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Segreti A, Celeski M, Guerra E, Crispino SP, Vespasiano F, Buzzelli L, Fossati C, Papalia R, Pigozzi F, Grigioni F. Effects of Environmental Conditions on Athlete's Cardiovascular System. J Clin Med 2024; 13:4961. [PMID: 39201103 PMCID: PMC11355938 DOI: 10.3390/jcm13164961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Revised: 08/13/2024] [Accepted: 08/17/2024] [Indexed: 09/02/2024] Open
Abstract
Environmental factors such as extreme temperatures, humidity, wind, pollution, altitude, and diving can significantly impact athletes' cardiovascular systems, potentially hindering their performance, particularly in outdoor sports. The urgency of this issue is heightened by the increasing prevalence of climate change and its associated conditions, including fluctuating pollution levels, temperature variations, and the spread of infectious diseases. Despite its critical importance, this topic is often overlooked in sports medicine. This narrative review seeks to address this gap by providing a comprehensive, evidence-based evaluation of how athletes respond to environmental stresses. A thorough assessment of current knowledge is essential to better prepare athletes for competition under environmental stress and to minimize the harmful effects of these factors. Specifically, adaptative strategies and preventative measures are vital to mitigating these environmental influences and ensuring athletes' safety.
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Affiliation(s)
- Andrea Segreti
- Cardiology Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy; (M.C.); (S.P.C.); (F.V.); (L.B.); (F.G.)
- Research Unit of Cardiovascular Science, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro de Bosis, 15, 00135 Roma, Italy; (C.F.); (F.P.)
| | - Mihail Celeski
- Cardiology Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy; (M.C.); (S.P.C.); (F.V.); (L.B.); (F.G.)
- Research Unit of Cardiovascular Science, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy
| | - Emiliano Guerra
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Via del Pozzo, 71, 41124 Modena, Italy;
| | - Simone Pasquale Crispino
- Cardiology Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy; (M.C.); (S.P.C.); (F.V.); (L.B.); (F.G.)
- Research Unit of Cardiovascular Science, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy
| | - Francesca Vespasiano
- Cardiology Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy; (M.C.); (S.P.C.); (F.V.); (L.B.); (F.G.)
- Research Unit of Cardiovascular Science, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy
| | - Lorenzo Buzzelli
- Cardiology Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy; (M.C.); (S.P.C.); (F.V.); (L.B.); (F.G.)
- Research Unit of Cardiovascular Science, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy
| | - Chiara Fossati
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro de Bosis, 15, 00135 Roma, Italy; (C.F.); (F.P.)
| | - Rocco Papalia
- Department of Orthopaedic and Trauma Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy;
- Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy
| | - Fabio Pigozzi
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro de Bosis, 15, 00135 Roma, Italy; (C.F.); (F.P.)
| | - Francesco Grigioni
- Cardiology Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy; (M.C.); (S.P.C.); (F.V.); (L.B.); (F.G.)
- Research Unit of Cardiovascular Science, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy
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Golubjatnikov M, Walker A. Endurance Sporting Events. Emerg Med Clin North Am 2024; 42:581-596. [PMID: 38925776 DOI: 10.1016/j.emc.2024.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024]
Abstract
Endurance sports encompass a broad range of events from marathons and triathlons to ultramarathons, long-distance cycling, skiing, and swimming. As these events have experienced a surge in popularity, we have a greater need to understand the associated medical risks. This article reviews the history of endurance races, reviews the most critical and common causes of cardiovascular, heat, electrolyte, and musculoskeletal injuries/illnesses, and discusses considerations for medical directors/personnel associated with such events.
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Affiliation(s)
- Matt Golubjatnikov
- St Joseph's Medical Center, 1800 N California Street, Stockton, CA 95204, USA
| | - Anne Walker
- St Joseph's Medical Center, 1800 N California Street, Stockton, CA 95204, USA.
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Bandiera D, Racinais S, Garrandes F, Adami PE, Bermon S, Pitsiladis YP, Tessitore A. Heat-related risk at Paris 2024: a proposal for classification and review of International Federations policies. Br J Sports Med 2024; 58:860-869. [PMID: 38950917 DOI: 10.1136/bjsports-2024-108310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2024] [Indexed: 07/03/2024]
Abstract
Several International Federations (IFs) employ specific policies to protect athletes' health from the danger of heat. Most policies rely on the measurement of thermal indices such as the Wet Bulb Globe Temperature (WBGT) to estimate the risk of heat-related illness. This review summarises the policies implemented by the 32 IFs of the 45 sports included in the Paris 2024 Olympic Games. It provides details into the venue type, measured parameters, used thermal indices, measurement procedures, mitigation strategies and specifies whether the policy is a recommendation or a requirement. Additionally, a categorisation of sports' heat stress risk is proposed. Among the 15 sports identified as high, very high or extreme risk, one did not have a heat policy, three did not specify any parameter measurement, one relied on water temperature, two on air temperature and relative humidity, seven on WBGT (six measured on-site and one estimated) and one on the Heat Stress Index. However, indices currently used in sports have been developed for soldiers or workers and may not adequately reflect the thermal strain endured by athletes. Notably, they do not account for the athletes' high metabolic heat production and their level of acclimation. It is, therefore, worthwhile listing the relevance of the thermal indices used by IFs to quantify the risk of heat stress, and in the near future, develop an index adapted to the specific needs of athletes.
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Affiliation(s)
- David Bandiera
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Roma, Italy
- Environmental Stress Unit, CREPS Montpellier-Font Romeu, Montpellier, France
| | - Sebastien Racinais
- Environmental Stress Unit, CREPS Montpellier-Font Romeu, Montpellier, France
- UMR 866 INRAE Université de Montpellier, Montpellier, France
| | | | | | | | - Yannis P Pitsiladis
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Roma, Italy
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, Kowloon, Hong Kong
| | - Antonio Tessitore
- Department of Movement, Human and Health Sciences, University of Rome Foro Italico, Roma, Italy
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Souza HLR, Arriel RA, Marocolo M. Heat stress challenges on sports: prioritizing the well-being of practitioners. J Appl Physiol (1985) 2024; 136:1335. [PMID: 38836533 DOI: 10.1152/japplphysiol.00238.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 04/02/2024] [Indexed: 06/06/2024] Open
Affiliation(s)
- Hiago L R Souza
- Department of Biophysics and Physiology, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Rhaí A Arriel
- Department of Biophysics and Physiology, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Moacir Marocolo
- Department of Biophysics and Physiology, Federal University of Juiz de Fora, Juiz de Fora, Brazil
- Department of Training and Exercise Science, Faculty of Sport Science, Ruhr University Bochum, Bochum, Germany
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5
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Dervišević E. Hyperthermia: Is it always an accidental death? Leg Med (Tokyo) 2024; 68:102418. [PMID: 38335833 DOI: 10.1016/j.legalmed.2024.102418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 02/01/2024] [Indexed: 02/12/2024]
Abstract
INTRODUCTION The research aimed to determine individual variations in different core temperature measurements before the experiment, after submersion, after 20 min of exposure for heat stroke. METHODS Rats were divided into three groups depending on the temperature and length of exposure to water: CG, G41-20 and G41-UD. The protocol was made according to the earlier described methodology of heat shock induction. RESULTS A significant difference was observed in the G41-UD group; p < 0.0005. The lowest body temperature of the rats was observed, from normothermia, and the highest temperature after death, 37.87 ± 0.62 °C vs 41.20 ± 0.76 °C, the difference between all three groups is p < 0.0005. CONCLUSION Exposure of Wistar rats to water temperatures in the CG and G41 groups led to a significant change in core temperature. In the control group, the thermoregulatory mechanism firmly established normothermia, while hyperthermia was revealed in the G41 group during the 20-minute exposure.
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Affiliation(s)
- Emina Dervišević
- Department of Forensic Medicine, Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
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Gibb K, Beckman S, Vergara XP, Heinzerling A, Harrison R. Extreme Heat and Occupational Health Risks. Annu Rev Public Health 2024; 45:315-335. [PMID: 38166501 DOI: 10.1146/annurev-publhealth-060222-034715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
Climate change poses a significant occupational health hazard. Rising temperatures and more frequent heat waves are expected to cause increasing heat-related morbidity and mortality for workers across the globe. Agricultural, construction, military, firefighting, mining, and manufacturing workers are at particularly high risk for heat-related illness (HRI). Various factors, including ambient temperatures, personal protective equipment, work arrangements, physical exertion, and work with heavy equipment may put workers at higher risk for HRI. While extreme heat will impact workers across the world, workers in low- and middle-income countries will be disproportionately affected. Tracking occupational HRI will be critical to informing prevention and mitigation strategies. Renewed investment in these strategies, including workplace heat prevention programs and regulatory standards for indoor and outdoor workers, will be needed. Additional research is needed to evaluate the effectiveness of interventions in order to successfully reduce the risk of HRI in the workplace.
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Affiliation(s)
- Kathryn Gibb
- Occupational Health Branch, California Department of Public Health, Richmond, California, USA;
| | - Stella Beckman
- Occupational Health Branch, California Department of Public Health, Richmond, California, USA;
| | | | - Amy Heinzerling
- Occupational Health Branch, California Department of Public Health, Richmond, California, USA;
| | - Robert Harrison
- Occupational Health Branch, California Department of Public Health, Richmond, California, USA;
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Ahdoot S, Baum CR, Cataletto MB, Hogan P, Wu CB, Bernstein A. Climate Change and Children's Health: Building a Healthy Future for Every Child. Pediatrics 2024; 153:e2023065505. [PMID: 38374808 DOI: 10.1542/peds.2023-065505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 02/21/2024] Open
Abstract
Observed changes in temperature, precipitation patterns, sea level, and extreme weather are destabilizing major determinants of human health. Children are at higher risk of climate-related health burdens than adults because of their unique behavior patterns; developing organ systems and physiology; greater exposure to air, food, and water contaminants per unit of body weight; and dependence on caregivers. Climate change harms children through numerous pathways, including air pollution, heat exposure, floods and hurricanes, food insecurity and nutrition, changing epidemiology of infections, and mental health harms. As the planet continues to warm, climate change's impacts will worsen, threatening to define the health and welfare of children at every stage of their lives. Children who already bear higher burden of disease because of living in low-wealth households and communities, lack of access to high quality education, and experiencing racism and other forms of unjust discrimination bear greater risk of suffering from climate change hazards. Climate change solutions, advanced through collaborative work of pediatricians, health systems, communities, corporations, and governments lead to immediate gains in child health and equity and build a foundation for generations of children to thrive. This technical report reviews the nature of climate change and its associated child health effects and supports the recommendations in the accompanying policy statement on climate change and children's health.
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Affiliation(s)
- Samantha Ahdoot
- University of Virginia School of Medicine, Charlottesville, Virginia
| | - Carl R Baum
- Section of Pediatric Emergency Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Mary Bono Cataletto
- Division of Pediatric Pulmonology and Sleep Medicine, Department of Pediatrics, New York University Long Island School of Medicine, Mineola, New York
| | - Patrick Hogan
- Pediatric Residency Program, Oregon Health & Science University, Portland, Oregon
| | - Christina B Wu
- O'Neill Center for Global and National Health Law, Georgetown University Law Center, Washington, District of Columbia
| | - Aaron Bernstein
- Division of General Pediatrics, Boston Children's Hospital, and Center for Climate, Health, and the Global Environment, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Notley SR, Mitchell D, Taylor NAS. A century of exercise physiology: concepts that ignited the study of human thermoregulation. Part 3: Heat and cold tolerance during exercise. Eur J Appl Physiol 2024; 124:1-145. [PMID: 37796292 DOI: 10.1007/s00421-023-05276-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 07/04/2023] [Indexed: 10/06/2023]
Abstract
In this third installment of our four-part historical series, we evaluate contributions that shaped our understanding of heat and cold stress during occupational and athletic pursuits. Our first topic concerns how we tolerate, and sometimes fail to tolerate, exercise-heat stress. By 1900, physical activity with clothing- and climate-induced evaporative impediments led to an extraordinarily high incidence of heat stroke within the military. Fortunately, deep-body temperatures > 40 °C were not always fatal. Thirty years later, water immersion and patient treatments mimicking sweat evaporation were found to be effective, with the adage of cool first, transport later being adopted. We gradually acquired an understanding of thermoeffector function during heat storage, and learned about challenges to other regulatory mechanisms. In our second topic, we explore cold tolerance and intolerance. By the 1930s, hypothermia was known to reduce cutaneous circulation, particularly at the extremities, conserving body heat. Cold-induced vasodilatation hindered heat conservation, but it was protective. Increased metabolic heat production followed, driven by shivering and non-shivering thermogenesis, even during exercise and work. Physical endurance and shivering could both be compromised by hypoglycaemia. Later, treatments for hypothermia and cold injuries were refined, and the thermal after-drop was explained. In our final topic, we critique the numerous indices developed in attempts to numerically rate hot and cold stresses. The criteria for an effective thermal stress index were established by the 1930s. However, few indices satisfied those requirements, either then or now, and the surviving indices, including the unvalidated Wet-Bulb Globe-Thermometer index, do not fully predict thermal strain.
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Affiliation(s)
- Sean R Notley
- Defence Science and Technology Group, Department of Defence, Melbourne, Australia
- School of Human Kinetics, University of Ottawa, Ottawa, Canada
| | - Duncan Mitchell
- Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
- School of Human Sciences, University of Western Australia, Crawley, Australia
| | - Nigel A S Taylor
- Research Institute of Human Ecology, College of Human Ecology, Seoul National University, Seoul, Republic of Korea.
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Galan-Lopez N, Esh CJ, Leal DV, Gandini S, Lucas R, Garrandes F, Bermon S, Adami PE, Kajeniene A, Hosokawa Y, Chrismas BCR, Stevens CJ, Taylor L. Heat Preparation and Knowledge at the World Athletics Race Walking Team Championships Muscat 2022. Int J Sports Physiol Perform 2023:1-12. [PMID: 37279899 DOI: 10.1123/ijspp.2022-0446] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 03/28/2023] [Accepted: 04/10/2023] [Indexed: 06/08/2023]
Abstract
PURPOSE To assess elite racewalkers' preparation strategies, knowledge, and general practices for competition in the heat and their health status during the World Athletics Race Walking Teams Championships (WRW) Muscat 2022. METHODS Sixty-six elite racewalkers (male: n = 42; mean age = 25.8 y) completed an online survey prior to WRW Muscat 2022. Athletes were grouped by sex (males vs females) and climate (self-reported) they live/trained in (hot vs temperate/cold), with differences/relationships between groups assessed. Relationships between ranking (medalist/top 10 vs nonmedalist/nontop 10) and precompetition use of heat acclimation/acclimatization (HA) were assessed. RESULTS All surveyed medalists (n = 4) implemented, and top 10 finishers were more likely to report using (P = .049; OR = 0.25; 95% CI, 0.06%-1%), HA before the championships. Forty-three percent of athletes did not complete specific HA training. Females (8% [males 31%]) were less likely to have measured core temperature (P = .049; OR = 0.2; 95% CI, 0.041-0.99) and more likely to not know expected conditions in Muscat (42% vs 14%; P = .016; OR = 4.3; 95% CI, 1%-14%) or what wet bulb globe temperature is (83% vs 55%; P = .024; OR = 4.1; 95% CI, 1%-14%). CONCLUSIONS Athletes who implemented HA before the championships tended to place better than those who did not. Forty-three percent of athletes did not prepare for the expected hot conditions at the WRW Muscat 2022, primarily attributed to challenges in accessing and/or cost of equipment/facilities for HA strategies. Further efforts to bridge the gap between research and practice in this elite sport are needed, particularly in female athletes.
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Affiliation(s)
- Natalia Galan-Lopez
- School of Sport, Exercise and Health Sciences, National Center for Sport and Exercise Medicine (NCSEM), Loughborough University, Loughborough,United Kingdom
| | - Chris J Esh
- School of Sport, Exercise and Health Sciences, National Center for Sport and Exercise Medicine (NCSEM), Loughborough University, Loughborough,United Kingdom
- Aspetar, Orthopedic and Sports Medicine Hospital, FIFA Medical Center of Excellence, Doha,Qatar
| | - Diogo Vaz Leal
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Maia, Maia,Portugal
| | - Silvia Gandini
- Centro Studi-Federazione Italiana di Atletica Leggera, Rome,Italy
| | | | - Frederic Garrandes
- Health and Science Department, World Athletics, Monaco
- Laboratoire Motricité Humaine Expertise Sport Santé, Université Côte d'Azur, Nice,France
| | - Stephane Bermon
- Health and Science Department, World Athletics, Monaco
- Laboratoire Motricité Humaine Expertise Sport Santé, Université Côte d'Azur, Nice,France
| | - Paolo Emilio Adami
- Health and Science Department, World Athletics, Monaco
- Laboratoire Motricité Humaine Expertise Sport Santé, Université Côte d'Azur, Nice,France
| | - Alma Kajeniene
- Department of Sports Medicine, Lithuanian University of Health Sciences, Kaunas,Lithuania
| | - Yuri Hosokawa
- Faculty of Sport Sciences, Waseda University, Shinjuku-ku,Japan
| | | | - Christopher J Stevens
- Physical Activity, Sport and Exercise Research Theme, Faculty of Health, Southern Cross University, Coffs Harbour, NSW,Australia
| | - Lee Taylor
- School of Sport, Exercise and Health Sciences, National Center for Sport and Exercise Medicine (NCSEM), Loughborough University, Loughborough,United Kingdom
- Sport and Exercise Discipline Group, Faculty of Health, University of Technology Sydney, Moore Park, NSW,Australia
- Human Performance Research Center, University of Technology Sydney (UTS), Sydney, NSW,Australia
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10
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Chao CM, Wang LY, Huang CC, Chang WT, Tang LY, Lin MT, Chang CP. Myocardial structure and functional alterations in a preclinical model of exertional heat stroke. Life Sci 2023; 323:121640. [PMID: 37004732 DOI: 10.1016/j.lfs.2023.121640] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 03/17/2023] [Accepted: 03/24/2023] [Indexed: 04/03/2023]
Abstract
AIM Relatively little information is available about the effect of an acute exertional heat stroke (EHS) on myocardium structure and function. Herein, we used a survival male rat model of EHS to answer the question. MAIN METHODS Adult male Wistar rats underwent forced treadmill running at a 36 °C room temperature and 50 % relative humidity until EHS onset, characterized by hyperthermia and collapse. All rats that were followed for 14 days survived. Injury severity scores of both gastrocnemius and myocardium were determined histologically. Following an EHS event, pathological echocardiography, skeletal muscle and myocardial damage scores and indicators, myocardial fibrosis, hypertrophy, and autophagy were elucidated. KEY FINDINGS Rats with EHS onset displayed skeletal muscle damage, elevated serum levels of skeletal muscle indicators (e.g., creatinine kinase, myoglobin, and potassium) and myocardial injury indicators (e.g., cardiac troponin I, creatinine kinase, and lactate dehydrogenase) returning to homeostasis within 3 days post-EHS. However, EHS-induced myocardial damage, pathological echocardiography, myocardial fibrosis, hypertrophy, and deposited misfolded proteins lasted up to 14 days post-EHS at least. SIGNIFICANCE First, we provide evidence to confirm that despite the apparent return to homeostasis, underlying processes may still be ongoing after EHS onset. Second, we provide several key findings emphasizing the pathophysiology and risk factors of EHS, highlighting gaps in knowledge with the aim of stimulating future studies.
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Racinais S, Hosokawa Y, Akama T, Bermon S, Bigard X, Casa DJ, Grundstein A, Jay O, Massey A, Migliorini S, Mountjoy M, Nikolic N, Pitsiladis YP, Schobersberger W, Steinacker JM, Yamasawa F, Zideman DA, Engebretsen L, Budgett R. IOC consensus statement on recommendations and regulations for sport events in the heat. Br J Sports Med 2023; 57:8-25. [PMID: 36150754 PMCID: PMC9811094 DOI: 10.1136/bjsports-2022-105942] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2022] [Indexed: 01/07/2023]
Abstract
This document presents the recommendations developed by the IOC Medical and Scientific Commission and several international federations (IF) on the protection of athletes competing in the heat. It is based on a working group, meetings, field experience and a Delphi process. The first section presents recommendations for event organisers to monitor environmental conditions before and during an event; to provide sufficient ice, shading and cooling; and to work with the IF to remove regulatory and logistical limitations. The second section summarises recommendations that are directly associated with athletes' behaviours, which include the role and methods for heat acclimation; the management of hydration; and adaptation to the warm-up and clothing. The third section explains the specific medical management of exertional heat stroke (EHS) from the field of play triage to the prehospital management in a dedicated heat deck, complementing the usual medical services. The fourth section provides an example for developing an environmental heat risk analysis for sport competitions across all IFs. In summary, while EHS is one of the leading life-threatening conditions for athletes, it is preventable and treatable with the proper risk mitigation and medical response. The protection of athletes competing in the heat involves the close cooperation of the local organising committee, the national and international federations, the athletes and their entourages and the medical team.
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Affiliation(s)
- Sebastien Racinais
- Research and Scientific Support Department, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Ad Dawhah, Qatar
| | - Yuri Hosokawa
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
| | - Takao Akama
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
| | | | - Xavier Bigard
- Union Cycliste Internationale (UCI), Aigle, Switzerland
| | - Douglas J Casa
- Korey Stringer Institiute, Department of Kinesiology, University of Connecticut, Storrs, Connecticut, USA
| | - Andrew Grundstein
- Department of Geography, University of Georgia, Athens, Georgia, USA
| | - Ollie Jay
- Heat and Health Research Incubator, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Andrew Massey
- Medical Department, Federation Internationale de Football Association, Zurich, Switzerland
| | | | | | | | | | - Wolfgang Schobersberger
- Institute for Sports Medicine, Alpine Medicine & Health Tourism (ISAG), UMIT Tirol – Private University for Health Sciences and technology, Hall, Austria,University Hospital/Tirol Kliniken, Innsbruck, Austria
| | | | | | - David Anthony Zideman
- International Olympic Committee Medical and Scientific Games Group, Pinner, Middlesex, UK
| | - Lars Engebretsen
- Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
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Cai W, Zhang C, Zhang S, Bai Y, Callaghan M, Chang N, Chen B, Chen H, Cheng L, Cui X, Dai H, Danna B, Dong W, Fan W, Fang X, Gao T, Geng Y, Guan D, Hu Y, Hua J, Huang C, Huang H, Huang J, Jiang L, Jiang Q, Jiang X, Jin H, Kiesewetter G, Liang L, Lin B, Lin H, Liu H, Liu Q, Liu T, Liu X, Liu X, Liu Z, Liu Z, Lou S, Lu C, Luo Z, Meng W, Miao H, Ren C, Romanello M, Schöpp W, Su J, Tang X, Wang C, Wang Q, Warnecke L, Wen S, Winiwarter W, Xie Y, Xu B, Yan Y, Yang X, Yao F, Yu L, Yuan J, Zeng Y, Zhang J, Zhang L, Zhang R, Zhang S, Zhang S, Zhao Q, Zheng D, Zhou H, Zhou J, Fung MFCC, Luo Y, Gong P. The 2022 China report of the Lancet Countdown on health and climate change: leveraging climate actions for healthy ageing. Lancet Public Health 2022; 7:e1073-e1090. [PMID: 36354045 PMCID: PMC9617661 DOI: 10.1016/s2468-2667(22)00224-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/15/2022] [Accepted: 08/23/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Wenjia Cai
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Chi Zhang
- School of Management and Economics, Beijing Institute of Technology, Beijing, China; Institute for Global Health and Development, Peking University, Beijing, China
| | - Shihui Zhang
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Yuqi Bai
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Max Callaghan
- Mercator Research Institute on Global Commons and Climate Change, Mercator Research Institute on Global Commons and Climate Change, Berlin, Germany; Priestley International Centre for Climate, University of Leeds, Leeds, UK
| | - Nan Chang
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Bin Chen
- School of Environment, Beijing Normal University, Beijing, China
| | - Huiqi Chen
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Liangliang Cheng
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xueqin Cui
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Hancheng Dai
- College of Environmental Sciences and Engineering, Peking University, Beijing, China
| | - Bawuerjiang Danna
- School of Journalism and Communication, Tsinghua University, Beijing, China
| | - Wenxuan Dong
- Institute of Public Safety Research, Tsinghua University, Beijing, China; Department of Engineering Physics, Tsinghua University, Beijing, China
| | - Weicheng Fan
- Institute of Public Safety Research, Tsinghua University, Beijing, China; Department of Engineering Physics, Tsinghua University, Beijing, China
| | - Xiaoyi Fang
- Research Center of Practical Meteorology, Chinese Academy of Meteorological Sciences, Beijing, China
| | - Tong Gao
- School of Business, Shandong Normal University, Jinan, China
| | - Yang Geng
- School of Architecture, Tsinghua University, Beijing, China
| | - Dabo Guan
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Yixin Hu
- Department of Statistics and Data Science, Southern University of Science and Technology, Shenzhen, China
| | - Junyi Hua
- School of International Affairs and Public Administration, Ocean University of China, Qingdao, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Hong Huang
- Institute of Public Safety Research, Tsinghua University, Beijing, China; Department of Engineering Physics, Tsinghua University, Beijing, China
| | - Jianbin Huang
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing, China
| | - Linlang Jiang
- School of Computer Science and Technology, University of Science and Technology of China, Hefei, China
| | - Qiaolei Jiang
- School of Journalism and Communication, Tsinghua University, Beijing, China
| | | | - Hu Jin
- Department of Atmospheric and Oceanic Sciences & Institute of Atmospheric Sciences, Fudan University, Shanghai, China; Integrated Research on Disaster Risk International Centre of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Gregor Kiesewetter
- Pollution Management Research Group, Energy, Climate, and Environment Program, International Institute for Applied Systems Analysis, Laxenburg, Austria
| | - Lu Liang
- Department of Geography and the Environment, University of North Texas, Denton, TX, USA
| | - Borong Lin
- School of Architecture, Tsinghua University, Beijing, China
| | - Hualiang Lin
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Huan Liu
- School of Environment, Tsinghua University, Beijing, China
| | - Qiyong Liu
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Tao Liu
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Xiaobo Liu
- College of Environmental Sciences and Engineering, Peking University, Beijing, China
| | - Xinyuan Liu
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhao Liu
- School of Airport Economics and Management, Beijing Institute of Economics and Management, Beijing, China
| | - Zhu Liu
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Shuhan Lou
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Chenxi Lu
- Department of Earth System Science, Tsinghua University, Beijing, China; College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Zhenyu Luo
- School of Environment, Tsinghua University, Beijing, China
| | - Wenjun Meng
- College of Urban and Environmental Sciences, Peking University, Beijing, China
| | - Hui Miao
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Chao Ren
- Faculty of Architecture, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Marina Romanello
- Institute for Global Health, University College London, London, UK
| | - Wolfgang Schöpp
- Pollution Management Research Group, Energy, Climate, and Environment Program, International Institute for Applied Systems Analysis, Laxenburg, Austria
| | - Jing Su
- School of Humanities, Tsinghua University, Beijing, China
| | - Xu Tang
- Department of Atmospheric and Oceanic Sciences & Institute of Atmospheric Sciences, Fudan University, Shanghai, China; Integrated Research on Disaster Risk International Centre of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Can Wang
- School of Environment, Tsinghua University, Beijing, China
| | - Qiong Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Laura Warnecke
- Pollution Management Research Group, Energy, Climate, and Environment Program, International Institute for Applied Systems Analysis, Laxenburg, Austria
| | - Sanmei Wen
- School of Journalism and Communication, Tsinghua University, Beijing, China
| | - Wilfried Winiwarter
- Pollution Management Research Group, Energy, Climate, and Environment Program, International Institute for Applied Systems Analysis, Laxenburg, Austria
| | - Yang Xie
- School of Economics and Management, Beihang University, Beijing, China
| | - Bing Xu
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Yu Yan
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xiu Yang
- Institute of Climate Change and Sustainable Development, Tsinghua University, Beijing, China
| | - Fanghong Yao
- Department of Physical Education, Peking University, Beijing, China
| | - Le Yu
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Jiacan Yuan
- Department of Atmospheric and Oceanic Sciences & Institute of Atmospheric Sciences, Fudan University, Shanghai, China; Integrated Research on Disaster Risk International Centre of Excellence on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Yiping Zeng
- Schwarzman Scholars, Tsinghua University, Beijing, China
| | - Jing Zhang
- School of Journalism and Communication, Tsinghua University, Beijing, China
| | - Lu Zhang
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Rui Zhang
- Department of Physical Education, Peking University, Beijing, China
| | - Shangchen Zhang
- School of Economics and Management, Beihang University, Beijing, China
| | - Shaohui Zhang
- Pollution Management Research Group, Energy, Climate, and Environment Program, International Institute for Applied Systems Analysis, Laxenburg, Austria; Department of Earth System Science, Tsinghua University, Beijing, China
| | - Qi Zhao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China; Climate Change and Health Center, Shandong University, Jinan, China
| | - Dashan Zheng
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Hao Zhou
- Institute for Urban Governance and Sustainable Development, Tsinghua University, Beijing, China
| | - Jingbo Zhou
- Business Intelligence Lab, Baidu Research, Beijing, China
| | | | - Yong Luo
- Department of Earth System Science, Tsinghua University, Beijing, China
| | - Peng Gong
- Institute for Climate and Carbon Neutrality, The University of Hong Kong, Hong Kong Special Administrative Region, China; Department of Earth Sciences and Department of Geography, The University of Hong Kong, Hong Kong Special Administrative Region, China.
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13
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LE Douairon Lahaye S, LE Cunuder A, Lachard T, Menard V, Lhuissier F, Dupont AC, Wurtz AS, Marblé C, Carré F, Schnell F. Cardiac Events in World-Class Athletes: An Internet-Based Study. Med Sci Sports Exerc 2022; 54:2064-2072. [PMID: 35881931 DOI: 10.1249/mss.0000000000003001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed at assessing the prevalence of adverse cardiac events, as identified in the media, in world-class athletes according to their sex and sports discipline. METHODS All female and male athletes from 30 individual Olympic sports who ranked in the international yearly top 10 between 2006 and 2018 were included. The name of each of them was associated in a Google search with selected key terms related to heart disease and/or acute cardiac events after their inclusion date. Global and sex-specific adverse cardiac event hazard function λ were calculated for each sport. Global and sex-specific prevalences of cardiac events were calculated, then compared (Fisher's exact test) between all sports. RESULTS From the 2471 athletes included, 15 cases of cardiac events (prevalence of 0.61%) were reported; 2 sudden cardiac deaths (0.08%) occurred in male athletes. The other events were related to arrhythmic events ( n = 13), mainly supraventricular arrhythmias ( n = 9). All surviving athletes were able to continue their career, mostly after ablation procedure. Male endurance athletes accounted for seven events, among which three events occurred among short-distance triathletes. Events among women were comparatively rare ( n = 4), and all were observed among short-distance triathletes. CONCLUSIONS A relatively unexpected high prevalence of cardiac events in endurance elite athletes was observed as compared with other sports, mainly, in short-distance male and female triathletes. This raises the question of particular cardiovascular constraints in this discipline and underlines the urge of international longitudinal follow-up studies in these kinds of athletes.
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Affiliation(s)
| | - Anne LE Cunuder
- Institute of Sport Sciences, University of Lausanne, Lausanne, SWITZERLAND
| | - Thibault Lachard
- CHU Rennes, Department of Sports Medicine, University Hospital of Rennes, Rennes, FRANCE
| | - Vincent Menard
- M2S Laboratory, Ecole Normale Supérieure Rennes, University of Rennes 2, Rennes, FRANCE
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14
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Hodgson JR, Chapman L, Pope FD. Amateur runners more influenced than elite runners by temperature and air pollution during the UK's Great North Run half marathon. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 842:156825. [PMID: 35752238 DOI: 10.1016/j.scitotenv.2022.156825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 06/06/2022] [Accepted: 06/15/2022] [Indexed: 06/15/2023]
Abstract
The short- and long-term impacts of air pollution on human health are well documented and include cardiovascular, neurological, immune system and developmental damage. Additionally, the irritant qualities of air pollutants can cause respiratory and cardiovascular distress. This can be heightened during exercise and especially so for those with respiratory conditions such as asthma. Meteorological conditions have also been shown to adversely impact athletic performance; but research has mostly examined the impact of pollution and meteorology on marathon times or running under laboratory settings. This study focuses on the half marathon distance (13.1 miles/21.1 km) and utilises the Great North Run held in Newcastle-upon-Tyne, England, between 2006 and 2019. Local meteorological (temperature, relative humidity, heat index and wind speed) and air quality (ozone, nitrogen dioxide and PM2.5) data is used in conjunction with finishing times of the quickest and slowest amateur participants, along with the elite field, to determine the extent to which each group is influenced in real-world conditions. Results show that increased temperatures, heat index and ozone concentrations are significantly detrimental to amateur half marathon performances. The elite field meanwhile is influenced by higher ozone concentrations. It is thought that the increased exposure time to the environmental conditions contributes to this greater decrease in performance for the slowest participants. For elite athletes that are performing closer to their maximal capacity (VO2 max), the higher ozone concentrations likely results in respiratory irritation and decreased performance. Nitrogen dioxide and PM2.5 pollution showed no significant relationship with finishing times. These results provide additional insight into the environmental effects on exercise, which is particularly important under the increasing effects climate change and regional air pollution. This study can be used to inform event organisation and start times for both mass participation and major elite events with the aim to reduce heat- and pollution-related incidents.
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Affiliation(s)
- James R Hodgson
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Birmingham B15 2TT, United Kingdom
| | - Lee Chapman
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Birmingham B15 2TT, United Kingdom
| | - Francis D Pope
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Birmingham B15 2TT, United Kingdom.
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15
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Périard JD, DeGroot D, Jay O. Exertional heat stroke in sport and the military: epidemiology and mitigation. Exp Physiol 2022; 107:1111-1121. [PMID: 36039024 PMCID: PMC9826288 DOI: 10.1113/ep090686] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 08/12/2022] [Indexed: 01/11/2023]
Abstract
NEW FINDINGS What is the topic of this review? Exertional heat stroke epidemiology in sport and military settings, along with common risk factors and strategies and policies designed to mitigate its occurrence. What advances does it highlight? Individual susceptibility to exertional heat stroke risk is dependent on the interaction of intrinsic and extrinsic factors. Heat policies in sport should assess environmental conditions, as well as the characteristics of the athlete, clothing/equipment worn and activity level of the sport. Exertional heat stroke risk reduction in the military should account for factors specific to training and personnel. ABSTRACT Exertional heat illness occurs along a continuum, developing from the relatively mild condition of muscle cramps, to heat exhaustion, and in some cases to the life-threatening condition of heat stroke. The development of exertional heat stroke (EHS) is associated with an increase in core temperature stemming from inadequate heat dissipation to offset the rate of metabolically generated heat. Susceptibility to EHS is linked to the interaction of several factors including environmental conditions, individual characteristics, health conditions, medication and drug use, behavioural responses, and sport/organisational requirements. Two settings in which EHS is commonly observed are competitive sport and the military. In sport, the exact prevalence of EHS is unclear due to inconsistent exertional heat illness terminology, diagnostic criteria and data reporting. In contrast, exertional heat illness surveillance in the military is facilitated by standardised case definitions, a requirement to report all heat illness cases and a centralised medical record repository. To mitigate EHS risk, several strategies can be implemented by athletes and military personnel, including heat acclimation, ensuring adequate hydration, cold-water immersion and mandated work-to-rest ratios. Organisations may also consider developing sport or military task-specific heat stress policies that account for the evaporative heat loss requirement of participants, relative to the evaporative capacity of the environment. This review examines the epidemiology of EHS along with the strategies and policies designed to reduce its occurrence in sport and military settings. We highlight the nuances of identifying individuals at risk of EHS and summarise the benefits and shortcomings of various mitigation strategies.
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Affiliation(s)
- Julien D. Périard
- Research Institute for Sport and ExerciseUniversity of CanberraCanberraAustralia
| | - David DeGroot
- Army Heat CenterMartin Army Community HospitalFort BenningGAUSA
| | - Ollie Jay
- Thermal Ergonomics LaboratoryHeat and Health Research IncubatorFaculty of Medicine and HealthUniversity of SydneyCamperdownAustralia
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16
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Lee JKW, Tan B, Ogden HB, Chapman S, Sawka MN. Exertional heat stroke: nutritional considerations. Exp Physiol 2022; 107:1122-1135. [PMID: 35521757 PMCID: PMC9790308 DOI: 10.1113/ep090149] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/02/2022] [Indexed: 12/30/2022]
Abstract
NEW FINDINGS What is the topic of this review? The potential role of nutrition in exertional heat stroke. What advances does it highlight? Certain nutritional and dietary strategies used by athletes and workers may exert a protective effect the pathophysiological processes of exertional heat stroke, whereas others may be detrimental. While current evidence suggests that some of these practices may be leveraged as a potential countermeasure to exertional heat stroke, further research on injury-related outcomes in humans is required. ABSTRACT Exertional heat stroke (EHS) is a life-threatening illness and an enduring problem among athletes, military servicemen and -women, and occupational labourers who regularly perform strenuous activity, often under hot and humid conditions or when wearing personal protective equipment. Risk factors for EHS and mitigation strategies have generally focused on the environment, health status, clothing, heat acclimatization and aerobic conditioning, but the potential role of nutrition is largely underexplored. Various nutritional and dietary strategies have shown beneficial effects on exercise performance and health and are widely used by athletes and other physically active populations. There is also evidence that some of these practices may dampen the pathophysiological features of EHS, suggesting possible protection or abatement of injury severity. Promising candidates include carbohydrate ingestion, appropriate fluid intake and glutamine supplementation. Conversely, some nutritional factors and low energy availability may facilitate the development of EHS, and individuals should be cognizant of these. Therefore, the aims of this review are to present an overview of EHS along with its mechanisms and pathophysiology, discuss how selected nutritional considerations may influence EHS risk focusing on their impact on the key pathophysiological processes of EHS, and provide recommendations for future research. With climate change expected to increase EHS risk and incidence in the coming years, further investigation on how diet and nutrition may be optimized to protect against EHS would be highly beneficial.
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Affiliation(s)
- Jason K. W. Lee
- Human Potential Translational Research Program, Yong Loo Lin School of MedicineNational University of SingaporeSingapore,Heat Resilience and Performance Centre, Yong Loo Lin School of MedicineNational University of SingaporeSingapore,Department of Physiology, Yong Loo Lin School of MedicineNational University of SingaporeSingapore,N.1 Institute for HealthNational University of SingaporeSingapore,Global Asia InstituteNational University of SingaporeSingapore,Institute for Digital MedicineYong Loo Lin School of MedicineNational University of SingaporeSingapore,Singapore Institute for Clinical SciencesAgency for Science, Technology and Research (A*STAR)Singapore,Campus for Research Excellence and Technological Enterprise (CREATE)SingaporeSingapore
| | - Beverly Tan
- Human Potential Translational Research Program, Yong Loo Lin School of MedicineNational University of SingaporeSingapore,Campus for Research Excellence and Technological Enterprise (CREATE)SingaporeSingapore
| | - Henry B. Ogden
- Army Recruit Health and Performance ResearchHeadquarters of Army Recruiting and Initial Training Command, UpavonPewseyUK,Department of Sport, Health and WellbeingPlymouth Marjon UniversityPlymouthUK
| | - Shaun Chapman
- Army Recruit Health and Performance ResearchHeadquarters of Army Recruiting and Initial Training Command, UpavonPewseyUK,Cambridge Centre for Sport and Exercise SciencesSchool of Psychology and Sport ScienceAnglia Ruskin UniversityCambridgeUK
| | - Michael N. Sawka
- School of Biological SciencesGeorgia Institute of TechnologyAtlantaGAUSA
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17
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Racinais S, Havenith G, Aylwin P, Ihsan M, Taylor L, Adami PE, Adamuz MC, Alhammoud M, Alonso JM, Bouscaren N, Buitrago S, Cardinale M, van Dyk N, Esh CJ, Gomez-Ezeiza J, Garrandes F, Holtzhausen L, Labidi M, Lange G, Lloyd A, Moussay S, Mtibaa K, Townsend N, Wilson MG, Bermon S. Association between thermal responses, medical events, performance, heat acclimation and health status in male and female elite athletes during the 2019 Doha World Athletics Championships. Br J Sports Med 2022; 56:439-445. [PMID: 35165084 PMCID: PMC8995810 DOI: 10.1136/bjsports-2021-104569] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2022] [Indexed: 12/14/2022]
Abstract
Purpose To determine associations between thermal responses, medical events, performance, heat acclimation and health status during a World Athletics Championships in hot-humid conditions. Methods From 305 marathon and race-walk starters, 83 completed a preparticipation questionnaire on health and acclimation. Core (Tcore; ingestible pill) and skin (Tskin; thermal camera) temperatures were measured in-competition in 56 and 107 athletes, respectively. 70 in-race medical events were analysed retrospectively. Performance (% personal best) and did not finish (DNF) were extracted from official results. Results Peak Tcore during competition reached 39.6°C±0.6°C (maximum 41.1°C). Tskin decreased from 32.2°C±1.3°C to 31.0°C±1.4°C during the races (p<0.001). Tcore was not related to DNF (25% of starters) or medical events (p≥0.150), whereas Tskin, Tskin rate of decrease and Tcore-to-Tskin gradient were (p≤0.029). A third of the athletes reported symptoms in the 10 days preceding the event, mainly insomnia, diarrhoea and stomach pain, with diarrhoea (9% of athletes) increasing the risk of in-race medical events (71% vs 17%, p<0.001). Athletes (63%) who performed 5–30 days heat acclimation before the competition: ranked better (18±13 vs 28±13, p=0.009), displayed a lower peak Tcore (39.4°C±0.4°C vs 39.8°C±0.7°C, p=0.044) and larger in-race decrease in Tskin (−1.4°C±1.0°C vs −0.9°C±1.2°C, p=0.060), than non-acclimated athletes. Although not significant, they also showed lower DNF (19% vs 30%, p=0.273) and medical events (19% vs 32%, p=0.179). Conclusion Tskin, Tskin rate of decrease and Tcore-to-Tskin gradient were important indicators of heat tolerance. While heat-acclimated athletes ranked better, recent diarrhoea represented a significant risk factor for DNF and in-race medical events.
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Affiliation(s)
- Sebastien Racinais
- Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
| | - George Havenith
- Environmental Ergonomics Research Centre, Loughborough University, Loughborough, Leics, UK
| | - Polly Aylwin
- Environmental Ergonomics Research Centre, Loughborough University, Loughborough, Leics, UK
| | - Mohammed Ihsan
- Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar.,Human Potential Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Lee Taylor
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.,Human Performance Research Centre, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Paolo Emilio Adami
- Health and Science, World Athletics, Monaco.,LAMHESS, Université Côte d'Azur, Nice, France
| | - Maria-Carmen Adamuz
- Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
| | - Marine Alhammoud
- Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
| | - Juan Manuel Alonso
- Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
| | - Nicolas Bouscaren
- Inserm CIC1410, CHU Reunion, La Réunion, Réunion.,Interuniversity Laboratory of Human Movement Biology-EA 7424, Université Jean Monnet Saint-Etienne, Saint-Etienne, France
| | | | - Marco Cardinale
- Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar.,Institute of Sport Exercise and Health (ISEH), University College London, London, UK
| | - Nicol van Dyk
- Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar.,High Performance Unit, Irish Rugby Football Union, Dublin, Ireland
| | - Chris J Esh
- Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar.,School of Sport Exercise and Health Sciences, Loughborough, UK
| | - Josu Gomez-Ezeiza
- Institute of Sport and Exercise Medicine, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, South Africa
| | - Frederic Garrandes
- Health and Science, World Athletics, Monaco.,LAMHESS, Université Côte d'Azur, Nice, France
| | - Louis Holtzhausen
- Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar.,Section Sports Medicine, University of Pretoria Faculty of Health Sciences, Pretoria, South Africa
| | - Mariem Labidi
- Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
| | | | - Alexander Lloyd
- Environmental Ergonomics Research Centre, Loughborough University, Loughborough, Leics, UK
| | - Sebastien Moussay
- Unicaen, Inserm, Comete, GIP Cyceron, Normandie Universite, Caen, France
| | - Khouloud Mtibaa
- Physical Education Department, College of Education, Qatar University, Doha, Qatar
| | - Nathan Townsend
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Mathew G Wilson
- Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar.,Institute of Sport Exercise and Health (ISEH), University College London, London, UK
| | - Stephane Bermon
- Health and Science, World Athletics, Monaco.,LAMHESS, Université Côte d'Azur, Nice, France
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18
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Bouchama A, Abuyassin B, Lehe C, Laitano O, Jay O, O'Connor FG, Leon LR. Classic and exertional heatstroke. Nat Rev Dis Primers 2022; 8:8. [PMID: 35115565 DOI: 10.1038/s41572-021-00334-6] [Citation(s) in RCA: 124] [Impact Index Per Article: 62.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/20/2021] [Indexed: 12/28/2022]
Abstract
In the past two decades, record-breaking heatwaves have caused an increasing number of heat-related deaths, including heatstroke, globally. Heatstroke is a heat illness characterized by the rapid rise of core body temperature above 40 °C and central nervous system dysfunction. It is categorized as classic when it results from passive exposure to extreme environmental heat and as exertional when it develops during strenuous exercise. Classic heatstroke occurs in epidemic form and contributes to 9-37% of heat-related fatalities during heatwaves. Exertional heatstroke sporadically affects predominantly young and healthy individuals. Under intensive care, mortality reaches 26.5% and 63.2% in exertional and classic heatstroke, respectively. Pathological studies disclose endothelial cell injury, inflammation, widespread thrombosis and bleeding in most organs. Survivors of heatstroke may experience long-term neurological and cardiovascular complications with a persistent risk of death. No specific therapy other than rapid cooling is available. Physiological and morphological factors contribute to the susceptibility to heatstroke. Future research should identify genetic factors that further describe individual heat illness risk and form the basis of precision-based public health response. Prioritizing research towards fundamental mechanism and diagnostic biomarker discovery is crucial for the design of specific management approaches.
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Affiliation(s)
- Abderrezak Bouchama
- King Abdullah International Medical Research Center, Experimental Medicine Department, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia.
| | - Bisher Abuyassin
- King Abdullah International Medical Research Center, Experimental Medicine Department, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Cynthia Lehe
- King Abdullah International Medical Research Center, Experimental Medicine Department, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Orlando Laitano
- Department of Nutrition & Integrative Physiology, College of Health and Human Sciences, Florida State University, Tallahassee, FL, USA
| | - Ollie Jay
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Francis G O'Connor
- Military and Emergency Medicine, Uniformed Services University, Bethesda, MD, USA
| | - Lisa R Leon
- Thermal and Mountain Medicine Division, United States Army Research Institute of Environmental Medicine, Natick, Massachusetts, USA
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19
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Scrocco C, Bezzina CR, Ackerman MJ, Behr ER. Genetics and genomics of arrhythmic risk: current and future strategies to prevent sudden cardiac death. Nat Rev Cardiol 2021; 18:774-784. [PMID: 34031597 DOI: 10.1038/s41569-021-00555-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/12/2021] [Indexed: 02/04/2023]
Abstract
A genetic risk of sudden cardiac arrest and sudden death due to an arrhythmic cause, known as sudden cardiac death (SCD), has become apparent from epidemiological studies in the general population and in patients with ischaemic heart disease. However, genetic susceptibility to sudden death is greatest in young people and is associated with uncommon, monogenic forms of heart disease. Despite comprehensive pathology and genetic evaluations, SCD remains unexplained in a proportion of young people and is termed sudden arrhythmic death syndrome, which poses challenges to the identification of relatives from affected families who might be at risk of SCD. In this Review, we assess the current understanding of the epidemiology and causes of SCD and evaluate both the monogenic and the polygenic contributions to the risk of SCD in the young and SCD associated with drug therapy. Finally, we analyse the potential clinical role of genomic testing in the prevention of SCD in the general population.
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Affiliation(s)
- Chiara Scrocco
- Cardiovascular Clinical Academic Group, Molecular and Clinical Sciences Institute, St George's University of London and St George's University Hospitals NHS Foundation Trust, London, UK
| | - Connie R Bezzina
- Amsterdam University Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Michael J Ackerman
- Departments of Cardiovascular Medicine, Pediatric and Adolescent Medicine, and Molecular Pharmacology & Experimental Therapeutics; Divisions of Heart Rhythm Services and Pediatric Cardiology, Mayo Clinic, Rochester, MN, USA.,Windland Smith Rice Genetic Heart Rhythm Clinic and the Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, Rochester, MN, USA
| | - Elijah R Behr
- Cardiovascular Clinical Academic Group, Molecular and Clinical Sciences Institute, St George's University of London and St George's University Hospitals NHS Foundation Trust, London, UK.
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Ebi KL, Capon A, Berry P, Broderick C, de Dear R, Havenith G, Honda Y, Kovats RS, Ma W, Malik A, Morris NB, Nybo L, Seneviratne SI, Vanos J, Jay O. Hot weather and heat extremes: health risks. Lancet 2021; 398:698-708. [PMID: 34419205 DOI: 10.1016/s0140-6736(21)01208-3] [Citation(s) in RCA: 325] [Impact Index Per Article: 108.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 12/15/2020] [Accepted: 05/20/2021] [Indexed: 01/18/2023]
Abstract
Hot ambient conditions and associated heat stress can increase mortality and morbidity, as well as increase adverse pregnancy outcomes and negatively affect mental health. High heat stress can also reduce physical work capacity and motor-cognitive performances, with consequences for productivity, and increase the risk of occupational health problems. Almost half of the global population and more than 1 billion workers are exposed to high heat episodes and about a third of all exposed workers have negative health effects. However, excess deaths and many heat-related health risks are preventable, with appropriate heat action plans involving behavioural strategies and biophysical solutions. Extreme heat events are becoming permanent features of summer seasons worldwide, causing many excess deaths. Heat-related morbidity and mortality are projected to increase further as climate change progresses, with greater risk associated with higher degrees of global warming. Particularly in tropical regions, increased warming might mean that physiological limits related to heat tolerance (survival) will be reached regularly and more often in coming decades. Climate change is interacting with other trends, such as population growth and ageing, urbanisation, and socioeconomic development, that can either exacerbate or ameliorate heat-related hazards. Urban temperatures are further enhanced by anthropogenic heat from vehicular transport and heat waste from buildings. Although there is some evidence of adaptation to increasing temperatures in high-income countries, projections of a hotter future suggest that without investment in research and risk management actions, heat-related morbidity and mortality are likely to increase.
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Affiliation(s)
- Kristie L Ebi
- Center for Health and the Global Environment, University of Washington, Seattle, WA, USA.
| | - Anthony Capon
- Monash Sustainable Development Institute, Monash University, Melbourne, VIC, Australia; Sydney School of Public Health, Sydney, NSW, Australia
| | - Peter Berry
- Faculty of Environment, University of Waterloo, Waterloo, ON, Canada
| | - Carolyn Broderick
- School of Medical Sciences, UNSW Sydney, NSW, Australia; The Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Richard de Dear
- Indoor Environmental Quality Laboratory, School of Architecture, Design, and Planning, Sydney, NSW, Australia; The University of Sydney, Sydney, NSW, Australia
| | - George Havenith
- Environmental Ergonomics Research Centre, School of Design and Creative Arts, Loughborough University, Loughborough, UK
| | - Yasushi Honda
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - R Sari Kovats
- NIHR Health Protection Research Unit in Environmental Change and Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Wei Ma
- School of Public Health and Climate Change and Health Center, Shandong University, Jinan, China
| | - Arunima Malik
- Discipline of Accounting, Business School, Sydney, NSW, Australia; School of Physics, Faculty of Science, ISA, Sydney, NSW, Australia
| | - Nathan B Morris
- Thermal Ergonomics Laboratory, Sydney, NSW, Australia; Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Lars Nybo
- Department of Nutrition, Exercise, and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Sonia I Seneviratne
- Institute for Atmospheric and Climate Science, ETH Zurich, Zurich, Switzerland
| | - Jennifer Vanos
- School of Sustainability, Arizona State University, Tempe, AZ, USA
| | - Ollie Jay
- Thermal Ergonomics Laboratory, Sydney, NSW, Australia; Sydney School of Health Sciences, Sydney, NSW, Australia; Sydney School of Public Health, Sydney, NSW, Australia; Faculty of Medicine and Health, Charles Perkins Centre, Sydney, NSW, Australia
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21
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Liu S, Xing L, Wang Q, Xin T, Mao H, Tao Y, Zhao J, Li X, Li C, Li Q, Dou Y, Li Y, Zhang W, Ning B, Song Q. Association Between Early Stage-Related Factors and Mortality in Patients with Exertional Heat Stroke: A Retrospective Study of 214 Cases. Int J Gen Med 2021; 14:4629-4638. [PMID: 34429645 PMCID: PMC8380138 DOI: 10.2147/ijgm.s322910] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/26/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE The purpose of this study is to evaluate the factors involved in the early stage of exertional heat stroke (EHS) that are associated with mortality. METHODS In this retrospective, case-control study, patients from 11 tertiary medical centers in China were enrolled from January 1, 2012, to December 31, 2019. Demographic information, underlying diseases, ambient temperature, and relative humidity, clinical manifestations, initial body temperature, time from onset to diagnosis of EHS (including suspected), and the duration of body temperature > 38°C of all enrolled patients were recorded. The occurrence of organ dysfunction within 72 h was evaluated, and in-hospital deaths were recorded. The patients were subsequently divided into a survival group and a non-survival group. The "case" refers to patients in the non-survival group, while the "control" refers to patients without death. RESULTS Of the 214 hospitalized patients with EHS, 183 survived and 31 died, and the overall mortality was 14.49% (31/214). A binary logistic regression showed that only the duration of body temperature > 38°C (OR 1.80, 95% CI 1.34-2.42) and the number of organs damaged within 72 h of onset (OR 6.54, 95% CI 2.31-18.56) were statistically significant in terms of risk of death in hospital (p < 0.05). A goodness of fit test produced a p-value of 0.76. According to receiver operating characteristic curve (ROC) analysis, the areas under the curve (AUC) were 0.989 (95% CI 0.978-1.000; p < 0.05) and 0.936 (95% CI 0.896-0.976; p < 0.05). CONCLUSION Of the various factors involved in the early stage of the disease, the duration of high body temperature and the number of organs damaged within 72 h of onset were independent risk factors and predictors associated with death.
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Affiliation(s)
- Shuyuan Liu
- Medical School of Chinese PLA, Beijing, People’s Republic of China
- Emergency Department, Sixth Medical Center, Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Ling Xing
- Medical School of Chinese PLA, Beijing, People’s Republic of China
- Department of Emergency, Beijing Tongren Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Qian Wang
- Emergency Department, Third Medical Center, Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Tianyu Xin
- Emergency Department, Sixth Medical Center, Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Handing Mao
- Medical School of Chinese PLA, Beijing, People’s Republic of China
| | - Ye Tao
- Health Care Department, Beijing Huangsi Aesthetic Surgery Hospital, Beijing, People’s Republic of China
| | - Jinbao Zhao
- Emergency Department, Sixth Medical Center, Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Xin Li
- Emergency Department, Third Medical Center, Chinese PLA General Hospital, Beijing, People’s Republic of China
| | - Cong Li
- Medical School of Chinese PLA, Beijing, People’s Republic of China
| | - Qinghua Li
- Department of Intensive Care Unit, The 990th Hospital of Chinese PLA, Zhumadian, People’s Republic of China
| | - Yan Dou
- Department of Intensive Care Unit, The 909th Hospital of Chinese PLA, Zhangzhou, People’s Republic of China
| | - Yixin Li
- Department of Intensive Care Unit, The 910th Hospital of Chinese PLA, Quanzhou, People’s Republic of China
| | - Wei Zhang
- Emergency Department, The 900th Hospital of Chinese PLA, Fuzhou, People’s Republic of China
| | - Bo Ning
- Department of Intensive Care Unit, Air Force Medical Center of China, Beijing, People’s Republic of China
| | - Qing Song
- Medical School of Chinese PLA, Beijing, People’s Republic of China
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22
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Pedlar CR, Myrissa K, Barry M, Khwaja IG, Simpkin AJ, Newell J, Scarrott C, Whyte GP, Kipps C, Baggish AL. Medical encounters at community-based physical activity events (parkrun) in the UK. Br J Sports Med 2021; 55:1420-1426. [PMID: 34348921 DOI: 10.1136/bjsports-2021-104256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To determine the incidence, clinical correlates and exposure risk of medical encounters during community-based physical activity events in the UK. METHODS An analysis of medical data from weekly, community-based physical activity events (parkrun) at 702 UK locations over a 6-year period (29 476 294 participations between 2014 and 2019) was conducted in order to define the incidence and clinical correlates of serious life-threatening, non-life-threatening and fatal medical encounters. RESULTS 84 serious life-threatening encounters (overall incidence rate=0.26/100 000 participations) occurred including 18 fatalities (0.056/100 000 participations). Statistical modelling revealed that the probabilities of serious life-threatening encounters were exceptionally low, however, male sex, increasing age, slower personal best parkrun time and less prior running engagement/experience (average number of runs per year and number of years as a parkrun participant) were associated with increased probability of serious life-threatening encounters. These were largely accounted for by cardiac arrest (48/84, 57%) and acute coronary syndromes (20/84, 24%). Non-life-threatening medical encounters were mainly attributed to tripping or falling, with a reported incidence of 39.2/100 000 participations. CONCLUSIONS Serious life-threatening and fatal medical encounters associated with parkrun participation are extremely rare. In the context of a global public health crisis due to inactivity, this finding underscores the safety and corollary public health value of community running/walking events as a strategy to promote physical activity.
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Affiliation(s)
- Charles R Pedlar
- Faculty of Sport and Applied Performance Science, St Mary's University Twickenham, Twickenham, UK .,Institute of Sport, Exercise and Health, University College London, London, UK
| | - Kyriaki Myrissa
- Faculty of Sport and Applied Performance Science, St Mary's University Twickenham, Twickenham, UK
| | - Megan Barry
- Faculty of Sport and Applied Performance Science, St Mary's University Twickenham, Twickenham, UK
| | - Iman G Khwaja
- Faculty of Sport and Applied Performance Science, St Mary's University Twickenham, Twickenham, UK
| | - Andrew J Simpkin
- School of Mathematics, Statistics and Applied Mathematics, NUI Galway, Galway, Ireland
| | - John Newell
- School of Mathematics, Statistics and Applied Mathematics, NUI Galway, Galway, Ireland
| | - Carl Scarrott
- School of Mathematics, Statistics and Applied Mathematics, NUI Galway, Galway, Ireland
| | - Greg P Whyte
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Courtney Kipps
- Institute of Sport, Exercise and Health, University College London, London, UK
| | - Aaron L Baggish
- Harvard Medical School, Boston, Massachusetts, USA.,Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA
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23
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Hodgson JR, Chapman L, Pope FD. The Diamond League athletic series: does the air quality sparkle? INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2021; 65:1427-1442. [PMID: 33760979 PMCID: PMC7988253 DOI: 10.1007/s00484-021-02114-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 02/08/2021] [Accepted: 03/09/2021] [Indexed: 06/12/2023]
Abstract
Urban air pollution can have negative short- and long-term impacts on health, including cardiovascular, neurological, immune system and developmental damage. The irritant qualities of pollutants such as ozone (O3), nitrogen dioxide (NO2) and particulate matter (PM) can cause respiratory and cardiovascular distress, which can be heightened during physical activity and particularly so for those with respiratory conditions such as asthma. Previously, research has only examined marathon run outcomes or running under laboratory settings. This study focuses on elite 5-km athletes performing in international events at nine locations. Local meteorological and air quality data are used in conjunction with race performance metrics from the Diamond League Athletics series to determine the extent to which elite competitors are influenced during maximal sustained efforts in real-world conditions. The findings from this study suggest that local meteorological variables (temperature, wind speed and relative humidity) and air quality (ozone and particulate matter) have an impact on athletic performance. Variation between finishing times at different race locations can also be explained by the local meteorology and air quality conditions seen during races.
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Affiliation(s)
- James R Hodgson
- School of Geography, Earth and Environmental Sciences, University of Birmingham, B15 2TT, Birmingham, UK
| | - Lee Chapman
- School of Geography, Earth and Environmental Sciences, University of Birmingham, B15 2TT, Birmingham, UK
| | - Francis D Pope
- School of Geography, Earth and Environmental Sciences, University of Birmingham, B15 2TT, Birmingham, UK.
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Bouscaren N, Faricier R, Millet GY, Racinais S. Heat Acclimatization, Cooling Strategies, and Hydration during an Ultra-Trail in Warm and Humid Conditions. Nutrients 2021; 13:1085. [PMID: 33810371 PMCID: PMC8065615 DOI: 10.3390/nu13041085] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/21/2021] [Accepted: 03/24/2021] [Indexed: 11/17/2022] Open
Abstract
The aim of this study was to assess the history of exertional heat illness (EHI), heat preparation, cooling strategies, heat related symptoms, and hydration during an ultra-endurance running event in a warm and humid environment. This survey-based study was open to all people who participated in one of the three ultra-endurance races of the Grand Raid de la Réunion. Ambient temperature and relative humidity were 18.6 ± 5.7 °C (max = 29.7 °C) and 74 ± 17%, respectively. A total of 3317 runners (56% of the total eligible population) participated in the study. Overall, 78% of the runners declared a history of heat-related symptoms while training or competing, and 1.9% reported a previous diagnosis of EHI. Only 24.3% of study participants living in temperate climates declared having trained in the heat before the races, and 45.1% of all respondents reported a cooling strategy during the races. Three quarter of all participants declared a hydration strategy. The planned hydration volume was 663 ± 240 mL/h. Fifty-nine percent of the runners had enriched their food or drink with sodium during the race. The present study shows that ultra-endurance runners have a wide variability of hydration and heat preparation strategies. Understandings of heat stress repercussions in ultra-endurance running need to be improved by specific field research.
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Affiliation(s)
- Nicolas Bouscaren
- Inserm CIC1410, CHU Réunion, 97448 Saint Pierre, France
- Inter-University Laboratory of Human Movement Biology, UJM-Saint-Etienne, Univ Lyon, EA 7424, 42023 Saint-Etienne, France; (R.F.); (G.Y.M.)
| | - Robin Faricier
- Inter-University Laboratory of Human Movement Biology, UJM-Saint-Etienne, Univ Lyon, EA 7424, 42023 Saint-Etienne, France; (R.F.); (G.Y.M.)
| | - Guillaume Y. Millet
- Inter-University Laboratory of Human Movement Biology, UJM-Saint-Etienne, Univ Lyon, EA 7424, 42023 Saint-Etienne, France; (R.F.); (G.Y.M.)
- Institut Universitaire de France (IUF), 75231 Paris, France
| | - Sébastien Racinais
- Research and Scientific Support Department, Aspetar Orthopedic and Sports Medicine Hospital, Doha 29222, Qatar;
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25
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Schulze-Bahr E, Dettmeyer RB, Klingel K, Kauferstein S, Wolf C, Baba HA, Bohle RM, Gebauer R, Milting H, Schmidt U, Meder B, Rieß O, Paul T, Bajanowski T, Schunkert H. Postmortale molekulargenetische Untersuchungen (molekulare Autopsie) bei kardiovaskulären und bei ungeklärten Todesfällen. KARDIOLOGE 2021. [DOI: 10.1007/s12181-020-00438-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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26
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Racinais S, Alhammoud M, Nasir N, Bahr R. Epidemiology and risk factors for heat illness: 11 years of Heat Stress Monitoring Programme data from the FIVB Beach Volleyball World Tour. Br J Sports Med 2020; 55:831-835. [DOI: 10.1136/bjsports-2020-103048] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2020] [Indexed: 12/29/2022]
Abstract
ObjectivesTo analyse 11 years of FIVB heat stress-monitoring data to determine the relative influence of the different environmental parameters in increasing the likelihood of a heat-related medical time-out (MTOheat).MethodsA total of 8530 matches were recorded. The referee measured air temperature, black globe temperature, relative humidity and wet-bulb globe temperature (WBGT) before the matches, and registered the MTOheat. The absolute humidity was computed at posteriori.ResultsThere were 20 MTOheat cases, but only 3 resulted in forfeiting the match. MTOheat incidence was not statistically impacted by sex (p=0.59). MTOheat cases were more prevalent during the games played in Asia during the 4th quarter of the year (p<0.001). Two cases of MTOheat experienced diarrhoea or gastroenteritis during the 5 preceding days; both of them forfeited the match. A principal component analysis showed a specific environmental profile for the matches with MTOheat. They occurred at higher WBGT, temperatures and absolute humidity (p<0.001), but with a lower relative humidity (p=0.027).ConclusionsThe current data showed that an increase in ambient or black globe temperature, but not relative humidity, increased the risk of a MTOheat; but that the absolute risk remained low in elite beach volleyball players. However, suffering or recovering from a recent illness may represent a risk factor for a MTOheat to lead to player forfeit.
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27
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Epidemiology of exertional heat illnesses in organised sports: A systematic review. J Sci Med Sport 2020; 23:701-709. [DOI: 10.1016/j.jsams.2020.02.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 01/13/2020] [Accepted: 02/07/2020] [Indexed: 11/21/2022]
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Liu SY, Song JC, Mao HD, Zhao JB, Song Q. Expert consensus on the diagnosis and treatment of heat stroke in China. Mil Med Res 2020; 7:1. [PMID: 31928528 PMCID: PMC6956553 DOI: 10.1186/s40779-019-0229-2] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 11/20/2019] [Indexed: 12/18/2022] Open
Abstract
Heat stroke (HS) is a fatal disease caused by thermal damage in the body, and it has a very high mortality rate. In 2015, the People's Liberation Army Professional Committee of Critical Care Medicine published the first expert consensus on HS in China, Expert consensus on standardized diagnosis and treatment for heat stroke. With an increased understanding of HS and new issues that emerged during the HS treatment in China in recent years, the 2015 consensus no longer meet the requirements for HS prevention and treatment. It is necessary to update the consensus to include the latest research evidence and establish a new consensus that has broader coverage, is more practical and is more in line with China's national conditions. This new expert consensus includes new concept of HS, recommendations for laboratory tests and auxiliary examinations, new understanding of diagnosis and differential diagnosis, On-site emergency treatment and In-hospital treatment, translocation of HS patients and prevention of HS.
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Affiliation(s)
- Shu-Yuan Liu
- Emergency Department, Sixth Medical Center, Chinese PLA General Hospital, Beijing, 100048, China
| | - Jing-Chun Song
- Department of Critical Care Medicine, No. 908th Hospital of PLA, Nanchang, 360104, China
| | - Han-Ding Mao
- Department of Critical Care Medicine, First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Jin-Bao Zhao
- Emergency Department, Sixth Medical Center, Chinese PLA General Hospital, Beijing, 100048, China
| | - Qing Song
- Department of Critical Care Medicine, First Medical Center, Chinese PLA General Hospital, Beijing, 100853, China.
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Profiling Collapsing Half Marathon Runners-Emerging Risk Factors: Results from Gothenburg Half Marathon. Sports (Basel) 2019; 8:sports8010002. [PMID: 31881684 PMCID: PMC7022577 DOI: 10.3390/sports8010002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 12/19/2019] [Accepted: 12/22/2019] [Indexed: 11/16/2022] Open
Abstract
Among several serious medical conditions, arrhythmia and heat stroke are two important causes of death during endurance races. Clinically, collapsing might be the first sign of these serious conditions and may mimic the more common and benign exercise-associated collapse. Several risk factors have been reported in the literature. We aimed to conduct a qualitative study to find a perceived risk profile among runners who collapsed and who were transported by ambulances to the nearest hospital during Gothenburg’s half marathon (2010–2017). Collapsing runners seem to lack the ability to make a decision to withdraw from the contest despite being exhausted. They feel the pain, but are unable to put meaning to their feeling, to adjust their pacing, and to handle other influences. Consequently, they do not overcome the problem or assess the situation. These individual mental characteristics may indicate a unique profile for collapsing runners. Pre-race health control and educational initiatives aiming at mental preparedness and information before endurance races might be a necessary step to avoid life-threatening complications.
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Emery MS, Kovacs RJ. Sudden Cardiac Death in Athletes. JACC-HEART FAILURE 2019; 6:30-40. [PMID: 29284578 DOI: 10.1016/j.jchf.2017.07.014] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 07/18/2017] [Accepted: 07/19/2017] [Indexed: 12/24/2022]
Abstract
Sudden cardiac death is a tragedy at any age and under any circumstances but is perhaps most tragic when it claims the life of the athlete, the individual who epitomizes health and a healthy lifestyle. Sports cardiologists from around the world have worked to quantitate the incidence of sudden cardiac death (SCD) in the athlete, to identify risk factors, to develop pre-participation screening tools, and to formulate plans to deal with on-field SCD. Progress has been made, but much remains to be done in order to make both competitive and recreational sports safer for both patients with known cardiac disease and athletes without known or suspected cardiac abnormalities.
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Affiliation(s)
- Michael S Emery
- Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis, Indiana; Center for Cardiovascular Care in Athletics, Indiana University Health, Indianapolis, Indiana
| | - Richard J Kovacs
- Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis, Indiana; Center for Cardiovascular Care in Athletics, Indiana University Health, Indianapolis, Indiana.
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Kondo Y, Hifumi T, Shimazaki J, Oda Y, Shiraishi SI, Hayashida K, Fukuda T, Wakasugi M, Kanda J, Moriya T, Yagi M, Kawahara T, Tonouchi M, Yokobori S, Yokota H, Miyake Y, Shimizu K. Comparison between the Bouchama and Japanese Association for Acute Medicine Heatstroke Criteria with Regard to the Diagnosis and Prediction of Mortality of Heatstroke Patients: A Multicenter Observational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16183433. [PMID: 31527479 PMCID: PMC6765926 DOI: 10.3390/ijerph16183433] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 09/08/2019] [Accepted: 09/09/2019] [Indexed: 12/24/2022]
Abstract
Background: This study aims to compare the Bouchama heatstroke (B-HS) and Japanese Association for Acute Medicine heatstroke (JAAM-HS) criteria with regard to the diagnosis and prediction of mortality and neurological status of heatstroke patients. Methods: This multicenter observational study recruited eligible patients from the emergency departments of 110 major hospitals in Japan from 1 July to 30 September, 2014. Results: A total of 317 patients (median age, 65 years; interquartile range, 39–80 years) were included and divided into the B-HS, JAAM-HS, and non-HS groups, with each group consisting of 97, 302, and 15 patients, respectively. The JAAM-HS (1.0; 95% confidence interval [CI], 0.87–1.0) and B-HS (0.29; 95% CI, 0.14–0.49) criteria showed high and low sensitivity to mortality, respectively. Similarly, the JAAM-HS (1.0; 95% CI, 0.93–1.0) and B-HS (0.35; 95% CI, 0.23–0.49) criteria showed high and low sensitivity to poor neurological status, respectively. Meanwhile, the sequential organ failure assessment (SOFA) scores demonstrated good accuracy in predicting mortality among heat-related illness (HRI) patients. However, both JAAM-HS and B-HS criteria could not predict in-hospital mortality. The AUC of the SOFA score for mortality was 0.83 (day 3) among the HRI patients. The patients’ neurological status was difficult to predict using the JAAM-HS and B-HS criteria. Concurrently, the total bilirubin level could relatively predict the central nervous system function at discharge. Conclusions: The JAAM-HS criteria showed high sensitivity to mortality and could include all HRI patients who died. The JAAM-HS criterion was considered a useful tool for judgement of admission at ED. Further investigations are necessary to determine the accuracy of both B-HS and JAAM-HS criteria in predicting mortality and neurological status at discharge.
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Affiliation(s)
- Yutaka Kondo
- Department of Emergency and Critical Care Medicine, Juntendo University Urayasu Hospital, Chiba 279-0021, Japan.
| | - Toru Hifumi
- Department of Emergency and Critical Care Medicine, St. Luke's International Hospital, Tokyo 104-8560, Japan.
| | - Junya Shimazaki
- Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan.
| | - Yasutaka Oda
- Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, Yamaguchi 755-8505, Japan.
| | - Shin-Ichiro Shiraishi
- Department of Emergency and Critical Care Medicine, Aidu Chuo Hospital, Fukushima 965-8611, Japan.
| | - Kei Hayashida
- Department of Emergency and Critical Care Medicine, School of Medicine, Keio University, Tokyo 160-8582, Japan.
| | - Tatsuma Fukuda
- Department of Emergency and Critical Care Medicine, Graduate School of Medicine, University of the Ryukyus, Okinawa 903-0215, Japan.
| | - Masahiro Wakasugi
- Emergency and Critical Care Center, Toyama University Hospital, Toyama 930-0152, Japan.
| | - Jun Kanda
- Department of Emergency Medicine, Teikyo University School of Medicine, Tokyo 173-8606, Japan.
| | - Takashi Moriya
- Department of Emergency and Critical Care Medicine, Saitama Medical Center, Jichi Medical University, Saitama 330-8503, Japan.
| | - Masaharu Yagi
- Department of Emergency and Critical Care Medicine, Urasoe General Hospital, Okinawa 901-2132, Japan.
| | | | | | - Shoji Yokobori
- Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo 113-8603, Japan.
| | - Hiroyuki Yokota
- Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo 113-8603, Japan.
| | - Yasufumi Miyake
- Department of Emergency Medicine, Teikyo University School of Medicine, Tokyo 173-8606, Japan.
| | - Keiki Shimizu
- Emergency and Critical Care Center, Tokyo Metropolitan Tama Medical Centre, Tokyo 183-8524, Japan.
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Zhang Y, Bishop PA. Can L-glutamine augmented heat shock protein 70 expression prevent exercise-induced exertional heat stroke and sudden cardiac death? CNS Neurosci Ther 2019; 26:148-150. [PMID: 31469237 PMCID: PMC6930829 DOI: 10.1111/cns.13217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 08/15/2019] [Accepted: 08/16/2019] [Indexed: 11/30/2022] Open
Affiliation(s)
- Yang Zhang
- Faculty for Sport and Physical Education, University of Montenegro, Podgorica, Montenegro
| | - Phillip A Bishop
- Department of Kinesiology, University of Alabama, Tuscaloosa, AL, USA
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Physical Activity and Sports-Real Health Benefits: A Review with Insight into the Public Health of Sweden. Sports (Basel) 2019; 7:sports7050127. [PMID: 31126126 PMCID: PMC6572041 DOI: 10.3390/sports7050127] [Citation(s) in RCA: 135] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 05/15/2019] [Accepted: 05/21/2019] [Indexed: 12/21/2022] Open
Abstract
Positive effects from sports are achieved primarily through physical activity, but secondary effects bring health benefits such as psychosocial and personal development and less alcohol consumption. Negative effects, such as the risk of failure, injuries, eating disorders, and burnout, are also apparent. Because physical activity is increasingly conducted in an organized manner, sport’s role in society has become increasingly important over the years, not only for the individual but also for public health. In this paper, we intend to describe sport’s physiological and psychosocial health benefits, stemming both from physical activity and from sport participation per se. This narrative review summarizes research and presents health-related data from Swedish authorities. It is discussed that our daily lives are becoming less physically active, while organized exercise and training increases. Average energy intake is increasing, creating an energy surplus, and thus, we are seeing an increasing number of people who are overweight, which is a strong contributor to health problems. Physical activity and exercise have significant positive effects in preventing or alleviating mental illness, including depressive symptoms and anxiety- or stress-related disease. In conclusion, sports can be evolving, if personal capacities, social situation, and biological and psychological maturation are taken into account. Evidence suggests a dose–response relationship such that being active, even to a modest level, is superior to being inactive or sedentary. Recommendations for healthy sports are summarized.
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Flouris AD, Friesen BJ, Herry CL, Seely AJE, Notley SR, Kenny GP. Heart rate variability dynamics during treatment for exertional heat strain when immediate response is not possible. Exp Physiol 2019; 104:845-854. [PMID: 30932277 DOI: 10.1113/ep087297] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 03/25/2019] [Indexed: 12/30/2022]
Abstract
NEW FINDINGS What is the central question of this study? Does a delay in cold water immersion treatment affect the cardiac autonomic control of exertionally heat-strained individuals? What is the main finding and its importance? Cold water immersion is effective for treating exertionally heat-strained individuals even when treatment is commenced with a significant delay. However, that treatment delay leads to only partial/transient restoration of cardiac autonomic control. Therefore, we recommend that exertional heatstroke patients are continuously monitored for several hours even after core temperature has returned to normal values. ABSTRACT Immediate cold water immersion (CWI) is the gold-standard treatment for exertional heatstroke. In the field, however, treatment is often delayed, primarily owing to a delayed paramedic response and/or inaccurate diagnosis. We examined the effect of treatment (reduction of rectal temperature to 37.5°C) delays of 5 (short), 20 (moderate) and 40 (prolonged) min on cardiac autonomic control [as assessed via heart rate variability (HRV)] in eight exertionally heat-strained (40.0°C rectal temperature) individuals. Eleven HRV indices were computed that have been described commonly in the literature and characterize almost all known domains of the variability and complexity of the cardiopulmonary system. We found that the cardiac autonomic control (as assessed via HRV) of exertionally heat-strained individuals was significantly affected by the amount of time it took for the CWI treatment to be applied. Six out of 11 HRV indices studied, from all variability domains, displayed strong (P ≤ 0.005) time × delay interaction effects. Moreover, the number of significantly (P ≤ 0.005) abnormal (i.e. different from the short delay) HRV indices more than doubled (seven versus 15) from the moderate delay to the prolonged delay. Finally, our results demonstrated that a CWI treatment applied with delays of 20 and, primarily, 40 min did not lead to a full restoration of cardiac autonomic control of exertionally heat-strained individuals. In conclusion, this study supports CWI for treating exertionally heat-strained individuals even when applied with prolonged delay, but it highlights the importance of continued cardiac monitoring of patients who have suffered exertional heatstroke for several hours after restoration of core temperature to normal.
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Affiliation(s)
- Andreas D Flouris
- FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Trikala, 42100, Greece.,Human Environmental Physiological Research Unit, University of Ottawa, Ottawa, ON, Canada
| | - Brian J Friesen
- Human Environmental Physiological Research Unit, University of Ottawa, Ottawa, ON, Canada
| | - Christophe L Herry
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ontario, Canada
| | - Andrew J E Seely
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ontario, Canada.,Thoracic Surgery and Critical Care Medicine, Ottawa Hospital, Ontario, Canada
| | - Sean R Notley
- Human Environmental Physiological Research Unit, University of Ottawa, Ottawa, ON, Canada
| | - Glen P Kenny
- Human Environmental Physiological Research Unit, University of Ottawa, Ottawa, ON, Canada.,Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ontario, Canada
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Wang X, Wang S, Liu W, Wang T, Wang J, Gao X, Duan R, Li Y, Pu L, Deng B, Chen Z. Epigenetic upregulation of miR-126 induced by heat stress contributes to apoptosis of rat cardiomyocytes by promoting Tomm40 transcription. J Mol Cell Cardiol 2019; 129:39-48. [DOI: 10.1016/j.yjmcc.2018.10.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 09/22/2018] [Accepted: 10/04/2018] [Indexed: 10/28/2022]
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Gamage PJ, Fortington LV, Finch CF. Risk perceptions for exertional heat illnesses in junior cricket in Sri Lanka. BMJ Open Sport Exerc Med 2019; 5:e000508. [PMID: 30899554 PMCID: PMC6407666 DOI: 10.1136/bmjsem-2019-000508] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2019] [Indexed: 11/08/2022] Open
Abstract
Objectives Exertional heat illnesses (EHI) can occur when sport is played in hot and humid environments, such as those common across Asia. Measures to reduce the risk of EHI are important; however, causal data on EHI occurrence are limited and challenging to capture. To gain an initial understanding of EHI risks, we aimed to assess the risk perceptions of EHI of youth cricketers. Methods A descriptive cross-sectional survey, comprised of 14 questions on EHI risks, was conducted with 365 Sri Lankan junior male cricketers (age=12.9±0.9 years) who typically play in hot and humid conditions. Results For climate related risks, relative humidity was perceived as having a low risk of EHI compared with ambient temperature. The EHI risk associated with wearing protective gear, as commonly used in cricket, was perceived as low. Most junior cricketers perceived a low level of risk associated with recommended preventive measures such as body cooling and heat-acclimatisation. Conclusion This is the first study to explore EHI risk perceptions in any sporting context. Young players may not be mindful of all risks. Therefore, leadership and initiative from competition organisers and parents is required to promote countermeasures.
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Affiliation(s)
- Prasanna Janaka Gamage
- School of Health and Life Sciences, Federation University Australia, Mt Helen, Victoria, Australia
| | - Lauren Victoria Fortington
- School of Health and Life Sciences, Federation University Australia, Mt Helen, Victoria, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Caroline F Finch
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,DVCRI Portfolio, Federation University Australia, Mt Helen, Victoria, Australia
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Abe M, Kinoshita K, Matsuoka K, Nakada T, Miura K, Hata Y, Nishida N, Tabata T. Lack of modulatory effect of the SCN5A R1193Q polymorphism on cardiac fast Na+ current at body temperature. PLoS One 2018; 13:e0207437. [PMID: 30419068 PMCID: PMC6231685 DOI: 10.1371/journal.pone.0207437] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 10/31/2018] [Indexed: 01/08/2023] Open
Abstract
SCN5A encodes the main subunit of the NaV1.5 channel, which mediates the fast Na+ current responsible for generating cardiac action potentials. The single nucleotide polymorphism SCN5A(R1193Q), which results in an amino acid replacement in the subunit, is common in East Asia. SCN5A(R1193Q) is often identified in patients with type 3 long QT syndrome and Brugada syndrome. However, its linkage to arrhythmic disorders is under debate. Previous electrophysiological studies performed at room temperature inconsistently reported the gain- or loss-of-function effect of SCN5A(R1193Q) on the NaV1.5 channel. More recently, it was theoretically predicted that SCN5A(R1193Q) would exert a loss-of-function effect at body temperature. Here, we experimentally assessed whether SCN5A(R1193Q) modulates the NaV1.5 channel at various temperatures including normal and febrile body temperatures. We compared voltage-gated Na+ currents in SCN5A(R1193Q)-transfected and wild-type SCN5A-transfected HEK293T cells using a whole-cell voltage-clamp technique. First, we made comparisons at constant temperatures of 25°C, 36.5°C, and 38°C, and found no difference in the conductance density, voltage dependence of gating, or time dependence of gating. This suggested that SCN5A(R1193Q) does not modulate the NaV1.5 channel regardless of temperature. Second, we made comparisons while varying the temperature from 38°C to 26°C in 3 min, and again observed no difference in the time course of the amplitude or time dependence of gating during the temperature change. This also indicated that SCN5A(R1193Q) does not modulate the NaV1.5 channel in response to an acute body temperature change. Therefore, SCN5A(R1193Q) may not be a monogenic factor that triggers arrhythmic disorders.
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Affiliation(s)
- Masayoshi Abe
- Laboratory for Biological Information Processing, Graduate School of Science and Engineering, University of Toyama, Toyama City, Toyama, Japan
| | - Koshi Kinoshita
- Department of Legal Medicine, Graduate School of Medical and Pharmaceutical Sciences, University of Toyama, Toyama City, Toyama, Japan
| | - Kenta Matsuoka
- Laboratory for Biological Information Processing, Graduate School of Science and Engineering, University of Toyama, Toyama City, Toyama, Japan
| | - Takahito Nakada
- Laboratory for Biological Information Processing, Graduate School of Science and Engineering, University of Toyama, Toyama City, Toyama, Japan
| | - Kimiaki Miura
- Laboratory for Biological Information Processing, Graduate School of Science and Engineering, University of Toyama, Toyama City, Toyama, Japan
| | - Yukiko Hata
- Department of Legal Medicine, Graduate School of Medical and Pharmaceutical Sciences, University of Toyama, Toyama City, Toyama, Japan
| | - Naoki Nishida
- Department of Legal Medicine, Graduate School of Medical and Pharmaceutical Sciences, University of Toyama, Toyama City, Toyama, Japan
| | - Toshihide Tabata
- Laboratory for Biological Information Processing, Graduate School of Science and Engineering, University of Toyama, Toyama City, Toyama, Japan
- * E-mail:
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Schwellnus M, Swanevelder S, Derman W, Borjesson M, Schwabe K, Jordaan E. Prerace medical screening and education reduce medical encounters in distance road races: SAFER VIII study in 153 208 race starters. Br J Sports Med 2018; 53:634-639. [DOI: 10.1136/bjsports-2018-099275] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2018] [Indexed: 01/09/2023]
Abstract
ObjectivesTo examine the efficacy and feasibility of an online prerace medical screening and educational intervention programme for reducing medical complications in long-distance races.MethodsThis was an 8-year observational study of medical encounter rates among 153 208 Two Oceans race starters (21.1 and 56 km) in South Africa. After the first 4-year control (CON) period, we introduced an online prerace medical screening (based on European pre-exercise screening guidelines) and an automated educational intervention programme. We compared the incidence of medical encounters (per 1000 starters; all and serious life threatening) in the CON versus the 4-year intervention (INT) period.ResultsIn comparison to the CON period (2008–2011: 65 865 starters), the INT period (2012–2015: 87 343 starters) had a significantly lower incidence (adjusted for age group, sex, race distance) of all medical encounters by 29% (CON=8.6 (7.9–9.4); INT=6.1 (5.6–6.7), p<0.0001), in the 21.1 km race by 19% (CON=5.1 (4.4–5.9); INT=4.1 (3.6–4.8), p=0.0356) and in the 56 km race by 39% (CON=14.6 (13.1–16.3); INT=9.0 (7.9–10.1), p<0.0001). Serious life-threatening encounters were significantly reduced by 64% (CON=0.6 (0.5–0.9); INT=0.2 (0.1–0.4); p=0.0003) (adjusted for age group and sex). Registration numbers increased in the INT period (CON=81 345; INT=106 743) and overall % race starters were similar in the CON versus INT period. Wet-bulb globe temperature was similar in the CON and INT periods.ConclusionAll medical encounters and serious life-threatening encounters were significantly lower after the introduction of a prescreening and educational intervention programme, and the programme was feasible.
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2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death. Heart Rhythm 2018; 15:e73-e189. [DOI: 10.1016/j.hrthm.2017.10.036] [Citation(s) in RCA: 177] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Indexed: 02/07/2023]
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Al-Khatib SM, Stevenson WG, Ackerman MJ, Bryant WJ, Callans DJ, Curtis AB, Deal BJ, Dickfeld T, Field ME, Fonarow GC, Gillis AM, Granger CB, Hammill SC, Hlatky MA, Joglar JA, Kay GN, Matlock DD, Myerburg RJ, Page RL. 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation 2018; 138:e272-e391. [PMID: 29084731 DOI: 10.1161/cir.0000000000000549] [Citation(s) in RCA: 249] [Impact Index Per Article: 41.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
| | - William G Stevenson
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
| | - Michael J Ackerman
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
| | - William J Bryant
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
| | - David J Callans
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
| | - Anne B Curtis
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
| | - Barbara J Deal
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
| | - Timm Dickfeld
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
| | - Michael E Field
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
| | - Gregg C Fonarow
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
| | - Anne M Gillis
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
| | - Christopher B Granger
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
| | - Stephen C Hammill
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
| | - Mark A Hlatky
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
| | - José A Joglar
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
| | - G Neal Kay
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
| | - Daniel D Matlock
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
| | - Robert J Myerburg
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
| | - Richard L Page
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information. †ACC/AHA Representative. ‡HRS Representative. §ACC/AHA Task Force on Performance Measures Liaison/HFSA Representative. ‖ACC/AHA Task Force on Clinical Practice Guidelines Liaison
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Al-Khatib SM, Stevenson WG, Ackerman MJ, Bryant WJ, Callans DJ, Curtis AB, Deal BJ, Dickfeld T, Field ME, Fonarow GC, Gillis AM, Granger CB, Hammill SC, Hlatky MA, Joglar JA, Kay GN, Matlock DD, Myerburg RJ, Page RL. 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol 2018; 72:e91-e220. [PMID: 29097296 DOI: 10.1016/j.jacc.2017.10.054] [Citation(s) in RCA: 700] [Impact Index Per Article: 116.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Burtscher M, Gatterer H, Burtscher J, Mairbäurl H. Extreme Terrestrial Environments: Life in Thermal Stress and Hypoxia. A Narrative Review. Front Physiol 2018; 9:572. [PMID: 29867589 PMCID: PMC5964295 DOI: 10.3389/fphys.2018.00572] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 04/30/2018] [Indexed: 12/22/2022] Open
Abstract
Living, working and exercising in extreme terrestrial environments are challenging tasks even for healthy humans of the modern new age. The issue is not just survival in remote environments but rather the achievement of optimal performance in everyday life, occupation, and sports. Various adaptive biological processes can take place to cope with the specific stressors of extreme terrestrial environments like cold, heat, and hypoxia (high altitude). This review provides an overview of the physiological and morphological aspects of adaptive responses in these environmental stressors at the level of organs, tissues, and cells. Furthermore, adjustments existing in native people living in such extreme conditions on the earth as well as acute adaptive responses in newcomers are discussed. These insights into general adaptability of humans are complemented by outcomes of specific acclimatization/acclimation studies adding important information how to cope appropriately with extreme environmental temperatures and hypoxia.
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Affiliation(s)
- Martin Burtscher
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria.,Austrian Society for Alpine and Mountain Medicine, Innsbruck, Austria
| | - Hannes Gatterer
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria.,Institute of Mountain Emergency Medicine, EURAC Research, Bolzano, Italy
| | - Johannes Burtscher
- Laboratory of Molecular and Chemical Biology of Neurodegeneration, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Heimo Mairbäurl
- Medical Clinic VII, Sports Medicine, University Hospital Heidelberg, Heidelberg, Germany.,German Center for Lung Research (DZL/TLRC-H), Heidelberg, Germany
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Vora A, Burkule N, Contractor A, Bhargava K. Prevention of sudden cardiac death in athletes, sportspersons and marathoners in India. Indian Heart J 2017; 70:137-145. [PMID: 29455769 PMCID: PMC5903013 DOI: 10.1016/j.ihj.2017.12.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 12/11/2017] [Accepted: 12/13/2017] [Indexed: 12/14/2022] Open
Abstract
The annual incidence of sudden cardiac death (SCD) in athletes is significantly lower than the general population. However, when SCD occurs in an athlete during sporting event or training, it sends shockwaves in the society and raises questions about cardiovascular effects of sports and exercise. This document reviews the causes and mechanism of SCD in sports and exercise in young and older athletes. In the Indian context, we suggest a ‘pre-participation screening’ of young and older athletes and consider a ‘supervised, graded exercise regime’ for the uninitiated, older sports participant. Finally, the document proposes medical infrastructure required to successfully revive a victim of sudden cardiac arrest during a sporting event.
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Affiliation(s)
- Amit Vora
- Arrhythmia Associates, Mumbai, India.
| | | | - Ashish Contractor
- Rehabilitation and Sports Medicine, Sir H.N. Reliance Foundation Hospital, Mumbai, India
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45
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McGuire CS, Lanier JB. Problems Related to Physical Agents. Fam Med 2017. [DOI: 10.1007/978-3-319-04414-9_53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lin GM, Li YH, Lee CJ, Shiang JC, Lin KH, Chen KW, Chen YJ, Wu CF, Lin BS, Yu YS, Lin F, Su FY, Wang CH. Rationale and design of the cardiorespiratory fitness and hospitalization events in armed forces study in Eastern Taiwan. World J Cardiol 2016; 8:464-471. [PMID: 27621774 PMCID: PMC4997527 DOI: 10.4330/wjc.v8.i8.464] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 06/18/2016] [Accepted: 07/13/2016] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the association between cardiorespiratory fitness and hospitalization events in a cohort of large voluntary arm forces in Taiwan.
METHODS The cardiorespiratory fitness and hospitalization events in armed forces (CHIEF) is a retrospective cohort consisting of more than 4000 professional military members aged 18-50 years in Eastern Taiwan. All participants received history taking, physical examination, chest radiography, 12-lead electrocardiography, blood tests for cell counts and fasting glucose, lipid profiles, uric acid, renal function and liver function in the Hualien Armed Forces General Hospital during 2014. In addition, participants were required to undergo two indoor resistant exercise tests including 2-min push-up and 2-min sit-up, both scored by infrared sensing, and one outdoor endurance 3000-m none weight-bearing running test, the main indicator of cardiorespiratory fitness in the Military Physical Training and Testing Center in Eastern Taiwan in 2014.
RESULTS Hospitalization events for cardiovascular disease, acute kidney injury, rhabdomyolysis, severe infectious disease, acute psychiatric illness, diabetes, orthopedic surgery and mortality will be identified in the National Insurance Research Database for 10 years.
CONCLUSION CHIEF will be among the largest Eastern Asian armed forces cohort, in which physical status was strictly evaluated to follow up the hospitalization events for severe illness.
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Michowitz Y, Viskin S, Rosso R. Exercise-induced Ventricular Tachycardia/Ventricular Fibrillation in the Normal Heart: Risk Stratification and Management. Card Electrophysiol Clin 2016; 8:593-600. [PMID: 27521092 DOI: 10.1016/j.ccep.2016.04.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Exercise-induced ventricular tachycardia (VT) rarely occurs in the absence of organic heart disease. Idiopathic monomorphic VT has an excellent prognosis. The main aspect of the risk stratification process is recognizing subtle forms of organic heart disease, particularly arrhythmogenic right ventricular cardiomyopathy. Exercise-induced polymorphic VT is potentially malignant. Exercise-induced polymorphic VT has also been seen in mitral valve prolapse. Some patients with stable coronary disease, and even healthy athletes, sometimes have short bursts of polymorphic VT during exercise tests but these arrhythmias are usually not reproducible during repeated testing and have unknown long-term clinical significance.
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Affiliation(s)
- Yoav Michowitz
- Department of Cardiology, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Weizman 6, Tel Aviv 64239, Israel
| | - Sami Viskin
- Department of Cardiology, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Weizman 6, Tel Aviv 64239, Israel.
| | - Raphael Rosso
- Department of Cardiology, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Weizman 6, Tel Aviv 64239, Israel
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48
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Navas de Solis C. Exercising arrhythmias and sudden cardiac death in horses: Review of the literature and comparative aspects. Equine Vet J 2016; 48:406-13. [DOI: 10.1111/evj.12580] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 03/28/2016] [Indexed: 12/25/2022]
Affiliation(s)
- C. Navas de Solis
- Swiss Institute of Equine Medicine; Faculty of Veterinary Science (Vetsuisse); University of Bern and Agroscope; Bern Switzerland
- Texas Veterinary Medical Center; Texas A&M University; College Station USA
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49
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Hainline B, Drezner J, Baggish A, Harmon KG, Emery MS, Myerburg RJ, Sanchez E, Molossi S, Parsons JT, Thompson PD. Interassociation consensus statement on cardiovascular care of college student-athletes. Br J Sports Med 2016; 51:74-85. [PMID: 27247099 DOI: 10.1136/bjsports-2016-096323] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2016] [Indexed: 12/24/2022]
Abstract
Cardiovascular evaluation and care of college student-athletes is gaining increasing attention from both the public and medical communities. Emerging strategies include screening of the general athlete population, recommendations of permissible levels of participation by athletes with identified cardiovascular conditions and preparation for responding to unanticipated cardiac events in athletic venues. The primary focus has been sudden cardiac death and the usefulness of screening with or without advanced cardiac screening. The National Collegiate Athletic Association convened a multidisciplinary task force to address cardiovascular concerns in collegiate student-athletes, and to develop consensus for an interassociation statement. This document summarises the task force deliberations and follow-up discussions, and includes available evidence on cardiovascular risk, preparticipation evaluation and the recognition of and response to cardiac arrest. Future recommendations for cardiac research initiatives, education and collaboration are also provided.
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Affiliation(s)
- Brian Hainline
- Sport Science Institute, National Collegiate Athletic Association, Indianapolis, Indiana, USA
| | - Jonathan Drezner
- Department of Family Medicine, University of Washington, Seattle, Washington, USA
| | - Aaron Baggish
- Cardiovascular Performance Program, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Kimberly G Harmon
- Department of Family Medicine, University of Washington, Seattle, Washington, USA
| | - Michael S Emery
- Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Robert J Myerburg
- Division of Cardiology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | | | - Silvana Molossi
- Division of Pediatric Cardiology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - John T Parsons
- Sport Science Institute, National Collegiate Athletic Association, Indianapolis, Indiana, USA
| | - Paul D Thompson
- Division of Cardiology, Hartford Hospital, Hartford, Connecticut, USA
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50
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Manolis AS, Manolis AA. Exercise and Arrhythmias: A Double-Edged Sword. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2016; 39:748-62. [PMID: 27120033 DOI: 10.1111/pace.12879] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 04/07/2016] [Accepted: 04/09/2016] [Indexed: 12/18/2022]
Abstract
Ample evidence indicates that moderate regular exercise is beneficial for both normal individuals and patients with cardiovascular (CV) disease. However, intense and strenuous exercise in individuals with evident or occult underlying CV abnormalities may have adverse effects with provocation and exacerbation of arrhythmias that may lead to life-threatening situations. Both of these aspects of exercise-induced effects are herein reviewed.
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Affiliation(s)
- Antonis S Manolis
- Third Department of Cardiology, Athens University School of Medicine, Athens, Greece
| | - Antonis A Manolis
- Third Department of Cardiology, Athens University School of Medicine, Athens, Greece
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