Caffeine is consumed by over 80% of U.S. adults. This review examines the effects caffeine has on cognitive and physical function, since most real-world activities require complex decision making, motor processing and movement. Caffeine exerts its effects by blocking adenosine receptors. Following low (∼40mg or ∼0.5mgkg) to moderate (∼300mg or 4mgkg) caffeine doses, alertness, vigilance, attention, reaction time and attention improve, but less consistent effects are observed on memory and higher-order executive function, such as judgment and decision making. Effects on physical performance on a vast array of physical performance metrics such as time-to-exhaustion, time-trial, muscle strength and endurance, and high-intensity sprints typical of team sports are evident following doses that exceed about 200mg (∼3mgkg). Many occupations, including military, first responders, transport workers and factory shift workers, require optimal physical and cognitive function to ensure success, workplace safety and productivity. In these circumstances, that may include restricted sleep, repeated administration of caffeine is an effective strategy to maintain physical and cognitive capabilities.

The purpose of the present study was to determine the separate and combined effects of aerobic fitness, short-term heat acclimation, and hypohydration on tolerance during light exercise while wearing nuclear, biological, and chemical protective clothing in the heat (40 degrees C, 30% relative humidity). Men who were moderately fit [(MF); <50 ml . kg-1 . min-1 maximal O2 consumption; n = 7] and highly fit [(HF); >55 ml . kg-1 . min-1 maximal O2 consumption; n = 8] were tested while they were euhydrated or hypohydrated by approximately 2.5% of body mass through exercise and fluid restriction the day preceding the trials. Tests were conducted before and after 2 wk of daily heat acclimation (1-h treadmill exercise at 40 degrees C, 30% relative humidity, while wearing the nuclear, biological, and chemical protective clothing). Heat acclimation increased sweat rate and decreased skin temperature and rectal temperature (Tre) in HF subjects but had no effect on tolerance time (TT). MF subjects increased sweat rate but did not alter heart rate, Tre, or TT. In both MF and HF groups, hypohydration significantly increased Tre and heart rate and decreased the respiratory exchange ratio and the TT regardless of acclimation state. Overall, the rate of rise of skin temperature was less, while DeltaTre, the rate of rise of Tre, and the TT were greater in HF than in MF subjects. It was concluded that exercise-heat tolerance in this uncompensable heat-stress environment is not influenced by short-term heat acclimation but is significantly improved by long-term aerobic fitness.

This study examined endotoxin-mediated cytokinemia during exertional heat stress (EHS). Subjects were divided into trained [TR; n=12, peak aerobic power (VO2peak)=70+/-2 ml.kg lean body mass(-1).min(-1)] and untrained (UT; n=11, VO2peak=50+/-1 ml.kg lean body mass(-1).min(-1)) groups before walking at 4.5 km/h with 2% elevation in a climatic chamber (40 degrees C, 30% relative humidity) wearing protective clothing until exhaustion (Exh). Venous blood samples at baseline and 0.5 degrees C rectal temperature increments (38.0, 38.5, 39.0, 39.5, and 40.0 degrees C/Exh) were analyzed for endotoxin, lipopolysaccharide binding protein, circulating cytokines, and intranuclear NF-kappaB translocation. Baseline and Exh samples were also stimulated with LPS (100 ng/ml) and cultured in vitro in a 37 degrees C water bath for 30 min. Phenotypic determination of natural killer cell frequency was also determined. Enhanced blood (104+/-6 vs. 84+/-3 ml/kg) and plasma volumes (64+/-4 vs. 51+/-2 ml/kg) were observed in TR compared with UT subjects. EHS produced an increased concentration of circulating endotoxin in both TR (8+/-2 pg/ml) and UT subjects (15+/-3 pg/ml) (range: not detected to 32 pg/ml), corresponding with NF-kappaB translocation and cytokine increases in both groups. In addition, circulating levels of tumor necrosis factor-alpha and IL-6 were also elevated combined with concomitant increases in IL-1 receptor antagonist in both groups and IL-10 in TR subjects only. Findings suggest that the threshold for endotoxin leakage and inflammatory activation during EHS occurs at a lower temperature in UT compared with TR subjects and support the endotoxin translocation hypothesis of exertional heat stroke, linking endotoxin tolerance and heat tolerance.

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.

T underestimated and U consistently perceived their physiological strain, as defined by PhSI, in accordance with the measured increases in core temperature and heart rate throughout an exposure to uncompensable exercise-heat stress.