Holmér I
Department of Occupational Medicine, National Institute for Working Life, Solna, Sweden.
Int J Circumpolar Health. 2000 Oct;59(3-4):267-72.
Human health and wellbeing require simple and effective strategies for prevention and alleviation of harmful effects of cold exposure. Adoption of a strategy should consider the type of cold stress; (1) whole body cooling, (2) extremity cooling, (3) convective cooling (wind chill), (4) conductive cooling (contact), and (5) airway cooling. The prime goal is to prevent tissue cooling. The risk, nature and magnitude of strain depend largely on the cooling effect, which results from the interaction of climate factors (mainly air temperature and wind), protection (clothing) and metabolic heat production (activity, "behaviour"). The effects (strain) of tissue cooling are acute, progressive or chronic. Acute effects are primarily thermoregulatory reflexes mediated by the sympathetic system and comprise immediate cardiovascular and respiratory reactions. Progressive effects are characterized by gradual temperature drop in peripheral or core tissues. This results in pain, neuro-muscular insufficiency, sensory loss and, eventually, cold injury. Chronic effects are likely to affect peripheral nerves and vessels, as well as cardio-respiratory function. The progressive degradation of physiological functions in the elderly increases the risk of harmful effects with cold exposure. This requires careful examination of relevant assessment criteria, as well as the development of simple and efficient strategies for prevention of cold stress.
人类的健康和福祉需要简单有效的策略来预防和减轻寒冷暴露的有害影响。采用何种策略应考虑冷应激的类型：（1）全身冷却，（2）肢体冷却，（3）对流冷却（风冷），（4）传导冷却（接触），以及（5）气道冷却。首要目标是防止组织冷却。应激的风险、性质和程度在很大程度上取决于冷却效果，而冷却效果是由气候因素（主要是气温和风）、防护（衣物）和代谢产热（活动、“行为”）之间的相互作用所导致的。组织冷却的影响（应激）可以是急性、渐进性或慢性的。急性影响主要是由交感神经系统介导的体温调节反射，包括即时的心血管和呼吸反应。渐进性影响的特征是外周或核心组织温度逐渐下降。这会导致疼痛、神经肌肉功能不全、感觉丧失，并最终造成冷损伤。慢性影响可能会影响外周神经和血管以及心肺功能。老年人生理功能的逐渐退化增加了寒冷暴露产生有害影响的风险。这就需要仔细审视相关评估标准，并制定简单有效的预防冷应激策略。
