Publications by authors named "Stephen A Lewandowski"

Objectives: To characterise intrinsic and extrinsic (climatic) risks for mild and severe exertional heat illness (EHI) among first-year army enlistees.

Methods: We examined 337 786 soldiers who enlisted between 2012 and 2019. Survival models were used to predict incident EHI from intrinsic factors (demographics, healthcare utilisation, chronic conditions, body mass index (BMI), Army Physical Fitness Test (APFT), upper/lower respiratory tract infections (URTI and LRTI), skin and soft-tissue infections (SSTI), extrinsic factors (geographical region, daily mean Universal Thermal Climate Index (UTCI), wet bulb globe temperature (WBGT)) and interactions.

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The American Lung Association's "State of the Air" 2023 report reveals almost 36% of Americans live with unhealthy levels of air pollution. Studies link air pollution with acute respiratory symptoms and exacerbation of respiratory and cardiovascular diseases. Differential air pollution exposures between white and nonwhite communities are significant components of environmental injustices.

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This study characterized associations between annually scaled thermal indices and annual heat stress illness (HSI) morbidity outcomes, including heat stroke and heat exhaustion, among active-duty soldiers at ten Continental U.S. (CONUS) Army installations from 1991 to 2018.

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Heat stress illnesses represent a rising public health threat; however, associations between environmental heat and observed adverse health outcomes across populations and geographies remain insufficiently elucidated to evaluate risk and develop prevention strategies. In particular, military-relevant large-scale studies of daily heat stress morbidity responses among physically active, working-age adults to various indices of heat have been limited. We evaluated daily means, maximums, minimums, and early morning measures of temperature, heat index, and wet bulb globe temperature (WBGT) indices, assessing their association with 31,642 case-definition heat stroke and heat exhaustion encounters among active duty servicemembers diagnosed at 24 continental US installations from 1998 to 2019.

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