A systematic review of the gender differences in the epidemiology and risk factors of exertional heat illness and heat tolerance in the Armed Forces

Alele, Faith, Malau-Aduli, Bunmi, Malau-Aduli, Aduli, and Crowe, Melissa (2020) A systematic review of the gender differences in the epidemiology and risk factors of exertional heat illness and heat tolerance in the Armed Forces. BMJ Open, 10. e031825.

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Abstract

Objectives: This review aimed to describe the epidemiology of all heat related illnesses in women compared to men in the armed forces and to identify gender-specific risk factors and differences in heat tolerance.

Design: A systematic review of multiple databases (MEDLINE, Emcare, CINAHL, PsycINFO, Informit, and Scopus) was conducted from the inception of the databases to 1 April 2019 using the preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines.

Eligibility criteria: All relevant studies investigating and comparing heat illness and heat tolerance in women and men in the armed forces were included in the review.

Results: Twenty-four (24) studies were included in the systematic review. The incidence of heat stroke in women ranged from 0.10 to 0.26 per 1000 person-years, while the incidence of heat stroke ranged from 0.22 to 0.48 per 1000 person-years in men. The incidence of other heat illnesses in women compared to men ranged from 1.30 to 2.89 per 1000 person-years vs 0.98 to 1.98 per 1000 person-years. The limited evidence suggests that women had a greater risk of exertional heat illness compared to men. Other gender-specific risk factors were slower run times and body mass index. Although there was a higher proportion of women who were heat intolerant compared to men; this finding needs to be interpreted with caution due to the limited evidence.

Conclusion: The findings of this review suggest that men experienced a slightly higher incidence of heat stroke than women in the armed forces. In addition, the limited available evidence suggests that a higher proportion of women were heat intolerant and being a female was associated with a greater risk of exertional heat illnesses. Given the limited evidence available, further research is required to investigate the influence of gender differences on heat intolerance and heat illness.

Item ID: 62423
Item Type: Article (Research - C1)
ISSN: 2044-6055
Copyright Information: © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions.
Date Deposited: 06 Mar 2020 00:29
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111705 Environmental and Occupational Health and Safety @ 35%
11 MEDICAL AND HEALTH SCIENCES > 1106 Human Movement and Sports Science > 110604 Sports Medicine @ 30%
11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110305 Emergency Medicine @ 35%
SEO Codes: 92 HEALTH > 9204 Public Health (excl. Specific Population Health) > 920405 Environmental Health @ 40%
81 DEFENCE > 810102 Army @ 30%
81 DEFENCE > 810101 Air Force @ 30%
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