Abstract
Firefighting is a stressful occupation. The monitoring of psychophysiological measures in those professionals can be a way to prevent and early detect cardiac diseases and other stress-related problems. The current study aimed to assess morphological changes in the ECG signal induced by acute stress. A laboratory protocol was conducted among 6 firefighters, including a laboratory stress-inducer task - the Trier Social Stress Task (TSST) - and a 2-choice reaction time task (CRTT) that was performed before (CRTT1) and after (CRTT2) the stress condition. ECG signals were continuously acquired using the VitalJacket (R), a wearable t-shirt that acts as a medical certified ECG monitor. Results showed that ECG morphological features such as QT and ST intervals are able to differentiate stressful from non stressful events in first responders. Group mean Visual Analogue Scale (VAS) for stress assessment significantly increased after the stress task (TSST), relatively to the end of CRTT2 (after TSST: 4.67 +/- 1.63; after CRTT2: 3.17 +/- 0.75), a change that was accompanied by a significant increase in group mean QT and ST segments corrected for heart rate during TSST. These encouraging results will be followed by larger studies in order to explore those measures and its physiological impact under realistic environments in a higher scalability.

Abstract
Firefighting is a hazardous occupation. Firefighters are commonly subjected to high levels of stress and fatigue that could interfere with their ability to take decisions under pressure. Based on this assumption, a laboratory protocol was conducted among 10 Portuguese firefighters in order to address their stress and mental fatigue levels and its impact on cognitive performance. A 2-Choice Reaction Time Task was used to measure cognitive performance (before and after a stress condition) and a psychosocial stress paradigm was used to assess stress. Visual Analogue Scales were also used to measure perceived stress and mental fatigue. Results suggested that firefighters felt more fatigued at the end of the protocol, however their performance only decreased in the first reaction time task. Furthermore, findings suggested that stress improved firefighters reaction times, however when stress levels increased, performance decreased. This suggests the need to better understand firefighters optimal stress levels and fatigue, in order to promote their health and work safety, by improving their performance under demanding situations.

Abstract

Abstract
Stress can impact multiple psychological and physiological human domains. In order to better understand the effect of stress on cognitive performance, and whether this effect is related to an autonomic response to stress, the Trier Social Stress Test (TSST) was used as a testing platform along with a 2-Choice Reaction Time Task. When considering the nature and importance of Air Traffic Controllers (ATCs) work and the fact that they are subjected to high levels of stress, this study was conducted with a sample of ATCs (n = 11). Linear Heart Rate Variability (HRV) features were extracted from ATCs electrocardiogram (ECG) acquired using a medical-grade wearable ECG device (Vital Jacket((R)) (1-Lead, Biodevices S.A, Matosinhos, Portugal)). Visual Analogue Scales (VAS) were also used to measure perceived stress. TSST produced statistically significant changes in some HRV parameters (Average of normal-to-normal intervals (AVNN), Standard Deviation of all NN (SDNN), root mean square of differences between successive rhythm-to-rhythm (RR) intervals (RMSSD), pNN20, and LF/HF) and subjective measures of stress, which recovered after the stress task. Although these short-term changes in HRV showed a tendency to normalize, an impairment on cognitive performance was evident. Despite that participant's reaction times were lower, the accuracy significantly decreased, presenting more errors after performing the acute stress event. Results can also point to the importance of the development of quantified occupational health (qOHealth) devices to allow for the monitoring of stress responses.

Abstract
Background: Air Traffic Control (ATC) is a complex and demanding process, exposing Air Traffic Controllers (ATCs) to high stress. Recently, efforts have been made in ATC to maintain safety and efficiency in the face of increasing air traffic demands. Computer simulations have been a useful tool for ATC training, improving ATCs skills and consequently traffic safety. Objectives: This study aims to: a) evaluate psychophysiological indices of stress in an ATC simulation environment using a wearable biomonitoring platform. In order to obtain a measure of ATCs stress levels, results from an experimental study with the same participants, that included a stress-induced task were used as a stress ground truth; b) understand if there are differences in stress levels of ATCs with different job functions (“advisors” vs “operationals”) when performing an ATC Refresher Training, in a simulator environment. Methods: Two studies were conducted with ATCs: Study 1, that included a stress-induced task - the Trier Social Stress Test (TSST) and Study 2, that included an ATC simulation task. Linear Heart Rate Variability (HRV) features from ATCs were acquired using a medical grade wearable Electrocardiogram (ECG) device. Self-reports were used to measure perceived stress. Results: TSST was self-reported as being much more stressful than the simulation task. Physiological data supports these results. Results from study 2 showed more stress among the “advisors” group when comparing to the “operational” group. Conclusion: Results point to the importance of the development of quantified Occupational Health (qOHealth) devices to allow monitoring and differentiation of ATCs stress responses. © 2018 Donato and Denaro.

Abstract
Firefighting is a hazardous profession commonly exposed to high stress that can interfere with firefighter's health and performance. Nevertheless, on-duty stress levels quantitative evaluations are very rare in the literature. In order to investigate firefighters' occupational health in terms of stress perceptions, symptoms, and quantified physiological reactions under real-world conditions, an ambulatory assessment protocol was developed. Therefore, cardiac signal from firefighters (N =6) was continuously monitored during two shifts within a working week with a medical clinically certified equipment (VitalJacket®), allowing continuous electrocardiogram (ECG) and actigraphy measurement. Psychological data were collected with an android application, collecting potential stressful events, stress symptoms, and stress appraisal. A total of 130 hours of medical-quality ECG were collected, from which heart rate variability (HRV) metrics were extracted and analyzed. Statistical significant differences were found in some HRV metrics - AVNN, RMSSD, pNN50 and LF/HF - between events and non-events, showing higher levels of physiological stress during events (p<0.05). Stress symptoms increase from the beginning to the end of the shift (from 1.54 ± 0.52 to 2.01 ± 0.73), however the mean stress self-perception of events was very low (3.22 ± 2.38 in a scale ranging from 0 to 10). Negative and strong correlations were also found between stress symptoms and some time-domain ECG measures (AVNN, SDNN and pNN50). It can be concluded that stress may not always be detected when using merely self-reports. These results enhance the importance of combining both self-report and ambulatory high-quality physiological stress measures in occupational health settings. Future studies should investigate not only what causes stress but also its impact on health and well-being of these professionals, in order to contribute to the design of efficient stress-management interventions. © 2018 IEEE.