Heat Illness Safety: How to Prepare for Rising Temperatures

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September 15, 2016

By Desi Rotenberg, MS, LAT, ATC

With the summer months coming to a close, the likelihood of heat related illnesses still remains a hot topic in the athletic population. While to some this topic may seem redundant and like a broken record, we must always remind ourselves that with outdoor participation comes the threat of a heat related incident.

In addition to a constant awareness of the negative outcomes that can arise from poor hydration in the heat, we must also acknowledge that global temperatures continue to rise. According to the National Weather Service, 2014 through 2016 showed the hottest increase in average temperature over a 2-year span since the late 1800s.1 Furthermore, according to NASA, the 10 warmest years for global surface temperature have all come since 2000.1

Now, the intention of this editorial is not to throw global warming statistics at you and inform you that you should all head for your nearest bunker. The purpose of this editorial is to bring further awareness to already prevalent issues in sport and exercise. Further precautions should be taken to ensure all players remain safe and understand proper hydration techniques required on a daily basis to ensure safe and optimal athletic performance. As Athletic Trainers (ATs), we must continue to educate coaches, athletes and parents and to enforce hydration policy adherence.

Heat illness and rising temperatures are now becoming a hot topic outside of the athletic population as well. As of 2015, the Occupational Safety and Health Administration issued a statement saying, “Under OSHA law, employers are responsible for providing workplaces free of known safety hazards. This includes protecting workers from extreme heat. An employer with workers exposed to high temperatures should establish a complete heat illness prevention program.”2 This attention to heat related injuries has come in response to a 2015 study by the U.S. Department of Labor that concluded, “In 2014 alone, 2,630 workers suffered from heat illness and 18 died from heat stroke and heat related illness on the job.”2 The fact of the matter remains that being outdoors in the heat for prolonged periods of time requires a concrete prevention and treatment plan.

According to the NATA, fluid replacement should approximate sweat and urine losses so that athletes lose no more than 2% body weight per day; on average, this equates to consuming 200-300 mL fluid every 10-20 minutes during exercise.3 In addition to monitoring fluid loss and fluid replacement, it is recommended that the AT or coaches check the temperature and humidity prior to the start of a practice or a game. NATA guidelines suggest a temperature of 90°F at 20% humidity could be suitable for conducting football practice with full protective gear, whereas a temperature of 90°F at 80% humidity could create a dangerous environment for which activity and equipment use should be limited.4

The guidelines are in place and will only change slightly every few years; however, we must do everything we can to educate our population, whether athletic, commercial, industrial or any other group working or exercising outdoors. Whether the temperature on Earth continues to heat up or average temperatures in specific locations continue to rise, our awareness should always be towards safety and hydration education. The best treatment is always a good preventative plan and the best preventative plan always requires a conscientiousness of your surroundings.



2. United States Department of Labor. Occupational Health and Safety Administration, Heat Illness Safety and Prevention.

3. Casa DJ, Armstrong LE, Hillman SK, Montain SJ, Reiff RV, et al. National Athletic Trainers' Association position statement: fluid replacement for athletes. J Athl Train 2000;35:212--24.

4. Binkley HM, Beckett J, Casa DJ, Kleiner DM, Plummer PE. National Athletic Trainers' Association position statement: exertional heat illnesses. J Athl Train 2002;37:329--43.


About the Author

Desi rotenberg

Desi Rotenberg, originally from Denver, Colorado, graduated with his bachelor's degree in 2012 from the University of Northern Colorado. He has been a BOC Certified Athletic Trainer since 2012 and earned his master's degree in Exercise Physiology from the University of Central Florida in 2014. He currently is a high school teacher, teaching anatomy/physiology and leadership development. Along with being a teacher, he wears many hats, such as basketball coach, curriculum developer and mentor. He has been a contributor to the BOC Blog since the summer of 2015.

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