The Heat Tolerance Test: An Efficient Screening Tool for Evaluating Susceptibility to Heat

Moran, Daniel S.; Erlich, Tomer; Epstein, Yoram

doi:10.1123/jsr.16.3.215

Cited by 87 publications

(116 citation statements)

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“…Bout 2 responders. Notably, four young athletes individually had consistently higher T C , HR (and PSI), and RPE responses in bout 2 compared with their first exercise session, which might indicate a lower tolerance (33) to repeated strenuous exercise in the heat and a potential greater clinical risk for these particular boys and girls during outdoor multiple-bout competition scenarios in hot weather. Although we did not evaluate any humoral measures to support the argument, we suspect that the greater degree of physiological strain observed in bout 2 was more likely related to a greater (albeit subclinical) pyrogenic response to the first period of exercise, thus contributing to the higher T C and cardiac frequency (11), as opposed to an acute exercise-induced inflammatory reaction to any potential muscle damage incurred (32) during bout 1.…”

Section: Repeated-bout Exercise In the Heat In Young Athletesmentioning

confidence: 93%

Repeated-bout exercise in the heat in young athletes: physiological strain and perceptual responses

Bergeron¹,

Laird²,

Marinik³

et al. 2009

Journal of Applied Physiology

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A short recovery period between same-day competitions is common practice in organized youth sports. We hypothesized that young athletes will experience an increase in physiological strain and perceptual discomfort during a second identical exercise bout in the heat, with 1 h (21°C) between bouts, even with ample hydration. Twenty-four athletes (6 boys and 6 girls: 12-13 yr old, 47.7 Ϯ 8.3 kg; 6 boys and 6 girls: 16 -17 yr old, 61.0 Ϯ 8.6 kg) completed two 80-min intermittent exercise bouts (treadmill 60%, cycle 40% peak oxygen uptake) in the heat (33°C, 48.9 Ϯ 6.1% relative humidity). Sweat loss during each bout was similar within each age group (12-13 yr old: bout 1, 943.6 Ϯ 237.1 ml; bout 2, 955.5 Ϯ 250.3 ml; 16 -17 yr old: bout 1, 1,382.2 Ϯ 480.7 ml; bout 2, 1,373.1 Ϯ 472.2 ml). Area under the curve (AUC) was not statistically different (P Ͼ 0.05) between bouts for core body temperature (12-13 yr old: bout 1 peak, 38.6 Ϯ 0.4°C; bout 2, 38.4 Ϯ 0.2°C; 16 -17 yr old: bout 1 peak, 38.8 Ϯ 0.7°C; bout 2, 38.7 Ϯ 0.6°C), physiological strain index (12-13 yr old: bout 1 peak, 7.9 Ϯ 0.9; bout 2, 7.5 Ϯ 0.7; 16 -17 yr old: bout 1 peak, 8.1 Ϯ 1.5; bout 2, 7.9 Ϯ 1.4), or thermal sensation for any age/sex subgroup or for all subjects combined. However, rating of perceived exertion AUC and peak were higher (P ϭ 0.0090 and 0.0004, respectively) during bout 2 in the older age group. Notably, four subjects experienced consistently higher responses throughout bout 2. With these healthy, fit, young athletes, 1 h of complete rest, cool down, and rehydration following 80 min of strenuous exercise in the heat was generally effective in eliminating any apparent carryover effects that would have resulted in greater thermal and cardiovascular strain during a subsequent identical exercise bout. hydration; recovery; risk management; thermoregulation; youth sports A SHORT RECOVERY PERIOD between same-day rounds of tournament competition is common practice in organized youth sports. With the additional effects imposed by a hot environment on cardiovascular and thermal strain, performance, and exertional heat injury risk (1,2,4,8,9,14,21,22,24,25,45,47,48), the ability to perform safely and effectively through multiple strenuous same-day competition bouts in the heat can be challenging for young athletes (8, 16). The apparent cumulative demands can often result in poor performance or complete withdrawal from play. Wallace et al. (58) found that exertional heat illness risk was more strongly associated with the combined effects of previous-day wet bulb globe temperature (WBGT) and current-day heat exposure than with either measure alone, suggesting a cumulative effect on thermal strain during exercise in the field. With same-day exercise, Ronsen et al. (46) found that a longer recovery period between bouts (6 vs. 3 h) attenuated the degree of increased metabolic stress and cardiovascular and thermal strain in the second exercise bout for elite endurance athletes, demonstrating how the extent of residual or carryover effects from a previous ...

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Section: Repeated-bout Exercise In the Heat In Young Athletesmentioning

confidence: 93%

Repeated-bout exercise in the heat in young athletes: physiological strain and perceptual responses

Bergeron¹,

Laird²,

Marinik³

et al. 2009

Journal of Applied Physiology

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“…The HTT has been in use by the IDF since 1983 and the investigators have suggested that it is useful and effective for identifying heat intolerance (Kazman et al 2013;Lisman et al 2014;Moran et al 2007). Soldiers who passed the HTT and fully resumed duty reportedly did not suffer a subsequent bout of heat injury (Epstein and Heled 2013;McDermott et al 2007).…”

Section: Militarymentioning

confidence: 99%

Thermal stress, human performance, and physical employment standards

Cheung

Lee

Oksa

2016

Appl. Physiol. Nutr. Metab.

109

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Many physically demanding occupations in both developed and developing economies involve exposure to extreme thermal environments that can affect work capacity and ultimately health. Thermal extremes may be present in either an outdoor or an indoor work environment, and can be due to a combination of the natural or artificial ambient environment, the rate of metabolic heat generation from physical work, processes specific to the workplace (e.g., steel manufacturing), or through the requirement for protective clothing impairing heat dissipation. Together, thermal exposure can elicit acute impairment of work capacity and also chronic effects on health, greatly contributing to worker health risk and reduced productivity. Surprisingly, in most occupations even in developed economies, there are rarely any standards regarding enforced heat or cold safety for workers. Furthermore, specific physical employment standards or accommodations for thermal stressors are rare, with workers commonly tested under near-perfect conditions. This review surveys the major occupational impact of thermal extremes and existing employment standards, proposing guidelines for improvement and areas for future research.Key words: Heat stress, cold stress, occupational physiology, testing, work.Résumé : Plusieurs emplois physiquement exigeants dans les économies développées et en émergence s'exercent dans des milieux thermiques extrêmes qui peuvent affecter la capacité de travail et, en fin de compte, la santé. Ces milieux de condition thermique extrême se retrouvent dans des environnements de travail intérieur ou extérieur et peuvent découler d'une combinaison d'un milieu ambiant naturel ou artificiel, de la production de chaleur métabolique due au travail physique, des procédés spécifiques au milieu de travail (p. ex. fabrication de l'acier) ou du port obligatoire d'un équipement de protection s'opposant à la dissipation de la chaleur. Globalement, l'exposition à la chaleur peut diminuer ponctuellement la capacité de travail et générer des effets chroniques sur la santé, augmentant ainsi le risque de maladie chez le travailleur et la diminution de la productivité. Étonnamment, dans la plupart des emplois même dans les économies développées, il y a rarement, à propos du froid et de la chaleur, des normes de sécurité ou des règlements en vigueur à l'intention des travailleurs. De plus, rares sont les normes spécifiques aux tâches physiques ou les accommodations aux agents de stress thermique et les travailleurs sont généralement évalués dans des conditions presque parfaites. Cette analyse documentaire sonde les effets principaux des agents thermiques extrêmes sur les tâches physiques, fait le bilan des normes en vigueur en matière d'emploi, suggère des lignes directrices et des pistes pour des études ultérieures. [Traduit par la Rédaction] Mots-clés : stress thermique, stress dû au froid, physiologie du travail, évaluation, travail.

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“…If return to vigorous activity is delayed because of heat intolerance or a recurrence of symptoms, laboratory exercise thermal testing may be obtained. The Israeli Defense Forces use a standard heat tolerance test (HTT) to assess readiness for return to military activities [53][54][55]56•], although experts question the validity and applicability of this test to determine safe sports clearance for athletes [40••]. A new HTT protocol was designed and utilized for an elite triathlete with prior episodes of EHS [57].…”

Section: Exertional Heatstrokementioning

confidence: 99%

Heat-related illness in sports and exercise

Nichols

2014

Curr Rev Musculoskelet Med

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Exertional heat-related illness (EHRI) is comprised of several states that afflict physically active persons when exercising during conditions of high environmental heat stress. Certain forms of EHRI may become life threatening if not treated. Exertional heat stroke (EHS), characterized by a core body temperature of >40°C and mental status changes, is the most severe form of EHRI. EHS must be treated immediately with rapid body cooling to reduce morbidity and mortality. Many EHRI cases are preventable by following heat acclimatization guidelines, modifying sports and exercise sessions during conditions of high environmental heat stress, maintaining adequate hydration, avoiding exertion in the heat when ill, and by educating sports medicine personnel, coaches, parents, and athletes on the early recognition and prevention of EHRI. Heat exhaustion, exercise-associated collapse, exercise-associated muscle cramps, exerciseassociated hyponatremia, and exertional rhabdomyolysis are also described.

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The Heat Tolerance Test: An Efficient Screening Tool for Evaluating Susceptibility to Heat

Abstract: The HTT that is based on controlled exposure to an exercise-heat stress is an applicable and an efficient tool in differentiating between a temporary and permanent state of heat susceptibility.

Cited by 87 publications

References 0 publications

Repeated-bout exercise in the heat in young athletes: physiological strain and perceptual responses

Repeated-bout exercise in the heat in young athletes: physiological strain and perceptual responses

Thermal stress, human performance, and physical employment standards

Heat-related illness in sports and exercise

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