Brianna Larsen

The Effect of Body Armor on Performance, Thermal Stress, and Exertion: A Critical Review

Armed forces worldwide utilize some form of body armor as part of their personal protective system. This is particularly essential in recent times because of the increased sophistication of weapons employed during modern warfare and the advent of unconventional combat methods (such as the increased use of improvised explosive devices). There is some evidence to show, however, that the usage of military body armor impairs physical performance. This review of the literature will focus on the effect of body armor on the performance of, and physiological and subjective responses during, military-style physical tasks. Because of the paucity of research investigating body armor, this review will also draw upon more generalized personal protective clothing and equipment literature from a range of physically demanding occupations (i.e., firefighting and other emergency services). The review will conclude with suggested directions for future research in this area.

Sleep restriction during simulated wildfire suppression: Effect on physical task performance

Objectives To examine the effects of sleep restriction on firefighters’ physical task performance during simulated wildfire suppression. Methods Thirty-five firefighters were matched and randomly allocated to either a control condition (8-hour sleep opportunity, n = 18) or a sleep restricted condition (4-hour sleep opportunity, n = 17). Performance on physical work tasks was evaluated across three days. In addition, heart rate, core temperature, and worker activity were measured continuously. Rate of perceived and exertion and effort sensation were evaluated during the physical work periods. Results There were no differences between the sleep-restricted and control groups in firefighters’ task performance, heart rate, core temperature, or perceptual responses during self-paced simulated firefighting work tasks. However, the sleep-restricted group were less active during periods of non-physical work compared to the control group. Conclusions Under self-paced work conditions, 4 h of sleep restriction did not adversely affect firefighters’ performance on physical work tasks. However, the sleep-restricted group were less physically active throughout the simulation. This may indicate that sleep-restricted participants adapted their behaviour to conserve effort during rest periods, to subsequently ensure they were able to maintain performance during the firefighter work tasks. This work contributes new knowledge to inform fire agencies of firefighters’ operational capabilities when their sleep is restricted during multi-day wildfire events. The work also highlights the need for further research to explore how sleep restriction affects physical performance during tasks of varying duration, intensity, and complexity.

The impact of sleep restriction and simulated physical firefighting work on acute inflammatory stress responses

Objectives This study investigated the effect restricted sleep has on wildland firefighters’ acute cytokine levels during 3 days and 2 nights of simulated physical wildfire suppression work. Methods Firefighters completed multiple days of physical firefighting work separated by either an 8-h (Control condition; n = 18) or 4-h (Sleep restriction condition; n = 17) sleep opportunity each night. Blood samples were collected 4 times a day (i.e., 06:15, 11:30, 18:15, 21:30) from which plasma cytokine levels (IL-6, IL-8, IL-1β, TNF-α, IL-4, IL-10) were measured. Results The primary findings for cytokine levels revealed a fixed effect for condition that showed higher IL-8 levels among firefighters who received an 8-h sleep each night. An interaction effect demonstrated differing increases in IL-6 over successive days of work for the SR and CON conditions. Fixed effects for time indicated that IL-6 and IL-4 levels increased, while IL-1β, TNF-α and IL-8 levels decreased. There were no significant effects for IL-10 observed. Conclusion Findings demonstrate increased IL-8 levels among firefighters who received an 8-h sleep when compared to those who had a restricted 4-h sleep. Firefighters’ IL-6 levels increased in both conditions which may indicate that a 4-h sleep restriction duration and/or period (i.e., 2 nights) was not a significant enough stressor to affect this cytokine. Considering the immunomodulatory properties of IL-6 and IL-4 that inhibit pro-inflammatory cytokines, the rise in IL-6 and IL-4, independent of increases in IL-1β and TNF-α, could indicate a non-damaging response to the stress of simulated physical firefighting work. However, given the link between chronically elevated cytokine levels and several diseases, further research is needed to determine if firefighters’ IL-8 and IL-6 levels are elevated following repeated firefighting deployments across a fire season and over multiple fire seasons.

Multiple Days of Heat Exposure on Firefighters’ Work Performance and Physiology

This study assessed the accumulated effect of ambient heat on the performance of, and physiological and perceptual responses to, intermittent, simulated wildfire fighting tasks over three consecutive days. Firefighters (n = 36) were matched and allocated to either the CON (19°C) or HOT (33°C) condition. They performed three days of intermittent, self-paced simulated firefighting work, interspersed with physiological testing. Task repetitions were counted (and converted to distance or area) to determine work performance. Participants were asked to rate their perceived exertion and thermal sensation after each task. Heart rate, core temperature (Tc), and skin temperature (Tsk) were recorded continuously throughout the simulation. Fluids were consumed ad libitum. Urine volume was measured throughout, and urine specific gravity (USG) analysed, to estimate hydration. All food and fluid consumption was recorded. There was no difference in work output between experimental conditions. However, significant variation in performance responses between individuals was observed. All measures of thermal stress were elevated in the HOT, with core and skin temperature reaching, on average, 0.24 ± 0.08°C and 2.81 ± 0.20°C higher than the CON group. Participants’ doubled their fluid intake in the HOT condition, and this was reflected in the USG scores, where the HOT participants reported significantly lower values. Heart rate was comparable between conditions at nearly all time points, however the peak heart rate reached each circuit was 7 ± 3% higher in the CON trial. Likewise, RPE was slightly elevated in the CON trial for the majority of tasks. Participants’ work output was comparable between the CON and HOT conditions, however the performance change over time varied significantly between individuals. It is likely that the increased fluid replacement in the heat, in concert with frequent rest breaks and task rotation, assisted with the regulation of physiological responses (e.g., heart rate, core temperature).

Subjective job task analyses for physically demanding occupations: What is best practice?

Workers in physically demanding occupations (PDOs) are frequently subjected to physical selection tests. To avoid legal ramifications, workplaces must be able to show that any personnel selection procedures reflect the inherent requirements of the job. A job task analysis (JTA) is fundamental in determining the work tasks required for employees. To date, there are no published instructions guiding PDO researchers on how to conduct job task analyses. Job task analysis research for non-PDOs offers some insight into the expected reliability and validity of data obtained on the most prevalent task domains in job analysis (importance, frequency, time spent and difficulty). This review critiques such research, and the existing published material on JTA of PDOs, and provides recommendations for future research and practice. Practitioner Summary: There are no published guidelines for physically demanding occupation (PDO) researchers conducting job task analysis (JTA). Given the legal consequences of improperly conducted JTA, scientifically valid instructions for JTA practitioners are required. This review critiques existing research which analyses reliabilities of JTA data, and provides guidelines for PDO researchers conducting JTA.

Firefighter feedback during active cooling: A useful tool for heat stress management?

Monitoring an individuals thermic state in the workplace requires reliable feedback of their core temperature. However, core temperature measurement technology is expensive, invasive and often impractical in operational environments, warranting investigation of surrogate measures which could be used to predict core temperature. This study examines an alternative measure of an individuals thermic state, thermal sensation, which presents a more manageable and practical solution for Australian firefighters operating on the fireground. Across three environmental conditions (cold, warm, hot & humid), 49 Australian volunteer firefighters performed a 20-min fire suppression activity, immediately followed by 20 min of active cooling using hand and forearm immersion techniques. Core temperature (Tc) and thermal sensation (TS) were measured across the rehabilitation period at five minute intervals. Despite the decline in Tc and TS throughout the rehabilitation period, there was little similarity in the magnitude or rate of decline between each measure in any of the ambient conditions. Moderate to strong correlations existed between Tc and TS in the cool (0.41, p<0.05) and hot & humid (0.57, p<0.05) conditions, however this was resultant in strong correlation during the earlier stages of rehabilitation (first five minutes), which were not evident in the latter stages. Linear regression revealed TS to be a poor predictor of Tc in all conditions (SEE=0.45-0.54°C) with a strong trend for TS to over-predict Tc (77-80% of the time). There is minimal evidence to suggest that ratings of thermal sensation, which represent a psychophysical assessment of an individuals thermal comfort, are an accurate reflection of the response of an individuals core temperature. Ratings of thermal sensation can be highly variable amongst individuals, likely moderated by local skin temperature. In account of these findings, fire managers require a more reliable source of information to guide decisions of heat stress management.

The Injury Profile of an Australian Specialist Policing Unit

This study investigated the injuries sustained by an Australian specialist police division. Injury records spanning four-years were analyzed. The role being performed when the injury occurred, injury cause, body part injured, and injury-related costs were quantified. The percentage of personnel injured multiple times was documented. One hundred and thirty eight personnel reported injuries, 58 of these on multiple occasions. This resulted in 229 injuries and 76 claims being raised. Half of the injuries occurred during operational policing tasks, however training activities accounted for >30% of injuries. The most common injury was strain/sprain, and upper body injuries were 2.5-times more common than lower-body or torso injuries. 1107 shifts were lost, and injuries cost the organization

A survey to identify physically demanding tasks performed during storm damage operations by Australian State Emergency Services personnel.

487,159 (Australian Dollars) over the four-year period. The injury costs (both financial and in manpower) may prompt policy makers to review the current training and post-injury rehabilitation protocols.

The Impact of Heat Exposure and Sleep Restriction on Firefighters’ Work Performance and Physiology during Simulated Wildfire Suppression

PURPOSE To identify and characterize the physically demanding tasks performed by SES personnel during storm damage work. METHODS Thirty-six tasks identified as the most operationally important to storm damage work were included in a survey which was available to all SES volunteers. The survey aimed to identify the physical demand, operational importance, frequency, duration, principal actions and fitness components of each task. RESULTS Twelve tasks were identified as the most physically demanding. Of these, carrying sandbags, lifting sandbags and shoveling sand (with hands) rated highest. Covering roof damages with tarpaulin and erecting external weather proofing were ranked highest for operational importance. Box lifting (single-person) and erecting external weather proofing returned the highest mode values for frequency, whereas tasks involving handling sandbags returned the highest mean and median frequency values. Covering roof damages with tarpaulin was identified as the longest task. Bending, lifting, twisting and carrying were the most common actions identified for the physically demanding tasks. Muscular strength and muscular endurance were the primary fitness components identified for the twelve tasks. CONCLUSION SES personnel perform a variety of storm response tasks, many of which are physically demanding. All or most of the physically demanding tasks contain elements of bending, lifting, twisting and carrying, and call upon personnels muscular strength and muscular endurance capabilities.

Identifying and characterising the physical demands for an Australian specialist policing unit

This study was designed to examine the effects of ambient heat on firefighters’ physical task performance, and physiological and perceptual responses when sleep restricted during simulated wildfire conditions. Thirty firefighters were randomly allocated to the sleep restricted (n = 17, SR; 19 °C, 4-h sleep opportunity) or hot and sleep restricted (n = 13, HOT + SR; 33 °C, 4-h sleep opportunity) condition. Firefighters performed two days of simulated, intermittent, self-paced work circuits comprising six firefighting tasks. Heart rate, and core temperature were measured continuously. After each task, firefighters reported their rating of perceived exertion and thermal sensation. Effort sensation was also reported after each work circuit. Fluids were consumed ad libitum. Urine volume and urine specific gravity were analysed. Sleep was monitored using polysomnography. There were no differences between the SR and HOT + SR groups in firefighters’ physiological responses, hydration status, ratings of perceived exertion, motivation, and four of the six firefighting tasks (charged hose advance, rake, hose rolling, static hose hold). Black out hose and lateral repositioning were adversely affected in the HOT + SR group. Working in hot conditions did not appear to consistently impair firefighters work performance, physiology, and perceptual responses. Future research should determine whether such findings remain true when individual tasks are performed over longer durations.