Heat illness in military populations: asking the right questions for research

@article{Stacey2014HeatII,
  title={Heat illness in military populations: asking the right questions for research},
  author={Mike Stacey and Dulani Woods and David Ross and D R Wilson},
  journal={Journal of the Royal Army Medical Corps},
  year={2014},
  volume={160},
  pages={121 - 124}
}
Reports of death and injury in military populations due to exertional heat illness (EHI) and its most severe form, exertional heat stroke, date from antiquity. Yet, understanding of why one soldier may succumb to EHI, while those around him do not, is incomplete. This paper sets out research questions in support of the health of military populations who may experience exertional heat stress. The mechanisms by which excess body heat arises and is dissipated are outlined and the significance of… 
View on BMJ
ncbi.nlm.nih.gov
16 Citations
Background Citations
4

16 Citations

Citation Type

Citation Type

Epidemiology of Exertional Heat Illness in the Military: A Systematic Review of Observational Studies
TLDR
Evidence suggests that loss of consciousness, absence of sweating and confusion were the common clinical features of exertional heat stroke (EHS), while elevated levels of creatine phosphokinase, liver enzymes, and creatinine were common biochemical markers of EHS.
Susceptibility to exertional heat illness and hospitalisation risk in UK military personnel
TLDR
There is a need for better evidence to inform guidelines that aim to prevent severe EHI concurrent to reducing overall morbidity, and Paradoxical association of traditional susceptibility factors with reduced hospitalisation risk may reflect the contemporary contexts in which severe E HI occurs.
Health Risks and Interventions in Exertional Heat Stress.
BACKGROUND With climate change, heat waves are expected to become more frequent in the near future. Already, on average more than 25 000 "heat deaths" are estimated to occur in Europe every year.…
The Gastrointestinal Exertional Heat Stroke Paradigm: Pathophysiology, Assessment, Severity, Aetiology and Nutritional Countermeasures
Exertional heat stroke (EHS) is a life-threatening medical condition involving thermoregulatory failure and is the most severe condition along a continuum of heat-related illnesses. Current EHS…
Methods for improving thermal tolerance in military personnel prior to deployment
TLDR
This review explores how heat acclimation (HA) prior to deployment may attenuate the effects of heat by initiating physiological and behavioural adaptations to more efficiently and effectively protect thermal homeostasis, thereby improving performance and reducing heat illness risk.
Expert consensus on the diagnosis and treatment of heat stroke in China
TLDR
It is necessary to update the consensus to include the latest research evidence and establish a new consensus that has broader coverage, is more practical and is more in line with China’s national conditions.
The Hearts of Heroes: the epidemiology of cardiac disease in the UK Armed Forces
TLDR
The epidemiology of cardiac disease in the UK Armed Forces is reviewed, both in terms of morbidity and mortality and the trend that with increasing age, the burden of disease shifts to ischaemic heart disease, which becomes the dominant cause of both death and disability.
Command application of UK military climatic guidance on Exercise SAIF SAREEA 3
TLDR
The author's personal view aims to describe the command and medical interaction on SAIF SAREEA 3 which the authors feel contributed to those successes against climatic effects.
A case of an avoidable admission to an Ebola treatment unit with malaria and an associated heat illness
TLDR
This case highlights why force protection measures are important to reduce the incidence of both malaria and heat illness in deployed military and civilian populations during the current EVD epidemic where presenting with these pathologies requires clinical assessment in the ‘red zone’ of an Ebola treatment unit.
An exertional heat illness triage tool for a jungle training environment
This article introduces a practical triage tool designed to assist commanders, jungle training instructors (JTIs) and medical personnel to identify Defence Personnel (DP) with suspected exertional…
...
1
2
...

References

SHOWING 1-10 OF 43 REFERENCES
Heat illness
TLDR
The epidemiology, pathophysiology and relevant aspects of management including prevention, acclimatisation and treatment of exertional heat illness, the predominant form affecting military personnel, are reviewed.
Pathophysiology of Heat-Related Illnesses
TLDR
This chapter provides an overview of the pathophysiologic responses that are observed in patients and experimental animal models at the time of heatstroke collapse and during long-term recovery.
Identification of risk factors for exertional heat illness: a brief commentary on genetic testing.
TLDR
Comparing existing literature regarding clinical cases of EHI and MH and the potential utility of genetic testing, specifically the ryanodine receptor (RYR1) gene and other genes related to disorders of skeletal muscle are compared.
Collapse from exertional heat illness: implications and subsequent decisions.
TLDR
There is a need to bypass considerations of the etiology of EHI and to identify the vulnerable and handicapped soldier by exposure after an interval of time to one or more exercise tolerance tests.
Exertional heat illness during training and competition
TLDR
Prevention strategies are essential to reducing the incidence of EHS, heat exhaustion, and exercise associated muscle cramping.
Risk factors predicting exertional heat illness in male Marine Corps recruits.
TLDR
A matched population-based case-control study was conducted on exertional heat illness in male Marine Corps recruits in basic training at Parris Island, SC, finding recruits at highest risk for developing exertionalheat illness had an eightfold higher risk during basic training when compared with those with BMI less than 22 kg.
The effects of continuous hot weather training on risk of exertional heat illness.
TLDR
The results provide evidence for a cumulative effect of previous day's heat exposure on EHI risk in these Marine Corps recruits and a simple index for use in predicting EHIrisk is proposed that includes the dry-bulb temperature and the relative humidity.
The pathopysiology of heat stroke: an integrative view of the final common pathway
TLDR
This review integrates the current theoretical and accepted knowledge of physiological alterations into one model that depicts a common pathway from heat stress to heat stroke.
Integrated physiological mechanisms of exercise performance, adaptation, and maladaptation to heat stress.
TLDR
The "traditional" notion that high core temperature is the critical mediator of exercise performance degradation and heat stroke is questioned, to perhaps explain heat stroke cases reported in low-risk populations performing routine activities.
Heat intolerance: does gene transcription contribute?
TLDR
The data suggest that transcriptional malfunction and sluggishness of the vasculature to thermal stimuli are predisposing factors in the HI group.
...
1
2
3
4
5
...