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Accuracy of Tympanic Temperature Measurement in Firefighters Completing a Simulated Structural Firefighting Task

  • Toby Keene (a1) (a2), Matt Brearley (a3), Beth Bowen (a1) and Anthony Walker (a4) (a5)
Abstract Introduction

In the course of their duties, firefighters risk heat stroke and other medical conditions due to exertion in high-temperature environments. Infrared tympanic temperature measurement (TTym) is often used by Emergency Medical Services (EMS) to assess the core body temperature of firefighters. The accuracy of TTym in this setting has been called into question.


This study aimed to examine the accuracy of TTym for core body temperature assessment at emergency firefighting events compared with gastrointestinal temperature measurement (TGI) as measured by ingestible thermometers.


Forty-five (42 male, three female) professional urban firefighters from an Australian fire service completed two 20-minute work periods in a 100°C (± 5°C) heat chamber while wearing personal protective clothing (PPC) and breathing apparatus (weighing approximately 22 kg). Measurements were taken immediately before entering, and on exiting, the heat chamber. Tympanic temperature was assessed by an infrared tympanic thermometer and TGI was measured by ingestible sensor and radio receiver.


Complete data were available for 37 participants. Participant temperatures were higher on exiting the heat chamber than at baseline (TTym: 35.9°C (SD=0.7) vs 37.5°C (SD=0.8); TGI: 37.2°C (SD=0.4) vs 38.6°C (SD=0.5)). Tympanic temperature underestimated TGI on average by 1.3°C (SD=0.5) before entering the chamber and by 1.0°C (SD=0.8) following the exercise. Using pooled data, the average underestimation was 1.2°C (SD=0.7).


Tympanic thermometers cause an unreliable measure of core body temperature for firefighters engaged in fire suppression activities. Accurate and practical measures of core body temperature are required urgently.

Keene T , Brearley M , Bowen B , Walker A . Accuracy of Tympanic Temperature Measurement in Firefighters Completing a Simulated Structural Firefighting Task. Prehosp Disaster Med. 2015;30(5):461465.

Corresponding author
Correspondence: Toby Keene, MPH Clinical Quality Assurance Officer ACT Ambulance Service 9 Amberley Avenue Fairbairn, ACT, 2609 GPO Box 158 Canberra City, ACT, 2601 E-mail:
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T Keene , M Brearley , B Bowen , A Walker . Accuracy of tympanic temperature measurement in firefighters completing a simulated structural firefighting task. Prehosp Disaster Med. 2015;30(5):461465.

1. D Barr , W Gregson , T Reilly . The thermal ergonomics of firefighting reviewed. Appl Ergon. 2010;41(1):161-172.

2. A Walker , M Driller , C Argus , J Cooke , B Rattray . The aging Australian firefighter: an argument for age-based recruitment and fitness standards for urban fire services. Ergonomics. 2014;57(4):612-621.

3. S Cheung , S Petersen , T McLellan . Physiological strain and countermeasures with firefighting. Scand J Med Sci Sports. 2010;20(s.3):103-116.

4. SS Cheung , TM McLellan , S Tenaglia . The thermophysiology of uncompensable heat stress. Sports Med. 2000;29(5):329-359.

5. D Hostler , J Suyama , FX Guyette , et al. A randomized controlled trial of aspirin and exertional heat stress activation of platelets in firefighters during exertion in thermal protective clothing. Prehosp Emerg Care. 2014;18(3):359-367.

6. D Smith , S Petruzzello , M Chludzinski , J Reed , J Woods . Selected hormonal and immunological responses to strenuous live-fire firefighting drills. Ergonomics. 2005;48(1):55-65.

7. DL Smith , SJ Petruzzello , E Goldstein , et al. Effect of live-fire training drills on firefighters' platelet number and function. Prehosp Emerg Care. 2011;15(2):233-239.

8. A Walker , M Driller , M Brearley , C Argus , B Rattray . Cold-water immersion and iced-slush ingestion are effective at cooling firefighters following a simulated search and rescue task in a hot environment. Appl Physiol Nutr Metab. 2014;39(10):1159-1166.

9. HE Wright-Beatty , TM McLellan , J Larose , RJ Sigal , P Boulay , GP Kenny . Inflammatory responses of older firefighters to intermittent exercise in the heat. Eur J Appl Physiol. 2014;114(6):1163-1174.

10. L Zeller , V Novack , L Barski , A Jotkowitz , Y Almog . Exertional heatstroke: clinical characteristics, diagnostic and therapeutic considerations. Eur J Intern Med. 2011;22(3):296-299.

12. N Gant , G Atkinson , C Williams . The validity and reliability of intestinal temperature during intermittent running. Med Sci Sports Exerc. 2006;38(11):1926-1931.

13. Y Amoateng-Adjepong , J Del Mundo , CA Manthous . Accuracy of an infrared tympanic thermometer. Chest. 1999;115(4):1002-1005.

15. D Gagnon , BB Lemire , O Jay , GP Kenny . Aural canal, esophageal, and rectal temperatures during exertional heat stress and the subsequent recovery period. J Athl Train. 2010;45(2):157.

16. MS Ganio , CM Brown , DJ Casa , et al. Validity and reliability of devices that assess body temperature during indoor exercise in the heat. J Athl Train. 2009;44(2):124.

18. PW Kong , G Beauchamp , J Suyama , D Hostler . Effect of fatigue and hypohydration on gait characteristics during treadmill exercise in the heat while wearing firefighter thermal protective clothing. Gait Posture. 2010;31(2):284-288.

19. D Hostler , SE Reis , JC Bednez , S Kerin , J Suyama . Comparison of active cooling devices with passive cooling for rehabilitation of firefighters performing exercise in thermal protective clothing: a report from the Fireground Rehab Evaluation (FIRE) trial. Prehosp Emerg Care. 2010;14(3):300-309.

22. JM Bland , D Altman . Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;327(8476):307-310.

23. JM Bland , DG Altman . Statistical methods for assessing agreement between two methods of clinical measurement. Int J Nurs Stud. 2010;47(8):931-936.

24. JM Bland , DG Altman . Agreement between methods of measurement with multiple observations per individual. J Biopharm Stat. 2007;17(4):571-582.

26. RR Pryor , JR Seitz , J Morley , et al. Estimating core temperature with external devices after exertional heat stress in thermal protective clothing. Prehosp Emerg Care. 2011;16(1):136-141.

28. H Daanen . Infrared tympanic temperature and ear canal morphology. J Med Eng Technol. 2006;30(4):224-234.

29. I Muir , P Bishop , R Lomax , J Green . Prediction of rectal temperature from ear canal temperature. Ergonomics. 2001;44(11):962-972.

31. T Yamakoshi , K Matsumura , P Rolfe , N Tanaka , Y Yamakoshi , K Takahashi . A novel method to detect heat illness under severe conditions by monitoring tympanic temperature. Aviat Space Environ Med. 2013;84(7):692-700.

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Prehospital and Disaster Medicine
  • ISSN: 1049-023X
  • EISSN: 1945-1938
  • URL: /core/journals/prehospital-and-disaster-medicine
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