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Identification of internal risk factors and interventions to prevent exertional heat illnesses in hikers: A systematic review

2024
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Objective: To identify internal risk factors (e.g., caffeine and alcohol consumption, weight, medications, and medical conditions) and intervention strategies for prevention of exertional heat-related illnesses in hikers.Methods: A systematic review was conducted using a predetermined list of MeSH headings to identify articles on exertional heat-related illnesses. CINHAL, MEDLINE, and PubMed databases were searched for articles published between 2009 and 2014. The studies were ranked using the Oxford Centre for Evidence-Based Medicine classification system. Studies were included if they had a level of evidence of 3 or higher or a grade of C or better.Results: The initial search resulted in a total of 330 articles. After the application of the exclusion criteria and analysis using the Oxford Centre for Evidence-Based Medicine classification system, 38 studies and guidelines remained. The studies and guidelines indicated that various medications and medical conditions affect sweat production, core temperature and can reduce the amount of water in the body. Internal factors increase potential for exertional heat-related illnesses: caffeine consumption, alcohol intake, and being overweight. In addition, heat acclimatization is necessary regardless of fitness level.Conclusion: To mitigate exertional heat-related illnesses related to medications, medical providers and dispensing pharmacists can assist patients with proper counseling regarding medications known to disrupt heat responses. Also, education of hikers about the effects of intermixing hiking activities with alcohol or caffeine may prevent or reduce the severity of exertional heat-related illnesses along with proper heat acclimatization.

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