Context Exertional heat illnesses (EHIs) among football athletes have been widely researched, but data examining all collegiate sports are limited. Objective To describe the epidemiology of EHI in 25 National Collegiate Athletic Association (NCAA) sports. Design Descriptive epidemiology study. Setting The NCAA Injury Surveillance Program during the 2009-2010 through 2014-2015 academic years. Patients or Other Participants A voluntary sample of 166 NCAA institutions over 2048 team-seasons. Main Outcome Measure(s) Athletic trainers reported EHIs to the NCAA Injury Surveillance Program. Only EHIs sustained during a sanctioned practice or competition were included. The EHI rate, specific diagnoses, and number of emergency transports were measured. Results Overall, 232 EHI events were reported (0.47/10?000 athlete-exposures [AEs]; 95% confidence interval [CI] = 0.41, 0.53). Football comprised 75% of all EHI events and had the largest rate (1.55/10000 AEs; 95% CI = 1.32, 1.78). The overall EHI rate was higher in preseason practices (1.16/10000 AEs) than all other time periods (regular and postseason practices and all competitions; 0.23/10?000 AEs, injury rate ratio [IRR] = 4.96; 95% CI = 3.79, 6.50). This result was retained when examining the individual sports of football (3.65/10000 versus 0.63/10?000 AEs, IRR = 5.82; 95% CI = 4.18, 8.10), men's soccer (1.11/10?000 versus 0.07/10?000 AEs, IRR = 16.819; 95% CI = 1.89, 138.55), and women's soccer (1.10/10000 versus 0.05/10000 AEs, IRR = 22.52; 95% CI = 2.77, 183.05). The EHI rates were highest in states with elevated annual temperatures (1.05/10000 AEs). Heat cramps (39%), heat exhaustion (27%), and dehydration (29%) were the most common types of EHI. Nineteen athletes with EHI (8%) required emergency transport. Conclusions Football players continue to experience the most EHIs; however, EHIs can potentially occur in all NCAA sports. Continued emphasis on preseason EHI policies and institution-specific environmental guidelines is needed to address EHI rates.
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