Core Temperature Responses of Fire-fighter Instructors During Work in a Hot and Normal Environment

It is important to employ training practices that ensure that fire-fighter instructors work in an environment which does not provoke unacceptable rises in core temperature (>38°C). PURPOSE: To assess the effects of a two-day fire-behaviour training (FBT) course on the core temperature (Tc) of fire-fighter instructors in order to establish whether current training practices ensure a safe working environment. METHODS: Eleven males (mean±sd age 38.3±4.3 yr, body mass 88.5±12.7 kg and stature 177.8±5.3 cm) from two regional training centres completed three days of standard FBT, wearing full protective clothing and breathing apparatus. Two consecutive days (HOT1 and HOT2, mean ambient temperature of 12.7°C) each consisted of a morning and an afternoon heat exposure (approximately 30 minutes in duration). The third day was a control (NORM), without heat exposure (mean Tc of 19.3 °C). Tc was measured at baseline (BASE) and at the start and end of the two exposures (PRE-AM, POST-AM and PRE-PM, POST-PM respectively) for each subject using a telemetry pill (HQ Inc, USA). RESULTS: There was a different pattern of Tc response over the two HOT days compared with the NORM day due to the significant increase in Tc associated with each of the heat exposures (p<0.01, PRE to POST, Table 1). Mean Tc did not reach 38°C, but in 10 out of 44 individual exposures subjects had a T above 38°C post heat exposure. In contrast, baseline T for the three days was not significantly different and showed a consistent significant increase to PRE-AM values (p<0.01, BASE to PRE-AM, Table 1) associated with the wearing of protective clothing and morning activities. The mean (±sd) unit temperatures of the HOT and NORM days were 160.2 (±89.3) and 27.6 (±8.4) °C respectively. CONCLUSION: The physiological strain experienced due to heat exposure in firefighter instructors resulted in a significant increase in Tc above that experienced during similar physical exertion with no heat exposure. While mean Tc did not reach 38°C, defined as an acceptable limit for work, Tc did rise above 38°C after approximately 1 in 4 individual heat exposures

Problems in the treatment of malabsorption in CF

ABSTRACT. Several factors play a role in the cause of malabsorption in CF. Besides the enzyme deficiency in the secretion of the exocrine pancreas, decreased bile‐salt concentration in the gut may also be an important factor in the fat malabsorption. The contribution to the fat absorption by other lipases, such as lingual lipase and gastric lipase, remains to he proved. The therapeutic measures are only partly effective because of the breakdown of swalled enzymes by gastric acid. Some improvement is reached by using a new acid‐resistant coating for the enzyme supplement. Newly developed and essential for its success is the application of small coated particles to prevent retention in the stomach, and the easy breakdown of the coating in an alkaline solution. The treatment of the bile salt deficiency has not been successful until now. A trial with additional Tween 80, with the option of supplementing the detergent activity which was found to he successful in Crohn disease, was without marked success. Copyrigh