Exertional Heat Illnesses and Environmental Conditions During High School Football Practices.
BACKGROUND
Guidelines for preventing exertional heat illnesses (EHIs) during extreme heat stress should be specific to regional environments, age, and sport and should be based on evidence of reducing the risk. Each year in the United States, over 1 million high school football players practice in the August heat; however, no published data describe the incidence of EHIs in these athletes.


OBJECTIVE
To describe the environmental conditions and incidence of EHIs during high school football practices over a 3-month period.


METHODS
Descriptive epidemiology study.


METHODS
For a 3-month period (August-October), athletic trainers at 12 high schools in North Central Florida recorded the practice time and length, environmental conditions (wet-bulb globe temperature), and incidences of EHIs in varsity football athletes.


RESULTS
Athletes suffered 57 total EHIs during 29,759 athlete-exposures (AEs) for the 3-month data collection period (rate = 1.92/1000 AEs). August accounted for the majority of all EHIs, with 82.5% (47/57) and the highest rate (4.35/1000 AEs). Of total heat illnesses, heat cramps accounted for 70.2% (40/57), heat exhaustion 22.8% (13/57), and heat syncope 7.0% (4/57). The odds ratio indicated that athletes in August practices that lasted longer than the recommended 3 hours were 9.84 times more likely to suffer a heat illness than those in practices lasting ≤3 hours.


CONCLUSIONS
The highest rate of EHIs was during August. Practices in August that exceeded the recommended 3 hours were associated with a greater risk of heat illnesses. The overall rate of EHIs was lower for the high school football athletes observed in the study compared with that reported for collegiate football athletes in the region. The low rates of EHIs recorded suggest that the prevention guidelines employed by sports medicine teams are appropriate for the region and population.


CONCLUSIONS
Team physicians and athletic trainers should employ evidence-based, region- and population-specific EHI prevention guidelines. Sports medicine teams, coaches, and athletes should be aware of the increased risk of EHIs during August practices and the risk of prolonged practices during August.
University of Florida, Gainesville, Florida, USA trippb@ufl.edu.
Brady L
BL
Tripp
Indiana State University, Terre Haute, Indiana, USA.
Lindsey E
LE
Eberman
University of Florida, Gainesville, Florida, USA.
Michael Seth
MS
Smith
D056352:Athletes / Q000706:statistics & numerical data*; D003681:Dehydration / Q000453:epidemiology*; D005260:Female; D005431:Florida / Q000453:epidemiology; D005538:Football; D018882:Heat Stress Disorders / Q000453:epidemiology*; D006358:Hot Temperature / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D008297:Male; D012574:Schools; D013334:Students / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology
athlete-exposure; football (American); risk; wet-bulb globe temperature