{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T06:40:15Z","timestamp":1794379215530,"version":"4.9.0"},"reference-count":53,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Sports Med"],"accepted":{"date-parts":[[2026,1,25]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to characterise the frequency of exertional heat stroke (EHS), did-not-finish (DNF) and medical encounter (MED) outcomes in elite Athletics competitions, and to evaluate their association with environmental, individual and race-related variables. Particular attention was given to the wet bulb globe temperature (WBGT), a thermal index widely used by international federations to estimate athlete heat strain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Data were collected from 4938 athletes of both sexes participating in 80 World Athletics races held between 2019 and 2024 in five disciplines: long distance track events, marathon, racewalking, cross-country and trail-running. Spearman rank coefficient correlations, Pearson \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      tests and negative binomial (NB) regressions were used to explore associations between outcomes (EHS, DNF, MED) and environmental, individual and race-related variables. The predictive ability of these variables was assessed using leave-one-out cross-validation to identify the best-performing univariable and multivariable models.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>EHS frequency was 8\/1000 on average and 16\/1000 when the WBGT was above 28.0\u00b0C, independent of sex (p=0.297) or discipline (p=0.980). DNF and MED were higher in marathon, racewalking and trail-running than shorter disciplines (p&lt;0.001). Among variables, the mean radiant temperature showed the strongest univariable association with EHS (R\u00b2=0.11, p&lt;0.001), while WBGT association was weaker (R\u00b2=0.04, p=0.018). Predictive accuracy was limited, with the best model having an error of 0.5\u00b10.7 EHS per race.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The risk of EHS is particularly high during elite endurance events in Athletics. While EHS was greater with higher WBGT and radiant temperatures, neither provided sufficient predictive accuracy for heat-related risk in elite endurance athletes. Future models should consider other factors such as heat acclimatisation and recent illness to enhance predictive ability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjsports-2025-110822","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T18:20:16Z","timestamp":1771352416000},"page":"534-542","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["What do thermal indices lack to help predict heat-related risk in elite Athletics?"],"prefix":"10.1136","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2618-1922","authenticated-orcid":false,"given":"David","family":"Bandiera","sequence":"first","affiliation":[{"name":"Department of Movement, Human and Health Sciences, Universit\u00e0 degli Studi di Roma Foro Italico, Roma, Italy"},{"name":"Environmental Stress Unit, CREPS Montpellier-Font Romeu, Montpellier, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Garrandes","sequence":"additional","affiliation":[{"name":"Health and Science Department, World Athletics, Monaco"},{"name":"Laboratoire Motricit\u00e9 Humaine Expertise Sport Sant\u00e9 (LAMHESS), Universit\u00e9 C\u00f4te d\u2019Azur, Nice, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5414-6556","authenticated-orcid":false,"given":"Jan","family":"Kowalski","sequence":"additional","affiliation":[{"name":"JK Biostatistics AB, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5975-5342","authenticated-orcid":false,"given":"Paolo Emilio","family":"Adami","sequence":"additional","affiliation":[{"name":"Health and Science Department, World Athletics, Monaco"},{"name":"Laboratoire Motricit\u00e9 Humaine Expertise Sport Sant\u00e9 (LAMHESS), Universit\u00e9 C\u00f4te d\u2019Azur, Nice, France"},{"name":"Physiology and Pharmacology Department \u201cV. 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