Heat Tolerance and Exertional Heat Illness in Female Military Recruits.

1997 ◽  
Author(s):  
C. B. Wenger
Keyword(s):  
Heat Tolerance ◽  
Heat Illness ◽  
Exertional Heat Illness ◽  
Military Recruits

scholarly journals When Should a Heat-Tolerance Test Be Scheduled After Clinical Recovery From an Exertional Heat Illness?

2020 ◽  
Vol 55 (3) ◽  
pp. 289-294 ◽  
Author(s):  
Haggai Schermann ◽  
Shir Hazut-Krauthammer ◽  
Yael Weksler ◽  
Sagi Spitzer ◽  
Yoram Epstein ◽  
...  
Keyword(s):  
Heat Tolerance ◽  
Outcome Measure ◽  
Heat Stroke ◽  
Group Versus ◽  
Tolerance Test ◽  
Heat Illness ◽  
Exertional Heat Illness ◽  
Clinical Recovery ◽  
Laboratory Results ◽  
Tolerance Testing

Objective Researchers have produced a hypothesis of transient heat intolerance (HI) after exertional heat stroke (EHS). Based on this hypothesis, heat-tolerance testing (HTT) has been postponed until weeks 6 to 8 after EHS and other types of exertional heat illness (EHI). We compared the HTT results of participants after either EHS or other EHI who were tested earlier (≤6-week group) versus those who were tested later (>6-week group) to verify the hypothesis. Design Cohort study. Setting Data obtained from records of military athletes who experienced EHS or EHI. Patients or Other Participants All participants who underwent HTT after EHI or EHS experienced between 2014 and 2018 and for whom complete data regarding the severity of the event (rectal temperature, neurologic symptoms, and laboratory results) and HTT results were available were included. Participants with suspected EHS and those with other EHIs were evaluated separately. Main Outcome Measure(s) The percentages of participants with HI and mean probability of heat tolerance were compared between those tested within 6 weeks of the event and those tested later. Results A total of 186 participants were included in this study (EHS: 12 in the <6-week group, 9 in the >6-week group; EHI: 94 in the <6-week group, 71 in the >6-week group). In the EHS group, the percentages with HI (33% versus 44%, P = .67) and mean probability of heat tolerance (0.82 versus 0.82, P = .98) did not differ. In the EHI group, participants who were tested after 6 weeks had a greater chance of being diagnosed with HI (38% versus 21.3%, P < .02) Conclusions The HTT results were similar between participants with EHS who were tested early (<6 weeks) and those tested late (>6 weeks). Further investigation of heat-tolerance changes in larger cohorts of patients after EHS is required to verify the theory of transient HI.

The validity of the heat tolerance test in prediction of recurrent exertional heat illness events

2018 ◽  
Vol 21 (6) ◽  
pp. 549-552 ◽  
Author(s):  
Haggai Schermann ◽  
Yuval Heled ◽  
Chen Fleischmann ◽  
Itay Ketko ◽  
Nathan Schiffmann ◽  
...  
Keyword(s):  
Heat Tolerance ◽  
Tolerance Test ◽  
Heat Illness ◽  
Exertional Heat Illness

scholarly journals Probability of Heat Intolerance: Standardized Interpretation of Heat-Tolerance Testing Results Versus Specialist Judgment

2018 ◽  
Vol 53 (4) ◽  
pp. 423-430 ◽  
Author(s):  
Haggai Schermann ◽  
Erin Craig ◽  
Einat Yanovich ◽  
Itay Ketko ◽  
Gary Kalmanovich ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heat Tolerance ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Heat Illness ◽  
Physiological Measures ◽  
Exertional Heat Illness ◽  
Operating Characteristic Curve ◽  
Prediction Density ◽  
Israel Defense Forces

Context:  The heat-tolerance test (HTT) is a screening tool for secondary prevention of exertional heat illness by the Israel Defense Forces. To discern participant tolerance, recruits are exposed to intermediate environmental and exercise stresses, and their physiological responses, core temperature, and heart rate are monitored. When their physiological measures rise at a higher rate or exceed the upper levels of absolute values compared with other participants, heat intolerance (HI) is diagnosed. Objective:  To develop a mathematical model to interpret HTT results and provide a quantitative estimate of the probability of heat tolerance (PHT). Design:  Cross-sectional study. Setting:  Warrior Health Research Institute. Patients or Other Participants:  The HTT results of 175 random individuals tested after an episode of exertional heat illness were classified qualitatively and then divided into training (n = 112) and testing (n = 63) datasets. All individuals were male soldiers (age range = 18–22 years) who had sustained an episode of definitive or suspected exertional heat stroke. Main Outcome Measure(s):  Based on the decision algorithm used by the Israel Defense Forces for manual interpretation of the HTT, we designed a logistic regression model to predict the heat-tolerance state. The model used a time series of physiological measures (core temperature and heart rate) of individuals to predict the manually assigned diagnosis of HT or HI. It was initially fitted and then tested on 2 separate, random datasets. The model produced a single value, the PHT, and its predictive ability was demonstrated by prediction-density plots, receiver operating characteristic curve, contingency tables, and conventional screening test evaluation measures. Results:  According to prediction-density plots of the testing set, all HT patients had a PHT of 0.7 to 1. The receiver operating characteristic curve plot showed that PHT was an excellent predictor of the manual HT interpretations (area under the curve = 0.973). Using a cutoff probability of 0.5 for the diagnosis of HI, we found that PHT had sensitivity, specificity, and accuracy of 100%, 90%, and 92.06%, respectively. Conclusions:  The PHT has the potential to be substituted for manual interpretation of the HTT and to serve in a variety of clinical and research applications.

scholarly journals Systematic review of gender differences in the epidemiology and risk factors of exertional heat illness and heat tolerance in the armed forces

BMJ Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. e031825 ◽  
Author(s):  
Faith Alele ◽  
Bunmi Malau-Aduli ◽  
Aduli Malau-Aduli ◽  
Melissa Crowe
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Gender Differences ◽  
Heat Tolerance ◽  
Heat Stroke ◽  
Armed Forces ◽  
Heat Illness ◽  
Limited Evidence ◽  
Exertional Heat Illness ◽  
Gender Specific

ObjectivesThis review aimed to describe the epidemiology of all heat-related illnesses in women compared with men in the armed forces and to identify gender-specific risk factors and differences in heat tolerance.DesignA 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 guidelines.Eligibility criteriaAll relevant studies investigating and comparing heat illness and heat tolerance in women and men in the armed forces were included in the review.ResultsTwenty-four 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 with men ranged from 1.30 to 2.89 per 1000 person-years versus 0.98 to 1.98 per 1000 person-years. The limited evidence suggests that women had a greater risk of exertional heat illness compared with 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 with men, this finding needs to be interpreted with caution due to the limited evidence.ConclusionThe 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.

Exertional heat illness

The Lancet ◽  
2000 ◽  
Vol 355 (9219) ◽  
pp. 1993
Author(s):  
Diana Brahams
Keyword(s):  
Heat Illness ◽  
Exertional Heat Illness

An exertional heat illness triage tool for a jungle training environment

2017 ◽  
Vol 164 (4) ◽  
pp. 287-289 ◽  
Author(s):  
Mike Smith ◽  
R Withnall ◽  
M Boulter
Keyword(s):  
Medical Personnel ◽  
First Aid ◽  
Heat Illness ◽  
Training Environment ◽  
Exertional Heat Illness ◽  
First Aid Training ◽  
Illness Recognition

This article introduces a practical triage tool designed to assist commanders, jungle training instructors (JTIs) and medical personnel to identify Defence Personnel (DP) with suspected exertional heat illness (EHI). The challenges of managing suspected EHI in a jungle training environment and the potential advantages to stratifying the urgency of evacuation are discussed. This tool has been designed to be an adjunct to the existing MOD mandated heat illness recognition and first aid training.

The Pathophysiology of Exertional Heatstroke

2004 ◽  
Vol 90 (3) ◽  
pp. 135-138
Author(s):  
J. E. Smith
Keyword(s):  
Heat Stroke ◽  
Armed Forces ◽  
Heat Illness ◽  
Exertional Heat Illness ◽  
Military Unit

AbstractExertional heat illness remains a major cause of morbidity and occasional mortality within the Armed Forces. This review explores the normal responses to heat, known causes of exertional heatstroke, and suggests possible answers to the question of why one member of a military unit collapses with heat stroke, while matched controls at his side remain unaffected.

Exertional Heat Illness Considerations in the Military

2019 ◽  
pp. 181-209
Author(s):  
Nathaniel S. Nye ◽  
Francis G. O’Connor
Keyword(s):  
Heat Illness ◽  
Exertional Heat Illness ◽  
The Military
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