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Epidemiology and risk factors for heat illness: 11 years of Heat Stress Monitoring Programme data from the FIVB Beach Volleyball World Tour
  1. Sebastien Racinais1,
  2. Marine Alhammoud2,
  3. Nada Nasir1,
  4. Roald Bahr3,4
  1. 1Research and Scientific Support, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
  2. 2Surgery Department, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
  3. 3Department of Sports Sciences, Oslo Sports Trauma Research Center, Oslo, Norway
  4. 4ASPREV, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
  1. Correspondence to Dr Sebastien Racinais, Research and Scientific Support, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, PO Box 29222, Qatar; sebastien.racinais{at}


Objectives To analyse 11 years of FIVB heat stress-monitoring data to determine the relative influence of the different environmental parameters in increasing the likelihood of a heat-related medical time-out (MTOheat).

Methods A total of 8530 matches were recorded. The referee measured air temperature, black globe temperature, relative humidity and wet-bulb globe temperature (WBGT) before the matches, and registered the MTOheat. The absolute humidity was computed at posteriori.

Results There were 20 MTOheat cases, but only 3 resulted in forfeiting the match. MTOheat incidence was not statistically impacted by sex (p=0.59). MTOheat cases were more prevalent during the games played in Asia during the 4th quarter of the year (p<0.001). Two cases of MTOheat experienced diarrhoea or gastroenteritis during the 5 preceding days; both of them forfeited the match. A principal component analysis showed a specific environmental profile for the matches with MTOheat. They occurred at higher WBGT, temperatures and absolute humidity (p<0.001), but with a lower relative humidity (p=0.027).

Conclusions The current data showed that an increase in ambient or black globe temperature, but not relative humidity, increased the risk of a MTOheat; but that the absolute risk remained low in elite beach volleyball players. However, suffering or recovering from a recent illness may represent a risk factor for a MTOheat to lead to player forfeit.

  • exertional heat stress
  • thermoregulation
  • elite performance
  • volleyball
  • heat acclimatisation

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  • Contributors All authors critically reviewed the manuscript, provided significant input and approved the final version. SR drafted the manuscript and interpreted the data. MA analysed the data. NN prepared the data. RB designed the FIVB Heat Stress Monitoring Programme and monitored data collection.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

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

  • Data availability statement Data are available upon reasonable request.