Effects of Acute Sleep Deprivation on the Physiological Response to Woodsmoke and Exercise.

OBJECTIVE: To evaluate sleep deprivation effects on the acute physiological response to a combined stressor of woodsmoke and exercise. METHODS: Ten participants completed two exercise trials (8 hours of sleep vs 4 hours) with woodsmoke. Trials were conducted in a crossover design. Key measures examined before and after each trial included heart rate variability, pulse wave velocity, blood pressure, pulmonary function testing, and oxidative stress. RESULTS: Acute sleep deprivation experienced before exercise and woodsmoke exposure did not impact metrics of heart rate variability, pulse wave velocity, pulmonary function testing, blood pressure, or oxidative stress. CONCLUSIONS: Acute sleep deprivation did not amplify physiologic metrics in response to moderate-intensity aerobic exercise with inhaled woodsmoke. Although findings do not eliminate the negative impacts of inhaling woodsmoke, more research is needed to understand the acute effects of woodsmoke exposure on the cardiovascular system. 1.

Twenty-Four Percent of Wildland Firefighters Reach Critical Levels of Serum Creatine Kinase During 80-Hour Critical Training.

INTRODUCTION: Wildland firefighters (WLFFs) must undergo a 2-wk critical training (CT) period prior to deployment to the field. This stress may result in clinical risks, including severe muscle damage and rhabdomyolysis. We aimed to document the effects of WLFFs' CT on physiologic markers of muscle damage and soreness. METHODS: Two interagency hotshot crews (n=25) were followed during spring 2022 for 80 h of training. Activity counts as well as records of upper-body (US) and lower-body (LS) muscle soreness were collected daily. Body weight (BW) and skinfold measurements were recorded on Day 1 (D1) and D11 to estimate body fat (BF) and lean body weight (LBW). Blood was collected on D1 and D11 to measure muscle and liver damage markers. RESULTS: Critical training resulted in significant elevations in creatine kinase (CK) (216.9±57.4 U/L vs 5166.4±1927.8 U/L, P=0.017) and lactate dehydrogenase (LDH) (175.5±4.0 IU/L vs 340.0±42.6 IU/L, P=0.001) despite no significant changes in BW, BF, LBW, cortisol, or testosterone. Main effects of time were seen in US and LS, peaking on D11 (US: 5.2±0.4 cm, P<0.001; LS: 5.5±0.4 cm, P<0.001). Those who spent the most minutes with activity counts of >1500 counts/min showed the greatest increase in CK and LDH. CONCLUSIONS: These data suggest that WLFFs undergo significant physiologic stressors, resulting in muscle soreness and damage during CT, with 6 of the 25 subjects reaching critical levels of serum CK. It appears that much of the muscle damage and soreness occurred because of unaccustomed WLFF job-specific tasks.

Wildland Firefighter Critical Training Elicits Positive Adaptations to Markers of Cardiovascular and Metabolic Health.

INTRODUCTION: The purpose of this study was to identify physiologic changes in body composition and resting metabolic markers of health across 2 wk of critical training (CT) in wildland firefighters (WLFFs). METHODS: Twenty-two male and 3 female participants were recruited from 2 hotshot crews across the western United States prior to the 2022 fire season and monitored over their 80-h CT. Body weight (BW) and skinfolds were recorded before and after CT to estimate body fat (BF) and lean body weight (LBW). Blood was analyzed for changes in hematocrit, hemoglobin, plasma volume, and resting values of a lipid and metabolic panel. RESULTS: The high physical demands of CT resulted in improvements in total cholesterol (-19.3 mg/dL, P<0.001), triglycerides (-34.4 mg/dL, P<0.001), low-density lipoprotein cholesterol (-18.1 mg/dL, P<0.001), very-low-density lipoprotein cholesterol (-5.2 mg/dL, P<0.001), high-density lipoprotein cholesterol (+4.0 mg/dL, P=0.002), non-high-density lipoprotein cholesterol (-19.3 mg/dL, P<0.001), and fasting glucose (-4.3 mg/dL, P=0.008) from before CT to after CT. Significant decreases in hemoglobin and hematocrit were also seen (P<0.001) with corresponding increases in estimated plasma volume (+6.1%, P<0.001). These alterations were seen despite maintenance of BW, LBW, and BF. Lower pretraining BF was associated with a greater magnitude of improvements in fasting glucose and cholesterol markers. CONCLUSIONS: The observed improvements in baseline metabolic and cardiovascular markers along with plasma volume expansion suggest a positive response to the physical stress of WLFF CT. It appears that higher preseason fitness was associated with greater adaptations to the CT stressor.

Application of a Novel Collection of Exhaled Breath Condensate to Exercise Settings.

The collection of exhaled breath condensate (EBC) is a non-invasive method for obtaining biosamples from the lower respiratory tract, an approach amenable to exercise, environmental, and work physiology applications. The purpose of this study was to develop a cost-effective, reproducible methodology for obtaining larger volume EBC samples. Participants (male: n = 10; female: n = 6; 26 ± 8 yrs.) completed a 10 min EBC collection using a novel device (N-EBC). After initial collection, a 45 min bout of cycling at 75% HRmax was performed, followed by another N-EBC collection. In a subset of individuals (n = 5), EBC was obtained using both the novel technique and a commercially available EBC collection device (R-EBC) in a randomized fashion. N-EBC volume-pre- and post-exercise (2.3 ± 0.8 and 2.6 ± 0.9 mL, respectively)-and pH (7.4 ± 0.5 and 7.4 ± 0.5, respectively) were not significantly different. When normalized for participant body height, device comparisons indicated N-EBC volumes were larger than R-EBC at pre-exercise (+12%) and post-exercise (+48%). Following moderate-intensity exercise, no changes in the pre- and post-trial values of Pentraxin 3 (0.25 ± 0.04 and 0.26 ± 0.06 pg/mL, respectively) and 8-Isoprostrane (0.43 ± 0.33 and 0.36 ± 0.24 pg/mL, respectively) concentrations were observed. In a cost-efficient fashion, the N-EBC method produced larger sample volumes, both pre- and post-exercise, facilitating more biomarker tests to be performed.

Deterioration of Lipid Metabolism Despite Fitness Improvements in Wildland Firefighters.

OBJECTIVE: Determine serum lipid and general health/fitness alterations following a 5-month wildfire suppression season. METHODS: We recruited 100 wildland firefighters (WLFFs) to a 5-month pre- to post-season observational study. Nude body mass, blood pressure (BP), grip strength, and steptest heart rate (HR) were recorded. Blood samples were collected for lipid panel analysis (total cholesterol, high density lipoproteins (HDL)-cholesterol, low density lipoproteins-cholesterol, very low density lipoproteinscholesterol, triglycerides, triglyceride:HDL-cholesterol ratio). Two-tailed dependent t tests determined statistical significance (P < 0.05). RESULTS: There were pre- to post-season changes in nude body mass (+2 ±â€Š4%, P  = 0.001), systolic BP (-2 ±â€Š10%, P  = 0.01), step-test HR (-5 ±â€Š10%, P  < 0.001), and all serum lipids (total cholesterol: +5 ±â€Š14%, P  = 0.02, HDL-cholesterol: = 1 ±â€Š17%, P  = 0.04, low density lipoproteins-cholesterol: +8 ±â€Š22%, P  = 0.02, very low density lipoproteins-cholesterol: +31 ±â€Š49%, P  < 0.001, triglycerides: +30 ±â€Š49%, P  < 0.001, triglyceride:HDL-cholesterol ratio: +37 ±â€Š58%, P  < 0.001). Pre- to post-season diastolic BP (P = 0.12) and grip strength (P = 0.60) remained stable. CONCLUSIONS: WLFFs demonstrate maladaptive serum lipids and body mass alterations despite subtle aerobic fitness improvements.

Nutrient Intake of Wildland Firefighters During Arduous Wildfire Suppression: Macronutrient and Micronutrient Consumption.

Wildland firefighters (WLFFs) perform in adverse environments making rapid adjustments to dietary needs. The National Mobile Food Services (NMFS) contract details WLFF dietary provisions on wildfire incidents. OBJECTIVE: Determine the nutrient content of food and drink provided to and consumed by WLFFs under the NMFS contract. METHODS: Individual (n = 122) dietary provisions and consumption was recorded during 1 workday. Nutritional analysis of items provided was compared with consumption and the recommended dietary allowance (RDA). RESULTS: WLFFs consumed significantly (P < 0.05) fewer macronutrients than provided for calories, protein, and fat. Provided and consumed micronutrients were below the RDA for vitamins D and E, magnesium, and manganese. CONCLUSION: Most dietary recommendations were met by NMFS provisions. Next steps include WLFF nutrition education to improve consumption and contract revisions to meet micronutrient recommendations.

Workshift Changes in Hydration Status During Wildfire Suppression.

OBJECTIVE: Document wildland firefighters (WLFFs) hydration status during a singular workshift (13.7 ±â€Š1.4 hours). METHODS: WLFF researchers documented real-time WLFF (n = 71) urine metrics and fluid consumption. Body weight and blood samples (n = 25) were also collected. Two-tailed dependent t tests determined statistical significance (P < 0.05). RESULTS: Body weight significantly decreased (-0.3 ±â€Š1.1%, P > 0.05). Fluid consumption totaled 6.2 ±â€Š2.3 L including food and 5.0 ±â€Š2.1 L without food. Morning versus afternoon urine frequency (2.6 ±â€Š1.3, 3.1 ±â€Š1.9 voids), urine volume (1.2 ±â€Š0.7, 1.3 ±â€Š0.8 L), urine volume per void (440 ±â€Š157, 397 ±â€Š142 mL), and urine specific gravity (1.010 ±â€Š0.007, 1.010 ±â€Š0.007) were not significantly different (P > 0.05). Pre- to post-workshift serum chloride (103.2 ±â€Š1.9, 101.4 ±â€Š1.7 mM) and blood glucose (5.2 ±â€Š0.4, 4.5 ±â€Š0.7 mM) significantly decreased (P < 0.05), while serum sodium (141.5 ±â€Š2.4, 140.8 ±â€Š2.0 mM) and serum potassium (4.3 ±â€Š0.3, 4.2 ±â€Š0.3 mM) remained stable (P > 0.05). CONCLUSIONS: WLFFs can ingest fluid and food amounts that maintain workshift euhydration and electrolyte status.

Alterations in Metabolic and Cardiovascular Risk Factors During Critical Training in Wildland Firefighters.

OBJECTIVE: To identify physiologic stressors related to cardiovascular disease via changes in metabolic, inflammatory, and oxidative stress biomarkers during 2 weeks of preseason training in wildland firefighters (WLFFs). METHODS: Participants were recruited from a local hotshot crew and monitored during preseason training. Fitness was assessed via the Bureau of Land Management fitness challenge. Venipuncture blood was collected on days 1, 4, 8, and 11 and analyzed for changes in a lipid and glucose panel, C-reactive protein, and oxidative stress markers 8-isoprostane (8ISO), 3-nitrotyrosine (3NT), lipid hydroperoxides (LOOH), and protein carbonyls. RESULTS: The high physical demands of training resulted in significant (P < 0.05) reductions in total cholesterol, glucose, and hemoglobin A1c. A main effect for time was observed in 8ISO, 3NT, and LOOH. CONCLUSIONS: Alterations in metabolic and oxidative stress markers suggest an acute, high-intensity physical stress during WLFF preseason training.

Evaluation of Environmental Conditions on Self-Selected Work and Heat Stress in Wildland Firefighting.

INTRODUCTION: The purpose of this study was to evaluate heat stress occurring in wildfire management activities with variable environmental conditions. METHODS: Direct observation and real-time wireless physiological monitoring allowed for weather and physiological metrics, including heart rate, core temperature (Tc), skin temperature, and physiological strain index (PSI), of male (n=193) and female (n=28) wildland firefighters (WLFFs) to be recorded during wildfire management activities. Accelerometry data were used to categorize intensity level of activity. RESULTS: Ambient temperature and relative humidity values were used to compute the heat index (HI; n=3891 h) and divided into quartiles (Q1: 13.3-25.1°C; Q2: 25.2-26.4°C; Q3: 26.5-28.9°C; Q4: 29.0-49.1°C). Activity levels remained relatively constant across all HI quartiles. The percentage of time spent performing moderate/vigorous activities was lowest during the hotter Q4 (Q1: 3%; Q2: 2%; Q3: 2%; Q4: 1%). Heart rate, Tc, PSI, and skin temperature associations with HI varied by resource type. Sixty-one percent of WLFFs (n=134) experienced a Tc ≥38.0°C, and 50% of WLFFs (n=111) experienced a PSI ≥6.0. CONCLUSIONS: Heat stress was prevalent as WLFFs performed job tasks of varying intensities in all ambient conditions. Spontaneous bouts of arduous labor, duration of work shifts, and other occupation characteristics present the possibility for substantial durations of hyperthermia, although no heat-related injuries occurred in this study. Despite chronic exposure to rugged sloped terrain, load carriage, and environmental conditions, self-regulation and individual attention to managing work:rest appears to be the primary management strategy in mitigating excessive accumulation of body heat in this occupation.

Muscle Damage and Overreaching During Wildland Firefighter Critical Training.

OBJECTIVE: To document the effects of wildland firefighter (WLFF) critical training (CT) on physiologic markers of muscle damage and acute overreaching. METHODS: Eighteen male and three female WLFFs were studied during an 11-day CT. Upper-body (US), lower-body (LS) muscle soreness and body weight (BW) were collected daily. Blood was collected on days 1, 4, 8, and 11 to measure creatine kinase (CK), lactate dehydrogenase (LDH), cortisol, and testosterone. Skinfolds were taken on days 1 and 11 to estimate body fat (BF) and lean body weight (LBW). RESULTS: CT resulted in a significant depression in BF and elevation in LBW, while main effects of time were seen in US, LS, CK, LDH, cortisol, and testosterone/cortisol ratio (P < 0.05). CONCLUSION: These data suggest WLFFs undergo significant physiological stressors resulting in muscle soreness, damage, and possible overreaching during CT.

Total Energy Intake and Self-Selected Macronutrient Distribution During Wildland Fire Suppression.

INTRODUCTION: Wildland firefighters (WLFF) work long hours in extreme environments, resulting in high daily total energy expenditure. Increasing work-shift eating episodes and/or providing rations that promote convenient eating has shown augmented self-selected work output, as has regular carbohydrate (CHO) consumption. It remains unclear how current WLFF feeding strategies compare to more frequent nutrient delivery. Our aim was to determine WLFFs' self-selected field total energy intake (TEI), composition, and feeding patterns during wildland fire suppression shifts. METHODS: WLFF were deployed to fire incidents across the United States throughout the 2018 fire season. Preshift food inventories collected at basecamp provided item-specific nutrient content (kilocalories, CHO, fat, protein). Work shift consumption (TEI, feeding frequency, episodic composition) was monitored in real time by field researchers on fireline via observational data capture using mobile tablets. Shift work output was also quantified via actigraph accelerometry. RESULTS: Eighty-six WLFF (27.5±6.4 y; 16 female, 70 male) worked 14.0±1.1 h shifts, with a TEI of 6.3±2.5 MJ (1494±592 kcal) (51±10, 37±9, 13±4% for CHO, fat, and protein, respectively). WLFF averaged 4.3±1.6 eating episodes (1.4±1.3 MJ [345±306 kcal] and 44±38 g CHO·episode-1). WLFF who consumed >20 kcal·kg-1 averaged less sedentary activity than those consuming <16 kcal·kg-1. Data are presented as mean±SD. CONCLUSIONS: Not including fire camp meals (breakfast, dinner), the present work-shift TEI approximates 33% of previously determined WLFF total energy expenditure and demonstrates that current WLFF consumption patterns may not deliver adequate nutrients for occupational demands.

Risk for heat-related illness among wildland firefighters: job tasks and core body temperature change.

OBJECTIVES: In order to make recommendations to protect wildland firefighters (WLFFs) from heat-related illness, the role physical exertion plays on core body temperature (Tc) in the work environment needs to be considered. We aimed to estimate the association of time-varying job tasks with differing exertion levels on change in Tc, among WLFFs engaged in fire management activities, while controlling for ambient conditions and individual characteristics. In addition, we examined whether duration of tasks modified the relationship between task and change in Tc. METHODS: We used data from The Wildland Firefighter Heat Related Illness study, a repeated measures study with individual-level data on 301 WLFFs from 2013 to 2016. Job tasks over one full shift were recorded and categorised into four levels (sedentary, light, moderate and high) based on estimated exertion levels. Tc was measured every 15 s using an ingestible sensor and personal monitors measured ambient conditions. The analysis used generalised estimating equations with an autoregressive correlation structure. RESULTS: We found statistically significant associations between job tasks with increased physical demand and increases in Tc. When compared with sedentary tasks, the estimated increases in Tc for light, moderate and high activity tasks of average duration were 0.07°C (95% CI 0.02 to 0.11°C), 0.19°C (95% CI 0.15 to 0.23) and 0.44°C (95% CI 0.39 to 0.49°C), respectively. In addition, we found evidence of interaction between task type and duration. CONCLUSIONS: This study supports the hypothesis that occupational exposure to physical exertion increases Tc, highlighting the need to update recommendations to protect WLFFs from heat-related illness.

Metabolic Demand of Hiking in Wildland Firefighting.

INTRODUCTION: The objective of this study was to document characteristics of hiking during wildland firefighter (WLFF) training and wildfire suppression. For the first time, the overall physical demands during wildland firefighting were evaluated in the field using global positioning systems coupled with wireless physiological monitoring and load carriage prediction models. METHODS: Male (n=116) and female (n=15) interagency hotshot crew and type II WLFFs on wildfires volunteered for this direct observation study. Participants' heart rate, internal temperature, speed, and elevation gain were monitored throughout training and during wildfire suppression. The Pandolf and Santee equations were used to predict metabolic rate to estimate oxygen consumption of uphill and downhill hiking. RESULTS: Equipment weight varied by crew type (type II: 24±9 kg and interagency hotshot crew: 28±6 kg; P<0.05). Grade of terrain was steepest during training hikes, and ingress hikes were statistically different from egress and training hikes (ingress: 4±9%, shift: 4±9%, egress: 1±8%, training hikes: 10±9%; P<0.01). Estimated oxygen consumption was highest during ingress hikes and was significantly different from all other hike types on fire assignments (ingress: 22±12, shift: 19±12, egress: 19±12 mL·kg-1·min-1; P=0.01). Oxygen consumption was higher during training hikes (34±14 mL·kg-1·min-1) than during job-related hikes (P<0.01). CONCLUSIONS: The greatest metabolic demand during wildfire assignments occurred during ingress hikes. On average, this was close to the estimated metabolic demand of the job qualification arduous pack test. However, greater metabolic demand occurred for periods during both shift (on the job) and training hikes. These data quantify the demands associated with actual wildland performance of WLFFs and can help define future work capacity testing and training procedures.

Work patterns dictate energy demands and thermal strain during wildland firefighting.

OBJECTIVE: The purpose of this investigation was to characterize the effects of self-selected work activity on energy expenditure, water turnover, and thermal strain during wildland fire suppression. A secondary aim was to contrast current data with data collected 15 years ago using similar methods to determine whether job demands have changed. METHODS: Participants (n=15, 26±3 years, 179±6 cm, 78.3±8.6 kg) were monitored for 3 days for total energy expenditure, water turnover, core and chest skin temperature, physical activity, and heart rate. Participants arrived to the mobile laboratory each morning, submitted a nude weight, ingested a temperature transmitter, provided a urine sample, and were equipped with a physiological and activity monitor. Participants completed live wildland fire suppression during their work shifts. RESULTS: Mean core temperature was 37.6°±0.2°C, mean chest skin temperature was 34.1°±1.0°C, mean heart rate was 112±13 beats/min, and the mean physiological strain index score was 3.3±1.0. Wildland firefighters spent 49±8%, 39±6%, and 12±2% in the sedentary, light, and moderate-vigorous intensity categories, respectively. The mean total energy expenditure was 19.1±3.9 MJ/d, similar to 1997 (17.5±6.9 MJ/d). The mean water turnover in 2012 was 9.5±1.7 L/d, which was higher (P<.05) compared with 1997-98 (7.0±1.7 L/d). CONCLUSIONS: Wildland firefighters do not induce consistently high cardiovascular and thermal strain while completing arduous work in a hot environment despite fairly high chest skin temperatures. The total energy expenditure in the current study suggests job demands are similar to those of 15 years ago, while the increased water turnover may reflect a change in drinking habits.