Real-Time Physiological Monitoring While Encapsulated in Personal Protective Equipment

William J Tharion, Adam W Potter, Cynthia M Duhamel, Anthony J Karis, Mark J Buller, Reed W Hoyt


Heat strain was monitored in real-time in soldiers performing chemical, biological, radiological, and nuclear (CBRN) training.  Wearable physiological status monitoring (PSM) systems (EQ-02; Hidalgo, Ltd, Swavesey, Cambridge, UK) were evaluated by nine soldiers from a Civil Support Team – Weapons of Mass Destruction (CST-WMD) team (age, 27.3±4.9 (SD) y; wt, 84.5±15.1 kg; ht, 178.1±10.1 cm).  Seven of these soldiers wore the PSM system during CBRN training and provided subjective feedback regarding the systems utility; two soldiers observed the training exercise and commented on the utility of the PSM system. During CBRN training, participants marched ~1600 m in 45 min while wearing Level A CBRN personal protective equipment (PPE).  A 0-to-10 Physiological Strain Index, i.e., a 0-to-10 index of thermal-work strain, was calculated from estimated core temperature and measured heart rate.  Individual PSI levels varied, with three individuals at a PSI > 8 (high thermal-work strain) and four individuals at a PSI < 8 (moderate strain).  Real-time PSI levels corresponded to the subjective feelings of thermal strain reported by the test volunteers.  In addition, the CST-WMD soldiers reported that real-time PSI information could be used to improve work performance and decrease the likelihood of experiencing heat illness during CBRN missions.


heat illness; heat injuries; Level A; medical monitoring; military training; ambulatory monitoring; personal protective equipment; thermal strain

Full Text:



Buller MJ, Tharion WJ, Karis AJ, Santee WR, Mullen SP, Blanchard LA. et al., “Demonstration of real-time physiological status monitoring of encapsulated 1st Civil Support Team – Weapons of Mass Destruction (CST-WMD) personnel.” U.S. Army Research Institute of Environmental Medicine Technical Report T08-01, Natick, MA, August 2007.

Muza SR, Banderet LE, Cadarette B. Protective uniforms for nuclear, biological and chemical warfare.” in Medical Aspects of Harsh Environments. Falls Church, VA: Office of the Surgeon General. United States Army;2002:1084-1127. [Google Scholar]

Petruzzello SJ, Gapin JI, Snook E, Smith DL. Perceptual and physiological heat strain: examination in firefighters in laboratory- and field-based studies. Ergonomics 2009;52(6):747-754. Available from: PubMed PMID: 19296322. [Google Scholar]

Moran, DS, Shitzer, A, Pandolf, KB. “A physiological strain index to evaluate heat stress.” Am. J. Physiol. Reg. Integrat. Comp. Physiol. 1998; 275(1): R129-R134. [Google Scholar]

Institute of Medicine, Monitoring Metabolic Status: Predicting Decrements in Physiological and Cognitive Performance, Washington, D.C.: National Academy Press, 2004.

Patel S, Park H, Bonato P, Chan L, Rodgers M. A review of wearable sensors and systems with application in rehabilitation. J. NeuroEng. Rehabil 2012;9:1-17. [Google Scholar]

Bernard TE, Kenney WL. Rationale for a personal monitor for heat strain. Am Ind Hyg Assoc J 1994;55(6):505-514. Available from: PubMed PMID: 8017291. doi: 10.1080/15428119491018772. [Google Scholar]

Mundt CW, Montgomery KN, Udoh UE, Barker VN, Thonier CC, Tellier AM, et al. A multiparameter wearable physiological monitoring system for space and terrestrial applications. IEEE Trans. Infor. Tech. Med 2005;9(3):382-391. Available from: PubMed PMID: 16167692. [Google Scholar]

Buller MJ, Tharion WJ, Hoyt RW, and Jenkins OC. Estimation of human internal temperature from wearable sensors. in Proceedings of Twenty-Second Innovative Applications of Artificial Intelligence (IAAI-10) Conference. Atlanta GA: 2010, pp. 1763-1768. [Google Scholar]

Sawka MN, and Young AJ. “Physiological systems and their responses to heat and cold.” in ACSM’s Advanced Exercise Physiology, C.M. Tipton, M.N. Sawka, C.A. Tate and R.L. Terjung, Eds. Philadelphia: Eds, Lippincott Williams and Wilkins, 2006, pp. 535 -563.

Lee CC. Enviornmental Engineering Dictionary. Latham, MD: Rowan and Littlefield Publishing Group, Inc., 2005, pp. 930.

Kraning K, Gonzalez R. A mechanistic computer simulation of human work in heat that accounts for physical and physiological effects of clothing, aerobic fitness, and progressive dehydration. J.Therm. Biol 1997;22:331-342. [Google Scholar]

Yokota M, Bathalon GP, Berglund LG. “Assessment of male anthropometric trends and the effects on thermal regulatory models.” Environ. Ergonomics. vol. XII, pp. 472-475, 2007.

Tharion WJ, Buller MJ, Potter AW, Karis AJ, Goetz V, & Hoyt RW. Acceptability and usability of an ambulatory health monitoring system for use by military personnel, IIE Transactions on Occupational Ergonomics and Human Factors, 2013;1(4): 203-214. doi: 10.1080/21577323.2013.838195 [Google Scholar]

Gribok AV, Buller MJ, Reifman J. Individualized short-term core temperature prediction in humans using biomathematical models. IEEE Trans Biomed Eng 2008;55(5):1477-1487. Available from: PubMed PMID: 18440893. doi: 10.1109/TBME.2007.913990. [Google Scholar]

Gribok AV, Buller MJ, Hoyt RW, Reifman J. A real-time algorithm for predicting core temperature in humans. IEEE Trans Inf Technol Biomed 2010 Apr;14(4):1039-1045. Available from: PubMed PMID: 20371418. doi: 10.1109/TITB.2010.2043956. [Google Scholar]

Potter AW, Tharion WJ, Elrod JM. Technology-assisted feedback for motor learning: A brief review. J Sport Hum Perf., 2013;1(3):43-49. [Google Scholar]



  • There are currently no refbacks.


 JSHP is hosted by the Mary and Jeff Bell Library, at Texas A&M University- Corpus Christi.