{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T22:56:25Z","timestamp":1793228185167,"version":"4.5.0"},"reference-count":25,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Journal of Sports Medicine"],"published-print":{"date-parts":[[2021,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Although experts have advocated for regionally specific heat safety guidelines for decades, guidelines have not been universally adopted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To describe the rate and risk factors associated with exertional heat illness (EHI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Descriptive epidemiology study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>For a 3-month period (August-October) over 6 years (2013-2018), athletic trainers at 13 high schools in North Central Florida recorded varsity football practice time and length, wet-bulb globe temperature (WBGT), and incidences of EHI, including heat stroke, heat exhaustion, and heat syncope.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Athletes sustained 54 total EHIs during 163,254 athlete-exposures (AEs) for the 3-month data collection periods over 6 years (incidence rate [IR], 3.31 \/10,000 AEs). Heat exhaustion accounted for 59.3% (32\/54), heat syncope 38.9% (21\/54), and heat stroke 1.9% (1\/54) of all EHIs recorded. Of the EHIs, 94.4% (51\/54) were experienced within the first 19 practices. The first 19 practices had an IR of 7.48 of 10,000 AEs, and the remaining 44 practices had an IR of 0.32 of 10,000 AEs, demonstrating that the risk of EHI for practices 1 to 19 was 23.7 times that of the remaining practices. When comparing morning to afternoon practices, 35.2% (19\/54) EHI incidents occurred during morning practices. The risk of EHI during practices with WBGT &gt;82\u00b0F (27.8\u00b0C) was 3.5 times that of practices with WBGT &lt;82\u00b0F.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In the current study, the risk of EHI was greatest in the first 19 practices of the season and during practices with WBGT &gt;82\u00b0F. As modifiable risk factors for EHI, increased vigilance and empowerment to adhere to acclimatization guidelines can mitigate EHI risk. Health care providers must continue to advocate for implementation of regulations and the authority to make decisions to ensure patient safety.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23259671211026627","type":"journal-article","created":{"date-parts":[[2021,9,22]],"date-time":"2021-09-22T09:14:00Z","timestamp":1632302040000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Factors Affecting Incidence Rate of Exertional Heat Illnesses: Analysis of 6 Years of High School Football Practices in North Central Florida"],"prefix":"10.1177","volume":"9","author":[{"given":"Brady L.","family":"Tripp","sequence":"first","affiliation":[{"name":"Department of Applied Physiology & Kinesiology, University of Florida, Gainesville, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary K.","family":"Winkelmann","sequence":"additional","affiliation":[{"name":"Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey E.","family":"Eberman","sequence":"additional","affiliation":[{"name":"Department of Applied Medicine and Rehabilitation, Indiana State University, Terre Haute, Indiana, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael Seth","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, University of Florida, Gainesville, Florida, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,9,22]]},"reference":[{"key":"bibr1-23259671211026627","doi-asserted-by":"publisher","DOI":"10.1249\/JSR.0000000000000585"},{"key":"bibr2-23259671211026627","doi-asserted-by":"publisher","DOI":"10.1249\/01.mss.0000174891.46893.82"},{"issue":"3","key":"bibr3-23259671211026627","first-page":"329","volume":"37","author":"Binkley HM","year":"2002","journal-title":"J Athl Train"},{"key":"bibr4-23259671211026627","doi-asserted-by":"publisher","DOI":"10.4085\/1062-6050-44.3.332"},{"key":"bibr5-23259671211026627","doi-asserted-by":"publisher","DOI":"10.4085\/1062-6050-50.9.07"},{"key":"bibr6-23259671211026627","doi-asserted-by":"publisher","DOI":"10.1097\/jes.0b013e3180a02bec"},{"key":"bibr7-23259671211026627","doi-asserted-by":"publisher","DOI":"10.4085\/1062-6050-51.8.08"},{"key":"bibr8-23259671211026627","doi-asserted-by":"publisher","DOI":"10.4085\/1062-6050-542-18"},{"key":"bibr9-23259671211026627","doi-asserted-by":"publisher","DOI":"10.1249\/JSR.0000000000000709"},{"key":"bibr10-23259671211026627","unstructured":"Georgia High School Association. By-law 2.67\u2014 Practice policy for heat and humidity. Accessed July 24, 2021. https:\/\/www.ghsa.net\/sites\/default\/files\/documents\/sports-medicine\/HeatPolicy2013.pdf"},{"key":"bibr11-23259671211026627","doi-asserted-by":"publisher","DOI":"10.1007\/s00484-018-1624-1"},{"key":"bibr12-23259671211026627","doi-asserted-by":"publisher","DOI":"10.1016\/j.apgeog.2014.10.014"},{"key":"bibr13-23259671211026627","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2012.09.058"},{"key":"bibr14-23259671211026627","doi-asserted-by":"publisher","DOI":"10.4085\/1062-6050-373-18"},{"key":"bibr15-23259671211026627","doi-asserted-by":"publisher","DOI":"10.1289\/EHP4163"},{"key":"bibr16-23259671211026627","doi-asserted-by":"publisher","DOI":"10.4085\/1062-6050-581-18"},{"issue":"2","key":"bibr17-23259671211026627","first-page":"207","volume":"41","author":"Knowles SB","year":"2006","journal-title":"J Athl Train"},{"key":"bibr18-23259671211026627","unstructured":"Kucera KL, Klossner D, Colgate B, Cantu RC. Annual survey of football injury research, 1931\u20132018. National Center for Catastrophic Injury Research. Accessed July 24, 2021. https:\/\/nccsir.unc.edu\/files\/2019\/02\/Annual-Football-2018-Fatalities-FINAL.pdf"},{"key":"bibr19-23259671211026627","volume-title":"Catastrophic Sports Injury Research: Twenty-Sixth Annual Reports. 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