Heat stress and athletic participation

Competitive and recreational sports participation in hot environments carries a risk of exertional heat stroke and often leads to decrements in performance, increased numbers of medical encounters and participants who are unable to complete the activity. Intensity of activity, acclimatization, hydration, medications and supplements, recent alcohol use, nutrition, sleep hygiene, exposure to air conditioning or night cooling, excessive sport equipment or clothing, malignant hyperthermia, and recent viral illness have all been implicated in the genesis of heat related collapse and exertional heat illness. Administrative decisions are required to modify or cancel competitions in hot environments that put athletes at undue risk. In general, elite athletes tolerate heat better than recreational and sub elite athletes.