{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T02:36:38Z","timestamp":1787970998340,"version":"build-2784847793"},"reference-count":45,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2018,5,23]],"date-time":"2018-05-23T00:00:00Z","timestamp":1527033600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sports Med - Open"],"published-print":{"date-parts":[[2018,12]]},"DOI":"10.1186\/s40798-018-0131-6","type":"journal-article","created":{"date-parts":[[2018,5,23]],"date-time":"2018-05-23T15:01:49Z","timestamp":1527087709000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Sickle Cell Trait and Sudden Death"],"prefix":"10.1186","volume":"4","author":[{"given":"Bruce L.","family":"Mitchell","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2018,5,23]]},"reference":[{"issue":"18","key":"131_CR1","doi-asserted-by":"publisher","first-page":"1001","DOI":"10.1056\/NEJM197905033001801","volume":"300","author":"P Heller","year":"1979","unstructured":"Heller P, Best WR, Nelson RB, Becktel J. Clinical implications of sickle cell trait and glucose-6-phosphate dehydrogenase deficiency in hospitalized black male patients. N Engl J Med. 1979;300(18):1001\u20135. [PubMed: 431593]","journal-title":"N Engl J Med"},{"issue":"Suppl","key":"131_CR2","doi-asserted-by":"publisher","first-page":"S512","DOI":"10.1016\/j.amepre.2009.12.022","volume":"38","author":"KL Hassell","year":"2010","unstructured":"Hassell KL. Population estimates of sickle cell disease in the U.S. Am J Prev Med. 2010;38(Suppl):S512\u201321.","journal-title":"Am J Prev Med"},{"key":"131_CR3","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1136\/bjsports-2011-090521","volume":"46","author":"M Loosemore","year":"2012","unstructured":"Loosemore M, Walsh SB, Morris E, et al. Sudden exertional death in sickle cell trait. Br J Sports Med. 2012;46:312\u20134.","journal-title":"Br J Sports Med"},{"key":"131_CR4","first-page":"597","volume":"87","author":"M Bookchin","year":"1976","unstructured":"Bookchin M, Balazs T, Landau LC. Determinants of red cell sickling: effects of varying pH and of increasing intracellular hemoglobin concentration by osmotic shrinkage. J Lab Clin Med. 1976;87:597\u2013616.","journal-title":"J Lab Clin Med"},{"key":"131_CR5","doi-asserted-by":"crossref","first-page":"4168","DOI":"10.1016\/S0021-9258(19)69413-5","volume":"256","author":"CT Noguchi","year":"1981","unstructured":"Noguchi CT, Torchia DA, Schechter AN. Polymerization of hemoglobin in sickle cell trait erythrocytes and lysates. J Biol Chem. 1981;256:4168\u201371.","journal-title":"J Biol Chem"},{"issue":"7","key":"131_CR6","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1016\/S0002-9343(89)80482-6","volume":"87","author":"TW Martin","year":"1989","unstructured":"Martin TW, Weismann IM, Zeballos RJ, Stephenson SR. Exercise and hypoxia increase sickling in venous blood from an exercising limb in individuals with sickle cell trait. Am J Med. 1989;87(7):48\u201356.","journal-title":"Am J Med"},{"key":"131_CR7","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1097\/PAF.0b013e3181873835","volume":"30","author":"JR Thogmartin","year":"2009","unstructured":"Thogmartin JR, Wilson CI, Palma NA, et al. Histological diagnosis of sickle cell trait: a blinded analysis. Am J Forensic Med Pathol. 2009;30:36\u20139.","journal-title":"Am J Forensic Med Pathol"},{"key":"131_CR8","first-page":"181","volume":"31","author":"JA Kark","year":"1994","unstructured":"Kark JA, Ward FT. Exercise and hemoglobin S. Semin Hematol. 1994;31:181\u2013225.","journal-title":"Semin Hematol"},{"key":"131_CR9","doi-asserted-by":"publisher","first-page":"1758","DOI":"10.1152\/jappl.1986.61.5.1758","volume":"61","author":"JA Simoneau","year":"1986","unstructured":"Simoneau JA, Boulay MR, et al. Skeletal muscle characteristics in sedentary Black and Caucasian males. J Appl Physiol. 1986;61:1758\u201361.","journal-title":"J Appl Physiol"},{"issue":"Suppl 3","key":"131_CR10","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1111\/j.1600-0838.2010.01208.x","volume":"20","author":"P Connes","year":"2010","unstructured":"Connes P. Hemorheology and exercise: effects of warm environments and potential consequences for sickle cell trait carriers. Scand J Med Sci Sports. 2010;20(Suppl 3):48\u201352.","journal-title":"Scand J Med Sci Sports"},{"key":"131_CR11","doi-asserted-by":"crossref","first-page":"179","DOI":"10.3233\/CH-2008-1078","volume":"39","author":"P Connes","year":"2008","unstructured":"Connes P, Hue O, Tripette J, et al. Blood rheology abnormalities and vascular cell adhesion mechanisms in sickle cell trait carriers during exercise. Clin Hemorheol Microcirc. 2008;39:179\u201384.","journal-title":"Clin Hemorheol Microcirc"},{"key":"131_CR12","doi-asserted-by":"publisher","first-page":"564","DOI":"10.1111\/j.1399-0004.2009.01251.x","volume":"76","author":"N Sambuughin","year":"2009","unstructured":"Sambuughin N, Capacchione J, Blokhin A, et al. The ryanodine receptor type 1 gene variants in African American men with exertional rhabdomyolysis and malignant hyperthermia susceptibility. Clin Genet. 2009;76:564\u20138.","journal-title":"Clin Genet"},{"key":"131_CR13","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1520\/JFS14982J","volume":"46","author":"DP Wirthwein","year":"2001","unstructured":"Wirthwein DP, Spotswood SD, Barnard JJ, Prahlow JA. Death due to microvascular occlusion in sickle cell trait following physical exertion. J Forensic Sci. 2001;46:399\u2013401.","journal-title":"J Forensic Sci"},{"key":"131_CR14","doi-asserted-by":"publisher","first-page":"56","DOI":"10.7205\/MILMED-D-11-00106","volume":"177","author":"K Ferster","year":"2012","unstructured":"Ferster K, Eichner ER. Exertional sickling deaths in Army recruits with sickle cell trait. Mil Med. 2012;177:56\u20139.","journal-title":"Mil Med"},{"issue":"1","key":"131_CR15","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1249\/MSS.0b013e3181ae0700","volume":"42","author":"ML Anzalone","year":"2010","unstructured":"Anzalone ML, Green VS, Buja M, et al. Sickle cell trait and fatal rhabdomyolysis in football training: a case study. Med Sci Sports Exerc. 2010;42(1):3\u20137.","journal-title":"Med Sci Sports Exerc"},{"issue":"5","key":"131_CR16","doi-asserted-by":"publisher","first-page":"1108","DOI":"10.1177\/0363546513478572","volume":"41","author":"BP Boden","year":"2013","unstructured":"Boden BP, Breit I, Beachler JA. Fatalities in high school and college football players. Am J Sports Med. 2013;41(5):1108\u201316.","journal-title":"Am J Sports Med"},{"key":"131_CR17","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1136\/bjsports-2011-090896","volume":"46","author":"KG Harmon","year":"2012","unstructured":"Harmon KG, Drezner JA, Klossner D. Sickle cell trait associated with a RR of death of 37 times in national collegiate athletic association football athletes: a database with 2 million athlete years as the denominator. Br J Sports Med. 2012;46:325\u201330.","journal-title":"Br J Sports Med"},{"key":"131_CR18","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1056\/NEJM197002052820607","volume":"282","author":"SR Jones","year":"1970","unstructured":"Jones SR, Binder RA, Donowho EM Jr. Sudden death in sickle cell trait. N Engl J Med. 1970;282:323\u20135.","journal-title":"N Engl J Med"},{"key":"131_CR19","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1097\/00000441-195310000-00008","volume":"226","author":"GW Thomas","year":"1953","unstructured":"Thomas GW. The incidence and significance of sickle cell disease in deaths subject to medicolegal investigation. Am J Med Sci. 1953;226:412\u20138.","journal-title":"Am J Med Sci"},{"key":"131_CR20","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1097\/00000441-196103000-00007","volume":"241","author":"WF McCormick","year":"1961","unstructured":"McCormick WF. Abnormal hemoglobins. II. The pathology of sickle-cell trait. Am J Med Sci. 1961;241:329\u201335.","journal-title":"Am J Med Sci"},{"key":"131_CR21","doi-asserted-by":"publisher","first-page":"781","DOI":"10.1056\/NEJM198709243171301","volume":"317","author":"JA Kark","year":"1987","unstructured":"Kark JA, Posey DM, Schumacher HR, et al. Sickle-cell trait as a risk factor for sudden death in physical training. N Engl J Med. 1987;317:781\u20137.","journal-title":"N Engl J Med"},{"key":"131_CR22","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1093\/milmed\/155.2.59","volume":"155","author":"P Sherry","year":"1990","unstructured":"Sherry P. Sickle cell trait and rhabdomyolysis: case report and review of the literature. Mil Med. 1990;155:59\u201361.","journal-title":"Mil Med"},{"key":"131_CR23","doi-asserted-by":"publisher","first-page":"1493","DOI":"10.1016\/S0196-0644(05)80068-X","volume":"21","author":"MA Rosenthal","year":"1992","unstructured":"Rosenthal MA, Parker DJ. Collapse of a young athlete. Ann Emerg Med. 1992;21:1493\u20138.","journal-title":"Ann Emerg Med"},{"key":"131_CR24","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1111\/j.1749-6632.1989.tb24205.x","volume":"565","author":"JA Kark","year":"1989","unstructured":"Kark JA, Martin SK, Canik JJ, et al. Sickle cell trait as an age-dependent risk factor for sudden death in basic training. Ann N Y Acad Sci. 1989;565:407\u20138.","journal-title":"Ann N Y Acad Sci"},{"key":"131_CR25","unstructured":"Kark JA, Garder JW, Ward FT, Virmani R. Prevention of exertional heat illness protects recruits with sickle cell trait from exercise-related death (abstract): SRGL, Sickle Cell Disease Program, National Institute of Health; 1999. Available at sickle.bwh.harvard.edu\/sickle_trait.html . Accessed 7 May 2018."},{"key":"131_CR26","doi-asserted-by":"publisher","first-page":"e929","DOI":"10.7205\/MILMED-D-14-00707","volume":"180","author":"RL Hughes","year":"2015","unstructured":"Hughes RL, Feig J. Sickle cell trait relate exertional deaths: observations and autopsy and review of the literature. Mil Med. 2015;180:e929\u201332.","journal-title":"Mil Med"},{"issue":"5","key":"131_CR27","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1056\/NEJMoa1516257","volume":"375","author":"DA Nelson","year":"2016","unstructured":"Nelson DA, Deuster PA, Carter R, et al. Sickle cell trait, rhabdomyolysis, and mortality among U.S. Army soldiers. NEJM. 2016;375(5):435\u201344.","journal-title":"NEJM"},{"key":"131_CR28","doi-asserted-by":"publisher","first-page":"945","DOI":"10.1182\/blood-2010-01-263889","volume":"116","author":"JA Kark","year":"2010","unstructured":"Kark JA, Labotka RJ, Gardner JW, Ward FT. Prevention of exercise-related death unexplained by preexisting disease (EDU) associated with sickle cell trait (SCT) without hemoglobin (Hb) screening or Hb specific management. Blood. 2010;116:945.","journal-title":"Blood"},{"key":"131_CR29","first-page":"1229","volume-title":"Strauss and Welt\u2019s diseases of the kidney. Vol 2","author":"LW Statius van Eps","year":"1979","unstructured":"Statius van Eps LW, Earley LE. The kidney in sickle cell disease. In: Earley LE, Gottchalk CW, editors. Strauss and Welt\u2019s diseases of the kidney. Vol 2. 3rd ed. Boston: Little, Brown and Co.; 1979. p. 1229\u201340.","edition":"3"},{"issue":"7644","key":"131_CR30","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1016\/S0140-6736(70)90836-6","volume":"1","author":"LW Statius van Eps","year":"1970","unstructured":"Statius van Eps LW, Pinedo-Veels C, de Vries GH, et al. Nature of concentrating defect in sickle cell nephropathy: microradioangiographic studies. Lancet. 1970;1(7644):450\u20132.","journal-title":"Lancet"},{"key":"131_CR31","unstructured":"Heat illness prevention. Aberdeen Proving Ground, MD: U.S. Army Medical Department, Army Public Health Center. https:\/\/www.phc.amedd.army.mil\/topics\/discond\/hipss\/pages\/heatinjuryprevention.aspx . Accessed 7 May 2018."},{"issue":"8","key":"131_CR32","doi-asserted-by":"publisher","first-page":"e929","DOI":"10.7205\/MILMED-D-14-00707","volume":"180","author":"RL Hughes","year":"2015","unstructured":"Hughes RL, Feig J. Sickle cell trait-related exertional deaths: observations at autopsy and review of the literature. Mil Med. 2015;180(8):e929\u201332.","journal-title":"Mil Med"},{"issue":"3","key":"131_CR33","first-page":"300","volume":"99","author":"BL Mitchell","year":"2007","unstructured":"Mitchell BL. Sickle cell trait and sudden death-bringing it home. J NMA. 2007;99(3):300\u20135.","journal-title":"J NMA"},{"key":"131_CR34","unstructured":"Navy Medicine. Manual of the Medical Department, Chapter 15. 2012. Available at http:\/\/www.med.navy.mil\/directives\/Pages\/NAVMEDP-MANMED.aspx . Accessed 7 May 2018."},{"key":"131_CR35","unstructured":"Eichner ER, Sickle cell trait and the athlete. Gatorade Sports Science Institute. Sports Sci Exch. 2006;19(4): 1\u20136."},{"key":"131_CR36","unstructured":"NCAA to test for sickle cell in settlement in Rice Case- https:\/\/www.chron.com\/sports\/collegefootball\/article\/NCAA-to-test . Accessed 7 May 2018."},{"issue":"3","key":"131_CR37","doi-asserted-by":"publisher","first-page":"340","DOI":"10.1002\/ajh.22271","volume":"87","author":"JC Goldsmith","year":"2012","unstructured":"Goldsmith JC, Bonham VL, Joiner CH. Framing the research agenda for sickle cell trait: building on the current understanding of clinical events and their potential implications. Am J Hematol. 2012;87(3):340\u20136.","journal-title":"Am J Hematol"},{"issue":"11","key":"131_CR38","doi-asserted-by":"publisher","first-page":"2045","DOI":"10.1249\/MSS.0b013e31826851c2","volume":"44","author":"FG O\u2019Connor","year":"2012","unstructured":"O\u2019Connor FG, Bergeron MF, Cantrell J, et al. ACSM and CHAMP summit on sickle cell trait: mitigating risks for warfighters and athletes. Med Sci Sports Exerc. 2012;44(11):2045\u201356.","journal-title":"Med Sci Sports Exerc"},{"key":"131_CR39","unstructured":"Nelson M. Teens boot camp death natural: The Ledger: 2006. www.cleveland.indymedia.org\/news\/2007\/09\/26994.php ."},{"key":"131_CR40","doi-asserted-by":"crossref","first-page":"1228","DOI":"10.1520\/JFS14391J","volume":"43","author":"JR Thogmartin","year":"1998","unstructured":"Thogmartin JR. Sudden death in police pursuit. J Forensic Sci. 1998;43:1228\u201331.","journal-title":"J Forensic Sci"},{"key":"131_CR41","first-page":"333","volume":"42","author":"DJ Casa","year":"2007","unstructured":"Casa DJ, Becker SM, Ganio MS, et al. Validity of devices that assess body temperature during outdoor exercise in the heat. J Athl Train. 2007;42:333.","journal-title":"J Athl Train"},{"key":"131_CR42","doi-asserted-by":"publisher","first-page":"124","DOI":"10.4085\/1062-6050-44.2.124","volume":"44","author":"MS Ganio","year":"2009","unstructured":"Ganio MS, Brown CM, Casa DJ, et al. Validity and reliability of devices that assess body temperature during indoor exercise in the heat. Athl Train. 2009;44:124.","journal-title":"Athl Train"},{"key":"131_CR43","doi-asserted-by":"crossref","unstructured":"Key SN, Derebail VK. Sickle cell trait: novel clinical significance. Hematol Am Soc Hematol Educ Progrm. 2010;2010:418\u201322.","DOI":"10.1182\/asheducation-2010.1.418"},{"key":"131_CR44","doi-asserted-by":"publisher","first-page":"1001","DOI":"10.1056\/NEJM197905033001801","volume":"300","author":"P Heller","year":"1979","unstructured":"Heller P, Best WR, Nelson RB, et al. Clinical implications of sickle cell trait and glucose-6-phospahte dehydrogenase deficiency in hospitalized black male patients. N Engl J Med. 1979;300:1001\u20135.","journal-title":"N Engl J Med"},{"key":"131_CR45","doi-asserted-by":"publisher","first-page":"170","DOI":"10.4085\/1062-6050-45.2.170","volume":"45","author":"SM Mazerolle","year":"2010","unstructured":"Mazerolle SM, Scruggs IC, Casa DJ, et al. Current knowledge, attitudes and practices of certified athletic trainers regarding recognition and treatment of exertional heat stroke. J Athl Train. 2010;45:170.","journal-title":"J Athl Train"}],"container-title":["Sports Medicine - Open"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s40798-018-0131-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s40798-018-0131-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s40798-018-0131-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,6]],"date-time":"2024-07-06T23:11:13Z","timestamp":1720307473000},"score":1,"resource":{"primary":{"URL":"https:\/\/sportsmedicine-open.springeropen.com\/articles\/10.1186\/s40798-018-0131-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,5,23]]},"references-count":45,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2018,12]]}},"alternative-id":["131"],"URL":"https:\/\/doi.org\/10.1186\/s40798-018-0131-6","relation":{},"ISSN":["2199-1170","2198-9761"],"issn-type":[{"value":"2199-1170","type":"print"},{"value":"2198-9761","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,5,23]]},"assertion":[{"value":"9 February 2018","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 April 2018","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 May 2018","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Bruce L. Mitchell, MD, is the sole author. The author read and approved the final manuscript.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Author\u2019s Contribution"}},{"value":"NA.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics Approval and Consent to Participate"}},{"value":"The author, Bruce L. Mitchell, declares that he has no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}},{"value":"Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Publisher\u2019s Note"}}],"article-number":"19"}}