Respiratory-related limitations in physically demanding occupations.

Respiratory muscle work limits high-intensity exercise tolerance in healthy human beings. Emerging evidence suggests similar limitations exist during submaximal work in some physically demanding occupations. In an occupational setting, heavy loads are routinely carried upon the trunk in the form of body armor, backpacks, and/or compressed air cylinders by military, emergency service, and mountain rescue personnel. This personal and respiratory protective equipment impairs respiratory muscle function and increases respiratory muscle work. More specifically, thoracic load carriage induces a restrictive ventilatory limitation which increases the elastic work of breathing, rendering the respiratory muscles vulnerable to fatigue and inducing a concomitant reduction in exercise tolerance. Similarly, breathing apparatus worn by occupational personnel, including fire fighters and military and commercial divers, increases the inspiratory elastic and expiratory resistive work of breathing, precipitating significant inspiratory and expiratory muscle fatigue and a reduction in exercise tolerance. An argument is presented that the unique respiratory challenges encountered in some occupational settings require further research, since these may affect the operational effectiveness and the health and safety of personnel working in physically demanding occupations.