Epidemiology of Exertional Heat Illness in the Military: A Systematic Review of Observational Studies

Faith O. Alele, Bunmi S. Malau-Aduli, Aduli E. O. Malau-Aduli and Melissa J. Crowe
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Faith O. Alele: College of Healthcare Sciences, James Cook University, Townsville QLD 4811, Australia
Bunmi S. Malau-Aduli: College of Medicine and Dentistry, James Cook University, Townsville QLD 4811, Australia
Aduli E. O. Malau-Aduli: College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville QLD 4811, Australia
Melissa J. Crowe: Division of Tropical Health and Medicine, James Cook University, Townsville QLD 4811, Australia

IJERPH, 2020, vol. 17, issue 19, 1-27

Abstract: Exertional heat illness (EHI) is an occupational hazard among military personnel. This systematic review describes the incidence, risk factors, clinical manifestations, and biomarkers of EHI in the military. Six databases from inception to 28 May 2020 were systematically reviewed using the PRISMA guidelines. Forty-one articles met the inclusion criteria and the incidence of EHI ranged from 0.2 to 10.5 per 1000 person years, while the prevalence rates ranged from 0.3% to 9.3%. Intrinsic risk factors influencing EHI were gender, physical fitness, obesity, previous history of heat illness, and motivation, while the extrinsic factors included hot environmental conditions and service unit. Evidence suggests that loss of consciousness, absence of sweating and confusion were the common clinical features of exertional heat stroke (EHS). The mean core temperature ranged from 40 to 41.6 °C, while elevated levels of creatine phosphokinase, liver enzymes, and creatinine were common biochemical markers of EHS. The findings of the review suggest a variation in the incidence of EHI among military populations possibly due to the varying definitions used. Although some risk factors of EHI were identified, more analytical studies are needed to investigate the association between EHI and other important factors such as acclimatisation and occlusive clothing.

Keywords: exertional heat illness; military personnel; armed forces; risk factors; epidemiology; biomarkers (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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