Exertional Heat Illness in the Military: Risk Mitigation

  • Josh B. Kazman
  • Francis G. O’Connor
  • D. Alan Nelson
  • Patricia A. Deuster
Part of the SpringerBriefs in Medical Earth Sciences book series (BRIEFSMEEASC)


This chapter focuses on exertional heat illness (EHI) in the military and covers common scenarios of EHI, the epidemiology, and guidelines related to risk mitigation and physical activity modifications. EHI risk is particularly high among new military recruits and those in combat occupational specialties. Other extrinsic and intrinsic factors are reviewed, including sickle cell trait and medications, which have received more attention recently. Military leaders are responsible for mitigating EHI risk at both the unit and individual level. The five steps of risk management are identify hazards, assess hazards, develop controls and make risk decisions, implement controls, and supervise and evaluate. Each step is discussed and elucidated with examples of work/rest hydration cycles by heat categories and Army risk management matrices. Military leaders need to remain vigilant and adapt risk management strategies; as the military’s demographic/occupational makeup changes, the evidence base for EHI risk mitigation evolves, and new technologies become available.


Acclimatization Mild heat illness Epidemiology Military leadership Force readiness 


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Copyright information

© The Author(s) 2018

Authors and Affiliations

  • Josh B. Kazman
    • 1
  • Francis G. O’Connor
    • 1
  • D. Alan Nelson
    • 2
  • Patricia A. Deuster
    • 1
  1. 1.Department of Military and Emergency MedicineUniformed Services University of the Health SciencesBethesdaUSA
  2. 2.Stanford University School of MedicineDepartment of MedicineStanfordUSA

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