Assessing the Need for Regional Heat Safety Guidelines in Athletics

Exertional heat illnesses (EHIs) are a prominent cause of injuries for athletes and among the top three causes of fatalities among American football players. While the etiology of EHIs are complex, an important component in such injuries is the environmental conditions. Many athletic organizations utilize the American College of Sports Medicine (ACSM) heat safety guidelines that adjust practice activities based on ambient environmental conditions. These guidelines, however, are uniform and do not account for regional acclimatization to heat exposure. Our study aims to investigate whether heat related fatalities of American Football players tend to occur on unusually oppressive days based on local climatology and if so, to identify empirically based local heat safety thresholds. Our dataset includes over 50 exertional heat stroke fatalities that occurred from 1980 – 2010 along with associated air temperature, dew-point temperature, and wet bulb globe temperature (WBGT) data on the day the death occurred. All meteorological data were standardized based on local climatology. Results indicate that almost 90% of the cases had either above normal air or dew-point temperatures and over 60% of the cases had above normal air and dew-point temperatures. Median z-scores for air temperature, dew-point temperature, and WBGT exceed the 70th percentile which may suggest empirical thresholds for limiting or canceling training activities. Finally, we observed many of the fatalities that occurred at near or below normal conditions were located in southern states, where even typical conditions may be oppressive.