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Safety and Efficacy of CarbonCool Half-Body Vest for HAZMAT Decontamination Crews Wearing Personal Protective Equipment: A Pilot Study

Published online by Cambridge University Press:  15 September 2020

Pamela Jia Min Tay*
Duke-NUS Medical School, Singapore
Zhi Xiong Koh
Department of Emergency Medicine, Singapore General Hospital, Singapore
Ying Hao
Health Services Research Centre, Singapore Health Services, Singapore
Mark Kwok Fai Leong
Department of Emergency Medicine, Singapore General Hospital, Singapore SingHealth Duke-NUS Emergency Medicine Academic Clinical Programme, Singapore
Correspondence: Pamela JM Tay, BSc Duke-NUS Medical School, Singapore E-mail:



Personal protective equipment (PPE) are essential for medical personnel responding to hazardous materials (HAZMAT) incidents. However, their impermeable design causes increased physiological strain and reduced thermoregulation, limiting work times and causing heat-related illnesses (HRI). Use of wearable cooling devices slow heat accumulation and have been shown to reduce thermal and cardiovascular strain in such situations.


This was a prospective clinical evaluation to determine the tolerability and effectiveness of the CarbonCool cooling system – a half-body cooling vest – in participants undergoing a HAZMAT decontamination recertification. Physiological measurements (heart rate [HR], weight, temperature, and blood pressure) and participant feedback were obtained. The main outcome of interest was participants’ tolerability of the cooling vest.


A total of 23 healthy participants were recruited, with 10 randomized to the intervention group and 13 in the control group. Mean age in the control and intervention group was 35.5 years old (SD = 7.8) and 30.0 years old (SD = 6.2), respectively. Qualitative feedback obtained from participants regarding safety, mobility, and cooling efficacy was largely positive. Difference of before-after temperature and HR was 0.3°C (SD = 0.8) and 11.5bpm (SD = 13.6) in the control group compared to 0.0°C (SD = 0.5) and 0.0bpm (SD = 6.4) for the intervention group.


This clinical evaluation showed that the CarbonCool cooling vest is safe and tolerable in participants wearing PPE. Further trials with sample size powered to detect physiological outcomes are needed to assess the effect of the cooling vest on a subject’s endurance to heat stress.

Original Research
© The Author(s), 2020. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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