Policy Analysis | August 2011

Summer Heat and Fall Sports

Jonathan Watts Hull

Students in many districts across the South are starting school next week or are already in session. An early start to school gives students a jump start on academics, athletics and activities. This year, the start to school has coincided with a scorching heatwave that has covered much of the South and Midwest, with temperatures exceeding 90 degrees for weeks, and humidity keeping nighttime temperatures in the upper 70s or low 80s.

This heat is more than an inconvenience, however. Heat is suspected of being a contributing factor in the deaths of four high school football players this month (including two from Georgia, one from Florida, and a 14-year-old player from South Carolina) and in the death of a Texas football coach. While few in number, these events point to heat-related stress among athletes that can lead to other health complications. A study released last year by the Centers for Disease Control and Prevention cited heat illness during practice or competition as a leading cause of death and disability among U.S. high school athletes, with football responsible for a rate of illness 10 times higher than the average rate.

Many state athletic associations have put into place heat policies for athletics and activities that restrict or regulate practices and competitions and outline cooling procedures during periods of extreme heat. The American Academy of Pediatricians recently revised their guidelines on heat stress and student athletes. The new policy retreats from their previous policy which presumed children and adolescents were more susceptible to heat stress, but underscores the need for student athletes to be gradually acclimatized to conditioning during periods of high heat and humidity, and emphasizes the additional risk recent illness, diabetes, and sickle cell anemia can present. The National Association of Athletic Trainers has similar policy recommendations on preventing exertion-related heat illness.

In general, states delegate authority over high school sports and athletics to one or more private membership associations. For their part, these state high school athletic and activity associations ask school districts to establish policies for heat and humidity, along with other risks. Consistency, compliance, and comprehensiveness can vary tremendously, with coaches and athletic directors balancing the pressure to prepare players for an upcoming season in a brief period and the health and safety demands of their students.

Kentucky, following the heat-related death of high school football player Max Gilpin, passed legislation in 2009 requiring that coaches trained in heat illness and other medical issues be present at all high school practices and athletic events, as well as improving record collection and increasing oversight when injuries occur.

Heat is not the only concern for young athletes when the temperatures rise. Summertime is smog season for many Southern cities and towns, and athletes training and competing in the late spring through late summer are exposed to both ozone and particulate matter pollution levels that have been demonstrated to have immediate and long-lasting health impacts, as well as posing a severe risk for athletes with existing conditions, such as asthma. Indeed, due to the intense respiratory nature of most athletics' training, the impact of poor air quality is most likely amplified for people exercising in areas or at times where air quality is poorest. Furthermore, participation in team sports in areas with high ozone concentrations has been linked as a possible factor in the development of asthma in children, making outdoor athletics on ozone alert days, as well as heat, a matter of concern for parents, players and coaches.

For the first time, the National Federation of State High School Associations, which is the national interscholastic association for sports and activities, has established guidelines for air quality through its Sports Medicine Advisory Committee to manage potential air quality problems. Because poor air quality is a trigger for asthma and other respiratory disorders that can have catastrophic effects for young athletes, a number of organizations, including the National Association of State Boards of Education and others, have crafted guidance documents for coaches and activity directors on how to best manage practice and competitions, such as moving them as far as possible from roadways, to minimize risk to school children.