Risk factors for heat illness among British soldiers in the hot Collective Training Environment

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.

Hearing loss in British Army musicians

BACKGROUND

Military musicians increasingly fulfil front line roles. Existing literature suggests that musicians are at greater risk of hearing loss than the general population. It is important to ascertain whether these findings apply to military musicians if they are to be placed in operational acoustically hazardous environments.

AIMS

To compare hearing loss between groups of British Army musicians and with their administrative (non-musician) counterparts.

METHODS

Routine health surveillance audiometric data for a group of military musicians were compared with military administrative staff during the first 8-12 years of their careers. Structured interviews were used to identify those meeting the study inclusion criteria (8 year minimum service, no significant, relevant medical history, no previous extraordinary loud noise exposure, service within study employment group throughout military career), and to clarify the instrument played.

RESULTS

Eighty-four musicians and 44 administrators participated. Using the Health & Safety Executive's (HSE's) age- and gender-correcting system, 12 (14%) musicians and 9 (20%) non-musicians had a deterioration in hearing. The overall odds ratio for developing hearing loss in musicians was 0.65 (95% CI 0.25-1.68). Compared with woodwind instrumentalists, the odds ratio for hearing loss in brass instrumentalists was 2.00 (95% CI 0.85-3.44) and for percussionists 1.83 (95% CI 0.77-2.90).

CONCLUSIONS

The findings suggest that military musicians are at no greater risk of hearing loss than their administrative counterparts after 8-12 years in service. This may represent a healthy-worker effect. There is no statistically significant differential risk of hearing loss between different instrumental groups.