Chapter 7: Understanding the

Potential Dangers of Adverse

Environmental Conditions

McGraw-Hill/Irwin

2013 McGraw-Hill Companies. All Rights Reserved.

 Environmental stress can adversely

impact an athletes performance and
pose serious health threats
Areas of concern
Hyperthermia
Hypothermia
Lightening storms
Over exposure to the sun

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Hyperthermia
Athletic trainers require knowledge and
information concerning temperature, humidity
and weather to adequately make decisions
regarding environmental dangers
Has caused a number of deaths over the
years
Must manage heat stress appropriately
Hyperthermia = increase in body temperature

7-3

 Anyone that supervises athletes practicing

and competing must realize that heat and
humidity impact every geographic region of
the United States
Imperative to be able to recognize signs and
symptoms associated with heat-related
illnesses and to be able to manage them
appropriately

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Heat Stress
Extreme caution should be used when training in
the heat
Overexposure could result in heat stress

It is preventable
Athletes that train under these extreme conditions
are at risk
Physiologically the body will continue to function if
body temperature is maintained
Body must dissipate heat to maintain homeostasis

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 Heat can be dissipated from the body through 4

mechanisms
Conduction (direct contact)
Convection (contact with cool air or water mass)
Radiation (heat generated from metabolism)
Evaporation (sweat evaporating from the skin)
* Heat can also be gained via these four mechanisms

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 Evaporative Heat Loss

Sweat glands allow water transport to surface
Evaporation of water takes heat with it
When radiant heat and environment temperature are higher than body
temperature, loss of heat through evaporation is key
Lose 1 quart of water per hour for up to 2 hours
Air must be relatively water free for evaporation to occur
relative humidity of 65% impairs evaporation
relative humidity of 75% stops evaporation

Heat illness can still occur in cold environment if body is unable to

dissipate heat
Caused by dehydration and inability to sweat

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Monitoring Heat Index

Heat, sunshine and humidity must be monitored
closely
Takes into account ambient air temperature and relative
humidity
Attempts to determine how hot it feels to the body

Wet bulb globe temperature index (WBGT) provides

objective measure for determining precautions
concerning participation in hot

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7-9

 WGBT incorporates different thermometer readings

Dry bulb (standard mercury temperature)
Wet bulb (thermometer with wet gauze that is swung
around in air)
Black bulb (black casing that measures radiant heat)
Formula yields WBGT index

DBT and WBT can be measured with psychrometer

(combines both thermometers)
Wet bulb will be lower due to evaporation of water
Drier air = greater depression of wet bulb temperature due
to evaporation

7-10

 Ventilation is
provided by whirling
thermometer (sling
psychrometer) or
suction fan
(aspiration
psychrometer
Newer models
utilize digital
sensors

7-11

7-12

Heat Illnesses
Heat Syncope (heat collapse)
Associated with rapid fatigue and overexposure,
standing in heat for long periods of time
Caused by peripheral vasodilation, or pooling of
blood in extremities resulting in dizziness and
fainting
Treatment
Lay athlete down in cool environment, elevate lower
extremities, consume fluids

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 Exertional Heat Cramps

Painful muscle spasms (calf, abdominal) due to
excessive water loss and electrolyte imbalance
Occurs in individual in good shape that overexert
themselves
Treatment
Prevent by consuming extra fluids and maintaining
electrolyte balance
Treat with fluid ingestion, light stretching with ice massage
Return to play unlikely due to continued cramping

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 Exertional Heat Exhaustion

Result of inadequate fluid replacement
Signs & Symptoms
Profuse sweating, pale skin, mildly elevated temperature, dizziness,
hyperventilation and rapid pulse
May develop heat cramps or become faint/dizzy
Core temperature will be ~102o
Critical to obtain accurate core temperature

Performance may decrease

Treatment
Immediate treatment includes fluid ingestion (intravenous replacement,
ultimately), place in cool environment

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 Exertional Heatstroke
Serious life-threatening condition, with unknown specific cause
Need emergency action plan in place to manage this life
threatening condition
Signs & Symptoms
Sudden onset - sudden collapse, LOC, flushed hot skin, minimal sweating,
shallow breathing, strong rapid pulse, and core temperature of > 104o F

Drastic measures must be taken to treat & cool the athlete

Strip clothing
Sponge with cool water
Immerse in water
Transport to hospital immediately

7-16

 Exertional Hyponatremia
Fluid/electrolyte disorder resulting in abnormally low
concentration of sodium in blood
Caused by ingesting too much fluid before, during and
after exercise
May be result of too little sodium in diet or in ingested
fluids over a period of prolonged exercise
Athletes that ingest large quantities of water and sweat
over several hours are at risk (marathon, triathlon)
Preventable must maintain balance

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Preventing Heat Illness

Must exercise common sense and precaution
Consume fluids and stay cool

Fluid and Electrolyte Replacement

Single most important step taken by a coach to
minimize the chance of heat illnesses
Continual re-hydration is critically important
Generally only 50% of fluid is ever replaced and
should therefore be replaced before, during and
after exercise

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 Fluid replacement should match sweat loss

Time of stomach emptying is critical
Water is absorbed rapidly from intestine
Drink with 6% CHO is eliminated at the same rate if the individual
is hydrated
Cold drinks tend to empty rapidly and will not induce cramping or
put heart at risk
Drinks with caffeine and alcohol will promote dehydration

Hydration levels can be monitored via urine color and

volume

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 Using Sports Drinks

More effective than just replacing fluids with water
Flavoring results in increased desire to consume
Replaces fluids and electrolytes
Water alone can prematurely stop thirst response and initiate
fluid removal by kidneys
Small amounts of sodium help in retention of water
Optimal CHO level is 14g per 8 ounces of water
More CHO results in slower absorption
Effective for both short & long term activities

7-20

 Gradual Acclimatization
Most effective method of avoiding heat stress
Involves becoming accustomed to heat and
exercising in heat
Early pre-season training and graded intensity
changes are recommended with progressive
exposure over 7-10 day period
80% of acclimatization can be achieved during first
5-6 days with 2 hour morning and afternoon
practice sessions

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 Identifying Susceptible Individuals

Athletes with large muscle mass
Overweight athletes are at an increased risk
Related to proportionality of metabolic heat production to surface
area

Athlete with increased fluid loss

Precautionary measures apply to both males and females
Medications or supplements may impair sweating and may
predispose them to injury
Poor fitness levels, a history of heat-related illnesses or
anyone with febrile conditions are at increased risk

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 Uniform Selection
Base on temperature and humidity
Dress for the weather and temperature
Avoid rubberized suits

Weight Records
Keep track of before and after measures for first two weeks
If increase in temperature and humidity occurs during the
season, weights should again be recorded
A loss of 3-5% = reduced blood volume and could be a
health threat

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Hypothermia
Cold weather vs. nature of particular sport
Most activity allows for adequate heat
production and dissipation, allowing for
sufficient functioning
Temperature in conjunction with wind chill
and dampness or wetness can increase
chances of hypothermia

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 With muscular fatigue, in cold weather, rate of

exercise begins to drop and rate of heat loss
relative to heat production may shift
Results in impaired neuromuscular responses and
exhaustion

Drop in core stimulates shivering but stops

after temp. drops below 85-90oF
Death is imminent when temp falls below 7785oF.

7-25

Cold Disorders
Fluid replacement is critical
Dehydration = decreased blood volume = less fluid
available for tissue warming

May be useful to monitor weight of athletes

training in cold temperatures
Injury/illness due to the cold can occur
Endurance type activities
Winter sports
Swimming in cold water

7-26

 Frost nip
Involves, ears, nose, chin, fingers, and toes
Occurs with high wind and/or severe cold
Skin appears firm with cold painless areas
that may peel and blister (24-72 hours)
Treat with firm pressure, blowing warm air
or hands in armpits (if fingers involved)
Do not rub

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 Frostbite
Superficial Frostbite involves only skin and
subcutaneous tissue
Appears pale, hard, cold and waxy
When re-warming the area will feel numb, then sting and burn
It may blister and be painful for several weeks

Deep Frostbite indicates frozen skin requiring

hospitalization
Gradual re-warming is necessary (100-110oF)
Tissue will become blotchy red, swollen, painful and may
become gangrenous

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7-29

 Prevention
Apparel geared for weather to provide semitropical
microclimate for body and prevent chilling
Waterproof and windproof fabrics wick moisture
away from skin, allowing passage of heat and sweat
Layers and adjusting them are key to maintaining
body temperature (during period of (in)activity)
Inadequate clothing, improper warm-up and chill
factor can lead to injury, frostbite, and/or minor
respiratory problems

7-30

Overexposure to Sun
Precautions must be taken to protect athletes,
coaches, athletic trainers and support staff
Long Term Effects on Skin
Premature aging and skin cancer due to ultraviolet
exposure
Premature aging is characterized by dryness, cracking
and inelasticity of the skin
Skin cancer is the most common malignant tumor found
in humans

7-31

 Sunscreen
Can help prevent effects of UV radiation
Sun Protection Factor (SPF)
Sunscreen effectiveness
Indicates how many times longer an individual can be exposed to the sun with
vs. without sunscreen before skin turns red.

Use

When outside considerable amount

Individuals with fair complexion, light hair, blue eyes or skin that burns easily
Throughout the year
Apply 15-30 minutes prior to exposure
Re-apply after exposure to water, excess sweating, rubbing skin with clothing
or a towel

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Safety in Lightening and

Thunderstorms
#2 cause of death by weather phenomena
NATA has established position statement due
to number of athletes and coaches potentially
exposed to lightening scenarios
Emergency action plans must be set for this
type of event
Involving chain of command, monitoring of weather
service, decision making regarding removal and
return to field
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 In the event of a storm, shelter indoors should

be obtained
Other guidelines
Avoid large trees, flag/light poles, standing water,
telephones, pools, showers, and metal objects
Last resorts find car, ravine, ditch or valley for safety
If hair stands up on hand you are in imminent
danger and should get down on the ground but not
flat as that increases surface area

7-34

 Additional Guidelines
Lightening is generally accompanied by thunder
(except 20-40% of the time due to atmospheric
disturbances)
Flash-to-bang methods estimates distance away
for the storm
From time lightening is sighted to the clap of thunder
count, divide by 5 to calculate the number of mile away
Count of 30 indicates inherent danger and everyone
should leave the field

7-35

 NATA, NCAA and National Weather

Service recommend returning to the field
30 minutes following the last clap of
thunder or lightening strike
Major misconception is that lightening that
is seen striking is coming down
In actuality it is the return stroke of the
lightening going back up after it has already hit
the ground

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 Lightening Detectors
Hand-held instrument with
electronic system to detect
presence and distance of
lightening/thunderstorm activity
(w/in 40 miles)
Can determine level of activity
and direction of movement
Provides audible and visual
warning signals
Inexpensive alternative to
contracting weather services

7-37