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Epidemiology of exertional heat illness among U.S. high school athletes[1]

Summary

National surveillance analysis (High School Sports-Related Injury Surveillance System, 2005/06-2010/11) of exertional heat illness in US high school athletes, against a background of >9,000 treated annually. Overall rate 1.20 per 100,000 athlete-exposures; 60.3% occurred in August, and 32% of practice cases occurred more than 2 hours into the session. Football's rate (4.42 per 100,000) was 11.4 times all other sports combined. Approximately one third (33.6%) of cases occurred with NO medical professional on site at onset. Concludes that all sports and regions carry risk and that coaches, athletes, administrators, and parents must be trained to identify and respond.

So what

The denominator study for scholastic heat illness and the sharpest coverage argument in the dataset: a third of heat-illness events began with no medical professional present, at predictable times (August, late in practice) in a predictable sport (football, 11x). For event medicine this defines the scheduling-and-coverage intervention set — acclimatization windows, practice-hour limits, and on-site medical presence for August football — and it anchors the youth end of the heat domain alongside the ACSM/NATA position statements and Epstein/Bouchama clinical reviews.

Key findings

  • 1.20 exertional heat illnesses per 100,000 athlete-exposures nationally
  • Football 4.42/100,000 - 11.4x all other sports combined
  • 60.3% in August; 32% of practice cases >2 hours into session
  • 33.6% occurred with no medical professional on site at onset
  • Layperson recognition training essential; prevention is schedule design

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