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Attending outdoor sporting events can be life-threatening. Amid , event organisers need to take extra care – not just for athletes, but also for officials, spectators and volunteers.

The consequences of extreme heat exposure range from . died in 2020 due to “exertional heat stroke” following an excessive pre-season training session. Scorching temperatures also disrupted the 2019 and wreaked havoc during the 2023 .

In Paris, the will proceed with . To reduce greenhouse gas emissions, organisers chose alternative cooling measures such as insulation, double-glazing, fans and pumping cool water through the floor. Unconvinced, the Australian Olympic Committee is just in case. Athletes from poorer nations are expected to just keep their curtains shut.

In the lead-up to the and other major sporting events in Queensland, the state government wants to prepare for extreme heat. explores this health hazard, the strategies recommended to reduce heat exposure at sporting events, and who is responsible for ensuring these strategies are put in place. Here we offer practical tips for all involved. We’re going to need them more than ever as the world warms.

What we did and what we found

We conducted an of research published between 2010 and 2023 to determine the current state of knowledge in this area.

Our systematic approach honed in on 40 peer-reviewed articles about heat at major sporting events. These were events held in large venues that attracted local, domestic and international spectators. The recommendations fell into six themes: planning, mitigation strategies, medical, policy, education and research.

A consistent pattern of heat-related challenges emerged. The increased along with the temperature. Certain groups of people . Athletes participating in endurance events such as long-distance running were at higher risk than those participating in short-duration sports involving throwing (javelin, discus) or jumping (high jump, long jump). The diverse needs of those with multiple medical conditions and differing abilities including also warrant special consideration.

We found the significant health risks of heat should be considered before, during and after major sporting events. Individuals, coaches, officials and organisers all have a role to play.

Our findings can inform evidence-based strategies to protect the health of those attending and competing in such events now and into the future.

It’s not just about athletes

While athletes may have prepared to compete in hot conditions, using technology such as , spectators are less likely to deliberately prepare their bodies for extreme temperatures. But there are plenty of things we can all do.

We can drink plenty of fluids, seek shade and use sun protection. Ideally, venue management will have provided access to drinking water, shady spaces and cooling (misters, fans or air conditioning). All requires careful planning and thoughtful construction.

Organisers need to decide what time to run each event, what temperatures will trigger heat policies (such as pushing events to a cooler time slot), whether rules need to be changed in the event of extreme heat (such as more or earlier break times), and what measures need to be in place to protect officials, spectators and volunteers.

Top tips for spectators

Here are some practical tips you can use to reduce heat-related risks when extreme heat strikes:

1. think about where your seat is located and whether there will be any shade, or whether you will be directly exposed to the elements

2. find out whether you can come and go, or attend the event later in the day – where possible, avoid events timed for the hottest part of the day

3. wear light-coloured, loose-fitting clothes and a hat

4. see if you can bring your own water bottle into the event and refill it, and make sure you are well hydrated before, during and after the event

5. avoid as these drinks can make your more dehydrated

6. check what event organisers have planned for extreme weather such as heatwaves.

A warning to event organisers

A great deal has changed since Australia at the turn of the century.

There are no excuses in 2024. All sports and sporting events should have a heat policy that addresses players, spectators and officials. Sports Medicine Australia’s is a good example.

For major sporting events, engaging with health services should be part of the planning process. Then they can prepare for the possibility of multiple people presenting with heat stroke.

At the event, medical teams should be skilled in recognising the warning signs of heat related illness, as well as diagnosis and treatment.

With extreme heat events becoming more common worldwide, sporting bodies must be prepared to alter scheduled events (including the time, location, scheduled breaks, and so on) as required.

Let’s ensure outdoor sporting events can continue in a warming climate.

By working together, we can provide safer, more enjoyable experiences for all involved.

Hannah Mason receives funding from the Queensland Department of Environment, Science and Innovation, and Queensland Fire and Emergency Services.

Amy Peden is an honorary Senior Research Fellow with Royal Life Saving Society – Australia and is the co-founder of the UNSW Beach Safety Research Group. She receives funding from the ³Ô¹ÏÍøÕ¾ Health and Medical Research Council.

Anthony Leicht receives funding from the Australian Department of Defence.

Jemma King receives funding from the Queensland Department of Environment, Science and Innovation. She is affiliated with the Australian Health Promotion Association as she holds an executive position with the Queensland Branch.

Richard Franklin receives funding from the Queensland Department of Environment, Science and Innovation, and Queensland Fire and Emergency Services. He is the President of Kidsafe Australia and the incoming President of the Australasian College of Tropical Medicine. He is a board member of the Royal Life Saving Society – Australia, Farmsafe Australia, and Auschem and a member of the World Association for Disaster and Emergency Medicine, the Public Health Association of Australia, the International Society of Agricultural Safety and Health, and the Australasian Epidemiological Association.