Defence personnel often push themselves to the physical limit in the pursuit of their public duties. Combined with heavy kit - an average of around 55-60kgs - full combat gear, boots, weapons, extreme environments and temperatures - duty can take its toll. As a result, one of the biggest challenges for defence personnel on missions in hot climates is heat stress caused by the body’s inability to thermoregulate properly. The British Medical Journal defines heat stress as where the core body temperature reaches 40°C with central nervous system (CNS) dysfunction, which can lead to delirium, coma and in the worst cases, death. 

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In 2016, ‘superfit’ Cpl Joshua Hoole died after an eight-mile test march in the Brecon Beacons on the hottest day of the year. Just three years earlier, three SAS candidates died in similar conditions around Pen-y-Fan, the highest peak in southern Britain (Brecon). These are extreme cases but heat stress in milder forms - heat cramps and heat exhaustion - is a common occurrence where a soldier may become dehydrated, delirious, and unable to perform to the best of their abilities. This can impact operational effectiveness, require possible emergency evacuation, loss of manpower or worse. The 2016 incident has refocused scrutiny on the measures that military organisations, like the MoD, are putting in place to keep personnel safer in challenging conditions.

Heat stress is considered more preventable than treatable. So identifying risk factors can help, including; understanding which soldiers are at greater risk, implementing management strategies such as buddy systems, and delivering specific acclimatisation and training programmes and education. However this can be costly and time consuming and potentially result in troops not necessarily working together. It is also unclear how successful these strategies are. Other measures include new designs for uniforms and garments that can lower core body temperature, all for immediate treatment. All of these may prove life-saving in some cases but it is currently not possible to identify exactly when a soldier is at direct risk or when core body temperatures are rising to critical levels.

Could technology help keep soldiers safer?
Technology is indisputably a major part of the answer. Commercial off-the-shelf (COTS) wearables like smartwatches and glasses, health and activity trackers are gaining huge momentum in the consumer world, with military organisations keen to take advantage. For any device to be considered by the military, however, it needs to meet stringent standards, and this is why some innovators are building military-grade wearables, specifically designed to support the welfare of soldiers in both training scenarios and in battle.

A new wave of hearable ear-worn devices is emerging to meet these needs. The ear is the only place in the body that all vital signs can be accurately and unobtrusively monitored in real time during training or in action. They can monitor vital signs including core body temperature, heart rate, VO2, distance and cadence; they can also tell whether a soldier has fallen. One such device sends physiological and biometric data wirelessly from the earpiece – which sits snugly under headgear – to a smart device such as ruggedised tablet, a smartwatch or via a communications device, or the data can simply be stored on the device for download later. Immediate access to the data means these devices would significantly reduce the risk of heat injury or other physiological stresses, through timely interventions. They would also improve physical performance and recovery time and better inform training or warfare strategies.

Reliable data
Data delivered from the device can be useful in a range of scenarios. For example, if one or a group of soldiers falls in the field, data can help piece together what went wrong; shaping future training strategies. If a medic or squadron leader has access to data from the outset, they have a better picture of what treatment is required and what may have happened. Longer term, data can also be analysed and patterns understood to benchmark normal and peak states for each soldier to understand typical responses to physiological stress.

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MoD’s modern future
The MoD is going through a period of significant modernisation and digitisation with initiatives such as C4ISR and Mike Stone’s adoption of common IT and standardising technologies, which are making a leaner, more agile IT operation improving support to soldiers actively involved in training and warfare. New solutions like Internet of Things (IoT), connected devices, drones, unmanned aerial systems (UAS) and robots, are now widely being used for automation, monitoring ammunition, fuel, vehicles, weapons and enemy environments. Yet it is also important to protect and secure the wellbeing of soldiers and servicemen too.

Wearables – and more specifically hearables – can help deliver the necessary understanding of each soldier’s physiology and help protect each soldier from injury. Data captured can help construct a deep understanding about how soldiers cope physiologically with specific training and battle scenarios and, eventually, reduce illness and improve the performance of individual service men and women and even predict the onset of conditions they have not yet experienced. Through measuring multiple vital signs with one device and in real-time, physiological warning signs can be identified, enabling early intervention, improving a squad’s overall well-being and allowing for the fine-tuning of training and operations.

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