Risk Factors Associated with Exertional Heat Related Illness in Recruits of Nepal Army during Training Period: A Case Control Study

Introduction: Prevention is an important strategy to reduce the incidence of Exertional heat-related illnesses (EHRI) during training. It comprises a group of symptoms that occur in response to heat accumulation in the body caused by exercise or work in a hot and humid environment for a long period of time until the body is unable to regulate its temperature. The aim of the study is to find out associated risk factors and factors contributing EHRI especially in recruits of Nepal Army. Methods: A case-control study was conducted in  recruit training center of Nepal army from June to September of 2017 using a Semi- structured questionnaire after taking ethical approval from IRB. All EHRI cases were included during data collection. The risk factors were analyzed with controls from the same center. 36 cases and 84 controls were taken. We computed the odd ratio (OR), corresponding 95% confidence interval (95% CI), Chi-Square test and Binary Logistic Regression test with SPSS version 20 software. Results: 85% were wearing army uniform with camouflage vest during the exertional phase of training which was identified as noticeable risk factor with odd ratio (OR) of 13.26 with 95% CI: 5.05 – 34.84 in comparisons to controls. Fear from instructors and seniors in following rules were the protective factors for EHRI (P<0.05). Conclusions: Wearing camouflouge vests and previous history of EHRI were significant risk factors associated with EHRI during training period. Proper clothing protocol and identifying vulnerable groups by the commanders and trainees may prevent EHRI in future.