperature (T micro ) and relative humidity (RH micro ), as well as core temperature (rectal and gastrointestinal; T c ) and heart rate (HR) were measured. Before and after the walk, participants conducted different cognitive tests and provided subjective ratings throughout the walk., Results: The use of the vests attenuated the increase in HR (103 ± 12 bpm) when compared to control trial (116 ± 17 bpm, p < 0.05). Four vests maintained a lower torso T sk (31.7 ± 1.5 °C) compared to control trial (36.1 ± 0.5 °C, p < 0.05). Two vests using PCM inserts attenuated the increase in T c between 0.2 and 0.5 °C in relation to control trial (p < 0.05). Cognitive performance remained unchanged between the trials. Physiological responses were also well reflected in subjective reports., Conclusion: Most vests could be considered as an adequate mitigation strategy for workers in industry under the conditions simulated in the present study., Competing Interests: Declaration of competing interest There are no conflicts of interest., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objectives: Haemoglobin mass (Hbmass) assessment with the carbon monoxide rebreathing method is a more accurate estimate than other measures of oxygen-carrying capacity. Blood may be collected by several means and differences in the measured variables may exist as a result. The present study assessed the validity and reliability of calculated Hbmass and intravascular volumes obtained from capillary blood (CAP) when compared to venous blood (VEN) draws. Methods: Twenty-two adults performed a carbon monoxide rebreathing procedure with paired VEN and CAP draws at baseline, pre-rebreathing and post-rebreathing (POST). Thirteen of these participants performed this protocol on two occasions to assess the data reliability from both blood sampling sites. In a second experiment, 14 adults performed a 20-min seated and a 20-min supine rest to assess for the effect of posture on haematological parameters. Results: Haemoglobin mass (CAP = 948.8 ± 156.8 g; VEN = 943.4 ± 157.3 g, p = 0.108) and intravascular volume (CAP = 6.5 ± 1 L; VEN = 6.5 ± 0.9 L, p = 0.752) were statistically indifferent, had low bias (Hbmass bias = 14.45 ± 40.42 g, LoA -64.78 g-93.67 g) and were highly correlated between sampling techniques. Reliability analysis demonstrated no difference in the mean change in variables calculated from both sampling sites and good to excellent intraclass correlation coefficients (>0.700), however, typical measurement error was larger in variables measured using CAP (VEN Hbmass TE% = 2.1%, CAP Hbmass TE% = 5.5%). The results indicate that a supine rest prior to the rebreathing protocol would have a significant effect on haemoglobin concentration and haematocrit values compared to a seated rest, with no effect on carboxyhaemoglobin %. Conclusion: The present study demonstrates that CAP and VEN were comparable for the calculation of Hbmass and intravascular volumes in terms of accuracy. However, reduced reliability and increased error in the CAP variables indicates that there are methodological considerations to address when deciding which blood drawing technique to utilise. To reduce this CAP error, increased replicate analyses are required., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Royal, Fisher, Mlinar, Mekjavic and McDonnell.)

Global warming has caused an increase in the frequency, duration, and intensity of summer heatwaves (HWs). Prolonged exposure to hot environments and orthostasis may cause conflicting demands of thermoregulation and blood pressure regulation on the vasomotor system, potentially contributing to cardiovascular complications and occupational heat strain. This study assessed cardiovascular and skin blood flow (SkBF) responses to orthostasis before, during and after a 3-day simulated HW. Seven male participants maintained a standard work/rest schedule for nine consecutive days split into three 3-day parts; thermoneutral pre-HW (25.4 °C), simulated HW (35.4 °C), thermoneutral post-HW. Gastrointestinal (T gi ) and skin (T sk ) temperatures, cardiovascular responses, and SkBF were monitored during 10-min supine and 10-min 60° head-up tilt (HUT). SkBF, indexed using proximal-distal skin temperature gradient (∆Tsk P-D ), was validated using Laser-Doppler Flowmetry (LDF). The HW significantly increased heart rate, cardiac output and SkBF of the leg in supine; HUT increased SkBF of the arm and leg, and significantly affected all cardiovascular variables besides cardiac output. Significant regional differences in SkBF presented between the arm and leg in all conditions; the arm displaying vasodilation throughout, while the leg vasoconstricted in non-HW before shifting to vasodilation in the HW. Additionally, ∆Tsk P-D strongly correlated with LDF (r = -.78, p < 0.001). Prolonged HW exposure and orthostasis, individually, elicited significant changes in cardiovascular and SkBF variables. Additionally, varying regional blood flow responses were observed, suggesting the upper and lower vasculature receives differing vasomotor control. Combined cardiovascular alterations and shifts towards vasodilation indicate an increased challenge to industrial workers during HWs., (© 2022. The Author(s).)

Acclima(tiza)tion to heat or hypoxia enhances work capacity in hot and hypoxic environmental conditions, respectively; an acclimation response is considered to be mediated by stimuli-specific molecular/systemic adaptations and potentially facilitated by the addition of exercise sessions. Promising findings at the cellular level provided the impetus for recent studies investigating whether acclimation to one stressor will ultimately facilitate whole body performance when exercise is undertaken in a different environmental condition. The present critical Mini-Review examines the theory of cross-adaptation between heat and hypoxia with particular reference to the determinants of aerobic performance. Indeed, early functional adaptations (improved exercise economy and enhanced oxyhemoglobin saturation) succeeded by later morphological adaptations (increased hemoglobin mass) might aid acclimatized humans perform aerobic work in an alternative environmental setting. Longer-term acclimation protocols that focus on the specific adaptation kinetics (and further allow for the adaptation reversal) will elucidate the exact physiological mechanisms that might mediate gains in aerobic performance or explain the lack thereof.

In a series of three companion papers published in this Journal, we identify and validate the available thermal stress indicators (TSIs). In this first paper of the series, we conducted a systematic review (registration: INPLASY202090088) to identify all TSIs and provide reliable information regarding their use (funded by EU Horizon 2020; HEAT-SHIELD). Eight databases (PubMed, Agricultural and Environmental Science Collection, Web of Science, Scopus, Embase, Russian Science Citation Index, MEDLINE, and Google Scholar) were searched from database inception to 15 April 2020. No restrictions on language or study design were applied. Of the 879 publications identified, 232 records were considered for further analysis. This search identified 340 instruments and indicators developed between 200 BC and 2019 AD. Of these, 153 are nomograms, instruments, and/or require detailed non-meteorological information, while 187 can be mathematically calculated utilizing only meteorological data. Of these meteorology-based TSIs, 127 were developed for people who are physically active, and 61 of those are eligible for use in occupational settings. Information regarding the equation, operating range, interpretation categories, required input data, as well as a free software to calculate all 187 meteorology-based TSIs is provided. The information presented in this systematic review should be adopted by those interested in performing on-site monitoring and/or big data analytics for climate services to ensure appropriate use of the meteorology-based TSIs. Studies two and three in this series of companion papers present guidance on the application and validation of these TSIs, to guide end users of these indicators for more effective use., Competing Interests: No potential conflict of interest was reported by the author(s)., (© 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.)

Around the planet, in many different scenarios, skin temperature is being used as a surrogate measure of deep body (core) temperature in the assessment of whether an individual is infected with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which causes the coronavirus disease (Covid-19), as indicated by the presence of fever. The key question is whether this is a valid methodology. If it is not, we run the risk of falsely excluding individuals from places they may want, or need, to go. We also run the risk of falsely allowing people into places where they can spread the undetected infection they have. In this review, we explore these and associated questions. We establish the limited utility of the current methodology for the mass screening of individuals for Covid-19 related fever using infrared thermography. We propose the development of an alternative method that may prove to be more sensitive., (© 2020 The Authors. Experimental Physiology © 2020 The Physiological Society.)

Purpose: Hypobaric hypoxic habitats are currently being touted as a potential solution to minimise decompression procedures in preparation for extra vehicular activities during future space missions. Since astronauts will live in hypoxic environments for the duration of such missions, the present study sought to elucidate the separate and combined effects of inactivity [simulated with the experimental bed rest (BR) model] and hypoxia on sleep characteristics in women., Methods: Twelve women (Age = 27 ± 3 year) took part in three 10-day interventions, in a repeated measures cross-over counterbalanced design: (1) normobaric normoxic BR (NBR), (2) normobaric hypoxic BR (HBR; simulated altitude of 4,000 m), and (3) normobaric hypoxic ambulatory (HAMB; 4,000 m) confinement, during which sleep was assessed on night 1 and night 10 with polysomnography. In addition, one baseline sleep assessment was performed. This baseline assessment, although lacking a confinement aspect, was included statistically as a fourth comparison (i.e., pseudo normobaric normoxic ambulatory; pNAMB) in the present study., Results: Hypoxia decreased sleep efficiency ( p = 0.019), increased N1% sleep ( p = 0.030), decreased N3 sleep duration ( p = 0.003), and increased apnea hypopnea index ( p < 0.001). BR impaired sleep maintenance, efficiency, and architecture [e.g., N2% sleep increased ( p = 0.033)]. Specifically, for N3% sleep, the effects of partial pressure of oxygen and activity interacted. Hypoxia decreased N3% sleep both when active (pNAMB vs HAMB; p < 0.001) and inactive (NBR vs HBR; p = 0.021), however, this decrease was attenuated in the inactive state (-3.8%) compared to the active state (-10.2%)., Conclusion: A 10-day exposure to hypoxia and BR negatively impacted sleep on multiple levels as in macrostructure, microstructure and respiratory functioning. Interestingly, hypoxia appeared to have less adverse effects on sleep macrostructure while the participants were inactive (bed ridden) compared to when ambulatory. Data were missing to some extent (i.e., 20.8%). Therefore, multiple imputation was used, and our results should be considered as exploratory., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Van Cutsem, Pattyn, Mairesse, Delwiche, Fernandez Tellez, Van Puyvelde, Lacroix, McDonnell, Eiken and Mekjavic.)

Purpose: We have previously observed substantially higher oxygen uptake in soldiers walking on terrain at night than when performing the same walk in bright daylight. The aims of the present study were to investigate the influence of vision on mechanical efficiency during slow, horizontal, constant-speed walking, and to determine whether any vision influence is modified by load carriage., Methods: Each subject (n = 15) walked (3.3 km/h) for 10 min on a treadmill in four different conditions: (1) full vision, no carried load, (2) no vision, no carried load, (3) full vision with a 25.5-kg rucksack, (4) no vision with a 25.5-kg rucksack., Results: Oxygen uptake was 0.94 ± 0.12 l/min in condition (1), 1.15 ± 0.20 l/min in (2), 1.15 ± 0.12 l/min in (3) and 1.35 ± 0.19 l/min in (4). Thus, lack of vision increased oxygen uptake by about 19%. Analyses of movement pattern, by use of optical markers attached to the limbs and torso, revealed considerably shorter step length (12 and 10%) in the no vision (2 and 4) than full vision conditions (1 and 3). No vision conditions (2 and 4) increased step width by 6 and 6%, and increased vertical foot clearance by 20 and 16% compared to full vision conditions (1 and 3)., Conclusion: The results suggest that vision has a marked influence on mechanical efficiency even during entrained, repetitive movements performed on an obstacle-free horizontal surface under highly predictable conditions., (© 2022. The Author(s).)

The present comprehensive review (i) summarizes the current knowledge on the impacts of occupational heat stress on outdoor workers, (ii) provides a historical background on this issue, (iii) presents a meta-analysis of published data, (iv) explores inter-individual and intra-individual factors, (v) discusses the available heat mitigation strategies, (vi) estimates physical work capacity, labour productivity, and metabolic rate for the year 2030, and (vii) provides an overview of existing policy and legal frameworks on occupational heat exposure. Meta-analytic findings from 38 field studies that involved monitoring 2,409 outdoor workers across 41 jobs in 21 countries suggest that occupational heat stress increases the core (r = 0.44) and skin (r = 0.44) temperatures, as well as the heart rate (r = 0.38) and urine specific gravity (r = 0.13) of outdoor workers (all p < 0.05). Moreover, it diminishes the capacity of outdoor workers for manual labour (r = -0.82; p < 0.001) and is responsible for more than two thirds of the reduction in their metabolic rate. Importantly, our analysis shows that physical work capacity is projected to be highly affected by the ongoing anthropogenic global warming. Nevertheless, the metabolic rate and, therefore, labour productivity are projected to remain at levels higher than the workers' physical work capacity, indicating that people will continue to work more intensely than they should to meet their financial obligations for food and shelter. In this respect, complementary measures targeting self-pacing, hydration, work-rest regimes, ventilated garments, and mechanization can be adopted to protect outdoor workers., Competing Interests: No potential conflict of interest was reported by the authors., (© 2022 Informa UK Limited, trading as Taylor & Francis Group.)

In a series of three companion papers published in this Journal, we identify and validate the available thermal stress indicators (TSIs). In this third paper, we conducted field experiments across nine countries to evaluate the efficacy of 61 meteorology-based TSIs for assessing the physiological strain experienced by individuals working in the heat. We monitored 372 experi-enced and acclimatized workers during 893 full work shifts. We continuously assessed core body temperature, mean skin temperature, and heart rate data together with pre/post urine specific gravity and color. The TSIs were evaluated against 17 published criteria covering physiological parameters, practicality, cost effectiveness, and health guidance issues. Simple meteorological parameters explained only a fraction of the variance in physiological heat strain (R 2  = 0.016 to 0.427; p < 0.001), reflecting the importance of adopting more sophisticated TSIs. Nearly all TSIs correlated with mean skin temperature (98%), mean body temperature (97%), and heart rate (92%), while 66% of TSIs correlated with the magnitude of dehydration and 59% correlated with core body temperature (r = 0.031 to 0.602; p < 0.05). When evaluated against the 17 published criteria, the TSIs scored from 4.7 to 55.4% (max score = 100%). The indoor (55.4%) and outdoor (55.1%) Wet-Bulb Globe Temperature and the Universal Thermal Climate Index (51.7%) scored higher compared to other TSIs (4.7 to 42.0%). Therefore, these three TSIs have the highest potential to assess the physiological strain experienced by individuals working in the heat., Competing Interests: No potential conflict of interest was reported by the authors., (© 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.)

In a series of three companion papers published in this Journal, we identify and validate the available thermal stress indicators (TSIs). In this second paper of the series, we identified the criteria to consider when adopting a TSI to protect individuals who work in the heat, and we weighed their relative importance using a Delphi exercise with 20 experts. Two Delphi iterations were adequate to reach consensus within the expert panel (Cronbach's α = 0.86) for a set of 17 criteria with varying weights that should be considered when adopting a TSI to protect individuals who work in the heat. These criteria considered physiological parameters such as core/skin/mean body temperature, heart rate, and hydration status, as well as practicality, cost effectiveness, and health guidance issues. The 17 criteria were distributed across three occupational health-and-safety pillars: (i) contribution to improving occupational health (55% of total importance), (ii) mitigation of worker physiological strain (35.5% of total importance), and (iii) cost-effectiveness (9.5% of total importance). Three criteria [(i) relationship of a TSI with core temperature, (ii) having categories indicating the level of heat stress experienced by workers, and (iii) using its heat stress categories to provide recommendations for occupational safety and health] were considered significantly more important when selecting a TSI for protecting individuals who work in the heat, accumulating 37.2 percentage points. These 17 criteria allow the validation and comparison of TSIs that presently exist as well as those that may be developed in the coming years., Competing Interests: No potential conflict of interest was reported by the author(s)., (© 2022 Informa UK Limited, trading as Taylor & Francis Group.)

Individual variation is of interest to Space Agency's, which cannot be explored with astronauts due to anonymity. We retrospectively analysed data collected throughout three projects (LunHab: 10-day male, PlanHab: 21-day male, and FemHab: 10-day female) to elucidate the potentially masked individual variation in the psychological responses to bed rest. The Profile of Mood State (POMS) and Positive and Negative Affect Schedule (PANAS) - instruments used to asses psychological state - and Lake Louise Mountain Sickness (LLMS) scores were collected prior to, following and throughout three interventions: 1: normoxic bed rest 2: hypoxic bed rest and 3: hypoxic ambulatory confinement. Total Mood Disturbance (TMD) was calculated from the POMS results, positive affect (PA), and negative affect (NA) from PANAS. The three instruments were included in a latent class mixed model. TMD, NA, and LLMS were included in a four-class model, with each class representing a specific type of response (Class 1: descending, Class 2: flat, Class 3: somewhat flat, Class 4: ascending). Responses for PA were assigned to only two classes (Classes 1 and 2). 54.55% or 24 participants were included in Class 2 (TMD, NA, and LLMS), where the responses did not change and neither hypoxia or activity level had a significant effect on emotional state. The remaining participants were allotted to Class 1, 3, or 4, where hypoxia was a significant covariate, while activity (bed rest) was significant only for class 3. For PA, 84.09% or 37 participants were assigned to class 2 indicating a significant effect of hypoxia on the participants responses with no effect of physical activity. Class 1 participants ( n = 7) were not affected by hypoxia, however, physical activity improved their PA. Participants undergoing confinement, hypoxia and bed rest do not exhibit a uniform emotional response and may be categorised into 2-4 distinct classes. These results indicate significant individual emotional responses, that may be masked and underreported by traditional statistical approaches like means ± SD. The emotional state of our participants is a complex construct likely influenced by past experiences and different coping mechanisms which allowed some to adapt to the experimental environment more readily., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Tobita, Mekjavic and McDonnell.)

There is a need to rapidly screen individuals for heat strain and fever using skin temperature (T sk ) as an index of deep body temperature (T b ). This study's aim was to assess whether T sk could serve as an accurate and valid index of T b during a simulated heatwave. Seven participants maintained a continuous schedule over 9-days, in 3-day parts; pre-/post-HW (25.4 °C), simulated-HW (35.4 °C). Contact thermistors measured T sk (T forehead , T finger ); radio pills measured gastrointestinal temperature (T gi ). Proximal-distal temperature gradients (ΔT forehead-finger ) were also measured. Measurements were grouped into ambient conditions: 22, 25, and 35 °C. T gi and T forehead only displayed a significant relationship in 22 °C (r: 0.591; p < 0.001) and 25 °C (r: 0.408; p < 0.001) conditions. A linear regression of all conditions identified T forehead and ΔT forehead-finger as significant predictors of T gi (r 2 : 0.588; F: 125.771; p < 0.001), producing a root mean square error of 0.26 °C. Additional residual analysis identified T forehead to be responsible for a plateau in T gi prediction above 37 °C. Contact T forehead was shown to be a statistically suitable indicator of T gi in non-HW conditions; however, an error of ~1 °C makes this physiologically redundant. The measurement of multiple sites may improve T b prediction, though it is still physiologically unsuitable, especially at higher ambient temperatures.

Due to the observations of weight loss at high altitude, normobaric hypoxia has been considered as a method of weight loss in obese individuals. With this regard, the aim of the present study was to determine the effect of hypoxia per se on metabolism in men with excess weight. Eight men living with excess weight (125.0 ± 17.7 kg; 30.5 ± 11.1 years, BMI: 37.6 ± 6.2 kg⋅m -2 ) participated in a randomized cross-over study comprising two 10-day confinements: normobaric (altitude of facility ≃ 940 m) normoxia (NORMOXIA; P I O 2 = 133 mmHg), and normobaric hypoxia (HYPOXIA). The P I O 2 in the latter was reduced from 105 (simulated altitude of 2,800 m) to 98 mmHg (simulated altitude of 3,400 m over 10 days. Before, and at the end of each confinement, participants completed a meal tolerance test (MTT). Resting energy expenditure (REE), circulating glucose, GLP-1, insulin, catecholamines, ghrelin, peptide-YY (PYY), leptin, gastro-intestinal blood flow, and appetite sensations were measured in fasted and postprandial states. Fasting REE increased after HYPOXIA (+358.0 ± 49.3 kcal⋅day -1 , p = 0.03), but not after NORMOXIA (-33.1 ± 17.6 kcal⋅day -1 ). Postprandial REE was also significantly increased after HYPOXIA ( p ≤ 0.05), as was the level of PYY. Furthermore, a tendency for decreased energy intake was concomitant with a significant body weight reduction after HYPOXIA (-0.7 ± 0.2 kg) compared to NORMOXIA (+1.0 ± 0.2 kg). The HYPOXIA trial increased the metabolic requirements, with a tendency toward decreased energy intake concomitant with increased PYY levels supporting the notion of a hypoxia-induced appetite inhibition, that could potentially lead to body weight reduction. The greater postprandial blood-glucose response following hypoxic confinement, suggests the potential development of insulin resistance., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Mekjavic, Amon, Simpson, Kölegård, Eiken and Macdonald.)

Hematological changes are commonly observed following prolonged exposure to hypoxia and bed rest. Typically, such responses have been reported as means and standard deviations, however, investigation into the responses of individuals is insufficient. Therefore, the present study retrospectively assessed individual variation in the hematological responses to severe inactivity (bed rest) and hypoxia. The data were derived from three-bed rest projects: two 10-d (LunHab project: 8 males; FemHab project: 12 females), and one 21-d (PlanHab project: 11 males). Each project comprised a normoxic bed rest (NBR; P I O 2 =133mmHg) and hypoxic bed rest (HBR; P I O 2 =91mmHg) intervention, where the subjects were confined in the Planica facility (Rateče, Slovenia). During the HBR intervention, subjects were exposed to normobaric hypoxia equivalent to an altitude of 4,000m. NBR and HBR interventions were conducted in a random order and separated by a washout period. Blood was drawn prior to (Pre), during, and post bed rest (R1, R2, R4) to analyze the individual variation in the responses of red blood cells (RBC), erythropoietin (EPO), and reticulocytes (Rct) to bed rest and hypoxia. No significant differences were found in the mean ∆(Pre-Post) values of EPO across projects (LunHab, FemHab, and PlanHab; p >0.05), however, female EPO responses to NBR (Range - 17.39, IQR - 12.97 mIU . ml -1 ) and HBR (Range - 49.00, IQR - 10.91 mIU . ml -1 ) were larger than males (LunHab NBR Range - 4.60, IQR - 2.03; HBR Range - 7.10, IQR - 2.78; PlanHab NBR Range - 7.23, IQR - 1.37; HBR Range - 9.72, IQR - 4.91 mIU . ml -1 ). Bed rest duration had no impact on the heterogeneity of EPO, Rct, and RBC responses (10-d v 21-d). The resultant hematological changes that occur during NBR and HBR are not proportional to the acute EPO response. The following cascade of hematological responses to NBR and HBR suggests that the source of variability in the present data is due to mechanisms related to hypoxia as opposed to inactivity alone. Studies investigating hematological changes should structure their study design to explore these mechanistic responses and elucidate the discord between the EPO response and hematological cascade to fully assess heterogeneity., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Royal, Eiken, Keramidas, McDonnell and Mekjavic.)

This retrospective study was designed to analyze the interindividual variability in the responses of different variables characterizing the skeletal muscle oxidative function to normoxic (N-BR) and hypoxic (H-BR) bed rests and to a hypoxic ambulatory confinement (H-AMB) of 10 and 21 days. We also assessed whether and how the addition of hypoxia to bed rest might influence the heterogeneity of the responses. In vivo measurements of O 2 uptake and muscle fractional O 2 extraction were carried out during an incremental one-leg knee-extension exercise. Mitochondrial respiration was assessed in permeabilized muscle fibers. A total of 17 subjects were included in this analysis. This analysis revealed a similar variability among subjects in the alterations induced by N-BR and H-BR both in peak O 2 uptake (SD: 4.1% and 3.3% after 10 days; 4.5% and 8.1% after 21 days, respectively) and peak muscle fractional O 2 extraction (SD: 5.9% and 7.3% after 10 days; 6.5% and 7.3% after 21 days), independently from the duration of the exposure. The individual changes measured in these variables were significantly related ( r = 0.66, P = 0.004 after N-BR; r = 0.61, P = 0.009 after H-BR). Mitochondrial respiration showed a large variability of response after both N-BR (SD: 25.0% and 15.7% after 10 and 21 days) and H-BR (SD: 13.0% and 19.8% after 10 and 21 days); no correlation was found between N-BR and H-BR changes. When added to bed rest, hypoxia altered the individual adaptations within the mitochondria but not those intrinsic to the muscle oxidative function in vivo, both after the short- and medium-term exposures.

Purpose: It has been reported that the cold-induced vasodilation (CIVD) response can be trained using either regular local cold stimulation or exercise training. The present study investigated whether repeated exposure to environmental stressors, known to improve aerobic performance (heat and/or hypoxia), could also provide benefit to the CIVD response., Methods: Forty male participants undertook three 10-day acclimation protocols including daily exercise training: heat acclimation (HeA; daily exercise training at an ambient temperature, T a  = 35 °C), combined heat and hypoxic acclimation (HeA/HypA; daily exercise training at T a  = 35 °C, while confined to a simulated altitude of ~ 4000 m) and exercise training in normoxic thermoneutral conditions (NorEx; no environmental stressors). To observe potential effects of the local acclimation on the CIVD response, participants additionally immersed their hand in warm water (35 °C) daily during the HeA/HypA and NorEx. Before and after the acclimation protocols, participants completed hand immersions in cold water (8 °C) for 30 min, followed by 15-min recovery phases. The temperature was measured in each finger., Results: Following the HeA protocol, the average temperature of all five fingers was higher during immersion (from 13.9 ± 2.4 to 15.5 ± 2.5 °C; p = 0.04) and recovery (from 22.2 ± 4.0 to 25.9 ± 4.9 °C; p = 0.02). The HeA/HypA and NorEx protocols did not enhance the CIVD response., Conclusion: Whole-body heat acclimation increased the finger vasodilatory response during cold-water immersion, and enhanced the rewarming rate of the hand, thus potentially contributing to improved local cold tolerance. Daily hand immersion in warm water for 10 days during HeA/Hyp and NorEx, did not contribute to any changes in the CIVD response., (© 2021. The Author(s).)

Purpose: As part of our investigations of intraocular pressure (IOP) as a potential contributing factor to the spaceflight-associated neuro-ocular syndrome using the 6° head-down tilt (6°HDT) bed rest experimental model, we compared the effect of rest and isometric exercise in prone and supine 6°HDT positions on IOP with that observed in the seated position., Methods: Ten male volunteers (age = 22.5 ± 3.1 yrs) participated in six interventions. All trials comprised a 10-min rest period, a 3-min isometric handgrip exercise at 30% of participant's maximum, and a 10-min recovery period. The trials were conducted under normocapnic (NCAP) or hypercapnic (F I CO 2  = 0.01; HCAP) conditions, the latter mimicking the ambient conditions on the International Space Station. IOP, systolic and diastolic pressures, and heart rate (HR) were measured during the trials., Results: Isometric exercise-induced elevations in HR and mean arterial blood pressure. IOP in the prone 6°HDT position was significantly higher (p < 0.001) compared to IOP in supine 6°HDT position and seated trials at all time points. IOP increased with exercise only in a seated HCAP trial (p = 0.042). No difference was observed between trials in NCAP and HCAP. IOP in the prone 6°HDT position was constantly elevated above 21 mmHg, the lower limit for clinical ocular hypertension., Conclusions: IOP in the prone 6°HDT position was similar to IOP reported in astronauts upon entering microgravity, potentially indicating that prone, rather than supine 6°HDT position might be a more suitable experimental analog for investigating the acute ocular changes that occur in microgravity., (© 2021 The Authors. Physiological Reports published by Wiley Periodicals LLC on behalf of The Physiological Society and the American Physiological Society.)

To evaluate the individual responses in skeletal muscle outcomes following bed rest, data from three studies (21-day PlanHab; 10-day FemHab and LunHab) were combined. Subjects ( n = 35) participated in three cross-over campaigns within each study: normoxic (NBR) and hypoxic bed rest (HBR), and hypoxic ambulation (HAMB; used as control). Individual variability (SD IR ) was investigated as √(SD Exp 2 -SD Con 2 ), where SD Exp and SD Con are the standard deviations of the change score (i.e., post - pre) in the experimental (NBR and HBR) and the control (HAMB) groups, respectively. Repeatability and moderators of the individual variability were explored. Significant SD IR was detected for knee extension torque, and thigh and calf muscle area, which translated into an individual response ranging from 3 to -17% for knee extension torque, -2 to -12% for calf muscle area, and -1 to -8% for thigh muscle area. Strong correlations were found for changes in NBR vs. HBR (i.e., repeatability) in thigh and calf muscle area ( r = 0.65-0.75, P < 0.0001). Change-scores in knee extension torque, and thigh and calf muscle area strongly correlated with baseline values ( P < 0.001; r between -0.5 and -0.9). Orthogonal partial least squares regression analysis explored if changes in the investigated variables could predict calf muscle area alterations. This analysis indicated that 43% of the variance in calf muscle area could be attributed to changes in all of the other variables. This is the first study using a validated methodology to report clinically relevant individual variability after bed rest in knee extension torque, calf muscle area, and (to a lower extent) thigh muscle area. Baseline values emerged as a moderator of the individual response, and a global bed rest signature served as a moderately strong predictor of the individual variation in calf muscle area alterations., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Fernandez-Gonzalo, McDonnell, Simpson, Macdonald, Rullman and Mekjavic.)

Due to the static and dynamic activity of the skin temperature sensors, the cutaneous thermal afferent information is dependent on the rate and direction of the temperature change, which would suggest different perceptions of temperature and of thermal comfort during skin heating and cooling. This hypothesis was tested in the present study. Subjects (N = 12; 6 females and 6 males) donned a water-perfused suit (WPS) in which the temperature was varied in a saw-tooth manner in the range from 27 to 42 °C. The rate of change of temperature of the water perfusing the suit (T WPS ) was 1.2 °C min -1 during both the heating and cooling phases. The trial was repeated thrice, with subjects reporting their perception of the temperature and thermal comfort at each 3 °C change in T WPS . In addition, subjects were instructed to report when they perceived T WPS uncomfortably cool and warm during cooling and heating, respectively. Subjects reproducibly identified the boundaries of their Thermal Comfort Zone (TCZ), defined as the lower (T low ) and upper (T high ) temperatures at which subjects reported slight thermal discomfort. During the heating phase, T low and T high were 30.0 ± 1.5 °C and 35.1 ± 2.9 °C, respectively. During the cooling phase, the boundary temperatures of T low and T high were 35.4 ± 1.9 °C and 38.7 ± 2.3 °C, respectively. The direction of the change in the cutaneous temperature stimulus affects the boundaries of the TCZ, such that they are higher during cooling and lower during heating. These findings are explained on the basis of the neurophysiology of thermal perception. From an applied perspective, the most important observation of the present study was the strong correlation between the perception of thermal comfort and the behavioral regulation of thermal comfort. Although it is not surprising that the action of regulating thermal comfort is aligned with its perception, this link has not been proven for humans in previous studies. The results therefore provide a sound basis to consider ratings of thermal comfort as reflecting behavioral actions to achieve the sensation of thermal neutrality.

New Findings: What is the central question of this study? Does a 35-day horizontal bedrest impair thermoeffector responses during whole-body submaximal exercise performed in temperate conditions? What is the main finding and its importance? Cardiovascular and muscular deconditioning ensuing from prolonged recumbency seems to augment, at least to a degree, exercise-induced increase in body core temperature, most likely due to an impairment in non-evaporative heat loss. The response is a function of the absolute exercise intensity imposed., Abstract: We examined the effects of a 35-day horizontal bedrest on thermoregulation during whole-body exercise. Fifteen healthy men were randomly assigned to either a bedrest (BR; n = 10) or a control (CON; n = 5) group. Prior to bedrest, both groups performed 40-min constant-load upright cycling at 30% of their peak workload (W peak ; PRE). One and 2 days after bedrest, the BR group performed, in a randomised counterbalanced order, two 40-min trials at 30% of (i) the pre-bedrest W peak (i.e., at a fixed absolute intensity; POST-A) and (ii) the post-bedrest W peak (i.e., at a fixed relative intensity; POST-R). The CON group conducted only the POST-A trial, at the same time intervals. During the trials, rectal (T rec ) and skin ( T ¯ sk ) temperatures, and the forehead sweating rate (SwR) were monitored. In the CON group, no differences were observed between the trials. Bedrest potentiated moderately the T rec elevation during the latter part of POST-A (∼0.10°C; P ≤ 0.05), but not of POST-R (∼0.04°C; P = 0.11). In both post-bedrest trials, T ¯ sk was attenuated by ∼1.5-2.0°C throughout (P < 0.01), whereas the forehead SwR was not modulated. T rec and T ¯ sk were similar in POST-A and POST-R, yet the forehead SwR was more dependent on the relative workload imposed (P = 0.04). The present findings therefore suggest that the cardiovascular and muscular deconditioning ensuing from a 35-day bedrest may aggravate the exercise-induced increase in body core temperature when working at a given absolute intensity, most likely due to an impairment in non-evaporative heat loss., (© 2021 The Authors. Experimental Physiology © 2021 The Physiological Society.)

As frequency and severity of heat waves are increasing, personal cooling systems are being considered as a tool to mitigate heat strain in workers in various occupational settings. This study assessed cooling capacities (C; W·h·m -2 ) of various commercially available vests using different cooling concepts. Measurements were conducted over 8 h in a climatic chamber (Ta: 35 °C, RH: 35 %) using a thermal manikin (Ts: 35 °C). Cooling power (P) and duration of efficient cooling (t c ) determined the C value of each vest. Among the cooling concepts the active cooling vests were the most efficient, extracting 331 W·h·m -2 , followed by the vests with phase change material (PCM) inserts, hybrid and evaporative vests, extracting a maximum of 164 W·h·m -2 , 146 W·h·m -2 and 113 W·h·m -2 , respectively. While some vests with PCM inserts provided intense but shorter cooling, evaporative vests provided mild but longer cooling throughout. Practitioner summary: The study assessed the cooling capacity of commercially available vests, using a thermal manikin. The vests present an affordable solution in various occupational settings where air-conditioning is not an option. A range of cooling capacities among different cooling concepts and vests of the same category were noted. Abbreviations: ACVs: air-cooled vests; LCVs: liquid-cooled vests; ECVs: evaporative cooling vests; HCVs: hybrid cooling vests; PCVs: phase-change cooling vests; PCM: phase change material; C: cooling capacity; Rt: thermal resistance; Re: evaporative resistance; Re (%): relative evaporative resistance; P: cooling power; P max : maximal cooling power; P avg : average cooling power; t c : cooling duration; AUC: area under the curve; Ta: ambient temperature; RH: relative humidity; v a : chamber air flow; Ts: manikin surface temperature.

Background: The aim of the study was to investigate the effect of a simulated heat-wave on the labour productivity and physiological strain experienced by workers., Methods: Seven males were confined for ten days in controlled ambient conditions. A familiarisation day was followed by three (pre, during, and post-heat-wave) 3-day periods. During each day volunteers participated in a simulated work-shift incorporating two physical activity sessions each followed by a session of assembly line task. Conditions were hot (work: 35.4 °C; rest: 26.3 °C) during, and temperate (work: 25.4 °C; rest: 22.3 °C) pre and post the simulated heat-wave. Physiological, biological, behavioural, and subjective data were collected throughout the study., Results: The simulated heat-wave undermined human capacity for work by increasing the number of mistakes committed, time spent on unplanned breaks, and the physiological strain experienced by the participants. Early adaptations were able to mitigate the observed implications on the second and third days of the heat-wave, as well as impacting positively on the post-heat-wave period., Conclusions: Here, we show for first time that a controlled simulated heat-wave increases workers' physiological strain and reduces labour productivity on the first day, but it promotes adaptations mitigating the observed implications during the subsequent days.

Size- and time-dependent particle removal efficiency (PRE) of different protective respiratory masks were determined using a standard aerosol powder with the size of particles in the range of an uncoated SARS-CoV-2 virus and small respiratory droplets. Number concentration of particles was measured by a scanning mobility particle sizer. Respiratory protective half-masks, surgical masks, and cotton washable masks were tested. The results show high filtration efficiency of FFP2, FFP3, and certified surgical masks for all sizes of tested particles, while protection efficiency of washable masks depends on their constituent fabrics. Measurements showed decreasing PRE of all masks over time due to transmission of nanoparticles through the mask-face interface. On the other hand, the PRE of the fabric is governed by deposition of the aerosols, consequently increasing the PRE.

New Findings: What is the topic of this review? This review describes the effect of extreme environments on the visual system. What advances does it highlight? The review highlights the way in which environmental stressors affect the eye and vision, both directly and indirectly., Abstract: Much is known about the physiology and anatomy of the eye. Much less is known about the impact of different environments on the eye, and yet it is the pathophysiology that results from this interaction that is often the precursor to disaster. The present review focuses on the effect of different extreme environments on the visual system; in particular, the way in which such environments affect the sensory mechanism of that system., (© 2020 The Authors. Experimental Physiology © 2020 The Physiological Society.)

New Findings: What is the central question of this study? Do females and males exhibit a similar sarcopenic response as a consequence of normoxic and hypoxic bed rest? What is the main finding and its importance? During 10-day bed rest, exposure to a simulated (normobaric hypoxia) altitude of ∼4000 m does not exert additional significant structural or functional effect on the weight-bearing muscles in females compared to those noted under normoxic conditions. Whereas males and females exhibit decrements in muscle cross-sectional area and mass during normoxic and hypoxic bed rest, a concomitant strength decrement was only observed in males., Abstract: This study investigated the effects of hypoxia on the known processes of adaptation of body composition and muscle function to normoxic inactivity. Females (n = 12) and males (n = 11) took part in the following interventions: hypoxic ambulation (HAMB; ∼4000 m); hypoxic bed rest (HBR; ∼4000 m) and normoxic bed rest (NBR). Prior to and immediately following each intervention, body composition, thigh and lower leg cross-sectional area (CSA) and isometric muscular strength were recorded. Participants lost body mass (HAMB: male -1.5 ± 0.9 kg, female -1.9 ± 0.7 kg; HBR: male -2.0 ± 1.8 kg, female -2.4 ± 0.8 kg; NBR: male -1.4 ± 1.3 kg, female -1.4 ± 0.9 kg) and lean mass (HAMB: male -3.9 ± 3.0%, female -3.4 ± 2.0%; HBR: male -4.0 ± 4.4%, female -4.1 ± 2.0%; NBR: male -4.0 ± 3.4%, female -2.2 ± 2.7%) with no between-condition or sex differences. Knee extension decreased for males in NBR compared to HAMB (HAMB: male -0.2 ± 9.1%, female 1.3 ± 4.9%; HBR: male -7.8 ± 10.3%, female -3.3 ± 10.9%; NBR: male -14.5 ± 11%, female -3.4 ± 6.9%). Loss of force during maximal voluntary contraction (MVC) in the knee extensors was significantly different between males and females following NBR. There were no other significant changes noted following the experimental interventions. There were no differences recorded between sexes in maximal MVC for elbow or ankle joints. Female lower leg CSA decreased following bed rest (HAMB: -4.5 ± 2.0%; HBR: -9.9 ± 2.6%; NBR: -8.0 ± 1.6%). These findings indicate that a 10-day hypoxic bed rest does not exert any significant additional effect on muscle atrophy when compared to NBR, except for female thigh CSA. In contrast to males, who exhibited a significant loss of muscle strength, no such decrement in strength was observed in the female participants., (© 2020 The Authors. Experimental Physiology © 2020 The Physiological Society.)

Seasonal variations in day length and light intensity can affect the circadian rhythm as well as some characteristics of temperature regulation. We investigated characteristics of autonomic (ATR), behavioural (BTR) and nocturnal (NTR) temperature regulation during spring and autumn. Eleven participants underwent experiments in both seasons. To assess ATR, participants performed a 30-min bout of submaximal upright exercise on a cycle ergometer, followed by 100 min of water immersion (28 °C). Thresholds for the onset of shivering and sweating and vasomotor response were measured. BTR was assessed using a water-perfused suit, with participants regulating the water-perfused suit temperature (Twps) within a range, considered as thermally comfortable. The Twps changed in a saw-tooth manner from 10 to 50 °C; by depressing a switch, the direction of the Twps changed, and this limit defined the thermal comfort zone (TCZ) for each participant. A 24-h proximal (calf)-distal (toe) skin temperature gradient (∆Tc-t) was measured to assess NTR. Initiation of vasomotor tone, shivering and sweating was similar between trials. Width of the TCZ was 8.1 °C in spring and 8.6 °C in autumn (p = 0.1), with similar upper and lower regulated temperatures. ∆Tc-t exhibited a typical circadian rhythm with no difference between seasons. Minor changes in skin temperature and oxygen consumption (p ˂ 0.05) between the seasons may indicate a degree of seasonal adaptation over the course of winter and summer, which persisted in spring and autumn. Other factors, such as country, race, sex and age could however modify the outcome of the study.

Exercise heat acclimation (HA) is known to magnify the sweating response by virtue of a lower threshold as well as increased gain and maximal capacity of sweating. However, HA has been shown to potentiate the shivering response in a cold-air environment. We investigated whether HA would alter heat loss and heat production responses during water immersion. Twelve healthy male participants underwent a 10-day HA protocol comprising daily 90-min controlled-hyperthermia (target rectal temperature, T re 38.5 °C) exercise sessions. Preceding and following HA, the participants performed a maximal exercise test in thermoneutral conditions (ambient temperature 23 °C, relative humidity 50%) and were, following exercise, immersed in 28 °C water for 60 min. Thermal comfort zone (TCZ) was also assessed with participants regulating the temperature of a water-perfused suit during heating and cooling. Baseline pre-immersion T re was similar pre- and post-HA (pre: 38.33 ± 0.33 °C vs post: 38.12 ± 0.36 °C, p = 0.092). The T re cooling rate was identical pre-to post-HA (-0.03 ± 0.01 °C·min -1 , p = 0.31), as was the vasomotor response reflected in the forearm-fingertip temperature difference. Shivering thresholds (p = 0.43) and gains (p = 0.61) were not affected by HA. TCZ was established at similar temperatures, with the magnitude in regulated water temperature being 7.6 (16.3) °C pre-HA and 5.1 (24.7) °C post-HA (p = 0.65). The present findings suggest that heat production and heat loss responses during whole body cooling as well as the skin thermal comfort zone remained unaltered by a controlled-hyperthermia HA protocol., Competing Interests: Declaration of competing interest There are no conflicts of interest., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

This study assessed the influence of a 10-day hypoxic bed rest on cartilage biomarkers and subchondral bone density across the patellofemoral joint (PFJ). Within clinical settings hypoxic tissue may arise in several types of disorders. Furthermore, a hypoxic environment is being considered for space flight habitats in the near future. Female participants (N = 12) participated in this study comprising three 10-day interventions: hypoxic ambulation (HAMB), normoxic bed rest (NBR), and hypoxic bed rest (HBR). Venous samples were collected prior to (day -2: Pre) and during the intervention (days 2 and 5), immediately before reambulation (D11) and 24 hr post intervention (R1). Blood samples were analyzed for: aggrecan, hyaluronan, Type IIA procollagen amino terminal propeptide (PIIANP), and cartilage oligomeric matrix protein (COMP). Total bone mineral density (BMD) in eight regions (2 mm × 10 mm) across the PFJ was determined. The three interventions (HAMB, HBR, and NBR) did not induce any significant changes in the cartilage biomarkers of hyaluronan or PIIANP. Aggrecan increased during the HAMB trial to 2.02 fold the Pre value. COMP decreased significantly in both NBR & HBR compared to HAMB on D5. There were significant differences in BMD measured across the PFJ from cortical patellar bone (735 to 800 mg/cm 3 ) to femur trabecular (195 to 226 mg/cm 3 ). However, there were no significant changes in BMD from Pre to Post bed rest. These results indicate that there were no significant detectable effects of inactivity/unloading on subchondral bone density. The biomarker of cartilage, COMP, decreased on D5, whereas the addition of hypoxia to bed rest had no effect, it appears that hypoxia in combination with ambulation counteracted this decrease., (© 2020 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.)

New Findings: What is the central question of this study? Astronauts on-board the International Space Station (ISS) perform daily exercises designed to prevent muscle atrophy and bone demineralization: what is the effect of resistive exercise performed by subjects while exposed to the same level of hypercapnia as on the ISS on intraocular pressure (IOP)? What is the main finding and its importance? The static exercise-induced elevation in IOP during 6° prone head-down tilt (simulating the headward shift of body fluids in microgravity) is augmented by hypercapnia and exceeds the ocular hypertension threshold., Abstract: The present study assessed the effect of 6° head-down (establishing the cephalad fluid displacement noted in astronauts in microgravity) prone (simulating the effect on the eye) tilt during rest and exercise (simulating exercise performed by astronauts to mitigate the sarcopenia induced by unloading of weight-bearing limbs), in normocapnic and hypercapnic conditions (the latter simulating conditions on the International Space Station) on intraocular pressure (IOP). Volunteers (mean age = 57.8 ± 6 years, n = 10) participated in two experimental sessions, each comprising: (i) 10 min rest, (ii) 3 min static handgrip exercise (30% max), and (iii) 2 min recovery, inspiring either room air (NCAP) or a hypercapnic mixture (1% CO 2 , HCAP). We measured IOP in the right eye, cardiac output (CO), stroke volume (SV), heart rate (HR) and mean arterial pressure (MAP) at regular intervals. Baseline IOP in the upright seated position while breathing room air was 14.1 ± 2.9 mmHg. Prone 6° head-down tilt significantly (P < 0.01) elevated IOP in all three phases of the NCAP (rest: 27.0 ± 3.7 mmHg; exercise: 32.2 ± 4.8 mmHg; recovery: 27.4 ± 4.0 mmHg) and HCAP (rest: 27.3 ± 4.3 mmHg; exercise: 34.2 ± 6.0 mmHg; recovery: 29.1 ± 5.8 mmHg) trials, with hypercapnia augmenting the exercise-induced elevation in IOP (P < 0.01). CO, SV, HR and MAP were significantly increased during handgrip dynamometry, but there was no effect of hypercapnia. The observed IOP measured during prone 6° HDT in all phases of the NCAP and HCAP trials exceeded the threshold pressure defining ocular hypertension. The exercise-induced increase in IOP is exacerbated by hypercapnia., (© 2020 The Authors. Experimental Physiology © 2020 The Physiological Society.)

Moderate-intensity exercise sessions are incorporated into heat-acclimation and hypoxic-training protocols to improve performance in hot and hypoxic environments, respectively. Consequently, a training effect might contribute to aerobic performance gains, at least in less fit participants. To explore the interaction between fitness level and a training stimulus commonly applied during acclimation protocols, we recruited 10 young males of a higher (more fit-MF, peak aerobic power [VO 2peak ]: 57.9 [6.2] ml·kg -1 ·min -1 ) and 10 of a lower (less fit-LF, VO 2peak : 41.7 [5.0] ml·kg -1 ·min -1 ) fitness level. They underwent 10 daily exercise sessions (60 min@50% peak power output [W peak ]) in thermoneutral conditions. The participants performed exercise testing on a cycle ergometer before and after the training period in normoxic (NOR), hypoxic (13.5% F i O 2 ; HYP), and hot (35°C, 50% RH; HE) conditions in a randomized and counterbalanced order. Each test consisted of two stages; a steady-state exercise (30 min@40% NOR W peak to evaluate thermoregulatory function) followed by incremental exercise to exhaustion. VO 2peak increased by 9.2 (8.5)% (p = .024) and 10.2 (15.4)% (p = .037) only in the LF group in NOR and HE, respectively. W peak increases were correlated with baseline values in NOR (r = -.58, p = .010) and HYP (r = -.52, p = .018). MF individuals improved gross mechanical efficiency in HYP. Peak sweat rate increased in both groups in HE, whereas MF participants activated the forehead sweating response at lower rectal temperatures post-training. In conclusion, an increase in VO 2peak but not mechanical efficiency seems probable in LF males after a 10-day moderate-exercise training protocol., (© 2020 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.)

The purpose was to evaluate whether a cold-water immersion test could be used to identify individuals susceptible to local cold injuries (LCI). Sixty-five healthy non-injured (N-I) subjects, and fifteen subjects, who were tested either prior to or after a LCI, sequentially immersed one hand and one foot, in 8 °C water for 30 min (CWI phase); this was followed by 15 min of spontaneous rewarming (RW phase). The LCI group showed a lower toe temperature during the CWI phase, and a lower maximum RW temperature of the fingers than the N-I group. However, digit temperatures during the CWI and RW phases exhibited low predictive values for LCI, e.g. results implied that to identify 80% of the LCI subjects, 34-78% of the N-I subjects would also be excluded. Thus, the results suggest that, in practice, hand or foot cold-water immersion tests cannot be used to identify individuals at high risk of LCI., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Purpose: Hypoxic acclimation enhances convective oxygen delivery to the muscles. Heat acclimation-elicited thermoregulatory benefits have been suggested not to be negated by adding daily exposure to hypoxia. Whether concomitant acclimation to both heat and hypoxia offers a synergistic enhancement of aerobic performance in thermoneutral or hot conditions remains unresolved., Methods: Eight young males ([Formula: see text]: 51.6 ± 4.6 mL min -1  kg -1 ) underwent a 10-day normobaric hypoxic confinement (F i O 2  = 0.14) interspersed with daily 90-min normoxic controlled hyperthermia (target rectal temperature: 38.5 °C) exercise sessions. Prior to, and following the confinement, the participants conducted a 30-min steady-state exercise followed by incremental exercise to exhaustion on a cycle ergometer in thermoneutral normoxic (NOR), thermoneutral hypoxic (F i O 2  = 0.14; HYP) and hot (35 °C, 50% relative humidity; HE) conditions in a randomized and counterbalanced order. The steady-state exercise was performed at 40% NOR peak power output (W peak ) to evaluate thermoregulatory function. Blood samples were obtained from an antecubital vein before, on days 1 and 10, and the first day post-acclimation., Results: [Formula: see text] and ventilatory thresholds were not modified in any environment following acclimation. W peak increased by 6.3 ± 3.4% in NOR and 4.0 ± 4.9% in HE, respectively. The magnitude and gain of the forehead sweating response were augmented in HE post-acclimation. EPO increased from baseline (17.8 ± 7.0 mIU mL -1 ) by 10.7 ± 8.8 mIU mL -1 on day 1 but returned to baseline levels by day 10 (15.7 ± 5.9 mIU mL -1 )., Discussion: A 10-day combined heat and hypoxic acclimation conferred only minor benefits in aerobic performance and thermoregulation in thermoneutral or hot conditions. Thus, adoption of such a protocol does not seem warranted.

Introduction: While hypoxia is known to decrease peak oxygen uptake ( V . ⁢ o 2 max ) and maximal power output in both adults and children its influence on submaximal exercise cardiorespiratory and, especially, muscle oxygenation responses remains unclear., Methods: Eight pre-pubertal boys (age = 8 ± 2 years.; body mass (BM) = 29 ± 7 kg) and seven adult males (age = 39 ± 4 years.; BM = 80 ± 8 kg) underwent graded exercise tests in both normoxic (P i O 2 = 134 ± 0.4 mmHg) and hypoxic (P i O 2 = 105 ± 0.6 mmHg) condition. Continuous breath-by-breath gas exchange and near infrared spectroscopy measurements, to assess the vastus lateralis oxygenation, were performed during both tests. The gas exchange threshold (GET) and muscle oxygenation thresholds were subsequently determined for both groups in both conditions., Results: In both groups, hypoxia did not significantly alter either GET or the corresponding V . ⁢ o 2 at GET. In adults, higher V . E levels were observed in hypoxia (45 ± 6 l/min) compared to normoxia (36 ± 6 l/min, p < 0.05) at intensities above GET. In contrast, in children both the hypoxic V . E and V . ⁢ o 2 responses were significantly greater than those observed in normoxia only at intensities below GET ( p < 0.01 for V . E and p < 0.05 for V . ⁢ o 2 ). Higher exercise-related heart rate (HR) levels in hypoxia, compared to normoxia, were only noted in adults ( p < 0.01). Interestingly, hypoxia per se did not influence the muscle oxygenation thresholds during exercise in neither group. However, and in contrast to adults, the children exhibited significantly higher total hemoglobin concentration during hypoxic as compared to normoxic exercise (tHb) at lower exercise intensities (30 and 60 W, p = 0.01)., Conclusion: These results suggest that in adults, hypoxia augments exercise ventilation at intensities above GET and might also maintain muscle blood oxygenation via increased HR. On the other hand, children exhibit a greater change of muscle blood perfusion, oxygen uptake as well as ventilation at exercise intensities below GET., (Copyright © 2019 Ušaj, Mekjavic, Kapus, McDonnell, Jaki Mekjavic and Debevec.)

Introduction: The present study tested the hypothesis that at any given ambient temperature (Ta), thermal comfort (TC) is not only a function of the temperature per se, but is also influenced by the temperatures rate of change and direction., Methods: Twelve healthy young (age: 23 ± 3) male participants completed experimental trials where Ta increased from 15° to 40 °C (heating) and then decreased from 40 to 15 °C (cooling). In one trial (FAST), the rate of change in Ta was maintained at 1 °C.min -1 , and in the other (SLOW) at 0.5 °C.min -1 . During each trial participants provided ratings of TC at 3-min intervals to determine their thermal comfort zone (TCZ)., Results: In the FAST trial, participants identified TCZ at an Ta between 22 ± 4 and 30 ± 4 °C during heating and between 25 ± 3 and 33 ± 3 °C during cooling phase (p = .003), and in the SLOW trial between 21 ± 3 and 33 ± 4 °C during heating and between 23 ± 4 and 34 ± 3 °C during cooling phase (p = .012). During the heating phase TCZ was established at a lower range of Ta, compared to cooling phase. The difference between the heating and cooling phases in preferred range of Ta was more pronounced in the FAST compared to SLOW trial., Conclusion: TCZ is influenced not only by the prevailing temperature, but also by the direction and the rate of the change in Ta. Faster changes in Ta (1 °C.min -1 ) established the TCZ at a higher Ta during cooling and at a lower Ta during heating phase., (Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.)

We examined the interactive effects of mild hypothermia and hypoxia on finger vasoreactivity to local cold stress. Eight male lowlanders performed, in a counterbalanced order, a normoxic and a hypoxic (partial pressure of oxygen: ~12 kPa) hand cold provocation (consisting of a 30-min immersion in 8°C water), while immersed to the chest either in 21°C [cold trials; 0.5°C fall in rectal temperature (T rec ) from individual preimmersion values], or in 35.5°C water, or while exposed to 27°C air. The duration of the trials was kept constant in each breathing condition. Physiological (T rec , skin temperature, cutaneous vascular conductance, oxygen uptake) and perceptual (thermal sensation and comfort, local pain, affective valence) reactions were monitored continually. Hypoxia accelerated the drop in T rec by ~14 min ( P = 0.06, d  = 0.67). In the air-exposure trials, hypoxia did not alter finger perfusion during the local cooling, whereas it impaired the finger rewarming response following the cooling ( P < 0.01). During the 35.5°C immersion, the finger vasomotor tone was enhanced, especially in hypoxia ( P = 0.01). Mild hypothermia aggravated finger vasoconstriction instigated by local cooling ( P < 0.01), but the response did not differ between the two breathing conditions ( P > 0.05). Hypoxia tended to attenuate the sensation of coldness ( P = 0.10, r  = 0.40) and thermal discomfort ( P = 0.09, r  = 0.46) in the immersed hand. Both in normoxia and hypoxia, the whole body thermal state dictates the cutaneous vasomotor reactivity to localized cold stimulus.

New Findings: What is the central question of this study? It is well established that muscle and bone atrophy in conditions of inactivity or unloading, but there is little information regarding the effect of a hypoxic environment on the time course of these deconditioning physiological systems. What is the main finding and its importance? The main finding is that a horizontal 10 day bed rest in normoxia results in typical muscle atrophy, which is not aggravated by hypoxia. Changes in bone mineral content or in metabolism were not detected after either normoxic or hypoxic bed rest., Abstract: Musculoskeletal atrophy constitutes a typical adaptation to inactivity and unloading of weightbearing bones. The reduced-gravity environment in future Moon and Mars habitats is likely to be hypobaric hypoxic, and there is an urgent need to understand the effect of hypoxia on the process of inactivity-induced musculoskeletal atrophy. This was the principal aim of the present study. Eleven males participated in three 10 day interventions: (i) hypoxic ambulatory confinement; (ii) hypoxic bed rest; and (iii) normoxic bed rest. Before and after the interventions, the muscle strength (isometric maximal voluntary contraction), mass (lean mass, by dual-energy X-ray absorptiometry), cross-sectional area and total bone mineral content (determined with peripheral quantitative computed tomography) of the participants were measured. Blood and urine samples were collected before and on the 1st, 4th and 10th day of the intervention and analysed for biomarkers of bone resorption and formation. There was a significant reduction in thigh and lower leg muscle mass and volume after both normoxic and hypoxic bed rests. Muscle strength loss was proportionately greater than the loss in muscle mass for both thigh and lower leg. There was no indication of bone loss. Furthermore, the biomarkers of resorption and formation were not affected by any of the interventions. There was no significant effect of hypoxia on the musculoskeletal variables. Short-term normoxic (10 day) bed rest resulted in muscular deconditioning, but not in the loss of bone mineral content or changes in bone metabolism. Hypoxia did not modify these results., (© 2019 The Authors. Experimental Physiology © 2019 The Physiological Society.)

Introduction: We tested the hypothesis that individual susceptibility to freezing cold injury might be reflected in an attenuated cold-induced vasodilatation (CIVD) response by comparing the CIVD responses of an elite alpinist with a history of freezing cold injury in the feet (case alpinist) with those of an age- and ability- matched noninjured alpinists control group (controls). According to this hypothesis, the vasomotor responses to a CIVD test of the case alpinist would represent a pathophysiological response when compared with the normal physiological response of a noninjured cohort., Methods: The case alpinist and the controls in the cohort group conducted a cold water immersion test comprising sequential immersion of a hand and foot for 5 min in 35°C water, followed by a 30-min immersion in 8°C water and a 10-min recovery period in room air. During this test we monitored the finger and toe skin temperatures., Results: The case alpinist had a significantly attenuated CIVD response and a lower skin temperature in all injured and noninjured digits during immersion (∼2°C lower than in the control group) and an attenuated recovery of finger skin temperatures (∼6°C lower than in the control group)., Conclusions: The attenuated CIVD response of the case alpinist may reflect a previously unrecognized enhanced susceptibility to frostbite. In addition to the poor vasomotor response observed in the injured toes, he also exhibited a poor vasomotor response in his noninjured fingers. The results of the present study indicate that a test of vasomotor activity during thermal stress may identify individuals predisposed to cold injury., (Copyright © 2019 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.)

New Findings: What is the central question of this study? Controlled-hyperthermia heat-acclimation protocols induce an array of thermoregulatory and cardiovascular adaptations that facilitate exercise in hot conditions. We investigated whether this ergogenic potential can be transferred to thermoneutral normoxic or hypoxic exercise conditions. What is the main finding and its importance? We showed that heat acclimation did not affect maximal cardiac output or maximal aerobic power in thermoneutral normoxic or hypoxic conditions. Heat acclimation augmented the sweating response in thermoneutral normoxic conditions. The cross-adaptation theory, according to which heat acclimation could facilitate hypoxic exercise capacity, is not supported by our data., Abstract: Heat acclimation (HA) mitigates heat-induced decrements in maximal aerobic power ( V ̇ O 2 peak ) and augments exercise thermoregulatory responses in the heat. Whether this beneficial effect of HA is observed in hypoxic or thermoneutral conditions remains unresolved. We explored the effects of HA on cardiorespiratory and thermoregulatory responses to exercise in normoxic, hypoxic and hot conditions. Twelve men [ V ̇ O 2 peak 54.7(standard deviation 5.7) ml kg -1 min -1 ] participated in a HA protocol consisting of 10 daily 90-min controlled-hyperthermia (target rectal temperature, T re  = 38.5°C) exercise sessions. Before and after HA, we determined V ̇ O 2 peak in thermoneutral normoxic (NOR), thermoneutral hypoxic (fractional inspired O 2  = 13.5%; HYP) and hot (35°C, 50% relative humidity; HE) conditions in a randomized and counterbalanced order. Preceding each maximal cycling test, a 30-min steady-state exercise bout at 40% of the NOR peak power output was used to evaluate thermoregulatory responses. Heat acclimation induced the expected adaptations in HE: reduced T re and submaximal heart rate, enhanced sweating response and expanded plasma volume. However, HA did not affect V ̇ O 2 peak or maximal cardiac output (P = 0.61). The peak power output was increased post-HA in NOR (P < 0.001) and HE (P < 0.001) by 41 ± 21 and 26 ± 22 W, respectively, but not in HYP (P = 0.14). Gross mechanical efficiency was higher (P = 0.004), whereas resting T re and sweating thresholds were lower (P < 0.01) post-HA across environments. Nevertheless, the gain of the sweating response decreased (P = 0.05) in HYP. In conclusion, our data do not support a beneficial cross-over effect of HA on V ̇ O 2 peak in normoxic or hypoxic conditions., (© 2018 The Authors. Experimental Physiology © 2018 The Physiological Society.)