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Body water turnover is a marker of hydration status for measuring total fluid gains and losses over a 24-h period. It can be particularly useful in predicting (and hence, managing) fluid loss in individuals to prevent potential physical, physiological and cognitive declines associated with hypohydration. There is currently limited research investigating the interrelationship of fluid balance, dietary intake and activity level when considering body water turnover. Therefore, this study investigates whether dietary composition and energy expenditure influences body water turnover. In our methodology, thirty-eight males (19 sedentary and 19 physically active) had their total body water and water turnover measured via the isotopic tracer deuterium oxide. Simultaneous tracking of dietary intake (food and fluid) is carried out via dietary recall, and energy expenditure is estimated via accelerometery. Our results show that active participants display a higher energy expenditure, water intake, carbohydrate intake and fibre intake, however, there is no difference in sodium or alcohol intake between the two groups. Relative water turnover in the active group is significantly greater than the sedentary group (Mean Difference (MD) [95% CI] = 17.55 g·kg−1·day−1 [10.90, 24.19], p = &lt, 0.001, g[95% CI] = 1.70 [0.98, 2.48]). A penalised linear regression provides evidence that the fibre intake (p = 0.033), water intake (p = 0.008), and activity level (p = 0.063) predict participants’ relative body water turnover (R2= 0.585). In conclusion, water turnover is faster in individuals undertaking regular exercise than in their sedentary counterparts, and is, in part, explained by the intake of water from fluid and high-moisture content foods. The nutrient analysis of the participant diets indicates that increased dietary fibre intake is also positively associated with water turnover rates. The water loss between groups also contributes to the differences observed in water turnover, this is partly related to differences in sweat output during increased energy expenditure from physical activity.

This is the protocol for a review and there is no abstract. The objectives are as follows:To assess the effects of heat acclimation interventions aimed at protecting health and performance from exertional heat stress.

Objective: The primary aim of this study was to assess the accuracy of an infrared camera and that of a skin thermistor, both commercially available. The study aimed to assess the agreement over a wide range of skin temperatures following cold exposure.Methods: Fifty-two males placed their right hand in a thin plastic bag and immersed it in 8 °C water for 30 min whilst seated in an air temperature of 30 °C. Following hand immersion, participants removed the bag and rested their hand at heart level for 10 min. Index finger skin temperature (Tsk) was measured with a thermistor, affixed to the finger pad, and an infrared camera measured 1 cm distally to the thermistor. Agreement between the infrared camera and thermistor was assessed by mean difference (infrared camera minus thermistor) and 95% limits of agreement analysis, accounting for the repeated measures over time. The clinically significant threshold for Tsk differences was set at ±0.5 °C and limits of agreement ±1 °C.Results: As an average across all time points, the infrared camera recorded Tsk 1.80 (SD 1.16) °C warmer than the thermistor, with 95% limits of agreement ranging from −0.46 °C to 4.07 °C.Conclusion: Collectively, the results show the infrared camera overestimated Tsk at every time point following local cooling. Further, measurement of finger Tsk from the infrared camera consistently fell outside the acceptable level of agreement (i.e. mean difference exceeding ±0.5 °C). Considering these results, infrared cameras may overestimate peripheral Tsk following cold exposure and clinicians and practitioners should, therefore, adjust their risk/withdrawal criteria accordingly.

The ASTM F2300-10 standard testing protocol was implemented for two continuous personal cooling systems (venturi air vest and cold-water perfused vest) with theoretically similar cooling capacities. Secondly, we used the same systems in step-wise increments of either temperature or relative humidity in order to define the upper limit of the prescriptive zone for each (i.e., critical environmental limits method). ASTM F2300-10 standard protocol saw both vests equally effective in reducing cardiovascular and thermal strain relative to a no cooling control. The critical environmental limits method saw the upper limit for humidity significantly increase in both vests, with no differences between the vests. However, the upper limit for temperature was increased in the cold-water vest, with the venturi air vest being no more beneficial than the control. Overall, this study used an evidence-based approach to demonstrate that a single environment, as per ASTM F2300-10, failed to delineate differences between continuous cooling systems promoting discrete mechanisms of heat loss. Most notably, relative to no cooling, the use of the air vest provided no additional evaporative cooling in a low humidity environment, and therefore no increase in the upper limits of critical temperature. This should highlight to end users not to assume that one size fits all for effective personal cooling systems if applied outside of the environment it was tested. Based on these findings, we suggest a range of environments be recommended by the ASTM F2300-10 standard for the evaluation of cooling systems to ensure systems ineffective in certain environments can be identified.

Investigate whether a range of cooling methods can extend tolerance time and/or reduce physiological strain in those working in the heat dressed in a Class 2 chemical, biological, radiological, nuclear (CBRN) protective ensemble.Eight males wore a Class 2 CBRN ensemble and walked for a maximum of 120 min at 35 °C, 50% relative humidity. In a randomised order, participants completed the trial with no cooling and four cooling protocols: 1) ice-based cooling vest (IV), 2) a non-ice-based cooling vest (PCM), 3) ice slushy consumed before work, combined with IV (SLIV) and 4) a portable battery-operated water-perfused suit (WPS). Mean with 95% confidence intervals are presented.Tolerance time was extended in PCM (46 [36, 56] min, P = 0.018), SLIV (56 [46, 67] min, P 0.001) and WPS (62 [53, 70] min, P 0.001), compared with control (39 [30, 48] min). Tolerance time was longer in SLIV and WPS compared with both IV (48 [39, 58 min]) and PCM (P ≤ 0.011). After 20 min of work, HR was lower in SLIV (121 [105, 136] beats·minAll cooling methods, except PCM, utilised in the present study reduced cardiovascular strain, while SLIV and WPS are most likely to extend tolerance time for those working in the heat dressed in a Class 2 CBRN ensemble.

Despite extensive documentation directed specifically toward mitigating thermal strain of first responders, we wished to ascertain the degree to which first responders applied cooling strategies, and what opinions are held by the various agencies/departments within the United States. An internet-based survey of first responders was distributed to the International Association of Fire Chiefs, International Association of Fire Firefighters, National Bomb Squad Advisory Board and the USA Interagency Board and their subsequent departments and branches. Individual first responder departments were questioned regarding the use of pre-, concurrent, post-cooling, types of methods employed, and/or reasons why they had not incorporated various methods in first responder deployment. Completed surveys were collected from 119 unique de-identified departments, including those working in law enforcement (29%), as firefighters (29%), EOD (28%) and HAZMAT technicians (15%). One-hundred and eighteen departments (99%) reported heat strain/illness to be a risk to employee safety during occupational duties. The percentage of departments with at least one case of heat illness in the previous year were as follows: fire (39%) HAZMAT (23%), EOD (20%) and law enforcement (18%). Post-cooling was the scheduled cooling method implemented the most (63%). Fire departments were significantly more likely to use post-cooling, as well as combine two types of scheduled cooling compared to other departments. Importantly, 25% of all departments surveyed provided no cooling whatsoever. The greatest barriers to personnel cooling were as follows – availability, cost, logistics, and knowledge. Our findings could aid in a better understanding of current practices and perceptions of heat illness and injury prevention in United States first responders. Abbreviations: EOD: explosive ordnance disposal; HAZMAT: hazardous materials

Objective The present study aimed to compare a range of cooling methods possibly utilised by occupational workers, focusing on their effect on body temperature, perception and manual dexterity. Methods Ten male participants completed eight trials involving 30 min of seated rest followed by 30 min of cooling or control of no cooling (CON) (34°C, 58% relative humidity). The cooling methods utilised were: ice cooling vest (CV0), phase change cooling vest melting at 14°C (CV14), evaporative cooling vest (CVEV), arm immersion in 10°C water (AI), portable water-perfused suit (WPS), heliox inhalation (HE) and ice slushy ingestion (SL). Immediately before and after cooling, participants were assessed for fine (Purdue pegboard task) and gross (grip and pinch strength) manual dexterity. Rectal and skin temperature, as well as thermal sensation and comfort, were monitored throughout. Results Compared with CON, SL was the only method to reduce rectal temperature (P = 0.012). All externally applied cooling methods reduced skin temperature (P0.05). Conclusion The present study observed that ice ingestion or ice applied to the skin produced the greatest effect on rectal and skin temperature, respectively. AI should not be utilised if workers require subsequent fine manual dexterity. These results will help inform future studies investigating appropriate pre-cooling methods for the occupational worker.

© 2017 Elsevier Ltd The importance of using infrared thermography (IRT) to assess skin temperature (t sk ) is increasing in clinical settings. Recently, its use has been increasing in sports and exercise medicine; however, no consensus guideline exists to address the methods for collecting data in such situations. The aim of this study was to develop a checklist for the collection of t sk using IRT in sports and exercise medicine. We carried out a Delphi study to set a checklist based on consensus agreement from leading experts in the field. Panelists (n = 24) representing the areas of sport science (n = 8; 33%), physiology (n = 7; 29%), physiotherapy (n = 3; 13%) and medicine (n = 6; 25%), from 13 different countries completed the Delphi process. An initial list of 16 points was proposed which was rated and commented on by panelists in three rounds of anonymous surveys following a standard Delphi procedure. The panel reached consensus on 15 items which encompassed the participants’ demographic information, camera/room or environment setup and recording/analysis of t sk using IRT. The results of the Delphi produced the checklist entitled “Thermographic Imaging in Sports and Exercise Medicine (TISEM)” which is a proposal to standardize the collection and analysis of t sk data using IRT. It is intended that the TISEM can also be applied to evaluate bias in thermographic studies and to guide practitioners in the use of this technique.

Current hydration assessments involve biological fluids that are either compromised in dehydrated individuals or require laboratory equipment, making timely results unfeasible. The eye has been proposed as a potential site to provide a field-based hydration measure. The present study evaluated the efficacy and sensitivity of intraocular pressure (IOP) to assess hydration status. Twelve healthy males undertook two 150 min walking trials in 40°C 20% relative humidity. One trial matched fluid intake to body mass loss (control, CON) and the other had fluid restricted (dehydrated, DEH). IOP (rebound tonometry) and hydration status (nude body mass and serum osmolality) were determined every 30 min. Body mass and serum osmolality were significantly (p < 0.05) different between trials at all-time points following baseline. Body mass losses reached 2.5 ± 0.2% and serum osmolality 299 ± 5 mOsmol.kg−1 in DEH. A significant trial by time interaction was observed for IOP (p = 0.042), indicating that over the duration of the trials IOP declined to a greater extent in the DEH compared with the CON trial. Compared with baseline measurements IOP was reduced during DEH (150 min: −2.7 ± 1.9 mm Hg; p < 0.05) but remained stable in CON (150 min: −0.3 ± 2.4 mm Hg). However, using an IOP value of 13.2 mm Hg to predict a 2% body mass loss resulted in only 57% of the data being correctly classified (sensitivity 55% and specificity 57%). The use of ΔIOP (−2.4 mm Hg) marginally improved the predictive ability with 77% of the data correctly classified (sensitivity: 55%; specificity: 81%). The present study provides evidence that the large inter-individual variability in baseline IOP and in the IOP response to progressive dehydration, prevents the use of IOP as an acute single assessment marker of hydration status.

Objective The perceptual strain index (PeSI) has been shown to overcome the limitations associated with the assessment of the physiological strain index (PSI), primarily the need to obtain a core body temperature measurement. The PeSI uses the subjective scales of thermal sensation and perceived exertion (RPE) to provide surrogate measures of core temperature and heart rate, respectively. Unfortunately, thermal sensation has shown large variability in providing an estimation of core body temperature. Therefore, the primary aim of this study was to determine if thermal comfort improved the ability of the PeSI to predict the PSI during exertional-heat stress. Methods Eighteen healthy males (age: 23.5 years; body mass: 79.4 kg; maximal aerobic capacity: 57.2 ml·kg− 1·min− 1) wore four different chemical/biological protective garments while walking on treadmill at a low (< 325 W) or moderate (326–499 W) metabolic workload in environmental conditions equivalent to wet bulb globe temperatures 21, 30 or 37 °C. Trials were terminated when heart rate exceeded 90% of maximum, when core body temperature reached 39 °C, at 120 min or due to volitional fatigue. Core body temperature, heart rate, thermal sensation, thermal comfort and RPE were recorded at 15 min intervals and at termination. Multiple statistical methods were used to determine the most accurate perceptual predictor. Results Significant moderate relationships were observed between the PeSI (r = 0.74; p < 0.001), the modified PeSI (r = 0.73; p < 0.001) and unexpectedly RPE (r = 0.71; p < 0.001) with the PSI, respectively. The PeSI (mean bias: − 0.8 ± 1.5 based on a 0–10 scale; area under the curve: 0.887), modified PeSI (mean bias: − 0.5 ± 1.4 based on 0–10 scale; area under the curve: 0.886) and RPE (mean bias: − 0.7 ± 1.4 based on a 0–10 scale; area under the curve: 0.883) displayed similar predictive performance when participants experienced high-to-very high levels of physiological strain. Conclusions Modifying the PeSI did not improve the subjective prediction of physiological strain. However, RPE provided an equally accurate prediction of physiological strain, particularly when high-to-very high levels of strain were observed. Therefore, given its predictive performance and user-friendliness, the evidence suggests that RPE in isolation is a practical and cost-effective tool able to estimate physiological strain during exertional-heat stress under these work conditions.

Research into obtaining a fast, valid, reliable and non-invasive measure of core temperature is of interest in many disciplinary fields. Occupational and sports medicine research has attempted to determine a non-invasive proxy for core temperature particularly when access to participants is limited and thermal safety is of a concern due to protective encapsulating clothing, hot ambient environments and/or high endogenous heat production during athletic competition. This investigation aimed to determine the validity of inner canthus of the eye temperature (TEC) as an alternate non-invasive measure of intestinal core temperature (TC) during rest, exercise and post-exercise conditions. Twelve physically active males rested for 30 min prior to exercise, performed 60 min of aerobic exercise at 60% V̇O2max and passively recovered a further 60 min post-exercise. TEC and TC were measured at 5 min intervals during each condition. Mean differences between TEC and TC were 0.61 °C during pre-exercise, −1.78 °C during exercise and −1.00 °C during post-exercise. The reliability between the methods was low in the pre-exercise (ICC=0.49 [−0.09 to 0.82]), exercise (ICC=−0.14 [−0.65 to 0.44]) and post-exercise (ICC=−0.25 [−0.70 to 0.35]) conditions. In conclusion, poor agreement was observed between the TEC values measured through IRT and TC measured through a gastrointestinal telemetry pill. Therefore, TEC is not a valid substitute measurement to gastrointestinal telemetry pill in sports and exercise science settings., Highlights • Inner canthus of the eye is not a valid measure of intestinal core temperature. • Inner canthus of the eye temperature has severe errors in exercises settings. • The variability is more evident in the aerobic exercise and post-exercise conditions.

This investigation aimed to quantify metabolic rate when wearing an explosive ordnance disposal (EOD) ensemble (~33kg) during standing and locomotion; and determine whether the Pandolf load carriage equation accurately predicts metabolic rate when wearing an EOD ensemble during standing and locomotion. Ten males completed 8 trials with metabolic rate measured through indirect calorimetry. Walking in EOD at 2.5, 4.0 and 5.5km·h−1 was significantly (p < 0.05) greater than matched trials without the EOD ensemble by 49% (127W), 65% (213W) and 78% (345W), respectively. Mean bias (95% limits of agreement) between predicted and measured metabolism during standing, 2.5, 4 and 5.5km·h−1 were 47W (19 to 75W); −111W (−172 to −49W); −122W (−189 to −54W) and −158W (−245 to −72W), respectively. The Pandolf equation significantly underestimated measured metabolic rate during locomotion. These findings have practical implications for EOD technicians during training and operation and should be considered when developing maximum workload duration models and work-rest schedules.

The dynamic nature of tissue temperature and the subcutaneous properties, such as blood flow, fatness, and metabolic rate, leads to variation in local skin temperature. Therefore, we investigated the effects of using multiple regions of interest when calculating weighted mean skin temperature from four local sites. Twenty-six healthy males completed a single trial in a thermonetural laboratory (mean±SD): 24.0 (1.2) °C; 56 (8%) relative humidity

PURPOSE:Skin temperature assessment has historically been undertaken with conductive devices affixed to the skin. With the development of technology, infrared devices are increasingly utilised in the measurement of skin temperature. Therefore, our purpose was to evaluate the agreement between four skin temperature devices at rest, during exercise in the heat, and recovery. METHODS:Mean skin temperature ([Formula: see text]) was assessed in thirty healthy males during 30 min rest (24.0 ± 1.2°C, 56 ± 8%), 30 min cycle in the heat (38.0 ± 0.5°C, 41 ± 2%), and 45 min recovery (24.0 ± 1.3°C, 56 ± 9%). [Formula: see text] was assessed at four sites using two conductive devices (thermistors, iButtons) and two infrared devices (infrared thermometer, infrared camera). RESULTS:Bland-Altman plots demonstrated mean bias ± limits of agreement between the thermistors and iButtons as follows (rest, exercise, recovery): -0.01 ± 0.04, 0.26 ± 0.85, -0.37 ± 0.98°C; thermistors and infrared thermometer: 0.34 ± 0.44, -0.44 ± 1.23, -1.04 ± 1.75°C; thermistors and infrared camera (rest, recovery): 0.83 ± 0.77, 1.88 ± 1.87°C. Pairwise comparisons of [Formula: see text] found significant differences (p < 0.05) between thermistors and both infrared devices during resting conditions, and significant differences between the thermistors and all other devices tested during exercise in the heat and recovery. CONCLUSIONS:These results indicate poor agreement between conductive and infrared devices at rest, during exercise in the heat, and subsequent recovery. Infrared devices may not be suitable for monitoring [Formula: see text] in the presence of, or following, metabolic and environmental induced heat stress.

The use of improvised explosive devices (IED) is becoming more prevalent in modern warfare, civil unrest and lone wolf terrorism. This has led to a greater role for explosive ordnance disposal (EOD) technicians to neutralise the threat of IED detonations. As such, the inherent risk to EOD technicians requires them to don a heavy (~34 kg) protective ensemble that subsequently increases the metabolic demand of tasks, such as locomotion. Previous research into the metabolic cost of protective clothing has focused primarily on chemical and fire ensembles [1]. Currently little is known about the metabolic cost of EOD protective clothing. The purpose of this investigation was 1) to quantify the metabolic demand when wearing an EOD ensemble at various speeds of locomotion and 2) establish whether the Pandolf predictive formula [2] is appropriate to estimate of EOD energy expenditure.