Gutiérrez-Arroyo Jorge, Rodríguez-Marroyo Jose A, García-Heras Fabio, Rodríguez-Medina Juan, Villa-Vicente Gerardo, Carballo-Leyenda Belén
VALFIS Research Group, Department of Physical Education and Sports, Institute of Biomedicine (IBIOMED), Universidad de León, Leon, Spain.
Sci Rep. 2025 Aug 12;15(1):29492. doi: 10.1038/s41598-025-15636-y.
Emergency personnel operating in high-temperature environments while wearing protective equipment experience substantial thermophysiological strain, impairing performance and increasing the risk of heat-related illnesses. This systematic review and meta-analysis evaluated the effects of cooling interventions on core temperature, skin temperature, heart rate, sweat rate and tolerance time in emergency personnel exposed to heat stress. A comprehensive search was conducted in PubMed-MEDLINE, Web of Science and Cochrane Library databases up to March 2024. Controlled experimental studies published in English or Spanish were included if they assessed cooling interventions (pre-, per-, intermittent, or post-cooling; internal vs. external methods) in participants wearing protective clothing in heat stress conditions (> 28 °C), and included a non-cooling control group. Twenty studies met the inclusion criteria. Cooling interventions significantly reduced core temperature (ES = - 0.56, p < 0.001), heart rate (ES = - 0.42, p = 0.001), and sweat rate (ES = - 0.70, p < 0.001), while improving tolerance time (ES = 1.44, p = 0.003). Intermittent and per-cooling approaches, particularly those employing mixed-method strategies (e.g., cooling vests with immersion or ice slurry ingestion), yielded the greatest benefits. No significant changes were observed in skin temperature. Cooling interventions effectively mitigate physiological strain in emergency personnel exposed to heat stress. Intermittent and per-cooling using combined methods appear most effective. Nonetheless, logistical constraints may limit field implementation, highlighting the need for further research to optimize practical cooling protocols.
在高温环境中穿着防护装备作业的急救人员会经历显著的热生理应激，这会损害其工作表现并增加与热相关疾病的风险。本系统评价和荟萃分析评估了冷却干预措施对暴露于热应激的急救人员的核心体温、皮肤温度、心率、出汗率和耐受时间的影响。截至2024年3月，我们在PubMed-MEDLINE、科学网和考科蓝图书馆数据库中进行了全面检索。纳入了以英文或西班牙文发表的对照实验研究，这些研究评估了在热应激条件（>28°C）下穿着防护服的参与者的冷却干预措施（预冷却、期间冷却、间歇冷却或后冷却；内部与外部方法），并且包括一个非冷却对照组。二十项研究符合纳入标准。冷却干预措施显著降低了核心体温（效应量= -0.56，p<0.001）、心率（效应量= -0.42，p = 0.001）和出汗率（效应量= -0.70，p<0.001），同时提高了耐受时间（效应量= 1.44，p = 0.003）。间歇冷却和期间冷却方法，特别是那些采用混合方法策略的（例如，带有浸入或摄入冰浆的冷却背心），产生的益处最大。皮肤温度未观察到显著变化。冷却干预措施有效地减轻了暴露于热应激的急救人员的生理应激。使用联合方法的间歇冷却和期间冷却似乎最有效。然而，后勤限制可能会限制现场实施，这突出表明需要进一步研究以优化实际的冷却方案。
