Fit to fight - from military hygiene to wellbeing in the British Army.

This paper reviews the historical evolution of the language and organization surrounding the health of personnel in the British Army from 'hygiene' through  to 'wellbeing'. It starts by considering the health of the army in the mid-nineteenth century and the emergence of military hygiene as a professional subject. It continues by looking at advances in military hygiene in the two world wars. Hygiene was replaced by the term 'health' in the 1950s as the collective noun used by professionals working in this field. This unity split when the professions of occupational medicine and public health established separate faculties and training pathways. However, the health issues for the armed forces remain fundamentally unchanged. Going forward, the term 'wellbeing' is helping to refresh the close relationships between executives, their medical advisers and those within the population of health professions charged with keeping the British Army healthy. The core theme is the collaborations between civil society, executive leadership and medical services in maximizing the health of the military population from recruitment through to life as a veteran.

The usefulness of hand washing during field training to prevent acute respiratory illness in a military training facility.

Hand washing plays a key role in preventing respiratory infection in many clinical settings. However, its effectiveness in preventing acute respiratory illness (ARI) during field training in military training facilities has been not studied.A quasi-interventional study was performed to evaluate the prevalence of ARIs over 4 weeks in a Korean army training center in South Korea from January 2009 to February 2009. A total of 1291 recruits participating in military training for 4 weeks were randomly distributed to 2 battalions (one with 631 and the other with 660). After noticing there is a difference between the 2 battalions in terms of the development of ARIs at the end of 2 weeks of training, we conducted interviews with the battle commanders to determine factors that may be related to one battalion having a higher incidence of ARI. Thereafter, we performed an intervention, which consists of instructing the battalion having a higher incidence of ARI to implement field hand washing from the third week. Following the intervention, we compared the cumulative rate of ARI during 4 weeks of training.The interviews revealed that there were no major differences between the 2 battalions in terms of the training schedules, living environments, or indoor hand washing methods. However, there was difference in terms of hand washing during field training for the first 2 weeks; whereas one battalion (the early hand washing group) implemented hand washing during field training starting in the first week, the other battalion did not implement hand washing for the first 2 weeks but instead began in the third week (the late hand washing group). The cumulative incidence rate of ARI during 4 weeks of training was significantly lower in the early hand washing group (13.0%, 95% confidence interval [CI]: 10.6%-15.9%) than in the late hand washing group (28.0%, 95% CI, 24.7%-31.5%).Our study suggests that outdoor hand washing during field training may be an effective precaution for reducing ARI incidence among recruits participating in military training.

Tactical combat movements: inter-individual variation in performance due to the effects of load carriage.

An examination into the effects of carried military equipment on the performance of two tactical combat movement simulations was conducted. Nineteen Airfield Defence Guards performed a break contact (five 30-m sprints) and a fire and movement simulation (16 6-m bounds) in five load conditions (10-30 kg). Heavier loads significantly increased movement duration on the break contact (0.8%/kg load) and fire and movement (1.1%/kg). Performance deterioration was observed from the beginning to the end of the series of movements (bounds or sprints) with deterioration becoming significantly greater in heavier load conditions. Inter-individual variation between slower and faster participants showed a range in load effects; 0.6, 0.8%/kg for fast and 1.0, 1.4%/kg for slow (break contact, fire and movement, respectively). Velocity profiles revealed that the initial acceleration and peak velocity were the primary determinants of performance. As the duration of these tactical combat movements reflects periods of heightened vulnerability, these findings highlight important implications for commanders. Practitioner Summary: Increasing amounts of carried military equipment impairs the performance of tactical combat movements. Examination of inter-individual variation in velocity profiles identified that the initial acceleration and the peak velocity achieved during sprints and bounds are key determinants of overall performance.

Lift performance and lumbar loading in standing and seated lifts.

This study investigated the effect of posture on lifting performance. Twenty-three male soldiers lifted a loaded box onto a platform in standing and seated postures to determine their maximum lift capacity and maximum acceptable lift. Lift performance, trunk kinematics, lumbar loads, anthropometric and strength data were recorded. There was a significant main effect for lift effort but not for posture or the interaction. Effect sizes showed that lumbar compression forces did not differ between postures at lift initiation (Standing 5566.2 ± 627.8 N; Seated 5584.0 ± 16.0) but were higher in the standing posture (4045.7 ± 408.3 N) when compared with the seated posture (3655.8 ± 225.7 N) at lift completion. Anterior shear forces were higher in the standing posture at both lift initiation (Standing 519.4 ± 104.4 N; Seated 224.2 ± 9.4 N) and completion (Standing 183.3 ± 62.5 N; Seated 71.0 ± 24.2 N) and may have been a result of increased trunk flexion and a larger horizontal distance of the mass from the L5-S1 joint. Practitioner Summary: Differences between lift performance and lumbar forces in standing and seated lifts are unclear. Using a with-in subjects repeated measures design, we found no difference in lifted mass or lumbar compression force at lift initiation between standing and seated lifts.

[Hygienic aspects of development and testing of individual military armour].

Hygienic aspects of development and testing of individual military armour. The article is devoted to scientific substantiation of proposals aimed at improving certain physical and hygienic properties of the personal body armour (PBA) and their test methods. The authors performed an analysis of the development of domestic and foreign PBA production. Analysed and described construction, ergonomic and medical-and-technical characteristics of PBA. The role of the study of hygienic, mechanical and ergonomic indicators in assessing the dynamics of the vector and the further development of PBA is presented. Substantiated proposals for their improvement.

[Present condition and perspective of development of self-care decontamination products].

Present condition and perspective of development of self-care decontamination products. This work provides data describing the current state and perspectives of development of self-care decontamination products for neutralization and removal of poisonous and highly toxic biologic and radioactive agents from open human body surfaces and close- fitting cloth. The history of self-care decontamination products creation in Russia and foreign countries is represented. The detailed performance characteristics of the developed individual anti-gas kits IPP-3, IPP-51, IPP-8, IPP-10, IPP-11, which were accepted to the Army and the Navy supply in the 1920-1930s, during the Great Patriotic war, in post-war period and now, are given. The individual anti-gas kits RSDL, M291, M295 and MKI for government-issue equipment of North Atlantic nations' armies are described in detail. It was showed that the general limitation both of the native and foreign anti-gas kit models is the poor efficacy against exposure of vesicants from the group of blister warfare agents. The most perspective research guidelines in creation of new self-care decontamination products. are validated.

[Peculiarities of sanitary and epidemiological (preventive) measures aimed at contraction and spread control of Ebola virus disease].

Now the Ebola virus continues to extend in the Western Africa. Cases, including with lethal outcomes are also registered in the countries of Europe and America. The probability of drift of this disease on the territory of the Russian Federation, including through the foreign military personnel who is trained in the country isn't excluded. For prevention of drift and distribution in Russia of the illness caused by the Ebola virus the complex of sanitary and anti-epidemic (preventive) actions is developed and introduced in practice of military health care. The specified actions allow to control an epidemiological situation on this infection and can be recommended for use to military medical experts at all levels.

Vaginal yeast infections while deployed in Southwest/Central Asia, active component females, U.S. Armed Forces, 2008-2013.

In field settings, female service members may not have adequate access to bathrooms, showers, laundry, or sanitary products necessary to maintain adequate feminine hygiene; therefore, service women may be at risk for vaginal yeast infections while deployed. During the 6-year surveillance period, nearly 3,000 U.S. military service women were diagnosed with at least one clinically significant yeast infection while supporting combat operations in Southwest/Central Asia. The crude overall incidence rate was 35.1 per 1,000 person-years (p-yrs). Overall incidence rates were higher among black, non-Hispanic service women, and among those in the Army and Air Force, in enlisted grades, and in communications/intelligence and motor transport occupations. The yearly rate of yeast infections was relatively stable from 2008 through 2010, then decreased in 2011 through 2013. Prior to deploying to austere operational settings, female service members should be provided practical and useful information, realistic training, and material support to decrease the risk of acquiring and increase the effectiveness of treating clinically and military operationally significant yeast infections.

The Portable Chemical Sterilizer (PCS), D-FENS, and D-FEND ALL: novel chlorine dioxide decontamination technologies for the military.

There is a stated Army need for a field-portable, non-steam sterilizer technology that can be used by Forward Surgical Teams, Dental Companies, Veterinary Service Support Detachments, Combat Support Hospitals, and Area Medical Laboratories to sterilize surgical instruments and to sterilize pathological specimens prior to disposal in operating rooms, emergency treatment areas, and intensive care units. The following ensemble of novel, 'clean and green' chlorine dioxide technologies are versatile and flexible to adapt to meet a number of critical military needs for decontamination(6,15). Specifically, the Portable Chemical Sterilizer (PCS) was invented to meet urgent battlefield needs and close critical capability gaps for energy-independence, lightweight portability, rapid mobility, and rugged durability in high intensity forward deployments(3). As a revolutionary technological breakthrough in surgical sterilization technology, the PCS is a Modern Field Autoclave that relies on on-site, point-of-use, at-will generation of chlorine dioxide instead of steam. Two (2) PCS units sterilize 4 surgical trays in 1 hr, which is the equivalent throughput of one large steam autoclave (nicknamed "Bertha" in deployments because of its cumbersome size, bulky dimensions, and weight). However, the PCS operates using 100% less electricity (0 vs. 9 kW) and 98% less water (10 vs. 640 oz.), significantly reduces weight by 95% (20 vs. 450 lbs, a 4-man lift) and cube by 96% (2.1 vs. 60.2 ft(3)), and virtually eliminates the difficult challenges in forward deployments of repairs and maintaining reliable operation, lifting and transporting, and electrical power required for steam autoclaves.

[Status and development prospects of radiological health in the Navy].

More than 7.5 thousands of people work as military and civilian personnel and have an access to a lot of sources of ionizing radiation on ships and vessels, at coastal units and institutions of the Navy. This fact determines the importance of radiation safety and medical preventive measures on naval fleets. The article analyses the state of radiation-hygienic measures, outlines the conceptual basis for the development of radiation hygiene in the Navy. Substantiated reconstruction tasks effectiveness of health control and state sanitary and epidemiological supervision of radiation safety, provides information about the optimal set of instruments for radiation monitoring equipment radiobiological laboratories and centres of state sanitary and epidemiological supervision at various levels.

[Primary diagnostics of nutritional status in draftees].

Economic crisis phenomena primarily affect negatively the consumer market of foods. And a human being needs adequate nutrition. In adolescence, the growing organism is most susceptible to imbalanced and physical activity-inadequate nutrition. The authors propose to use the Quetlet body mass index estimated in draftees for the sociohygienic monitoring of the population's well-being and an actual and economic access to foodstuffs in the broad segments of the population. The efficiency of the approach has been demonstrated during a long-term follow-up of navy draftees (about 150 thousand recruits in 1995-2010).

Examinations regarding the prevalence of intestinal parasitic diseases in Polish soldiers contingents assigned to missions abroad.

The aim of this paper is to present the program of diagnostic examinations regarding the detection and following treatment of intestinal parasitic diseases in the population of Polish soldiers serving in different climatic and sanitary conditions. Intestinal parasitoses remain one of the health problems of soldiers participating in contemporary military operations. This fact mainly results from unsatisfactory sanitary and hygienic standards in the regions where troops are deployed, contamination of water and soil, inappropriate processes of purifying drinking water, and the terrible condition of sewage systems, water purification plants, or sewage treatment facilities. The occurrence of such diseases is further facilitated by disregard of some basic principles of food and feeding hygiene. Mass examinations of Polish troops to find the prevalence of intestinal parasitoses will cause a decrease in the morbidity rate of parasitic diseases among Polish soldiers deployed in military operations. They can also lead to a decrease in expenditure on medical treatment of disease-related complications and on damages awarded to soldiers who have developed a serious disease while being engaged in a mission abroad.

Vulnerabilidades de salud y la sostenibilidad de la defensa / Health vulnerabilities and the defense maintenance

La doctrina militar cubana demanda garantizar la sostenibilidad de la defensa para el cumplimiento de sus misiones en las etapas de la guerra de todo el pueblo. La invulnerabilidad militar del país necesita, que el hombre, aún en condiciones complejas, aprenda a convivir en ambientes saludables. Lo anterior garantiza el mantenimiento de una situación higiénico-epidemiológica favorable que posibilite el desarrollo de las capacidades productiva, combativa y movilizativa de las tropas y de las comunidades, requerimiento indispensable tanto en tiempo de paz como de guerra. Es propósito de este artículo, profundizar en los conceptos de vulnerabilidad y sostenibilidad, y su aplicación en la gestión a nivel local para beneficio de la salud de los grupos humanos. La estabilidad de la situación de salud en condiciones excepcionales es uno de los objetivos del trabajo higiénico-epidemiológico, el cual debe tener en cuenta, las enfermedades infectocontagiosas supeditadas al deterioro ambiental que se produce al prolongarse la defensa y las enfermedades no transmisibles que son una importante causa de incapacidad y mortalidad. La identificación y solución de las vulnerabilidades constituye una estrategia priorizada para enfrentar los complejos escenarios futuros, que tienen como principales protagonistas los cambios ecológicos asociados a la polución ambiental, además de otras amenazas tecnológicas y sanitarias. La incorporación de los principios de la vulnerabilidad y la sostenibilidad contribuyen, a enfrentar, con un enfoque territorial, cualquier situación de emergencia en el país(AU)

The Cuban military doctrine claims the defense sustainment to fulfill its missions in the war stages of all the population. The military invulnerability of our country needs that the man even in complex situations, to learn to live together in healthy environments. The above stated guarantees the maintenance of a favorable hygienic-epidemiologic situation allowing the development of productive, combative and mobilization abilities of troops and of communities, an essential requirement in pace and in war times. The aim of present paper is to deepen in vulnerability and sustainment features and its implementation in management at local level to health benefit of the human groups. The stability of health situation under exceptional conditions is one of the objectives of the hygienic-epidemiologic task taking into account the infectious-contagious diseases subordinate to environmental deterioration produced due to defense lengthening where the non-communicable diseases are a leading cause of inability and mortality. Identification and solution of vulnerabilities is a priority strategy to confront the future complex scenarios where the main participants are the ecological changes associated with the environmental pollution, as well as other health and technologic threats. The incorporation of vulnerability and sustainment principles contribute to confront, with a territorial approach, any emergence situation in our country(AU)

Pursuing cleanliness in a field surgical environment.

Perioperative military nurses often are faced with the challenge of providing a clean surgical milieu in environments that are decidedly hostile to cleanliness. The combination of temperature extremes, blowing sand, dirt, mud, infection vectors, and the nature of battlefield wounds thwart the best intentions of maintaining cleanliness. Mitigating these problems requires setting priorities, teamwork, a rigorous daily regimen of cleaning, and a willingness to make improvements as opportunities become available.

Geografía médica de Haití / No disponible

El aumento del despliegue de nuestras Fuerzas Armadas en zones geográficas en las que son endémicas enfermedades de escaso o nulo riesgo epidemiológico en nuestro país hace que sea de gran importancia el conocimiento de las condiciones donde van a desarrollar la misión, así como de informar de las mismas y de poner en práctica medios para prevenirlas. Uno de estos lugares es Haití, donde la resolución 1.542 de la ONU se establece el despliegue de una Fuerza Multinacional (MINUSTAH) en la que España participa con 200 infantes de marina (FIMETX-II). Con este trabajo queremos informar a los miembros de nuestro Ejército que desplieguen en Haití de los riesgos sanitarios existentes, así como de loas medidas que deben tomar, antes, durante y después de la estancia, con el fin de prevenir las enfermedades más frecuentes en su país

No disponible