Skip to main content

Table 2 Key data, findings and critical appraisal scores (CAS) and methodological quality ratings of included articles

From: The impact of fire suppression tasks on firefighter hydration: a critical review with consideration of the utility of reported hydration measures

Study Participants Outcome measure(s) Intervention(s) Major Findings CAS (%)
Cuddy et al. [1] 15 Hot Spot firefighters
(12 male, 3 female)
Wore PPE
Water turnover
Nude BW
Live wildland fire suppression over 3 days of work shifts (11.4 ± 0.7 h/day) (hiking, line dragging, laying hose, chain sawing, clearing brush, lookout, and scouting)
Ad libitum drinking
27.5 ± 3.2 °C mean ambient temperature
No significant change (p = 0.12) in morning BW across 3 days (pre 77.3 ± 8.3 kg, post 77.0 ± 8.9 kg)
Mean water turnover 9.5 ± 1.7 L/d
54
(Fair)
Raines et al. [2] 32 firefighters (31 male,1 female)
Ad libitum(AD) group (n = 17), pre-shift (PR) group (n = 15)
PPE
Plasma Osm
Urine colour
USG
PR group consumed 500 mL fluid bolus pre shift and ad libitum remainder of shift
7 days (9.9 ± 2.2 h/day AD, 9.7 ± 2.3 h/day PR) of wildfire suppression (intense but intermittent work, using chainsaws, applying water, carrying, transit time and briefings)
Mild to warm ambient temperatures (15.8–26.4 °C)
No difference between groups in total fluid intake (3.4 ± 1.6 L AD, 3.7 ± 2.9 L PR, p = 0.730)
No significant differences between groups for any hydration marker (urine colour, p = 0.44; USG, p = 0.92; plasma Osm, p = 0.41)
Significant decrease in both urine colour (p = 0.001) and USG (p = 0.01) across the shift, but still dehydrated by end, though less than at start
Plasma Osm indicates firefighters arrived on shift dehydrated and finish dehydrated (p < 0.0001)
57
(Fair)
Horn et al. [6] 35 career, volunteer and industrial firefighters (31 male, 4 female)
Wore PPE and SCBA
Nude BW
Urine colour
USG
Urine Osm
Salivary Osm
3 h live fire training exercise in specialised training building. 3–4 evolutions lasting 15–25 min, separated by 10–15 min (obtain water, advance hoses, extinguish fires, forcible entries, search and rescue and ventilation tasks)
Encouraged ad libitum drinking (water and sport drink)
Cool autumn day
Significant BW loss of 1.1 ± 0.8 kg (p < 0.001) and 1.9 ± 0.9 kg (2.2 % BW loss) adjusted for fluid intake and voiding
Significant (p < 0.001) increase in salivary Osm (pre 78.0 ± 21.5 mOsm/kg, post 49.0 ± 15 mOsm/kg), reflective of dehydration
No significant (p > 0.05) changes in Urine Osm (pre 768 ± 260 mOsm/kg, post 712 ± 251 mOsm/kg), urine colour (pre score 5.8 ± 1.5, post score 5.3 ± 1.5), or USG (pre 1.025 ± 0.009, post 1.024 ± 0.009)
61
(Good)
Holsworth et al. [7] 9 volunteer firefighters
(8 males, 1 female)
WorePPE and SCBA
HCT 2 × 30 min strenuous live structural fires
No fluid intake
Significant (p = 0.0014) change in HCT (pre 43.7 ± 3.1 %, post 46.1 ± 2.3 %), indicating significant dehydration 61
(Good)
Smith et al. [8] 11 male professional firefighters
WorePPE and SCBA (20.4 kg)
HCT 3 trials of 5 standardised firefighting drills in a training structure (carrying a hose up 4 flights, hoisting a hose, discharging a pump can, dragging a dummy, chopping a block of wood). 10 min rest between trials
No fluid intake
Unknown ambient temperature
Significant (p < 0.001) change in HCT (pre 43.2 ± 0.75 %, post 47.3 ± 0.75 %), indicating significant dehydration 57
(Fair)
Angerer et al. [9] 49 firefighter trainees
(all male)
Wore PPE and SCBA (24 kg)
Nude BW 30 min fire operation in a large simulation plant (ascending stairs, dragging hoses, fire suppression, dragging 80 kg dummy up and downstairs, crouched progression)
No fluid intake
Maximum 200 °C at 1.5 m above ground and 700 °C below the ceiling
BW significantly (p <0.001) reduced by mean 0.6 ± 0.2 kg 61
(Good)
Raines et al. [12] 34 firefighters (32 male, 2 female)
AD group (n = 17)
PR group (n = 17)
Wore PPE
Plasma Osm
Urine colour
USG
PR group consumed 600mLwater and 600 mL sport drink per hour of shift
One day (9.9 ± 2.2 h/day AD, 10.5 ± 2.2 h/day PR) of wildfire suppression (intense but intermittent work, using chainsaws, applying water, carrying, transit time and briefings)
Mild to warm ambient temperature (15.8–26.4 °C)
PR group significantly higher total water intake (7.1 ± 3.1 L PR, 3.4 ± 1.6 L AD, p < 0.001)
Both groups began work dehydrated according to USG (1.019 ± 0.007 AD, 1.016 ± 0.005 PR)
PR post shift had significantly (p = 0.001) lower USG (1.004 ± 0.002) than AD (1.016 ± 0.008)
Change from dehydrated to euhydrated for PR group only
Significant (p < 0.01) change in urine colour for both groups (pre score 2.8 ± 0.4 AD, 2.6 ± 0.5 PR,
post score 2.3 ± 0.8 AD, 1.4 ± 0.5 PR), but still dehydrated
Plasma Osm no different between groups (p = 0.371), both arrived dehydrated and post shift both significantly reduced (p < 0.0001) to achieve similar euhydration
57
(Fair)
Ruby et al. [15] 14 wildland firefighters
Wore PPE
Water turnover
USG
Urine Osm
5 day period of arduous fire suppression (hiking with load and fire line construction)
Ad libitum drinking
Unspecified ambient temperature
Water turnover 6.7 ± 4 L/day
No significant change in USG (pre 1.016 ± 0.006, post 1.108 ± 0.006)
No significant change in urine Osm (pre 562 ± 175 mOsm/L, post 629 ± 216 mOsm/L)
50
(Fair)
Raines et al. [18] 12 male wildfire firefighters
Wore PPE
Plasma Osm 2 days of 12 h live fire prescribed operation (controlled fire application, building containment lines with hoe, chasing spot fires and applying water)
Ad libitum drinking
Hot ambient temperature (30.9 ± 3.6 °C day 1, 32.8 ± 5.7 °C day 2)
No significant (p = 0.73) change in plasma osmolality (day 1 292 ± 1 mOsm/L, day 2 289 ± 0.5 mOsm/L), indicating euhydration throughout 57
(Fair)
Eglin et al. [28] 14 firefighter instructors
(all male)
Wore PPE and SCBA (20.2 kg)
USG
Nude BW (adjusted)
Fluid deficit
30 hot fire (HF) exercises (33 ± 7.9 min, 74 ± 42 °C)
6 fire behaviour (FB) exercises (26.3 ± 5.5 min, 45 ± 12 °C) and
8 fire attack (FA) exercises (7.3 ± 2.6 min, 139 ± 48 °C) performed on same day with 2 h rest in-between
Ad libitum drinking
Mean BW change 0.96 ± 0.41 kg/h, fluid deficit 0.62 ± 0.61 L HF exercises (0.79 ± 0.80 %/h)
Mean BW change 1.59 ± 0.57 kg for FB and FA exercises
Mild hypohydration at end of exercises with insufficient fluid intake to counteract body weight loss from sweating
No significant (p > 0.05) change in USG (pre 1.019 ± 0.08, post 1.021 ± 0.009)
50
(Fair)
  1. CAS critical appraisal score, PPE personal protective equipment, SCBA self-contained breathing apparatus, HCT haematocrit, USG urine specific gravity, BW body weight, Osm osmolality
\