Institute for Exercise and Environmental Medicine, University of Texas Southwestern and Texas Health Presbyterian Hospital Dallas.
Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs.
J Athl Train. 2020 Dec 1;55(12):1224-1229. doi: 10.4085/1062-6050-539-19.
Sex, age, and wet-bulb globe temperature (WBGT) have been proposed risk factors for exertional heat stroke (EHS) despite conflicting laboratory and epidemiologic evidence.
To examine differences in EHS incidence while accounting for sex, age, and environmental conditions.
Observational study.
Falmouth Road Race, a warm-weather 7-mi (11.26-km) running road race.
We reviewed records from patients treated for EHS at medical tents.
MAIN OUTCOME MEASURE(S): The relative risk (RR) of EHS between sexes and across ages was assessed with males as the reference population. Multivariate linear regression analyses were calculated to determine the relative contribution of sex, age, and WBGT to the incidence of EHS.
Among 343 EHS cases, the female risk of EHS was lower overall (RR = 0.71; 95% confidence interval [CI] = 0.58, 0.89; P = .002) and for age groups 40 to 49 years (RR = 0.43; 95% CI = 0.24, 0.77; P = .005) and 50 to 59 years (RR = 0.31; 95% CI = 0.13, 0.72; P = .005). The incidence of EHS did not differ between sexes in relation to WBGT (P > .05). When sex, age, and WBGT were considered in combination, only age groups <14 years (β = 2.41, P = .008), 15 to 18 years (β = 3.83, P < .001), and 19 to 39 years (β = 2.24, P = .014) significantly accounted for the variance in the incidence of EHS (R2 = .10, P = .006).
In this unique investigation of EHS incidence in a road race, we found a 29% decreased EHS risk in females compared with males. However, when sex was considered with age and WBGT, only younger age accounted for an increased incidence of EHS. These results suggest that road race medical organizers should consider participant demographics when organizing the personnel and resources needed to treat patients with EHS. Specifically, organizers of events with greater numbers of young runners (aged 19 to 39 years) and males should prioritize ensuring that medical personnel are adequately prepared to handle patients with EHS.
尽管实验室和流行病学证据存在冲突，但性、年龄和湿球黑球温度（WBGT）已被提出是与体力活动相关的热射病（EHS）的风险因素。
在考虑性别、年龄和环境条件的情况下，检查 EHS 发病率的差异。
观察性研究。
法尔茅斯公路赛，一项在温暖天气下进行的 7 英里（11.26 公里）跑步公路赛。
我们查阅了在医疗帐篷中接受 EHS 治疗的患者的记录。
用男性作为参考人群，评估男女之间和不同年龄段 EHS 的相对风险（RR）。进行多元线性回归分析以确定性别、年龄和 WBGT 对 EHS 发病率的相对贡献。
在 343 例 EHS 病例中，女性整体发生 EHS 的风险较低（RR=0.71；95%置信区间[CI]为 0.58，0.89；P=0.002），40 至 49 岁年龄组（RR=0.43；95%CI 为 0.24，0.77；P=0.005）和 50 至 59 岁年龄组（RR=0.31；95%CI 为 0.13，0.72；P=0.005）。在与 WBGT 相关的情况下，男女之间 EHS 的发病率没有差异（P＞0.05）。当同时考虑性别、年龄和 WBGT 时，只有 14 岁以下年龄组（β=2.41，P=0.008）、15 至 18 岁年龄组（β=3.83，P＜0.001）和 19 至 39 岁年龄组（β=2.24，P=0.014）显著解释了 EHS 发病率的差异（R2=0.10，P=0.006）。
在这项对公路赛中 EHS 发病率的独特调查中，我们发现女性发生 EHS 的风险比男性低 29%。然而，当考虑性别、年龄和 WBGT 时，只有年轻的年龄才能导致 EHS 的发病率增加。这些结果表明，公路赛医疗组织者在组织治疗 EHS 患者所需的人员和资源时，应考虑参与者的人口统计学特征。具体来说，有更多年轻跑步者（19 至 39 岁）和男性参加的活动组织者应优先确保医疗人员充分准备好治疗 EHS 患者。
