Department of Geography, University of Georgia, Athens, GA, 30602, USA.
Scripps Institution of Oceanography, University of California at San Diego, La Jolla, CA, 92093, USA.
Int J Biometeorol. 2017 Aug;61(8):1471-1480. doi: 10.1007/s00484-017-1324-2. Epub 2017 Mar 17.
On August 1, 2001, Korey Stringer, a Pro Bowl offensive tackle for the Minnesota Vikings, became the first and to date the only professional American football player to die from exertional heat stroke (EHS). The death helped raise awareness of the dangers of exertional heat illnesses in athletes and prompted the development of heat safety policies at the professional, collegiate, and interscholastic levels. Despite the public awareness of this death, no published study has examined in detail the circumstances surrounding Stringer's fatal EHS. Using the well-documented details of the case, our study shows that Stringer's fatal EHS was the result of a combination of physiological limitations, organizational and treatment failings, and extreme environmental conditions. The COMfort FormulA (COMFA) energy budget model was used to assess the relative importance of several extrinsic factors on Stringer's EHS, including weather conditions, clothing insulation, and activity levels. We found that Stringer's high-intensity training in relation to the oppressive environmental conditions was the most prominent factor in producing dangerous, uncompensable heat stress conditions and that the full football uniform played a smaller role in influencing Stringer's energy budget. The extreme energy budget levels that led to the fatal EHS would have been avoided according to our modeling through a combination of reduced intensity and lower clothing insulation. Finally, a long delay in providing medical treatment made the EHS fatal. These results highlight the importance of modern heat safety guidelines that provide controls on extrinsic factors, such as the adjustment of duration and intensity of training along with protective equipment modifications based on environmental conditions and the presence of an emergency action plan focused on rapid recognition and immediate on-site aggressive cooling of EHS cases.
2001 年 8 月 1 日，科里·斯特林格（Korey Stringer），明尼苏达维京人队的职业碗进攻截锋，成为第一位也是迄今为止唯一一位死于运动性热射病（EHS）的职业美式足球运动员。他的死引起了人们对运动员运动性热病危险的认识，并促使职业、大学和校际各级制定了热安全政策。尽管公众对这一死亡事件有所了解，但没有发表的研究详细审查了斯特林格致命 EHS 的情况。利用该案件的记录详细信息，我们的研究表明，斯特林格的致命 EHS 是生理限制、组织和治疗失败以及极端环境条件的综合结果。COMfort FormulA（COMFA）能量预算模型用于评估几个外在因素对斯特林格 EHS 的相对重要性，包括天气条件、服装隔热和活动水平。我们发现，斯特林格高强度训练与恶劣的环境条件相结合，是产生危险、不可补偿的热应激条件的最突出因素，而全套足球服在影响斯特林格的能量预算方面作用较小。根据我们的模型，通过降低强度和降低服装隔热，就可以避免导致致命 EHS 的极端能量预算水平。最后，医疗救治的长时间延迟使 EHS 致命。这些结果强调了现代热安全指南的重要性，该指南对外部因素进行了控制，例如根据环境条件调整训练的持续时间和强度，以及对防护设备进行修改，并制定了以快速识别和立即在现场进行 EHS 病例的积极冷却为重点的应急行动计划。
