IOC consensus statement on recommendations and regulations for sport events in the heat

Abstract

This document presents the recommendations developed by the IOC Medical and Scientific Commission and several international federations (IF) on the protection of athletes competing in the heat. It is based on a working group, meetings, field experience and a Delphi process. The first section presents recommendations for event organisers to monitor environmental conditions before and during an event; to provide sufficient ice, shading and cooling; and to work with the IF to remove regulatory and logistical limitations. The second section summarises recommendations that are directly associated with athletes' behaviours, which include the role and methods for heat acclimation; the management of hydration; and adaptation to the warm-up and clothing. The third section explains the specific medical management of exertional heat stroke (EHS) from the field of play triage to the prehospital management in a dedicated heat deck, complementing the usual medical services. The fourth section provides an example for developing an environmental heat risk analysis for sport competitions across all IFs. In summary, while EHS is one of the leading life-threatening conditions for athletes, it is preventable and treatable with the proper risk mitigation and medical response. The protection of athletes competing in the heat involves the close cooperation of the local organising committee, the national and international federations, the athletes and their entourages and the medical team.

Keywords: heat-shock response; hot temperature.

Figure 1

Environmental condition monitoring and reporting. Panels A and B: devices specifically developed for World Athletics and for the Australian Open Tennis tournament, respectively. These are the recommended solutions. Panels C and D: commercially available units used on the field of play. It is not recommended to use a hand-held device (panel C) when the device was stored in the shade between measurements as it led to a 2°C error compared with the stationary device. The device should be fixed on a tripod prior to the event to allow for some time to equilibrate to the environment for accurate measures (panel D). Panel E: the display of wet bulb globe temperature (WBGT) monitor and risk category prepared by the Tokyo Organising Committee of the Olympic and Paralympic Games. This display may confuse the athletes as most do not know the WBGT and may misinterpret it as air temperature. Furthermore, the colour coding was different from what has been implemented by various international federations. Panel F: colour-coded 1–5 Heat stress scale developed for the Australian Open Tennis tournament by the University of Sydney. It provides the actual index (value) and the corresponding recommendation. This feedback method provides a clear message for athletes and is recommended.

Figure 2

Ice provision per sport during the 2020 Tokyo Summer Olympic Games. Panel A: values in kilogram per venue. It does not account for the ice provided at the polyclinic and the Olympic Village. Panel B: example of ice storage facilities during the event.

Figure 3

Example of heat mitigation strategies by the Tokyo Organising Committee of the Olympic and Paralympic Games. Panel A: misting of the boat preparation area. Panel B: shading of the warm-up area. Panel C: shading of the field of play. Panel D: shading of the mixed-zone. Panel E–F: cold bath for recovery at a sport venue and at the polyclinic, respectively.

Figure 4

Real-time monitoring of athlete’s thermal responses during the 2020 Tokyo Summer Olympic Games. Panel A: dashboard accessible online allowing to follow an athlete during a race walk event (the route consisted of 1 km loops at Odori Park, Sapporo). Panel B: example of data recorded during the male 10 000 m and being visualised in real time (Olympic stadium).

Figure 5

Example of a heat stress scale that could be adapted and used across sports. The scale uses a common 1–5 colour-coded rating with the exact value indicated. The current preventive measures to action are openly listed to inform athletes, organisers, medical services and other stakeholders. The listed modifications are non-contractual examples; each IF is in charge of their heat policies.