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Susceptibility to exertional heat illness and hospitalisation risk in UK military personnel

Stacey, Michael J., Parsons, Iain T, Woods, David R, Taylor, Peter, Ross, David and J Brett, Stephen 2015. Susceptibility to exertional heat illness and hospitalisation risk in UK military personnel. BMJ Open Sport & Exercise Medicine 1 (1) , e000055. 10.1136/bmjsem-2015-000055

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Abstract

Background: Susceptibility to exertional heat illness (EHI) is considered multifactorial in nature. The aims of this study were to (1) review traditional susceptibility factors identified in cases of EHI and (2) determine how they are related to risk of hospitalisation. Methods: Review of an electronic database of EHI reported in the British Army between 1 September 2007 and 31 December 2014. Cases were categorised by demographic, situational and susceptibility variables. Univariate and multivariate logistic regression was performed for the OR for hospitalisation by risk factor. Results: 361 reports were included in the analysis. 33.5% of cases occurred in hot climates, 34.6% in temperate climates during summer months and 31.9% in temperate climates outside of summer months. Traditional susceptibility factors were reported in 193 but entirely absent from 168 cases. 137 cases (38.0%) were admitted to hospital. Adjusted OR for hospitalisation was lower for recruits (OR 0.42, 95% CI 0.18 to 0.99, p<0.05) and for personnel wearing occlusive dress (OR 0.56, 95% CI 0.34 to 0.93, p<0.05) or unacclimatised to heat (OR 0.31, 95% CI 0.15 to 0.66, p<0.01). Conclusions: The global, year-round threat of EHI is highlighted. Absence of susceptibility factors in nearly half of reports highlights the challenge of identifying EHI-prone individuals. Paradoxical association of traditional susceptibility factors with reduced hospitalisation risk may reflect the contemporary contexts in which severe EHI occurs. These findings also suggest a need for better evidence to inform guidelines that aim to prevent severe EHI concurrent to reducing overall morbidity.

Item Type: Article
Date Type: Published Online
Status: Published
Schools: Medicine
Subjects: R Medicine > R Medicine (General)
Publisher: BMJ Group Ltd
ISSN: 2055-7647
Date of First Compliant Deposit: 13 September 2017
Date of Acceptance: 11 September 2015
Last Modified: 13 Sep 2017 15:08
URI: http://orca.cf.ac.uk/id/eprint/104618

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