Heat illness in the Armed Forces – a real and preventable risk

The summer is well and truly here and with it comes the occupational hazards of heat exhaustion and heat stroke, particularly in the Armed Forces.

Military training instructors often overlook the gravity of heat illness – illness that is typically preventable by appropriate awareness and risk management. But climate change has made heatwaves more likely – and more severe – so it is increasingly important to take heat safety seriously.

In the forces, risk assessments may be cast aside, ignored or not even considered, and the phrases ‘man up’ and ‘it’s just team building’ can be heard all too often.

Types of heat illness

Heat exhaustion can range from mild to severe, with symptoms including:

• Tiredness
• Feeling faint
• Muscle cramps
• Heavy sweating
• Heat rash
• Weakness
• Headache
• Feeling or being sick
• Feeling very thirsty

Heat stroke is more serious and can include:

• High body temperature or fever
• A seizure or fit
• Confusion
• Skin that’s cold to the touch, with a high body temperature
• Fainting or losing consciousness
• Severe difficulty breathing
• Lack of co-ordination

The NHS website explains some do’s and don’ts around heat illness and warns against “tiring physical activity, like running, in very hot or humid weather”.

The very nature of military training always brings a risk of injury and military leaders are unlikely to stop training exercises because of hot weather.

During a military exercise on the Brecon Beacons in July 2013, several service personnel became unwell from heat illness due to the high temperatures and the physical demands of the exercise. Two service personnel died on the day; a third died in hospital later that month. In addition, a further eight were unwell, with some needing hospital treatment.

Part of the investigation into the incident identified an inherent lack of understanding of the risks involved and there was no Safe System of training in place to reduce the risk to as low as reasonably practicable.

The investigation concluded that the exercise planners, those overseeing the exercise – including medical teams – and the chain of command did not understand exertional heat illness and therefore did not comprehend the exercise was a high-risk activity and that the risk increased significantly in hot conditions.

The MOD has produced the Commander’s Guide to Heat Illness Prevention which explains heat illness is a serious and potentially life-threatening condition, but recognises it is preventable. The document aims to improve awareness and the management of heat illness prevention across defence.

Importantly, Commanders need to recognise the individual risk factors that may have a bearing on how personnel feel when taking part in activities in hot weather such as:

• Lifestyle factors – weight, smoking, alcohol, drugs
• Health factors – asthma, vaccinations, dehydration, recent illness, sickle cell, age, sunburn
• Work factors – inexperience, lack of sleep, poor diet, air travel, acclimatisation

Long term effects of heat illness can include organ damage, increased risk of chronic diseases and cognitive impairments.

It is important to seek help as soon as possible if you or a colleague show any signs of heat illness.

If you or a loved one has been affected by heat illness and have sustained long-term ill health as a result of heat illness, or a loved one has died as a result, you may wish to take legal advice.