BIGFORK, Mont. – On a recent afternoon, it was 70 degrees on the high school football field in this northwestern Montana community less than 200 miles south of the Canada-US border.
Vikings head coach Jim Benn led his team through drills in the pristine fall weather without much interruption. A few weeks earlier, however, players needed frequent water breaks as they sweated through temperatures in the low to mid-90s, about 15 degrees warmer than average for the time of year.
Although temperatures have started to drop now that fall is underway, Montana and many other northern US states are warming up and staying warm longer. August is when many high school sports heat up, and this year was either the hottest on record or close to it for many Montana communities, according to the National Weather Service and d other meteorologists. The heat wave extended into September, and at least six cities in Montana broke the 100-degree mark in the first half of the month.
This August was the hottest on record for the neighboring states of Idaho, Washington and Oregon. Nationally, this summer was the third hottest on record, according to the National Oceanic and Atmospheric Association.
Health experts and researchers say states – especially northern states in the United States, such as Idaho, Maine, Montana and North Dakota – are not adapting quickly enough to ensure the safety of high school athletes. Students and their families have sued schools, accusing them of not doing enough to protect athletes. Many states that have taken action have done so only after the death of an athlete.
“Between high school and college, we lose about six athletes each year to exertional heat stroke, and the majority of them are high school athletes,” said Rebecca Stearns, director of operating at the University of Connecticut’s Korey Stringer Institute, which is named after a Minnesota Vikings player who died of heatstroke in 2001. The institute studies and tries to prevent the disease.
The actual number of heat-related deaths could be higher, she said, because death certificates aren’t always filled out accurately. Exertional heat illness is the second leading cause of death among high school and college athletes, behind cardiac arrest, she said.
At Bigfork, Benn said he hasn’t seen any of his athletes suffer from exertional heat illness – such as heat exhaustion or heat stroke, which can cause fainting, vomiting and even death – during his nearly 30-year coaching career in Montana until the end year. An athlete overheated during a soccer camp in early summer during the record-breaking heat wave of 2021.
“We immediately put water on him, cooled him down,” he said.
The player recovered after being sprayed with a hose. Benn said he didn’t have an immersion tub filled with ice water on hand, which Stearns said was the recommended treatment.
“This is exactly why we need standard policies that incorporate medical best practices,” Stearns said.
The Korey Stringer Institute ranks the 50 states and Washington, D.C., on how well they adhere to best practices for preventing and responding to exertional heat-related illness in high school athletes, as well as other health risks such as cardiac arrest. Montana is 48th on the list, followed by Minnesota, Maine and California.
California is last, according to the institute’s report, as it is the only state that does not regulate high school athletic trainers, who are generally responsible for the health and safety of athletes. Stearns said the institute is working with California sports officials who are pushing for laws requiring licensing for sports trainers.
The northern states of the United States dominate the bottom third of the institute’s rankings. Stearns said many states the institute has approached to improve thermal safety think it’s not a problem or are resisting certain policies because implementing them could come at a high price.
But some efforts don’t cost a penny, she said. At Bigfork High School, for example, Benn has implemented a three-day acclimatization period, without football skates, when his players return to the field in early August. “It really is a low hanging fruit, in my opinion,” Stearns said.
Stearns added that most heat-related illnesses occur during the first days of training, which are usually the hottest and when athletes are not used to exercising in the heat. But she said the state’s high school athletic association should mandate acclimatization periods.
Montana and many other states also don’t have a system dictating when practices should be changed — such as removing pads or reducing the length and number of workouts — or canceled altogether, Stearns said. Policies that require a contingency plan to respond to exertional heat illness are also lacking in many northern states.
Stearns and other researchers, such as Bud Cooper of the University of Georgia, said states should use what’s called “wet globe temperature” – which takes into account air temperature, humidity and radiant heat from surfaces such as grass that absorb sunlight – to make these determinations, rather than the heat index. The heat index does not take radiant heat into account, which increases the risk of developing heat illness. The National Federation of State High School Associations Foundation said in February it was sending 5,000 special thermometers to high schools nationwide.
Stearns said research suggests that periods of acclimatization reduce the number of exertional heat-related illnesses by up to 55% and that states that have used wet bulb temperature to enforce practice changes have seen an 80% reduction.
In Georgia, Cooper’s work documenting heat-related deaths among high school athletes led to sweeping policy changes in 2012. Since the policy change, Georgia has gone from the state with the highest number of heat-related deaths among high school football players to have no fatalities.
Researchers such as Cooper have begun to provide regional policy guidelines based on local wet globe average temperatures to help states understand the risks to high school athletes and give them a starting point for making policy changes.
New Jersey was among the first to adopt the wet bulb system among northern states in the United States when it passed a law in 2020 requiring school districts to purchase the thermometers. The state also requires hundreds of schools to install on-site cold immersion bins when temperatures reach a certain level. The state is now second in the institute’s sports safety policy rankings, behind Florida and ahead of Georgia.
In the Pacific Northwest, Oregon and Washington have policies that mandate changes to school athletic practices based on heat index, not wet bulb temperature. Heat and sports safety researchers say it’s better than nothing.
The Montana High School Association, which regulates high school athletics, has heat guidelines in place that allow referees to request extra breaks during football or soccer games, executive director Brian Michelotti said. The association also asks other sports, such as cross-country, to schedule meetings early in the day.
While Montana health officials say the state has never documented a heat illness-related death among high school athletes in the state, the historic heat waves of the past two summers have brought the sports officials to consider additional precautions. “It really prompted us to have more discussions about it and to really come back and review with some sports science committees,” Michelotti said.
He said any policy changes would need to be approved by the association’s seven-member board and would not happen until at least next year.
Heat and sports safety experts such as Stearns of the Korey Stringer Institute said adding statewide policies and mandates saves lives by ensuring all coaches and schools follow best practices before that a death does not occur.
“A life is too high a price for all the games in a season,” she said.
