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Mp-Hfm-086-$$All NORTH ATLANTIC TREATY RESEARCH AND TECHNOLOGY ORGANISATION ORGANISATION AC/323(HFM-086)TP/54 www.rta.nato.int RTO MEETING PROCEEDINGS MP-HFM-086 Maintaining Hydration: Issues, Guidelines, and Delivery (Le maintien de l’hydratation : enjeux, principes directeurs et logistique) Papers presented at the RTO Human Factors and Medicine Panel (HFM) Specialists’ Meeting held in Boston, United States, 10-11 December 2003. This Meeting was organized back to back with a USARIEM and the American College of Sports Medicine (ACSM) Specialists’ Meeting on "Hydration and Physical Activity" from 8-9 December 2003. Papers published in Annex to RTO-MP-HFM-086. Published July 2004 Distribution and Availability on Back Cover NORTH ATLANTIC TREATY RESEARCH AND TECHNOLOGY ORGANISATION ORGANISATION AC/323(HFM-086)TP/54 www.rta.nato.int RTO MEETING PROCEEDINGS MP-HFM-086 Maintaining Hydration: Issues, Guidelines, and Delivery (Le maintien de l’hydratation : enjeux, principes directeurs et logistique) Papers presented at the RTO Human Factors and Medicine Panel (HFM) Specialists’ Meeting held in Boston, United States, 10-11 December 2003. This Meeting was organized back to back with a USARIEM and the American College of Sports Medicine (ACSM) Specialists’ Meeting on "Hydration and Physical Activity" from 8-9 December 2003. Papers published in Annex to RTO-MP-HFM-086. The Research and Technology Organisation (RTO) of NATO RTO is the single focus in NATO for Defence Research and Technology activities. Its mission is to conduct and promote co-operative research and information exchange. The objective is to support the development and effective use of national defence research and technology and to meet the military needs of the Alliance, to maintain a technological lead, and to provide advice to NATO and national decision makers. The RTO performs its mission with the support of an extensive network of national experts. It also ensures effective co-ordination with other NATO bodies involved in R&T activities. RTO reports both to the Military Committee of NATO and to the Conference of National Armament Directors. It comprises a Research and Technology Board (RTB) as the highest level of national representation and the Research and Technology Agency (RTA), a dedicated staff with its headquarters in Neuilly, near Paris, France. In order to facilitate contacts with the military users and other NATO activities, a small part of the RTA staff is located in NATO Headquarters in Brussels. The Brussels staff also co-ordinates RTO’s co-operation with nations in Middle and Eastern Europe, to which RTO attaches particular importance especially as working together in the field of research is one of the more promising areas of co-operation. The total spectrum of R&T activities is covered by the following 7 bodies: • AVT Applied Vehicle Technology Panel • HFM Human Factors and Medicine Panel • IST Information Systems Technology Panel • NMSG NATO Modelling and Simulation Group • SAS Studies, Analysis and Simulation Panel • SCI Systems Concepts and Integration Panel • SET Sensors and Electronics Technology Panel These bodies are made up of national representatives as well as generally recognised ‘world class’ scientists. They also provide a communication link to military users and other NATO bodies. RTO’s scientific and technological work is carried out by Technical Teams, created for specific activities and with a specific duration. Such Technical Teams can organise workshops, symposia, field trials, lecture series and training courses. An important function of these Technical Teams is to ensure the continuity of the expert networks. RTO builds upon earlier co-operation in defence research and technology as set-up under the Advisory Group for Aerospace Research and Development (AGARD) and the Defence Research Group (DRG). AGARD and the DRG share common roots in that they were both established at the initiative of Dr Theodore von Kármán, a leading aerospace scientist, who early on recognised the importance of scientific support for the Allied Armed Forces. RTO is capitalising on these common roots in order to provide the Alliance and the NATO nations with a strong scientific and technological basis that will guarantee a solid base for the future. The content of this publication has been reproduced directly from material supplied by RTO or the authors. Published July 2004 Copyright © RTO/NATO 2004 All Rights Reserved ISBN 92-837-1124-6 Single copies of this publication or of a part of it may be made for individual use only. The approval of the RTA Information Management Systems Branch is required for more than one copy to be made or an extract included in another publication. Requests to do so should be sent to the address on the back cover. ii RTO-MP-HFM-086 Maintaining Hydration: Issues, Guidelines, and Delivery (RTO-MP-HFM-086) Executive Summary Maintaining body hydration at normal or euhydrated levels is essential to optimize both physical and cognitive performance. Inadequate fluid replacement and a state of dehydration or hypohydration can lead to an increased risk of heat injury. The challenge for the soldier to maintain a euhydrated state is exacerbated when rates of fluid loss are increased such as during exposure to hot environments that can include prolonged periods of work carrying equipment and ammunition and wearing body armour and other forms of protective clothing. The logistics of providing the fluid is of critical importance since the soldier is already expected to carry heavy loads and every kilogram (or litre of fluid) added to the soldier’s pack increases their physiological cost of moving over the terrain. In addition, there is the need for the medical support teams to be prepared to deal with an increased incidence of heat injury, including heat stroke, and the rare cases of hyponatremia that may occur with overhydration. On 10-11 December 2003, scientists, engineers, medical officers and other military representatives from NATO and Partners for Peace countries met in Boston, Massachusetts, U.S.A. for a Human Factors and Medicine Panel (HFM) Specialist's meeting on "Maintaining Hydration: Issues, Guidelines and Delivery”. The purpose of the HFM Specialist’s meeting was to bring together experts from the military and defence science community that could examine the physiological and logistical costs associated with maintaining hydration during recent deployments to the hot climatic regions of the Middle East and mountainous terrains of Afghanistan. There were two keynote addresses and 18 scientific and technical papers presented over the two days. There were 39 registrants from 7 countries with papers given by scientists and medical officers from the Netherlands, United Kingdom and United States. The program was divided into 4 sessions entitled "Hydration Issues and Problems", “Current Military Fluid Guidelines, Requirements and Planning”, “Water Logistics and Delivery System” and “Medical Issues with Fluid/Electrolyte Imbalances”. The US, UK and NE forces experienced significant heat injury cases and problems with maintaining operational tempo during recent deployments to Afghanistan and Iraq. The logistics of providing water to assist with the management of the heat stress was an enormous issue. There is a need to provide more precise estimates of fluid requirements to lessen the loads that the soldier might have to carry and reduce the costs associated with water transport and re-supply. There is the need to continue to validate and improve prediction models for estimating fluid requirements in the operational theatre. There is also a need to improve the ability of the soldier to have access to water on the move as well as improve the delivery and resupply mechanisms. The ability to generate water from other sources such as engine exhausts and purify natural sources of water while on the move is critical for the soldiers of the future to be able to meet the requirements of the Objective Force of self-sustainment for 3-7 days. New methods and technologies to assess the soldier’s hydration status in the field were also presented and discussed with the aim of preparing the soldier of the future to better meet the challenges of maintaining operational requirements during exposure to such extreme environmental temperatures. The discussions clearly documented the heat stress problems facing the military during deployments to countries with extreme environmental conditions. The most significant challenge that remains for the military is to provide sufficient water supply for the fast advancing strike force that may be expected to continue their operations without re-supply for up to 7 days. The soldier cannot be burdened by the need to carry all of their water requirements. New technologies that provide a source of water supply while the soldier is on the move are critical for sustaining operations for the Objective Force warrior and soldier of the future. RTO-MP-HFM-086 iii Le maintien de l’hydratation : enjeux, principes directeurs et logistique (RTO-MP-HFM-086) Synthèse Le maintien de l’hydratation du corps à des niveaux normaux ou euhydratés est indispensable à l’optimisation des performances physiques et cognitives. L’insuffisance du remplacement liquidien, associée à un état de déshydratation ou d’hypohydratation peut accroître le risque de malaise causé par la chaleur. La difficulté qu’éprouve le combattant à maintenir un état d’euhydratation est exacerbée lorsque les pertes de fluides organiques augmentent, comme par exemple lors de l’exposition
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