Regional differences in exertional heat illness rates among Georgia USA high school football players

Abstract

Many high school associations in recent years are developing policies to improve player safety regarding exertional heat illnesses (EHIs). A question is whether states with diverse climates need multiple sets of guidelines with different activity modification thresholds. We examine this question in the state of Georgia, which has a diverse climate. Our study leverages a multi-year dataset of exertional heat illnesses (EHIs) among high school football players to test the hypothesis that EHI rates under similar wet bulb globe temperatures (WBGTs) will be greater among athletes in the cooler, northern region versus warmer, southern region of the state. The focus of this study is on a 3-year period (2012–2014) when uniform heat safety polices, including acclimatization and activity modification guidelines, were implemented across the state. Results show that athletes in the northern region acclimatize to cooler conditions. Almost 68% of practices have WBGTs < 27.8 °C (82 °F) compared to the southern region where athletes receive many times the exposures to hotter WBGTs in the 27.8–30.5 °C and 30.6–32.2 °C categories. In the post-acclimatization period, we observed statistically significantly (p < .05) greater EHI rates among athletes in the northern region of the state, even when controlling for meteorological conditions. Our findings suggest that differential acclimatization between football players in the northern and southern regions of the state is impacting EHI rates and that regional heat safety guidelines may be needed in Georgia and other states with similarly diverse climates.

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Acknowledgments

The authors would like to thank the National Athletic Trainers’ Association Research and Education Foundation, Georgia High School Association, National Federation of High Schools, and Georgia Athletic Trainers Association for their support of the data collection in this study.

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Correspondence to Andrew Grundstein.

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Poore, S., Grundstein, A., Cooper, E. et al. Regional differences in exertional heat illness rates among Georgia USA high school football players. Int J Biometeorol 64, 643–650 (2020). https://doi.org/10.1007/s00484-019-01853-4

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Keywords

  • Exertional heat illness
  • American football
  • Interscholastic athletics
  • Wet bulb globe temperature
  • Acclimatization
  • Georgia
  • USA