{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:58:44Z","timestamp":1759798724310,"version":"build-2065373602"},"reference-count":16,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T00:00:00Z","timestamp":1759708800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"the Japan Society for the Promotion of Science","doi-asserted-by":"crossref","award":["23K10364"],"award-info":[{"award-number":["23K10364"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>In large-scale disasters such as the anticipated Nankai Trough Earthquake, millions of evacuees are expected to remain in shelters, often sleeping on cold, hard floors in classrooms and gymnasiums, contributing to musculoskeletal pain and sleep disruption. While cardboard beds have been employed since the Great East Japan Earthquake due to their rapid mass-production capability, municipalities are not required to stockpile them, and many were unable to provide sufficient quantities during the Kumamoto Earthquake. Furthermore, the large size and weight of these beds complicate timely delivery, and their use alone provides only limited body pressure distribution. Consequently, there is concern that large-scale disasters will result in a severe shortage of appropriate bedding. This study aimed to determine whether air cushions can provide sufficient body pressure distribution and thermal insulation to serve as practical floor mats in evacuation shelters. Twenty healthy adults were enrolled in this randomized controlled crossover trial. Participants were instructed to lie on an air cushion, a urethane pad, and a plastic sheet, during which body pressure distribution was evaluated. Subjective perceptions of firmness and comfort were assessed using a numeric rating scale, and thermal insulation properties were evaluated by measuring surface temperature changes when each material was placed over a cooling gel pack. Compared with plastic sheets, the air cushion reduced mean body pressure by over 20% and increased contact area by more than 30%, with improvements exceeding those observed for urethane pads. Participants rated air cushions as significantly less firm and more comfortable than urethane pads. The air cushion also demonstrated thermal insulation comparable to urethane pads. These findings suggest that air cushions could serve as practical emergency floor mats in evacuation shelters, complementing cardboard beds and potentially reducing musculoskeletal strain and sleep disturbances in disaster settings.<\/jats:p>","DOI":"10.1371\/journal.pgph.0005259","type":"journal-article","created":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T17:23:38Z","timestamp":1759771418000},"page":"e0005259","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating the effects of air cushions on body pressure distribution and thermal insulation in evacuation shelters: A randomized controlled crossover study"],"prefix":"10.1371","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5785-0426","authenticated-orcid":true,"given":"Seiji","family":"Hamanishi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2842-3561","authenticated-orcid":true,"given":"Shinsuke","family":"Sasaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,10,6]]},"reference":[{"issue":"9862","key":"pgph.0005259.ref001","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/S0140-6736(13)60091-4","article-title":"Features of disaster-related deaths after the Great East Japan Earthquake","volume":"381","author":"H Ichiseki","year":"2013","journal-title":"Lancet"},{"issue":"3","key":"pgph.0005259.ref002","article-title":"Symposium on disaster-related deaths after the Fukushima Daiichi Nuclear Power Plant accident","volume":"42","author":"M Tsuboi","year":"2022","journal-title":"J Radiol Prot"},{"key":"pgph.0005259.ref003","unstructured":"Cabinet office. Damage Assumption for Nankai Trough Earthquake. In: Damage Assumption for Nankai Trough Earthquake [Internet]. 2013 [cited 6 Dec 2022]. Available from: https:\/\/www.bousai.go.jp\/jishin\/nankai\/taisaku_wg\/pdf\/20130318_shiryo2_3.pdf"},{"issue":"6","key":"pgph.0005259.ref004","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1017\/dmp.2013.107","article-title":"The clinical utility of makeshift beds in disaster shelters","volume":"7","author":"M Nara","year":"2013","journal-title":"Disaster Med Public Health Prep"},{"key":"pgph.0005259.ref005","unstructured":"Cabinet Office. Report on Case Studies and Support for Disaster Victims in Evacuation Shelters. 2016. Available from: https:\/\/www.bousai.go.jp\/taisaku\/hinanjo\/pdf\/houkokusyo.pdf"},{"key":"pgph.0005259.ref006","unstructured":"Mizutani Y. Living Environment in Shelters: Perspectives on Securing Cardboard Beds and Other Provisions. 24 Aug 2024 [cited 5 Jan 2025]. Available from: https:\/\/www.bousai.go.jp\/jishin\/noto\/taisaku_wg_02\/pdf\/siryo4_1_5.pdf"},{"issue":"12","key":"pgph.0005259.ref007","doi-asserted-by":"crossref","first-page":"4252","DOI":"10.3390\/ijerph17124252","article-title":"Evaluation of Sleep Quality in a Disaster Evacuee Environment","volume":"17","author":"H Ogata","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"pgph.0005259.ref008","doi-asserted-by":"crossref","DOI":"10.7717\/peerj.15173","article-title":"Comparison of body pressure distribution in healthy subjects between bubble wrap and an emergency mattress laid on a cardboard bed: a randomized controlled crossover trial","volume":"11","author":"S Hamanishi","year":"2023","journal-title":"PeerJ"},{"key":"pgph.0005259.ref009","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.apergo.2015.11.011","article-title":"Effect of cardboard under a sleeping bag on sleep stages during daytime nap","volume":"54","author":"K Okamoto-Mizuno","year":"2016","journal-title":"Appl Ergon"},{"key":"pgph.0005259.ref010","doi-asserted-by":"crossref","DOI":"10.7717\/peerj.17392","article-title":"Comparative evaluation of the sleep quality metrics between a cardboard bed and a camp cot: a randomized controlled crossover study","volume":"12","author":"S Hamanishi","year":"2024","journal-title":"PeerJ"},{"issue":"11","key":"pgph.0005259.ref011","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1253\/circrep.CR-19-0097","article-title":"Clinical Features of Disaster-Related Deaths After the Kumamoto Earthquake 2016 - Comparison With the Great East Japan Earthquake 2011","volume":"1","author":"D Sueta","year":"2019","journal-title":"Circ Rep"},{"key":"pgph.0005259.ref012","article-title":"Cardboard Bed Without Mattress Is Ineffective in Improving the body Contact Pressure-a Preliminary Study Using a Dummy Model","volume":"58","author":"S Hamanishi","year":"2021","journal-title":"Inquiry"},{"key":"pgph.0005259.ref013","volume-title":"BPG2 Clinical Guidelines for the Use of Interface Pressure Mapping for Seating","author":"International Interdisciplinary Conference on Posture and Wheeled Mobility","year":"26"},{"key":"pgph.0005259.ref014","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1111\/j.2041-210x.2012.00261.x","article-title":"A general and simple method for obtaining R2 from generalized linear mixed-effects models","volume":"4","author":"S Nakagawa","year":"2013","journal-title":"Methods Ecol Evol"},{"key":"pgph.0005259.ref015","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1186\/s12940-017-0323-4","article-title":"Health effects of milder winters: a review of evidence from the United Kingdom","volume":"16","author":"S Hajat","year":"2017","journal-title":"Environ Health"},{"issue":"1","key":"pgph.0005259.ref016","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1186\/s10195-021-00616-5","article-title":"What type of mattress should be chosen to avoid back pain and improve sleep quality? Review of the literature","volume":"22","author":"G Caggiari","year":"2021","journal-title":"J Orthop Traumatol"}],"container-title":["PLOS Global Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0005259","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T17:23:42Z","timestamp":1759771422000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pgph.0005259"}},"subtitle":[],"editor":[{"given":"Julia","family":"Robinson","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,10,6]]},"references-count":16,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10,6]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pgph.0005259","relation":{},"ISSN":["2767-3375"],"issn-type":[{"value":"2767-3375","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,6]]}}}