Heat preparedness and exertional heat illness in Paralympic athletes: A Tokyo 2020 survey

Paralympic athletes may be at increased risk for exertional heat illness (EHI) due to reduced thermoregulatory ability as a consequence of their impairment. This study investigated the occurrence of heat-stress related symptoms and EHI, and the use of heat mitigation strategies in Paralympic athletes, both in relation to the Tokyo 2020 Paralympic Games and previous events. Paralympic athletes competing in Tokyo 2020 were invited to complete an online survey five weeks prior to the Paralympics and up to eight weeks after the Games. 107 athletes (30 [24–38] years, 52% female, 20 nationalities, 21 sports) completed the survey. 57% of respondents had previously experienced heat-stress related symptoms, while 9% had been medically diagnosed with EHI. In Tokyo, 21% experienced at least one heat-stress related symptom, while none reported an EHI. The most common symptom and EHI were, respectively, dizziness and dehydration. In preparation for Tokyo, 58% of respondents used a heat acclimation strategy, most commonly heat acclimatization, which was more than in preparation for previous events (45%; P = 0.007). Cooling strategies were used by 77% of athletes in Tokyo, compared to 66% during past events (P = 0.18). Cold towels and packs were used most commonly. Respondents reported no medically-diagnosed EHIs during the Tokyo 2020 Paralympic Games, despite the hot and humid conditions in the first seven days of competition. Heat acclimation and cooling strategies were used by the majority of athletes, with heat acclimation being adopted more often than for previous competitions.残奥会运动员因自身残疾导致体温调节能力下降，罹患劳力性热疾病（exertional heat illness, EHI）的风险可能升高。本研究围绕2020年东京残奥会及往届赛事，调查了残奥会运动员的热应激相关症状与EHI发生情况，以及防暑降温策略的使用现状。本研究邀请参与2020年东京残奥会的运动员于残奥会开幕前五周至赛后八周内完成线上问卷，最终共有107名运动员完成调研，其年龄中位值为30岁（四分位间距24~38岁），女性占比52%，涵盖20个国家与21个运动项目。57%的受访者此前曾出现过热应激相关症状，另有9%曾被医学诊断为EHI。在东京残奥会赛事期间，21%的受访者至少出现1种热应激相关症状，但无一人报告罹患EHI。最常见的热应激症状为头晕，最常见的EHI类型为脱水。为备战东京残奥会，58%的受访者采用了热适应策略，其中最常用的手段为热习服训练，该比例高于往届赛事备战阶段的45%（P=0.007）。东京残奥会期间，77%的运动员采用了降温策略，而往届赛事中该比例为66%（P=0.18），其中最常用的降温方式为冷毛巾与冷敷袋。尽管赛事首七日天气炎热潮湿，但受访者均未报告在2020年东京残奥会期间被医学诊断为EHI。绝大多数运动员采用了热适应与降温策略，其中热适应策略的使用比例较往届赛事有所提升。