Timing and Predictors of Mild and Severe Heat Illness among New Military Enlistees

Purpose Heat illnesses are important and potentially fatal conditions among physically active individuals. We determined predictors of heat illness among enlistees in a large military population experiencing common physical activity patterns. Methods We estimated the adjusted odds of mild and severe heat illness associated with demographic, health-related, and geographic factors among active-duty, United States Army soldiers enlisting between January 2011 – December 2014 (N=238,168) using discrete-time multivariable logistic regression analyses. Results We observed 2,612 incident cases of mild heat illness (MHI) and 732 incident cases of severe heat illness (SHI) during 427,922 person-years of follow-up, with a mean and median of 21.6 and 21 months per subject. During the first six duty months, 71.3% of the MHIs and 60.2% of the SHIs occurred, peaking at month two. The odds of MHI quadrupled among those with prior SHI (OR=4.02, 95% confidence interval [CI]: 2.67 – 6.03). Body mass index (BMI) extremes increased risk substantially (ORs at BMI ≥30: for MHI, 1.41, CI 1.19 – 1.67; for SHI, 1.94, CI 1.47 – 2.56; ORs at BMI

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