Heat and sun related medical concerns in Australian led outdoor activities : a three-year prospective study

Active participation in the outdoors is beneficial for health and wellbeing. However, the impact of extreme weather, particularly heat, on safe participation is causing concern for organisations who lead these activities. Local mitigation strategies and acute management of heat- and sun-related illness (HSRI) are generally well understood by researchers and medical practitioners, however, cases continue to occur so further understanding of why this happens is required. This study aimed to identify the number, nature and contributory factors of HSRI in Australian led outdoor activities in order to seek opportunities for their prevention. This study presents a descriptive analysis of contributory factors to HSRI occurring during led outdoor activities. Cases were prospectively collected across 3 years (2014-2017) from a national Australian incident reporting system. Cases were included by identification of keywords linked with sun or heat exposure. From 2,015 incident cases, 48 cases were included: 25 termed heat stroke and 23 as "other adverse outcomes related to sun or heat." One in three (35%) cases occurred during outdoor walking or running, and one in four occurred while camping. A total 146 contributory factors were identified. These factors were attributed to the activity participant (e.g. competence, decision making); equipment and resources (e.g. food/drink, dehydration); and environment (e.g. hot weather.). Mild to moderate HSRI was identifiable by signs/symptoms. Contributory factors were linked to the individual participant. Potentially, these factors could be mitigated through system focused approaches. Awareness of wider responsibility for preventing HSRI should be promoted across led outdoor activities. [Author abstract]