By Karen Springen
NEWSWEEK

July 21 issue - Playing hard enough to soak your T shirt is one of summer’s great pleasures. But hot-weather sports can be dangerous. Some 300 Americans die in heat-related incidents each year, and they’re not all kids in cars or old folks in unventilated rooms.

“EXERTIONAL HEAT ILLNESS” kills professional athletes-Baltimore Orioles pitcher Steve Bechler became the most recent victim during his spring training in Florida-and it sickens civilians as well. Heat stroke, heat exhaustion and dehydration can creep up on you before you realize you’re in trouble. An 18-agency task force led by the National Athletic Trainers’ Association recently issued guidelines to help people prevent and treat heat-related illness (for more details go to nata.org).

Some pointers:

Obey your thirst. A sweating body needs fluids to maintain blood volume, so drink water or sports drinks (not caffeinated or alcoholic beverages) before, during and after exercise. How much you need to drink depends on how big you are and how hot it is, but as a rule of thumb, drink six to eight ounces for every 15 minutes of intense exercise in the heat. By weighing in before and after a workout, you can determine exactly how much fluid you’ve lost (a pound equals 16 ounces). Try to replace a bit more than you lose. With dehydration, blood volume decreases and the heart must work harder. “It’s like being down a quart of oil,” says Penn State physiologist W. Larry Kenney, president of the American College of Sports Medicine. During summer exertion, blood volume may drop by as much as 10 percent.

Just say no. Be careful with drugs and supplements-and stay away from ephedra, a diet herb that has been linked to heart attacks, seizures and heat stroke. Bechler was using ephedra when he died of heat stroke (his body temperature rose to 108 degrees). Avoid diuretics, which cause the loss of fluids, and check the side effects of any medications you’re using. Tricyclic antidepressants such as Elavil or Tofranil decrease sweating, beta blockers reduce skin blood flow and antihistamines constrict blood vessels.

Start slow. Get accustomed to the heat by gradually ramping up outdoor activity. “Your body becomes more efficient over a series of days,” says Stephen Cantrill, associate director of emergency medicine at Denver Health Medical Center. “You produce more sweat, enabling you to cool yourself more efficiently.” This year the National Collegiate Athletic Association is requiring schools to phase in football practices in which players wear heat- trapping padded armor.

Don’t be a hero. Take breaks in a shady or air-conditioned place. Skip outdoor exercise in extreme humidity, which keeps sweat from evaporating to cool you off. Wear a hat and use sunscreen. Sunburned skin doesn’t sweat properly.

Recognize the symptoms. Some general warning signs include headaches, muscle cramps, nausea, vomiting, fainting and loss of coordination. If someone is stricken, move him to a shaded or air-conditioned area and take off excess clothing and gear. Check the person’s pulse and temperature. A temperature of 104 or more may signal heat stroke, the most severe form of heat illness. (Other symptoms include confusion and seizures.) If you suspect heat stroke, call 911-and do everything possible to lower the person’s body temperature. “The faster you can cool the person, the more likely they’re going to survive,” says NATA task-force chair Douglas Casa, an athletic trainer. Strip them to their underwear and immerse them in ice water. If there’s no tub, use fans, ice bags or cold towels.

You don’t have to stay on the couch to stay safe. Sweat can be sweet. Just don’t overdo it, or your body may shut down.

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