Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA.
Department of Anthropology, Tulane University, New Orleans, Louisiana, USA.
Am J Ind Med. 2020 Nov;63(11):988-1007. doi: 10.1002/ajim.23175. Epub 2020 Sep 4.
The purpose of this systematic review is to examine cooling intervention research in outdoor occupations, evaluate the effectiveness of such interventions, and offer recommendations for future studies. This review focuses on outdoor occupational studies conducted at worksites or simulated occupational tasks in climatic chambers.
This systematic review was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. PubMed, Embase, and Web of Science were searched to identify original research on intervention studies published in peer-reviewed journals that aimed at reducing heat stress or heat-related illness from January 2000 to August 2020.
A systematic search yielded a total of 1042 articles, of which 21 met the inclusion criteria. Occupations with cooling intervention studies included agriculture (n = 5), construction (n = 5), industrial workers (n = 4), and firefighters (n = 7). The studies focused on multiple types of cooling interventions cooling gear (vest, bandanas, cooling shirts, or head-cooling gel pack), enhanced heat dissipation clothing, forearm or lower body immersion in cold water, water dousing, ingestion of a crushed ice slush drink, electrolyte liquid hydration, and modified Occupational Safety and Health Administration recommendations of drinking water and resting in the shade.
Current evidence indicates that using multiple cooling gears along with rest cycles may be the most effective method to reduce heat-related illness. Occupational heat-related illnesses and death may be mitigated by targeted cooling intervention and workplace controls among workers of vulnerable occupational groups and industries.
本系统评价旨在研究户外作业中的冷却干预研究，评估此类干预的效果，并为未来的研究提供建议。本综述重点关注在工作场所或气候室中模拟职业任务进行的户外职业研究。
本系统评价按照系统评价和荟萃分析的首选报告项目（PRISMA）指南进行。检索 PubMed、Embase 和 Web of Science，以确定 2000 年 1 月至 2020 年 8 月期间发表的旨在降低热应激或与热相关疾病的干预研究的原始研究。
系统检索共产生了 1042 篇文章，其中 21 篇符合纳入标准。进行冷却干预研究的职业包括农业（n=5）、建筑（n=5）、工业工人（n=4）和消防员（n=7）。这些研究侧重于多种类型的冷却干预措施，包括冷却装备（背心、头巾、冷却衬衫或头部冷却凝胶包）、增强散热的服装、前臂或下肢浸入冷水、水喷淋、摄入碎冰沙饮料、电解质液体水合作用以及修改职业安全与健康管理局关于饮水和在阴凉处休息的建议。
目前的证据表明，使用多种冷却装备并结合休息周期可能是降低与热相关疾病的最有效方法。针对脆弱职业群体和行业的工人，通过有针对性的冷却干预和工作场所控制，可能会减轻职业性与热相关的疾病和死亡。
