The Tokyo 2020 Olympic Games is expected to be among the hottest Games in modern history, increasing the chances for exertional heat stroke (EHS) incidence, especially in non-acclimatised athletes/workers/spectators. The urgent need to recognise EHS symptoms to protect all attendees’ health has considerably accelerated research examining the most effective cooling strategies and the development of wearable cooling technology and real-time temperature monitoring. While these technological advances will aid the early identification of EHS cases, there are several potential ethical considerations for governing bodies and sports organisers. For example, the impact of recently developed cooling wearables on health and performance is unknown. Concerning improving athletic performance in a hot environment, there is uncertainty about this technology’s availability to all athletes. Furthermore, the real potential to obtain real-time core temperature data will oblige medical teams to make crucial decisions around their athletes continuing their competitions or withdraw. Therefore, the aim of this review is (1) to summarise the practical applications of the most novel cooling strategies/technologies for both safety (of athletes, spectators and workers) and performance purposes, and (2) to inform of the opportunities offered by recent technological developments for the early recognition and diagnosis of EHS. These opportunities are presented alongside several ethical dilemmas that require sports governing bodies to react by regulating the validity of recent technologies and their availability to all.

中文翻译：

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与使用新的冷却技术和运动中劳累性热病的早期识别相关的伦理困境和有效性问题

预计 2020 年东京奥运会将成为现代历史上最热门的奥运会之一，这增加了劳力性中暑 (EHS) 的发生率，尤其是在未适应环境的运动员/工人/观众中。迫切需要识别 EHS 症状以保护所有与会者的健康，这大大加快了研究最有效的冷却策略以及可穿戴冷却技术和实时温度监测的发展。虽然这些技术进步将有助于早期识别 EHS 案例，但管理机构和体育组织者有几个潜在的道德考虑因素。例如，最近开发的冷却可穿戴设备对健康和性能的影响是未知的。关于在炎热环境中提高运动成绩，这项技术对所有运动员的可用性存在不确定性。此外，获得实时核心温度数据的真正潜力将迫使医疗团队围绕运动员继续比赛或退出做出重要决定。因此，本综述的目的是 (1) 总结最新颖的冷却策略/技术在安全（运动员、观众和工人）和性能方面的实际应用，以及 (2) 告知由早期识别和诊断 EHS 的最新技术发展。这些机会与一些道德困境同时出现，体育管理机构需要通过规范最新技术的有效性及其对所有人的可用性来做出反应。获得实时核心体温数据的真正潜力将迫使医疗团队围绕运动员继续比赛或退出做出重要决定。因此，本综述的目的是 (1) 总结最新颖的冷却策略/技术在安全（运动员、观众和工人）和性能方面的实际应用，以及 (2) 告知由早期识别和诊断 EHS 的最新技术发展。这些机会与一些道德困境同时出现，体育管理机构需要通过规范最新技术的有效性及其对所有人的可用性来做出反应。获得实时核心体温数据的真正潜力将迫使医疗团队围绕运动员继续比赛或退出做出重要决定。因此，本综述的目的是 (1) 总结最新颖的冷却策略/技术在安全（运动员、观众和工人）和性能方面的实际应用，以及 (2) 告知由早期识别和诊断 EHS 的最新技术发展。这些机会与一些道德困境同时出现，体育管理机构需要通过规范最新技术的有效性及其对所有人的可用性来做出反应。