Heat strain during military training activities: The dilemma of balancing force protection and operational capability

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ABSTRACT

Military activities in hot environments pose 2 competing demands: the requirement to perform realistic training to develop operational capability with the necessity to protect armed forces personnel against heat-related illness. To ascertain whether work duration limits for protection against heat-related illness restrict military activities, this study examined the heat strain and risks of heat-related illness when conducting a military activity above the prescribed work duration limits. Thirty-seven soldiers conducted a march (10 km; ∼5.5 km h ⁻¹) carrying 41.8 ± 3.6 kg of equipment in 23.1 ± 1.8°C wet-bulb globe temperature. Body core temperature was recorded throughout and upon completion, or withdrawal, participants rated their severity of heat-related symptoms. Twenty-three soldiers completed the march in 107 ± 6.4 min (Completers); 9 were symptomatic for heat exhaustion, withdrawing after 71.6 ± 10.1 min (Symptomatic); and five were removed for body core temperature above 39.0°C (Hyperthermic) after 58.4 ± 4.5 min. Body core temperature was significantly higher in the Hyperthermic (39.03 ± 0.26°C), than Symptomatic (38.34 ± 0.44°C; P = 0.007) and Completers (37.94 ± 0.37°C; P<0.001) after 50 min. Heat-related symptom severity was significantly higher among Symptomatic (28.4 ± 11.8) compared to Completers (15.0 ± 9.8, P = 0.006) and Hyperthermic (13.0 ± 9.6, P = 0.029). The force protection provided by work duration limits may be preventing the majority of personnel from conducting activities in hot environments, thereby constraining a commander's mandate to develop an optimised military force. The dissociation between heat-related symptoms and body core temperature elevation suggests that the physiological mechanisms underpinning exhaustion during exertional heat stress should be re-examined to determine the most appropriate physiological criteria for prescribing work duration limits.

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Influence of body temperature on the development of fatigue during prolonged exercise in the heat.

J González-Alonso, C. Teller, S L Andersen … (1999)

We investigated whether fatigue during prolonged exercise in uncompensable hot environments occurred at the same critical level of hyperthermia when the initial value and the rate of increase in body temperature are altered. To examine the effect of initial body temperature [esophageal temperature (Tes) = 35.9 +/- 0.2, 37.4 +/- 0. 1, or 38.2 +/- 0.1 (SE) degrees C induced by 30 min of water immersion], seven cyclists (maximal O2 uptake = 5.1 +/- 0.1 l/min) performed three randomly assigned bouts of cycle ergometer exercise (60% maximal O2 uptake) in the heat (40 degrees C) until volitional exhaustion. To determine the influence of rate of heat storage (0.10 vs. 0.05 degrees C/min induced by a water-perfused jacket), four cyclists performed two additional exercise bouts, starting with Tes of 37.0 degrees C. Despite different initial temperatures, all subjects fatigued at an identical level of hyperthermia (Tes = 40. 1-40.2 degrees C, muscle temperature = 40.7-40.9 degrees C, skin temperature = 37.0-37.2 degrees C) and cardiovascular strain (heart rate = 196-198 beats/min, cardiac output = 19.9-20.8 l/min). Time to exhaustion was inversely related to the initial body temperature: 63 +/- 3, 46 +/- 3, and 28 +/- 2 min with initial Tes of approximately 36, 37, and 38 degrees C, respectively (all P < 0.05). Similarly, with different rates of heat storage, all subjects reached exhaustion at similar Tes and muscle temperature (40.1-40.3 and 40. 7-40.9 degrees C, respectively), but with significantly different skin temperature (38.4 +/- 0.4 vs. 35.6 +/- 0.2 degrees C during high vs. low rate of heat storage, respectively, P < 0.05). Time to exhaustion was significantly shorter at the high than at the lower rate of heat storage (31 +/- 4 vs. 56 +/- 11 min, respectively, P < 0.05). Increases in heart rate and reductions in stroke volume paralleled the rise in core temperature (36-40 degrees C), with skin blood flow plateauing at Tes of approximately 38 degrees C. These results demonstrate that high internal body temperature per se causes fatigue in trained subjects during prolonged exercise in uncompensable hot environments. Furthermore, time to exhaustion in hot environments is inversely related to the initial temperature and directly related to the rate of heat storage.

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Gregory J. Brewer, R Ramsbottom, Geoffrey Williams (1988)

The purpose of the present study was to examine the validity of using a 20 m progressive shuttle run test to estimate maximal oxygen uptake. Running ability was described as the final level attained on the shuttle run test and as time on a 5 km run. Maximal oxygen uptake (VO2 max) was determined directly for seventy-four volunteers (36 men, 38 women) who also completed the shuttle run test. Maximal oxygen uptake values were 58.5 +/- 7.0 and 47.4 +/- 6.1 ml.kg-1.min-1 for the men and women respectively (mean +/- SD, P less than 0.01). The levels attained on the shuttle run test were 12.6 +/- 1.5 (men) and 9.6 +/- 1.8 (women; P less than 0.01). The correlation between VO2 max and shuttle level was 0.92. The correlation between VO2 max and the 5 km run was -0.94 and the correlation between both field tests was -0.96. The results of this study suggest that a progressive shuttle run test provides a valid estimate of VO2 max and indicates 5 km running potential in active men and women.

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Fatal exertional heat stroke: a case series.

Moshe Rav-Acha, Yuval Heled, Eran Hadad … (2004)

Exertional heat stroke (EHS) is one of the most serious conditions that occur when excess heat, generated by muscular exercise, exceeds the body's heat-dissipation rate. The consequent elevated body core temperature causes damage to the body's tissues, resulting in a characteristic multiorgan syndrome, which is occasionally fatal. We analyzed the fatal EHS cases that occurred in the Israeli Defence Forces during the last decade according to Minard's paradigm for evaluation of EHS predisposing factors, aiming to characterize the common features and unique circumstances leading to fatality. Accumulation of predisposing factors, particularly those concerning training regulations, coupled with inappropriate treatment at site, were found to be strong predictors of a grave prognosis. Analysis of the pathologic findings of the fatal EHS cases on autopsy revealed a possible association between the duration and length of exercise prior to EHS occurrence and the extent of pathologic findings. Strict adherence to existing training regulations may prevent further heat stroke fatalities.

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Author and article information

Journal

Journal ID (nlm-ta): Temperature (Austin)

Journal ID (iso-abbrev): Temperature (Austin)

Journal ID (publisher-id): KTMP

Journal ID (publisher-id): ktmp20

Title: Temperature: Multidisciplinary Biomedical Journal

Publisher: Taylor & Francis

ISSN (Print): 2332-8940

ISSN (Electronic): 2332-8959

Publication date Collection: Apr-Jun 2016

Publication date (Electronic): 26 February 2016

Publication date PMC-release: 26 February 2016

Volume: 3

Issue: 2 , How Hot is Down Under? Temperature-related Sciences in Australia and New Zealand (1 of 2) Guest Editors: Eugene Nalivaiko, PhD; Stephen Kent, PhD; Shane Maloney, PhD; Toby Mündel, PhD; and Irina Vetter, PhD

Pages: 307-317

Affiliations

[a ]Land Division, Defense Science and Technology Group, Department of Defence , Fishermans Bend, Australia

[b ]Centre for Human and Applied Physiology, School of Medicine, University of Wollongong , Wollongong, NSW, Australia

Author notes

CONTACT Andrew Hunt andrew.hunt2@ 123456dsto.defence.gov.au Defence Science and Technology Group , 506 Lorimer Street, Fishermans Bend, VIC 3207, Australia

Article

Publisher ID: 1156801

DOI: 10.1080/23328940.2016.1156801

PMC ID: 4965006

PubMed ID: 27857960

SO-VID: 6b02de2e-907f-4a88-a81a-3e3ff8dc41da

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution-Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. The moral rights of the named author(s) have been asserted.

History

Date received : 28 January 2016

Date revision received : 16 February 2016

Date accepted : 17 February 2016

Page count

Figures: 4, Tables: 1, References: 35, Pages: 11

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Heat strain during military training activities: The dilemma of balancing force protection and operational capability

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Most cited references 26

Influence of body temperature on the development of fatigue during prolonged exercise in the heat.

A progressive shuttle run test to estimate maximal oxygen uptake.

Fatal exertional heat stroke: a case series.

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