Pathogenesis, Pathobiology and Treatment of Exertional Heat Injury/Stroke
In 1931 the American Football Coaches Association (AFCA) initiated the First Annual Survey of Football Fatalities. The survey was conducted at the University of North Carolina at Chapel Hill (UNC-CH) since 1965 and in 1980 the AFCA appointed Frederick O. Mueller to continue the research at UNC-CH under the new title, Annual Survey of Football Injury Research. The primary purpose of the research is to make the game of football a safer and more enjoyable sport activity.
Upon notification of a suspected football fatality immediate contact is made with the appropriate officials and pertinent information is collected through questionnaires and personal contact. Heat related fatalities are classified as indirect (fatalities caused by systemis failure as a result of exertion while participating in a football activity).
SUMMARY OF RESULTS
since the beginning of the research through 1959 there were five cases of heat stroke which resulted in death. From 1960 through 2001 there have been 101 heat stroke cases that resulted in death. Heat stroke deaths were a major concern during the 1960's and early 1970's when water breaks were unheard of. In fact in 1970 there were eight heat stroke deaths, the highest number ever. The number of cases dropped dramatically during the late 1970's and 1980's and in 1993 and 1994, when there were no cases. The present concern are the 20 cases from 1995 through 2001. Fifteen of these cases were at the high school level, three at the college level, and two were professionals. These numbers are worse than the 15 cases from 1960–1964.
Most all of the medical and professional literature state that heat stroke fatalities in football are preventable. If this is true, there is a major problem concerning heat stroke deaths in football at the present time.