Risk factors for recruit exertional heat illness by gender and training period

Exertional heat illness (EHI) is a recurrent problem for both male and female recruits during basic military training. A matched case control study investigated the effects of fitness and conditioning on EHI risk among Marine Corps recruits during 12 wk of basic training at Marine Corps Recruit Depot, Parris Island, SC. Physical fitness and anthropometric measurements at entrance were acquired for 627 EHI cases that occurred during the period 1988-1996 and for 1802 controls drawn from the same training platoons. Conditional logistic regression was used to estimate EHI risk. Slower physical fitness test run times during processing week strongly predicted risk for subsequent EHI in both male and female recruits. A 9% increase in risk for EHI associated with body mass index (BMI = kg x m(-2); weight/height2) was found in male recruits, while BMI was not associated with risk among female recruits. BMI and initial run time were important predictors for EHI in early training, while in late training the initial BMI was no longer as important a risk factor and improvements in fitness reduced risk. Tables of estimated absolute risks categorized by BMI and VO2max are provided as a guide for identifying recruits who are at high risk for developing EHI during training.