JOSH ELLIS, MSED, ATC, CSCS PUBH-8165 ENVIRONMENTAL HEALTH WALDEN UNIVERSITY Heat Illness and Injury in Sport

Problem Significance From , the Center for Disease Control and Prevention recorded 8,015 deaths due to extreme heat in the United States (Center for Disease Control and Prevention, 2010). Heat illnesses 3 rd leading cause of death among high school athletes (Prentice & Arnheim, 2009).

Heat Dissipation The body dissipates heat in four ways (Prentice & Arnheim, 2009) : Conduction Convection Radiant heat exchange Evaporation

Heat Injury and Illness Occur when a persons body is unable to compensate for the increase in body temperature (Center for Disease Control and Prevention, 2010). Conditions in the environment have a large effect on the bodys ability to dissipate heat and compensate for increases in body temperature (Prentice & Arnheim, 2009).

Types of Heat Injury & Illness Heat injuries and illnesses present themselves in five different ways (Prentice & Arnheim, 2009): Exercise-associated muscle (heat) cramps Heat syncope Exercise (heat) exhaustion Exertional heat stroke Exertional hyponatremia

Muscle Cramps Acute, painful, involuntary muscle contractions that can be due to one or more of the following (Prentice & Arnheim, 2009): Dehydration Electrolyte imbalance Neuromuscular fatigue

Heat Syncope Rapid physical fatigue generally caused by (Prentice & Arnheim, 2009): Peripheral vasodilation Hypotension Pooling of the blood in the extremities

Heat Exhaustion Results from inadequate fluid replacement Associated with a core temperature of degrees Fahrenheit (Prentice & Arnheim, 2009).

Heat Stroke The most serious and life-threatening condition Breakdown in the thermoregulatory system Increased core body temperature of 104 degrees Fahrenheit or greater (Prentice & Arnheim, 2009).

Exertional Hyponatremia Condition involving a fluid/electrolyte disorder resulting in a decrease of Sodium concentration in the blood (Binkley et al., 2002; Prentice & Arnheim, 2009).

Acclimatization Environmental conditions have a strong impact on whether heat illnesses occur, but acclimatization also has an impact on the occurrence of heat illnesses (Cooper et al., 2006).

Thermoregulation Athletes that are at significant risk for heat illness: Increased body mass Increased equipment needs Lower aerobic fitness levels

Electrolyte Supplementation Can delay the onset of heat-related injuries in sports. If injuries are delayed, the timing of rest periods becomes valuable to the prevention of those injuries occurring (Prentice & Arnheim, 2009).

Activity Adjustments Recommendations can range from normal activity to limiting intense activity or stopping activity (Prentice & Arnheim, 2009).

Policies & Regulations The National Athletic Trainers Association (NATA) was the leading force in creating recommendations for exercising in the heat. Check out

Education If guidelines are followed appropriately and people are properly educated in prevention strategies heat illnesses can be prevented. Heat illnesses SHOULD NOT BE the 3 rd leading cause of death among high school athletes.

Remember 1% to 2% of body weight loss through sweating and fluid loss will have a negative effect on performance. 3% or higher increases risk of heat illness.

Keys To Prevention 1 Pound lost = 1 Pint fluid replaced 20 ounces two to three hours before 3 to 6 ounces every 20 minutes of exercise When urine is clear your clear (hydrated) Everyone is different

References: Binkley, H., Beckett, J., Casa, D., Kleiner, D., Plummer, P. (2002). National Athletic Trainers Association Position Statement: Exertional Heat Illnesses. Journal of Athletic Training. 37(3) Center for Disease Control and Prevention. (2008). Extreme Heat. Retrieved on July 21, 2010 from: Casa, D., Armstrong, L., Hillman, S., Montain, S., Reiff, R., Rich, B., Roberts, W., Stone, J. (2000). National Athletic Trainers Association Position Statement: Fluid Replacement for Athletes. Journal of Athletic Training. 35(2) Cooper, E., Ferrara, M., Broglio, S. (2006). Exertional Heat Illness and Environmental Conditions During a Single Football Season in the Southeast. Journal of Athletic Training. 41(3)

References Fowkes-Godek, S., Bartolozzi, A., Burkholder, R., Surgarman, E., Dorshimer, G. (2006). Core Temperature and Percentage of Dehydration in Professional Football Linemen and Backs During Preseason Practices. Journal of Athletic Training. 41(1) Prentice, W., Arnheim, S. (2009). Arnheims Principles of Athletic Training: A Competency-Based Approach. 13 th ed. New York, NY: McGraw-Hill. Sparling, P. (2000). Heat Acclimatization: Preparing Athletes to Compete in Hot Environments. Journal of Athletic Training. 1(2).