NATA releases exertional heat illness guidelines for football

The National Athletic Trainers’ Association (NATA) has released new guidelines on preventing and treating exertional heat illness (EHI) on the football field and in the workplace.

As temperatures are expected to keep rising, NATA said these guidelines can help reduce risk and ensure appropriate care of EHI and related conditions.

“Exertional heat stroke (EHS) is a leading cause of sudden death in sport and especially among American football lineman,” NATA President A.J. Duffy III said in a news release. “Additionally, occupational heat stress is a growing public health concern.

“Athletic trainers are uniquely qualified experts in heat safety. The two new NATA Task Force statements demonstrate how their competency in this area translates directly to protecting football players and workers alike.”

A new paper, “Preventing Exertional Heat Stroke (EHS) Death in American Football Linemen,” chaired by NATA Task Force chair Rebecca Stearns, revealed:

• American football linemen exceed deaths over all other football positions
• Linemen account for more than 90% of all EHS fatalities in secondary and collegiate levels
• Linemen face unique vulnerabilities, including larger body mass, lower aerobic fitness, greater metabolic heat production and reduced cooling efficiency
• Most EHS events occur during training sessions and not during competitions

Based on the findings, the NATA Task Force, which consists of a multidisciplinary panel, published 20 recommendations spanning education, training, administration and emergency preparedness. Recommendations include:

• Adopting the wet bulb globe temperature (WBGT), which combines ambient temperature, humidity, wind speed and solar radiation to reflect how the human body experiences heat
• Requiring all sport coaches and strength and conditioning personnel complete initial and recurring training on EHS prevention, recognition and treatment
• Employing credentialed professionals to adhere to established professional standards
• Implementing defined transition periods during the first five days of return to training
• Individualizing training for linemen with conditioning programs that reflect their specific physiological demands
• Eliminating punitive conditioning while training; exercise must never be used as punishment

“The statement emphasizes that effective EHS prevention requires a shift toward position-specific training, structured acclimatization, environmental safeguards and coordinated emergency response systems,” Stearns said. “When implemented collectively, these strategies provide a comprehensive framework to substantially reduce EHS incidence and fatalities in this high-risk population.”