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Strategies and factors associated with preparing for competing in the heat: a cohort study at the 2015 IAAF World Athletics Championships
  1. Julien D Périard1,
  2. Sébastien Racinais1,
  3. Toomas Timpka2,
  4. Örjan Dahlström2,
  5. Armin Spreco2,
  6. Jenny Jacobsson2,3,
  7. Victor Bargoria2,4,
  8. Karin Halje2,5,
  9. Juan-Manuel Alonso6
  1. 1Athlete Health and Performance Research Centre, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
  2. 2Athletics Research Center, Linköping University, Linköping, Sweden
  3. 3Swedish Athletics Association, Stockholm, Sweden
  4. 4Department of Orthopaedics and Rehabilitation, Moi University, Eldoret, Kenya
  5. 5Young Adults Centre, Region Östergötland, Linköping, Sweden
  6. 6Sports Medicine Department, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
  1. Correspondence to Dr Julien Périard, Athlete Health and Performance Research Centre, Aspetar Orthopaedic and Sports Medicine Hospital, P.O. Box 29222, Doha, Qatar; julien.periard{at}


Purpose Assess exertional heat illness (EHI) history and preparedness in athletes competing in a World Athletics Championships under hot/humid conditions and identify the factors associated with preparedness strategies.

Methods Of the 207 registered national teams invited to participate in the study, 50 (24%) accepted. The 957 athletes (49% of all 1965 registered) in these teams were invited to complete a precompetition questionnaire evaluating EHI history, heat stress prevention (heat acclimatisation, precooling and hydration) and recovery. Responses from 307 (32%) athletes were separated in field events, sprints, middle-distance and long-distance running, and decathlon/heptathlon for analysis.

Results 48% of athletes had previously experienced EHI symptoms and 8.5% had been diagnosed with EHI. 15% heat acclimatised (∼20 days) before the championships. 52% had a precooling strategy, ice slurry ingestion (24%) being the most prevalent and women using it more frequently than men (p=0.005). 96% of athletes had a fluid consumption strategy, which differed between event categories (p<0.001). The most common volumes planned on being consumed were 0.5–1 L (27.2%) and ≥2 L (21.8%), water being the most frequent. 89% of athletes planned on using at least one recovery strategy. Female sex (p=0.024) and a previous EHI diagnosis increased the likelihood of using all 3 prevention strategies (p<0.001).

Conclusions At a World Championships with expected hot/humid conditions, less than one-fifth of athletes heat acclimatised, half had a precooling strategy and almost all a hydration plan. Women, and especially athletes with an EHI history, were more predisposed to use a complete heat stress prevention strategy. More information regarding heat acclimatisation should be provided to protect athlete health and optimise performance at major athletics competitions in the heat.

  • Heat acclimatisation
  • Elite performance
  • Exertional heat stress
  • Hydration

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  • Twitter Follow Julien Périard @DrJPeriard, Sébastien Racinais @SebRacinais, Jenny Jacobsson @Jenny_Jacobsson and Juan Manuel Alonso @DrJuanMAlonso

  • Contributors JDP, SR and J-MA made substantial contributions to the conception of the study. JDP, SR, J-MA, TT and ÖD made substantial contributions to the study design. J-MA, TT, ÖD, AS, JJ, VB and KH were involved in data collection. JDP, TT, ÖD, AS, JJ, VB and KH were involved in the analysis of the data. All authors made substantial contributions to data interpretation. JDP made the substantial contribution to the drafting and writing of the manuscript. All authors were involved in the revising of the manuscript and gave final approval of the version to be published.

  • Competing interests None declared.

  • Ethics approval The study was approved by the Anti-Doping Laboratory Qatar Institutional Review Board and conformed to the current Declaration of Helsinki guidelines.

  • Provenance and peer review Not commissioned; externally peer reviewed.