Operating under extreme environmental conditions in recreational, professional, or sports contexts poses significant implications for human physiology, health, and performance. This symposium discusses environmental stressors of underwater, high-altitude, and spaceflight, highlighting acute and long-term adaptations, performance limitations, and coping strategies. Shared risks across these environments include hypoxia, hypercapnia, and decompression due to altered ambient pressure and available life-support solutions, fluid shifts and their effects on gas exchange and work of breathing, and the risk of altered pressures for disease in mountaineers, divers, and astronauts. This symposium highlights risks and potential coping strategies that can be applied before or during exposure to maintain health and performance. Emphasis will be placed on interdisciplinary approaches to enhance human resilience and functionality across these extreme environments, innovative countermeasures, and current limitations.
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