1
|
Mason HM, King JC, Peden AE, Leicht AS, Franklin RC. The impact of extreme heat on mass-gathering sporting events: Implications for Australia and other countries. J Sci Med Sport 2024; 27:515-524. [PMID: 38796374 DOI: 10.1016/j.jsams.2024.04.015] [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: 11/08/2023] [Revised: 04/21/2024] [Accepted: 04/29/2024] [Indexed: 05/28/2024]
Abstract
OBJECTIVES As temperatures increase across the globe due to climate change, human exposure to extreme heat is a public health challenge. During sporting events, athletes, officials, spectators, and staff are at risk of heat stress and resulting illness. The objective of this review was to explore the impact of heat on the health outcomes of these groups and the wider health system and discuss implications for outdoor mass-gathering sporting events in Australia. DESIGN A systematic review was undertaken to identify literature published from 2010 to 2023. METHODS Seven databases were searched: Web of Science, SportDiscus, Scopus, Medline, CINAHL, Emcare, and PsychInfo, for relevant key search terms such as heatwave, heat stress, extreme heat, stadium, arena, sports facilit*, sport, athletic, and Olympic. An inductive thematic analysis was undertaken. Articles were quality checked using Joanna Briggs Institute critical appraisal tools and data were extracted, tabulated, and synthesized. RESULTS Forty papers were included in the final analysis: 17 quantitative, and 23 descriptive and qualitative (including reviews). Health outcomes explored across the literature included exertional heat illness, exertional heat stroke, hyperthermia, and general heat related illness. Six recommendation themes emerged: planning, mitigation strategies, medical, policy, research, and education. CONCLUSIONS The impact of heat on health outcomes during sporting events is significant, and should be considered by individuals, coaches, officials, and organizers before, during, and after mass-gathering sporting events. These findings can inform evidence-based preparedness strategies to protect the health of those attending and competing in mass-gathering sporting events now and into the future.
Collapse
Affiliation(s)
- Hannah M Mason
- Discipline of Public Health and Tropical Medicine, James Cook University, Australia
| | - Jemma C King
- Discipline of Public Health and Tropical Medicine, James Cook University, Australia
| | - Amy E Peden
- Discipline of Public Health and Tropical Medicine, James Cook University, Australia; School of Population Health, Faculty of Medicine and Health, University of New South Wales, Australia
| | - Anthony S Leicht
- Sport and Exercise Science, James Cook University, Australia; Australian Institute of Tropical Health and Medicine, James Cook University, Australia
| | - Richard C Franklin
- Discipline of Public Health and Tropical Medicine, James Cook University, Australia.
| |
Collapse
|
2
|
Hopkins C, Graham B, Donnelly B, Robertson A, Strange J. Adolescent track and field injuries presenting to US emergency departments. PHYSICIAN SPORTSMED 2024; 52:349-354. [PMID: 37738218 DOI: 10.1080/00913847.2023.2263195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 09/21/2023] [Indexed: 09/24/2023]
Abstract
OBJECTIVES Track and field (T&F) is a highly popular sport for adolescents. The diversity of running, jumping, and throwing events within the sport can result in unique injury patterns for adolescent track and field participants. The purpose of this study was to estimate injury risk in adolescent T&F and describe the types of injuries resulting in ED visits, classified by T&F events. METHODS Emergency department (ED) data from the National Electronic Injury Surveillance System were obtained for a 20-year period from 2000 through 2019. Cases involving 14- to 18-year-olds participating in T&F were classified by sex, case severity, involved body region, and the T&F event patients were engaged in at the time of their injury. National estimates and Injury rates were calculated using national high school T&F participation data. Longitudinal trends in ED visits were measured using linear regression. Rate ratios (RRs) were used to compare the risk and severity of ED visits by sex. RESULTS 8,060 track and field related ED encounters were observed, representing an estimated 272,227 encounters nationally over the 20-year study period. The rate of ED encounters increased significantly over the study period (p < 0.001). Adolescent females exhibited a higher rate of ED encounters (RR: 1.23, 95% CI: 1.22-1.24), but a lower rate of hospital admissions (RR: 0.68, 95% CI: 0.64-0.73) compared to males. The lower extremity was the most commonly injured body region for most T&F events, but this differed for sprinting, high jumping, shot put, and javelin events. Most T&F events resulted in unique injury patterns characteristic of their athletic demands. CONCLUSIONS There was an increasing trend of ED visits from adolescent T&F participants throughout the 20-year study period with different injury patterns observed by sex and T&F event discipline.
Collapse
Affiliation(s)
- Chris Hopkins
- Furman University, Department of Health Sciences, Greenville, SC, USA
| | - Bethany Graham
- Furman University, Department of Health Sciences, Greenville, SC, USA
| | - Beth Donnelly
- Furman University, Department of Health Sciences, Greenville, SC, USA
| | - Abigail Robertson
- Furman University, Department of Health Sciences, Greenville, SC, USA
| | - Jonna Strange
- Furman University, Department of Health Sciences, Greenville, SC, USA
| |
Collapse
|
3
|
Havenga H, Gharbi D, Sewry N, Language B, Neumann FH, Finch JM, Hill T, Boulter J, Jordaan E, Piketh SJ, Schwellnus M, Burger RP. Healthy environments for athleTes (HEAT): environmental conditions along a 90 km ultra-marathon event, South Africa. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024:10.1007/s00484-024-02703-8. [PMID: 38869702 DOI: 10.1007/s00484-024-02703-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 04/22/2024] [Accepted: 05/09/2024] [Indexed: 06/14/2024]
Abstract
This paper provides an overview of the HEAT (Healthy Environments for AthleTes) project, which aims to understand the impact of environmental conditions on athlete health and performance during major sporting events such as long-distance running, cycling, and triathlons. In collaboration with the SAFER (Strategies to reduce Adverse medical events For the ExerciseR) initiative, the HEAT project carried out a field campaign at the 2022 Comrades Marathon in the KwaZulu-Natal province of South Africa. The measurement campaign deployed seven weather stations, seven PM2.5 monitors and one spore trap along the 90 km route to capture spatially representative measurements of complex micro-climates, allergenic aerospora, and particulate matter exposure. The results indicate that runners were exposed to moderate risk heat stress conditions. Novel findings from this initial campaign shows elevated and potentially harmful PM2.5 levels at spectator areas, possibly coinciding with small fire events around the race day festivities. Our findings show values PM2.5 levels over the WHO 24-h guidelines at all stations, while 2000 µg/m3 at two stations. However, the lack of an acute exposure standard means direct health impacts cannot be quantified in the context of a sport event. The HEAT project highlights important aspects of race day monitoring; regional scale climatology has an impact on the race day conditions, the microclimatic conditions (pollution and meteorology) are not necessarily captured by proximity instruments and direct environmental measurements are required to accurately capture conditions along the route.
Collapse
Affiliation(s)
- H Havenga
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom, South Africa.
| | - D Gharbi
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom, South Africa
| | - N Sewry
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- International Olympic Committee Research Centre, Pretoria, South Africa
| | - B Language
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom, South Africa
| | - F H Neumann
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom, South Africa
| | - J M Finch
- School of Agricultural, Earth and Environmental Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - T Hill
- School of Agricultural, Earth and Environmental Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - J Boulter
- Comrades Marathon Association (CMA), Medical Director, Pietermaritzburg, South Africa
| | - E Jordaan
- Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa
- Statistics and Population Studies Department, University of the Western Cape, Cape Town, Western Cape, South Africa
| | - S J Piketh
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom, South Africa
| | - M Schwellnus
- Sport, Exercise Medicine and Lifestyle Institute (SEMLI), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- International Olympic Committee Research Centre, Pretoria, South Africa
| | - R P Burger
- Unit for Environmental Sciences and Management, North-West University, Potchefstroom, South Africa
| |
Collapse
|
4
|
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.
Collapse
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;
| |
Collapse
|
5
|
Edouard P, Dandrieux PE, Hollander K, Zyskowski M. Injuries and illnesses at the Munich 2022 European Championships: a prospective study of 5419 athletes from 52 countries involved in 9 sports. BMJ Open Sport Exerc Med 2024; 10:e001737. [PMID: 38374943 PMCID: PMC10875512 DOI: 10.1136/bmjsem-2023-001737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2024] [Indexed: 02/21/2024] Open
Abstract
Objective To describe the incidence and characteristics of the sports injuries and illnesses that occurred during the 2022 European Championships. Methods We conducted a prospective study on newly incurred injuries and illnesses collected by the national medical teams and the local organising committee physicians using a standardised online report form on a daily basis, in all athletes registered at the 2022 European Championships from 11 August 2022 to 21 August 2022 in Munich (Germany). Results In total, 5419 athletes were registered at the 2022 European Championships in 9 sports. A total of 181 in-competition injuries were reported, representing an overall incidence of 33.4 injuries per 1000 registered athletes, with higher values in triathlon, cycling and athletics. More injuries located at the lower limb and involving the muscles and skin were reported in athletics, at the lower limb and involving the skin in triathlon, at the head and trunk and upper limb and involving head and skin in cycling. A total of 65 illnesses were reported, representing an overall incidence of 12.0 illnesses per 1000 registered athletes, with higher values in athletics and rowing. The most affected common system was the cardiovascular system (24.6%), followed by the gastrointestinal (18.5%) and upper respiratory tracts (16.9%). The most frequent causes were exercise (36.9%), infections (30.8%) and 'others' (10.8%). Conclusion This was the first injury and illness surveillance during multisports European Championships providing relevant results to help anticipate medical services and athletes' health protection, and highlighting the need for special attention for triathlon and cycling.
Collapse
Affiliation(s)
- Pascal Edouard
- Inter-university Laboratory of Human Movement Biology (EA 7424), Université Jean Monnet, Lyon 1, Université Savoie Mont-Blanc, Saint-Etienne, France
- Department of Clinical and Exercise Physiology, Sports Medicine Unit, University Hospital of Saint-Etienne, Faculty of Medicine, Saint-Etienne, France
- European Athletics Medical & Anti-Doping Commission, European Athletics Association (EAA), Lausanne, Switzerland
| | - Pierre-Eddy Dandrieux
- Inter-university Laboratory of Human Movement Biology (EA 7424), Université Jean Monnet, Lyon 1, Université Savoie Mont-Blanc, Saint-Etienne, France
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
- INSERM, U 1059 Sainbiose, Centre CIS, Mines Saint-Etienne, Univ Lyon, Univ Jean Monnet, Saint-Etienne, France
| | - Karsten Hollander
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | - Michael Zyskowski
- Department of Trauma Surgery, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| |
Collapse
|
6
|
Klöwer M, Edouard P, Niess AM, Racinais S, Pitsiladis YP, Pappenberger F, Hollander K. Forecasting feels-like temperatures as a strategy to reduce heat illnesses during sport events. Br J Sports Med 2023; 57:559-561. [PMID: 36882307 DOI: 10.1136/bjsports-2022-106413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2023] [Indexed: 03/09/2023]
Affiliation(s)
- Milan Klöwer
- Atmospheric, Oceanic, and Planetary Physics, University of Oxford, Oxford, UK
- Earth, Atmospheric and Planetary Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Pascal Edouard
- Inter-university Laboratory of Human Movement Biology (EA 7424), Université Jean Monnet, Lyon 1, Université Savoie Mont-Blanc, Saint-Etienne, France
- Department of Clinical and Exercise Physiology, Sports Medicine Unit, University Hospital of Saint-Etienne, Faculty of Medicine, Saint-Etienne, France
| | - Andreas M Niess
- Department of Sports Medicine, University Hospital of Tuebingen, Tuebingen, Germany
| | - Sebastien Racinais
- Research and Scientific Support, ASPETAR - Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | | | | | - Karsten Hollander
- IInstitute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
| |
Collapse
|
7
|
Lu H, Aratake S, Naito H, Nogawa M, Nemoto T, Togawa T, Tanaka S. Development of a Core Body Thermometer Applicable for High-Temperature Environment Based on the Zero-Heat-Flux Method. SENSORS (BASEL, SWITZERLAND) 2023; 23:1970. [PMID: 36850568 PMCID: PMC9959565 DOI: 10.3390/s23041970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/04/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
Monitoring core body temperature (CBT) allows observation of heat stress and thermal comfort in various environments. By introducing a Peltier element, we improved the zero-heat-flux core body thermometer for hot environments. In this study, we performed a theoretical analysis, designed a prototype probe, and evaluated its performance through simulator experiments with human subjects. The finite element analysis shows that our design can reduce the influence of external temperature variations by as much as 1%. In the simulator experiment, the prototype probe could measure deep temperatures within an error of less than 0.1 °C, regardless of outside temperature change. In the ergometer experiment with four subjects, the average difference between the prototype probe and a commercial zero-heat-flux probe was +0.1 °C, with a 95% LOA of -0.23 °C to +0.21 °C. In the dome sauna test, the results measured in six of the seven subjects exhibited the same trend as the reference temperature. These results show that the newly developed probe with the Peltier module can measure CBT accurately, even when the ambient temperature is higher than CBT up to 42 °C.
Collapse
Affiliation(s)
- Hanzi Lu
- Graduate School of Natural Science & Technology, Kanazawa University, Kanazawa 920-1164, Japan
| | - Shun Aratake
- Graduate School of Natural Science & Technology, Kanazawa University, Kanazawa 920-1164, Japan
| | - Hisashi Naito
- Institute of Science and Engineering, Kanazawa University, Kanazawa 920-1164, Japan
| | - Masamichi Nogawa
- Faculty of Health Sciences, Komatsu University, Komatsu 923-0961, Japan
| | - Tetsu Nemoto
- Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa 920-0942, Japan
| | - Tatsuo Togawa
- Advanced Research Center for Human Sciences, Waseda University, Tokorozawa 359-1192, Japan
| | - Shinobu Tanaka
- Institute of Science and Engineering, Kanazawa University, Kanazawa 920-1164, Japan
| |
Collapse
|
8
|
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.
Collapse
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
| |
Collapse
|
9
|
Sugawara M, Manabe Y, Yamasawa F, Hosokawa Y. Athlete Medical Services at the Marathon and Race Walking Events During Tokyo 2020 Olympics. Front Sports Act Living 2022; 4:872475. [PMID: 35529419 PMCID: PMC9072790 DOI: 10.3389/fspor.2022.872475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/15/2022] [Indexed: 11/27/2022] Open
Abstract
Epidemiological data from race walk and marathon events suggest that a high incidence rate of exertional heat illness is associated with high ambient temperature and relative humidity. The 2020 Summer Olympics in Tokyo was no exception, which led the organizing committee to relocate the race walk and marathon competitions to Sapporo, which was predicted to experience much milder heat. Nonetheless, during the Games, Sapporo recorded the highest daytime ambient temperature in the past 97 years, with consecutive days over 30°C from July 22nd to August 7th, 2021. Five events (men's and women's 20 km race walk, men's 50 km race walk, women's and men's marathon) were held in Sapporo from August 5th to August 8th, 2021. The percentage of athletes who did not finish (DNF) in each event was 8.8% in men's 20 km race walk, 20.3% in men's 50 km race walk, 8.6% in women's 20 km race walk, 17.1% in women's marathon and 28.3% in men's marathon. A total of fifty athletes were transferred to the athlete medical station: 28 athletes completed the race (i.e., collapsed after finish line), while 24 were DNF athletes transported from the course. Forty-eight (96%) of athletes who were admitted to the athlete medical station exhibited signs and symptoms of exertional heat illness. Two athletes diagnosed with exertional heat stroke and three athletes diagnosed with severe heat exhaustion (rectal body temperature >39.5°C with or without central nervous system disturbance) were cooled using whole-body cold water immersion at the heat deck located within the athlete medical station. All athletes who were cooled successfully recovered without any complications. These athletes required an average of 14 ± 9.4 min (range, 6–30 min) to cool their rectal temperature below 39°C. These results show the importance for event organizers to prepare strategies to keep athletes cool, such as an ample amount of ice and water to supply whole-body cold water immersion.
Collapse
Affiliation(s)
- Makoto Sugawara
- Medical Committee, Japan Association of Athletics Federations (JAAF), Tokyo, Japan
- Matsuda Orthopedic Memorial Hospital, Sapporo, Japan
- *Correspondence: Makoto Sugawara
| | - Yoshiaki Manabe
- Medical Committee, Japan Association of Athletics Federations (JAAF), Tokyo, Japan
- Department of Sports Science, Chukyo University, Nagoya, Japan
| | - Fumihiro Yamasawa
- Medical Committee, Japan Association of Athletics Federations (JAAF), Tokyo, Japan
- Marubeni Health Promotion Center, Tokyo, Japan
| | - Yuri Hosokawa
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| |
Collapse
|
10
|
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.
Collapse
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
| |
Collapse
|