Our research addresses the challenges of environmental extremes on human function. We develop and evaluate products and interventions to influence health, occupational activity and sporting performance, practice and policy. The public and governmental agencies have been informed how to undertake safe and effective physical activity in environmental extremes from our research.
When sports people are striving for a competitive advantage, and while sports organisers seek ever more watchable competition, who looks out for the health of the athletes? Our sports health and sports science research within the University of Brighton has been helping athletes and para athletes understand the optimal preparation for competition, while helping them remain within safe boundaries.
Recent Achievements and Impact of the Environmental Extremes Lab’s Research, Knowledge Exchange and Education Activity are detailed below:
Sport-focussed Research
Our sport science research at the university has identified contextual and environmental factors that determine outcomes in athletic performance and competition. We have generated a substantial body of research evidence around heat mitigation for sports performance (~30 peer-reviewed publications with supporting lay articles) to prepare for exercise in thermally challenging environments. We have evaluated the efficacy of different acute and chronic strategies on physiological and behavioural reactions, and exercise performance in able-bodied and disabled populations, across genders. Our research has generated evidence of effective strategies for improving safety, performance, and preparing the body for competition in inhospitable environments (e.g. Marathon des Sables, winter and summer Olympic Games). The research has also identified heat and exercise issues for para-athletes, who may experience compromised thermoregulation arising from their physical disability [Webborn et al, 2005, 2010]. Some of our early work was used by the USA Olympic committee to guide its strategy for athletes competing in the 2008 Beijing Olympic Games [Castle et al, 2006].
In the decade that followed, we pioneered methods of identifying heat susceptibility and evaluated the efficacy and utility of different heat alleviation manoeuvres to optimise performance and mitigate illness. We extended our understanding of responses to intermittent sprint exercise in the heat amongst athletes with tetraplegia, recognising spinal cord injury alters heat tolerance [Webborn et al, 2008]. We expanded our understanding of heat tolerance – an individual’s ability to mitigate or avoid extreme body temperature elevations when exercising in hot environments [Mee, 2016]. We developed a new running heat tolerance test that was reliable and sensitive to heat adaptation after heat acclimation [Mee et al, 2015a, 2015b], which has been utilised by practitioners and across various population groups. Our acute heat alleviating research investigated the efficacy of pre- and per-cooling on sports performance using internal, external and mixed method approaches, observing an improvement in physiological strain alongside improvements in pacing strategy from altered behavioural thermoregulation [James et al, 2015]. We found partial heat adaptation through heat acclimation can be experienced amongst athletes with a spinal cord lesion [Castle et al, 2013]. Evaluating the intensity [Gibson et al, 2013], duration [Gibson et al, 2015], and frequency [Willmott et al, 2016] of the controlled hyperthermia heat acclimation method on phenotypic and genotypic markers led to the prescription of short-term heat acclimation (STHA) at a critical temperature threshold providing sufficient heat adaptation to benefit endurance performance [James et al, 2016, Willmott et al, 2016].
Our research has considered the thermoregulation and heat adaptation of females to determine the currency of national / international guidelines, poignant owing to only 34% of participants included in all sport and exercise science journals are female. We reported females require more daily exposures to hot ambient conditions to establish hallmark heat acclimation adaptations compared with males and developed a mixed method heat acclimation approach, which combined daily exercise in the heat with a sauna exposure [Mee et al, 2017], which accelerated the rate of heat adaptation, confirming a time efficient strategy. This has helped to optimise strategies for improving safety and preparing female athletes and military personnel for competition and deployment in inhospitable environments.
This critical mass of research evidence led to Brazil’s National Olympic Committee endorsing our research ahead of the Rio 2016 Olympics and the English Institute of Sport (EIS, now UK Sports Institute) to commission us to write an 87-page heat optimisation strategy report in 2018 ahead of Tokyo 2020/21 Olympic and Paralympic Games for Team GB. With a Memorandum of Understanding between the University and the EIS, our research informed their policy and practice, with Dr Neil Maxwell (UoB) joining the EIS’ Tokyo 2020 Technical Physiology Advisory Panel. We wrote the heat acclimation strategy for England Rugby ahead of their Tokyo 2019 World Cup. Presentations by our team (2018-2020) to Team GB doctors, coaches and science practitioners, showcasing our and others’ research reinforced the importance of developing bespoke, sport-specific and medically based heat strategies for the health of the athletes and support staff. As part of our Tokyo preparations, in 2018/19, nineteen of our BSc students carried out eight research projects identified as a priority to improve chances of GB winning medals at the Games as part of their dissertation projects. We were invited by the journal Temperature to capture our entire body of research which we entitled, ‘Heat alleviation strategies for athletic performance: a review and practitioner guidelines’ and has been one of their most read papers (>25k views, [Gibson et al, 2020]). In 2020, the international Paralympic Association commissioned us to create a series of athlete/coach-centric presentations around hydration, cooling, heat acclimation and heat illness prevention for a global audience. We then contributed towards a consensus statement on the prehospital management of exertional heat stroke at sports competitions for Paralympic athletes [Hosakawa et al, 2021]. A testimonial from Team GB’s Deputy Chef de Mission, Performance, Tokyo 2020 Olympic Games stated: “The UoB research and expertise has been particularly valuable in relation to the introduction of alternative heat acclimation approaches to fit around training commitments, helping our practitioners to provide more rigorous and individualised heat alleviation methods to their teams”.
Our early altitude-focussed research investigated hypoxic tolerance [Richardson et al, 2008] and the impact of hydration status during an acute exercise-hypoxic stimulus [Richardson et al, 2009a, 2009b]. Our research investigated individual susceptibility to hypoxia through an erythropoietin-mediated response [Mackenzie et al, 2008]. Using the well-established 6-minute walk test in normoxia and hypoxia, we continued this research direction and have been able to predict the physiological responses and adaptation of those individuals at altitude [Gibson et al, 2015]. This research has been endorsed by the altitude awareness charity, Para-Monte, who recommends its use as a vehicle to identify and educate those more at risk from incurring an altitude-related illness. As ambassadors for the charity Para-Monte, we provide screening, education, and advocacy to prioritise being altitude aware.
Work published by another BSc to MSc through to PhD student [Turner, 2016], reflects a decade of altitude-based research with elite endurance athletes, including monitoring their physiological and haematological responses to a live high-train high altitude training camp using a hypoxic sensitivity test [Turner et al, 2022]. In this study, we drew from our previous research that assessed inflammatory responses in hypoxia versus normoxia [Richardson et al, 2016], measuring exercise tolerance in hypoxia [Twomey et al, 2017] and incorporating the carbon monoxide rebreathing technique we had refined to determine haemoglobin mass Turner et al, 2014a, 2014b]. We bring a strong methodological approach to all our research and have regularly examined the reliability and validity of our protocols and techniques ahead of evaluating the efficacy of different interventions.
In the last decade, we have begun exploring human cross-adaptation, given the paucity of data characterising human responses to combinations of exercise stimuli and/or environmental stressors [Gibson et al, 2017, Willmott et al, 2024]. Yet as discussed above there is significant potential for its use and the development of novel research paradigm. One of our former BSc, MSc and PhD student’s final study found heat acclimation to attenuate physiological strain and the Hsp72 mRNA response to acute normobaric hypoxia [Gibson et al, 2015], giving efficacy to cross tolerance pathways at a cellular/molecular level. These data suggest hyperthermia as viable potentiating stimuli for cross adaptive mechanisms and opens up application towards occupational and, or health/clinical populations.
Occupationally, Industry & Safety-focussed Research
Acknowledging the high number of occupations that are exposed to environmental extremes with risk to productivity, health, wellbeing and even life, has led to an important part of our research investigating the health and exercise prescription of fire fighters and instructors. This work is cited by the National Fire Chiefs Council and the Fire Brigades Union and forms part of national working guidance. Cited work discusses physiological and immunological issues with Fire Instructor workloads [Watt et al, 2016] and methods to reduce thermal strain [Watkin et al, 2018]. We developed a new occupational heat tolerance test [Watkins et al, 2018] used by firefighters and the UK military. All existing research is presented on the UK Fire Research and Development web pages, being used as a national and international resource for policy production. Our work has evidenced the challenging workloads and practices of UK fire instructors, resulting in chronic inflammation, suppressed immune function and elevated risk of cardiac injury. The National Compartment Fire Behaviour Training Instructor Group have endorsed our work with the aim of changing national workloads and practices of all UK Fire Instructors. With support from the Fire Brigade Unions and Union Learning, we translated our research into a free online educational package for all UK fire service personnel (~44k) on severe heat exposure, illness and best preparation and recovery practices, now used as a standard educational package for fighters in Australia, Canada, the Netherlands, South Africa, and the USA. In collaboration with some of these countries, we led an international survey on female firefighter working practices and health [Watkins et al, 2019], which helped identify and develop female specific equipment, facilities, research and health needs worldwide. We have since investigated the menstrual cycle phasing, contraceptive pill use, and heat tolerance for female firefighters.
Another arm of our occupational-based research has been working with industrial partners to find solutions to thermal stress through product testing and development of prototype equipment with application to environmental extremes. We supported Bodychillz Ltd. by evaluating the safety and efficacy of the CAERvest® – a novel endothermic hypothermic medical emergency device used by paramedics and other first responders for core body cooling (e.g. treatment of heat stroke [Willmott et al, 2017]) leading to its use in the field. We have worked with various companies to test equipment functionality, reliability, and validity, such as KuduSmart, Cosinuss, BodyTrak and Equivital. We supported Cryogenx Ltd. in the product testing and development of a new device to treat heat illness in the field and supported Astinno Ltd. as they develop the Grace – a cooling bracelet to manage menopause hot flashes.
In collaboration, as co-applicants, with Dr Thomas Rupp (Université de Savoie, Chambery) through several funded French Ministry of Defence PhD studentships, we have developed and evaluated simple, practical, and effective heat acclimation strategies that does not induce additional fatigue and may preserve cognitive function during exercise-heat stress, which would optimise operational capacity during deployment of armed forces [Di Domenico et al, 2023].
Health and Clinically Focussed Research
We recognised the potential for our sport-based, environmental physiology research to be translated to benefit health and clinical populations. Our early hypoxic research by a former BSc (Hons) student who joined our MSc degree, found that acute normobaric hypoxia stimulated erythropoietin release [Mackenzie et al, 2008]. This student continued onto a PhD to investigate ‘glucose metabolism during and following acute hypoxia and exercise in individuals with type 2 Diabetes’. A series of studies [Mackenzie et al, 2011, 2012a, 2012b] led to four primary conclusions: 1) hypoxia has the ability to increase glucose disposal, both during and following acute exposure; 2) the effects of exercise on glucose disposal are enhanced by moderate hypoxia; 3) improvements in insulin sensitivity may contribute to hypoxic-induced glucose transport activity; and 4) intermittent exercise can acutely improve glucose control. That hypoxia altered glucose metabolism, suggests an important clinical role for hypoxia, or potentially other environmental stressors, in the management of type 2 diabetes.
Our understanding of thermal reactions to heat stress amongst able-bodied and disabled populations, has recently been translated to protect the healthy and clinically symptomatic by examining heat reactions in older people [Waldock et al, 2018, 2021a, 2021b], breast cancer survivors [Relf et al, 2021], those with cystic fibrosis [Willmott et al, 2020], and through international collaboration and funding, pregnant farm workers in The Gambia [Bonell et al, 2020, 2022a, 2022b, 2024, 2025]. Our body of precooling research was used in this collaboration to support healthcare workers in The Gambia during the pandemic [Bonell et al, 2021]. The novel findings that when completing exercise that equates to activities of daily living, older people could have a decreased perceptual awareness of the environment, even though physiological markers of thermal strain are elevated, means they could be less likely to implement behavioural thermoregulation interventions (i.e., seek shade and/or remove excess layers). We know that acute and chronic heat alleviation techniques can reduce physiological strain during activities of daily living in hot UK climatic conditions. Our research observations of compromised behavioural thermoregulation in older people have led to new heat strategies which have been endorsed nationally at Public Health Heatwave Seminars and led to invitations to publish in the journal, Public Health’s special edition on ‘Heat Related Harm’. However, older people may still be at increased risk of heat illness, due to not feeling hot and uncomfortable enough to implement physiological strain reducing strategies.
