BACKGROUND: Open water swimming (OWS) competitions in hot climates elevate core temperature (Tc), impairing performance and increasing risks of exertional heat illness (EHI) and exertional heat stroke (EHS). High water temperatures (e.g., ~29°C in Tokyo 2020 Olympics; ~33°C in Fran Crippen's fatal 2010 event) limit heat dissipation via reduced gradients and suppressed sweating. Behavioral countermeasures (e.g., hydration, reduced intensity) are impractical during races. AccurateTcmonitoring is essential for early hyperthermia detection and safety, yet ecologically valid field measurements remain challenging. This integrative review aimed to survey literature on feasible instruments and techniques forTcmeasurement and management in OWS swimmers. METHODS: This integrative review searched PubMed, Scopus, Embase, Web of Science (Dec 2023-Mar 2024) using Boolean: ("open water swimming*" OR endurance* OR triathlon* OR "marathon swimming*") AND heat* AND sport* AND athlete* AND "core temperature measurement*". Inclusion: English full texts on healthy swimmers/athletes,Tcapplicability in OWS training/competition. Exclusion: thermogenic substances, non-athletes. Quality assessed via CASP; three reviewers screened via Rayyan. RESULTS: From 610 references (274 duplicates removed), 21 full texts screened; 4 included. Studies provided insights on swimming thermometry (not exclusively OWS/hot): ingestible sensors (e-Celsius), rectal probes, skin sensors (TX-4/TX-2), infrared tympanic (inadequate post-cold water). Invasive sites (e.g., esophageal, rectal; gold standard: pulmonary artery) vs. non-invasive (tympanic, forehead). Emerging wearables (CoreTemp, Equivital EQ02+, Kenzen Patch, Cosinuss° One) enable continuousTcwith HR, SpO* via RF/Bluetooth, per World Aquatics Rule 15.3. CONCLUSIONS: Tcmeasurement in OWS is feasible via wearables integrating physiological/biomechanical data for real-time thermal profiles, personalized precooling/hydration, earlyEHI/EHSdetection, and dynamic pacing. Despite limitations (validation, comfort), these technologies promise enhanced safety/performance amid climate-driven heat stress, warranting OWS-specific research
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