Heat illness can get YOU too!

Triathlon crew member
Author:  Gary Moorhead, CEO, Sports Medicine Australia
Issue: Volume 4 Number 2

Recently, the Australian media has been full of horror stories involving adverse outcomes from playing sport and exercising in hot weather. Recent headlines have included:

  • 'Six runners hospitalised and 60 others treated for dehydration during the Melbourne Marathon'
  • 'Soldier dies from heat during exercises'
  • 'Man who melted: we pulled him out of the grave'.

The greatest fear with heat illness is the condition known as heatstroke. Heatstroke is a killer. The mortality rate is 20 to 75 per cent if cooling is not effective and survivors usually have some permanent damage. While heatstroke occurs most commonly in conditions of high ambient temperature and high humidity, heat stroke can occur in the absence of both (Barker, Motz and Gersoff 2001).  British army medical staff attending the 2004 Australian Conference of Science and Medicine in Sport reported incidences of heat illness in cool weather, where the precipitating factor was apparently exertion and gear and clothing-related rather than hot weather and hydration.

For officials, this is an important point to consider – heat illness can be caused by conditions other than exertion or hydration. The cricket umpire who moves no more than to change ends and who keeps well-hydrated can still be in danger if the weather is exceptionally hot and they obligingly act as a 'clothes stand' for players.

There are a number of warning signals, apart from high temperatures, that officials should heed if they are to avoid the dangers of heat illness:

  1. Pre-existing medical conditions - these could predispose a person to heat illness. Conditions include asthma, diabetes, pregnancy, heart conditions and epilepsy. Pre-existing medical conditions can include also recent illnesses, such as influenza or gastroenteritis, or even a hangover. Some medications can also predispose a person to heat illness. Medications should be checked for warnings.
  2. Unseasonable weather – hot days early in the season can be a danger time for heat illness because the body has not acclimatised to hot weather.
  3. Time of the day - be aware that if the event is scheduled between 11:00am and 3.00pm, this is the hottest part of the day.
  4. Surface type - standing (or sitting) over an asphalt or concrete surface increases the intensity of the sunlight.
  5. Surroundings - a breeze blowing over the body is one of the best ways to prevent heat illness developing. If airflow is blocked (for example, in a non-airconditioned building), take greater care.
  6. Clothing -  avoid clothing that attracts or stores heat. Clothing needs to be sensible and a hat must be worn. Sensible clothing can also offer protection from skin cancer.

How do you know if the heat is affecting you? Symptoms include dizziness, high heart rate, headache, loss of faculties (for example, forgetting the score, or what ball it is), confusion and nausea.

If you experience any of these symptoms, you should stop what you are doing and move to a shaded and preferably breezy area, sit down and drink some water. Splashing water or a spray mist over the face and head or using an icepack can also help. In most cases, symptoms will pass, but if they persist or get worse, you must see a doctor as soon as possible.

Reference

Barker TA, Motz HA, Gersoff WK 2001. 'Environmental Factors in Athletic Performance' in Sports Injuries: mechanisms, prevention, treatment, 2nd edn, Lippincott Williams and Wilkins Philadelphia, p. 67.


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