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Updated: Aug 18, 2026

Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management
Published on: November 21, 2017
Active versus passive cooling during work in warm environments while wearing firefighting protective clothing
G A Selkirk1, T M McLellan, J Wong
1Operational Medicine Section-Defence R&D Canada--Toronto, Toronto, Ontario, Canada. glen.selkirk@drdc-rddc.gc.ca
Abstract:
This study examined whether active or passive cooling during intermittent work reduced the heat strain associated with wearing firefighting protective clothing (FPC) and self-contained breathing apparatus (SCBA) in the heat (35 degrees Celsius, 50% relative humidity). Fifteen male Toronto firefighters participated in the heat-stress trials. Subjects walked at 4.5 km.h(-1) with 0% elevation on an intermittent work (50 min) and rest (30 min) schedule. Work continued until rectal temperature (T(re)) reached 39.5 degrees Celsius, or heart rate (HR) reached 95% of maximum or exhaustion. One of three cooling strategies, forearm submersion (FS), mister (M), and passive cooling (PC) were employed during the rest phases. Tolerance time (TT) and total work time (WT) (min) were significantly increased during FS (178.7 +/- 13.0 and 124.7 +/- 7.94, respectively) and M (139.1 +/- 8.28 and 95.1 +/- 4.96, respectively), compared with PC (108.0 +/- 3.59 and 78.0 +/- 3.59). Furthermore, TT and WT were significantly greater in FS compared with M. Rates of T(re) increase, HR and T-(sk) were significantly lower during active compared with passive cooling. In addition, HR and T(re) values in FS were significantly lower compared with M after the first rest phase. During the first rest phase, T(re) dropped significantly during FS (approximately 0.4 degree Celsius) compared with M (approximately 0.08 degree Celsius) while PC increased (approximately 0.2 degree Celsius). By the end of the second rest period T(re) was 0.9 degree Celsius lower in FS compared with M. The current findings suggest that there is a definite advantage when utilizing forearm submersion compared with other methods of active or passive cooling while wearing FPC and SCBA in the heat.
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