Subjective symptoms and postural control during a disabled submarine simulation

To simulate conditions aboard a disabled submarine, 7 submariners were confined for 5 d to a normobaric environment of 16.75% O2, 2.5% CO2, 4 degrees C, and 85% relative humidity (RH). After 2 control days and 1 d of hypoxia, the remaining environmental conditions were imposed for the next 5 d, followed by 1 additional day of just hypoxia. Daily morning symptoms were assessed using the Environmental Symptoms Questionnaire (ESQ). Postural stability was determined on 4 occasions using a computerized balance system: control period, after 2.7 and 4.7 d of steady-state test conditions, and after 5.7 d (with return to normal ambient temp, RH, and CO2). Three balance tests were performed: eyes open, eyes closed, and a dynamic test. Postural stability deteriorated after 2.7 d (87% eyes open, P < 0.001 and 26% eyes closed, P = 0.01). ESQ symptom subsets for acute mountain sickness, exertion, fatigue, alertness, and ear/nose/throat were not significantly different. Cold symptom subsets were increased after 3-7 d (P < 0.001); distress and muscle discomfort subsets after 7 d (P = 0.02). Continued exposure to the combination of cold and hypoxia elicited subjective symptom changes and disturbances in postural stability that are statistically significant. These observations may be of practical importance when tasks aboard a disabled submarine involve balance and mobility.