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Abstract
Athletic trainers must consider environmental conditions when making decisions concerning football practices. Those working in southern settings are faced with stressful environmental conditions often associated with the late summer and early fall. Strategies to minimize heat stress include proper acclimatization, hydration, conditioning, heat illness recognition, and weather monitoring. The purpose of this study was to evaluate the rate of exertional heat illness (EHI) in athletes during a three month period (August-October) at five southeastern universities. The Heat Stroke Checker (KEM Kyoto Electronics Manufacturing Ltd; Japan) was used to measure environmental conditions three times a day at each location. The American College of Sports Medicine (ACSM) and Department of Defense (DOD) Wet Bulb Globe Temperature (WBGT) Heat Stress Index Charts were used to identify the levels of heat illness risk. Heat cramps, heat syncope, heat exhaustion, heat stroke, and hyponatremia were evaluated based on the NATA Exertional Heat Illness position statement. A reportable injury was any athlete who incurred a heat related illness evaluated by the medical staff. A total of 139 heat-illnesses were reported with an EHI rate of 4.19/1000 athlete-exposures (AE) during the three-month period. No cases of heat stroke or hyponatremia were reported. Evaluating each month individually, the greatest number of EHIs occurred during August (88%) with an EHI rate of 8.95/1000 AE. During August, the EHI rate was 6.31/1000 AE for heat cramps, 2.06/1000 AE for heat exhaustion and 0.58/1000 AE for heat syncope. Pearson correlations between the ACSM and DOD Heat Stress Index Charts and specific heat illnesses were not statistically significant relationships (p>.05). In our study we found a higher heat exhaustion injury rate compared to the NCAA surveillance data possibly due to differences in EHI definitions and reporting mechanisms. The incidence of heat illness in the months of September and October decreased dramatically, suggesting football athletes are at greatest risk of heat illness during August. Our data suggests that during the late summer, previously reported guidelines may overstate the risk of heat illness in highly trained football athletes practicing with the southeastern United States. The development of regionally specific heat index guidelines is recommended.