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Working in the Heat at Simulated Altitude: Effects of Normobaric Hypoxia on Physiological Strain

2026년 7월 11일 업데이트: Glen P. Kenny, University of Ottawa

Effects of Normobaric Hypoxia on Initial Stay Time and Physiological Strain During Moderate-Intensity Work in the Heat in Young and Older Males

Extreme heat events are becoming more frequent, intense, and prolonged, increasing the risk of heat-related illness among workers performing physically demanding work in hot environments. Occupational heat-stress guidelines use work-rest schedules to limit increases in core temperature and physiological strain, but they do not clearly define the safe maximum duration of continuous work before heat-mitigation controls should begin, known as the initial stay time. Recent work has generated initial stay time recommendations for young and older workers performing moderate-intensity work in the heat; however, these recommendations were developed under normoxic conditions. In many workplaces, heat may occur alongside additional stressors such as hypoxia, including work at altitude or in oxygen-reduced environments. Hypoxia can increase cardiovascular strain, reduce arterial oxygen saturation, and impair exercise tolerance, potentially compromising heat-stress guidance developed under normal oxygen conditions. Older workers may be especially vulnerable because of age-related reductions in thermoregulatory and cardiovascular function. It remains unclear whether hypoxia increases physiological strain during work in the heat or whether current initial stay time and recovery recommendations remain protective under combined heat and hypoxic stress.

The primary objective of this study is to determine whether hypoxia increases physiological strain during moderate-intensity work in the heat in young and older males. Specifically, the study will assess whether normoxia-derived initial stay times and recovery recommendations for work at 29°C wet-bulb globe temperature (37.5°C, 35% RH) remain effective during exposure to 14% inspired oxygen, simulating approximately 3000 m altitude. Healthy young and older males will complete two simulated occupational heat exposures: heat alone and heat plus hypoxia. Participants will perform moderate-intensity treadmill work based on age-specific initial stay times, followed by prescribed work-rest cycles and seated recovery. Core temperature, cardiovascular strain, oxygen saturation, skin temperature, hydration status, perceptual responses, mood, environmental stress symptoms, and cognitive function will be assessed to determine whether hypoxia modifies responses to work in the heat. Findings will help determine whether occupational heat-stress guidance requires refinement for workers exposed to combined heat and hypoxic stress.

연구 개요

연구 유형

중재적

등록 (추정된)

20

단계

  • 해당 없음

연락처 및 위치

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연구 연락처

  • 이름: Glen P Kenny, PhD
  • 전화번호: 4282 6135625800
  • 이메일: gkenny@uottawa.ca

연구 장소

    • Ontario
      • Ottawa, Ontario, 캐나다, K1N 6N5
        • 모병
        • University of Ottawa
        • 연락하다:

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

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아니

설명

Inclusion Criteria:

  • Are male.
  • Do not smoke or have been smoke free for at least 5 years.
  • English or French speaking.
  • Ability to provide informed consent.
  • Are physically active (engage in exercise at least 2 times per week for ≥30 minutes)

Exclusion Criteria:

  • Are regularly exposed to hot environments (e.g., occupational heat exposure)
  • Are regularly exposed to hypoxic environments (e.g., high altitudes)
  • Experience claustrophobia or discomfort in enclosed environments
  • Episode(s) of severe hypoglycemia (requiring the assistance of another person) within the previous year, or inability to sense hypoglycemia (hypoglycemia unawareness).
  • Serious complications related to diabetes (gastroparesis, renal disease, uncontrolled hypertension, severe autonomic neuropathy).
  • Uncontrolled hypertension - BP >150 mmHg systolic or >95 mmHg diastolic in a sitting position.
  • Restrictions in physical activity due to disease (e.g. intermittent claudication, renal impairment, active proliferative retinopathy, unstable cardiac or pulmonary disease, disabling stroke, severe arthritis, etc.).
  • Use of or changes in medication judged by the patient or investigators to make participation in this study inadvisable.
  • Cardiac abnormalities identified during screening

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 기초 과학
  • 할당: 무작위
  • 중재 모델: 크로스오버 할당
  • 마스킹: 하나의

무기와 개입

참가자 그룹 / 팔
개입 / 치료
실험적: Normoxic exposure
Participants complete a simulated moderate-intensity occupational heat exposure protocol in a hot environment (37.5°C, 35% RH) under normoxic conditions. Participants walk on a treadmill until they reach their initial stay time, followed by prescribed work-rest cycles and seated recovery.
Participants complete a simulated moderate-intensity occupational heat exposure protocol involving treadmill walking in a hot environment (37.5°C, 35% RH) under normoxic conditions (~20.9% inspired oxygen). Participants walk until they reach their initial stay time, followed by prescribed work-rest cycles and seated recovery.
실험적: Hypoxic exposure
Participants complete a simulated moderate-intensity occupational heat exposure protocol in a hot environment (37.5°C, 35% RH) with an added hypoxic exposure equivalent to 14% inspired oxygen. Participants walk on a treadmill until they reach their initial stay time, followed by prescribed work-rest cycles and seated recovery.
Participants complete a simulated moderate-intensity occupational heat exposure protocol involving treadmill walking in a hot environment (37.5°C, 35% RH) with an added hypoxic exposure equivalent to 14% inspired oxygen. Participants walk until they reach their initial stay time, followed by prescribed work-rest cycles and seated recovery.

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Total work volume
기간: During the 240-minute work period
Total work completed during the 240-minute work bout. The work period consists of an initial continuous walking phase to a core temperature 38.0°C or 1°C increase above baseline resting, followed by intermittent work-rest cycles.
During the 240-minute work period

2차 결과 측정

결과 측정
측정값 설명
기간
Time to core temperature of 38.0°C
기간: During the 240-minute work period
Time, in minutes, from the start of continuous walking to the point at which core temperature reaches 38.0°C. Participants who do not reach 38.0°C before voluntary termination, reaching the applicable stopping criterion, or completing 240 minutes of continuous walking will have their time recorded at termination or completion.
During the 240-minute work period
Time to 1.0°C increase in core temperature
기간: During the 240-minute work period
Time, in minutes, from the start of continuous walking to the point at which rectal temperature increases by 1.0°C above baseline. For participant safety, continuous walking will not continue beyond a rectal temperature of 38.5°C. Therefore, for participants who reach 38.5°C before attaining a 1.0°C increase in rectal temperature, the time at which 38.5°C is reached will be recorded. Participants who voluntarily terminate exercise or complete 240 minutes of continuous walking before reaching either endpoint will have their time recorded at termination or completion.
During the 240-minute work period
Average core temperature during work/rest cycles
기간: During the 240-minute work period
Average core temperature measured during the intermittent work-rest cycles following the initial continuous work period.
During the 240-minute work period
Heart rate at core temperature of 38.0°C
기간: During the 240-minute work period
Heart rate measured at the time a participant reaches a rectal temperature of 38.0°C during the initial continuous walking period. For participants who do not reach a rectal temperature of 38.0°C before voluntary termination, reaching the applicable stopping criterion, or completing 240 minutes of continuous walking, heart rate at termination or completion will be recorded.
During the 240-minute work period
Heart rate at 1.0°C increase in core temperature
기간: During the 240-minute work period
Heart rate measured at the time a participant achieves a 1.0°C increase in core temperature above baseline during the initial continuous walking period. For participant safety, continuous walking will not continue beyond a core temperature of 38.5°C. Therefore, for participants who reach a core temperature of 38.5°C before attaining a 1.0°C increase above baseline, the heart rate at 38.5°C will be recorded. Participants who voluntarily terminate exercise or complete 240 minutes of continuous walking before reaching either endpoint will have their final recorded heart rate used.
During the 240-minute work period
Average heart rate during work/rest cycles
기간: During the 240-minute work period
Average heart rate measured during the intermittent work-rest cycles following the initial continuous work period.
During the 240-minute work period
Mean skin temperature at core temperature of 38.0°C
기간: During the 240-minute work period
Mean skin temperature measured at the time a participant reaches a core temperature of 38.0°C during the initial continuous walking period. For participants who do not reach a core temperature of 38.0°C before voluntary termination, reaching the applicable stopping criterion, or completing 240 minutes of continuous walking, mean skin temperature at termination or completion will be recorded.
During the 240-minute work period
Mean skin temperature at 1.0°C increase in core temperature
기간: During the 240-minute work period
Mean skin temperature measured at the time a participant achieves a 1.0°C increase in core temperature above baseline during the initial continuous walking period. For participant safety, continuous walking will not continue beyond a core temperature of 38.5°C. Therefore, for participants who reach a core temperature of 38.5°C before attaining a 1.0°C increase above baseline, the mean skin temperature at 38.5°C will be recorded. Participants who voluntarily terminate exercise or complete 240 minutes of continuous walking before reaching either endpoint will have their final recorded mean skin temperature used.
During the 240-minute work period
Average mean skin temperature during work/rest cycles
기간: During the 240-minute work period
Average mean skin temperature measured during the intermittent work-rest cycles following the initial continuous work period.
During the 240-minute work period
Recovery core temperature
기간: During 1 hour recovery following the 240-minute work period
Average core temperature during the recovery period. Core temperature will be measured continuously throughout recovery.
During 1 hour recovery following the 240-minute work period
Recovery heart rate
기간: During 1 hour recovery following the 240-minute work period
Average heart rate during the recovery period. Heart rate will be measured continuously throughout recovery.
During 1 hour recovery following the 240-minute work period
Recovery mean skin temperature
기간: During 1 hour recovery following the 240-minute work period
Average mean skin temperature during the recovery period. Skin temperature will be measured continuously throughout recovery.
During 1 hour recovery following the 240-minute work period
Tissue oxygenation
기간: During 240-minute work bout and subsequent 1 hour recovery
Functional near-infrared spectroscopy will be used to continuously assess changes in cerebral and skeletal muscle oxygenation
During 240-minute work bout and subsequent 1 hour recovery
Peripheral oxygen saturation
기간: During 240-minute work bout and subsequent 1 hour recovery
Peripheral oxygen saturation will be continuously monitored using pulse oximetry to assess the level of arterial oxygen saturation during work and recovery; indicates the degree of hypoxemia and helps determine whether reduced oxygen availability contributes to physiological strain during heat exposure
During 240-minute work bout and subsequent 1 hour recovery
Urine specific gravity
기간: Assessed at baseline and after recovery
Urine specific gravity will be measured to assess hydration status. Higher values indicate greater urine concentration and therefore poorer hydration status, whereas lower values indicate lower urine concentration and therefore better hydration status.
Assessed at baseline and after recovery
Fluid loss from body mass change
기간: Assessed at baseline and throughout protocol
Fluid loss calculated from changes in body mass during exposure, corrected for fluid intake.
Assessed at baseline and throughout protocol
Changes in plasma volume
기간: Assessed at baseline and after recovery
Change in plasma volume from baseline values calculated from duplicate measurements of hemoglobin and hematocrit at the start and end of exposure using the technique by Dill and Costill
Assessed at baseline and after recovery
Systolic blood pressure
기간: Assessed at baseline and throughout protocol
Systolic blood pressure measured in triplicate using automated oscillometry.
Assessed at baseline and throughout protocol
Diastolic blood pressure
기간: Assessed at baseline and throughout protocol
Diastolic blood pressure measured in triplicate using automated oscillometry.
Assessed at baseline and throughout protocol
Orthostatic hypotension questionnaire
기간: Assessed at baseline and throughout protocol
Cumulative sum of scores on 6 questions asking participant to rank symptoms associated with orthostatic intolerance. All symptoms scored on a scale from 0 (none) to 10 (worst possible) and include feelings of: (1) "dizziness, lightheadedness, feeling faint, or feeling like you might black out"; (2) "Problems with vision (blurring, seeing spots, tunnel vision, etc.)"; (3) "Weakness"; (4) "Fatigue"; (5) "Trouble concentrating"; and (6) "Head and neck discomfort"
Assessed at baseline and throughout protocol
Lake Louise Mountain Sickness Questionnaire
기간: Assessed at baseline and throughout protocol
Assess symptoms of acute mountain sickness, including headache, gastrointestinal discomfort, fatigue/weakness, dizziness/lightheadedness, and sleep disturbance. Each symptom is scored from 0 - 3 and summed for a total score, with higher scores indicating greater symptom severity and acute mountain sickness typically defined as headache plus a total score ≥3.
Assessed at baseline and throughout protocol
Thermal sensation scale
기간: Assessed at baseline and throughout protocol
Thermal sensation will be assessed using a visual analog ASHRAE-based scale in response to the question "How hot do you feel?" Scores range from 0 (neutral) to 7 (extremely hot). Higher scores indicate a greater sensation of heat and therefore a worse outcome, whereas lower scores indicate less perceived heat and therefore a better outcome.
Assessed at baseline and throughout protocol
Thermal comfort
기간: Assessed at baseline and throughout protocol
Thermal comfort will be assessed in response to the question "How comfortable does your body temperature feel?" using a visual analog scale ranging from 1 (comfortable) to 4 (very uncomfortable). Higher scores indicate lower thermal comfort and therefore a worse outcome, whereas lower scores indicate greater thermal comfort and therefore a better outcome.
Assessed at baseline and throughout protocol
Thirst sensation
기간: Assessed at baseline and throughout protocol
Thirst sensation will be assessed in response to the question "How thirsty are you?" using a visual analog scale ranging from 1 (not thirsty at all) to 9 (very, very thirsty). Higher scores indicate greater thirst and therefore a worse outcome, whereas lower scores indicate less thirst and therefore a better outcome.
Assessed at baseline and throughout protocol
Rating of Perceived Exertion (Borg 6-20 Scale)
기간: Assessed during 240-minute work period
Perceived exertion will be assessed using a visual analog scale in response to the question "How hard are you working?" Scores range from 6 (no exertion at all) to 20 (maximal exertion). Higher scores indicate greater perceived effort and therefore a worse outcome, whereas lower scores indicate less perceived effort and therefore a better outcome.
Assessed during 240-minute work period
Feel-good scale
기간: Assessed at baseline and throughout protocol
Feelings of well-being will be assessed using a visual analog scale in response to the question "How good do you feel?" Scores range from -5 (very bad) to +5 (very good), with 0 representing neutral. Higher scores indicate more positive feelings and therefore a better outcome, whereas lower scores indicate more negative feelings and therefore a worse outcome.
Assessed at baseline and throughout protocol
Profiles of Mood States (POMS-40) total mood disturbance score
기간: Assessed at baseline and end of recovery
Mood state will be assessed using the 40-item Profiles of Mood States (POMS-40) questionnaire. Participants will rate how they feel at the time of assessment using a 5-point Likert scale ranging from 0 (not at all) to 4 (extremely). Responses will be summed to generate a total score. Higher scores indicate greater overall mood disturbance and therefore a worse outcome, whereas lower scores indicate lower mood disturbance and therefore a better outcome.
Assessed at baseline and end of recovery
Environmental Symptoms Questionnaire-IV (ESQ-IV) total symptom score
기간: Assessed at baseline and end of recovery
Environmental symptomatology associated with prolonged heat exposure will be assessed using the Environmental Symptoms Questionnaire-IV (ESQ-IV). Participants will rate 68 symptoms using a 6-point Likert scale ranging from 0 (not at all) to 5 (extreme). Responses are summed, with positive items reverse scored as appropriate, to generate a Total Symptom Score ranging from 0 to 340. Higher scores indicate greater symptom burden and therefore a worse outcome, whereas lower scores indicate fewer symptoms and therefore a better outcome.
Assessed at baseline and end of recovery
Heart rate variability: standard deviation of normal R-R intervals (SDNN)
기간: During 240-minute work bout and subsequent 1 hour recovery
Cardiac autonomic modulation will be assessed using a 5-lead Holter electrocardiogram (ECG) monitor (DigiTrak XT, Philips Zymed, Andover, MA, USA). Consecutive R-R intervals will be derived from the ECG recording to calculate the standard deviation of normal R-R intervals (SDNN), measured in milliseconds (ms). Higher values indicate greater heart rate variability and cardiac autonomic modulation, whereas lower values indicate reduced heart rate variability and cardiac autonomic modulation.
During 240-minute work bout and subsequent 1 hour recovery
Heart rate variability: root mean square of successive differences (RMSSD)
기간: During 240-minute work bout and subsequent 1 hour recovery
Cardiac autonomic modulation will be assessed using a 5-lead Holter electrocardiogram (ECG) monitor (DigiTrak XT, Philips Zymed, Andover, MA, USA). Consecutive R-R intervals will be derived from the ECG recording to calculate the root mean square of successive differences between adjacent normal R-R intervals (RMSSD), measured in milliseconds (ms). Higher values indicate greater parasympathetic modulation and heart rate variability, whereas lower values indicate reduced parasympathetic modulation and heart rate variability.
During 240-minute work bout and subsequent 1 hour recovery

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

수사관

  • 수석 연구원: Glen P Kenny, PhD, University of Ottawa

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (추정된)

2026년 6월 17일

기본 완료 (추정된)

2026년 12월 31일

연구 완료 (추정된)

2027년 2월 28일

연구 등록 날짜

최초 제출

2026년 6월 17일

QC 기준을 충족하는 최초 제출

2026년 6월 17일

처음 게시됨 (실제)

2026년 6월 24일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2026년 7월 14일

QC 기준을 충족하는 마지막 업데이트 제출

2026년 7월 11일

마지막으로 확인됨

2026년 7월 1일

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