Research Institute of Human Ecology, College of Human Ecology, Seoul National University, Seoul, Republic of Korea.
Research Institute of Human Ecology, College of Human Ecology, Seoul National University, Seoul, Republic of Korea.
J Therm Biol. 2021 Apr;97:102858. doi: 10.1016/j.jtherbio.2021.102858. Epub 2021 Jan 21.
The Asia-Pacific contains over half of the world's population, 21 countries have a Gross Domestic Product <25% of the world's largest economy, many countries have tropical climates and all suffer the impact of global warming. That 'perfect storm' exacerbates the risk of occupational heat illness, yet first responders must perform physically demanding work wearing personal-protective clothing and equipment. Unfortunately, the Eurocentric emphasis of past research has sometimes reduced its applicability to other ethnic groups. To redress that imbalance, relevant contemporary research has been reviewed, to which has been added information applicable to people of Asian, Melanesian and Polynesian ancestry. An epidemiological triad is used to identify the causal agents and host factors of work intolerance within hot-humid climates, commencing with the size dependency of resting metabolism and heat production accompanying load carriage, followed by a progression from the impact of single-layered clothing through to encapsulating ensembles. A morphological hypothesis is presented to account for inter-individual differences in heat production and heat loss, which seems to explain apparent ethnic- and gender-related differences in thermoregulation, at least within thermally compensable states. The mechanisms underlying work intolerance, cardiovascular insufficiency and heat illness are reviewed, along with epidemiological data from the Asia-Pacific. Finally, evidence-based preventative and treatment strategies are presented and updated concerning moisture-management fabrics and barriers, dehydration, pre- and post-exercise cooling, and heat adaptation. An extensive reference list is provided, with >25 recommendations enabling physiologists, occupational health specialists, policy makers, purchasing officers and manufacturers to rapidly extract interpretative outcomes pertinent to the Asia-Pacific.
亚太地区拥有世界一半以上的人口，21 个国家的国内生产总值不到世界最大经济体的 25%，许多国家属于热带气候，都受到全球变暖的影响。这种“完美风暴”加剧了职业性热疾病的风险，但急救人员必须穿着个人防护装备进行体力劳动。不幸的是，过去研究的以欧洲为中心的重点有时降低了其对其他种族群体的适用性。为了纠正这种不平衡，审查了相关的当代研究，并增加了适用于亚洲、美拉尼西亚和波利尼西亚人后裔的信息。采用流行病学三联症来确定在湿热气候中导致工作不耐受的原因和宿主因素，从与负荷携带相关的静息代谢和产热的大小依赖性开始，然后从单层服装的影响进展到封装服装。提出了一个形态假说，以解释热产生和热损失的个体差异，这似乎可以解释至少在热补偿状态下，热调节方面明显的种族和性别差异。综述了工作不耐受、心血管功能不全和热疾病的发病机制，并结合亚太地区的流行病学数据进行了讨论。最后，提供了基于证据的预防和治疗策略，并更新了关于吸湿排汗面料和屏障、脱水、运动前后冷却以及热适应的内容。提供了一个广泛的参考列表，其中有超过 25 条建议，使生理学家、职业健康专家、政策制定者、采购人员和制造商能够快速提取与亚太地区相关的解释结果。
