Heat IllnessPresented by:

Bernard L. Fontaine, Jr., CIH, CSP, AIHA FellowMember of the New Jersey State Federation of Baseball Umpires (NJSFU) and the New Jersey

State Interscholastic Athletic Association (NJSIAA)

New York Times By MURRAY CHASS

Published: April 2, 1996

BASEBALL: Umpire Dies After Collapsing on Field

John McSherry, working the first inning of his 26th season as a major league umpire, collapsed and died in Cincinnati yesterday on the opening day of the baseball season. He was believed to be the first person to be stricken fatally on the field during a major league baseball game since 1920.

McSherry, working behind home plate at Riverfront Stadium, called just seven pitches before walking back toward the stands and collapsing. He never regained consciousness and was pronounced dead at University Hospital in Cincinnati about an hour after the start of the game between the Reds and the Montreal Expos. The hospital said McSherry, 51 years old, suffered sudden cardiac death.

Heat-Related Deaths

Heat Illness•Introduction •Physiology •Heat Illness •Treatment •Prevention

• Major concern for all umpires who work in hot and/or humid conditions

•Affects physiology, judgment and performance on and off the field

•Affects your physiology especially for those on medications or afflicted with certain illnesses and/or disease

Heat Illness

Some initial symptoms include: • Chills • Dark colored urine• Dizziness • Dry mouth• Headaches • Thirst • Weakness

Heat Illness

Metabolic Heat • Basal metabolic heat production (at rest): 60-70 kcal/hr. - 50% from organs • Exercise metabolic heat production:         1000 kcal/hr.         90% heat for muscle metabolism• Core body temperature rises 1oC with every 5-8 minutes of exercise    

Heat Illness

Thermoregulation

Umpires can lose body heat by:

• Evaporation of sweat from the skin• Conduction by touching cooler objects• Convection from a cool breeze, and• Radiation from release of infrared heat

Heat Illness

Human Physiology• Core body temperature is 98.6 oF• Body heat is centrally controlled by the hypothalamus and spinal cord• Body removes excess metabolic heat by increasing blood flow to skin and increasing sweat production• Evaporation reduced by high humidity

Heat Illness

Health problems in hot environments

• Heat rash is most common problem • Caused by sweating without ability for moisture to evaporate from skin• Red cluster of raised pimples or small blisters• Appears on neck, upper chest, groin, under breasts, and elbow creases

Heat Illness

Heat Illness Can Progress To More Serious Symptoms Such As:

• Difficulty breathing• Mental confusion or incoherence• Elevated core body temperature• Muscle cramps • Nausea, vomiting, and diarrhea• Tingling of the hands or feet, and • Death from heat stroke, respiratory failure or heart attack

Heat Illness

Health problems in hot environments

• Heat cramps are muscle pains caused by physical work in a hot and humid environment

• Heat cramps result from a continued loss of body salts and bodily fluids from continued sweating

Heat Illness

Health problems in hot environments

• Heat exhaustion is the next most serious heat-related health problem

• Signs and symptoms are headache, nausea, dizziness, weakness, irritability, confusion, severe thirst, heavy sweating, and a rising body temperature greater than 100.4°F

Heat Illness

Health problems in hot environments

• Heat exhaustion affects the ability to call balls/strikes, cover rotations, and judge safe/out on close plays• Occurs at any air temperature and not associated with collapse• Result of dehydration most common in hot and humid environments

Heat Illness

Health problems in hot environments

• Heat stroke is the most serious• Occurs when the body temperature regulating system fails and core body temperature rises above the critical level (> 104°F)• This medical emergency can result in death and EMS must be activated!

Heat Illness

Risk Factors

• High temperature and humidity• Low fluid consumption• Direct sun exposure (with no shade)• Poor nutrition• Limited air movement (breeze/wind)• Physical exertion• Multiple layers of clothing/equipment

Heat Illness

Risk Factors

• Poor physical condition • Ongoing health problems• Some medications• Pregnancy• No prior exposure to hot environment• Previous heat-related illness

Heat Illness

Best Treatment is Prevention

• Proper training for heat symptoms• Monitor intensity of physical activity for fitness and acclimatization status • If symptoms begin during a game, consult with your partner or athletic trainer to prevent or treat heat-related illness

Heat Illness

Best Treatment is Prevention

• Replace fluids by hydrating before, during, and after a game• Wear light colored and loose fitting clothes during summer months• Early recognition via visual monitoring of partner, especially plate umpire during extended inning games and/or multiple game assignments

Heat Illness

Acclimatization• Gradually increase duration/intensity first 10-14 days of heat exposure• Full acclimatization takes 12 weeks of exposure• Repeated heat exposure helps skin blood flow, rapid onset of sweating, increases plasma volume, and helps decreases metabolic rate

Heat Illness

When Should An Umpire Hydrate?

• Drink 16 ounces of water or a sport drink before and after the game

• Hydration should continue with at least 4-8 fluid ounces every 15-20 minutes (e.g., every complete inning), especially for the plate umpire as long as game play continues

Heat Illness

How Should An Umpire Hydrate?

• Plain water is adequate for those games lasting 45-minutes to 1-hour

• Games more than 1-hour or multiple games in the same day, fluids should contain carbohydrates, sodium (Na) and potassium (K), which are found in sport drinks

Heat Illness

What NOT To Drink• Drinks with >8% carbohydrate (CHO)

• Fruit juices, sodas, and sport drinks with >6-8% carbohydrates

• Beverages with caffeine, alcohol, or carbonation to reduce dehydration from excess urine production and/or decreased voluntary fluid intake

Heat Illness

How Can Heat Illness Be Treated?

• Get umpire to a cool shaded area• If heat stroke, remove protective equipment and cool body rapidly using cold water immersion or spray water on body, cold water sponging or towels, or insert insulated bags of ice/ice packs behind the neck, under the arms and groin area

Heat Illness

How Can Heat Illness Be Treated? • Monitor skin or body temperature by using a thermal scan thermometer• Provide cool beverages only if the umpire does not have altered state of consciousness• Do not remove wet clothing• Get medical assistance quickly

Heat Illness

How Can Heat Illness Be Prevented?

• Train umpires on health hazards, risk factors, signs and symptoms• Increase the number/type of game assignments during the summer• Remind umpires to bring and drink water or sport drinks before, during, and after the game

Heat Illness

How Can Heat Illness Be Prevented?

• Maximum fluid intake is limited to 12 quarts in 24-hours• Monitor weather and reschedule games for cooler times of the day• Use breaks between games for rest/ recovery under a shady tree, covered dugout, or air-conditioned vehicle

Heat Illness

QuestionsThank you for your participation in the course. We hope that you understand the hazards, risks, and methods to help prevent heat-related illness while officiating during the summer. Please have a safe and enjoyable baseball and/or softball season this year.