Adults have been increasingly motivated to compete in recreational endurance sports events. Amateurs may lack a complete understanding of recommended strategies for handling heat and humidity, making heat-related illnesses increasingly possible. This is compounded by global climate change and increasing average surface and air temperatures, especially in urban areas of industrialized nations in Europe and North America that have hosted most events to date. We conducted an on-line, secure survey at the 2nd Annual ING Georgia Marathon and Half-Marathon in Atlanta, Georgia, in 2008. We included previously validated questions on participant socio-demographics, training locations, and knowledge and awareness of heat-related illnesses. Participants were aware of heat illnesses, and of heat stroke as a serious form of heat stress. However, the majority, across age and gender, did not understand the potential severity of heat stroke. Furthermore, 1-in-5 participants did not understand the concept of heat stress as a form of heat-related illness, and how heat stress may result from buildup of muscle-generated heat in the body. Adult recreational endurance athletes are another susceptible, vulnerable population sub-group for applied research and public health educational interventions, especially in urban areas of industrialized nations in Europe and North America.
Heat stress Heat stroke Urban health Endurance sports Recreational athletes
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We thank Georgia State University (GSU) Research Foundation, Atlanta, for our interdisciplinary team research funding for 2007-2008, and the GSU Partnership for Urban Health Research for supporting D. Shendell’s PsychData license for 7/2006-5/2008. We also acknowledge the efforts of dozens of undergraduate respiratory therapy and physical therapy students, and master’s students in nutrition, who volunteered time to help set up the various events and/or who assisted in data collection and entry at the events or on campus. We thank our three anonymous graduate students who served as internal reviewers and/or for assisting in the assimilation and review of metropolitan Atlanta temperature and air quality data for November 2006 to March 2007. We are grateful to staff of Active.com for timely collaboration with D. Shendell. Finally, we acknowledge the in-kind support received from the College of Health and Human Sciences, GSU, and Georgia Marathon, LLC.
The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.
Davis RE, Knappenberger PC, Michaels PJ, Novicoff WM (2003) Changing heat-related mortality in the United States. Environ Health Perspect 111(14):1712–1718PubMedGoogle Scholar
Donaldson GC, Keatinge WR, Näyhä S (2003) Changes in summer temperature and heat-related mortality since 1971 in North Carolina, South Finland, and Southeast England. Environ Res 91(1):1–7CrossRefPubMedGoogle Scholar
Ebi KL, Exuzides KA, Lau E, Kelsh M, Barnston A (2004) Weather changes associated with hospitalizations for cardiovascular diseases and stroke in California, 1983-1998. Int J Biometeorol 49(1):48–58CrossRefPubMedGoogle Scholar
Ebi KL, Mills DM, Smith JB, Grambsch A (2006) Climate change and human health impacts in the United States: an update on the results of the U.S. national assessment. Environ Health Perspect 114(9):1318–1324CrossRefPubMedGoogle Scholar
Ellis FP (1977) Heat illness. III. Acclimatization. Trans R Soc Trop Med Hyg 70(5–6):419–425Google Scholar
El-Zein A, Tewtel-Salem M, Nehme G (2004) A time-series analysis of mortality and air temperature in Greater Beirut. Sci Total Environ 330(1–3):71–80PubMedGoogle Scholar
Fouillet A, Rey G, Jougla E, Frayssinet P, Bessemoulin P, Hémon D (2007) A predictive model relating daily fluctuations in summer temperatures and mortality rates. BMC Pub Health 7:114CrossRefGoogle Scholar
Galloway J (2002) Galloway’s book on running, 2nd edn. Shelter Publishing, Bolinas, CA. ISBN 0-936070-27-7Google Scholar
Kim H, Ha JS, Park J (2006) High temperature, heat index, and mortality in 6 major cities in South Korea. Arch Environ Occup Health 61(6):265–270CrossRefPubMedGoogle Scholar
Johnson H, Kovats RS, McGregor G, Stedman J, Gibbs M, Walton H, Cook L, Black E (2005) The impact of the 2003 heat wave on mortality and hospital admissions in England. Health Stat Q 25:6–11PubMedGoogle Scholar
Jokl P, Sethi PM, Cooper AJ (2004) Master’s performance in the New York City Marathon 1983–1999. Br J Sports Med 38:408–412CrossRefPubMedGoogle Scholar
Kalkstein LS, Greene JS (1997) An evaluation of climate/mortality relationships in large U.S. cities and the possible impacts of a climate change. Environ Health Perspect 105(1):84–93CrossRefPubMedGoogle Scholar
Kinney PL, O’Neill MS, Bell ML, Schwartz J (2008) Approaches for estimating effects of climate change on heat-related deaths: challenges and opportunities. Environ Sci Policy 11:87–96CrossRefGoogle Scholar
Knowlton K, Rotkin-Ellman M, King G, Margolis HG, Smith D, Solomon G, Trent R, English P (2009) The 2006 California heat wave: impacts on hospitalizations and emergency department visits. Environ Health Perspect 117(1):61–67PubMedGoogle Scholar
Kovats RS, Hajat S, Wilkinson P (2004) Contrasting patterns of mortality and hospital admissions during hot weather and heat waves in Greater London, UK. Occup Environ Med 61:893–898CrossRefPubMedGoogle Scholar
Kyselý J (2004) Mortality and displaced mortality during heat waves in the Czech Republic. Int J Biometeorol 49(2):91–97CrossRefPubMedGoogle Scholar
Maartens JW (1998) Climate change, thermal stress and mortality changes. Soc Sci Med 46(3):331–344CrossRefGoogle Scholar
Patz JA, McGeehin MA, Bernard SM et al (2000) The potential health impacts of climate variability and change for the United States: executive summary of the report of the health sector of the U.S. National Assessment. Environ Health Perspect 108(4):367–376CrossRefPubMedGoogle Scholar
Running USA-RRC (2009) In: Annual marathon reports and participation statistics (1976-2008, including total number of participants, gender and age group breakdown for selected years). Available at http://www.runningusa.org. Accessed 8 May 2009
Schwartz J (2005) Impact of control for air pollution and respiratory epidemics on the estimated associations of temperature and daily mortality. Int J Biometeorol 50(2):121–129CrossRefPubMedGoogle Scholar
Semenza JC, McCullough JE, Flanders D, McGeehin MA, Lumpkin JR (1999) Excess hospital admissions during the July 1995 heat wave in Chicago. Am J Prev Med 16:269–277CrossRefPubMedGoogle Scholar
Smoyer KE, Rainham DG, Hewko JN (2000) Heat-stress-related mortality in five cities in Southern Ontario: 1980–1996. Int J Biometeorol 44(4):190–197CrossRefPubMedGoogle Scholar
Smoyer-Tomic KE, Rainham DG (2001) Beating the heat: development and evaluation of a Canadian hot weather health-response plan. Environ Health Perspect 109(12):1241–1248CrossRefPubMedGoogle Scholar
Walker DK (2008) Time to embrace public health approaches to national and global challenges. Am J Public Health 98(11):1934–1936CrossRefPubMedGoogle Scholar
Wyndham CH, Fellingham SA (1978) Climate and disease. S Afr Med J 53(26):1051–1061PubMedGoogle Scholar