Personal protective equipment(PPE)inhibits heat dissipation and elevates heat strain. Impairedcooling with PPE warrants investigation into practical strategies to improve work capacity and mitigate exertional heat illness. Examine physiological and subjectiveeffects of forearm immersion (FC), fan mist (MC), and passive cooling (PC) following three intermittent treadmill bouts while wearing PPE. Twelve males (27 ± 6years; 57.6 ± 6.2ml/kg/min; 78.3 ± 8.1kg; 183.1 ± 7.2cm) performed three 50-min (10min of 40%, 70%, 40%, 60%, 50% vVO2max)treadmill bouts in the heat (36°C, 30% relative humidity). Thirty minutes of cooling followed eachbout, using one of the three strategies per trial.Rectal temperature (Tcore), skin temperature (Tsk), heart rate (HR), heart rate recovery (HRR), rating of perceived exertion (RPE), thirst, thermal sensation (TS), and fatigue were obtained. Repeated-measures analysis of variance (condition x time) detected differences between interventions. Final Tcorewas similar betweentrials (P > .05). Cooling rates were largerin FC and MC vs PC following bout one (P < .05). HRR was greatest in FC following bouts two (P = .013) and three (P < .001). Tsk, fluid consumption, and sweat rate were similar between all trials (P > .05). TS and fatigue during bout three were lower in MC, despite similar Tcoreand HR. UtilizingFC and MC during intermittent workin the heat with PPE yields some thermoregulatory and cardiovascularbenefit, but military health and safety personnel should explore new and novelstrategies to mitigate risk and maximize performance under hot conditions while wearing PPE.
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