Objectives Hot environmental conditions can result in a high core-temperature and dehydration which can impair physical and cognitive performance. This study aimed to assess the effects of a hot operating theatre on various performance, physiological and psychological parameters in staff during a simulated burn surgery. Methods Due to varying activity levels, surgery staff were allocated to either an Active (n = 9) or Less-Active (n = 8) subgroup, with both subgroups performing two simulated burn surgery trials (CONTROL: ambient conditions; 23±0.2˚C, 35.8±1.2% RH and HOT: 34±0˚C, 28.3±1.9% RH; 150 min duration for each trial), using a crossover design with four weeks between trials. Manual dexterity, core-temperature, heart-rate, sweat-loss, thermal sensation and alertness were assessed at various time points during surgery. Results Pre-trials, 13/17 participants were mildly-significantly dehydrated (HOT) while 12/17 participants were mildly-significantly dehydrated (CONTROL). There were no significant differences in manual dexterity scores between trials, however there was a tendency for scores to be lower/impaired during HOT (both subgroups) compared to CONTROL, at various time-points (Cohen's d =-0.74 to-0.50). Furthermore, alertness scores tended to be higher/ better in HOT (Active subgroup only) for most time-points (p = 0.06) compared to CONTROL , while core-temperature and heart-rate were higher in HOT either overall (Active; p<0.05) or at numerous time points (Less-Active; p<0.05). Finally, sweat-loss and thermal sensation were greater/higher in HOT for both subgroups (p<0.05).

This experimental study investigates the effect of ambient temperature in the cognitive functioning and perceived workload of burns surgical teams. Response times and accuracy on cognitive tasks were analysed. Results suggest that high ambient temperatures impair cognitive functioning of surgical team members at 60 minutes or longer.