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

Melani R Kelly; Dawn M Emerson; Toni M Torres-McGehee; Nancy A Uriegas; Matthew O Smith; Kevin Kloesel; Allison B Smith

doi:10.1016/j.smhs.2024.04.004

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

Sports Med Health Sci. 2024 Apr 26;7(2):132-142. doi: 10.1016/j.smhs.2024.04.004. eCollection 2025 Mar.

Authors

Melani R Kelly^{1

2}, Dawn M Emerson^{1

3}, Toni M Torres-McGehee³, Nancy A Uriegas³, Matthew O Smith⁴, Kevin Kloesel⁵, Allison B Smith⁶

Affiliations

¹ Department of Health, Sport and Exercise Sciences, University of Kansas, Lawrence, KS, 66045, USA.
² Department of Exercise Science and Outdoor Recreation, Utah Valley University, Orem, UT, 84058, USA.
³ Department of Exercise Science, University of South Carolina, Columbia, SC, 29208, USA.
⁴ School of Music, University of Kansas, Lawrence, KS, 66045, USA.
⁵ Department of Campus Safety, University of Oklahoma, Norman, OK, 73072, USA.
⁶ Department of Allied Health, Otterbein University, Westerville, OH, 43081, USA.

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: Acclimatization; Antidepressants; Exertional heat stroke; Performing arts; Pre-participation examination.