So It has been a hell of a last 18 months and it is difficult to process the magnitude of what we have experienced in the wake of the pandemic. However, as we are days away from the opening of the Tokyo 2020 (2021) Olympic Games, as all good practitioners should do, I thought it was worth reflecting on what the Environmental Extremes Lab (EEL)’s contribution has been to helping our athletes, coaches, practitioners, officials, governing bodies and many others along the way, as they step up and face the heat of Tokyo.

We must first step back in time to understand the early beginnings as we evolved to what we are now. Our earliest research into heat mitigation was published back in 2006, with Dr Paul Castle’s Precooling leg muscle improves intermittent sprint exercise performance in hot, humid conditions (which was cited in the US Olympic Committee’s heat preparation strategy ahead of the 2008 Beijing Olympics). However, I remember in 1997 when I first arrived at the University of Brighton, it was a motivated 3rd year BSc student, Mark Hayes (now Dr Mark Hayes), who carried out the first precooling study that examined ‘the effect of precooling on endurance and time to exhaustion in a  hot and humid environment‘ that built upon Booth et al (1997)’s seminal pre-cooling work. Through our support to Chris Howarth as he embarked upon his Jungle Marathon preparations in 2004, we also experimented with the idea of a progressive model of heat acclimation where the heat stress was increased in the latter stages of the protocol to maintain the stimulus for heat adaptation (essentially what the more common controlled-hyperthermia heat acclimation model aims to achieve). It seemed to work for Chris!

This approach to heat acclimation formed the basis and future rationale to Mark Hayes’ PhD entitled, ‘The effect of progressive heat acclimation on games players performing intermittent-sprint exercise in the heat’. So, our growing understanding of heat mitigation has been borne out of nearly 25 years of research, that has seen 14 PhD students and one MPhil student come out of EEL, with seven of those research students (Dr Paul Castle, Dr Mark Hayes, Dr Oli Gibson, Dr Carl James, Dr Jess Mee, Dr Ash Willmott and Mr Drew Smith) whose research was directly linked to heat mitigation to optimise sports performance in the heat. We have published 33 research papers in peer-reviewed journals and presented 25 abstracts at conferences linked to our acute and chronic heat mitigation research. Many more unpublished BSc and MSc dissertation studies have gone on behind the scenes to develop and test our understanding of heat mitigation. Dr Oli Gibson led a heat alleviation review for practitioners that was published in 2020 that really captured the journey we have gone on through our exploration of heat mitigation strategies to support athletic performance and specifically practitioners. I am really proud of all the research that we have published in this field, but this I am especially proud off as it is a reflection and summary of our overall contribution to the field to-date and I think offered a new insight as we directed it towards those supporting the athletes. It was nice for it to be picked up and showcased in the New York Times recently to help the recreational runner exercise in the summer heat.

Our support to the English Institute of Sport and Team GB has been developing since the 2008 Beijing Olympics, but this was ramped up on the road to Tokyo through a Memorandum of Understanding with the EIS in 2018 that began with a workshop that led to an 87-page Resource Pack being written (top image) that formed the basis for Team GB’s heat strategy as they prepared for Tokyo. Twenty, 3rd year BSc (Hons) Sport and Exercise Science students informed the EIS pre Tokyo by embarking upon eight research studies that were identified as priority questions the EIS wanted answers on ahead of Tokyo and showed that with good planning and support, our students can make a difference to the cause too.

Dr Mark Hayes and Dr Ash Willmott presented to GB Hockey on pre, per and post cooling, with England Rugby attending that led to us reviewing their heat acclimation plans ahead of the Tokyo 2019 World Cup. The irony was we had an Irishman (Dr Mark Hayes) and a Scotsman (Dr Neil Maxwell), both passionate about rugby supporting England Rugby (I think I might be disowned by saying this out loud!). Dr Oli Gibson and Dr Ash Willmott, who were also part of the team, ensured there was no sabotage! Dr Hayes and Willmott’s presentation clearly hit the mark as we were asked to expand it out to the whole of Team GB’s Practitioners.

Dr Maxwell extended the reach of the Environmental Extremes Lab’s research by presenting to the EIS Doctor’s who would be heading out to Tokyo, reminding them it was important for them to heat acclimate as well!

As I reflect on the entire journey, but especially the last few years as we have ramped up our involvement and contribution to the Tokyo preparations, it is great to feel that we have helped our athletes, both in optimising their sports performance, but also reducing the chances of incurring a  heat-related illness. Along the way, being able to work with experts in the field (Dr Caroline Sunderland, Dr Andy Garrett and Professor Julien Periard) on a Frontiers in Physiology Special Topic on Heat Acclimation for Special Populations, with a second topic underway, has been a privilege.I was also really pleased to hear when Dr Gareth Turner, who has been central to the achievements and successes of the Environmental Extremes Lab for many years, got the call-up to be a sports physiologist practitioner out in Tokyo. This is what most of us enter sport and exercise science for, to work with elite athletes at the Olympics and so to see Gareth achieve this goal was fantastic and a testament to all the hard work he has put in over the years. I did say that I knew a few good physiologists who could work up a heat acclimation plan for him!

Our contribution to Tokyo preparations has extended to the Paralympic Games too and with the expertise of Professor Nick Webborn, OBE, we are finishing off some presentations that will be circulated by the International Paralympic Committee to all athletes around the theme of heat mitigation. In collaboration with St Mary’s University, we are also in the midst of providing some heat acclimation to British Paralympic wheelchair athlete, David Weir, CBE, ahead of him heading out to Tokyo. It is a great opportunity for one of our team, Mr Bill Norton, to use towards his BASES Supervised Experience with help from MSc student, Andy Knowles, who himself is leading our MDS heat acclimation programme. It is really important for our students to have the opportunity to translate what they have learnt from theory into practice, not least while working with such a well-decorated Paralympian.

So many people (EEL members, other University of Brighton staff, external collaborators and students) have contributed to the journey that has led to our sustained research into heat mitigation to optimise sports performance in the heat. It has been great to work and learn from these great minds who all have a common passion.

Collectively, we have been able to change policy, practice and impact people on the ground (i.e. the athletes) with what they receive in terms of heat mitigation strategies. Some of our research has also led to product development and testing of equipment that supports our mission – to address the challenges of environmental extremes on human health and function. We develop and evaluate interventions using basic and applied scientific methodologies to influence practice and policy locally, nationally and internationally for health, occupation and human performance. It is therefore, very humbling to think that we may have made a difference to the performance and safety of so many athletes.

An up-shot of our heat mitigation research to optimise sports performance, is that we have been able to translate it towards occupational, health and clinical populations where we are looking to influence workforce quality and safety, quality of life as well as morbidity and mortality rates. Dr Alan Richardson, with support from Dr Emily Watkins, Associative Professor Peter Watt and Dr Mark Hayes have really transformed our understanding of how heat stress can influence fire fighters and fire instructors and how acute cooling strategies can mitigate the heat strain to enable safe and effective performance in hazardous situations. Dr Kirsty Waldock‘s recent studies, with support from fellow PhD student Gregor Eichhorn (and congratulations on the engagement!), into how cooling and heat acclimation can protect the elderly during heat waves has allowed what we have learnt from our sports performance research to help more vulnerable populations who we know suffer during periods of hot weather. This has been especially rewarding, even as hard as the research was to conduct, and maybe as you get older you realise that to be able to impact someone’s quality of life and reduce the chances of a serious injury or worse, is even more satisfying than the prospect of a podium position.

On that vain, one of my external PhD students, Dr Ana Bonell, from the London School of Health and Tropical Medicine has been investigating ‘an investigation into the effect of climate and exercise on pregnancy and pregnancy outcome‘ in The Gambia, funded by a Wellcome Trust Clinical PhD Grant. However, in spite nearly 90 participants worth of data collected, the study had to be cut short due to COVID. However, Ana’s initiative and coordination and through the support of the Wellcome Trust, allowed the remaining funds to be diverted to investigate ‘Keeping healthcare workers cool and comfortable in PPE in West Africa during COVID‘ which should be published later this year. There is no question, that what we know about cooling for the benefit of athletic populations influenced the experimental approach we took. It was also extremely gratifying to know that we were doing something on an international scale to help healthcare workers remain safe during the pandemic.

With this in mind, it is with immense satisfaction and pride to reflect on we have learnt about thermoregulation of the able-bodied athlete, has led Rebecca Relf to investigate and present some initial conclusions on exercise-heat reactions in breast cancer survivors, which appears to be the first time it has been empirically investigated. As the research field has started to see heat being used as a form of therapy for some populations, it is nice to know that we have contributed to this evidence and been able to expand our research within athletic populations to those who are thought to be more clinically vulnerable. Well done Rebecca, this was an immense challenge that you have risen to! I am pleased to have a new PhD student, Chanel Coppard, to take on our own Olympic research torch from Rebecca and continue the research theme of heat reactions in breast cancer survivors (good luck Chanel!)

Taking all this together and reading back on this journey, it makes me quite emotional (but as my kids and wife would confirm, this does not take much!). So many people, plenty who I have not been able to mention (and apologies for that), are behind these successes and achievements that have come out of the Environmental Extremes Lab. If there is anything I have learnt of leadership, it is to make sure you surround yourself with great people and that are far more talented than you! I am fortunate that through those who currently reside at the University of Brighton and those who have contributed to our teaching, research and knowledge exchange over the years, who are part of our extended EEL team, this is what has led to what you read before you.

Therefore, it only leaves me on behalf of the Environmental Extremes Lab, to wish our athletes and support staff all the very best in Tokyo 2020/21 Olympic and Paralympic Games.

Neil Maxwell