FIFPro’s Chief Medical Officer, Doctor Vincent Gouttebarge, discusses with the PFA the impact of playing in extreme heat on players and why a safe workplace must be non-negotiable.Q: What impact does playing in extreme heat have on players?

VG: All human bodies have one key priority, which is to maintain its core temperature at around 37 degrees Celsius. When you exercise, your core temperature increases and your body reacts to this by using regulation systems to maintain your core temperature. In most cases it is possible for the body to maintain this, but it becomes very difficult for the body to do this in extreme heat. When your core temperature increases it causes heat related stress.

Q. What are the likely symptoms that result from heat related stress?

VG: Within each disorder we can speak about heat cramps, heat exhaustion and heat stroke. Heat cramps, sees players experience cramps and muscle fatigue. In more severe cases of heat stress players can suffer headaches, vomiting and their heart rate increases as their heart has to work a lot harder to try to keep their core temperature steady.

When it comes to heat exhaustion you feel as if you cannot move as smoothly as normal, and also it becomes difficult for your body to sweat. Sweat is one of the most important regulation systems in order to keep your core temperature steady, with your body losing water in order to keep your temperature stable. When players experience heat exhaustion they cannot sweat because you don’t have water in your body and your temperature keeps rising and it can be really severe.

Players can also experience adverse psychological impacts where they can’t think as normal. In the worse states of heat stroke players can loose consciousness, and that in its absolute worst cases can lead to death.

Q. How difficult can heat make it for players to perform at their best?

VG: Heat has a significant impact on the health and safety of the players but also a significant impact on the quality of the players’ performance. We know a lot about the health consequences and we also know that the performance of the player in hot conditions is not the same as in normal conditions.

Scientific studies have monitored the performance of players in really hot conditions and what they have shown is that the distance covered by players during games in extreme heat drops significantly.

Q. You have conducted research into additional cooling measures such as two drink breaks per half, what are some of the strategies you would recommend exploring?

VG: I think if you want to avoid health related trauma and a decrease in performance, you should try to schedule matches at a time when the chance of extreme heat is lower and the sun is not shinning, as the sun’s radiation has a big impact on the players.

There is some evidence that two drink breaks may be effective from a scientific point of view. This is because we know the body can ingest 200 to 250mls of water every 15 minutes. In extreme conditions it could be more effective than one drinks break per half. However, that requires consultation with the players on how they feel about this change to their match routine but it is worth exploring. It is really important to drink during the game to avoid dehydration and a rise in core temperature.

Q. How important is both the human element and a commonsense approach to a heat policy that ensures players health and safety?

VG: You need some cut off points but of course the voice of the player must be listened to and the experience of the player must be used to inform the heat policy.

Q. Finally, is there opportunity for Australia to be world leader in heat by having a policy that ensures both the health and safety of the players, but also the best chance of a high quality match?

VG: If you look at the A-League competition it is very respected and if you look at sports science in Australia it is also extremely well respected. I think the PFA as the voice of the players is essential to the best possible heat policy and they must be allowed to play a role. All stakeholders should work towards defining and implementing the highest possible standard of heat policy. This can only be possible when you combine scientific knowledge and the voice of the players.