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Context Slips, trips, and falls are leading causes of musculoskeletal injuries in firefighters. Researchers have hypothesized that heat stress is the major contributing factor to these fireground injuries. Objective To examine the effect of environmental conditions, including hot and ambient temperatures, and exercise on functional and physiological outcome measures, including balance, rectal temperature, and perceived exertion. Design Randomized controlled clinical trial. Setting Laboratory environmental chamber. Patients or Other Participants A total of 13 healthy, active career firefighters (age = 26 ± 6 years [range = 19–35 years], height = 178.61 ± 4.93 cm, mass = 86.56 ± 16.13 kg). Intervention(s) Independent variables consisted of 3 conditions (exercise in heat [37.41°C], standing in heat [37.56°C], and exercise in ambient temperature [14.24°C]) and 3 data-collection times (preintervention, postintervention, and postrecovery). Each condition was separated from the others by at least 1 week and lasted a maximum of 40 minutes or until the participant reached volitional fatigue or a rectal temperature of 40.0°C. Main Outcome Measure(s) Firefighting-specific functional balance performance index, rectal temperature, and rating of perceived exertion. Results Exercise in the heat decreased functional balance, increased rectal temperature, and altered the perception of exertion compared with the other intervention conditions. Conclusions A bout of exercise in a hot, humid environment increased rectal temperature in a similar way to that reported in the physically active population and negatively affected measures of functional balance. Rather than independently affecting balance, the factors of exercise and heat stress appeared to combine, leading to an increased likelihood of slips, trips, and falls.

Context: Heat injury is a significant threat to military trainees. Different methods of heat mitigation are in use across military units. Mist fans are 1 of several methods used in the hot and humid climate of Fort Benning, Georgia. Objectives: To determine if (1) the mist fan or the cooling towel effectively lowered participant core temperature in the humid environment found at Fort Benning and (2) the mist fan or the cooling towel presented additional physiologic or safety benefits or detriments when used in this environment. Design: Randomized controlled clinical trial. Setting: Laboratory environmental chamber. Patients or Other Participants: Thirty-five physically active men aged 19 to 35 years. Intervention(s): (1) Mist fan, (2) commercial cooling towel, (3) passive-cooling (no intervention) control. All treatments lasted 20 minutes. Participants ran on a treadmill at 60% V̇o2max. Main Outcome Measure(s): Rectal core temperature, heart rate, thermal comfort, perceived temperature, perceived wetness, and blood pressure. Results: Average core temperature increased during 20 minutes of cooling (F1,28 = 64.76, P < .001, ηp2 = 0.70), regardless of group (F1,28 = 3.41, P = .08, ηp2 = 0.11) or condition (F1,28 < 1.0). Core temperature, heart rate, and blood pressure did not differ among the 3 conditions. Perceived temperature during 20 minutes of cooling decreased (F1,30 = 141.19, P < .001, ηp2 = 0.83) regardless of group or condition. Perceived temperature was lower with the mist-fan treatment than with the control treatment (F1,15 = 7.38, P = .02, ηp2 = 0.32). The mist-fan group perceived themselves to be cooler even at elevated core temperatures. Conclusions: The mist fan and cooling towel were both ineffective at lowering core temperature. Core temperature continued to increase after exercise in all groups. The mist fan produced feelings of coolness while the core temperature remained elevated, possibly increasing the risk of heat illness.

Context: Musculoskeletal injuries (MSIs) are among the most important challenges facing our military. They influence career success and directly affect military readiness. Several methods of screening initial entry training (IET) soldiers are being tested in an effort to predict which soldiers will sustain an MSI and to develop injury-prevention programs. The Army 1-1-1 Fitness Assessment was examined to determine if it could be used as a screening and MSI prediction mechanism in male IET soldiers.Objective: To determine if a relationship existed among the Army 1-1-1 Fitness Assessment results and MSI, MSI type, and program of instruction (POI) in male IET soldiers.Design: Retrospective cohort study.Setting: Fort Benning, Georgia.Patients or Other Participants: Male Army IET soldiers (N = 1788).Main Outcome Measure(s): The likelihood of sustaining acute and overuse MSI was modelled using separate logistic regression analyses. The POI, run time, push-ups and sit-ups (combined into a single score), and IET soldier age were tested as predictors in a series of linear models.Results: With POI controlled, slower run time, fewer push-ups and sit-ups, and older age were positively correlated with acute MSI; only slower run time was correlated with overuse MSI. For both MSI types, cavalry POIs had a higher risk of acute and overuse MSIs than did basic combat training, armor, or infantry POIs.Conclusions: The 1-1-1 Fitness Assessment predicted both the likelihood of MSI occurrence and type of MSI (acute or overuse). One-mile (1.6-km) run time predicted both overuse and acute MSIs, whereas the combined push-up and sit-up score predicted only acute MSIs. The MSIs varied by type of training (infantry, basic, armor, cavalry), which allowed the development of prediction equations by POI. We determined 1-1-1 Fitness Assessment cutoff scores for each event, thereby allowing the evaluation to be used as an MSI screening mechanism for IET soldiers.