title: Environmental conditions and the occurrence of exertional heat illnesses and exertional heat stroke at the Falmouth Road Race.
abstract: BACKGROUND
  The Falmouth Road Race is unique because of the environmental conditions and relatively short distance, which allow runners to maintain a high intensity for the duration of the event. Therefore, the occurrence of exertional heat illnesses (EHIs), especially exertional heat stroke (EHS), is 10 times higher than in other races.
  
  
  OBJECTIVE
  To summarize the occurrence and relationship of EHI and environmental conditions at the Falmouth Road Race.
  
  
  METHODS
  Descriptive epidemiologic study.
  
  
  METHODS
  An 11.3-km (7-mile) road race in Falmouth, Massachusetts.
  
  
  METHODS
  Runners who sustained an EHI while participating in the Falmouth Road Race.
  
  
  METHODS
  We obtained 18 years of medical records and environmental conditions from the Falmouth Road Race and documented the incidence of EHI, specifically EHS, as related to ambient temperature (Tamb), relative humidity, and heat index (HI).
  
  
  RESULTS
  Average Tamb, relative humidity, and HI were 23.3 ± 2.5°C, 70 ± 16%, and 24 ± 3.5°C, respectively. Of the 393 total EHI cases observed, EHS accounted for 274 (70%). An average of 15.2 ± 13.0 EHS cases occurred each year; the incidence was 2.13 ± 1.62 cases per 1000 runners. Regression analysis revealed a relationship between the occurrence of both EHI and EHS and Tamb (R(2) = 0.71, P = .001, and R(2) = 0.65, P = .001, respectively) and HI (R(2) = 0.76, P < .001, and R(2) = 0.74, P < .001, respectively). Occurrences of EHS (24.2 ± 15.5 cases versus 9.3 ± 4.3 cases) and EHI (32.3 ± 16.3 versus 13.0 ± 4.9 cases) were higher when Tamb and HI were high compared with when Tamb and HI were low.
  
  
  CONCLUSIONS
  Because of the environmental conditions and race duration, the Falmouth Road Race provides a unique setting for a high incidence of EHS. A clear relationship exists between environmental stress, especially as measured by Tamb and HI, and the occurrence of EHS or other EHI. Proper prevention and treatment strategies should be used during periods of high environmental temperatures as the likelihood of runners experiencing EHS is exacerbated in these harsh conditions.
authors: Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs;
authors: Julie K
authors: JK
authors: DeMartini
authors: Douglas J
authors: DJ
authors: Casa
authors: Luke N
authors: LN
authors: Belval
authors: Arthur
authors: A
authors: Crago
authors: Rob J
authors: RJ
authors: Davis
authors: John J
authors: JJ
authors: Jardine
authors: Rebecca L
authors: RL
authors: Stearns
mesh_terms: D001831:Body Temperature / Q000502:physiology*; D004781:Environmental Exposure / Q000009:adverse effects*; D018883:Heat Stroke / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D006358:Hot Temperature / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008404:Massachusetts / Q000453:epidemiology; D005082:Physical Exertion / Q000502:physiology*; D012189:Retrospective Studies; D012420:Running
keywords: heat stress; thermoregulation