title: Risk factors for heat illness among British soldiers in the hot Collective Training Environment.
abstract: BACKGROUND
  Heat illness is a preventable disorder in military populations. Measures that protect vulnerable individuals and contribute to effective Immediate Treatment may reduce the impact of heat illness, but depend upon adequate understanding and awareness among Commanders and their troops.
  
  
  OBJECTIVE
  To assess risk factors for heat illness in British soldiers deployed to the hot Collective Training Environment (CTE) and to explore awareness of Immediate Treatment responses.
  
  
  METHODS
  An anonymous questionnaire was distributed to British soldiers deployed in the hot CTEs of Kenya and Canada. Responses were analysed to determine the prevalence of individual (Intrinsic) and Command-practice (Extrinsic) risk factors for heat illness and the self-reported awareness of key Immediate Treatment priorities (recognition, first aid and casualty evacuation).
  
  
  RESULTS
  The prevalence of Intrinsic risk factors was relatively low in comparison with Extrinsic risk factors. The majority of respondents were aware of key Immediate Treatment responses. The most frequently reported factors in each domain were increased risk by body composition scoring, inadequate time for heat acclimatisation and insufficient briefing about casualty evacuation.
  
  
  CONCLUSIONS
  Novel data on the distribution and scale of risk factors for heat illness are presented. A collective approach to risk reduction by the accumulation of 'marginal gains' is proposed for the UK military. This should focus on limiting Intrinsic risk factors before deployment, reducing Extrinsic factors during training and promoting timely Immediate Treatment responses within the hot CTE.
authors.affiliation: Department of Medicine, Frimley Health Foundation Trust, Frimley, UK.
authors.forename: Alice C
authors.initials: AC
authors.lastname: Moore
authors.affiliation: Department of Military Medicine, RCDM, Birmingham, UK.|Department of Surgery and Cancer, Imperial College London, London, UK.
authors.forename: M J
authors.initials: MJ
authors.lastname: Stacey
authors.affiliation: Occupational Medicine, Headquarters Army Recruiting and Training Division, Upavon, Wiltshire, UK.
authors.forename: K G H
authors.initials: KG
authors.lastname: Bailey
authors.affiliation: Environmental Monitoring Team, Army Medical Directorate, Camberley, UK.
authors.forename: R J
authors.initials: RJ
authors.lastname: Bunn
authors.affiliation: Department of Military Medicine, RCDM, Birmingham, UK.|Carnegie Research Institute, Leeds Beckett University, Leeds, UK.
authors.forename: D R
authors.initials: DR
authors.lastname: Woods
authors.affiliation: Occupational Medicine, Headquarters Army Recruiting and Training Division, Upavon, Wiltshire, UK.
authors.forename: K J
authors.initials: KJ
authors.lastname: Haworth
authors.affiliation: Department of Surgery and Cancer, Imperial College London, London, UK.|General Intensive Care Unit, Hammersmith Hospital, Du Cane Road, Greater London, UK.
authors.forename: S J
authors.initials: SJ
authors.lastname: Brett
authors.affiliation: Occupational Medicine, Headquarters Army Recruiting and Training Division, Upavon, Wiltshire, UK.
authors.forename: S E F
authors.initials: SE
authors.lastname: Folkes
mesh_terms: D000064:Acclimatization; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001823:Body Composition; D002170:Canada / Q000453:epidemiology; D003681:Dehydration / Q000453:epidemiology; D018882:Heat Stress Disorders / Q000453:epidemiology*; D006633:Histamine Antagonists / Q000627:therapeutic use; D006801:Humans; D006815:Hunger; D007630:Kenya / Q000453:epidemiology; D008889:Military Personnel; D010809:Physical Fitness; D015995:Prevalence; D012307:Risk Factors; D012892:Sleep Deprivation / Q000453:epidemiology; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D000319:Adrenergic beta-Antagonists; D000894:Anti-Inflammatory Agents, Non-Steroidal; D006633:Histamine Antagonists
keywords: EPIDEMIOLOGY; OCCUPATIONAL & INDUSTRIAL MEDICINE; PREVENTIVE MEDICINE