降温中心在缓解长时间热暴露期间老年人生理压力方面的效果:基于实验室的热浪模拟。
Efficacy of Cooling Centers for Mitigating Physiological Strain in Older Adults during Daylong Heat Exposure: A Laboratory-Based Heat Wave Simulation.
机构信息
Human and Environmental Physiology Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada.
Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA.
出版信息
Environ Health Perspect. 2023 Jun;131(6):67003. doi: 10.1289/EHP11651. Epub 2023 Jun 1.
BACKGROUND
Health agencies, including the U.S. Centers for Disease Control and Prevention and the World Health Organization, recommend that heat-vulnerable older adults without home air-conditioning should visit cooling centers or other air-conditioned locations (e.g., a shopping mall) during heat waves. However, experimental evidence supporting the effectiveness of brief air-conditioning is lacking.
OBJECTIVE
We evaluated whether brief exposure to an air-conditioned environment, as experienced in a cooling center, was effective for limiting physiological strain in older adults during a daylong laboratory-based heat wave simulation.
METHODS
Forty adults 64-79 years of age underwent a 9-h simulated heat wave (heat index: 37°C) with (cooling group, ) or without (control group, ) a cooling intervention consisting of 2-h rest in an air-conditioned room (, hours 5-6). Core and skin temperatures, whole-body heat exchange and storage, cardiovascular function, and circulating markers of acute inflammation were assessed.
RESULTS
Core temperature was 0.8°C (95% CI: 0.6, 0.9) lower in the cooling group compared with the control group at the end of the cooling intervention (; hour 6), and it remained 0.3°C (95% CI: 0.2, 0.4) lower an hour after returning to the heat (; hour 7). Despite this, core temperatures in each group were statistically equivalent at hours 8 and 9, within (). Cooling also acutely reduced demand on the heart and improved indices of cardiovascular autonomic function (); however, these outcomes were not different between groups at the end of exposure ().
DISCUSSION
Brief air-conditioning exposure during a simulated heat wave caused a robust but transient reduction in core temperature and cardiovascular strain. These findings provide important experimental support for national and international guidance that cooling centers are effective for limiting physiological strain during heat waves. However, they also show that the physiological impacts of brief cooling are temporary, a factor that has not been considered in guidance issued by health agencies. https://doi.org/10.1289/EHP11651.
背景
包括美国疾病控制与预防中心和世界卫生组织在内的卫生机构建议,没有家庭空调的易受热影响的老年人在热浪期间应前往降温中心或其他有空调的地方(例如购物中心)。然而,缺乏关于短暂空调暴露有效性的实验证据。
目的
我们评估了在基于实验室的模拟热浪期间,老年人在降温中心短暂暴露于空调环境中是否能有效限制生理应激。
方法
40 名 64-79 岁的成年人经历了 9 小时的模拟热浪(热指数:37°C),其中(降温组)有或没有(对照组)降温干预,包括在空调房间中休息 2 小时(,第 5-6 小时)。评估核心和皮肤温度、全身热交换和储存、心血管功能以及循环中急性炎症标志物。
结果
与对照组相比,降温组在降温干预结束时(;第 6 小时)核心温度低 0.8°C(95%CI:0.6,0.9),在返回热环境 1 小时后仍低 0.3°C(95%CI:0.2,0.4)(;第 7 小时)。尽管如此,在第 8 和 9 小时,两组的核心温度在统计学上是相等的()。降温还急性降低了心脏的需求,并改善了心血管自主功能的指数();然而,在暴露结束时,这些结果在两组之间没有差异()。
讨论
在模拟热浪期间短暂的空调暴露导致核心温度和心血管应激的显著但短暂的降低。这些发现为国家和国际指南提供了重要的实验支持,即降温中心在热浪期间限制生理应激是有效的。然而,它们也表明短暂降温的生理影响是暂时的,这是卫生机构发布的指南中没有考虑到的因素。