Prevalence of hot weather conditions related to sports participation guidelines: A South Australian investigation

Roundtable on Preseason Heat Safety in Secondary School Athletics: Environmental Monitoring During Activities in the Heat

OBJECTIVE

To develop best-practice recommendations using thermal indices to determine work-to-rest ratios and facilitate further implementation of environmental monitoring for heat safety in secondary school athletics in the United States.

DATA SOURCES

A narrative review of the current literature in environmental monitoring for heat safety during athletics was conducted by content experts. A list of action-oriented recommendations was established from the narrative review and further refined using the Delphi method.

CONCLUSIONS

Assessment of wet bulb globe temperature at the site of activity throughout the duration of the event is recommended to assist clinicians and administrators in making appropriate decisions regarding the duration and frequency of activity and rest periods. Activity modification guidelines should be predetermined and approved by stakeholders and should outline specific actions to be followed, such as the work-to-rest ratio, frequency and timing of hydration breaks, and adjustment of total exercise duration, equipment, and clothing. Furthermore, integration of exertional heat illness injury data with environmental condition characteristics is critical for the development of evidence-based heat safety guidelines for secondary school athletics. Athletic trainers play an essential role in conducting prospective injury data collection, recording onsite wet bulb globe temperature levels, and implementing recommendations to protect the health and safety of athletes.

Regional differences in exertional heat illness rates among Georgia USA high school football players

Many high school associations in recent years are developing policies to improve player safety regarding exertional heat illnesses (EHIs). A question is whether states with diverse climates need multiple sets of guidelines with different activity modification thresholds. We examine this question in the state of Georgia, which has a diverse climate. Our study leverages a multi-year dataset of exertional heat illnesses (EHIs) among high school football players to test the hypothesis that EHI rates under similar wet bulb globe temperatures (WBGTs) will be greater among athletes in the cooler, northern region versus warmer, southern region of the state. The focus of this study is on a 3-year period (2012-2014) when uniform heat safety polices, including acclimatization and activity modification guidelines, were implemented across the state. Results show that athletes in the northern region acclimatize to cooler conditions. Almost 68% of practices have WBGTs < 27.8 °C (82 °F) compared to the southern region where athletes receive many times the exposures to hotter WBGTs in the 27.8-30.5 °C and 30.6-32.2 °C categories. In the post-acclimatization period, we observed statistically significantly (p < .05) greater EHI rates among athletes in the northern region of the state, even when controlling for meteorological conditions. Our findings suggest that differential acclimatization between football players in the northern and southern regions of the state is impacting EHI rates and that regional heat safety guidelines may be needed in Georgia and other states with similarly diverse climates.

Assessment of the Australian Bureau of Meteorology wet bulb globe temperature model using weather station data

Exertional heat illnesses affect thousands of athletes each year and are a leading cause of death in sports. The wet bulb globe temperature (WBGT) is widely used as a heat stress metric in athletics for adjusting activities. The WBGT can be measured on-site with portable sensors, but instrument cost may provide a barrier for usage. Modeling WBGT from weather station data, then, presents an affordable option. Our study compares two WBGT models of varying levels of sophistication: the Australian Bureau of Meteorology (ABM) model which uses only temperature and humidity as inputs and a physically based model by Liljegren that incorporates temperature, humidity, wind speed, and solar radiation in determining WBGT outputs. The setting for the study is 19 University of Georgia Weather Network stations selected from across the state of Georgia, USA, over a 6-year period (2008-2014) during late summer and early fall months. Results show that the ABM model's performance relative to the Liljegren model varies based on time of day and weather conditions. WBGTs from the ABM model are most similar to those from the Liljegren model during midday when the assumption of moderately high sun most frequently occurs. We observed increasingly large positive biases with the ABM model both earlier and later in the day during periods with lower solar radiation. Even during midday, large (≥ 3 °C) underestimates may occur during low wind conditions and overestimates during periods with high cloud cover. Such differences can lead to inaccurate activity modification and pose dangers for athletes either by underestimating heat-related hazards or by imposing an opportunity cost if practice activities are limited by overestimating the heat hazard.

Heat stress incident prevalence and tennis matchplay performance at the Australian Open

OBJECTIVES

To examine the association of wet bulb globe temperature (WBGT) with the occurrence of heat-related incidents and changes in behavioural and matchplay characteristics in men's Grand Slam tennis.

DESIGN

On-court calls for trainers, doctors, cooling devices and water, post-match medical consults and matchplay characteristic data were collected from 360 Australian Open matches (first 4 rounds 2014-2016).

METHODS

Data were referenced against estimated WBGT and categorised into standard zones. Generalised linear models assessed the association of WBGT zone on heat-related medical incidences and matchplay variables.

RESULTS

On-court calls for doctor (47% increase per zone, p=0.001), heat-related events (41%, p=0.019), cooling devices (53%, p<0.001), and post-match heat-related consults (87%, p=0.014) increased with each rise in estimated WBGT zone. In WBGT's >32°C and >28°C, significant increases in heat-related calls (p=0.019) and calls for cooling devices (p<0.001), respectively, were evident. The number of winners (-2.5±0.006% per zone, p<0.001) and net approaches (-7.1±0.008%, p<0.001) reduced as the estimated WBGT zone increased, while return points won increased (1.75±0.46, p<0.001). When matches were adjusted for player quality of the opponent (Elo rating), the number of aces (5±0.02%, p=0.003) increased with estimated WBGT zone, whilst net approaches decreased (7.6±0.013%, p<0.001).

CONCLUSIONS

Increased estimated WBGT increased total match doctor and trainer consults for heat related-incidents, post-match heat-related consults (>32°C) and cooling device callouts (>28°C). However, few matchplay characteristics were noticeably affected, with only reduced net approaches and increased aces evident in higher estimated WBGT environments.

Wet-bulb globe temperature (WBGT)--its history and its limitations

Wet-bulb globe temperature (WBGT) is nowadays the most widely used index of heat stress, yet many users appear to be unaware of its history and its limitations. HISTORY OF WBGT: WBGT was invented and first used during the 1950s as one element in a successful campaign to control serious outbreaks of heat illness in training camps of the United States Army and Marine Corps. Control measures based on air temperature and humidity, and applied to all trainees alike, had proved effective but had entailed excessive compliance costs in the form of lost training time. New control measures introduced in 1956 further reduced heat illness and also lost fewer training hours. Crucial innovations were (1) replacing the temperature and humidity measurements with WBGT, which additionally responds to sun and wind, (2) using epidemiologic analyses of casualty records to identify hazardous levels of WBGT and vulnerable trainees, and (3) protecting the most vulnerable trainees by suspending drill at lower levels of WBGT, and by improving their heat tolerance in special conditioning platoons. This campaign has considerable relevance to the prevention of heat illness in sport. LIMITATIONS OF WBGT: WBGT's most serious limitation is that environments at a given level of the index are more stressful when the evaporation of sweat is restricted (by high humidity or low air movement) than when evaporation is free. As with all indices that integrate elements of the thermal environment, interpretation of the observed levels of WBGT requires careful evaluation of people's activity, clothing, and many other factors, all of which can introduce large errors into any predictions of adverse effects. Moreover, the accuracy of WBGT is being eroded by measurement errors associated with the omission of the globe temperature, with non-standard instrumentation, and with unsatisfactory calibration procedures. Because of the above limitations WBGT can provide only a general guide to the likelihood of adverse effects of heat. A much clearer assessment can be obtained by measuring the individual elements of the thermal environment, and using those measurements to estimate the requirement for evaporative cooling, the likelihood of achieving it, and more accurate and comprehensive indices of heat stress.