VERMONT PRINCIPALS ASSOCIATION POLICY for Athletic Participation in the HEAT

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VERMONT PRINCIPALS ASSOCIATION POLICY for Athletic Participation in the HEAT Exercise in a hot environment with associated fluid loss and elevated body temperature can lead to: Dehydration, Heat Exhaustion, and Exertional Heat Stroke and Death. Modifications need to be made if the environment is putting athletes at greater risk for heat illness. All schools are expected to adhere to the following policy for athletic participation in all sports during times of high heat and/or humidity Exertional Heat Stroke is on the rise in this country, and is currently among the top three reasons why athletes die during sporting activities. State mandatory policy for athletic activity in the heat provides critical standards to protect athletes against heat illnesses, and potentially save lives. This policy follows recommended guidelines from the National Athletic Trainers Association, American College of Sports Medicine, and Korey Stringer Institute. STEPS FOR MONITORING HOT WEATHER: Weather should be monitored by designated athletic department personnel (Athletic Trainer if present) and an advisory should be issued to school coaching staff when applicable. Usually by email the day prior to the event warning of the potential, and the day of the event with potential modifications. Athletic Department officials should use a Wet Bulb Globe Temperature Measuring (WBGT) Device. It is considered the gold standard measurement tool. (if cost prohibitive, Heat Index measuring devices can be used, although considered less accurate than WBGT) o The WGBT considers ambient temperature, relative humidity, wind, and solar radiation. o The Heat Index considers effects of ambient temperature and relative humidity only. o WBGT can be estimated from the chart below in cases where there is full sun and light wind by using a heat index monitor. o A list of potential devices to be used for measurement can be seen on pg.4. Weather readings MUST be measured at the practice/game site, using a Wet Bulb Globe Temperature Device (or Heat Index Monitor). Measurements should be obtained beginning 1 hour prior to the event and monitored 30 minutes thereafter. Reminder: Synthetic Turf/Asphalt/Dark colored surfaces are significantly hotter than the ambient air temperature, especially if in full sun. Based on information from local/on-site weather measurements and from the National Weather Service, determine the risk of potential danger to participants using Table 1 below. Issue a warning and implement the practice or game plan for that day to be distributed to all coaches prior to practice time. See list on pg. 3 for additional Competition Modifications. Avoid scheduling training and competitions during the hottest part of the day (between 11am and 4pm). Shaded Areas should be easily accessible to athletes during rest/fluid breaks with unlimited fluids available

Activity Modification Chart Table 1 RISK WBGT* MODIFICATIONS # Minimal Risk < 76.1 o F Normal Activities, no modifications necessary < 24.5C Low Risk 76.2-81 o F Normal Activities/Regular practice/game prep 24.4-27.2C Discretion for Intense/Prolonged Activity; Watch at Risk Players Provide at least 3 rest/fluid breaks each hour of 4+mins each. Moderate Risk 81.1-84 o F Rest/Work ratio to be increased; 27.3-28.9C 15-20 min of activity followed by 4+ min rest/fluid breaks; Practice will be in shorts, helmets, shoulder pads only No equipment may be worn for conditioning activities Maximum length of practice 2 hours High Risk 84.1-86 o F Rest/Work ratio to be increased; 20 mins activity/6+ min rest 29-30C 20 mins of rest distributed throughout 1 hr of practice Practice will be in shorts only (all protective equipment removed) No conditioning activities Maximum Length of practice 1 hour Change Time of Day activity is held (no practices b/t 11am-4pm) Extreme Risk >86.1 o F No Outdoor Workouts > 30C May delay practice until cooler WBGT reading occurs Shaded Areas should be made available for all athletes during rest/fluid breaks, unlimited fluids, remove equipment Reminder: the temperatures shown in the above table are WBGT temps, not ambient temperatures *Cat 1 from Grundstein # Adapted from: Andrew Grundstein, Applied Geography, 2015 Regional Safety Thresholds for athletics in the Contiguous US

VERMONT PRINCIPALS ASSOCIATION POLICY for Athletic Participation in the HEAT Recommended Preventative Strategies for Competitions: Competition Modifications: Unlimited supply of water at the site of each activity Move competition times to a cooler part of the day; early morning or early evening Meet with officials prior to game to discuss any or all of the concerns and/or strategies. Use player substitutions more often during play A mandatory water time out at the mid-way point of each half of play for both teams An extended half time for players to recover/cool more completely Cold water/ice towels and/or fans should be used to cool players Recommend removal of helmets and other equipment during rest periods or stoppage of play. Have plenty of extra ice and water at the site in the event a player needs immediate first aid/cooling o A on-site cold/ice water tub (kiddie pool) for emergent athlete immersion is recommended Athletic Trainers/Coaches should be especially vigilant and monitor player s physical condition in extreme temperatures Hydration: Prior to Activity: At least 500mls (2-3 glasses) During Activity: 200mls (1-2 glasses) every 15 minutes o Preferably water however sports drinks may be appropriate Unlimited supply of water at the site of activity Clothing: It is essential that everyone is made aware of the importance of: Wear appropriate clothing during play (wear light colors, wicking quick dry fabric) Practice without equipment on. Appropriate application and re-application of SPF 30+ sunscreen Factors Affecting Body Temperature Regulation: Air Temperature Activity Intensity Adaptability/Acclimatization of the body Humidity Fluid Intake Age of the Athlete (children, adolescent, elderly) Wind Clothing Susceptibility Prior History of heat illnesses Unacclimatized athletes (early season, unusually high temps) Overweight (high BMI) or Underweight Athletes (Low BMI) Some medications and/or some medical conditions Dehydration/Greater than 3% body weight loss during the event Heavy or Salty Sweaters High Temperature/humidity the previous participation day

HEAT ILLNESS Exposure to prolonged or abnormal amounts of heat and humidity can be especially dangerous for young athletes who sweat less, adjust more slowly and produce more internal heat than adults. Remember: More water does not make it less hot! Exercise in a hot environment, with associated fluid loss and elevated body temperature, can lead to: Dehydration, Heat Exhaustion and Heat Stroke. Heat stroke is a preventable, potentially fatal condition and must be treated immediately. Children who take certain medications, have chronic health problems or are overweight may be more susceptible to heat illness. HEAT ILLNESS DEFINITIONS: Dehydration Fluid loss occurs during exercise, due to perspiration and respiration. It makes an athlete more susceptible to fatigue and muscle cramps. Inadequate fluid replacement before, during and after exercise will lead to excessive dehydration and may lead to other heat illnesses. Treatment: Fluid replacement before, during and after activity until urine is a light lemonade color Heat Exhaustion Dehydration can lead to heat exhaustion and an inability to sustain adequate cardiac output. Symptoms include: - Fatigue, weakness - Headache, dizziness - Loss of endurance/skill - Light-headedness - Pale, clammy, sweaty skin - Nausea Athletes will pass little urine, which will be highly concentrated. Muscle cramps may be associated with heat exhaustion Treatment: Cool athlete in shade or air conditioning, provide fluids, remove equipment, elevate legs Exertional Heat Stroke Severe overheating, thermoregulatory failure may lead to exertional heat stroke. More or Large amounts of water do not prevent heat stroke HEAT STROKE is LIFE THREATENING and PREVENTABLE! Symptoms include: - Fatigue - Headache, dizziness - Nausea - White skin, may or may not be sweating - Confusion - Increased body temperature - Increased heart rate, respirations - Collapse Exertional Heat stroke may arise in an athlete who has not been identified as suffering from heat exhaustion and has persisted in further activity. Treatment: Immediate, drastic on-site cooling in ice/cold water immersion, fans, ice bags to groin arm pits, neck, EMS to hospital References: www.nata.org/position-statements Exertional Heat Illnesses Fluid Replacement for Athletes www.acsm.org Exertional Heat Illness in Training & Competition VPA Sports Medicine Advisory Committee August 2015

INFORMATION ON WET BULB GLOBE TEMPERATURE DEVICES The VPA is sensitive to directing schools to instruments that are portable and that are within the $150.00 - $400.00 price range. The following list of instruments and web sites that you may find the devices. It is not an exhaustive list there are other units on the market that are functional and affordable. http://kestrelmeters.com/products/kestrel-4400-heat-stress-meter Kyoto KEM WBGT-103 Heat Stroke Checker http://kestrelmeters.com/products/kestrel-drop www.medco-athletics.com General Reed -- WBGT meter 8778 www.testequipmentdepot.com Reed SD-2010 www.schoolhealth.com EBGT Model #13099