title: Effects of chemical defense clothing and individual equipment on ventilatory function and subjective reactions.
abstract: BACKGROUND
  We hypothesized that the multiple layers of protective clothing (PC) of a Chemical Defense Uniform (CDU) with body armor (BA), and load bearing equipment (LBE) impose an external impedance on breathing mechanics in addition to that caused by the chemical-biological protective mask (CB mask).
  
  
  METHODS
  We measured the effects of wearing the CDU with BA + LBE on the mechanics and pattern of breathing and subjective reactions in 15 male soldiers during rest and sustained exercise (600 W). Heat strain on each soldier was made minimal and equivalent between the battle dress uniform (BDU) and CDU configurations.
  
  
  RESULTS
  Results from wearing the CDU were contrasted with data from wearing a physical training uniform (PTU), or BDU. At rest, the CDU decreased maximal voluntary ventilation (MVV) by 25% (p < 0.05) compared with the PTU. The CB mask alone reduced MVV 20% (p < 0.05), and the PC + BA + LBE components of the CDU contributed an additional 5% decrement (p = 0.059). The CB mask decreased maximal respiratory flows (p < 0.05), whereas the PC + BA + LBE components decreased lung volumes (p < 0.05), and potentiated the decrement of respiratory flows. Total respiratory system elastance (Ers) was increased by 16% (p < 0.05) in the CDU. During exercise, VE was comparable for both the CDU and BDU, but VT was smaller (p < 0.01) and fR greater (p < 0.05) in the CDU; a breathing pattern consistent with the increased Ers. Perceptions of anxiety, not getting enough air, not breathing the way one usually does, and not being relaxed were greater (p < 0.05) during exercise in the CDU than in the BDU.
  
  
  CONCLUSIONS
  This study shows that some of the respiratory impairment associated with the wearing of CDU is created by the PC, BA and LBE which present a unique external constraint on the chest wall. These impairments to ventilation may provoke more aversive effects than the larger resistive loads imposed by the CB mask.
authors.affiliation: U.S. Army Research Institute of Environmental Medicine, Natick, MA 01760-5007, USA.
authors.forename: S R
authors.initials: SR
authors.lastname: Muza
authors.forename: L E
authors.initials: LE
authors.lastname: Banderet
authors.forename: V A
authors.initials: VA
authors.lastname: Forte
mesh_terms: D000328:Adult; D002618:Chemical Warfare / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008397:Masks; D005082:Physical Exertion; D011481:Protective Clothing; D015656:Respiratory Mechanics / Q000502:physiology*; D012677:Sensation / Q000502:physiology*; D011795:Surveys and Questionnaires