A History of Heat Health Management Policies in the Singapore Military.

Our paper, which is the first historical study about heat injuries in Singapore, seeks to situate the Singapore Armed Forces' (SAF) history of heat stress management policies within the national context. Firstly, we observe that since the late 1970s, a research-driven approach has been adopted by the SAF's military medical leaders to formulate a range of policies to address the Forces' high incidence of heat injuries. This has resulted in the introduction of SAF-wide training measures, and the assembling of local scientific research expertise, which has led to a sharp reduction in heat injury incidence from the 1980s to 2000s. Through this, the SAF sought to demonstrate that its heat stress mitigation measures made the Singapore military 'heat proof'. Secondly, the state shaped a soldier safety agenda in the late 2000s on the back of an increasing emphasis on safety and the transformation of the SAF into a highly-educated and technologically-sophisticated force. This meant a shift towards concern about the welfare of every soldier, particularly through the state's drive to eradicate all training-related deaths. Accordingly, the SAF medical military leaders responded to the state's safety agenda by introducing heat stress management research and policies that were oriented towards the target of eradicating deaths due to heat stress. This policy and research direction, as such, has been strongly guided by the state's safety agenda and utilised to demonstrate to the public that all efforts have been taken to comprehensively mitigate the risks of heat.

When the heat is on: High temperature resistance of buds from European tree species.

The heat resistance of meristematic tissues is crucial for the survival of plants exposed to high temperatures, as experienced during a forest fire. Although the risk and frequency of forest fires are increasing due to climate change, knowledge about the heat susceptibility of buds, which enclose apical meristems and thus enable resprouting and apical growth, is scarce. In this study, the heat resistance of buds in two different phenological stages was experimentally assessed for 10 European tree species. Cellular heat tolerance of buds was analyzed by determining the electrolyte leakage following heat exposure. Further, the heat insulation capability was tested by measuring the time required to reach lethal internal temperatures linked to bud traits. Our results highlighted differences in cellular heat tolerance and insulation capability among the study species. The phenological stage was found to affect both the thermal stability of cells and the buds' insulation. Further, a good relationship between size-related bud traits and insulation capability was established. Species-specific data on the heat resistance of buds give a more accurate picture of the fire susceptibility of European tree species and provide useful information for estimating tree post-fire responses more precisely.

Heat stress in rice vermicelli manufacturing factories.

OBJECTIVE: This study provides an assessment of heat stress in indoor rice vermicelli manufacturing factories. METHODS: Worker interviews and heat stress assessments were conducted in food manufacturing factories in Singapore. The Wet Bulb Globe Temperature (WBGT) and Heat Stress Index (HSI) were used as heat stress indicators. RESULTS: The highest WBGT and HSI levels recorded in the rice vermicelli manufacturing factories were 36.68°C and 3777 in the drying and steaming process respectively. These levels were above the recommended permissible HSI and WBGT action limit for heat exposure and considered to be high risk. CONCLUSION: Workers in indoor rice vermicelli manufacturing factories can be exposed to heat stress, and the current measures in place may not be sufficient to protect workers against heat stress injuries. Preventive measures such as engineering controls and heat acclimatization programs are important.

Exertional Heat Illness in American Football Players: When Is the Risk Greatest?

CONTEXT: Knowledge about the specific environmental and practice risks to participants in American intercollegiate football during preseason practices is limited. Identifying risks may mitigate occurrences of exertional heat illness (EHI). OBJECTIVE: To evaluate the associations among preseason practice day, session number, and wet bulb globe temperature (WBGT) and the incidence of EHI. DESIGN: Descriptive epidemiology study. SETTING: Sixty colleges and universities representing 5 geographic regions of the United States. PATIENTS OR OTHER PARTICIPANTS: National Collegiate Athletic Association football players. MAIN OUTCOME MEASURE(S): Data related to preseason practice day, session number, and WBGT. We measured WBGT every 15 minutes during the practice sessions and used the mean WBGT from each session in the analysis. We recorded the incidence of EHIs and calculated the athlete-exposures (AEs). RESULTS: A total of 553 EHI cases and 365 810 AEs were reported for an overall EHI rate of 1.52/1000 AEs (95% confidence interval [CI] = 1.42, 1.68). Approximately 74% (n = 407) of the reported EHI cases were exertional heat cramps (incidence rate = 1.14/1000 AEs; 95% CI = 1.03, 1.25), and about 26% (n = 146) were a combination of exertional heat syncope and heat exhaustion (incidence rate = 0.40/1000 AEs; 95% CI = 0.35, 0.48). The highest rate of EHI occurred during the first 14 days of the preseason period, and the greatest risk was during the first 7 days. The risk of EHI increased substantially when the WBGT was 82.0°F (27.8°C) or greater. CONCLUSIONS: We found an increased rate of EHI during the first 14 days of practice, especially during the first 7 days. When the WBGT was greater than 82.0°F (27.8°C), the rate of EHI increased. Sports medicine personnel should take all necessary preventive measures to reduce the EHI risk during the first 14 days of practice and when the environmental conditions are greater than 82.0°F (27.8°C) WBGT.

The secondary school football coach's relationship with the athletic trainer and perspectives on exertional heat stroke.

CONTEXT: Prior researchers have examined the first-aid knowledge and decision making among high school coaches, but little is known about their perceived knowledge of exertional heat stroke (EHS) or their relationships with an athletic trainer (AT). OBJECTIVE: To examine secondary school football coaches' perceived knowledge of EHS and their professional relationship with an AT. DESIGN: Qualitative study. SETTING: Web-based management system. PATIENTS OR OTHER PARTICIPANTS: Thirty-eight secondary school head football coaches (37 men, 1 woman) participated in this study. Their average age was 47 ± 10 years old, and they had 12 ± 9 years' experience as a head football coach. DATA COLLECTION AND ANALYSIS: Participants responded to a series of online questions that were focused on their perceived knowledge of EHS and professional relationships with ATs. Data credibility was established through multiple-analyst triangulation and peer review. We analyzed the data by borrowing from the principles of a general inductive approach. RESULTS: Two dominant themes emerged from the data: perceived self-confidence of the secondary school coach and the influence of the AT. The first theme highlighted the perceived confidence, due to basic emergency care training, of the coach regarding management of an emergency situation, despite a lack of knowledge. The second theme illustrated the secondary school coach's positive professional relationships with ATs regarding patient care and emergency procedures. Of the coaches who participated, 89% (34 out of 38) indicated positive interactions with their ATs. CONCLUSIONS: These secondary school coaches were unaware of the potential causes of EHS or the symptoms associated with EHS, and they had higher perceived levels of self-confidence in management abilities than indicated by their perceived knowledge level. The secondary school football coaches valued and understood the role of the AT regarding patient and emergency care.