Original researchExertional heat fatalities in Australian sport and recreation
Section snippets
Practical implications
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Two distinct populations who had a fatal heat related death were identified — males aged 15–45 years and international visitors. Any safety and awareness information that is developed must be relevant and accessible to these populations.
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Most fatalities occurred during hiking on days of high temperature and high humidity. Clear and simple messaging of ‘hiking on days of extreme heat is strongly discouraged’ should be promoted.
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Delays in accessing medical care contributed to many fatalities.
Background
The 2019–2020 Australian Summer of high temperatures, bushfires and smoke significantly impacted participation in sport and recreation across the country.1 These events raised concern that as extreme temperatures become more common, safe participation in outdoor sport and recreation will become increasingly challenging.2 Existing evidence has shown that an increased number of hospital admissions are reported during heat waves in Australia.3 Most of these cases are attributed to the classic form
Methods
A population-based retrospective cohort study was performed to examine all cases of exertional heat-related deaths in sport and recreation notified to Australian Coroners from 1 January 2001 to 31 December 2018. This study was approved by the Justice Human Research Ethics Committee CF/19/24669 and Western Australia Coronial Ethics Committee.
The primary data source for this study was the National Coronial Information System (NCIS). The NCIS is an internet-based data repository of all deaths
Results
There were 38 exertional heat-related deaths in Australia related to active sport or recreation identified. Cases were most frequently male (n = 29, 74%) and ages ranged from 8 to 77 years (median 40 years) (Table 1). At least one case was recorded for residents from all States/Territories, the majority residing in Western Australia (WA) (n = 7), New South Wales (NSW) (n = 5) and Queensland (QLD) (n = 5). Most deaths occurred in recreation (n = 36, 95%), including 27 hiking deaths. Two deaths
Discussion
This is the first study to present national population-based data on heat-related deaths linked to sport and recreation activity in Australia. The results confirm that while such deaths are rare, they occur with enough regularity to warrant renewed attention toward their prevention. Three key findings of our study are highlighted: population targets; hiking in the heat; and sign/symptom awareness. Firstly, we found two distinct populations at risk. One is young-to-middle aged men, between the
Conclusion
The heat and extreme conditions in Australia are generally respected and there are several ways in which awareness of extreme days are promoted to reduce morbidity and mortality. Despite this, there were 38 preventable deaths identified in this series. Most cases were participating in outdoor recreation, such as hiking, on a day of high temperature. Specific consideration of how to reach young-to-middle aged men and international visitors with safety messaging is critical. Messaging must
Funding information
Funding was received from the Victorian State Government for conduct of the project from which this study is derived.
Declaration of interest
Author LVF is an Associate Editor with the Journal of Science and Medicine in Sport. There are no other conflicts of interest declared.
Confirmation of ethical compliance
This study was approved by the Justice Human Research Ethics Committee CF/19/24669 and Western Australia Coronial Ethics Committee.
Acknowledgements
We acknowledge the Department of Justice and Community Safety (source organisation of the data), and the National Coronial Information System (database source).
References (24)
- et al.
Epidemiology of exertional heat illnesses in organised sports: a systematic review
J Sci Med Sport
(2020) How to plan and perform a qualitative study using content analysis
NursingPlus Open
(2016)Environmental deaths in the Northern Territory of Australia, 2003–2018
Wilderness Environ Med
(2019)- et al.
Best practice principles for communicating safety messages in national parks
J Outdoor Recreat Tour
(2019) - et al.
Exertional heat-related illnesses at the Grand Canyon National Park, 2004–2009
Wilderness Environ Med
(2013) State of the Climate 2020
- et al.
Heat illness in sport and exercise (website)
- et al.
The health impacts of heat waves in five regions of New South Wales, Australia: a case-only analysis
Int Arch Occup Environ Health
(2010) - et al.
Exertional heat illness in adolescents and adults: epidemiology, thermoregulation, risk factors, and diagnosis
- et al.
The public policy approach to injury prevention
Inj Prev
(2011)
Applying a systems thinking lens to injury causation in the outdoors: evidence collected during 3 years of the understanding and preventing led outdoor accidents data system
Inj Prev
Document analysis of exertional heat illness policies and guidelines published by sports organisations in Victoria, Australia
BMJ Open Sport Exerc Med
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