Victims of exertional heat stroke (EHS) in whom treatment is delayed have higher rates of multi-organ failure and a greater number of fatalities. Death related to EHS is preventable, through immediate treatment via cold-water immersion (CWI). To date little is known about the influence of treatment delays on core cooling following EHS. Thus we sought to examine the effects of treatment delays on cardiovascular and thermal responses prior to, during, and following CWI treatment in individuals with exercise-induced hyperthermia. Our findings demonstrate that treatment delays resulted in a sustained level of hyperthermia and cardiovascular strain that significantly increased the time an individual is at risk to the potential lethal effects of EHS. Moreover, we report that cold water immersion treatment is powerful enough to overcome the adverse effects of treatment delays and rapidly reduce core temperatures while facilitating the re-establishment of blood pressure towards normal resting levels.

Victims of exertional heat stroke (EHS) in whom treatment is delayed have higher rates of multi-organ failure and a greater number of fatalities. Death related to EHS is preventable, through immediate treatment via cold-water immersion (CWI). To date little is known about the influence of treatment delays on core cooling following EHS. Thus we sought to examine the effects of treatment delays on cardiovascular and thermal responses prior to, during, and following CWI treatment in individuals with exercise-induced hyperthermia. Our findings demonstrate that treatment delays resulted in a sustained level of hyperthermia and cardiovascular strain that significantly increased the time an individual is at risk to the potential lethal effects of EHS. Moreover, we report that cold water immersion treatment is powerful enough to overcome the adverse effects of treatment delays and rapidly reduce core temperatures while facilitating the re-establishment of blood pressure towards normal resting levels.

This investigation examined the acute physiological demand associated with a typical Freeride Mountain Bike (FMB) ride. Measures of cardiovascular strain (heart rate, RPE) and neuromuscular fatigue (quarter squat and handgrip MVICs) were assessed in 22 experienced mountain bikers during an observed ride on Mt. Fromme in North Vancouver, British Columbia. The ride involved an initial ascent of 350 vertical meters over horizontal distance of 5.93km, (mean duration 46.61 min). The descent covered a 350m loss in elevation through intermediate to expert level trails spanning a horizontal distance of 4.24km, (mean duration 28.55 min). Heart rate monitoring was continuous. Blood Lactate was assessed pre-ride, at the top of the ascent (mid-ride), and following the descent (post-ride). RPE was assessed mid-ride and post-ride. Handgrip and quarter squat MVICs were taken pre-ride and post-ride. An a priori alpha of .05 was set for all statistical tests. Both measures of neuromuscular strain decreased pre-post ride, equal to 2.8% in quarter squat MVIC and 6.1% and 4.3% in handgrip MVIC for the right and left hands respectively. Blood lactate increased from rest to mid-ride and decreased from mid-ride to post-ride. The mean heart rates (- 80% PHRmax) and RPEs (-14.5) associated with the ascent and descent were not significantly different. The acute physiological and ride pattern data indicate that FMB satisfies the American College of Sports Medicine's guidelines for increasing cardiovascular health and fitness.

This investigation examined the acute physiological demand associated with a typical Freeride Mountain Bike (FMB) ride. Measures of cardiovascular strain (heart rate, RPE) and neuromuscular fatigue (quarter squat and handgrip MVICs) were assessed in 22 experienced mountain bikers during an observed ride on Mt. Fromme in North Vancouver, British Columbia. The ride involved an initial ascent of 350 vertical meters over horizontal distance of 5.93km, (mean duration 46.61 min). The descent covered a 350m loss in elevation through intermediate to expert level trails spanning a horizontal distance of 4.24km, (mean duration 28.55 min). Heart rate monitoring was continuous. Blood Lactate was assessed pre-ride, at the top of the ascent (mid-ride), and following the descent (post-ride). RPE was assessed mid-ride and post-ride. Handgrip and quarter squat MVICs were taken pre-ride and post-ride. An a priori alpha of .05 was set for all statistical tests. Both measures of neuromuscular strain decreased pre-post ride, equal to 2.8% in quarter squat MVIC and 6.1% and 4.3% in handgrip MVIC for the right and left hands respectively. Blood lactate increased from rest to mid-ride and decreased from mid-ride to post-ride. The mean heart rates (- 80% PHRmax) and RPEs (-14.5) associated with the ascent and descent were not significantly different. The acute physiological and ride pattern data indicate that FMB satisfies the American College of Sports Medicine's guidelines for increasing cardiovascular health and fitness.

Représentant 43% des décès rapportés au cours des dix dernières années, la mort subite due à un événement cardiaque est la cause de décès au travail la plus fréquente chez les pompiers américains. Des études démontrent que le risque d’événements cardiaques au travail chez les pompiers est accentué par deux causes principales, la première étant la présence d’une maladie coronarienne, d’une cardiomégalie/hypertrophie ventriculaire gauche (HVG) ou de dommages occasionnés antérieurement par un infarctus du myocarde, la seconde étant l’importante contrainte cardiovasculaire subie au travail. Aucune étude n’a été réalisée pour évaluer l’état de santé cardiovasculaire des pompiers et pompières du Québec. Une telle étude permettrait d’en connaître davantage sur leur risque de maladies et d’événements cardiovasculaires. Par ailleurs, on constate que la prévalence des facteurs de risque des maladies cardiovasculaires (MCV) est élevée chez les pompiers américains, ce qui corrèle avec le nombre élevé d’événements cardiaques au travail. Le premier objectif de cette thèse était donc de dresser un portrait de la santé cardiovasculaire des pompiers et pompières du Québec. Ensuite, dans le but de réduire le risque d’événements cardiaques au travail, il était pertinent d’étudier une stratégie de prévention des MCV chez les pompiers. Le risque de développer une maladie coronarienne ou une cardiomégalie/HVG pourrait être réduit en adoptant et maintenant de saines habitudes de vie, dont une pratique régulière d’activités physiques. Plusieurs services de sécurité incendie au Québec permettent aux pompiers de faire du conditionnement physique en caserne pendant les heures de travail. Cette pratique pourrait contribuer à augmenter leur quantité d’activités physiques hebdomadaire et à améliorer leur santé cardiovasculaire. Le deuxième objectif de cette thèse était donc de comparer la pratique d’activités physiques hebdomadaire et différents indicateurs de santé cardiovasculaire chez les pompiers qui font et ceux qui ne font pas de conditionnement physique pendant les heures de travail. Enfin, dans le but de réduire le risque d’événements cardiaques au travail, il semblait pertinent de s’intéresser à la prévention de la contrainte cardiovasculaire subie au travail chez les pompiers, considérant qu’elle agit comme « déclencheur ». Cette contrainte pourrait être réduite en évitant d’écourter les périodes de repos octroyées entre les phases de travail lors d’une intervention. Le troisième objectif de cette thèse était de comparer et de caractériser la contrainte cardiaque engendrée par deux interventions simulant les tâches du métier de pompiers, soit deux phases de travail identiques entrecoupées d’une période de récupération passive courte versus prolongée. Les résultats principaux de cette thèse montrent qu’une proportion importante de pompiers (Chapitre 2) et pompières (Chapitre 3) du Québec sont à risque moyen/élevé de MCV. Ils montrent aussi que les pompiers qui font du conditionnement physique pendant les heures de travail pratiquent plus d’activité physique par semaine et présentent de meilleurs indicateurs de santé cardiovasculaire que les pompiers qui n’en font pas (Chapitre 4). Finalement, les résultats montrent qu’une période de récupération passive d’une durée de 5 minutes entre deux phases de travail de 25 minutes lors d’une simulation d’intervention engendre une contrainte cardiaque largement plus importante qu’une période de 20 minutes et que cette différence semble être principalement redevable à une contrainte thermique et une déshydratation plus importantes (Chapitre 5). Ces projets de recherche ont été subventionnés par les Fonds de recherche du Québec – Santé sous la forme d'une bourse d'étude de formation de doctorat. / Accounting for 43% of deaths reported in the past decade, sudden cardiac death is the most common cause of on-duty deaths among US firefighters. Studies show that the risk of on-duty cardiac events in firefighters is accentuated by two main causes: the first is the presence of coronary heart disease, cardiomegaly/left ventricular hypertrophy (LVH) and/or damage caused previously by a myocardial infarction, the second being the important cardiovascular strain suffered at work. No studies have been conducted to assess the cardiovascular health status of Québec firefighters. Such a study would allow us to know more about their risk of cardiovascular diseases (CVD) and on-duty cardiac events. Futhermore, the prevalence of CVD risk factors was shown to be high among US firefighters, consistent with the high number of on-duty cardiac events. The first objective of this thesis was thus to assess the cardiovascular health profile of Québec male and female firefighters. Second, in order to reduce the risk of on-duty cardiac events, it was relevant to pore over the prevention of CVD in firefighters. The risk of developing coronary heart disease and/or cardiomegaly/LVH could be reduced by engaging in and maintaining healthy lifestyle behavior including regular physical activity. Several fire departments in Québec allow firefighters to do on-duty physical training in fire stations. This could help increase their weekly physical activity level and improve their cardiovascular health. The second objective of this thesis was to compare the weekly physical activity level and various cardiovascular health indicators in firefighters who physically train on duty in the fire station and those who do not. Lastly, in order to reduce the risk of on-duty cardiac events, it was also relevant to look at the prevention of cardiovascular strain suffered by firefighters, considering that it acts as a "trigger". This could be reduced by avoiding shortened recovery periods between periods of work during interventions. The third objective of this thesis was to compare and characterize the cardiac strain generated by two firefighting simulations consisting of two identical work bouts intercalated with a short vs. extended passive recovery period. iv The main results of this thesis show that a high proportion of Québec male and female firefighters are at moderate to high risk of CVD. They also show that firefighters who physically train on duty in fire stations have a higher weekly physical activity level and have better cardiovascular health indicators compared to firefighters who do not. Finally, the results show that a passive recovery period of 5 minutes between two 25-minute work bouts during a firefighting simulation results in a greater cardiac strain than a 20-minute recovery period and that this difference seems to be mainly due to a greater thermal strain and dehydration. These projects were funded by Fonds de recherche du Québec – Santé in the form of a doctoral research scholarship.