Modifications of Exertional Heat Illness and Lightning Policies in U.S. High School Athletics Over an Academic Year

Cross-sectional evaluations show high schools are not compliant with written policies addressing exertional heat illness and lightning injuries. This study evaluated modifications of exertional heat illness and lightning policies in U.S. high schools over one academic year, as reported by athletic trainers. Findings reveal marginal modifications to these policies. Multinomial logistic regression analysis indicated years at school, age, and heat region significantly predicted changes in self-reported decision-making stages regarding environmental monitoring and heat stroke diagnosis. Greater years at school and heat region Category 3 were associated with lower odds of negative change. Intervention efforts may be warranted.