I currently work at a hospital, in the decontamination area, as a Sterile Processing Technician. The temperature and the relative humidity in this environment is highly regulated. It's also under negative air pressure, taking the hot summer are directly from the outside. The specified air temperature is 65 degrees, and the relative humidity is 60 percent. Personal protective equipment must be worn, from head to toe - full protection. Regardless of what workstation you are assigned in that area, you are all but guaranteed to be in a full body sweat within 30 minutes of your 8-hour shift. If you are assigned to the hand or machine washing area, you will additionally be submerging medical instruments in water that is at a minimum 100-120 degrees. Furthermore, the individual instruments and instrument trays can be quite heavy and you are required to repetitively lift them. As you can see, this is a highly physically demanding position with environmental conditions that exacerbate these demands. Additionally, you may experience some physical discomfort due to the need to focus highly on attention to detail and ensuring that you are cleaning in a safe, sanitary manner. Having said all that, I still love the job because I'm contributing to helping keep individuals and families safe. I knew when I joined this department that the decontamination area would be a component of this position. I don't do well with heat nor humidity. Personally, I prefer that it be below 80 degrees outside and that the relative humidity is low. So, I knew that I would need a vest that was highly effective for this kind of environment and work. So, is the vest comfortable and is it lightweight? It's very comfortable for me and it's pretty lightweight, even with the cooling packs and inserted and frozen. So, how well does this vest perform? I couldn't wait to get this vest, I've only been using it for a week but for the first 2-3 hours, closer to 3 hours, the difference is like night and day. The KewlTech made it so that for the first time since I've been working in the decontamination area that I was not in a full sweat. In fact, only after the third hour of using the vest in the decontamination area did I start to notice the effectiveness of the cooling packs losing their cooling ability. You'll need to recharge the ice pack inserts at this point, if you are needing the same level of cooling performance. The medium/large was a little too loose on me, and I would recommend that you have the vest tight because it will cool a lot more effectively that way. I found a solution though, after tightening the velcro straps tight as possible and finding it wasn't tight enough, I found that if I pull the straps as tight as possible and then tie them around one another in the middle, but it provided a pretty tight fit. See the two pictures I've included. I would recommend buying a second pack of the TechKewl ice pack inserts, or simply buying a second TechKewl vest. As for all the reviews I'm going to give this vest anything below a five star rating - please kindly disregard. I'm assume these people mean well, but, they are grossly misinformed. Does this vest add weight? Yes, of course, find me one that doesn't - it's a natural component of a cooling vest. Is it bulky? Yes, there is some bulk to it as it is a cooling vest. Even I found it interesting to tie my shoelaces, , because I couldn't been down quite as far, but if you sit on a bench or use a chair then it's not a problem. Any reviewer giving less than a five star rating should work just one shift in the decontamination area, at the Sterile Processing department at their local hospital. Go ahead and work 8 hours shift without this best, and then with it, then tell me what you think of it. As the headline of my review says, it won't for miracles, but IMHO it does a great job.