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gold medal A Physician's Olympic Recap: Proper Planning Minimized the Heat Impact

William O. Roberts, MD, an editorial board member for The Physician and Sportsmedicine, signed on to help cover the distance events at the 1996 Olympic Summer Games, but ended up covering much more. In addition, he had his laptop computer at his side and graciously e-mailed us about his experiences. Roberts is a family physician at MinnHealth SportsCare in White Bear Lake, Minnesota, and is medical director for the Twin Cities Marathon.

What did you do at the Olympics?

I worked on the athlete care team for men's and women's marathons and race walks. I also filled in at the volleyball venue for spectator care and at Centennial Park for crowd care.

How did things go at the men's marathon?

It was 74 degrees Fahrenheit at the start and humid. The cloud cover kept the temperature down, and it remained cloudy until 2 hours and 40 minutes into the race. Then it got hazy. There were 10 to 15 drop outs [out of a field of 111], and 45 athletes were treated at the end-about 20 for heat problems. Only 2 intravenous lines were started.

How about the men's race walk?

The race walk went well and was medically easy. We were assisted by a dense cloud cover; shortly after the race finished the sun came out and it was very hot. Even with the clouds, the wet bulb globe temperature was 72 degrees F.

What are your thoughts on the Atlanta heat? Did it turn out to be the biggest "nonstory" of the Olympics?

The Atlanta heat is real and was less of an issue because it had been cloudy, so the peak heat potential was not reached. I was impressed that the radiant heat is a large factor in increasing the incidence of heat collapse. Interestingly, the people at greatest risk seemed to be the spectators and the volunteers. Had the weather been "usual" this past week the heat would have been the hot story.

Proper scheduling of events spared the athletes from the true heat stress of Atlanta: morning starts for the distance road races and no events in the 1 to 5 pm times for track events.

What are some of the unique cooling techniques you saw athletes and spectators making use of?

It was very humid the whole, and the spectators felt the brunt of the heat stress while waiting in line. The mass of people crowded together compounded the problem in the subways and in line for events and exhibits. The Atlanta Committee for the Olympic Games (ACOG) should be commended in their effort to educate the public on the use of hydration stations and for publicizing other heat safety tips. They required all venue vendors to provide free water along with for-sale beverages. The medical treatment of spectators was immediate and superb. The spectator medical crews are the unsung heroes of the games and will never get the credit they deserve for their time and expertise.

I have applied my sports background to the care of spectators and have had great results. My new knowledge is a healthy respect for the sun and the effect of crowds on heat regulation. I wonder if runners in a tight pack are at greater risk in the heat, and if a runner should move the edge of the pack to stay cool.