Exertional Heat Illnesses and Environmental Conditions During High School Football Practices

Area of Science:

• Sports Medicine
• Environmental Health
• Epidemiology

Background:

• Exertional heat illnesses (EHIs) pose a risk to athletes, particularly during extreme heat.
• Over 1 million U.S. high school football players practice in August heat annually.
• Limited data exist on EHI incidence in high school football athletes.

Purpose of the Study:

• To determine the incidence of EHIs in high school football athletes.
• To describe environmental conditions during practices.
• To analyze EHI risk factors over a 3-month period.

Main Methods:

• A descriptive epidemiology study was conducted over 3 months (August-October).
• Athletic trainers at 12 North Central Florida high schools recorded practice details, environmental data (wet-bulb globe temperature), and EHI occurrences.
• Data were collected for varsity football athletes.

Main Results:

• A total of 57 EHIs occurred across 29,759 athlete-exposures (rate: 1.92/1000 AEs).
• August had the highest EHI incidence (82.5% of cases, rate: 4.35/1000 AEs).
• Practices longer than 3 hours in August were associated with a 9.84 times higher risk of EHI.

Conclusions:

• The highest EHI rates were observed in August, particularly for practices exceeding 3 hours.
• The overall EHI rate was lower than in collegiate athletes, suggesting current prevention guidelines are effective for this population.
• Evidence-based, region-specific prevention guidelines are crucial for team physicians, athletic trainers, coaches, and athletes.