{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T22:56:22Z","timestamp":1793228182317,"version":"4.5.0"},"reference-count":25,"publisher":"National Athletic Trainers' Association","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,8,1]]},"abstract":"<jats:sec>\n                  <jats:title>Context:<\/jats:title>\n                  <jats:p>Knowledge about the specific environmental and practice risks to participants in American intercollegiate football during preseason practices is limited. Identifying risks may mitigate occurrences of exertional heat illness (EHI).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective:<\/jats:title>\n                  <jats:p>To evaluate the associations among preseason practice day, session number, and wet bulb globe temperature (WBGT) and the incidence of EHI.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design:<\/jats:title>\n                  <jats:p>Descriptive epidemiology study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting:<\/jats:title>\n                  <jats:p>Sixty colleges and universities representing 5 geographic regions of the United States.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients or Other Participants:<\/jats:title>\n                  <jats:p>National Collegiate Athletic Association football players.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main Outcome Measure(s):<\/jats:title>\n                  <jats:p>Data related to preseason practice day, session number, and WBGT. We measured WBGT every 15 minutes during the practice sessions and used the mean WBGT from each session in the analysis. We recorded the incidence of EHIs and calculated the athlete-exposures (AEs).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results:<\/jats:title>\n                  <jats:p>A total of 553 EHI cases and 365\u200a810 AEs were reported for an overall EHI rate of 1.52\/1000 AEs (95% confidence interval [CI] = 1.42, 1.68). Approximately 74% (n = 407) of the reported EHI cases were exertional heat cramps (incidence rate = 1.14\/1000 AEs; 95% CI = 1.03, 1.25), and about 26% (n = 146) were a combination of exertional heat syncope and heat exhaustion (incidence rate = 0.40\/1000 AEs; 95% CI = 0.35, 0.48). The highest rate of EHI occurred during the first 14 days of the preseason period, and the greatest risk was during the first 7 days. The risk of EHI increased substantially when the WBGT was 82.0\u00b0F (27.8\u00b0C) or greater.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions:<\/jats:title>\n                  <jats:p>We found an increased rate of EHI during the first 14 days of practice, especially during the first 7 days. When the WBGT was greater than 82.0\u00b0F (27.8\u00b0C), the rate of EHI increased. 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\u00b0F (27.8\u00b0C) WBGT.<\/jats:p>\n               <\/jats:sec>","DOI":"10.4085\/1062-6050-51.8.08","type":"journal-article","created":{"date-parts":[[2016,9,19]],"date-time":"2016-09-19T17:41:22Z","timestamp":1474306882000},"page":"593-600","source":"Crossref","is-referenced-by-count":62,"title":["Exertional Heat Illness in American Football Players: When Is the Risk Greatest?"],"prefix":"10.4085","volume":"51","author":[{"given":"Earl R.","family":"Cooper","sequence":"first","affiliation":[{"name":"Department of Kinesiology, University of Georgia, Athens;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael S.","family":"Ferrara","sequence":"first","affiliation":[{"name":"College of Health and Human Services, University of New Hampshire, Durham;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas J.","family":"Casa","sequence":"first","affiliation":[{"name":"Korey Stringer Institute, University of Connecticut, Storrs;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John W.","family":"Powell","sequence":"first","affiliation":[{"name":"Department of Kinesiology, Michigan State University, East Lansing;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven P.","family":"Broglio","sequence":"first","affiliation":[{"name":"NeuroTrauma Research Laboratory, University of Michigan, Ann Arbor;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob E.","family":"Resch","sequence":"first","affiliation":[{"name":"Department of Kinesiology, University of Virginia, Charlottesville;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald W.","family":"Courson","sequence":"first","affiliation":[{"name":"University of Georgia Athletic Association, Athens"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2557","reference":[{"issue":"3","key":"2020060411471745100_i1062-6050-51-8-593-b01","first-page":"329","article-title":"National Athletic Trainers' Association position statement: exertional heat illnesses","volume":"37","author":"Binkley","year":"2002","journal-title":"J Athl Train"},{"key":"2020060411471745100_i1062-6050-51-8-593-b02","article-title":"Annual Survey of Football Injury Research 1931\u20132009","author":"Mueller","year":"2016","journal-title":"Chapel Hill, NC: The American Football Coaches Association, National Collegiate Athletic Association, and National Federation of State High School Associations; 2010"},{"key":"2020060411471745100_i1062-6050-51-8-593-b03","unstructured":"Mueller \n              FO, \n            \n            \n              Colgate \n              B. \n            \n          \n          Annual Survey of Football Injury Research 1931\u20132010. National Center for Catastrophic Sport Injury Research Web site. http:\/\/nccsir.unc.edu\/files\/2014\/05\/2010FBAnnual.pdf. Published 2011. Accessed May 20,2016."},{"issue":"2","key":"2020060411471745100_i1062-6050-51-8-593-b04","first-page":"221","article-title":"Descriptive epidemiology of collegiate men's football injuries: National Collegiate Athletic Association Injury Surveillance System, 1988\u20131989 through 2003\u20132004","volume":"42","author":"Dick","year":"2007","journal-title":"J Athl Train"},{"issue":"1","key":"2020060411471745100_i1062-6050-51-8-593-b05","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/s00484-010-0391-4","article-title":"A retrospective analysis of American football hyperthermia deaths in the United States","volume":"56","author":"Grundstein","year":"2012","journal-title":"Int J Biometeorol"},{"key":"2020060411471745100_i1062-6050-51-8-593-b06","first-page":"157","article-title":"Thermoregulatory responses to acute exercise-heat stress and heat acclimation","author":"Sawka","year":"1996","journal-title":"Handbook of Physiology. Section 4: Environmental Physiology"},{"issue":"3","key":"2020060411471745100_i1062-6050-51-8-593-b07","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1249\/MSS.0b013e31802fa199","article-title":"American College of Sports Medicine position stand: exertional heat illness during training and competition","volume":"39","author":"American College of Sports Medicine","year":"2007","journal-title":"Med Sci Sports Exerc"},{"issue":"1","key":"2020060411471745100_i1062-6050-51-8-593-b08","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.jsams.2007.07.003","article-title":"Wet-bulb globe temperature (WBGT): its history and its limitations","volume":"11","author":"Budd","year":"2008","journal-title":"J Sci Med Sport"},{"issue":"4","key":"2020060411471745100_i1062-6050-51-8-593-b09","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1007\/BF00417983","article-title":"Responses of plasma human atrial natriuretic factor to high intensity submaximal exercise in the heat","volume":"57","author":"Kraemer","year":"1988","journal-title":"Eur J Appl Physiol Occup Physiol"},{"issue":"4","key":"2020060411471745100_i1062-6050-51-8-593-b10","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1093\/milmed\/168.4.298","article-title":"Exertional heat illness in Air Force basic military trainees","volume":"168","author":"Smalley","year":"2003","journal-title":"Mil Med"},{"issue":"3","key":"2020060411471745100_i1062-6050-51-8-593-b11","first-page":"463","article-title":"Heat acclimatization and hydration status of American football players during initial summer workouts","volume":"20","author":"Yeargin","year":"2006","journal-title":"J Strength Cond Res"},{"key":"2020060411471745100_i1062-6050-51-8-593-b12","first-page":"51","article-title":"Human adaptation to hot environments","volume":"2001","author":"Wenger","year":"2016","journal-title":"Medical Aspects of Harsh Environments. Vol 1"},{"issue":"7","key":"2020060411471745100_i1062-6050-51-8-593-b13","doi-asserted-by":"crossref","first-page":"463","DOI":"10.3810\/psm.2002.07.377","article-title":"Heat balance limits in football uniforms","volume":"30","author":"Kulka","year":"2002","journal-title":"Physician Sportsmed"},{"key":"2020060411471745100_i1062-6050-51-8-593-b14","first-page":"197","article-title":"Recommendations for athletes and weekend warriors","author":"Maresh","year":"2003","journal-title":"Exertional Heat Illnesses"},{"issue":"3","key":"2020060411471745100_i1062-6050-51-8-593-b15","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1123\/jsr.16.3.204","article-title":"Predisposing risk factors on susceptibility to exertional heat illness: clinical decision-making considerations","volume":"16","author":"Cleary","year":"2007","journal-title":"J Sport Rehabil"},{"key":"2020060411471745100_i1062-6050-51-8-593-b16","unstructured":"Preventative medicine for ground forces. United States Navy Medicine Web site. http:\/\/www.med.navy.mil\/directives\/Pub\/5010-9.pdf. Published 1991. Accessed May 13,2016."},{"issue":"3","key":"2020060411471745100_i1062-6050-51-8-593-b17","first-page":"332","article-title":"Exertional heat illness and environmental conditions during a single football season in the southeast","volume":"41","author":"Cooper","year":"2006","journal-title":"J Athl Train"},{"key":"2020060411471745100_i1062-6050-51-8-593-b18","unstructured":"Guideline 2C: prevention of heat illness. National Collegiate Athletic Association Web site. http:\/\/www.ncaapublications.com\/productdownloads\/MD15.pdf. Published 2014. Accessed May 17,2016."},{"issue":"4","key":"2020060411471745100_i1062-6050-51-8-593-b19","first-page":"302","article-title":"Control of heat casualties at military training centers","volume":"16","author":"Yaglou","year":"1957","journal-title":"AMA Arch Ind Health"},{"key":"2020060411471745100_i1062-6050-51-8-593-b20","unstructured":"Data tools: find a station. National Centers for Environmental Information Web site. http:\/\/www.ncdc.noaa.gov\/cdo-web\/datatools\/findstation. Accessed May 13,2016."},{"issue":"suppl 2","key":"2020060411471745100_i1062-6050-51-8-593-b21","first-page":"S51","article-title":"Relationship between weather station data and heat stress\/thermal environment monitors [abstract]","volume":"42","author":"Resch","year":"2007","journal-title":"J Athl Train"},{"issue":"7","key":"2020060411471745100_i1062-6050-51-8-593-b22","doi-asserted-by":"crossref","first-page":"1118","DOI":"10.1249\/01.MSS.0000074563.61975.9B","article-title":"Risk of knee and ankle sprains under various weather conditions in American football","volume":"35","author":"Orchard","year":"2003","journal-title":"Med Sci Sports Exerc"},{"issue":"8","key":"2020060411471745100_i1062-6050-51-8-593-b23","doi-asserted-by":"crossref","first-page":"1338","DOI":"10.1249\/01.mss.0000174895.19639.ed","article-title":"Epidemiology of hospitalizations and deaths from heat illness in soldiers","volume":"37","author":"Carter","year":"2005","journal-title":"Med Sci Sports Exerc"},{"issue":"5","key":"2020060411471745100_i1062-6050-51-8-593-b24","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1123\/att.14.5.12","article-title":"Heat and hydration curriculum issues: part 4 of 4. Cold water immersion","volume":"14","author":"Mazerolle","year":"2009","journal-title":"Athl Ther Today"},{"key":"2020060411471745100_i1062-6050-51-8-593-b25","article-title":"Inter-Association Task Force on Exertional Heat Illnesses: consensus statement","year":"2011","journal-title":"National Athletic Trainers' Association Web site"}],"container-title":["Journal of Athletic Training"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/meridian.allenpress.com\/jat\/article-pdf\/51\/8\/593\/2191235\/1062-6050-51_8_08.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/meridian.allenpress.com\/jat\/article-pdf\/51\/8\/593\/2191235\/1062-6050-51_8_08.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T18:57:05Z","timestamp":1749668225000},"score":1,"resource":{"primary":{"URL":"https:\/\/nata.kglmeridian.com\/view\/journals\/attr\/51\/8\/article-p593.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,8,1]]},"references-count":25,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2016,8,1]]}},"URL":"https:\/\/doi.org\/10.4085\/1062-6050-51.8.08","relation":{},"ISSN":["1062-6050"],"issn-type":[{"value":"1062-6050","type":"print"}],"subject":[],"published":{"date-parts":[[2016,8,1]]}}}