The National Athletic Trainers’ Association (NATA) has just released new guidelines on preventing and treating exertional heat illness (EHI) on the football field and in the workplace. With temperatures expected to soar in the days ahead, these guidelines can help to reduce risk and ensure appropriate care of EHI and related conditions.
“Exertional heat stroke (EHS) is a leading cause of sudden death in sport and especially among American football lineman. Additionally, occupational heat stress is a growing public health concern,” said NATA President A.J. Duffy III, MS, ATC, PT. “Athletic trainers are uniquely qualified experts in heat safety. The two new NATA Task Force statements demonstrate how their competency in this area translates directly to protecting football players and workers alike.”
Preventing Exertional Heat Stroke (EHS) Death in American Football Linemen, now in press in Sports Health, and chaired by task force chair Rebecca Stearns, PhD, ATC, chief operating officer, Korey Stringer Institute; associate professor-in-residence, University of Connecticut in Storrs, revealed:
- American football linemen exceed deaths over all other football positions
- Linemen account for over 90% of all EHS fatalities in secondary and collegiate levels
- Linemen face unique vulnerabilities, including larger body mass, lower aerobic fitness, greater metabolic heat production, and reduced cooling efficiency.
- Most EHS events occur during training sessions, not during competitions
Key Recommendations for Collegiate and Secondary Schools:
The NATA Task Force, consisting of a multidisciplinary panel, produced 20 actionable recommendations spanning education, training, administration, and emergency preparedness. Among them:
- Adopt the Wet Bulb Globe Temperature (WBGT), which combines ambient temperature, humidity, wind speed and solar radiation to reflect how the human body experiences heat
- Require all sport coaches and strength conditioning personnel complete initial and recurring training on EHS prevention, recognition, and treatment
- Employ credentialed professionals to adhere to established professional standards
- Implement defined transition periods during the first 5 days of return to training
- Individualize training for linemen with conditioning programs that reflect theirspecific physiological demands
- Eliminate punitive conditioning while training; exercise must never be used as punishment
“The statement emphasizes that effective EHS prevention requires a shift toward position-specific training, structured acclimatization, environmental safeguards and coordinated emergency response systems. When implemented collectively, these strategies provide a comprehensive framework to substantially reduce EHS incidence and fatalities in this high-risk population,” said Stearns.
UIL Mandates Web Bulb Globe Temperature Protocol:
The newly mandated Wet Bulb Globe Test (WBGT) twill go into effect in August for all University Interscholastic League (UIL) Schools in Texas, the largest inter-school organization of its kind in the world. Texas is the 20th state to mandate or require this protocol.
“Prior to Texas”, said Stearns, “42% of all high school athlete participants were protected by the WBGT policy. Now that Texas has adopted it, and given the size of the state, 53% of high school student athletes will now benefit from this protocol.”
The Athletic Trainers’ Role in Implementing Heat Stress Mitigation Strategies in the Occupational Setting, recently published in the Journal of Athletic Training and led by task force chair Christianne Eason PhD, ATC, president of Sport Safety and Education, Korey Stringer Institute; assistant professor-in-residence, Department of Kinesiology, University of Connecticut in Storrs, revealed:
- More than 13 million people in the U.S. are exposed to extreme heat on their jobs during the summer
- More than 90% of workplace exertional injuries reported to the Occupational Safety and Health Administration (OSHA) are attributed to heat stress
- In addition to heat illness, occupational heat exposure contributes to the increased risk of injury, cardiac events, cognitive dysfunction, and falls
- Climate trends, increased environmental heat exposure, and physically-demanding work amplify risk across both outdoor and indoor industries
- Global productivity losses associated with heat stress are projected to reach trillions of dollars annually by 2030
Key Recommendations for Employers:
The NATA Task Force prepared 48 evidence-informed recommendations to mitigate heat stress in the occupational setting. Among them:
- Develop heat illness prevention plans
- Implement environmental monitoring using WBGT and heat forecasting
- Establish heat acclimatization protocols
- Provide hydration and cooling access
- Plan emergency actions
- Recognize and treat exertional heat stroke ASAP
- Create safe return-to-work procedures
“Importantly, the recommendations acknowledge that heat stress mitigation is not solely a medical issue, but also a workforce sustainability and productivity issue. We have provided practical strategies that employers can implement now with the support of athletic trainers, uniquely qualified to lead and support these initiatives, to reduce risk and help improve worker health,” says Eason.
Resources:
Executive Summary- NATA Task Force: The AT's Role in Implementing Heat Stress Mitigation Strategies in the Occupational Setting
Heat Fact Sheet
Exertional Heat Stroke (Korey Stringer Institute)
For more information about EHI prevention, please visit www.nata.org.
About NATA: National Athletic Trainers’ Association – Health Care for Life & Sport
Athletic trainers are health care professionals who specialize in the prevention, diagnosis, treatment, and rehabilitation of injuries and sport-related illnesses. They prevent and treat chronic musculoskeletal injuries from sports, physical and occupational activity, and provide immediate care for acute injuries. Athletic trainers offer a continuum of care that is unparalleled in health care. The National Athletic Trainers’ Association (NATA) is the professional membership association for certified athletic trainers and others who support the athletic training profession. Founded in 1950, NATA has grown to a community of members that cover the globe. Visit nata.org for more information.
