ABSTRACT
Personal Protective Equipment (PPE) surrounds the individual responder in a unique microenvironment with its own temperature, humidity, air currents, sounds, odors, and problems. Although contact with chemical warfare agents and toxic industrial chemicals can occur with ingestion and injection, such exposures are extraordinarily rare. Consequently, the major routes of exposure are respiratory tract exposure to vapor, dermal exposure to liquids, and dermal exposure to vapor. The absolute minimum amount of clothing should be worn within PPE, as each layer of clothing not only increases heat retention by the layering effect but also increases metabolic work by the hobbling effect. Heat buildup within the protective ensemble provides the physiological basis for painful heat cramps in muscle tissue, heat exhaustion, and heat stroke. Children are not little adults, repeat with emphasis, children are NOT little adults, and there are many differences between the two groups in anatomical, physiological, biochemical, psychological, and social respects.
