Department of Nutrition, Exercise and Sports, Section for Integrative Physiology, University of Copenhagen, Copenhagen N, Denmark.
Thermal Ergonomics Laboratory, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
Environ Health. 2020 Sep 4;19(1):95. doi: 10.1186/s12940-020-00641-7.
Climate change is set to exacerbate occupational heat strain, the combined effect of environmental and internal heat stress on the body, threatening human health and wellbeing. Therefore, identifying effective, affordable, feasible and sustainable solutions to mitigate the negative effects on worker health and productivity, is an increasingly urgent need.
To systematically identify and evaluate methods that mitigate occupational heat strain in order to provide scientific-based guidance for practitioners.
An umbrella review was conducted in biomedical databases employing the following eligibility criteria: 1) ambient temperatures > 28 °C or hypohydrated participants, 2) healthy adults, 3) reported psychophysiological (thermal comfort, heart rate or core temperature) and/or performance (physical or cognitive) outcomes, 4) written in English, and 5) published before November 6, 2019. A second search for original research articles was performed to identify interventions of relevance but lacking systematic reviews. All identified interventions were independently evaluated by all co-authors on four point scales for effectiveness, cost, feasibility and environmental impact.
Following screening, 36 systematic reviews fulfilled the inclusion criteria. The most effective solutions at mitigating occupational heat strain were wearing specialized cooling garments, (physiological) heat acclimation, improving aerobic fitness, cold water immersion, and applying ventilation. Although air-conditioning and cooling garments in ideal settings provide best scores for effectiveness, the limited applicability in certain industrial settings, high economic cost and high environmental impact are drawbacks for these solutions. However, (physiological) acclimatization, planned breaks, shading and optimized clothing properties are attractive alternative solutions when economic and ecological sustainability aspects are included in the overall evaluation.
Choosing the most effective solution or combinations of methods to mitigate occupational heat strain will be scenario-specific. However, this paper provides a framework for integrating effectiveness, cost, feasibility (indoors and outdoor) and ecologic sustainability to provide occupational health and safety professionals with evidence-based guidelines.
气候变化将加剧职业性热应激，即环境和人体内部热应激对人体的综合影响，威胁人类健康和福祉。因此，寻找有效、经济实惠、可行且可持续的解决方案来减轻对工人健康和生产力的负面影响，是一项日益紧迫的需求。
系统地识别和评估减轻职业性热应激的方法，为从业者提供基于科学的指导。
采用以下纳入标准进行了伞式综述：1）环境温度＞28°C 或脱水参与者，2）健康成年人，3）报告心理生理（热舒适度、心率或核心温度）和/或表现（体力或认知）结果，4）用英文书写，5）发表于 2019 年 11 月 6 日之前。还进行了第二次原始研究文章的搜索，以确定相关但缺乏系统评价的干预措施。所有确定的干预措施均由所有合著者独立评估，评估标准为有效性、成本、可行性和环境影响，分值为 4 分制。
经过筛选，有 36 篇系统评价符合纳入标准。在缓解职业性热应激方面最有效的解决方案是穿着特殊的冷却服装、（生理）热适应、提高有氧健身水平、冷水浸泡和使用通风设备。虽然在理想环境中使用空调和冷却服装可提供最佳的效果评分，但在某些工业环境中的适用性有限、经济成本高和环境影响大，这些都是这些解决方案的缺点。然而，（生理）适应、计划休息、遮阳和优化服装性能是在考虑经济和生态可持续性的情况下的有吸引力的替代解决方案。
选择最有效的解决方案或缓解职业性热应激的方法组合将因具体情况而异。然而，本文提供了一个框架，用于整合有效性、成本、可行性（室内和室外）和生态可持续性，为职业健康和安全专业人员提供基于证据的指导。
