Physical demands and physiological strain of American football referees while officiating

Certain occupations are associated with greater risk of triggering a sudden cardiac event because of high levels of physical exertion and extreme thermal environments in which they occur. The extent to which sports officials--particularly high school (HS) American football referees--experience these conditions is unknown. Forty-six male HS officials (72% White/Caucasian; age = 48 ± 12 years, body mass index = 31.7 ± 6.6 kg·m^-2) were studied to quantify the physiological strain and physical demands of officiating.

Referee demographics (e.g., experience, habitual exercise), pre-game urine specific gravity (U_SG), thermal (peak core temperature [T_core]) and cardiovascular (average heart rate [HR]) strain, kinematic activity (e.g., total distance, speed, mechanical intensity), and environmental conditions were measured during 10 regular season varsity HS football games (≈2.5 h each) in the Southeastern United States (average wet bulb globe temperature and relative humidity: 18.9 ± 6.0 °C and 78.2% ± 12.1%). Analyses included descriptive statistics, bivariate correlations, and linear regression.

Referees covered 5.2 ± 1.2 km per game, eliciting average HR and peak T_core of 71.5% ± 8.0% HR_max and 38.3 ± 0.5 °C, respectively; 38% began games dehydrated (U_SG = 1.026 ± 0.004). Multiple regression analyses revealed that obesity (β = 0.34), not participating in regular exercise (β = -0.36), and officiating at lower mechanical intensity (β = -0.33) predicted greater cardiovascular strain (all p ≤ 0.03). White/Caucasian race/ethnicity (β = 0.59), younger age (β = -0.46), and obesity (β = 0.28) predicted greater thermal strain (all p ≤ 0.01).

HS football referees experienced elevated levels of physiological strain while officiating, with individual factors modulating the magnitude of strain. Strategies aimed at reducing obesity, increasing exercise participation, and improving cardiovascular health should be emphasized to mitigate strain and prevent cardiac events.