Summertime in North Carolina means high temperatures, and when you mix in the humidity, the heat can become dangerous for athletes participating in sports practices and contests.

Understanding how to stay safe in the heat while playing sports means looking at more than just the temperature. Things like the dew point and wet bulb globe temperature are also critically important.

Organizations like the N.C. High School Athletic Association, individual school districts, and schools themselves have policies and procedures to help reduce the risk of heat illnesses. Athletic trainers and first responders are trained to look for early signs of heat illness and to react quickly if an athlete becomes ill.

There are standardized minimum thresholds that all high schools in North Carolina must follow when it comes to heat-related illness prevention.

However, there are also steps individual athletes can take to make sure they are not putting themselves at risk.

The science behind heat

When you look at your thermometer on your car, you’re seeing the temperature. This is a measure of the actual air temperature outside (although the thermometer on your car is probably not the most accurate). The air temperature in North Carolina during the summer is often in the 90s, and can even break 100 degrees.

The dew point is the measure of how much water is in the air, which is what makes it feel humid. If you step outside and the air feels thick, chances are the dew point is high. During the summer months, dew points in North Carolina are routinely in the 70s.

When dew points rise, it makes it harder for sweat to evaporate off the skin, which can increase the chances that someone suffers from a heat-related illness. Your body produces sweat to cool itself, which happens when the sweat evaporates off the skin. However, when the humidity (or dew point) level is high, it’s harder for the sweat to evaporate, which can then raise your body temperature.

According to the National Weather Service the wet bulb globe temperature is a measure of heat stress when in direct sunlight. The temperature in direct sunlight is only part of the calculation. The wet bulb globe temperature also includes humidity, the wind speed, sun angle, and cloud clover. The NCHSAA heat policies are all based on the wet bulb globe temperature.

The wet bulb globe temperature is not the same thing as the heat index you often hear meteorologists talk about on television. The heat index only takes into account the air temperature and humidity. This is similar to the “feels like” temperature on many weather apps. The heat index is measured for shady areas and not for direct sunlight. The National Weather Service says stepping out into direct sunlight can increase the heat index by as much as 15 degrees.

On days where the temperatures are exceptionally hot, the National Weather Service may issue advisories for the heat. There are three types of advisories the National Weather Service may issue:

• Heat Advisory: When the heat index reaches 105 degrees for at least three hours, or when the heat index will top 100 degrees for several consecutive days.
• Excessive Heat Watch: When the heat index could reach 110 degrees within the next 1-2 days, or when there is a long period of heat where the heat index is near 110 degrees.
• Excessive Heat Warning: When the heat index reaches 110 degrees.

Types of heat illnesses in athletes

When athletes are participating in activities outside during the summer heat, they can experience signs and symptoms that are warning signs of potential heat illnesses.

There are three main types of heat illnesses, each getting progressively worse.

The first sign of heat-related illnesses could be in the form of heat cramps, which are painful muscle spasms and are often accompanied by heavy sweating. This is a sign of dehydration. The Centers for Disease Control and Prevention says applying firm pressure and gently massaging the affected muscles can help stop a spasm, and the person should take sips of water unless they feel nauseated. If the cramps last longer than one hour, medical attention should be sought.

Heat exhaustion is the next form of heat illness. A person suffering from heat exhaustion may experience heavy amounts of sweating, weakness or exhaustion, dizziness, muscles cramps, and nausea or vomiting. They may also have a fast, weak pulse, and their skin may be cool, pale, and clammy. An athlete exhibiting signs of heat exhaustion should move to a cooler location, loosen tight clothes, and sip water. Cold packs or wet cloths can also be used, or a person can sit in a cool tub of water. However, if the person begins vomiting, if the symptoms don’t get better in an hour, or if the person’s condition gets worse, they should seek medical attention.

Finally, a person suffering from a heat stroke is having a medical emergency and 911 should be called so the person can be transported to the hospital immediately. Signs of heat stroke include a severe headache, confusion and dizziness, nausea and vomiting, fainting, and loss of consciousness. A person suffering a heat stroke may have a body temperature above 103 degrees, present a rapid and strong pulse, and have red, dry, or damp skin.

Heat stroke can result in death if treatment is delayed. After calling 911, the person should be moved to a cooler location and efforts should be made to reduce the body temperature using cold packs, wet cloths, or a cold tub. However, you should not give fluids to someone who is experiencing a heat stroke.

Signs and symptoms of heat illnesses in athletes

Here are the signs and symptoms you should be looking for when participating in high school athletics during hot weather:

Heat exhaustion signs & symptoms:

• Feeling faint or dizzy
• Excessive, heavy sweating
• Skin feels cool & looks pale
• Nausea or vomiting
• A rapid, weak pulse
• Muscle cramps
• Feeling tired or weak
• Headache
• Fainting

Heat stroke signs & symptoms

• Body temperature of 103 degrees or higher
• No sweating
• Hot, red skin that can be dry or damp
• Strong and rapid pulse
• Confusion, dizziness, or loss of consciousness
• Nausea or vomiting

Preventing heat illness in athletes

There are steps athletes can take to prevent heat illness while participating in high school sports. According to the Centers for Disease Control and Prevention, these recommendations fall into three categories — stay cool, stay hydrated, stay informed.

• Wear loose-fitting and lightweight clothes
• Limit outdoor activity during the hottest parts of the day and allow your body time to recover in cool areas
• Work to gradually acclimate your body to the intense heat, starting with shorter, less strenuous workouts.
• Wear sunscreen to prevent sunburn, which can reduce your body’s ability to cool itself and contribute to dehydration.
• Watch what you eat. Eating hot meals or heavy foods increase the heat in your body.
• Drink lots of fluids and don’t wait until you’re thirsty. Stay away from sugary and alcoholic drinks. Cold drinks can also cause stomach cramps.
• Replace the electrolytes your body loses with sports drinks.
• Know the signs of heat illnesses.
• Monitor yourself and others. Report any concerning symptoms.

The National Federation for State High School Associations has published a free online course called “Heat Illness Prevention” for coaches, administrators, parents, and others who want to learn more about heat illnesses.

Hot weather guidelines & policies for high school sports

The N.C. High School Athletic Association has set minimum heat guidelines that all member schools must follow when students are participating in activities in hot weather.

According to the NCHSAA, the majority of heat-related illnesses happen during the first week of practice and training. Because of this, the NCHSAA says acclimatization periods should gradually introduce athletes to the heat and humidity while increasing the physical exertion over time. Acclimatization means beginning with less intense practices that last for small amounts of time and include longer recovery intervals, reducing the amount of gear athletes are wearing, and emphasizing instruction over conditioning at the beginning of a season.

Coaches have been instructed to consider the individual medical conditions of athletes and their differing levels of physical conditioning during the acclimatization period. They’re also encouraged to reduce the physical exertion when the heat becomes excessive. Unlimited amounts of water must be provided to athletes, and coaches are never allowed to withhold water from athletes.

Schools are required to monitor to the wet bulb globe temperature when activities are taking place outdoors in heat. The NCHSAA has set guidelines that schools must follow based on the the wet bulb globe temperature:

• Less than 80 degrees: Unlimited activity with primary cautions for new or unconditioned athletes or extreme exertion; schedule mandatory rest/water breaks (5 min water/rest break every 30 min)
• 80-84.9 degrees: Normal practices for athletes; closely monitor new or unconditioned athletes and all athletes during extreme exertion. Schedule mandatory rest/water breaks. (5 min water/rest break every 25 min)
• 85-87.9 degrees: New or unconditioned athletes should have reduced intensity practice and modifications in clothing. Well-conditioned athletes should have more frequent rest breaks and hydration as well as cautious monitoring for symptoms of heat illness. Have cold or ice immersion pool on site for practices. Schedule frequent water/rest breaks. (5 min water/rest break every 20 min)
• 88-89.9 degrees: All athletes must be under constant observation and supervision. Remove pads and equipment. Have cold or ice immersion pool on site for practice. Schedule frequent mandatory rest/water breaks. (5 min water/rest break every 15 min).
• 90+ degrees: Suspend all practices. Competition may continue with mandatory water breaks as designated by the gameday administrator.

These are minimum standards set by the NCHSAA. Individual schools and school districts can have more restrictive guidelines, but they cannot be less restrictive. For example, some school districts prevent activities during certain hours in the middle of the day during the summer.

Athletes also play a key role in the prevention of heat illnesses. Hydrating outside of practices is important. Athletes should ensure they are hydrating in the days before and after exposure to intense heat, and replacing the fluids lost during practice. Athletes should avoid drinks with sugar and caffeine.

How NC high school football players are acclimated to heat

The N.C. High School Athletic Association has very specific guidelines for high school football teams when it comes to heat acclimatization. All football teams are required to follow these standards beginning on the first official day of practice

Practice Time Guidelines: On the first five days of official practices, schools cannot hold more than one practice per day and total practice time cannot exceed three hours in any one day. Teams can hold a maximum of a one-hour walkthrough during the first five days, but there must be a minimum three-hour break in a cool environment between practices and walkthroughs.

Beginning on the sixth practice day, double-practices can be held, but a double-practice day must be followed by a single-practice day. On double-practice days, neither practice can go longer than three hours, and the total practice time cannot surpass five hours.

Equipment Guidelines: On the first two days of practice, players can only wear helmets. Shoulder pads can be added on days 3-5 and contact with blocking sleds and tackling dummies is allowed. All equipment can be worn and full contact can begin on day six.

Source: highschoolot.com