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Heat illness during initial military training
  1. Ali Everest1 and
  2. N Taylor2
  1. 1 AH Health Policy, SHA(A), MOD, Andover, Hampshire, UK
  2. 2 Academic Department of Military General Practice, Royal Centre for Defence Medicine, Birmingham, UK
  1. Correspondence to Maj N Taylor, Academic Department of Military General Practice, Royal Centre for Defence Medicine, Birmingham B45 9UA, UK; natalie.taylor485{at}


Introduction Exertional heat illness (EHI) is recognised as a significant problem for fit young individuals taking part in strenuous activity in temperate climates. The aim of this research was to relate episodes of reported EHI against known risk factors for heat illness and determine whether modification of the training programme had an effect on the number of cases reported. Publication was not possible when the work was originally conducted in 2000 because of barriers within Royal Military Academy Sandhurst (RMAS) at the time.

Methods A retrospective study examined the medical data for Officer Cadets in training at the RMAS for a 2-year period ending April 2000.

Results 60 cases were initially reported as EHI, in 58 individuals. Using the following criteria; dizziness, collapse, reduced conscious level, headache, nausea, vomiting, elevated core (rectal) temperature and the results of urine and blood tests, 35 cases were diagnosed as EHI and 25 cases had other diagnoses recorded after investigation. Minority of cases (n=12) had an identifiable risk factor but the majority appeared to be fit young individuals who were susceptible to EHI in conditions where the rest of the population was unaffected.

Discussion Further work is planned to study individuals during strenuous activity events in the hope of accurately identifying those at risk and further reducing the incidence of EHI. EHI is common, case definition is poor, risk factors are not present in all individuals but modification of training programmes is effective.

  • occupational & industrial medicine
  • sports medicine
  • epidemiology

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  • Contributors AE wrote the paper in 2000 and NT only edited for publication in 2020.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval It is a review of lessons learnt from EHI at RMAS in 1990s.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Author note This paper was originally written as an internal military report in 2000 and has now been published verbatim as a footnote and endpiece as it fills an important gap in the exertional heat illness (EHI) literature, while demonstrating that the British Army can be progressive in its approach to training and is committed to organisational learning. Its publication offers opportunity to disseminate best practice beyond RMAS, which continues to model this in respect of prevention, detection and treatment of the inevitable – but potentially much reduced – incidence of EHI in military personnel. Publication was not possible when the work was conducted because of barriers within RMAS at the time. However, this paper demonstrates the learning culture with RMAS and this has been recognised with authority to publish 20 years later.

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