VOLUME 22 – ISSUE 4 • S U M M E R 2 0 0 5 Incorporating The Bulletin Opinions expressed throughout this journal are the Contents contributor’s own and do not necessarily reflect the views or policy of Sports Medicine Australia (SMA). Members and readers are advised that SMA cannot be held responsible for the accuracy of statements made in advertisements nor the quality of the goods or services advertised. All materials copyright. FROM THE CEO ___________________________________________ 2 On-acceptance of an article for publication, copyright passes to the publisher. Wrestling the heat demon Publisher Sports Medicine Australia PO Box 237 Dickson ACT 2602 Tel: (02) 6230 4650 DR J __________________________________________________ 4 Fax: (02) 6230 5908 Email: [email protected] A safe and level playing field should be the goal of drugs in sport policy Web: www.sma.org.au Circulation: 5000 ISSN No. 1032-5662 Editors DRUGS AND SPORT ________________________________________ 8 John Orchard Kerry Mummery Government discussion paper: investigating doping in sport Managing Editor Options for “independent and transparent” way to investigate doping Dominic Nagle Chief Executive Officer allegations Gary Moorhead Alcohol and sport: same again? Subscription Manager Joyce McClune Maurie O’Connor Design/Typesetting Levitate Graphic Design, Canberra. SMA STATE BRANCHES UNCOVERING THE SECRET OF THE DON: BRADMAN RE-ASSESSED _______16 ACT ACT Sports House Paul Glazier, Keith Davids, Ian Renshaw, Chris Button 100 Maitland St Hackett ACT 2602 Tel: (02) 6247 5115 New South Wales PO Box 724, Glebe NSW 2037 SPORTS INJURY, SPORTS SAFETY 1997 TO 2002 ____________________22 Tel: (02) 9660 4333 Northern Territory “Sport safety in Australia: an update – July 2003” PO Box 2331, Darwin NT 0801 Tel: (08) 8981 5362 New Department of Health and Ageing report Queensland Sports House, 150 Caxton St, Milton QLD 4064 Tel: (07) 3367 2700 South Australia VIETNAM VETERANS: THE “HEARTMOVES” EXERCISE PROGRAM _______25 PO Box 219, Brooklyn Park SA 5025 Tel: (08) 8234 6369 Mike Climstein, Janet Currie, Leanne Otter, Mark Debeliso, Kent J Adams Victoria and Tasmania 1st Floor, 120 Jolimont Rd Jolimont VIC 3002 Tel: (03) 9654 7733 THE BULLETIN ___________________________________________29 Western Australia PO Box 57, Claremont WA 6010 Cover photograph: Australian Sports Commission Tel: (08) 9285 8033 SUBSCRIPTION RATES 2003 Australia A$35 Overseas A$50 SMA members receive Sport Health as part of their membership fee Single copies and back copies A$15 (includes-postage) PP No. 226480/00028 For subscriptions contact Joyce McClune Phone: (02) 6230 4650 Email: [email protected] F R O M T H E CEO Wrestling the Heat Demon By Gary Moorhead Over the last couple of months, the • Sport is infinitely variable – both responses for the whole state of Australian media have been full between sports and within different Queensland, failed to turn up any of horror stories involving adverse levels of competition of the same cases of heat illness relating to outcomes from playing sport and sport. children2. exercising in hot weather. Recent • Weather conditions are one of the • Medical coverage data and headlines have included: great variables of life – especially information from the Medical • “Six runners hospitalized and 60 if you live in Melbourne. “Weather Director of the Alice Springs others treated for dehydration forecast” is probably the world’s Masters Games showed no during the Melbourne Marathon.” greatest lie; “unseasonable incidences of heat illness • “Soldier Dies from Heat During weather” is the one thing you can experienced by athletes at the other 3 Exercises” rely on. end of the age spectrum . • “Man Who Melted: we pulled him • Australia is a continent that has • Scientific studies, and research out of the grave”. weather conditions ranging from carried out by the Australian tropical to cool temperate – and Bureau of Meteorology (BOM), But at the same time as these sometimes this can be on the same began to cast doubt on the “horrors” are occurring, Sports day in the same place! reliability and validity of the Medicine Australia is changing its WBGT readings. In fact, the BOM In 2001, SMA issued revised “Guidelines for Preventing Heat WBGT is derived not from a single Illness in Sport” to remove mandatory Guidelines for Preventing Heat measuring device (a wet bulb cancellation recommendations. Illness in Sport, which were based globe thermometre) but from an Does this make sense? From SMA’s on new Guidelines issued by the algorithm that takes into account perspective it makes complete sense. American College of Sports Medicine a range of atmospheric variables. (ACSM). For the first time, SMA also With the Heat Guidelines, SMA is Industries where heat is an issue published a specific cancellation/ being asked to reduce a very complex use a measure called the Thermal postponement policy: 28 degrees Wet issue to a series of simple solutions to Work Limit (TWL) and this may Bulb Globe Temperature (WBGT) fit the needs of a very diverse range give a more accurate reading if for adults and 34 degrees ambient of interests: adapted for sport4. temperature for children. The year • Sporting organisations want clear 2001 was at the height of medical Fundamentally, the major problem direction on when it is safe – and indemnity controversy in Australia with any guideline is the impossibility when it is not – to play sport in hot and the new Guidelines took an ultra of creating a “one size fits all” weather. safety-first stance. The cancellation recommendation. recommendations were based on • Parents want to know that their The greatest fear with heat illness is worst case scenarios – responses by children will not be in any danger the condition known as “heat stroke”. athletes in endurance running. when they play sport. Heat stroke is a killer. The mortality • Public health promoters (and Over the next three years, these rate is 20% to 75% if cooling is not sporting organisations) want to Guidelines – and the cancellation effective and survivors usually have minimise any disruption to people recommendation – began to seem an some permanent damage. over-reaction to the problem: engaging in sport and physical While heat stroke occurs most activity. • Detailed evidence was produced to commonly in conditions of high • Politicians want to be seen to be show that a literal interpretation of ambient temperature and high acting to solve problems and deal the Guidelines would see no sport humidity (the conditions we try to with issues. played in the northern half of the measure with WBGT), heat stroke can country for a large part of the year1. occur in the absence of both5. Further, At the same time, we have to factor in British army medical staff attending a mass of variables: • A detailed study over 10 years the 2004 Australian Conference of presentations to Cairns Base • People are different – physically, of Science and Medicine in Sport Hospital, of recalled events of physiologically, psychologically, reported incidences of heat illness in Cairns doctors and of ambulance genetically. cool weather where the precipitating 2 Sport Health F R O M T H E CEO factor was apparently exertion and/or indicator. (This will be developed the natural inclination is to stop what gear and clothing related rather than in conjunction with BOM to we are doing. In many cases, ceasing hot weather and hydration6. give readings in a wide range of activity is the first and best step to locations around Australia and preventing heat illness occurring. The task of those charged with displayed on SMA websites) the care of the health of athletes is made even harder by problems with 3. Promoting effective 1. Dr Mark Young, sports physician, Brisbane Orthopaedic and Sports Medicine Centre. diagnosing the seriousness of heat countermeasures. These will Temperature data supplied by mail to SMA 1 illness and whether or not it is likely include options such as shorter October 2002. 2. Brun S. The incidence of heat related illness in the to develop into heat stroke. Initial playing periods, longer breaks, child athlete in Cairns, Far North Queensland, symptoms of both are similar. moving activity from the hottest and the associated environment variables. Journal of Science and Medicine in Sport parts of the day, being sensitive to 2004;7:4Supplement);110. The most reliable predictor is needs of players to self-regulate, 3. Dr Geoff Thompson, sports physician, Territory core temperature7. Following the provision of shaded rest areas and Sports Medicine. Symposium transcript: “Preventing Heat Symposium at the Australian injury from exercise in hot weather”. Australian fans for cooling. Conference of Science and Medicine in Sport, Alice Conference of Science and Medicine Springs, 6-9 October 2004. in Sport in Alice Springs in October 4. Reminding people that heat illness 4. Brake D. The application of a rational heat stress index (Thermal Work Limit) to sports medicine. 2004, the President of the AFL Medical is not always about dehydration. Journal of Science and Medicine in Sport 2004;7:4(S Officers recommended to the AFL that Adequate fluids are essential, but upplement);102. 5. Barker TA, Motz HA, Gersoff WK. Environmental rectal thermometers be added to the heat illness can occur despite factors in Athletic Performance” in Sports Injuries: “Emergency Management Bag” at AFL adequate hydration. Mechanisms, Prevention, Treatment (p67). Philadelphia. Lippincott Williams & Wilkins. 2001. games and training8. 5. Distinguishing elite sport as a 6. Edwards S and Nicol A. Symposium transcript: “Preventing injury from exercise in hot weather”. While the incidence of heat injury is separate category. Most heat Australian Conference of Science and Medicine in probably much lower than has been illness seems to occur when Sport, Alice Springs, 6-9 October 2004. accepted anecdotally, especially in athletes “push themselves” beyond 7. Barker et al (p68). 8. Seward H. “Heat symposium. SMA Conference the northern parts of Australia, it is the body’s natural limits.