Self-reported exertional heat illness and risk factors among collegiate marching band artists

Abstract

Marching band (MB) artists are often part of the general student population and not required to complete a pre-participation health screening to identify predisposing medical conditions or risks for injury/illness. Anecdotally, exertional heat illnesses (EHI) are a concern for MB artists. As more athletic trainers provide MB healthcare, research is needed on EHI occurrence and MB associated EHI risk factors. We utilized an exploratory cross-sectional study design to determine EHI risk factors, including previous EHI occurrence, among collegiate MB artists. MB artists (n ​= ​1 207; age ​= ​[19.6 ​± ​1.3] years) actively participating in their college/university's MB during the 2019 football season completed an online survey to characterize demographics, medical history, medication and supplement use, and nutrition behaviors. Chi-square and binomial logistical regressions assessed associations between categorical variables. Previous EHI was reported by 50.6% of MB artists, with 466 (76.3%) experiencing exertional heat exhaustion and 31 (5.1%) exertional heat stroke. More females reported exertional heat exhaustion overall (68.2%, p ​< ​0.001) and in the previous year (73.3%, p ​< ​0.001). Experiencing a previous EHI was significantly associated with having a mood/neurological condition (63.5%, p ​< ​0.001), diagnosed (74.3%, p ​= ​0.004) or perceived eating disorder (66.7%, p ​< ​0.001), and taking prescription medications (59.4%, p ​< ​0.001), over-the-counter medications (58.9%, p ​= ​0.002), and supplements (55.4%, p ​= ​0.037). Half of collegiate MB artists reported experiencing previous EHIs and engaged in behaviors known to increase EHI risk. MB artists should complete pre-participation examinations to identify pre-existing medical conditions and risks for adverse medical events. Healthcare providers working with MB artists should develop policies and procedures to mitigate EHI risks and occurrence.

Keywords

Exertional heat stroke / Antidepressants / Acclimatization / Performing arts / Pre-participation examination

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Thank you to Cormac Cannon, Tonya Mitchell-Spradlin, Jack Eaddy, and Sharon Toulouse for their support of this research. Thank you to the College Band Directors National Association for their support and all the marching band artists who took the time to complete the survey. Thank you to the research assistants who helped with data analysis, especially Kate Ruffalo. Thank you to Joseph Weir and Jacob Siedlik for assistance with statistical analysis.