Heat Mitigation Strategies Employed at the U.S. Air Force's Special Warfare Training Pipeline.

Despite interventions at the SWTW, EHI remained prevalent to include an EHS proportion surge (1.80%) in FY24, indicating potential limitations and need for improved training adaptations, early detection, and risk management in high-intensity environments. Achieving zero EHI may not be feasible, thus, leadership must make decisions that acknowledge risk and apply evidence-based strategies to meet mission objectives. Seasonal patterns suggest tailored interventions may be necessary. Future studies should assess morbidity metrics, trainee fitness, and acclimatization to further evaluate and refine prevention strategies.