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  1. D Broman1,2,
  2. R Fearn1,
  3. M Wittenberg1
  1. 1Maccabi Great Britain, London, United Kingdom
  2. 2Barts Health NHS Trust, London, United Kingdom


Background The risk of heat-related illness in sport is significant. It can range from minor symptoms, through heat exhaustion to heat stroke, coma and possible death. Early recognition and cooling can reduce morbidity and mortality associated with exertional heat illness (EHI).

Objective The aim of our study was to establish a protocol for the prevention, recognition and prompt management of EHI, in athletes, who are participating in potentially dangerous weather conditions/environments.

Design We performed a prospective, cohort study of the incidence of EHI occurring during a multi-sport event.

Setting Our study was performed at the Maccabiah Games 2013 in Israel. This event compromised a variety of skill levels, including amateur, semi-professional and Olympic level athletes. The weather conditions in Israel in July 2013, ranged from temperatures of 23°c −41°c.

Patients In our role, as the medical team for Team GB, we studied all athletes for Great Britain. This included 424 participants, both male and female, at all age levels from 14–58 years old, including a variety of skill levels from amateur to professional athletes.

Interventions We established a 'heat policy' which we implemented during the Games. The medical team reviewed every athlete with common symptoms of EHI at the pitch-side, recording their temperature, and if necessary removing them from sport and initiating management of hyperthermia.

Main outcome measurements The main outcome measurement, which was formulated before the data collection began, was to establish risk factors for which athletes developed EHI. We also studied what interventions successfully reduced the risk of developing EHI.

Results & conclusions We documented 21 cases of EHI, across a spectrum of severity, but with no cases of severe heat stroke/coma. Despite the high-intensity and frequency of sport, in extreme heat, none of our athletes needed tertiary/specialist care.

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