Exertional heat illness during training and competition

Medicine and Science in Sports and Exercise

Volumn 39, Issue 3, 2007, Pages 556-572

  Armstrong, Lawrence E ^a   Casa, Douglas J ^a   Millard Stafford, Mindy ^a   Moran, Daniel S ^a   Pyne, Scott W ^a   Roberts, William O ^a  

^a NONE

Author keywords

[No Author keywords available]

Indexed keywords

ADRENERGIC RECEPTOR STIMULATING AGENT; BENZODIAZEPINE DERIVATIVE; EPHEDRA SINICA EXTRACT; EPHEDRINE; NON PRESCRIPTION DRUG; OXEDRINE;

ARTICLE; CENTRAL NERVOUS SYSTEM DISEASE; COLLAPSE; COMPETITION; COOLING; DEHYDRATION; DISEASE ASSOCIATION; DISEASE PREDISPOSITION; ENVIRONMENTAL TEMPERATURE; FLUID THERAPY; HEAT EXHAUSTION; HEAT INJURY; HEAT STROKE; HIGH RISK POPULATION; HUMAN; HUMIDITY; HYPERTHERMIA; HYPERTHERMIC THERAPY; INCIDENCE; LIFESTYLE MODIFICATION; MEDICAL PERSONNEL; MORBIDITY; MORTALITY; MULTIPLE ORGAN FAILURE; MUSCLE CRAMP; MUSCLE EXERCISE; NUTRITIONAL SUPPORT; PALLIATIVE THERAPY; PATHOPHYSIOLOGY; PREVALENCE; PREVENTIVE MEDICINE; RECTUM TEMPERATURE; RISK ASSESSMENT; RISK REDUCTION; SEIZURE; SPORT INJURY; SYMPTOM; TRAINING; COMPETITIVE BEHAVIOR; ENDURANCE; EXERCISE; MEDICAL SOCIETY; MOTOR ACTIVITY; PHYSIOLOGY; REVIEW; RISK FACTOR; SPORT; SPORTS MEDICINE; UNITED STATES;

COMPETITIVE BEHAVIOR; EXERTION; HEAT EXHAUSTION; HEAT STRESS DISORDERS; HUMANS; MOTOR ACTIVITY; PHYSICAL ENDURANCE; RISK FACTORS; SOCIETIES, MEDICAL; SPORTS; SPORTS MEDICINE; UNITED STATES;

EID: 34247557456     PISSN: 01959131     EISSN: 15300315     Source Type: Journal    
DOI: 10.1249/MSS.0b013e31802fa199     Document Type: Article

References (177)

1. AARSETH, H. P., I. EIDE, B. SKEIE, and E. THAULOW. Heatstroke in endurance exercise. Acta Med. Scand. 220:279-283, 1986.
2. ADNER, M. M., J. J. SCARLET, W. ROBINSON, and B. H. JONES. The Boston Marathon medical care team: ten years of experience. Physician Sportsmed. 16:99-106, 1988.
3. ADOLPH, E. F. In: Physiology of Man in the Desert, New York: Interscience, pp. 5-43, 326-341, 1947.
4. ADOLPH, E. F. Water metabolism. Ann. Rev. Physiol. 9:381-408, 1947.
5. AL-MARZOOGI, A., M. KHOGALI, and A. EL-ERGESUS. Organizational set-up: detection, screening, treatment, and follow-up of heat disorders. In: Heatstroke and Temperature Regulation, M. Khogali and J. R. S. Hales. Sydney, Australia: Academic Press, pp. 31-40, 1983.
6. ALLEN, S. D., and R. P. O'BRIEN. Tropical anhidrotic asthenia: preliminary report. Med. J. Aust. 2:335-337, 1944.
7. AMERICAN ACADEMY OF PEDIATRICS. Climatic heat stress and the exercising child and adolescent. Pediatrics 106(1):158-159, 2000.
8. AMERICAN COLLEGE OF SPORTS MEDICINE. Position Stand: the prevention of thermal injuries during distance running. Med. Sci. Sports Exerc. 19:529-533, 1987.
9. AMERICAN COLLEGE OF SPORTS MEDICINE. Position Stand: Heat and cold illnesses during running. Med. Sci. Sports Exerc. 28: i-x, 1996.
10. ARMSTRONG, L. E. Classification, nomenclature, and incidence of the exertional heat illnesses. In: Exertional Heat Illnesses. L. E. Armstrong. Champaign, IL: Human Kinetics, pp. 17-28, 2003.
11. ARMSTRONG, L. E., and J. M. ANDERSON. Heat exhaustion, exercise-associated collapse, and heat syncope. In: Exertional Heat Illnesses, L. E. Armstrong. Champaign, IL: Human Kinetics, pp. 57-90, 2003.
12. ARMSTRONG, L. E., D. L. COSTILL, and W. J. FINK. Influence of diuretic-induced dehydration on competitive running performance. Med. Sci. Sports Exerc. 17(4):456-461, 1985.
13. ARMSTRONG, L. E., A. E. CRAGO, R. ADAMS, W. O. ROBERTS, and C. M. MARESH. Whole-body cooling of hyperthermic runners: comparison of two field therapies. Am. J. Emerg. Med. 14:355-358, 1996.
14. ARMSTRONG, L. E., J. P. DELUCA, and R. W. HUBBARD. Time course of recovery and heat acclimation ability of prior exertional heatstroke patients. Med. Sci. Sports Exerc. 22:36-48, 1990.
15. ARMSTRONG, L. E., R. W. HUBBARD, W. J. KRAEMER, J. P. DE LUCA, and E. L. CHRISTENSEN. Signs and symptoms of heat exhaustion during strenuous exercise. Ann. Sports Med. 3: 182-189, 1988.
16. ARMSTRONG, L. E., R. W. HUBBARD, P. C. SZLYK, I. V. SILS, and W. J. KRAEMER. Heat intolerance, heat exhaustion monitored: a case report. Aviat. Space Environ. Med. 59:262-266, 1988.
17. ARMSTRONG, L. E., and C. M. MARESH. The induction and decay of heat acclimatisation in trained athletes. Sports Med. (New Zealand) 12:302-312, 1991.
18. ARMSTRONG, L. E., C. M. MARESH, A. E. CRAGO, R. ADAMS, and W. O. ROBERTS. Interpretation of aural temperatures during exercise, hypothermia, and cooling therapy. Med. Exerc. Nutr. Health 3:9-16, 1994.
19. ARMSTRONG, L. E., C. M. MARESH, C. V. GABAREE, et al. Thermal and circulatory responses during exercise: effects of hypohydration, dehydration, and water intake. J. Appl. Physiol. 82: 2028-2035, 1997.
20. ASSIA, E., Y. EPSTEIN, and Y. SHAPIRO. Fatal heatstroke after a short march at night: a case report. Aviat. Space Environ. Med. 56:441-442, 1985.
21. BANGSBO, J. The Physiology of Soccer-With Special Reference to Intense Intermittent Exercise, Copenhagen: August Krogh Institute, University of Copenhagen, 1993.
22. BAR-OR, O., H. M. LUNDERGREN, and E. R. BUSKIRK. Heat tolerance of exercising lean and obese women. J. Appl. Physiol. 26:403-409, 1969.
23. BELL, D. G., I. JACOBS, T. M. MCL ELLAN, M. MIYAZAKI, and C. M. SABISTON. Thermal regulation in the heat during exercise after caffeine and ephedrine ingestion. Aviat. Space Environ. Med. 70(6):583-588, 1999.
24. BERGERON, M. F. Heat cramps during tennis: a case report. Int. J. Sport Nutr. 6:62-68, 1996.
25. BERGERON, M. F. Exertional heat cramps. In: Exertional Heat Illnesses, L. E. Armstrong. Champaign, IL: Human Kinetics, pp. 91-102, 2003.
26. BERGERON, M. F. Heat cramps: fluid and electrolyte challenges during tennis in the heat. J. Sci. Med. Sport 6(1): 19-27, 2003.
27. BERNHEIM, P. J., and J. N. COX. Coup de chaleur et intoxication amphetaminique chez un sportif. Schweiz Medicine Wochenschrift 90:322-331, 1960.
28. BIANCHI, L., H. OHNACKER, K. BECK, and M. ZIMMERLI-NING. Liver damage in heatstroke and its regression. Hum. Pathol. 3:237-249, 1972.
29. BINKLEY, H. M., J. BECKETT, D. J. CASA, D. M. KLEINER, and P. E. PLUMMER. Position statement: exertional heat illnesses. J. Athl. Train. 37:329-343, 2002.
30. BLACK, D. A., R. A. MCCANCE, and W. F. YOUNG. A study of dehydration by means of balance experiments. J. Physiol. (London) 102:406-414, 1944.
31. BOSENBERG, A. T., J. G. BROCK-UTNE, M. T. WELLS, G. T. BLAKE, and S. L. GAFFIN. Strenuous exercise causes systemic endotoxemia. J. Appl. Physiol. 65:106-108, 1988.
32. BRENDA, C. Outwitting muscle cramps-is it possible? Physician Sportsmed. 17:173-178, 1989.
33. BRENGELMAN, G. L. Dilemma of body temperature measurement. In: Man in Stressful Environments, K. Shiraki and M. K. Yousef. Springfield, IL: C.C. Thomas Publishers, 1987, pp. 5-22.
34. BRODEUR, V. B., S. R. DENNETT, and S. L. GRIFFIN. Hyperthermia, ice baths, and emergency care at the Falmouth Road Race. J. Emerg. Nurs. 15:304-312, 1989.
35. BROWN, A. H. Dehydration exhaustion. In: Physiology of Man in the Desert, New York: Interscience, pp. 208-217, 1947.
36. CASA, D. J., J. ALMQUIST, S. ANDERSON, et al. Inter-association task force on exertional heat illnesses consensus statement. NATA News 6:24-29, 2003.
37. CASA, D. J., and L. E. ARMSTRONG. Exertional heatstroke: a medical emergency. In: Exertional Heat Illnesses, L. E. Armstrong. Champaign, IL: Human Kinetics, pp. 29-56, 2003.
38. CASA, D. J., and E. R. EICHNER. Exertional heat illness and hydration. In: Athletic Training and Sports Medicine, C. Starkey and G. Johnson. Boston, MA: Jones and Bartlett Publishers, pp. 597-615, 2005.
39. CASA, D. J., and W. O. ROBERTS. Considerations for the medical staff: Preventing, identifying, and treating exertional heat illnesses. In: Exertional Heat Illnesses, L. E. Armstrong. Champaign, IL: Human Kinetics, pp. 169-196, 2003.
40. CHEUVRONT, S. N., R. C. CARTER, S. J. MONTAIN, and M. N. SAWKA. Daily body mass variability and stability in active men undergoing exercise-heat stress. Int. J. Sports Nutr. Exerc. Metab. 14:532-540, 2004.
41. CHEUVRONT, S. N., R. C. CARTER, and M. N. SAWKA. Fluid balance and endurance exercise performance. Cur. Sports Med. Reports 2:202-208, 2003.
42. CHEUVRONT, S. N., and E. M. HAYMES. Thermoregulation and marathon running: biological and environmental influences. Sports Med. (New Zealand) 31:743-762, 2001.
43. CLEMENTS, J. M., D. J. CASA, J. C. KNIGHT, et al. Ice-water immersion and cold-water immersion provide similar cooling rates in runners with exercise-induced hyperthermia. J. Athl. Train. 37:146-150, 2002.
44. CLOWES, G. H. A. JR., and T. F. O'DONNELL. Heatstroke. N. Engl. J. Med. 291:564-567, 1974.
45. COSTILL, D. L., R. COTE, E. MILLER, T. MILLER, and S. WYNDER. Water and electrolyte replacement during days of work in the heat. Aviat. Space Environ. Med. 46:795-800, 1970.
46. COSTILL, D. L., W. F. KAMMER, and A. FISHER. Fluid ingestion during distance running. Arch. Environ. Health 21:520-525, 1970.
47. COSTRINI, A. Emergency treatment of exertional heatstroke and comparison of whole body cooling techniques. Med. Sci. Sports Exerc. 22:15-18, 1990.
48. COSTRINI, A. M., H. A. PITT, A. B. GUSTAFSON, and D. E. UDDIN. Cardiovascular and metabolic manifestations of heatstroke and severe heat exhaustion. Am. J. Med. 66:296-302, 1979.
49. DEPARTMENT OF THE ARMY AND AIR FORCE. In: Heat Stress Control and Heat Casualty Management, Washington, DC: Department of the Army, 2003, pp. 1-66. Technical bulletin No. TB MED 507.
50. 2max. Occup. Med. 50:259-263, 2000.
51. DONOGHUE, A. M., and G. P. BATES. The risk of heat exhaustion at a deep underground metalliferous mine in relation to surface temperatures. Occup. Med. 50:334-336, 2000.
52. DONOGHUE, A. M., M. J. SINCLAIR, and G. P. BATES. Heat exhaustion in a deep underground metalliferous mine. Occup. Environ. Med. 57:165-174, 2000.
53. EATON, J. M. Is this really a muscle cramp? Postgrad. Med. 86:227-232, 1989.
54. ELIAS, S. R., W. O. ROBERTS, and D. C. THORSON. Team sports in hot weather: guidelines for modifying youth soccer. Physician Sports Med. 19:67-80, 1991.
55. EPSTEIN, Y. Heat intolerance: predisposing factor or residual injury? Med. Sci. Sports Exerc. 22:29-35, 1990.
56. EPSTEIN, Y., E. SOHAR, and Y. SHAPIRO. Exertional heatstroke: a preventable condition. Isr. J. Med. Sci. 31:454-462, 1995.
57. FALLOWFIELD, J. L., C. WILLIAMS, J. BOOTH, B. H. CHOO, and S. GROWNS. Effect of water ingestion on endurance capacity during prolonged running. J. Sports Sci. 14:497-502, 1996.
58. GALLOWAY, S. D., and R. J. MAUGHAN. Effects of ambient temperature on the capacity to perform prolonged cycle exercise in man. Med. Sci. Sports Exerc. 29:1240-1249, 1997.
59. GISOLFI, C. V., and R. J. COHEN. Relationships among training, heat acclimation and heat tolerance in men and women: the controversy revisited. Med. Sci. Sports 11:56-59, 1979.
60. GISOLFI, C. V., and J. R. COPPING. Thermal effects of prolonged treadmill exercise in the heat. Med. Sci. Sports 6:108-113, 1974.
61. GONZALEZ-ALONSO, J., C. TELLER, S. ANDERSEN, et al. Influence of body temperature on the development of fatigue during prolonged exercise in the heat. J Appl Physiol 86(3):1032-1039, 1999.
62. GRABER, C. D., R. B. REINHOLD, and J. G. BREMAN. Fatal heatstroke. J. A. M. A. 216:1195-1196, 1971.
63. HADAD, E., M. RAY-ACHA, Y. HELED, Y. EPSTEIN, and D. S. MORAN. Heat stroke: a review of cooling methods. Sports Med. (New Zealand) 34:501-511, 2004.
64. HANSON, P. G., and S. W. ZIMMERMAN. Exertional heatstroke in novice runners. J. A. M. A. 242:154-158, 1979.
65. HART, L. E., B. P. EGIER, A. G. SHIMIZU, P. J. TANDAN, and J. R. SUTTON. Exertional heatstroke: The runner's nemesis. Can. Med. Assoc. J. 122:1144-1149, 1980.
66. HAYMES, E. M., R. J. MCCORMICK, and E. R. BUSKIRK. Heat tolerance of exercising lean and obese prepubertal boys. J. Appl. Physiol. 39:457-461, 1975.
67. HEADQUARTERS, DEPARTMENTS OF THE ARMY AND AIR FORCE. Heat stress control and heat casualty management, Washington, D.C: Headquarters Department of the Army and Air Force, 2003. Publication TB MED 507.
68. HELED, Y., M. RAY-ACHA, Y. SHANI, Y. EPSTEIN, and D. S. MORAN. The "golden hour" for heatstroke treatment. Mil. Med. 169:184-186, 2004.
69. HOLTZHAUSEN, L. M., and T. D. NOAKES. Collapsed ultradistance athlete: proposed mechanisms and an approach to management. Clin. J. Sport Med. 7:292-301, 1997.
70. HUBBARD, R. W. An introduction: the role of exercise in the etiology of exertional heatstroke. Med. Sci. Sports Exerc. 22:2-5, 1990.
71. HUBBARD, R. W., and L. E. ARMSTRONG. The heat illness: biochemical, ultrastructural, and fluid-electrolyte considerations. In: Human Performance Physiology and Environment Medicine at Terrestrial Extremes, K. B. Pandolf, M. N. Sawka, and R. R. Gonzalez. Indianapolis: Benchmark Press, pp. 305-359, 1988.
72. HUBBARD, R. W., and L. E. ARMSTRONG. Hyperthermia: new thoughts on an old problem. Physician Sportsmed. 17:97-113, 1989.
73. HUBBARD, R. W., W. T. MATTHEW, R. E. L. CRISS, et al. Role of physical effort in the etiology of rat heatstroke injury and mortality. J. Appl. Physiol. 45:463-468, 1978.
74. HUBBARD, R. W., C. B. MATTHEW, M. J. DURKOT, and R. P. FRANCESCONI. Novel approaches to the pathophysiology of heatstroke: the energy-depletion model. Ann. Emerg. Med. 16:1066-1075, 1987.
75. HUBBARD, R. W., W. MATTHEW, D. WRIGHT. Survey and analysis of the heat casualty prevention experiment for Resphiblex 1-81, Operation Lancer Eagle, 43D, MAU. Natick, MA: U. S. Army Research Institute of Environmental Medicine, Technical Report T 5-82, 1982.
76. HUGHSON, R. L., H. J. GREEN, M. E. HOUSTON, J. A. THOMSON, D. R. MACLEAN, and J. R. SUTTON. Heat injuries in Canadian mass participation runs. Can. Med. Assoc. J. 122:1141-1144, 1980.
77. HUGHSON, R. L., L. A. STANDI, and J. M. MACKIE. Monitoring road racing in the heat. Physician Sportsmed. 11:94-105, 1983.
78. INBAR, O., N. MORRIS, Y. EPSTEIN, and G. GASS. Comparison of thermoregulatory responses to exercise in dry heat among prepubertal boys, young adults and older males. Exp. Physiol. 89:691-700, 2004.
79. KARK, J. A., P. BURR, C. B. WENGER, E. GASTALDO, and J. W. GARDNER. Exertional heat illness in marine corps recruit training. Aviat. Space Environ. Med. 67:354-360, 1996.
80. KEATINGE, W. R., G. C. DONALDSON, E. CORDIOLI, et al. Heat related mortality in warm and cold regions of Europe: observational study. Brit. Med. J. 321:670-673, 2000.
81. KEREN, G., Y. EPSTEIN, and A. MAGAZANIK. Temporary heat intolerance in a heatstroke patient. Aviat. Space Environ. Med. 52:116-117, 1981.
82. KHOGALI, M., and J. S. WEINER. Heatstroke: report on 18 cases. Lancet 2:276-278, 1980.
83. KIELBLOCK, A. J. Strategies for the prevention of heat disorders with particular reference to body cooling procedures. In: Heat Stress, J. R. S. Hales and D. A. B. Richards. Amsterdam: Elsevier, pp. 489-497, 1987.
84. KIELBLOCK, A. J., N. B. STRYDOM, F. J. BURGER, P. J. PRETORIUS, and M. MANJOO. Cardiovascular origins or heatstroke pathophysiology. An anesthetized rat model. Aviat. Space Environ. Med. 53:171-178, 1982.
85. KNOCHEL, J. P. Environmental heat illness: an eclectic review. Arch. Intern. Med. 133:841-864, 1974.
86. KNOCHEL, J. P., and G. REED. Disorders of heat regulation. In: Clinical Disorders, Fluid and Electrolyte Metabolism, M. H. Kleeman, C. R. Maxwell, and R. G. Narin. New York: McGraw-Hill, pp. 1197-1232, 1987.
87. KULKA, T. J., and W. L. KENNEY. Heat balance limits in football uniforms. Physician Sportsmed. 30:29-39, 2002.
88. LADELL, W. S. S. Heat cramps. Lancet 2:836-839, 1949.
89. LADELL, W. S. S., J. C. WATERLOW, and M. F. HUDSON. Desert climate: physiological and clinical observations. Lancet 2:527-531, 491-497, 1944.
90. LAMBERT, E. V., A. ST CLAIR GIBSON, and T. D. NOAKES. Complex systems model of fatigue: integrative homoeostatic control of peripheral physiological systems during exercise in humans. Br. J. Sports Med. 39:52-62, 2005.
91. LAMBERT, G. P. Role of gastrointestinal permeability in exertional heatstroke. ESSR 32:185-190, 2004.
92. LEITHEAD, C. S., and E. R. GUNN. The aetiology of cane cutter's cramps in British Guiana. In: Environmental Physiology and Psychology in Arid Conditions, Leige, Belgium: United Nations Educational Scientific and Cultural Organization, pp. 13-17, 1964.
93. LEITHEAD, C. S., and A. R. LIND. Heat syncope. In: Heat Stress and Heat Disorders, Philadelphia: F. A. Davis Co, pp. 136-140, 1964.
94. LEITHEAD, C. S., and A. R. LIND. Water and salt depletion heat exhaustion. In: Heat Stress and Heat Disorders, Philadelphia: F. A. Davis Co, pp. 143-169, 1964.
95. LEITHEAD, C. S., and A. R. LIND. Heat cramps. In: Heat Stress and Heat Disorders, Philadelphia: F. A. Davis Co, pp. 170-177, 1964.
96. LEVIN, S. Investigating the cause of muscle cramps. Physician Sportsmed. 21:111-113, 1993.
97. MAGER, M., R. W. HUBBARD, M. D. KERSTEIN. Survey and analysis of the medical experience for CAX 8-80. Natick, MA: U. S. Army Research Institute of Environmental Medicine, Technical Report, 1980.
98. MARON, M. B., J. A. WAGNER, and S. M. HORVATH. Thermoregulatory responses during competitive marathon running. J. Appl. Physiol. 42:909-914, 1977.
99. MARTINEZ, M., L. DAVENPORT, J. SAUSSY, and J. MARTINEZ. Drug-associated heat stroke. South. Med J. 95(8):799-802, 2002.
100. MAUGHAN, R. J., S. J. MERSON, N. P. BROAD, and S. M. SHIRREFFS. Fluid and electrolyte intake and loss in elite soccer players during training. Int. J. Sport Nutr. Exerc. Metab. 14:333-346, 2004.
101. MONTAIN, S. J., and E. F. COYLE. Influence of graded dehydration on hyperthermia and cardiovascular drift during exercise. J. Appl. Physiol. 73:1340-1350, 1992.
102. MONTAIN, S. J., M. N. SAWKA, and C. B. WENGER. Hyponatremia associated with exercise: risk factors and pathogenesis. Exerc. Sport Sci. Rev. 29:113-117, 2001.
103. MORAN, D. S., Y. HELED, L. STILL, A. LAOR, and Y. SHAPIRO. Assessment of heat tolerance for post exertional heat-stroke individuals. Med. Sci. Mon. 10(6):CR252-CR257, 2004.
104. MULDOON, S., P. DEUSTER, B. BRANDOM, and R. BUNGER. Is there a link between malignant hyperthermia and exertional heat illness? Exerc. Sport Sci. Rev. 32:174-179, 2004.
105. NADEL, E. R., C. B. WENGER, M. F. ROBERTS, J. A. J. STOLWIJK, and E. CAFARELLI. Physiological defenses against hyperthermia of exercise. Ann. N. Y. Acad. Sci. 301:98-109, 1977.
106. NATIONAL CENTER FOR HEALTH STATISTICS. International Classification of Diseases, 9th revision, Washington, D. C.: Department of Health and Human Services, 2001. Publication Number PHS-01-1260.
107. NATIONAL COLLEGIATE ATHLETIC ASSOCIATION. Five-day acclimatization period, Divisions I-A and I-AA. In: NCAA Division I Manual. Indianapolis, IN, 2003, Rule 17.11.2.3.
108. NATIONAL COLLEGIATE ATHLETIC ASSOCIATION. Game plan set for new preseason football practice policies. NCAA News June 9, 2003.
109. NICHOLSON, R. N., and K. W. SOMERVILLE. Heatstroke in a "run for fun". Brit. Med. J. 1:1525-1526, 1976.
110. NIELSEN, B., and L. NYBO. Cerebral changes during exercise in the heat. Sports Med. (New Zealand) 33:1-11, 2003.
111. NOAKES, T. D. Body cooling as a method for reducing hyperthermia. S. Afr. Med. J. 70:373-374, 1986.
112. NOAKES, T. D. Fluid and electrolyte disturbances in heat illness. Int. J. Sports Med. 19:S146-S149, 1998.
113. NOAKES, T. D. Hyperthermia, hypothermia and problems of hydration. In: Endurance in Sport, Vol. II, 2nd edition, R. J. Shephard and P. O. Astrand. Oxford, England: Blackwell Science, pp. 591-613, 2000.
114. NOAKES, T. D., A. ST CLAIR GIBSON, and E. V. LAMBERT. From catastrophe to complexity: a novel model of integrative central neural regulation of effort and fatigue during exercise in humans. Br J Sports Med 38:511-514, 2004.
115. NOAKES, T. D., and A. ST CLAIR-GIBSON. Logical limitations to the "catastrophe" models of fatigue during exercise in humans. Br. J. Sports Med. 38(1):648-649, 2004.
116. NOAKES, T. D., A. ST CLAIR GIBSON, and E. V. LAMBERT. From catastrophe to complexity: a novel model of integrative central neural regulation of effort and fatigue during exercise in humans: summary and conclusions. Br. J. Sports Med. 39: 120-124, 2005.
117. NOBLE, H. B., and D. BACHMAN. Medical aspects of distance race planning. Physician Sportsmed. 7:78-84, 1979.
118. NYBO, L., and N. H. SECHER. Cerebral perturbations provoked by prolonged exercise. Progr. Neurobiol. 72(4):223-261, 2004.
119. NYBO, L., N. H. SECHER, and B. NIELSEN. Inadequate heat release from the human brain during prolonged exercise with hyperthermia. J. Phys. 545(2):697-704, 2002.
120. O'DONNELL, T. J. JR. Acute heatstroke, epidemiologic, biochemical, renal and coagulation studies. J. A. M. A. 234:824-828, 1975.
121. OH, R. C., and J. S. HENNING. Exertional heatstroke in an infantry soldier taking ephedra-containing dietary supplements. Mil. Med. 168(6):429-430, 2003.
122. PANDOLF, K. B., R. L. BURSE, and R. F. GOLDMAN. Role of physical fitness in heat acclimatization, decay and reinduction. Ergonomics 20:399-408, 1977.
123. PAYEN, J., L. BOURDON, H. REUTENAUER, et al. Exertional heatstroke and muscle metabolism: an in vivo 31P-MRS study. Med. Sci. Sports Exerc. 24:420-425, 1992.
124. PIWONKA, R. W., S. ROBINSON, V. L. GAY, and R. S. MANALIS. Preacclimatization of men to heat by training. J. Appl. Physiol. 20:379-384, 1965.
125. PROULX, C. I., M. B. DUCHARME, and G. P. KENNY. Effect of water temperature on cooling efficiency during hyperthermia in humans. J. Appl. Physiol. 94:1317-1323, 2003.
126. PUGH, L. G. C. E., J. L. CORBETT, and R. H. JOHNSON. Rectal temperatures, weight losses and sweat rates in marathon running. J. Appl. Physiol. 23:347-352, 1967.
127. RICHARDS, R., and D. RICHARDS. Exertion-induced heat exhaustion and other medical aspects of the City-to-Surf fun runs, 1978-1984. Med. J. Australia 141:799-805, 1984.
128. RICHARDS, R., D. RICHARDS, P. J. SCHOFIELD, V. ROSS, and J. R. SUTTON. Reducing the hazards in Sydney's The Sun City-to-Surf Runs, 1971 to 1979. Med. J. Aust. 2:453-457, 1979.
129. RICHARDS, D., R. RICHARDS, P. J. SCHOFIELD, V. ROSS, and J. R. SUTTON. Management of heat exhaustion in Sydney's The Sun City-to-Surf fun runners. Med. J. Aust. 2:457-461, 1979.
130. RICHARDS, R., D. RICHARDS, P. J. SCHOFIELD, V. ROSS, and J. R. SUTTON. Organization of The Sun City-to Surf fun run, Sydney, 1979. Med. J. Aust. 2:470-474, 1979.
131. ROBERTS, W. O. Common threads in a random tapestry: Another viewpoint on exertional heatstroke. Physician and Sportsmedicine 33(10):42-49, 2005.
132. ROBERTS, W. O. Exercise-associated collapse in endurance events: a classification system. Physician Sportsmed. 17:49-55, 1989.
133. ROBERTS, W. O. Exertional heat stroke during a cool weather marathon: A case study. Med Sci Sports Exerc 38(7):1197-1202, 2006.
134. ROBERTS, W. O. Managing heatstroke: on-site cooling. Physician Sportsmed. 20:17-28, 1992.
135. ROBERTS, W. O. Assessing core temperature in collapsed athletes. Physician Sportsmed. 22:49-55, 1994.
136. ROBERTS, W. O. A 12-yr profile of medical injury and illness for the Twin Cities Marathon. Med. Sci. Sports Exerc. 32:1549-1555, 2000.
137. ROBINSON, S., J. R. NICHOLAS, J. H. SMITH, W. J. DALY, and M. PEARCY. Time relation of renal and sweat gland adjustments to salt deficiency in men. J. Appl. Physiol. 8:159-165, 1955.
138. ROBINSON, S., S. L. WILEY, L. G. BOUDURANT, and S. MAMLIN JR. Temperature regulation of men following heatstroke. Isr. J. Med. Sci. 12:786-795, 1976.
139. ROWELL, L. B. Cutaneous and skeletal muscle circulations. In: Human Circulation: Regulation During Physical Stress., New York: Oxford University Press, pp. 96-116, 1986.
140. ROYBURT, M., Y. EPSTEIN, Z. SOLOMON, and J. SHEMER. Long term psychological and physiological effects of heatstroke. Physiol. Behav. 54:265-267, 1993.
141. SAWKA, M. N., S. J. MONTAIN, and W. A. LATZKA. Hydration effects on thermoregulation and performance in the heat. Comp. Biochem. Physiol. 128:679-690, 2001.
142. SAWKA, M. N., and K. B. PANDOLF. Effects of body water loss on physiological function and exercise performance. In: Perspectives in Exercise Science and Sports Medicine. Vol. 3. Fluid Homeostasis During Exercise, C. V. Gisolfi and D. R. Lamb. Carmel, IN: Benchmark Press, pp. 1-38, 1990.
143. SAWKA, M. N., A. J. YOUNG, R. P. FRANCESCOI, S. R. MUZA, and K. B. PANDOLF. Thermoregulatory and blood responses during exercise at graded hypohydration levels. J. Appl. Physiol. 59:1394-1401, 1985.
144. SAWKA, M. N., A. J. YOUNG, W. A. LATZKA, P. D. NEUFER, M. D. QUIGLEY, and K. B. PANDOLF. Human tolerance to heat strain during exercise: influence of hydration. J. Appl. Physiol. 73(1):368-375, 1992.
145. SCHNIRRING, L. Core temperature measurement goes high tech. Pill sensor enables wireless monitoring. Physician Sportmed. 32:10, 2004.
146. SHAHID, M. S., L. HATLE, H. MANSOUR, and L. MIMISH. Echocardiographic and doppler study of patients with heatstroke and heat exhaustion. Int. J. Card. Imaging 15:279-285, 1999.
147. SHAPIRO, Y., A. MAGAZANIK, R. UDASSIN, G. BEN-BARUCH, E. SHVARTZ, and Y. SHOENFELD. Heat tolerance in former heatstroke patients. Ann. Intern. Med. 90:913-916, 1979.
148. SHIBASAKI, M., I. YOSHIMITSU, N. KNODO, and A. IWATA. Thermoregulatory responses of prepubertal boys and young men during moderate exercise. Eur. J. Appl. Physiol. 75:212-218, 1997.
149. SHIBOLET, S., R. COLL, T. GILAT, and E. SOHAR. Heatstroke: its clinical picture and mechanism in 36:525-547, 1967.
150. SHIBOLET, S., M. C. LANCASTER, and Y. DANON. Heatstroke: a review. Aviat. Space Environ. Med. 47:280-301, 1976.
151. SHINOZAKI, T., R. DEANE, and F. M. PERKINS. Infrared tympanic thermometer: evaluation of a new clinical thermometer. Crit. Care Med. 16:148-150, 1988.
152. SHVARTZ, E., Y. SHAPIRO, A. MAGAZANIK, et al. Heat acclimation, physical fitness, and responses to exercise in temperate and hot environments. J. Appl. Physiol. 43:678-683, 1977.
153. SINERT, R., L. KOHL, T. RAINONE, and T. SCALEA. Exercise-induced rhabdomyolysis. Ann. Emerg. Med. 23:1301-1306, 1994.
154. SMALLEY, B., R. M. JANKE, and D. C. COLE. Exertional heat illness in air force basic military trainees. Mil. Med. 168: 298-303, 2003.
155. SMITH, H. R., G. S. DHATT, W. M. A. MELIA, and J. G. DICKINSON. Cystic fibrosis presenting as hyponatremic heat exhaustion. Brit. Med. J. 310:579-580, 1995.
156. SOHAR, E., D. MICHAELI, U. WAKS, and S. SHIBOLET. Heatstroke caused by dehydration and physical effort. Arch. Intern. Med. 122:159-161, 1968.
157. SPORTS MEDICINE AUSTRALIA. Revised hot weather guidelines. Web address http://www.smasa.asn.au/, web site active January 11, 2006.
158. ST CLAIR-GIBSON, A., and T. D. NOAKES. Evidence for complex system integration and dynamic neural regulation of skeletal muscle recruitment during exercise in humans. Br. J. Sports Med. 38(6):797-806, 2004.
159. STRAUSS, R. H. Skeletal muscle abnormalities associated with sports activities. In: Sports Medicine, Philadelphia: W. B. Saunders, pp. 159-164, 1984.
160. SUTTON, J. R. 43°C in fun runners! Med. J. Australia 2:463-467, 1979.
161. SUTTON, J. R. Heat illness. In: Sports Medicine, R. H. Strauss. Philadelphia: W. B. Saunders, pp. 307-322, 1984.
162. SUTTON, J. R. Thermal problems in the masters athlete. In: Sports Medicine for the Mature Athlete, J. R. Sutton and R. M. Brock. Indianapolis: Benchmark Press, pp. 125-132, 1986.
163. SUTTON, J. R. Clinical implications of fluid imbalance. In: Perspectives in Exercise Science and Sports Medicine. Vol. 3. Fluid Homeostasis During Exercise, C. V. Gisolfi and D. R. Lamb. Carmel, IN: Benchmark Press, pp. 425-455, 1990.
164. SUTTON, J. R., and O. BAR-OR. Thermal illness in fun running. American Heart Journal 100:778-781, 1980.
165. SUTTON, J. R., M. J. COLEMAN, A. P. MILLAR, L. LAZARUS, and P. RUSSO. The medical problems of mass participation in athletic competition. The "City-to-Surf" race. Med. J. Aust. 2:127-133, 1972.
166. TALBOT, J. H. Heat cramps. In: Medicine, Baltimore, MD: Williams and Wilkins, pp. 323-376, 1935.
167. U. S. DEPARTMENT OF HEALTH AND HUMAN SERVICES. Working in Hot Environments. DHHS Publication No. 86-112. Washington, D.C.: Public Health service, Centers for Disease Control, National Institute for Occupational Safety and Health, 1986.
168. WALLACE, R. F., D. KRIEBEL, L. PUNNETT, et al. The effects of continuous hot weather training on risk of exertional heat illness. Med. Sci. Sports Exerc. 37(1):84-90, 2005.
169. WEINER, J. S. An experimental study of heat collapse. J. Ind. Hyg. 20:389-393, 1938.
170. WEINER, J. S., and G. O. HORNE. A classification of heat illness. Brit. Med. J. 28(1):1533-1535, 1958.
171. WEIR, J. P., T. W. BECK, J. T. CRAMER, and T. J. HOUSH. Is fatigue all in your head? A critical review of the central governor model. Br J Sports Med 40(7):573-586, 2006.
172. WYNDHAM, C. H., M. C. KEW, R. KOK, I. BERSOHN, and N. B. STRYDOM. Serum enzyme changes in unacclimatized and acclimatized men under severe heat stress. J. Appl. Physiol. 37: 695-698, 1974.
173. WYNDHAM, C. H., and N. B. STRYDOM. The danger of inadequate water intake during marathon running. S. Afr. Med. J. 43:893-896, 1969.
174. YAGLOU, C. P., and D. MINARD. Control of heat casualties at military training centers. Arch. Ind. Health 16:302-305, 1957.
175. YARBROUGH, B. E., and R. W. HUBBARD. Heat-related illnesses. In: Management of Wilderness and Environmental Emergencies, 2nd edition, P. S. Auerbach and E. C. Geehr. St. Louis: C. V. Mosby, pp. 119-143, 1989.
176. YEARGIN, S. W., D. J. CASA, L. E. ARMSTRONG, G. WATSON, D. A. JUDELSON, E. PSATHAS, and S. SPARROW. Heat acclimatization and hydration status of American football players during initial summer workouts. J. Strength Cond. Res. 20(3):463-470, 2006.
177. ZUNIS FOUNDATION. Heat Stress Adviser: A Program For Palm-Type PDA's. World wide web address: http://www.zunis.org/ sports_p.htm web site active January 11, 2006.