How hot is too hot for football in the Pacific?

Source: Radio New Zealand

Medical experts are warning sporting organisations need to do more to manage the risks of heat illness in football, after recent tournaments in the Pacific were played in extreme conditions.

During a recent World Cup qualifier, three Samoan players were struck down by heatstroke in temperatures nearing 40C, while another player in the OFC Pro League required hospitalisation after pushing his body to the limit.

Heat illness can be life-threatening in sport, and has led to deaths internationally.

Dr Mark Fulcher, chair of the Oceania Football Confederation medical commission and a doctor with Auckland FC in the OFC Pro League, has seen first-hand how dangerous it can become if risks are not properly managed.

“For some people, heat is probably a small thing. It makes them feel unpleasant, they might have a headache, they might need to go lie in an ice bath for a little while. But for some people, it’s a life-threatening condition, so it’s about having an awareness that it’s not a benign problem,” said Fulcher, who has worked in elite football for 20 years.

The Football Ferns’ first OFC Women’s World Cup qualifier against Samoa on 27 February was played in ambient temperatures in the late 30s in the Solomon Islands. It was a windless day with extreme humidity.

Immediately after the match Samoa coach Paul Ifill questioned the conditions.

“We had a lot of people really struggling with the heat, we’ve got three players with heat stroke,” Ifill said.

“I think the organisers need to look at the timing, playing at 1 o’clock I don’t think is fair to the players … I’ve got players now that won’t be able to probably play for the rest of the tournament.”

It was not just the Samoan players feeling the heat in Honiara.

Football Fern Michaela Foster said the heat was something the players and coaches considered in the game plan during the tournament which wrapped up last week.

“It is hot, the humidity has been quite challenging … in this heat we obviously want to minimise the unnecessary running.”

Fulcher said more needed to be done to manage the risk for all athletes – and it was beyond looking at the forecast.

“Sporting organisations and the people leading the organisations need to understand that this is potentially a very serious issue.

“If you look at North America there are several people that die every year from heat illness in sport.

“If you look at the NRL, they’ve had a recent issue with a fatality that was linked to heat illnesses.

“So I think we really need to look at where are these tournaments being held, when in the day, looking at historical data around temperatures and things like that to help make those determinations. Then there needs to be very clear education of all the stakeholders about the risks of heat illness and how we can mitigate those.”

Is it too hot in the Pacific Islands to be hosting tournaments?

Fulcher believed there would be locations and times of day that it would become too hot to safely host football tournaments – and cancellations would need to be considered.

He had some concerns about recent tournaments in the Solomon Islands and Papua New Guinea.

“The rules and regulations that we need to have for tournaments in the Pacific are probably different to the rules and regulations that you might see in the UEFA Champions League,” he said.

The world cup qualifiers were not the only football games being played in this part of the world with a lot resting on the results.

Round two of the new OFC Pro League was in Papua New Guinea in early February where the conditions in Port Moresby were described as extremely hot and humid.

A Solomon Kings player was hospitalised after a win over Auckland FC in PNG after pushing through in a match that took a physical toll on the players.

Fulcher said in these scenarios players could be their own worst enemy.

“Athletes are not very good at self-regulating and saying, hey, I’m feeling a bit hot. They want to push themselves and often push themselves until they fall over and they can’t do it anymore.

“The things that make them good athletes, that they’re not quitters, often mean they don’t know that they’ve got a problem until they’ve got quite a big problem.”

Fulcher compared the situation athletes at [https://www.rnz.co.nz/news/sport/575322/tennis-atp-open-to-formal-heat-rule-after-string-of-retirements-in-shanghai-sauna the Australian Open in tennis, which is played annually in January and where players could be playing for hours in temperatures in the 40 degrees Celsius, to what the footballers were dealing with.

“If it was very hot in Melbourne, the medical infrastructure in Melbourne to deal with the Australian Open is extremely good, both in terms of experienced clinicians at a tournament and experienced clinicians in a large tertiary hospital.

“Whereas if you have heat illness in the Solomon Islands, I would say the infrastructure available at the ground, the infrastructure available at the hospital, the ability to then travel to a tertiary hospital or somewhere for additional care, it’s quite a different environment.”

Fulcher believed players travelling from the likes of New Zealand to the islands could do little to prepare for the conditions that included “very big temperature change and no real scope to acclimatise to that”.

“There are lots of publications that talk about protocols of training and heat chambers and these sorts of things, and there’s a small amount of adaptation you can do before you travel.

“But that requires significant resourcing, and that’s also not always available to some of these teams and players.

“So I think number one, it’s only partially effective and number two it’s logistically difficult to implement.”

What are the rules?

During the OFC Women’s World Cup qualifiers in the Solomon Islands there were drinks breaks and cooling breaks. Cooling breaks allow all players to go to their respective bench/technical area and use ice and cold towels to cool down when the mercury rises.

Governing body FIFA has also introduced three-minute hydration breaks for this year’s men’s Football World Cup in Canada, USA and Mexico.

Under the new policy, regardless of the temperature, referees will stop games 22 minutes into each half so players can rehydrate.

FIFA said this will streamline and simplify the previous rules, which required cooling breaks 30 minutes into each half when the temperature at kick-off exceeded 32 degrees Celsius.

A report published last year by Football for the Future, Common Goal and Jupiter Intelligence found 10 of the 16 venues for this year’s men’s world cup, across the three host countries, are at very high risk of extreme heat stress conditions.

Fulcher said cooling is an important strategy to try and get players to reduce their core body temperature but in “isolation they’re pretty futile”.

“The cold hard reality is often the conditions are extremely hot and cooling breaks, while they’re better than nothing, are not effective strategies.”

Over his decades involved with football and New Zealand national teams Fulcher had experimented with giving players very cold water and cold water with ice slurries during drinks breaks.

“It is very difficult to consume enough of the very cold water or ice slurries to make a meaningful difference.

“In the same way that a car with a full radiator can still overheat, players are still going to overheat despite being well hydrated.”

‘Scope to improve things’

Fulcher has been on the medical staff with New Zealand football teams that have travelled across the Pacific, Africa and “other areas where it is very, very hot”.

From what he has seen with the OFC Pro League he said the staging of the tournament itself and the preparation around the tournament by teams and officials was an improvement on what has happened in the past in the region.

“There’s still scope to improve things.

“There have been some things in these tournaments that I think have gone really well. For example, the provision of equipment to treat heat illness, circulating advice around how to manage heat illness in advance so that teams are prepared.

“These sort of things, I think, are relatively small steps, but they are definitely steps in the right direction.”

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– Published by EveningReport.nz and AsiaPacificReport.nz, see: MIL OSI in partnership with Radio New Zealand