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Table 2 Study characteristics

From: Sustainable solutions to mitigate occupational heat strain – an umbrella review of physiological effects and global health perspectives

Author (year)

Aim

Number of studies

Number of participants

Cooling Interventions

Study context

Type of analysis

Adams 2014 [91]

Evaluate the change in heart rate for every 1% loss in body mass

20

a188

(173 M, 15 F)

Hydration

Athletic performance

ES + MR

Alhadad 2019 [93]

Evaluate heat mitigation strategies to lower core temperature pre, mid and post exercise

123

a1470

(1382 M, 88 F)

Aerobic fitness, heat acclimation (low and high humidity), fluid ingestion (ad libitum, low and high consumption, hypohydrated, euhydrated), pre-cooling (cold water immersion, cold air exposure, cooling vests, cold fluid ingestion, ice slurry ingestion)

Athletic performance

ES

Best 2018 [80]

Meta-analyze the effect of internal and external cooling methods applied before and during exercise on performance

10

a101

(101 M, 0 F)

Ice slurry ingestion, ice towels, oral rehydration, water dousing, external menthol application, cold fluids with menthol

Athletic performance

ES

Bongers 2015 [89]

Evaluate precooling and percooling on exercise performance and thermoregulatory responses

28

a261

(283 M, 8 F)

Cooling vest, cold water immersion, cold water ingestion, cooling packs, mixed methods

Athletic performance

ES + MR

Born 2013 [88]

Summarize evidence concerning compression garments on performance and recovery

b3

30

(30 M, 0 F)

Compression garments

Athletic performance

ES

Brearley 2015 [81]

Efficacy of water immersion in firefighting settings to rapidly reduce core temperature

43

642

(517 M, 125 F)

Limb immersion

Firefighters

QUAL

Burdon 2010 [86]

Determine whether ingesting cool beverages lowers core temperature and improves athletic performance

10

86

(86 M, 0 F)

Cold fluid ingestion

Athletic performance

ES

Burdon 2012 [84]

Effect of beverage temperature on drink palatability

11

233

(208 M, 25 F)

Fluid ingestion

Athletic performance

ES

Chalmers 2014 [65]

Investigate the effect of short term heat acclimation on physical performance

8

98

(79 M, 19 F)

Short term heat acclimation

Athletic performance

QUAL

Chan 2015 [73]

Determine the effectiveness of multiple microenvironment cooling systems on physical performance

32

235

(231 M, 4 F)

Phase change garments, air cooled garments, cold-air cooled garments, liquid cooled garments, hybrid cooling garments, local cooling packs, cooling packs on neck and head

Sport, military, chemical protection, firefighting, and occupational health

ES + MR

Choo 2018 [79]

Effect of cold water immersion and ingestion on psychophysiological and athletic performance

22

245

(213 M, 32 F)

Cold water immersion, ice slurry ingestion

Athletic performance

ES

Daanen 2018 [64]

Systematically review and analyze heat acclimation decay and reacclimation

21

449

(428 M, 21 F)

Heat acclimation (decay)

Athletic performance

MR

Douzi 2019 [75]

Evaluate effect of various methods of percooling on aerobic and anaerobic performance

36

a,c379

(356 M, 23 F)

Neck cooling, air-ventilation, cold fluid ingestion, ice vests, cooling garments

Athletic performance

ES

Goodman 2019 [70]

Meta-analyze the effect of active hypohydration on cognitive performance

10

179

(124 M, 55 F)

Hypohydration

Cognitive performance

ES

Goulet 2011 [85]

Effect of exercise induced dehydration on time trial performance

5

39

(32 M, 7 F)

Exercise induced dehydration

Athletic performance

ES + MR

Hefferman 2019

Systematically review trace mineral element supplementation on athletic performance

e15

a377

(328 M, 49 F)

Sodium supplementation

Athletic performance

QUAL

Holland 2017 [67]

Determine effect of fluid ingestion on exercise performance

9

71

(64 M, 7 F)

Fluid ingestion

Athletic performance

ES + MR

Jeffries 2019 [77]

Meta-analyze the effect of menthol use on athletic performance and psychophysiological responses

11

126

(126 M, 0 F)

Internal and external menthol application

Athletic performance

ES

Jones 2012 [66]

Summarize the effectiveness of pre cooling methods

13

119

(108 M, 11 F)

Cold water immersion, cooling garment, cold water ingestion, ice slurry ingestion, leg cooling

Athletic performance

ES

Junge 2016 [95]

The effect of environmental heat stress factors on cycling time trial performance

14

a145

(131 M, 14 F)

Environmental conditioning

Athletic and occupaltional performance

MR

Martin 2019 [94]

Environmental heat stress on cognitive and military task performance

f31

a683

(563 M, 120F)

Environmental heat stress

Cognitive and military task performance

QUAL

McCartney 2017 [68]

Fluid intake following dehydration on physical and cognitive performance

64

643

(598 M, 45 F)

Fluid ingestion

Athletic performance

ES

McDermott 2009 [88]

Evaluate the effect of whole-body methods for reducing exercise induced hyperthermia

7

a68

(56 M, 12 F)

Cold water immersion, wet towels, cold air exposure, skin wetting with fan use, ice packs,

Athletic performance

QUAL

McEntire 2013 [83]

Systematically review cooling techniques and practices among firefighters

27

a308

(287 M, 21 F)

Passive cooling in air, hand and arm immersion, foot immersion, cooling vests, hand cooling, intravenous cooling, fanning, fanning with misting, cooling sock, liquid and air cooled suits,

Firefighters

QUAL

Rahimi 2019 [78]

Heat acclimation on athletic performance and psychophysiological responses

11

215

(195 M, 20 F)

Heat acclimation

Athletic performance

ES

Ranalli 2010 [74]

Effect of body cooling on exercise performance

c9

a107

(92 M, 15 f)

Ice vest, cold water immersion, cooling collar

Athletic performance

%Increase

Ross 2013 [97]

Evaluate the established pre-cooling literature

64

631

(587 M, 44 F)

Cold air, cold water immersion, cooling packs, cooling vests, ice towels, cold water ingestion, cold air inhalatiion

Athletic performance

QUAL

Ruddock 2017 [72]

Does cooling during exercise decrease physiological strain and improve exercise performance

15

135

(135 M, 0 F)

Cold fluid, ice slurry, neck cooling collar, hand cooling,

Athletic performance

ES

Stearns 2010 [87]

Meta-analyze the effect of protein and carbohydrate ingestion on exercise performance

d1

a13

(7 M, 6 F)

Protein ingestion

Athletic performance

QUAL

Tomes 2017 [71]

Effect of wearing protective body armour

16

433

(353 M, 80 F)

Clothing variety (protective)

Law enforcement personnel wellbeing

QUAL

Tyler 2015 [90]

Effect of pre and percooling on exercise performance and capacity in the heat

38

335

(318 M, 17 F)

Mist and fan, ice vest, neck cooling collar

Athletic performance

ES

Tyler 2016 [69]

Effect of heat acclimation on physiological, perceptual and performance variables

96

1056

(980 M, 76 F)

Heat acclimation

Athletic performance

ES

Vandenbogaerde 2011

Conduct a meta-analysis to determine the effect of carbohydrates on athletic performance

154

1628

(1469 M, 159 F)

Carbohydrate ingestion

Athletic performance

MR

Walker 2016 [96]

Investigate the effect of fighting fires on hydration status

10

225

(214 M, 11 F)

Hydration

Firefighter hydration

QUAL

Wegmann 2012 [92]

Effect of pre cooling on sport performance

27

268

(260 M, 8 F)

Cooling vest, cold water immersion, skin wetting, cooling packs, cold water ingestion, cold air

Athletic performance

ES

Wittbrodt 2018 [98]

Determine the impact of dehydration on cognitive performance

33

463

(396 M, 67 F)

Hydration

Athletic and occupational cognitive performance

ES + MR

  1. M Male; F Female; ES Effect size; MR Meta-regression; QUAL Qualitative analysis
  2. a Distribution of male and female participants determined from the original investigations
  3. b Only includes studies examining the effect of core temperature as exercise performance was conducted in temperate conditions
  4. c Includes only the studies examining effect on aerobic performance/ excludes anaerobic performance
  5. d While this review examined and meta-analysed the results of 11 studies, they marked that protein ingestion was only
  6. e Number of studies pertaining to sodium ingestion only
  7. f Number of studies pertaining to the heat only