Heat illness prevention interventions

In accordance with World Rugby guidelines, the following Game Day Interventions should be implemented when the Heat Stress Index is above 150 (or as a rough guideline when the temperature is above 30C and the humidity is above 50%):

Game day interventions

• Provision of dressing room fans if air conditioning not available.
• Provision of side line shade if game played during the day when radiant heat (direct sunlight) is a contributing factor.
• Strategic positioning of towels immersed in ICE water around the ground – behind goal posts and at junction of each quarter line and side line.
• 2 minute break at the 20 minute mark of each half. The focus of this break should be threefold, a medical assessment of each athlete for signs of heat stress, cooling of athletes and re-hydration. It is suggested that cooling would be best achieved by immediately removing jersey and shoulder pads, application of ICE water to head ± body. Utilising sideline fans and shade (if game during day) would also be ideal. It should be noted that a 2 minute break has been recommended (as opposed to a 1 minute break) because the focus during this break is primarily medical assessment and cooling.

It should be noted that increasing access of water carriers to the field has not been recommended as it is felt that there is adequate breaks in the course of a game to allow water carrier access and player re-hydration.

Training guidelines

The recommendations re-education, scheduling and acclimatization should also apply to training sessions. Training sessions are more easily manipulated and the following is recommended during periods of significant heat stress (Index > 150):

• Plan training at the most appropriate time of the day – check Bureau of Meteorology statistics.
• Plan training to allow players to acclimatize – gradually increase exposure times and training volumes and intensity.
• Identify players who may have a viral infection or are volume depleted.
• Be aware of the early signs of heat stress.
• Schedule fluid breaks every 10 – 15 minutes.
• Each 40 minute session should be followed by a 15 minute rest period where players are rested, COOLED, re-hydrated and protected from radiant heat (direct sunlight).

In addition the following are also recommended:

• training apparel should be light weight, loose fitting and allow evaporation of sweat
• adequate quantities of ICE should always be available
• drinks should be provided at a temperature which are known to assist with rapid absorption - less than 15 degrees Celsius (ICE fluids)
• shade should be utilized during any break in training

Crisis management

Each training and playing venue should have in place a crises management plan. This plan should reflect that prompt recognition and immediate total body cooling will resolve or mitigate the problems of hyperthermia.

Conclusion

These Heat Guidelines are intended to minimize the risk of the onset of heat illness and provide a framework for each team and venue to operate safely during periods of climatic extreme.

For more information on heat illness related to rugby, please visit the WR Player welfare website;

www.playerwelfare.worldrugby.org