Predisposing risk factors on susceptibility to exertional heat illness: clinical decision-making considerations.

@article{Cleary2007PredisposingRF,
  title={Predisposing risk factors on susceptibility to exertional heat illness: clinical decision-making considerations.},
  author={Michelle Cleary},
  journal={Journal of sport rehabilitation},
  year={2007},
  volume={16 3},
  pages={
          204-14
        }
}
  • M. Cleary
  • Published 1 August 2007
  • Medicine
  • Journal of sport rehabilitation
OBJECTIVE To present strategies for identifying predisposing conditions, susceptibility, and incidence reduction for the most common exertional heat illnesses (EHI): heat cramps, heat exhaustion, and most importantly, heat stroke. DATA SOURCES A comprehensive literature review of MEDLINE and 1996 to 2006, including all retrospective, controlled studies of EHI risk using the following keywords: exertional heat illness risk, exertional heat stroke risk, and exercise-induced dehydration risk… 
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Background Citations
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Systematic review of gender differences in the epidemiology and risk factors of exertional heat illness and heat tolerance in the armed forces
TLDR
The findings of this review suggest that men experienced a slightly higher incidence of heat stroke than women in the armed forces and being a female was associated with a greater risk of exertional heat illnesses.
Epidemiology of exertional heat illnesses in organised sports: A systematic review.
Women and exertional heat illness: identification of gender specific risk factors.
TLDR
The present study found that differences between men and women in heat tolerance classification are largely explained by VO₂max, a major risk factor for EHI, and maximizing the aerobic power of women will be critical to force health protection and readiness as they integrate into combat military occupational specialties.
Exertional Heat Illness in American Football Players: When Is the Risk Greatest?
TLDR
Sports medicine personnel should take all necessary preventive measures to reduce the EHI risk during the first 14 days of practice and when the environmental conditions are greater than 82.0°F (27.8°C) WBGT.
On-Site Treatment of Exertional Heat Stroke
TLDR
On-site treatment of athletes who develop exertional heat stroke appears to be both safe and effective, and may decrease the local burden of critically ill patients to emergency departments during large athletic events.
Activity modification in heat: critical assessment of guidelines across athletic, occupational, and military settings in the USA
TLDR
Future interagency collaboration to advance heat mitigation plans among physically active population is desired to maximize the existing resources and data to facilitate advancement in AMGs for environmental heat.
Exertional Heat Illness: The Role of Heat Tolerance Testing
Exertional heat stroke (EHS) is a common clinical problem for both athletes and warriors; however, evidence-based guidance for return-to-play/duty (RTP/RTD) decisions is limited. Heat tolerance…
Exertional Heat Illness Among Secondary School Athletes
TLDR
This descriptive, exploratory study explored school policies, resources, and practices of coaches in a mid-Atlantic state in the prevention and identification of EHI and found that school districts should comply with evidence-based guidelines.
Personal risk factors associated with heat-related illness among new conscripts undergoing basic training in Thailand
TLDR
A high BMI was associated with heat-related illnesses among conscripts undergoing basic training in Thailand and daily monitoring of heat- related illnesses, body temperature, body weight and urine color in each new conscript during basic military training was feasible.
New Perspectives on Risk Factors for Exertional Heat Stroke
TLDR
New perspectives on risk factors for EHS that focus on hydration, heat acclimatization, medical conditions, climate change and policies, medications, and strength and conditioning sessions are addressed.
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References

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Risk factors predicting exertional heat illness in male Marine Corps recruits.
TLDR
A matched population-based case-control study was conducted on exertional heat illness in male Marine Corps recruits in basic training at Parris Island, SC, finding recruits at highest risk for developing exertionalheat illness had an eightfold higher risk during basic training when compared with those with BMI less than 22 kg.
Effect of hydration status on thirst, drinking, and related hormonal responses during low-intensity exercise in the heat.
TLDR
Dehydration preceding low-intensity exercise in the heat magnifies thirst-driven drinking during exercise-heat stress and result in similar fluid regulatory hormonal responses and comparable modifications in plasma volume regardless of preexercise hydration state.
Exertional Heat Illnesses
Physiology of heat stress classification, Nomenclature, and incidence of the exertional heat illnesses exertional heatstroke heat exhaustion, exercise-associated collapse, and heat syncope exertional…
Exercise in the heat: strategies to minimize the adverse effects on performance.
TLDR
For athletes from temperate climates, the negative effects of heat had humidity can be attenuated by a period of acclimatization, which requires up to 10-14 days.
HEAT ACCLIMATIZATION AND HYDRATION STATUS OF AMERICAN FOOTBALL PLAYERS DURING INITIAL SUMMER WORKOUTS
TLDR
Heart rate, TGI, and ESQ measurements indicated that football players experienced gradual heat acclimatization and enhanced heat tolerance, despite progressive increases of exercise variables, clothing, and environmental stressors.
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TLDR
Reductions in gastric emptying appear to be related to the severity of the thermal strain induced by an exercise/heat stress, and exercise in a warm environment when hypohydrated reduces gastric emptied rate and stomach secretions.
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TLDR
If practice is conducted outdoors in Alabama during August and September, copious amounts of water should be consumed prior to practice; frequent water breaks should be scheduled throughout practice at which time each player should consume 150 - 200 ml; and the player should be carefully monitored for signs of heat illness.
Acute and adaptive responses in humans to exercise in a warm, humid environment
TLDR
The physiological adaptations induced by acute and repeated exposure for 8–13 consecutive days to exercise in humid heat were similar to those induced by dry heat acclimation, however, in humidHeat the effect of acclimations on performance was small due to physical limitations for evaporative heat loss.
Hydration Status in College Football Players during Consecutive Days of Twice-a-Day Preseason Practices
TLDR
Body weight, plasma volume, urine specific gravity, and urine sodium indicate that football players become dehydrated by day 2 of preseason training.
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TLDR
The thermal and evaporative resistance data presented in this paper can be used in the solution of heat balance equations to predict physiological responses of football players.
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