{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T07:33:49Z","timestamp":1777880029824,"version":"3.51.4"},"reference-count":27,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T00:00:00Z","timestamp":1750982400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Triservice Nursing Research Program"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Workplace Health Saf"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Heat stress injury (HSI) is an occupational hazard for industrial workers. For active-duty Sailors, shipyard conditions of high ambient temperatures, confined spaces, and increased fire-fighting training exacerbate those risks. This evidence-based practice project aimed to decrease Sailor HSI cases on a U.S. Navy ship undergoing multi-year shipyard maintenance after high numbers of HSI events over 5\u2009months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Three mitigation efforts augmented existing guidelines to decrease HSI rates among Sailors: (1) distribution of oral rehydration solution (ORS) and hydration protocol; (2) scaled personal protective equipment (PPE) wear during firefighting training based on wet-bulb globe temperature; (3) targeted education about HSI risk factors, identification, first aid, and prevention. HSI-related medical response team activations data were collected from ship\u2019s logs at baseline and for 2\u2009years following implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings:<\/jats:title>\n                    <jats:p>\n                      1,700 Sailors received education, 185 drills occurred with scaled PPE, and 35,500 servings of ORS were distributed. Sailor HSI events at baseline were higher (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200910) than civilians (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.046). After implementation, Sailor HSI events decreased in years 1 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095) and 2 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092) and were not significantly different from civilian HSI rate in years 1 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.112) and 2 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.101) who were excluded from interventions. Estimated HSI odds for 2023 Sailors were 70% lower (\n                      <jats:italic>OR<\/jats:italic>\n                      \u2009=\u20090.3, 95% CI [0.02, 4.06]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Application to Practice:<\/jats:title>\n                    <jats:p>Shipyard-specific, multi-pronged interventions effectively reduced HSI events over multiple years, which may be adapted to other occupational environments.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21650799251345842","type":"journal-article","created":{"date-parts":[[2025,6,27]],"date-time":"2025-06-27T13:40:22Z","timestamp":1751031622000},"page":"516-523","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["A Multi-Pronged Approach to Shipyard Heat Stress Injury Prevention"],"prefix":"10.1177","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6193-462X","authenticated-orcid":false,"given":"Emily","family":"Latimer","sequence":"first","affiliation":[{"name":"US Navy Nurse Corps, Emergency Department, Naval Medical Center Camp Lejeune"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron","family":"Georgas","sequence":"additional","affiliation":[{"name":"US Navy Nurse Corps, Ship\u2019s Nurse, USS John C. Stennis (CVN 74)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1645-9921","authenticated-orcid":false,"given":"Andrea","family":"McGlynn","sequence":"additional","affiliation":[{"name":"Navy Medicine Readiness &amp; Training Command Portsmouth, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0045-6035","authenticated-orcid":false,"given":"Melissa","family":"Troncoso","sequence":"additional","affiliation":[{"name":"Daniel K. Inouye Graduate School of Nursing, Uniformed Services University of Health Sciences"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,6,27]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2009.329"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.2040-4603.2014.tb00555.x"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11894-014-0376-2"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.7205\/MILMED.170.8.715"},{"issue":"4","key":"e_1_3_3_6_1","article-title":"Intravenous versus oral rehydration: Physiological, performance, and legal considerations","volume":"7","author":"Casa D. J.","year":"2008","unstructured":"Casa D. J., Ganio M. S., Lopez R. M., McDermott B. P., Armstrong L. E., Maresh C. M. (2008). Intravenous versus oral rehydration: Physiological, performance, and legal considerations. 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