1. Exercise and the Environment

2. Objectives
Describe the changes in atmospheric pressure, air temperature, and air density with increasing altitude.
Describe how altitude affects sprint performances and explain why that is the case.
Explain why distance running performance decreases at altitude.
Draw a graph to show effect of altitude on VO2 max and list the reasons for this response.
Graphically describe effect of altitude on the heart rate and ventilation responses to submaximal work, and explain why these changes are appropriate.

3. Objectives
Describe the process of adaptation to altitude, and the degree to which this adaptation can be complete.
Explain why such variability exists among athletes in the decrease in VO2 max upon exposure to altitude, the degree of improvement in VO2 max at altitude, and the gains made upon return to sea level.
Describe potential problems associated with training at high altitude and how one might deal with them.

4. Objectives
Explain the circumstances that caused physiologists to reevaluate their conclusions that humans could not climb Mount Everest without oxygen.
Explain the role that hyperventilation plays in helping to maintain a high oxygen-hemoglobin saturation at extreme altitudes.
List and describe the factors influencing the risk of heat injury.
Provide suggestions for the fitness participant to follow to minimize the likelihood of heat injury.
Describe in general terms the guidelines suggested for running road races in the heat.

5. Objectives
Describe the three elements in the heat stress index, and explain why one is more important than the other two.
List the factors influencing hypothermia.
Explain what the wind chill index is relative to heat loss.
Explain why exposure to cold water is more dangerous than exposure to air of the same temperature.
Describe what the “clo” unit is and how recommendations for insulation change when one does exercise.

6. Objectives
Describe the role of subcutaneous fat and heat production in the development of hypothermia.
List the steps to follow to deal with hypothermia.
Explain how carbon monoxide can influence performance, and list the steps that should be taken to reduce the impact of pollution on performance.

7. Outline Altitude Heat Air Pollution Cold Atmospheric Pressure
Short-Term Anaerobic Performance
Long-Term Aerobic Performance
Maximal Aerobic Performance and Altitude
Adaptation to High Altitude
Training for Competition at Altitude
The Quest for Everest
Heat
Hyperthermia
Cold
Environmental Factors
Insulating Factors
Heat Production
Descriptive Characteristics
Dealing with Hypothermia
Air Pollution
Particulate Matter
Ozone
Sulfur Dioxide
Carbon Monoxide

8. Altitude Atmospheric pressure Decreases at higher altitude
Partial pressure
Same percentages of O2, CO2, and N2 in the air
Lower partial pressure of O2, CO2, and N2
Hypoxia:
Low PO2 (altitude)
Normoxia:
Normal PO2 (sea level)
Hyperoxia:
High PO2

9. Effect of Altitude on Performance
Short-term anaerobic performance
Lower PO2 at altitude should have no effect of performance
O2 transport to muscle does not limit performance
Lower air resistance may improve performance
Long-term aerobic performance
Lower PO2 results in poorer aerobic performance
Dependent on oxygen delivery to muscle
Comparison of performances
1964 Olympics in Tokyo
1968 Olympics in Mexico City

10. Short Races: 1964 and 1968 Olympics
Altitude
Short Races: 1964 and 1968 Olympics

11. Long Races: 1964 and 1968 Olympics
Altitude
Long Races: 1964 and 1968 Olympics

12. A Closer Look 24.1 Jumping Through Thin Air
Altitude
A Closer Look 24.1 Jumping Through Thin Air
Bob Beamon set new world record for long jump in 1968 Olympic Games in Mexico City
29 feet, 2.5 inches
Lower air density at higher altitude
How much was gained at altitude?
Biomechanical calculations indicate only 2.4 cm gained at higher altitude

13. Altitude
In Summary
The atmospheric pressure, PO2, air temperature, and air density decrease with altitude.
The lower air density at altitude offers less resistance to high-speed movement, and sprint performances are either not affected or are improved.

14. Maximal Aerobic Power and Altitude
Decreased VO2 max at higher altitude
Primarily due to lower oxygen extraction
Up to moderate altitudes (~4,000m)
Decreased VO2 max due to decreased arterial PO2
At higher elevations
VO2 max reduction also due to fall in maximum cardiac output
Decreased maximal HR at altitude

15. Changes in VO2 Max with Increasing Altitude
Figure 24.1

16. Effect of Altitude on Submaximal Exercise
Elicits higher heart rate
Due to lower oxygen content of arterial blood
Requires higher ventilation
Due to reduction in number of O2 molecules per liter of air

17. Effect of Altitude on the Heart Rate Response to Submaximal Exercise
Figure 24.2

18. Effect of Altitude on the Ventilation Response to Submaximal Exercise
Figure 24.3

19. Altitude
In Summary
Distance-running performances are adversely affected at altitude due to the reduction in the PO2, which causes a decrease in hemoglobin saturation and VO2 max.
Up to moderate altitudes (~4,000 m), the decrease in VO2 max is due primarily to the decrease in arterial oxygen content brought about by the decrease in atmospheric PO2. At higher altitudes, the rate at which VO2 max falls may be increased due to a reduction in maximal cardiac output.
Submaximal performances conducted at altitude require higher heart rate and ventilation responses due to the lower oxygen content of arterial blood and the reduction in the number of oxygen molecules per liter of air, respectively.

20. Adaptation to High Altitude
Production of more red blood cells
Higher hemoglobin concentration
Via erythropoietin (EPO)
Counters desaturation caused by lower PO2
Lifetime altitude residents
Have complete adaptations in arterial oxygen content and VO2 max
In those recently arriving at altitude
Adaptations are less complete

21. Altitude
In Summary
Persons adapt to altitude by producing more red blood cells to counter the desaturation caused by the lower PO2. Altitude residents who spent their growing years at altitude show a rather complete adaptation, as seen in their arterial oxygen content and VO2 max values. Lowlanders who arrive as adults show only a modest adaptation.

22. Training for Competition at Altitude
Effect of training at altitude on VO2 max varies among athletes
Due to degree of saturation of hemoglobin
Some athletes can improve VO2 max by training at altitude, others cannot
May be due to training state before arriving at altitude
Some athletes have higher VO2 max upon return to low altitude, while others do not
Could be due to “detraining” effect
Cannot train as intensely at altitude

23. The Winning Edge 24.1 Live High, Train Low
Altitude
The Winning Edge 24.1 Live High, Train Low
Live at high altitude
Elicits an increase in red blood cell mass
Via EPO
Leads to increase in VO2 max
≥22 hr/day at 2,000–2,500 m required
Or simulated altitude of 2,500–3,000 m for 12–16 hr/day
Intermittent hypobaric hypoxia
For example, 3 hr/day, 5 days/wk at 4,000–5,000 m
Train at low altitude
Maintain high interval training velocity
Some athletes still experience hemoglobin desaturation

24. The Winning Edge 24.1 Live High, Train Low
Altitude
The Winning Edge 24.1 Live High, Train Low
Traditionally, increased RBC mass leads to increased VO2 max
Some studies have shown improved VO2 max without increased RBC mass
With intermittent hypoxia
Potential mechanisms:
Improved mitochondrial function
Increased buffering capacity
This is an area of active debate and research

25. Altitude
In Summary
When athletes train at altitude, some experience a greater decline in VO2 max than others. This may be due to differences in the degree to which each athlete experiences a desaturation of hemoglobin. Remember, some athletes experience desaturation during maximal work at sea level.
Some athletes show an increase in VO2 max while training at altitude, whereas others do not. This may be due to the degree to which the athlete was trained before going to altitude.

26. Altitude
In Summary
In addition, some athletes show an improved VO2 max upon return to sea level, whereas others do not. Part of the reason may be the altitude at which they train. Those who train at high altitudes may actually “detrain” due to the fact that the quality of their workouts suffers at the high altitudes. To get around this problem, one can alternate low-altitude and sea-level exposures.

27. Altitude
The Quest for Everest
Mount Everest was first successfully climbed in 1953
Using supplemental oxygen
Climbed without oxygen in 1978
Previously thought this would be impossible
VO2 max at summit would be just above rest
Actually, VO2 max estimated at 15 ml•kg–1•min–1
Due to miscalculation of barometric pressure at summit

28. The Highest Altitudes Attained by Climbers in the 20th Century
Figure 24.4

29. Maximal Oxygen Uptake Measured at a Variety of Altitudes
Figure 24.5

30. Challenges of High-Altitude Climbing
Successful climbers have great capacity for hyperventilation
Drives down PCO2 and H+ in blood
Allows more O2 to bind with hemoglobin at same PO2
Climbers must contend with loss of appetite
Weight loss
Reduced type I and type II muscle fiber diameter

31. A Closer Look 24.3 The Lactate Paradox
Altitude
A Closer Look 24.3 The Lactate Paradox
Upon exposure to altitude
Higher HR, ventilation, and lactate during exercise
Due to hypoxia
After acclimatization
Lactate response is reduced
Despite continued hypoxia
Causes of the lactate paradox
Lower plasma epinephrine
May also be due to muscle adaptations
Great debate about this topic
Causes of the lactate paradox?
Does it even exist?
Some studies do not observe this phenomenon

32. Altitude
In Summary
Climbers reached the summit of Mount Everest without oxygen in This surprised scientists who thought VO2 max would be just above resting VO2 at that altitude. They later found that the barometric pressure was higher than they previously had thought and that the estimated VO2 max was about 15 ml•kg–1•min–1 at this altitude.
Those who are successful at these high altitudes have a great capacity to hyperventilate. This drives down the PCO2 and the [H+] in blood, and allows more oxygen to bind at the same arterial PO2.

33. Altitude
In Summary
Finally, those who are successful at climbing to extreme altitudes must contend with the loss of appetite that results in a reduction of body weight and in the cross-sectional area of type I and type II muscle fibers.

34. Heat Hyperthermia Elevated body temperature Heat-related problems
Heat syncope
Heat cramps
Heat exhaustion
May require medical attention
Heat stroke
Medical emergency
Treatment
Cold water immersion is the most rapid way to lower body temperature

35. Heat-Related Problems

36. Factors Related to Heat Injury
Fitness
Higher fitness related to lower risk of heat injury
Tolerate more work in heat
Acclimatize faster
Sweat more
Fit individuals still have risk of heat injury
Acclimatization
Exercise in the heat for 10–14 days
Low intensity, long duration (<50% VO2 max, 60–100 min)
Moderate intensity, short duration (75% VO2 max, 30–35 min)
Lower body temperature and HR response
Best protection against heat stroke and exhaustion

37. Factors Related to Heat Injury
Hydration
Inadequate hydration increases risk of heat injury
No differences among water, electrolyte drinks, or carbohydrate-electrolyte drinks
Environmental temperature
Convection and radiation dependent on gradient between skin and air temperature
High temperature may result in heat gain
Clothing
Expose as much skin as possible
Chose materials that “wick” sweat away from skin

38. Factors Related to Heat Injury
Humidity (water vapor pressure)
Evaporation is dependent on gradient between skin and air
Relative humidity is a good index of water vapor pressure
Metabolic rate
Core temperature is proportional to work rate
High work rate increases metabolic heat production
Wind
Wind will increase heat loss by convection and evaporation

39. Factors Affecting Heat Injury
Figure 24.6

40. Effect of Different Types of Uniforms on Body Temperature
Heat
Effect of Different Types of Uniforms on Body Temperature
Figure 24.7

41. Implications for Fitness
Heat
Implications for Fitness
Know signs/symptoms of heat illness
Cramps, lightheadedness, etc.
Exercise in cooler part of the day
Gradually increase exposure to heat/humidity to acclimatize
Drink water before, during, and after exercise
Wear light clothing
Monitor HR and alter exercise intensity
Stay within target heart rate zone

42. Implications for Performance
Heat
Implications for Performance
Emphasis on pre-season conditioning
Improve fitness and promote acclimatization
Safety during events in high heat/humidity
Cooler time of day, season of the year
Frequent water stops
Encourage drinking of 150–300 ml water every 15 minutes
Identification of those with heat illness
Coordinate proper treatment
First aid, ambulance services, hospitals
Competitor education
Provide information about heat illness

43. Environmental Heat Stress
Wet bulb globe temperature (WBGT)
Dry bulb temperature (Tdb)
Air temperature in shade
Black globe temperature (Tg)
Radiant heat load in direct sunlight
Wet bulb temperature (Twb)
Index of ability to wick sweat
Most important in determining overall heat stress
Risk of heat stress depends on WBGT
WBGT = 0.7Twb + 0.2Tg + 0.1Tdb

44. Risk of Exercise-Related Heat Stroke (EHS)
WBGT ≤50.0°F (≤10.0°C)
Risk of hypothermia; EHS can occur
WBGT 50.0–65.0°F (10.0–18.3°C)
Low risk of hypo- and hyperthermia; EHS can occur
WBGT 65.1–72.0°F (18.4–22.2°C)
Caution: moderate risk of heat illness
WBGT 72.1–78.0°F (22.3–25.6°C)
Extreme caution: risk of hyperthermia increased for all
WBGT 78.1–82.0°F (25.7–27.8°C)
Extreme caution: high risk for unfit, non-acclimatized
WBGT >82.0°F (>18.3°C)
Extreme risk of hyperthermia; cancel or postpone event

45. Heat
In Summary
Heat injury is influenced by environmental factors such as temperature, water vapor pressure, acclimatization, hydration, clothing, and metabolic rate. The fitness participant should be educated about the signs and symptoms of heat injury; the importance of drinking water before, during, and after the activity; gradually becoming acclimated to the heat; exercising in the cooler part of the day; dressing appropriately; and checking the HR on a regular basis.

46. Heat
In Summary
Road races conducted in times of elevated heat and humidity need to reflect the coordinated wisdom of the race director and medical director to minimize heat and other injuries. Concerns include running the race at the correct time of the day and season of the year, frequent water stops, traffic control, race monitors to identify and stop those in trouble, and communication between race monitors, medical director, ambulance services, and hospitals.
The heat stress index includes dry bulb, wet bulb, and globe temperatures. The wet bulb temperature, which is a good indicator of the water vapor pressure, is more important than the other two in determining overall heat stress.

47. Cold Hypothermia Core temperature below 35°C (95°F)
2°C drop associated with maximal shivering
4°C drop associated with ataxia and apathy
6°C drop associated with unconsciousness
Further drop associated with ventricular fibrillation, reduced brain blood flow, asystole, death
Heat loss exceeds heat production
Conduction, convection, radiation, evaporation
Important to protect against heat loss
Maintain core temperature

48. Factors Affecting Hypothermia
Cold
Factors Affecting Hypothermia
Figure 24.8

49. Environmental Factors
Cold
Environmental Factors
Temperature
Gradient for convective heat loss
Vapor pressure
Low water vapor pressure encourages evaporation
Wind
Rate of heat loss influenced by wind speed
Windchill index
“Effective” temperature
Water immersion
Rate of heat loss 25x greater than air of same temperature

50. Cold
Wind Chill Chart

51. Effect of Water Temperature on Survival
Cold
Effect of Water Temperature on Survival
Figure 24.9

52. Cold
In Summary
Hypothermia is influenced by natural and added insulation, environmental temperature, vapor pressure, wind, water immersion, and heat production.
The wind chill index describes how the wind lowers the effective temperature at the skin such that convective heat loss is greater than what it would be in calm air at that same temperature.
Water causes heat to be lost by convection twenty-five times faster than it would be by exposure to air of the same temperature.

53. Insulating Factors Subcutaneous fat Especially effective in cold water
Clothing
Clo units
1 clo is insulation needed to maintain core temperature at rest at 21°C, 50% RH, and 6 m•min–1 wind
Increased clothing required in cold, wet, windy conditions
Dry clothing more effective than wet
Amount of insulation required is lower during exercise

54. Heat Production Heat production increases upon exposure to cold
Inverse relationship between VO2 and body fatness
Earlier onset of shivering in lean men
Resting VO2 and core temperature maintained in “fat” men in cold water
Increased VO2 and decreased core temperature in “thin” men
Fuel use
Fat is primary fuel for shivering
Shivering can lead to muscle glycogen depletion

55. Descriptive Characteristics Influencing Responses to Cold Exposure
Gender
At rest, women show faster reduction in body temperature then men
In cold water, decrease in body temperature similar in men and women
Differences can be explained by body composition and anthropometry
Age
Older (>60 years) less tolerant to cold
Children experience faster fall in body temperature

56. Cold
Changes in Insulation Requirement at Different Temperatures and Activities
Figure 24.10

57. Cold
In Summary
Subcutaneous fat is the primary “natural” insulation and is very effective in preventing rapid heat loss when a person is exposed to cold water.
Clothing extends this insulation, and the insulation value of clothing is described in clo units, where a value of 1 describes what is needed to maintain core temperature while sitting in a room set at 21°C and 50% RH with an air movement of 6 m•sec–1.

58. Cold
In Summary
The amount of insulation needed to maintain core temperature is less when one exercises because the metabolic heat production helps maintain the core temperature. Clothing should be worn in layers when exercising so one can shed one insulating layer at a time as body temperature increases.
Heat production increases on exposure to cold, with an inverse relationship between the increase in VO2 and body fatness. Women cool faster than men when exposed to cold water, exhibiting a longer delay in the onset of shivering and a lower VO2, despite a greater stimulus to shiver.

59. Dealing with Hypothermia
Cold
Dealing with Hypothermia
Effects of hypothermia
Reduced coordination
Slurred speech
Impaired judgment
Treatment of hypothermia
Get person out of cold, wind, and rain
Remove all wet clothing
Provide warm drinks and dry clothing
Put person into sleeping bag
With another person, if semiconscious
Find a source of heat

60. Cold
In Summary
If a person becomes hypothermic, get the person out of the wind, rain, and cold; remove wet clothing and put on dry clothing; use a sleeping bag for warmth; and if it is an extreme case, remove clothing from the person and have another person in the sleeping bag to provide warmth; finally, provide some source of heat.

61. Air Pollution Variety of gases and particulates
Have detrimental effect on health and performance
Decrease capacity to transport oxygen
Increase airway resistance
Alter perception of effort
Physiological response depends on:
Amount or “dose” received
Concentration in air
Duration of exposure
Volume of air inhaled
Increases during exercise

62. Air Pollution Particulate matter Promote pulmonary infection
Elevate blood pressure, reduce fibrinolysis, reduce vasodilation
Cause oxidative stress and DNA damage
Ozone
Decreases VO2 max and respiratory function
Sulfur dioxide
Causes bronchoconstriction in asthmatics
Carbon monoxide
Binds to hemoglobin and reduces oxygen transport
Affects submaximal exercise and VO2 max

63. Effect of Carbon Monoxide on VO2 Max
Air Pollution
Effect of Carbon Monoxide on VO2 Max
Figure 24.11

64. Preventing Air Pollution Problems
Reduce exposure time
Effects are dose-dependent
Stay away from “bolus” amounts of pollutants
Smoking areas, high-traffic areas, urban areas
Do not exercise during most polluted parts of day
7–10 a.m., 4–7 p.m.
Monitor the air quality index (AQI)
Measure of five pollutants
Ozone, particulate matter, CO, SO2, and NO2
AQI scale runs from 0–500

65. Air Pollution
Air Quality Index
Figure 24.12

66. Air Pollution
In Summary
Air pollution can affect performance. Exposure to ozone decreases VO2 max and respiratory function, while sulfur dioxide causes bronchoconstriction in asthmatics.
Carbon dioxide binds to hemoglobin and reduces oxygen transport in much the same way that altitude does.
To prevent problems associated with pollution of any type, reduce exposure time; stay away from “bolus” amounts of the pollutant; and schedule activity at the least polluted part of the day.
The Air Quality Index should be monitored to determine if conditions are safe for exercising outdoors.

67. Study Questions
Describe the changes in barometric pressure, PO2, and air density with increasing altitude.
Why is sprint performance not affected by altitude?
Explain why maximal aerobic power decreases at altitude and what effect this has on performance in long-distance races.
Graphically describe the effect of altitude on the HR and ventilation responses to submaximal work, and provide recommendations for fitness participants who occasionally exercise at altitude.
Describe the process by which an individual adapts to altitude, and contrast the adaptation of the permanent residents of high altitude with that of the lowlander who arrives there as an adult.

68. Study Questions
While training at altitude can be beneficial, how could someone “detrain”? How can you work around this problem?
It was formerly believed that a person could not climb Mount Everest without oxygen because the estimated VO2 max at altitude was close to basal metabolic rate. When two climbers accomplished the feat in 1978, scientists had to determine how this was possible. What were the primary reasons allowing the climb to take place without oxygen?
List and describe the factors related to heat injury.
What is the heat stress index, and why is the wet bulb globe temperature weighed so heavily in the formula?
List the factors related to hypothermia.

69. Study Questions
Explain what the wind chill index is relative to convective heat loss.
What is a clo unit, and why is the insulation requirement less when you exercise?
What would you do if a person had hypothermia?
Explain how carbon monoxide can influence VO2 max and endurance performance.
What steps would you follow to minimize the effect of pollution on performance?