Brearley Matt B
National Critical Care and Trauma Response Centre, Darwin, NT, Australia.
Thermal Hyperformance, Howard Springs, NT, Australia.
Saf Health Work. 2017 Dec;8(4):327-328. doi: 10.1016/j.shaw.2017.07.001. Epub 2017 Jul 11.
Despite provision of drinking water as the most common method of occupational heat stress prevention, there remains confusion in hydration messaging to workers. During work site interactions in a hot and humid climate, workers commonly report being informed to consume tepid fluids to accelerate rehydration. When questioned on the evidence supporting such advice, workers typically cite that fluid absorption is delayed by ingestion of chilled beverages. Presumably, delayed absorption would be a product of fluid delivery from the gut to the intestines, otherwise known as gastric emptying. Regulation of gastric emptying is multifactorial, with gastric volume and beverage energy density the primary factors. If gastric emptying is temperature dependent, the impact of cooling is modest in both magnitude and duration (≤ 5 minutes) due to the warming of fluids upon ingestion, particularly where workers have elevated core temperature. Given that chilled beverages are most preferred by workers, and result in greater consumption than warm fluids during and following physical activity, the resultant increased consumption of chilled fluids would promote gastric emptying through superior gastric volume. Hence, advising workers to avoid cool/cold fluids during rehydration appears to be a misinterpretation of the research. More appropriate messaging to workers would include the thermal benefits of cool/cold fluid consumption in hot and humid conditions, thereby promoting autonomy to trial chilled beverages and determine personal preference. In doing so, temperature-based palatability would be maximized and increase the likelihood of workers maintaining or restoring hydration status during and after their work shift.
尽管提供饮用水是预防职业性热应激最常见的方法,但在向工人传达补水信息方面仍存在混乱。在炎热潮湿气候下的工作现场交流中,工人们普遍报告说,他们被告知要饮用温热的液体以加速补水。当被问及支持此类建议的证据时,工人们通常会说,饮用冰镇饮料会延迟液体吸收。据推测,吸收延迟可能是液体从胃输送到肠道(即胃排空)的结果。胃排空的调节是多因素的,主要因素是胃容量和饮料能量密度。如果胃排空与温度有关,由于摄入的液体会升温,尤其是在工人核心体温升高的情况下,冷却的影响在幅度和持续时间上(≤5分钟)都较小。鉴于工人最喜欢冰镇饮料,而且在体育活动期间和之后,冰镇饮料的饮用量比温热饮料更多,因此,饮用冰镇液体量的增加会通过增加胃容量来促进胃排空。因此,建议工人在补水时避免饮用凉/冷的液体似乎是对研究的误解。向工人传达更合适的信息应包括在炎热潮湿条件下饮用凉/冷液体的热益处,从而促进他们自主尝试冰镇饮料并确定个人喜好。这样做可以最大限度地提高基于温度的适口性,并增加工人在轮班期间和之后维持或恢复水合状态的可能性。