Expression of intracellular cytokines, HSP72, and apoptosis in monocyte subsets during exertional heat stress in trained and untrained individuals.

This study examined intracellular cytokine, heat shock protein (HSP) 72, and cellular apoptosis in classic and inflammatory CD14(+) monocyte subsets during exertional heat stress (EHS). Subjects were divided into endurance-trained [TR; n = 12, peak aerobic power (Vo(2peak)) = 70 +/- 2 ml.kg lean body mass (LBM)(-1).min(-1)] and sedentary-untrained (UT; n = 11, Vo(2peak) = 50 +/- 1 ml.kg LBM(-1).min(-1)) groups before walking at 4.5 km/h with 2% elevation in a climatic chamber (40 degrees C, 30% relative humidity) wearing protective clothing until exhaustion (Exh). Venous blood samples at baseline and 0.5 degrees C rectal temperature increments (38.0, 38.5, 39.0, 39.5, and 40.0 degrees C/Exh) were analyzed for cytokines (TNF-alpha, IL-1beta, IL-6, IL-1ra, and IL-10) in CD14(++)CD16(-)/CD14(+)CD16(+) and HSP72/apoptosis in CD14(Bri)/CD14(Dim) subsets. In addition, serum levels of extracellular (e)HSP72 were also examined. Baseline and Exh samples were separately stimulated with LPS (1 microg/ml) or heat shocked (42 degrees C) and cultured in vitro for 2 h. A greater temperature-dependent increase in CD14(+)CD16(+) cells was observed in TR compared with UT subjects as well as a greater LPS tolerance following in vitro LPS stimulation. TNF-alpha and IL-1beta cytokine expression was elevated in CD14(+)CD16(+) but not in CD14(++)CD16(-) cells. A greater induction of intracellular HSP72 and eHSP72 was observed in TR compared with UT subjects, which coincided with reduced apoptosis at Exh and following in vitro heat shock. Induced HSP in vitro was not uniform across CD14(+) subsets. Findings suggest that circulating CD14(+)CD16(+), but not CD14(++)CD16(-) monocytes, contribute to the proinflammatory cytokine profiles observed during EHS. In addition, the enhanced HSP72 response in endurance-trained individuals may confer improved heat tolerance through both anti-inflammatory and anti-apoptotic mechanisms.

Mild endotoxemia, NF-kappaB translocation, and cytokine increase during exertional heat stress in trained and untrained individuals.

This study examined endotoxin-mediated cytokinemia during exertional heat stress (EHS). Subjects were divided into trained [TR; n=12, peak aerobic power (VO2peak)=70+/-2 ml.kg lean body mass(-1).min(-1)] and untrained (UT; n=11, VO2peak=50+/-1 ml.kg lean body mass(-1).min(-1)) groups before walking at 4.5 km/h with 2% elevation in a climatic chamber (40 degrees C, 30% relative humidity) wearing protective clothing until exhaustion (Exh). Venous blood samples at baseline and 0.5 degrees C rectal temperature increments (38.0, 38.5, 39.0, 39.5, and 40.0 degrees C/Exh) were analyzed for endotoxin, lipopolysaccharide binding protein, circulating cytokines, and intranuclear NF-kappaB translocation. Baseline and Exh samples were also stimulated with LPS (100 ng/ml) and cultured in vitro in a 37 degrees C water bath for 30 min. Phenotypic determination of natural killer cell frequency was also determined. Enhanced blood (104+/-6 vs. 84+/-3 ml/kg) and plasma volumes (64+/-4 vs. 51+/-2 ml/kg) were observed in TR compared with UT subjects. EHS produced an increased concentration of circulating endotoxin in both TR (8+/-2 pg/ml) and UT subjects (15+/-3 pg/ml) (range: not detected to 32 pg/ml), corresponding with NF-kappaB translocation and cytokine increases in both groups. In addition, circulating levels of tumor necrosis factor-alpha and IL-6 were also elevated combined with concomitant increases in IL-1 receptor antagonist in both groups and IL-10 in TR subjects only. Findings suggest that the threshold for endotoxin leakage and inflammatory activation during EHS occurs at a lower temperature in UT compared with TR subjects and support the endotoxin translocation hypothesis of exertional heat stroke, linking endotoxin tolerance and heat tolerance.

The impact of various rehydration volumes for firefighters wearing protective clothing in warm environments.

This study examined different fluid replacement quantities during intermittent work while wearing firefighting protective clothing and self-contained breathing apparatus in the heat (35 degrees C, 50% relative humidity). Twelve firefighters walked at 4.5 km per h with 0% elevation on an intermittent work (50 min) and rest (30 min) schedule until they reached a rectal temperature of 39.5 degrees C during work periods and 40.0 degrees C during rest, heart rates of 95% of maximum and/or exhaustion. During the heat-stress trials subjects received one of four fluid replacement quantities, high (H), moderate (M), low (L), and no hydration (NH), where H, M and L represented 78%, 63% and 37% of fluid loss, respectively. The total tolerance time (work + rest) was significantly greater during H (111.8 +/- 3.5), M (112.9 +/- 5.2) and L (104.2 +/- 5.8) compared to NH (95.3 +/- 3.8). In addition, work time (min), which excluded rest periods, was significantly greater in H (82.6 +/- 3.5), and M (82.9 +/- 5.2) compared to NH (65.3 +/- 3.8). It is concluded that incorporating even partial fluid replacement strategies while wearing firefighting protective clothing and self-contained breathing apparatus in the heat improves tolerance time.

Active versus passive cooling during work in warm environments while wearing firefighting protective clothing.

This study examined whether active or passive cooling during intermittent work reduced the heat strain associated with wearing firefighting protective clothing (FPC) and self-contained breathing apparatus (SCBA) in the heat (35 degrees Celsius, 50% relative humidity). Fifteen male Toronto firefighters participated in the heat-stress trials. Subjects walked at 4.5 km.h(-1) with 0% elevation on an intermittent work (50 min) and rest (30 min) schedule. Work continued until rectal temperature (T(re)) reached 39.5 degrees Celsius, or heart rate (HR) reached 95% of maximum or exhaustion. One of three cooling strategies, forearm submersion (FS), mister (M), and passive cooling (PC) were employed during the rest phases. Tolerance time (TT) and total work time (WT) (min) were significantly increased during FS (178.7 +/- 13.0 and 124.7 +/- 7.94, respectively) and M (139.1 +/- 8.28 and 95.1 +/- 4.96, respectively), compared with PC (108.0 +/- 3.59 and 78.0 +/- 3.59). Furthermore, TT and WT were significantly greater in FS compared with M. Rates of T(re) increase, HR and T-(sk) were significantly lower during active compared with passive cooling. In addition, HR and T(re) values in FS were significantly lower compared with M after the first rest phase. During the first rest phase, T(re) dropped significantly during FS (approximately 0.4 degree Celsius) compared with M (approximately 0.08 degree Celsius) while PC increased (approximately 0.2 degree Celsius). By the end of the second rest period T(re) was 0.9 degree Celsius lower in FS compared with M. The current findings suggest that there is a definite advantage when utilizing forearm submersion compared with other methods of active or passive cooling while wearing FPC and SCBA in the heat.

Physical work limits for Toronto firefighters in warm environments.

This study examined the relationship between time to reach critical end points (tolerance time [TT] and metabolic rate for three different environmental temperatures (25 degrees C, 30 degrees C, and 35 degrees C, 50% relative humidity), while wearing firefighting protective clothing (FPC) and self-contained breathing apparatus (SCBA). Thirty-seven Toronto firefighters (33 male and 4 female) were divided into four work groups defined as Heavy (H, n = 9), Moderate (M, n = 9), Light (L, n = 10), and Very Light (VL, n = 9). At 25 degrees C, 30 degrees C, and 35 degrees C, TT (min) decreased from 56 to 47 to 41 for H, 92 to 65 to 54 for M, 134 to 77 to 67 for L, and 196 to 121 to 87 for VL. Significant differences in TT were observed across all group comparisons, excluding M versus L at 30 degrees C and 35 degrees C, and H versus M at 35 degrees C. Comparing 25 degrees C to 30 degrees C, M, L, and VL had significant decreases in TT, whereas only VL had a significant decrease when 30 degrees C was compared to 35 degrees C. For 25 degrees C to 30 degrees C, the relative change in TT was significantly greater for L (37%) and VL (41%) compared with H (16%) and M (26%). For 30 degrees C to 35 degrees C, the relative change among the groups was similar and approximately 17%. During passive recovery at 35 degrees C, rectal temperature (T(re)) continued to increase 0.5 degrees C above T(re final), whereas heart rate declined significantly. These findings show the differential impact of environmental conditions at various metabolic rates on TT while wearing FPC and SCBA. Furthermore, these findings reveal passive recovery may not be sufficient to reduce T(re) below pre-recovery levels when working at higher metabolic rates in hot environments.

Heat stress while wearing long pants or shorts under firefighting protective clothing.

It was the purpose of this study to examine whether replacing long pants (P) with shorts (S) would reduce the heat stress of wearing firefighting protective clothing during exercise in a warm environment. Twenty-four Toronto Firefighters were allocated to one of four groups that performed heavy (H, 4.8 km x h(-1), 5% grade), moderate (M, 4.5 km x h(-1), 2.5% grade), light (L, 4.5 km x h(-1)) or very light (VL, 2.5 km x h(-1)) exercise while wearing their full protective ensemble and self-contained breathing apparatus. Participants performed a familiarization trial followed by two experimental trials at 35 degrees C and 50% relative humidity wearing either P or S under their protective overpants. Replacing P with S had no impact on the rectal temperature (Tre) or heart rate response during heavy or moderate exercise where exposure times were less than 1 h (40.8 +/- 5.8 and 53.5 +/- 9.2 min for H and M, respectively while wearing P, and 43.5 +/- 5.3 and 54.2 +/- 8.4 min, respectively while wearing S). In contrast, as exposure times were extended during lighter exercise Tre was reduced by as much as 0.4 degrees C after 80 min of exercise while wearing S. Exposure times were significantly increased from 65.8 +/- 9.6 and 83.5 +/- 11.6 min during L and VL, respectively while wearing P to 73.3 +/- 8.4 and 97.0 +/- 12.5 min, respectively while wearing S. It was concluded that replacing P with S under the firefighting protective clothing reduced the heat stress associated with wearing the protective ensemble and extended exposure times approximately 10 - 15% during light exercise. However, during heavier exercise where exposure times were less than 1 h replacing P with S was of little benefit.

Influence of aerobic fitness and body fatness on tolerance to uncompensable heat stress.

This study examined the independent and combined importance of aerobic fitness and body fatness on physiological tolerance and exercise time during weight-bearing exercise while wearing a semipermeable protective ensemble. Twenty-four men and women were matched for aerobic fitness and body fatness in one of four groups (4 men and 2 women in each group). Aerobic fitness was expressed per kilogram of lean body mass (LBM) to eliminate the influence of body fatness on the expression of fitness. Subjects were defined as trained (T; regularly active with a peak aerobic power of 65 ml x kg LBM(-1) x min(-1)) or untrained (UT; sedentary with a peak aerobic power of 53 ml x kg LBM(-1) x min(-1)) with high (High; 20%) or low (Low; 11%) body fatness. Subjects exercised until exhaustion or until rectal temperature reached 39.5 degrees C or heart rate reached 95% of maximum. Exercise times were significantly greater in T(Low) (116 +/- 6.5 min) compared with their matched sedentary (UT(Low); 70 +/- 3.6 min) or fatness (T(High); 82 +/- 3.9 min) counterparts, indicating an advantage for both a high aerobic fitness and low body fatness. However, similar effects were not evident between T(High) and UT(High) (74 +/- 4.1 min) or between the UT groups (UT(Low) and UT(High)). The major advantage attributed to a higher aerobic fitness was the ability to tolerate a higher core temperature at exhaustion (the difference being as great as 0.9 degrees C), whereas both body fatness and rate of heat storage affected the exercise time as independent factors.