Heat Illness - A Review of Military Experience (Part 1)

Abstract

This paper is the first part of a two part review of the published literature reporting the military experience of heat illness. It summarises current concepts of the mechanisms for the development of heat illness. The reports of heat illness in the military medical literature from pre-World War 1 to the end of World War 2 are discussed. The second part will consider reports from the end of the Second World War to the present day. Epidemiological evidence for the factors causing heat illness will be summarised and finally the current areas of uncertainty will be identified with proposals for future research.

A Critical Review of OSHA Heat Enforcement Cases

“…Military medicine since the Roman Empire has long supported battle readiness through appropriate guidance on managing heat illness. 1 Scientists have made important contributions to the understanding of heat illness and addressed methods to assess the environmental contribution to heat stress. [2][3][4][5][6] State governments have acted to prevent heat illness; for example, California and Washington have regulatory requirements addressing occupational heat stress.…”

Heat: not black, not white. It’s gray!!!

“…Heat cramps, also known as muscle cramps, refer to painful muscle contractions due to salt deficiency [28]. Any physical activity leading to profuse sweating followed by too little or too much fluid intake leads to hypernatremia or hyponatremia, respectively.…”

“…Severe forms of HRIs include heat exhaustion and heatstroke [28]. Heat exhaustion is indicated by weakness, nausea, headache, thirst, and malaise [21,27,28].…”

“…It causes a person to faint due to cerebral hypoxia caused by dilation of peripheral blood vessels. Vasodilation can result in orthostatic intolerance [21,27,28]. The other symptoms are headache, giddiness, thirst, vomiting, and fatigue [14].…”

“…Heat exhaustion is indicated by weakness, nausea, headache, thirst, and malaise [21,27,28]. It is characterized by Tc between 37°C (98.6°F) and 40°C [21] and failure of the cardiovascular response to workload, typically under conditions of high external temperature and dehydration [22].…”