Epidemiology of exertional heat illness in the military: a systematic review of observational studies

Alele, Faith O., Malau-Aduli, Bunmi S., Malau-Aduli, Aduli E.O., and Crowe, Melissa J. (2020) Epidemiology of exertional heat illness in the military: a systematic review of observational studies. International Journal of Environmental Research and Public Health, 17 (19). 7037.

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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.

Item ID: 64487
Item Type: Article (Research - C1)
ISSN: 1660-4601
Keywords: exertional heat illness; military personnel; armed forces; risk factors; epidemiology; biomarkers
Copyright Information: © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Date Deposited: 30 Sep 2020 02:36
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111705 Environmental and Occupational Health and Safety @ 100%
SEO Codes: 92 HEALTH > 9205 Specific Population Health (excl. Indigenous Health) > 920504 Occupational Health @ 100%
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