Exertional heat illness in interscholastic football athletes in the state of Georgia
Miles, Jessica Raquel Dysart
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Exertional Heat Illness (EHI) is a deadly but preventable disease. Interscholastic football players are particularly at risk for EHI, but there are no evidence-based guidelines for safety and acclimatization to prevent morbidity and mortality. Thus, the purpose of this study was: to investigate the effect the new Georgia High School Association (GHSA) pre-season acclimatization policy implementation had on the total and significant (heat stroke/heat exhaustion (HS/HE)) injury rates (IR), over the entire season and first two weeks of data ; to determine if IR’s by WBGT ranges during the first two weeks of data collection were significantly different in the time period before the policy change (Seasons 2009-11, PRE) when compared to those following change (2012 season, POST); and to determine the effectiveness of current heat stress index scales (HSIS) and which mitigate risk for EHI events. There were a total of 761 EHI cases and 259,413 Athlete Exposures (AE) for an overall EHI rate of 2.93/1000 AE (95%CI=2.73, 3.15). Risk for HS/HE was approximately 4 times greater for the entire data collection period (annual) for PRE [0.82/1000AE (95%CI=0.70, 0.95)] compared to the POST period, 0.22/1000 AE (0.12, 0.37)) and 7 times greater for the first two weeks of participation for the PRE period [1.85/1000AE; (95%CI=1.54, 2.21)] compared to the POST period at 0.27/1000 AE (95%CI=0.09, 0.65)). The EHI risk was lower in the POST period than in the PRE period for the entire data collection period [2.24/1000AE (95%CI=1.88, 2.65)] and 3.14/1000 AE (95%CI=2.90, 3.39, respectively) and first 2 weeks of data collection [1.22/1000AE (95%CI=0.75, 1.89] and 4.48/1000 AE (95%CI=3.98, 5.02), respectively). The Pearson correlation showed an r of 0.963 and an r2 value of 0.927 between WBGT and Discomfort Index (DI). The majority of the HSIS’s appeared to capture risk well. This study demonstrated mitigation in EHI risk following the policy change and that existing HSIS’s seem to adequately stratify risk.