The thermal ergonomics of firefighting reviewed
David Barr*, Warren Gregson, Thomas Reilly
Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Henry Cotton Campus, Webster Street, Liverpool L3 2ET, United Kingdom
a r t i c l e i n f o
Received 1 December 2008
Accepted 12 July 2009
a b s t r a c t
The occupation of firefighting is one that has repeatedly attracted the research interests of ergonomics.
Among the activities encountered are attention to live fires, performing search and rescue of victims, and
dealing with emergencies. The scientific literature is reviewed to highlight the investigative models used
to contribute to the knowledge base about the ergonomics of firefighting, in particular to establish the
multi-variate demands of the job and the attributes and capabilities of operators to cope with these
demands. The job requires individuals to be competent in aerobic and anaerobic power and capacity,
muscle strength, and have an appropriate body composition. It is still difficult to set down thresholds for
values in all the areas in concert. Physiological demands are reflected in metabolic, circulatory, and
thermoregulatory responses and hydration status, whilst psychological strain can be partially reflected in
heart rate and endocrine measures. Research models have comprised of studying live fires, but more
commonly in simulations in training facilities or treadmills and other ergometers. Wearing protective
clothing adds to the physiological burden, raising oxygen consumption and body temperature, and
reducing the time to fatigue. More sophisticated models of cognitive function compatible with decision-
making in a fire-fighting context need to be developed. Recovery methods following a fire-fighting event
have focused on accelerating the restoration towards homeostasis. The effectiveness of different recovery
strategies is considered, ranging from passive cooling and wearing of cooling jackets to immersions in
cold water and combinations of methods. Rehydration is also relevant in securing the safety of fire-
fighters prior to returning for the next event in their work shift.
Crown Copyright ? 2009 Published by Elsevier Ltd. All rights reserved.
Firefighting is an occupation characterised by prolonged periods
of low-intensity work and occasional bouts of moderate to high-
intensity efforts (Bos et al., 2004; Scott, 1988). In some instances,
firefighters may also perform strenuous work for periods of an
unpredictable duration under conditions of high environmental
heat strain (Romet and Frim, 1987; Rossi, 2003; Smith et al. 1997,
2001). The tasks associated with firefighting place high physical
demands upon those engaged. Carrying equipment, operating in
protective clothing, and dealing with the tasks in hand entail a large
outlay of energy expenditure (Bilzon et al., 2001; Gledhill and
Jamnik, 1992; Lemon and Hermiston, 1977; von Heimburg et al.,
2006). In order to complete such tasks successfully the firefighters
must possess certain physiological characteristics. Successful
completion of fire-fighting activities requires high levels of
contribution from both aerobic and anaerobic energy systems
(Bilzon et al., 2001; Gledhill and Jamnik, 1992) and is associated
with high levels of muscular strength and endurance. In an occu-
pational setting such as firefighting, protective clothing is required
to shield the individual from hazards (e.g. fires and chemical
substances) that may be encountered during work. The protective
clothing worn by firefighters is typically heavy, thick with multiple
layers, and also encapsulates the head. The reduced water-vapour
permeability across the clothing layers also limits the rate of
evaporative heat exchange with the environmental conditions
increasing the degree of physiological strain (Cheung et al., 2000;
Nunneley, 1989). The combined effects of strenuous exercise,
protective clothing, and high ambient temperatures under which
firefighters are frequently required to operate may lead to high
levels of cardiovascular and thermoregulatory strain. Such physi-
ological alterations are frequently associated with decrements in
work capacity (Hancock and Vasmatzidis, 2003) and heat-induced
exhaustion (Cheung et al., 2000).
In this review we will summarise the available literature on the
physical demands of fire-fighting activities and the physical attri-
butes required for successful performance of such tasks. The
physiological responses during fire-fighting simulations, the
metabolic effects of protective clothing, and its impact on heat
production and heat loss will also be described. The final section
* Corresponding author.
E-mail address: D.A.Barr@2006.ljmu.ac.uk (D. Barr).
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Applied Ergonomics 41 (2010) 161–172
will focus on research into interventions for reducing the physio-
2. Physiological profile of the firefighter
The tasks associated with fire suppression and search and rescue
activities impose a high physical burden on those engaged. Carrying
equipment, operating in protective clothing, and dealing with the
they possess certain physiological characteristics to allow for rapid
and successful execution of fire-fighting activities. High levels of
aerobic fitness, in combination with muscular strength and endur-
ance in both the upper and lower body, flexibility, and a favourable
body composition, are essential for meeting the demands associated
with firefighting, maintaining the health and safetyof the firefighter,
effectively maylessen the amount ofcasualtiesand humansuffering,
and significantly reduce financial loss.
2.1. Aerobic fitness
Tasks such as search and rescue of victims, climbing ladders and
stairs, and charging a hose when performed in full fire-fighting
protective clothing and self-contained breathing apparatus can
have an energy cost corresponding to 80–100% of a firefighter’s
_VO2max(Lemon and Hermiston,1977; O’Connell et al.,1986; Bilzon
et al., 2001; von Heimburg et al., 2006; Holmer and Gahved, 2007;
Elsner and Kolkhorst, 2008). The findings from these studies have
led to a variety of recommendations for aerobic power levels that
provide an adequate safety margin for firefighters when perform-
ing fire-fighting activities.
Maximal oxygen uptake values of firefighters from various
countries are shown in Table 1. With no standard test for assessing
_VO2maxit is difficult to draw comparisons between brigades as
a number of studies from many different countries have reported
_VO2maxvalues with some measured during maximal exercise tests
and others estimated using submaximal exercise protocols, multi-
stage fitness test or even a questionnaire, and in some cases no
indication of how_VO2maxwas assessed. The studies in Table 1
indicate that firefighters have a mean aerobic power ranging from
39.6 to 61 ml$kg?1$min?1; with some individual values ranging
from 31.5 to 73.3 ml$kg?1$min?1. The firefighters at the lower end
of the scale would not be able to perform successful execution of
Elsner and Kilkhorst (2008) shied away from prescribing a defi-
nite threshold for firefighters whilst emphasising its importance,
reporting that those firefighters with the lower levels for_VO2max
tended to complete a simulation that averaged 11.65?2.21 min
more slowly than counterparts with higher levels of
Moreover, the latter group members were able to operate at a higher
proportionof_VO2maxthanthe formergroup.Ina study by Sothmann
et al. (1990), seven from a group of 32 firefighters voluntarily quit
a protocol involving fire-fighting activities due to excessive fatigue;
five of the firefighters had
_VO2max values between 26 and
33.5 ml$kg?1$min?1and the remaining two had_VO2max values
below 35 ml$kg?1$min?1. As a result of these findings the authors
proposed an aerobic power value of 33.5 ml$kg?1$min?1as the
minimum acceptable level for performing fire-fighting activities.
Another important finding from this study was that performance
time of the fire-fighting simulation increased with advancing age
even when subjects were matched for_VO2max. This finding and the
fact thatbothcross-sectional and longitudinalstudies have indicated
a decline in maximal aerobic power at a rate of around
5 ml$kg?1$min?1per decade after the age of 30 years in both
endurance-trained and untrained individuals (Buskirk and Hodgson,
1987; Wilson and Tanaka, 2000) and firefighters (Kilbom, 1980;
Saupe et al.,1991) have implications forfirefighters of advancingage,
as the required demands for successful completion of fire-fighting
activities remain the same regardless of age.
In a study of UK firefighters, Scott et al. (1988) reported thatover
93% of firefighters rated themselves as having average or above-
average fitness levels compared to the general population. The
43.7 ml$kg?1$min?1. Peate et al. (2002) also reported a lack of
association between self-perception and actual aerobic fitness in
US firefighters. From a group of firefighters in this study who rated
themselves as having high fitness levels, 29% had a_VO2maxvalue
Summary of studies reporting aerobic capacity for firefighters.
Davis et al., 1982
Faff and Tutak, 1989
Gahved and Holmer, 1989
Sweden volunteer and professional
Finish firefighting instructors
UK Petro-chemical plant fire response
Australian bush firefighters
UK Royal Navy firefighters
UK firefighting instructors
UK firefighting instructors
2 x 12 males
V, 33 ?5/ P, 34 ?3
Balke Treadmill protocol
Ilmarinen et al., 1997
Smith and Petruzzello, 1998
Carter et al., 1999
Estimated from 1.5 mile run
Bruce Protocol Treadmill
Hooper et al., 2001
Bilzon et al., 2001
Peate et al., 2002
Clark et al., 2002
Eglin et al., 2004
McLellan and Selkirk, 2004
Eglin et al., 2004
Smith et al., 2005
Selkirk et al., 2004
von Heimburg et al., 2006
Ilmarinen et al., 2004
Carter et al., 2007
Barr et al., 2008
Barr et al., 2009
21 males,1 female
34 males, 15 females
96 males, 5 females
54.6?5 m/43?8.1 f
Bruce Protocol Treadmill
Bruce Protocol Treadmill
Submaximal step test
Predicted (Astrand et al 2003
Estimated from 1.5 mile run
Graded treadmill test
Bruce Protocol Treadmill
Bruce Protocol Treadmill
D. Barr et al. / Applied Ergonomics 41 (2010) 161–172162
between 22 and 37 ml$kg?1$min?1. These studies highlight the
compared to formal objective assessments.
2.2. Anaerobic fitness
Studies have indicated that fire-fighting activities require high
levels of contribution from the anaerobic energy system of around
40% of total energy expenditure (Lemon and Hermiston, 1977;
Weafer,1999; Bilzon et al., 2001). Blood lactate concentrations of up
to 13.1 mmol$l?1have been reported during fire-fighting simula-
tions (Lemon and Hermiston, 1977; Gledhill and Jamnik, 1992;
Smith et al., 1996; von Heimburg et al., 2006; Holmer and Gavhed,
2007), which can lead to the onset of fatigue, the extent of which
depend on the fitness of a firefighter (Bilzon et al., 2001). The
anaerobic threshold occurs at a higher percentage of maximal
aerobic power in individuals with greater aerobic power (Ready
and Quinney, 1982). As a result of this adaptation, a greater
percentage of energy is derived from aerobic processes during fire-
fighting activities of high intensity (Lemon and Hermiston, 1977;
Bilzon et al., 2001). This capability is an advantage in that the
recovery period following high-intensity efforts is shortened.
Data for the anaerobic capacity of firefighters are limited, and
the test protocols used to measure anaerobic capacity have not
been validated. Nevertheless, a strong correlation between anaer-
obic capacity and performance of fire-fighting activities has been
reported in male firefighters. Rhea et al. (2004) reported superior
performance of fire-fighting activities that included hose pull,
victim drag, stair climb, and equipment hoist in firefighters who
performed better at a 400-m sprint. The anaerobic power of
incumbent female firefighters was measured using the Wingate
Anaerobic Test by Findley et al. (2002) who reported that female
firefighters possessed anaerobic power levels similar to that of the
general female population. The authors concluded that female
firefighters might not possess the necessary properties within their
skeletal muscle to perform the high-intensity work associated with
2.3. Muscular strength
Activities associated with firefighting such as carrying ladders
and using heavy manual/hydraulic tools have been rated by fire-
fighters to be the most demanding and frequently encountered
tasks in terms of muscular strength and endurance, utilizing both
upper and lower body musculature (Lusa et al., 1994). A high level
of muscular strength is not only an important attribute for
successful performance of fire-fighting tasks but also may serve to
reduce the incidence of injury (Wilson et al., 2005).
The relationship between muscular strength and fire-fighting
activity using both single and multiple strength measurements is
well documented. Davis et al. (1982), Williford et al. (1999), Bilzon
et al. (2001), and Rhea et al. (2004) used isometric hand grip as
a measure of strength, which is strongly correlated with upper-
body strength and lean body mass (Leyk et al., 2007). These four
studies reported strong relationships with fire-fighting activities
which require both muscular strength and endurance such as
forcible entry, hoisting of a hose, chopping tasks, and victim rescue.
Sothmann et al. (2004) employed a test battery of field measures
consisting of a hose drag/high-rise pack carry, arm lift, and arm
endurance exercise. These testbattery items combined significantly
to predict performance time in fire-suppression activities. The
authors concluded that use of this test battery would identify 82%
and 72% of successful and unsuccessful performers, respectively.
Similar findings were reported by Henderson et al. (2007) who
noted that a high level of composite strength (bench press, ‘‘lat pull
down’’, and grips strength) was a good predictor of fire-fighting
performance time. Both Sothmann et al. (2004) and Henderson
et al. (2006) advocatedthe use of simple field measures of muscular
strength for the determination of successful fire-fighting perfor-
mance. Nevertheless, the use of dynamic performance tests and
isokinetic assessments could generate additional insights although
their contributions have not been adequately assessed in this area.
As strength is directly related to muscle cross-sectional area, the
above findings suggest that individuals with low muscle mass, in
particular women, may struggle to perform fire-fighting activities
as the relative contribution is greater compared to larger
2.4. Body composition
Excess body fat impacts on a firefighters’ performance in
a number of ways. During exposure to hot environmental condi-
tions, body fat acts as an insulator and hinders heat dissipation,
thereby contributing to a greater rise in core temperature (McLel-
lan, 1998). Excess body fat acts as a dead weight when performing
locomotive work against gravity (Reilly, 1996), impacting on
activities such as ladder and stair climbing (Willford et al., 1999).
Excess body fat is also associated with low levels of cardiorespira-
tory fitness, which along with being overweight, is a risk factor for
cardiovascular morbidities. One of the leading causes of in-line
deaths of firefighters is myocardial infarction (Kales et al., 2003).
Autopsies have shown underlying atherosclerosis in firefighters to
be the major contributing factor in these myocardial infarctions
(Kales et al., 2003).
Significant correlations have been reported between percentage
body fat and simulated fire-fighting performance. Willford et al.
(1999) reported strong relationships between both percentage
body fat and fat-free weight with performance of fire-fighting
activities which included: stair climbing, hose hoist, forcible entry,
advancing a hose, and victim rescue. The strongest relationship
reported was between percent body fat and stair climbing, those
with the highest fat values performing more slowly. Lyons et al.
(2005) reported significant correlations between percentage body
fat and both metabolic rate and heart rate during treadmill walking
when wearing heavy fire-fighting protective clothing. Individuals
with greater fat massmaythereforedisplaya greater metabolic rate
and a resultant increase in heat storage during fire-fighting activ-
ities relative to leaner individuals.
Despite the above information, various authors have reported
firefighters to be overweight and obese. Scott et al. (1988) reported
that over 50% were overweight, with differences ranging from 3.6
to 12.1 kg. An increase in the prevalence of obesity with advancing
age in firefighters was found by Soteriades et al. (2005) in a study
performed over 5 years in which a 4-fold increase in firefighters
with a body mass index (BMI) of over 40 was reported. Obese
firefighters in this study were more likely to possess other risk
factors for cardiovascular disease, such as hypertension and an
unfavourable lipid profile. Clark et al. (2002) studied a group of US
firefighters and reported that despite the firefighters meeting the
requirements for maximal oxygen uptake (44 ml$kg?1$min?1), 60%
were overweight and 32% were morbidly obese according to the
BMI. However, due to the fact that firefighters tend to play sports
such as rugby and soccer and also engage in resistance training,
activities which increase skeletal muscle mass, the use the BMI
must be applied with caution in this population as it tends to
overestimate in people with high muscularity (Going and Davis,
2001; Reilly and Sutton, 2008). This was found to be the case in
a study by Barr et al. (2008) who used dual-energy X-ray absorp-
tiometry to assess body composition and reported that a group of
30 firefighters with a mean age of 41 and a BMI of 28 had a total
D. Barr et al. / Applied Ergonomics 41 (2010) 161–172163
body fat of 20%, which is within the healthy range for males of that
age (World Health Organisation, 2000).
3. Physical demands of fire-fighting activity
Firefighting is an occupation that imposes high physical
demands on the operator when engaging in activities such as
ladder and stair climbing, victim rescue, and equipment trans-
portation. The physical demands associated with firefighting which
result in near and maximal heart rate and require contributions
from both aerobic and anaerobic energy systems are the result of
the intrinsic metabolic and physical demands of various tasks
combined with extrinsic stressors such as clothing and equipment
(Bilzon et al., 2001). The metabolic demands of fire-fighting
activities have been investigated in the absence of environmental
stressors under both laboratory and field conditions.
Routine station activities including equipment maintenance,
cleaning and administration duties, hydrant inspection, fire
prevention, and topography average w20% of a firefighters_VO2max
(Scott et al., 1988). Activities which require the transportation of
ones own mass against gravity while wearing full fire-fighter
protective clothing, along with self-contained breathing apparatus
in addition to moving heavy equipment required for firefighting,
have been found to yield the greatest levels of energy expenditure.
These findings have been reported during civilian (Lemon and
Hermiston, 1977; O’Connell et al., 1986; Gledhill and Jamnik, 1992;
von Heimburg et al., 2006; Holmer and Gavhed, 2007), naval (Bil-
zon et al., 2001), and industrial (Weafer, 1999) fire-fighting activi-
ties. The metabolic demands of civilian fire-fighting activities
performed under field conditions are well documented. Gledhill
and Jamnik (1992) investigated activities including carrying
equipment upstairs in a high-rise building, rescuing victims, and
forcible entry*. The most metabolically demanding activity was
carrying a halligen tool* up high-rise stairs, resulting in a mean
oxygen uptake of 44 ml$kg–1min?1and a heart rate response of
163 beats$min?1. Activities such as forcible entry and dragging
a 90-kg manikin casualty utilised an oxygen uptake of 30.5 and 20
beats$min?1) value was reported during a pitched roof ventilation*
task which only required an oxygen uptake of 28 ml$kg–1min?1,
suggesting a high anaerobic contribution during this task, probably
due to the fact that activities such as this are more reliant on upper
Lemon and Hermiston (1977)investigated the physicaldemands
of firefighters in protective clothing, but without self-contained
breathing apparatus performed four tasks, namely: aerial ladder
climb, victim rescue, hose dragging, and ladder raise. The design of
this study allowed for individual quantification of each task as they
were performed separately. The data indicated that all four tasks
were of similar intensity; firefighters were working at w70%
_VO2max, 10 METS, and using around 12 kcalmin?1. Those fire-
fighters with a_VO2maxgreater than 40 ml$kg–1min?1were able to
perform a greater percentage of each task aerobically compared to
firefighters with a_VO2maxless than 40 ml$kg–1min?1, who were
more reliant on anaerobic processes.
Holmer and Gahved (2007) quantified the metabolic cost of
‘simulated work tasks’ performed on a test ground. In total, five
activities were performed twice. These activities included walking/
running on a flat ground, climbing three flights of stairs, and
descending four flights of stairs into a basement. The average
completion time of the activity was w22 min. The whole exercise
elicited an oxygen uptake of 2.75 l$min?1(33.9 ml$kg–1min?1).
The highest oxygen uptake value was observed during stair
climbing of 3.55 l$min?1(43.8 ml$kg–1min?1). In this study, fire-
fighters who had a high aerobic fitness were able to complete the
The highestheartrate (181
fire-fighting simulation in the shortest time period. O’Connell et al.
(1986) reported that a minimal value of 2.7 l min?1(39 mlkg?1
min?1) was required to complete 5 min of stair climbing on a stair-
treadmill ergometer at a rate of 60 steps min?1in full personal
protective clothing incorporating self-contained breathing appa-
ratus. During this activity the firefighters were working at 80.3%,
94%, and 87.8% of their maximum_VO2max, heart rate, and power
output (watts), respectively.
Rescue of victims from multi-storey buildings is a part of
firefighting; during emergency situations it is unsafe to use lifts.
Therefore, during victim rescue, firefighters must engage in
activities such as stair climbing prior to performing rescue work.
von Heimburg et al. (2006) documented the energy cost of victim
rescue from a hospital with firefighters wearing full personal
protective ensemble incorporating self-contained breathing appa-
ratus (SCBA). During this field-based study firefighters climbed six
floors up a staircase (a vertical assent of 20.5 m) while carrying
a 10-m fire hose, an axe, and a flashlight (total weight including PPE
and SCBA 37 kg). Once at the top of the stairs, the firefighter
rescued six patients, by dragging them individually along the floor
on a ‘rescue mat’, covering a total distance of 162 m. Mean oxygen
uptake, heart rate, and blood lactate at the top of the stairs
measured 2.8 l$min?1(44 ml$kg–1min?1, 88% maximum),167?13
beats min?1(83% of maximum), and 6.8 mmol l?1, respectively. The
greatest oxygen uptake value of 3.7 l$min?1was recorded during
the patient rescue. The entire operation took w5 min to finish, and
on completion mean heart rate and blood lactate were 182 beats
min?1and 13 mmol$l?1, respectively.
Firefighting in industrial settings entails performing tasks
specific in nature to that industry that are not encountered during
civilian firefighting. Tasks such as forcible entry, ladder raising, and
ceiling overhauls are very rarely or never performed during
a chemical plant fire. The physical demands of firefighting in
a petrochemical plant were examined by Weafer (1999). Informa-
tion gathered from senior officers led to the identification of five
essential tasks requiring stamina that are commonly encountered
and performed by a single firefighter under emergency conditions
in a petrochemical plant. These tasks were pulling a trailer (mass
210 kg) over a gravel surface, opening and closing a stiff valve,
ascending and descending a vertical 10-m ladder, running out hose
reels, followed by hoisting a hose up a 10-m structure using a rope
line. The energy expenditure of these tasks was then quantified in
a group of firefighters (mean_VO2peakof 48.75 ml$kg–1min?1). The
mean oxygen uptake and heart rate required across all the tasks
was 40.14 ml$kg–1min?1and 171 beats$min?1, respectively. Pulling
the trailerelicited the greatest metabolic response of 46.38 ml$kg–1
min?1and 174 beats$min?1, respectively.
Firefighting on board, a ship also requires the performance of
tasks that are specific only to shipboard fire suppression activities.
For example, activities such as drum carrying are essential to get
liquid foam to fire-fighting teams working in below-deck engine
rooms. Bilzon et al. (2001) quantified the metabolic demands of
52.6 mlkgd1min?1) and female (_VO2max43 mlkg?1min?1) Royal
Navy fire-fighting personnel. Firefighters completed five 4-min
tasks that are performed during shipboard firefighting; these tasks
consisted of boundary cooling*, drum carry, extinguisher carry,
hose run, and ladder climb while wearing a full fire-fighter
ensemble incorporating SCBA. Each task was performed at a work-
rate endorsed as a ‘minimal acceptable standard’. The greatest
heart rate responses in the males were observed during the drum-
carrying task (88% of maximum heart rate) and the lowest during
the boundary-cooling task (77% of maximum heart rate). The
boundary cooling was the least demanding activity eliciting
a metabolic demand of 44% and 55%_VO2maxin males and females,
D. Barr et al. / Applied Ergonomics 41 (2010) 161–172164
respectively. The most demanding exercise was the ‘drum carrying’
requiring a peak metabolic demand of 82% and 78%_VO2maxin
males and females, respectively. The data from the above studies
indicate that firefighting is a physically challenging occupation
requiring high levels of an individual’s physical capacity. This work
associated with such tasks result in high levels of metabolic heat
production, due to the inefficiency of the body to get rid of heat and
the impermeability of the protective clothing to dissipate heat. This
will result in heat storage and increases in core temperature.
The data from the above studies indicate that firefighting is
a physically challenging occupation requiring high levels of an
individual’s physical capacity. This observation demonstrates the
need for firefighters to possess both high levels of muscular and
aerobic fitness, and as the job itself is not enough to help fire-
fighters maintain adequate levels of fitness, training programmes
and allocated time should be made available for firefighters during
‘stand down’ time.
4. Thermal environments encountered by firefighters
The environmental conditions encountered by firefighters
impose heat strain through a combination of high ambient
temperatures and radiant heat flux. Abbott and Schulmann (1976),
Hoschke (1981), and Foster and Roberts (1994) have classified the
environmental conditions that firefighters are exposed to into
categories ranging from routine to emergency and critical. Routine
conditions apply to the majority of operational conditions
encountered by firefighters. Foster and Roberts (1994) proposed
a time limit of 25 min when operating in temperatures of 100?C
and thermal radiation limits of 1 kW m2. Hazardous conditions
reflect environmental conditions outside a burning building, in
which firefighters would be expected to work for only a short time
period due to extreme temperatures and radiant heat flux. The
proposed limits for operating in hazardous conditions would be
w1 min at 160?C and thermal radiation of 4 kW m2. Extreme and
critical conditions refer to those encountered during a flashover;
extreme conditions were found to be greater than those reported
for hazardous but do not exceed 235?C and 10 kW m2. Foster and
Roberts (1994) reported that these conditions can be tolerated for
a duration of w1 min, however, they reported an unacceptable
level of damage to equipment and protective clothing that occurred
which would put fire-fighting personnel at risk, and therefore these
conditions would be too dangerous to operate under. Critical
conditions are considered potentially life threatening, and fire-
fighters would not be expected to persevere with operating in such
Problems exist when monitoring and controlling environmental
conditions during live fire simulations. Many researchers have
reported temperature data collected by means of temperature-
sensitive thermocouples which are held in fixed positions at
a variety of locations within fire-fighting training facilities (Rossi,
2003). In some cases where temperature readings have been
reported, no means of how and where environmental temperature
was monitored was provided (Smith et al., 2001; Smith and Pet-
ruzzello,1998). Without accurate details of actual exposure time to
a given temperature, it is difficult to establish whether the physi-
ological strain induced by the activities were the result of the
physical demands of the activities or the heat stress imposed by the
environment, or a combination of the two. Eglin et al. (2004) have
shown that environmental temperature readings using thermo-
couples attached at fixed positions within the training facility do
not reflect temperature at the surface of the protective clothing
worn by fire-fighting personnel. Environmental temperature was
monitored on each floor where each instructor observed recruits
during fire-fighter training. Measurement was achieved using
thermocouples attached to a metal pole positioned at heights of
0.3, 0.6, 0.9, 1.2, 1.5, and 1.8 m above ground level. Additionally,
thermocouples were attached to the outside of the instructor’s
tunics at heights level with the shoulder, waist, and hip. Higher
temperatures were reported from the thermocouples attached to
the metal pole (74? 42?C) compared to the instructor’s tunics
(shoulder 55?14?C, 48?17?C, and hip 42?12?C). Although
these results were taken from fire-fighting instructors whose brief
it is to shelter in cool places, they demonstrate that fixed thermo-
couples do not provide accurate data on the actual temperatures
experienced by fire-fighting personnel.
5. Physiological responses to firefighting
No published data exist on thermoregulatory responses during
real-life operations, as it is impractical and could be dangerous to
kit out a firefighter with physiological monitoring equipment
during hazardous events. Nevertheless, it has been possible to
monitor heart rate continuously throughout the entire shift of
a firefighter (Barnard and Duncan, 1975; Kuorinka and Korhonen,
1981; Sothmann et al.,1992; Bos et al., 2004). Lack of control in the
monitoring and regulation of environmental conditions during real
fire-fighting operations make it difficult to collect data suitable for
research purposes. Consequently, research into physiological
responses during fire-fighting activities is reliant on data collected
during simulations of live fires performed in facilities that are used
to train newly recruited firefighters.
5.1. Live fires
A few research groups have monitored heart rate responses
during actual emergencies (Barnard and Duncan, 1975; Kuorinka
and Korhonen, 1981; Sothmann et al., 1992; Bos et al., 2004) but
provide no data on environmental conditions. Both Barnard and
Duncan (1975) and Kuorinka and Korhonen (1981) reported sharp
increases in heart rates (approximately 60 beats min?1) after
responding to an alarm; heart rates dropped slightly but still
remained elevated compared to the pre-alarm value whilst trav-
elling on the truck to a fire. These initial increases in heart rate
cannot be attributed to high environmental temperatures or
increased metabolic demands induced by the addition of protective
clothing, but morelikely tobe the combination of a sudden increase
in physical activity and the high level of psychological stress. These
findings emphasise the need for caution when using heart rate as
a measurement during real-life fire-fighting activities as the rela-
tive contributions of the cardiovascular, nervous, and thermoreg-
ulatory system are difficult to determine.
5.2. Fire-fighting simulations
The levels of thermal and cardiovascular stress of firefighting
vary depending on the intensity, duration, and nature of the
physical tasks and environmental stressors that firefighters are
exposed to. Romet and Frim (1987) documented the physiological
responses of various activities of a fire-fighting crew during
a training simulation. The most demanding activity, which was
a 24-min victim search and rescue, resulted in average heart rates
of 153 beats$min?1(85% of agepredicted maximum), a rise in rectal
temperature from 37.7 to 39?C. and mean skin temperature from
34.5 to 37.4?C. The least-demanding activity, which was that of the
crew captain, resulted in average heart rates of 112 beats$min?1
(65% of age predicted maximum), and rises in rectal temperature
and mean skin temperature of 0.3 and 1.5?C, respectively. The
authors concluded that rotating duties with those crew members
performing less strenuous activities could reduce heat stress during
D. Barr et al. / Applied Ergonomics 41 (2010) 161–172 165
firefighting. No subjective measurements of rating of perceived
exertion, subjective thermal strain, or ambient temperature data
were reported in this study.
Subsequent studies have included subjective measurements,
which are important in helping to separate the thermal and
cardiovascular effects of firefighting. A study by Smith et al. (1996)
consisted of a 16-min training drill split into 8 min of advancing
a hose followed by8 min of woodchopping in a building containing
live fires in which ambient temperatures and relative humidity
ranged from 76.7 to 93.3?C and 60–92%, respectively. At the end of
the hose task perceived exertion and perceptions of thermal
sensations were ‘somewhat hard’ (RPE of 13) and warm (thermal
sensation of 5), respectively, complemented with tympanic
temperature and heart rate responses of w38.8?C and 170
beats$min?1(89% of age predicted maximum). Blood lactate rose to
4.2 mmol l?1at the end of the first 8-min bout. Ratings of perceived
exertion and perceptions of thermal sensations at the end of the
second tasks were 16 (very hard) and 6 (hot), respectively; these
subjective measurements were coupled with heart rates of 186
beats$min?1(97% of age predicted maximum) and a tympanic
temperature increase from 37 to 40?C.
Using a training drill of similar duration and intensity as the
above study, Smith et al. (2001) reported rectal temperature and
heart rate increases from 36.7 to 38.1?C and 70 to 186 beats$min?1,
respectively. Rectal temperature continued to rise and peaked
approximately 10 min into the recovery period to 38.7?C. The
author stated that RPE and thermal sensations increased signifi-
cantly throughout the training drill but did not provide any data.
The discrepancies in core temperature between Smith et al. (1996,
2001) are most likely to be due to the different measurement sites
used; it appears that tympanic temperature could be affected by
environmental temperature as the drills in both studies were of
similar nature and duration and produced similar heart rate
responses, but the reported tympanic temperature measurements
were almost 2?C higher than the rectal temperature reported by
Smith et al. (2001). These studies highlight the limitations of using
tympanic temperature during fire-fighting activities.
Performing fire-fighting activities under different thermal
conditions allows for the effects of environment and activity to be
determined separately. Under temperate conditions, Smith et al.
(1997), Rayson et al. (2005), and Carter et al. (2007) reported
increases in tympanic and intestinal temperature of 0.01, 0.017, and
(89.6?C) Smith and co-workers reported an increase in rate of rise
in tympanic temperature (0.11?C min?1) compared to Carter et al.
(2007) and Rayson et al. (2005) who reported an increases in the
rate of rise of 0.03 and 0.054?Cmin?1, respectively. This finding
suggests that environmental conditions may have impacted on
tympanic temperature readings. In all of these studies, compared to
the temperate conditions, the firefighters were under greater
physiological strain during hot conditions as indicated by the
significantly higher heart rates and skin temperature, greater
thermal sensation, and perceived exertion.
When operating in a temperate environment the level of heat
strain is determined by the intensity and duration of exercise per-
formed. For example, in the absence of high ambient temperatures,
Rayson et al. (2005) investigated the physiological responses of
ascending a tall building (climbing 28 flights of stairs) both with
without carrying extended duration breathing apparatus (EDBA)
and a hose (w25 kg of external load). When carrying EDBA and
hose it took w30 s to ascend each flight yielding a heart rate
response of 81% of heart rate reserve during which core tempera-
ture and skin temperature rose by w0.02 and 0.07?C per flight,
respectively. Without carrying EBDA or hose, the firefighters were
able to climb more quickly, taking w15 s to climb each flight. Heart
?C min?1, respectively. However, under hot conditions
rate responses of 69% of heart rate reserve were reported and core
temperature increased by w0.01?C per flight. Carter et al. (2007)
documented the physiological responses from a simulated deep
underground tunnel penetration in which firefighters walked at
a pace of w4.2 km$h?1for 89 min at an ambient temperature of
w17?C and relative humidity of 44%. During this study inwhich the
firefighters wore gas-tight suits and EDBA, core (intestinal)
temperature increased from 37.51 to 38.31?C, a rate of rise of
0.009?C$min?1and skin temperature increased from 32.65 to
34.12?C. The firefighters on an average worked at 56% of heart rate
reserve and estimated sweat rate was 0.72 l$h?1. The above studies
show that the physiological strain associated with firefighting
results from a number of factors. Even in the absence of high
ambient temperaturesthe endogenous heat production is sufficient
at imposing heat strain when the physical activity is of a strenuous
nature. Transportation of vital equipment against gravity which is
often required exacerbates the physiological strain further. Active
cooling would be beneficial following search and rescue activities
and between repeated bouts of fire-fighting activities in a hot
environment where recovery periods of short duration are
6. Physiological consequences of wearing fire-fighters
Firefighters encounter a range of physical and chemical
hazards, therefore, wearing protective clothing is essential as it
affords protection from such harmful exposures. Protective
clothing worn during firefighting shields the firefighter from the
extreme environmental temperatures which vary as a function of
how long the fire has been burning and the materials involved.
Firefighters’ protective clothing consists of an outer shell, moisture
barrier, and a thermal liner; with each layer having a specific
purpose. The total ensemble is made up of boots, heavy-duty
gloves, bunker pants, coat, flash hood, and also worn during fire
fighting is SCBA. A typical fire-fighting ensemble (including SCBA)
weighs w26 kg. The protective clothing of firefighters has an
insulation value of w0.47 m2KW?1(clo rating of 2.44) (Holmer
et al., 2006). The overall function is to provide the firefighter with
adequate protection from heat, flames, and other hazardous
environments. However, this protection is often achieved at the
expense on body heat balance. The limited vapour permeability
across the protective clothing’s layers and the added metabolic
heat production resulting from the increased weight impact on the
thermoregulatory system by reducing the ability to dissipate
generated heat. The end result is continued heat storage in the
body (Cheung et al., 2000).
6.1. Effects of firefighter protective on oxygen consumption
Firefighter protective clothing increases the metabolic cost
(measured using oxygen consumption) of work in two ways, by
resisting movement and increasing the total mass of the individual
(Huck, 1988). The restriction of movement caused by the added
bulk alters the mechanics of gait and the efficiency of movement of
the body’s joints, resulting in a ‘hobbling’ or ‘binding’ effect (Coca
et al., 2007). A pronounced ‘forward lean’ imposed by the shift in
the centre of gravity also impacts on locomotion.
The metabolic costs of ‘fire-fighting protective clothing’ have
been well documented in well-controlled laboratory conditions
with comparisons usually made with uniform or physical education
kit. Studies indicatethat during treadmill walking performed at low
(Skoldstrom, 1987), moderate (Graveling et al., 1999), or high
intensity (Baker et al., 2000; Dreger et al., 2006) fire-fighting
D. Barr et al. / Applied Ergonomics 41 (2010) 161–172 166
Skoldstrom (1987) reported significant increases in oxygen
consumption from 0.8 to 1.2 l$min?1when wearing fire-fighter
protective clothing and SCBA (total weight w30 kg), equivalent to
20% and 30% of maximal oxygen uptake while walking on a tread-
mill at a low intensity (3.5 km$h?1) for 60 min in temperate
conditions (15?C). Heart rate was also 25 beats$min?1higher, and
perceived exertion was greater when wearing protective clothing
compared to a reference condition. The difference between
clothing conditions in oxygen uptake was the same regardless of
the ambient temperature even though operating in 45?C resulted
in greater heart rate response, increased sweat rate, and subjective
responses compared to performing the same work at 15?C.
Graveling et al. (1999) reported a 15–20% increase in oxygen uptake
during high-intensity treadmill walking (5 km$h?1, 7.5% gradient.)
when firefighters wore protective clothing without SCBA. A further
increased oxygen uptake by a similar margin was observed when
operating with the use of SCBA. However, increases imposed by
SCBA appear to be dependent on the weight of the apparatus.
Hooper et al. (2001) compared lightweight (15 kg) with conven-
tional (27 kg) SCBA on oxygen consumption. The lightweight
apparatus was of significant benefit, requiring 0.26 l$min?1less
than the conventional set. Heart rate was also significantly lowered
with the lightweight apparatus, a finding which demonstrates
a reduced cardiovascular strain when operating with lightweight
SCBA. This favourable cardiovascular response could prolong work
tolerance in firefighters during operational activities.
6.2. Thermoregulatory responses of wearing fire-fighter protective
Heat stress associated with fire-fighter protective clothing has
been documented under different environmental conditions and at
various exercise intensities of activity. Under temperate conditions,
White and Hodous (1987) reported that treadmill walking
(5 km$h?1and 8% gradient) while wearing fire-fighter protective
clothing and SCBA significantly reduced the time to a pre-
determined level of physiological strain. Fire-fighter protective
clothing also impacted on skin temperature, heart rate, and on the
rate of rise in core temperature compared to wearing light work
clothing (1.85 vs 0.23?C$h?1). Skoldstrom (1987) reported a greater
rate of increase in core body temperature when performing
treadmill walking at a lower intensity (3.5 km$h?1) but in the
presence of heat (45?C and RH 15%) rectal temperature while
wearing protective clothing increased at a rate of 2.24?C compared
to 0.23?C in a standard uniform. These studies demonstrate the
relative contribution of both intrinsic and extrinsic factors on
Fogarty et al. (2004) examined the cardiovascular and thermal
impact of a ‘fire-fighter protective ensemble’ under conditions of
uncompensable heat stress. The use of an exercise protocol con-
sisting of semi-recumbent cycle ergometry permitted the use of
impedance cardiography and venous occlusion plethysmography
for the measurement of stroke volume and skin blood flow,
respectively. Significantly greater core and skin temperature and
heart rate responses were found when wearing protective clothing
compared to the ‘unclothed’ condition confirming the finding of
previous studies. Significant increases in sweat rate in the ‘fire-
fighter protective ensemble’ (1.2 vs 1.9 l h?1) were accompanied by
a higher stroke volume, cardiac output, and skin blood flow values
compared to the ‘unclothed’ condition. The thermoregulatory
responses of three kinds of firefighters’ ‘turnout gear’ with different
clo ratings ranging from 2.77 to 3.03 were investigated by Holmer
et al. (2006); firefighters engaged in treadmill walking at 5 km$h?1
for 30 min in a climatic chamber with an ambient temperature and
relative humidity of 55?C and 30%, respectively. No differences in
heart rate, skin temperature, or core temperature were found
between either turnout suits. These authors concluded that small
differences in terms of design, thickness, and insulation value had
no effect on the resultant thermoregulatory strain.
7. Cognitive function
During fire-fighting search and rescue activities, maintaining
adequate performance of mental function in situations of extreme
heat and emotional stress is a matter of significant importance as
the health and safety of the firefighter, the crew, and the public may
be compromised. Under potentially life-threatening conditions,
firefighters must make important decisions, remain vigilant, and
also remember various geographical points located within a struc-
ture on fire in order to be able to navigate their way out of
a building either when ambient oxygen levels become low or
a casualty is located. In addition to heightened emotional
responses, the intensity of the work performed during firefighting
and the environmental conditions experienced result in increased
core temperature and levels of dehydration which are associated
with deteriorations in cognitive performance, specifically those
pertinent to central executive tasks (Cian et al., 2000, 2001). It is
postulated that during times of increased stress, individuals real-
locate attention resources to appraise and cope with stress, which
reduces the capacity to process task-relevant information. Profuse
sweating resulting in body mass reductions of around 2% body-
weight have been observed in firefighters during simulated fire-
fighting search and rescue activities (Rayson et al., 2005). Such
changes in body mass imposed by heat stress have been shown to
impact on mental concentration and working memory (Sharma
et al., 1986).
Data on the cognitive performance of firefighters are limited;
with the few studies that have attempted to measure changes in
cognitive performance of firefighters following simulated fire-
fighting activities have done so using mental performance tests
such as simple reaction time which are not of primary importance
during firefighting. The matter of major importance during fire-
fighting is that the correct decision is made and that a few milli-
seconds are unlikely to incur any detrimental consequences. It has
also been reported that such tasks may not be challenging enough
to detect differences between different environmental conditions
(Smith and Petruzzello, 1998). In a study involving UK firefighters,
Rayson et al. (2005) reported no change in rapid visual information
processing, spatial memory span, and choice reaction time
following a fire-fighting simulation. However, these tests were
administered 30 min post-event, the authors acknowledging that
any lack of effect could have been lost during the transition period.
In the absence of environmental heat, Kivimaki and Lusa (1994)
investigated the effects of stress choice reaction, as measured from
changes in heart rate from resting heart rate on cognitive function
during a solitary ‘smoke-diving’ exercise. It was reported that as the
physical stress during firefighting increased, task-focused thinking
(measured using the ‘think out aloud method’ for which firefighters
were required to speak their thoughts) decreased. No thermoreg-
ulatory measurements were taken in this study, making it difficult
to ascertain the impact of heat stress that occurs when performing
strenuous smoke-diving activities on cognitive function processes.
Questions remain unanswered with respect to the impact of
heat stress and dehydration on mental performance in firefighters.
First, it is not known whether any decline in mental performance
during firefighting is dictated solely by the physiological strain; the
psychological aspects (anxiety) and experience of firefighters may
also be contributory factors. It may be that mental performance
declines when cerebral blood flow is reduced as a result of heat
stress (Nybo and Nielsen, 2001; Wilson et al., 2003) which impacts
D. Barr et al. / Applied Ergonomics 41 (2010) 161–172167
on tasks associated with the central executive (working memory)
(Collette and Van der Linden, 2002). While maintenance of proper
hydration levels and active body cooling can help to reduce the
physiological strain, their effects on mental performance in fire-
fighters are unknown. Future work on cognitive function in fire-
fighters may be performed in climatic chambers in hot conditions
using computer-based cognitive function tests that have ecological
validity whilst firefighters perform physical tasks at the typical
duration and intensities that reflect the energy expended during
8. Recovery strategies
In sporting events, cooling of the body often occurs prior to the
event but in firefighting this is not really possible or practical due to
the unexpected demands of the role. As a consequence, cooling
may only be permitted during or following the activity, the latter
being important when repeated bouts of fire-fighting activities are
undertaken. The purpose of a cooling strategy following heat
exposure during firefighting is to restore the body to physiological
equilibrium in as quick a time as possible, both for the health and
safety of the individual and in preparation for any subsequent
operation that may occur. In order to meet the demands of fire-
fighting activity there may be a need for practical cooling strategies
that are quick and easy to use, and also possess sufficient capacity
to reduce thermal stress in a relatively short period of time. Cooling
strategies in firefighters, whilst wearing personal protective
equipment (PPE) and self-contained breathing apparatus (SCBA),
have been investigated in both laboratory and field settings using
several modalities. These methods vary in their effectiveness and
practicality and have included passive recovery (Barr et al., 2008,
2009; Carter et al., 1999, 2007; Selkirk et al., 2004), the use of
extractor fans (Carter et al.,1999), misting fans (Selkirk et al., 2004),
and hand and forearm immersion in water (House, 1994, 1996,
1997; McTiffin,1994; Selkirket al., 2004). The benefits of combining
cooling strategies have also been investigated (Barr, 2008, 2009).
Vests containing ice, cold air, and phase change material have been
worn during fire-fighting activities (House 1996; Smolander et al.,
2004; Carter et al., 2006), and shorts under PPE have been also
examined (McLellan and Selkirk, 2004).
8.1. Passive recovery
Passive cooling is an inexpensive and practical method, which
consists of firefighters removing breathing apparatus and tunic,
having access to drinking water and sitting in shaded area where
possible. During cooling research in firefighters, passive recovery
has been generally employed as a control condition in both labo-
ratory (Carter et al.,1999; Selkirk et al., 2004; Barr et al., 2008) and
field settings (Carter et al., 2007; Barr et al., 2009). The data from
studies which have used rest periods in high temperatures indicate
that passive cooling is an ineffective method of reducing physio-
logical strain as reflected by a continued rise in core temperature.
However, during which the recovery took place in a more
temperate environment (w15?C), Carter et al. (2007) reported
a drop in core temperature with the use of passive cooling. This
finding suggests that passive cooling may only be beneficial in
conditions where outdoor temperature is cool, possibly during the
winter months of the year and should not be employed in hotter
climates or during the summer months.
8.2. Hand and forearm immersion
The distal regions (mainly the hands and feet) of the circulatory
system are rich in arteriovenous anastomoses (AVAs) which control
blood flow by shunting blood directly to the venous system from
arterioles, bypassing capillaries. During heat stress it is purported
that AVAs become maximally dilated allowing for greater blood
flow to increase heat dissipation (Krogstad et al.,1995). Immersion
of the hands in water therefore serves as an effective cooling
strategy due to the reduction in the temperature of the cutaneous
blood supply imposed by the cold water, which would in turn cool
the blood returning to the core, thereby reducing the body
temperature (Tipton et al., 1993).
Studies using hand and forearm immersion as a cooling strategy
are summarised in Table 2. The general consensus is that hand and
forearm immersion is an effective method of reducing heat strain in
firefighters, with most of the heat loss occurring within 10 min of
immersion. The benefits of hand and forearm immersion are also
evident during a subsequent bout of work in the heat (Giesbrecht
et al., 2007; House,1996). Hand and forearm immersion may be of
benefit in warmer climates or during the summer months when
ambient temperatures are higher than at other times of the year
(Carter et al., 2007). An important question to address is the
optimal water temperature that should be used during hand and
forearm immersion? It seems that as a function of increasing water
temperature, immersion of a greater surface area of the arm is
required for a similar cooling rate to be maintained (Giesbrecht
et al., 2007). The fastest cooling rates occur inwater of around 10?C
(Giesbrecht et al., 2007; House et al., 1997). Tap water which has
a temperature of w15?C would be a simple solution due to its
accessibility. Water with a temperature of up to 20?C can also be
effective if both the hands and forearms are immersed fully
(Giesbrecht et al., 2007). In order for hand and forearm immersion
to be successful in reducing core temperature, the maintenance of
peripheral blood flow is a requirement. Studies indicate that when
an individual is in a hyperthermic state, vasodilation of arteriove-
nous anastomoses is not compromised at water temperatures
ranging between 10 and 20?C (House, 1994, 1996; McTiffin and
Pethybridge, 1994; House et al., 1997; House and Groom, 1998;
Selkirk et al., 2004).
8.3. Cooling vests
Cooling vests have been traditionally worn prior to exercise in
an attempt to reduce the level of cardiovascular and thermoregu-
latory strain and increase exercise capacity. Cooling vests operate
by conducting heat from the body and can contain either phase
change material or ice packs. Chou et al. (2008) compared ice vests
with cooling vests containing phase change material (PCM) using
cycle ergometry. Firefighters donned vests 10 min prior to exercise.
The PCM vests attenuated the rise in rectal temperature and skin
temperature compared to ice vests and control. The authors
claimed that the phase-change vests were a betteralternative to ice
vests, although caution must be displayed when interpreting these
finding as non-weight-bearing activity was used and as the PCM
vest (1.7 kg) was heavier thanthe ice vests (1.2 kg). Duringactivities
such as stair and ladder climbing, cooling vests may be of limited
benefit due to the increase in metabolic rate imposed by the extra
weight which could outweigh any potential benefits.
Wearing an ice vest has been shown to promote marked
decrements in thermal strain during laboratory-based treadmill
walking activities in the heat during work bouts of low (Bennett
et al., 1995), moderate, and high intensity (Smolander et al., 2004).
Bennett et al. (1995) reported that wearing an ice vest for 40 min
prior to exercise led to a 0.7?C reduction in rectal temperature
following 30 min of moderate intensityexercisein the heat. Despite
ice vests clearly providing physiological benefits to firefighters
working in the heat, this method lacks practicality during fire-
fighting activity in real-life situations since the timing of incidents
D. Barr et al. / Applied Ergonomics 41 (2010) 161–172 168
is unknown, and only relativelyshort periods of preparationmaybe
permitted prior to initial entry into the heat.
8.4. Air movement systems
The use of an extractor fan is based on the idea that all fire
appliances carry a fan; therefore, it would be economical and
simple to administer in a hot environment, providing a source of
convective heat loss. The use of extractor fans as a cooling strategy
was investigated in a laboratory setting by Carter et al. (1999) who
reported that an extractor fan alleviated the physiological stress by
significantly reducing heart rate and attenuating the rise in rectal
temperature during a subsequent 10-minwork period. Selkirk et al.
(2004) examined the use of a misting fan which delivered a fan-
propelled fine mist water vapour at subjects who were seated at
a distance of 1.5 m in front of the fans. The misting fan had
a significanteffect on cardiovascular
attenuating the rise in both heart rate and rectal temperature,
which allowed work time to be increased by 25% compared to
control condition. A possible disadvantage of this method is that
the firefighter could be put at risk of overheating due to the
increased moisture content in the protective clothing gained from
the misting system.
8.5. Combination cooling
Research into cooling strategies for firefighters which have
included cooling vests, the use of fans and hand and forearm
immersion has generally been carried out under laboratory
conditions following bouts of moderate intensity work in the
heat. Barr et al. (2008, 2009) examined the effects of wearing
a cooling vest in conjunction with hand and forearm immersion
administered during a 15-min recovery period between two
bouts of strenuous work in the heat and also in a separate study
during simulated search and rescue activities in a building con-
taining live fires. This cooling strategy was successful in
temperature by 0.5 and 0.7?C laboratory study and live fire
study, respectively. Other parameters such as heart rate, skin
temperature, and the firefighters’ perception of thermal sensa-
tion were significantly lower following the use of this cooling
strategy. The core temperature responses in the cooling condition
in these two studies are greater than reported in other studies
which have used hand and forearm immersion alone following
a single bout of activity in the heat. Both House (1998) and Sel-
kirk et al. (2004) reported a 0.3?C reduction in rectal tempera-
ture following 20 min of hand and forearm immersion. The
findings in both the studies from Barr and co-workers suggest
that cooling via application of an ice vest in conjunction with
hand and forearm immersion is more effective in mediating
decrements in physiological strain during repeated bouts of
strenuous fire-fighting activity than hand and forearm immer-
sion alone. However, differences in heat strain with other studies
due to methodological differences make it difficult to draw direct
comparisons as to the relative contribution of each cooling
method. Future research in this area should serve to try and
derive the simplest but most effective strategy for cooling
8.6. Clothing configurations
Modern day firefighters’ protective clothing provides greater
thermal protection than the traditional fire-fighter clothing. Fire
authorities in the USA responded to this change by replacing long
pant and long-sleeve T-shirts with short pants and short-sleeve T-
shirts. McLellan and Selkirk (2004) investigated the wearing of
shorts underneath PPE as an alternative to long pants in an attempt
to reduce heat stress. During work tasks of a very light and light
intensity, wearing shorts significantly attenuated the rise in rectal
temperature, but this difference was not apparent during moderate
and heavy work. Indeed, altering clothing configurations can be an
effective way of alleviating heat stress. Perhaps of greater concern
Summary of studies reporting the effectiveness of hand and forearm immersion at reducing core body temperature.
Study (year)Subjects Exercise mode
Water temperature (oC) Main outcomes
Selkirk et al. (2004)Toronto firefighters Treadmill walking
(35?C, 50%) for 55 min
20 minutes of hand and
forearm immersion in room
with ambient temperature
(35?C, RH 50%)
Y Rectal temperature
Y Skin temperature and
[ Work tolerance time
Y In aural temperature
of 08?C after 10 min
Y Rectal temperature
of 0.3?C within 20 min
No Y in control
Y Aural temperature
of 0.9?C within 20 min
House and Groom (1998)RN firefighters Stepping exercises (40?C)
until rectal reached 38.5
40 min of hand immersion
in room with ambient
Exercise until aural
38.5?C (40?C, 50%)
Repeated bouts of
until aural temperature
reached 38.5?C (30?C)
60 min of hand, foot,
and hand and foot
immersion (40?C, 50%)
House (1994)RN fire-fighting
20Significant attenuation in
compared to control
Carter et al. (2006) UK firefightersHand immersion (w15?C)17Non-significant Y in core
temperature, compared to
Significant Y in aural
temperature with hand
immersion in 10?C water,
and hand and forearm in
10, 20, and 30?C water
No Y with hand immersion
in 20 and 30?C
Giesbrecht et al. (2007)Canadian firefighters Repeated bouts
of stepping exercise
until aural temperature
reached 38.5?C (30?C)
Hand immersion, and
hand and forearm
Hand immersion in
10, 20, and 30?C.
Hand and forearm
immersion in 10, 20,
D. Barr et al. / Applied Ergonomics 41 (2010) 161–172 169
for replacement of long pants with shorts is whether the protection
of the firefighters’ clothing ensemble is in any way compromised
such that personnel would be at increased risk of heat injury or
burns. Prezant et al. (2001) found no significant difference in upper
and lower extremity burns when wearing short pants and short
sleeve T-shirt or long pants and long sleeve T-shirt.
8.7. Hydration status and fluid replacement
Working in protective clothing in extreme heat results in
profuse sweating and consequently dehydration. Dehydration is
known to impair both cognitive and cardiovascular function
(Gonzalez-Alonso et al., 1997) and reduces tolerance time when
working in uncompensable conditions compared to euhydrated
individuals (McLellan et al., 1999). Brown et al. (2007) investigated
the effects of hydration status which was determined from urine
specific gravity (USG) in 190 firefighters prior to participation of
a series of simulated fire-fighting activities performed under live
fire conditions. During these simulations, the firefighters deemed
to be in dehydrated state (USG>1.020) demonstrated significantly
greater cardiovascular strain (heart rate 151?3.4 vs 135?9.3 beats
min?1) than firefighters deemed to be in a euhydrated state
(USG<1.020). These findings highlight the importance of being in
a euhydrated state prior to commencement of work. Investigations
into rehydrating firefighters with water during rest periods
between work bouts in the heat (Selkirk et al., 2006) and following
live fire simulations (Smith et al., 2001) have yielded positive
findings in both the cases. Avariety of rehydration strategies during
rest periods were investigated by Selkirk et al. (2006). In this study
three levels of rehydration were examined, with 78%, 63%, and 37%
of fluid loss, respectively, being replaced with water. Each level of
rehydration improved tolerance time and attenuated the rise in
core temperature in a graded manner. Smith et al. (2001) reported
that drinking w1.5 l of water during a 10-min rest period and a 90-
min recovery period restored plasma volume to pre-work values.
However, it must be stated that dinking 1.5 l of water in such a short
time period is a fairly aggressive hydration strategy.
In order to meet the demands of firefighting, a firefighter must
possess high levels of muscular, anaerobic, and aerobic fitness and
have a favourable body composition. However, some research
indicates that firefighters fall short of the mark and therefore
struggle at times to meet the demands of the occupation. The
combination of strenuous work, wearing protective clothing, and
thermal environments encountered by firefighters impose severe
physiological strain. The level of this physiological strain is in the
range reported to impact on cognitive function processes. Report-
ing to work in a euhydrated state is of considerable benefits for
firefighters when performing fire-fighting activities. During the
warm months of the year active cooling may be required to accel-
erate the physiological recovery. Hand and forearm immersion in
water appears to be the most effective method, however, research
is needed under conditions representative to firefighting in order to
determine the most effective and efficient method.
The authors are grateful for the grant for this work provided by
Merseyside Fire and Rescue Service, who have no commercial
interest in the outcomes in any of the material reviewed.
Abbott, N., Schulmann, S., 1976. Protection from fire: non-flammable fabrics and
coatings. J. Coated Fabrics 6, 648–664.
Baker, S.J., Grice, J., Roby, L., Matthews, C., 2000. Cardiorespiratory and thermo-
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Glossary of fire-fighting terms
Advancing a hose: navigating through a building with uncharged hose lines while
searching for a reported fire.
Boundary cooling: a technique employed during shipboard firefighting in which the
external walls of a ships compartment are cooled so that a fire maybe controlled
and confined to the compartment of origin.
Ceiling overhaul: careful examination of building that occurs during the latter
stages of an operation when firefighters look for hidden fire inside attics,
ceilings, and walls, searching for remaining sources of heat that may
Charging a hose: to make water pressure available on a hose in final preparation for
its use. This is done on the scene after the hose is advanced.
Forcible entry: gaining entry to an area using force to disable or bypass security
devices, typically using force tools, sometimes using tools specialized for entry
(e.g. Halligan, K-tool).
Halligan tool: forcible entry tool with a pointed pick and a wedge at right angles
on one end of a shaft and a fork or cat’s paw at the opposite end. Used in
combination with maul or flat-headed axe for forcing padlocks, doors, and
High-rise pack: hose bundle prepared for carrying to a standpipe in a high-rise
building, usually consisting of 50 or more feet of hose and a combination
Hose hoist: from the top of the tower, using a hand-over-hand motion, pulling a rope
to hoist a donut roll of a hose.
Ladder raise: lifting the end of a ladder and using hand-over-hand technique on each
rung, walking up the ladder until it is fixed against a wall.
Search and rescue: entering a fire building or collapse zone for an orderly search and
removal of live victims.
Smoke diving: entering into smoke-filled enclosures to perform search and rescue
activities and hose advancing.
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