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Differences of proportions of heat stress prevention strategies over different home continent, sex and event category were examined using χ2 tests with φ as effect size (φ=0.1 was considered a small effect, φ=0.3 a medium effect and φ=0.5 a large effect). An analysis of non-participating athletes was performed by comparing their distribution of home continent, the Human Development Index (HDI),15 sex and age with the final study group. Examination of potential factors explaining the use of heat stress prevention strategies at the championship was performed using logistic regression analysis. First, analyses were performed with simple models (ie, logistic regression analyses with 1 explanatory variable). Thereafter, analyses were performed with multiple models (ie, logistic regression analyses with several explanatory variables) for each of the four definitions of heat stress prevention. The multiple models were fitted using stepwise elimination of non-significant variables. The explanatory variables were sex, age, home continent, the HDI, event category, availability of medical support before the championships, experience of previous heat-related symptoms, and previously having been diagnosed with EHI. Events for these models were coded into two categories: speed/power (field, sprints and decathlon/heptathlon) and endurance (middle and long distance) events. All statistical calculations were performed using SPSS Statistics for Windows, V.21.0 (IBM Corporation, Armonk, New York, USA). All statistical tests were two-sided and outcomes with p


Athletes performing exercise in warm/hot and humid environments have elevated sweat rates which can result in large body water and electrolyte deficits, exacerbating the performance impairments associated with heat stress.5 Athletes competing in the championships may have been aware of the impact that hydration status may have on performance and recovery, as more than 80% had a fluid consumption strategy (table 3). This was especially noticeable in the decathletes and heptathletes spending the better part of an entire day on the track and field, consuming water, as well as electrolytes and carbohydrates. However, it is not possible to determine from the current data if the planned hydration strategy of the athletes was different from their usual strategy in cooler environments. Interestingly, endurance athletes had a lower likelihood of adopting a fluid consumption strategy than speed/power athletes (table 6). However, this most likely relates to the decathletes and heptathletes having been included in the speed/power athlete category of the explanatory models and the nature of the question, which for some could have included the warm-up and cool down (eg, sprints).

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