The football world tends to characterize deaths related to heatstroke as accidental tragedies, but medical experts say they can be prevented if teams and players adhere to certain measures.
The latest victim was high-profilePro Bowl offensive tackle Korey Stringer of the Minnesota Vikings. Stringer, who was 27 with a wife and 3-year-old son, died Wednesday morning, a day after he suffered forced breathing and vomited three timesclassic heatstroke symptoms. He collapsed in the presence of a trainer during the Vikings' Tuesday morning practice in 91-degree heat. His temperature registered over 108.
"This kind of death is completely preventable," said Dr. Steve Marshall, a sports injury epidemiologist for the School of Public Health at the University of North Carolina. "(Stringer's) case seems very unusual. At that level, there is a very high quality of medical staff on hand. From what I understand, he exhibited symptoms of trouble earlier (yet still died). That's troubling."
A study by the Exercise and Sports Science Department at UNC claims that, before Stringer, there were 19 deaths of high school and college players from heatstroke since 1995.
Heatstroke is derived from the mixing of strenuous outdoor activity with extreme heat and humidity, which can cause dehydration, which can lead to heat exhaustion, heatstroke and, ultimately, death.
Stringer and the Vikings practiced Tuesday in full gear on the hottest day of the year in the Midwest. The heat index rose to 110 degrees.
"(Stringer's death) says that there's no safe place just because you're an NFL guy and you have the latest high-tech equipment, or you have the best rehab equipment (or) you know all the nutritional values," said Bob Whitfield, offensive tackle for the Falcons.
According to the UNC study, football players' fates as they relate to heat exhaustion can be controlled. "There is no excuse for any number of heatstroke deaths," the report says. Eleven precautions are listed.
At the University of Georgia, the staff concentrates on heat conditions daily. "We know that on Aug. 16, it's going to be 100 degrees and they're going to have 50 pounds of pads on them," said Dave Van Halanger, director of strength and conditioning. "You have to prepare them for that because football isn't going to slow down."
Similar steps are taken at Georgia Tech. "But there's only so much you can do," said Don Lowe, director of sports medicine. "It's scary."
Still, many teams choose to practice in the hottest part of the daybetween 4 and 5 p.m. during the summer. UGA has broken from that pattern this year under new coach Mark Richt with an evening practice, while some high school teams schedule their morning session as early as 6:45 a.m.
Yet Marshall cited cases of heatstrokes in 80-degree temperatures because the humidity was so high. "The potential for a stroke is there even when the temperature is not so high," he said.
On the high school level, some teams conduct three practices a day, which makes intense heat unavoidable. Cobb County is ahead of the curve. The death of a high school player two years ago prompted officials to require a device to gauge the combined dry air temperature, humidity, ground-radiated heat and wind speed. The device alerts coaches and staff of dangerous conditions.
Players who take creatine and other nutritional supplements place themselves at special risk. The muscle-building substances, used increasingly on all levels, dehydrate users.
"If they do take creatine, they have to hydrate and get tons of fluids in their body," Van Halanger said. "If they'll drink plenty of fluids, 10 to 12 to 15 glasses of water per day with the creatine, it shouldn't be a problem."
Marshall said Stringer's death can be used as the impetus to end heat-related deaths in football. "This is an excellent time of year to re-evaluate the practice schedules and how they are run," he said. "There should be more water breaks. Players should take off their helmets more because hair is a radiator of heat. Even if there was cold water sprayed on them, that would help.
"If we all did the right thing, we can eradicate the problem. Completely."