Westwood Caroline S, Fallowfield Joanne L, Delves Simon K, Nunns Michael, Ogden Henry B, Layden Joseph D
School of Sport, Health and Wellbeing, Plymouth Marjon University, Plymouth, UK.
Institute of Naval Medicine, Alverstoke, UK.
Exp Physiol. 2021 Jan;106(1):191-199. doi: 10.1113/EP088458. Epub 2020 May 8.
What is the topic of this review? Exertional heat illness (EHI) remains a persistent problem for athletes and individuals. This threat remains despite numerous athletic position statements and occupational guidance policies. This review explores primary evidence that demonstrates a direct association between 'known' risk factors and EHI. What advances does it highlight? Primary evidence to support 'known' risk factors associated with EHI is not comprehensive. Furthermore, it is not evident that single individual factors predispose individuals to greater risk. In fact, the evidence indicates that EHI can manifest in non-hostile compensable environments when a combination of risk factors is prevalent.
Despite the widespread knowledge of exertional heat illness (EHI) and clear guidance for its prevention, the incidence of EHI remains high. We carried out a systematic review of available literature evaluating the scientific evidence underpinning the risk factors associated with EHI. Medline, PsycINFO, SportDiscus and Embase were searched from inception to January 2019 with no date limitation, with supplementary searches also being performed. Search terms included permutations of risk and heat illness, with only studies in English included. Study selection, data extraction and quality assessment, using the QUALSYST tool, were performed by two independent reviewers. Of 8898 articles identified by the searches, 42 were included in the systematic review as primary evidence demonstrating a link between a risk factor and EHI. The quality scores ranged from 57.50 to 100%, and studies were generally considered to be of strong quality. The majority of risks attributable to EHI were categorized as those associated with lifestyle factors. The findings from the systematic review suggest complex manifestation of EHI through multiple risk factors rather than any one factor in isolation. Further research is needed to explore the accumulation of risk factors to help in development of effective preventative measures.
本综述的主题是什么？运动性热疾病（EHI）对于运动员和个人而言仍然是一个持续存在的问题。尽管有众多运动立场声明和职业指导政策，但这种威胁依然存在。本综述探讨了能证明“已知”风险因素与EHI之间存在直接关联的主要证据。它突出了哪些进展？支持与EHI相关的“已知”风险因素的主要证据并不全面。此外，单一的个体因素是否会使个体面临更高风险也不明确。事实上，有证据表明，当多种风险因素同时存在时，EHI可能在非恶劣的可补偿环境中出现。
尽管运动性热疾病（EHI）广为人知且有明确的预防指南，但其发病率仍然很高。我们对现有文献进行了系统综述，以评估支持与EHI相关的风险因素的科学证据。检索了Medline、PsycINFO、SportDiscus和Embase数据库，时间跨度从建库至2019年1月，无日期限制，同时还进行了补充检索。检索词包括风险和热疾病的各种组合，仅纳入英文研究。由两名独立评审员使用QUALSYST工具进行研究选择、数据提取和质量评估。在检索到的8898篇文章中，有42篇被纳入系统综述，作为证明风险因素与EHI之间存在联系的主要证据。质量得分在57.50%至100%之间，这些研究总体上被认为质量较高。大多数可归因于EHI的风险被归类为与生活方式因素相关的风险。系统综述的结果表明，EHI是通过多种风险因素而非单一因素复杂地表现出来的。需要进一步研究以探索风险因素的累积情况，从而有助于制定有效的预防措施。
