Paris 2024 Olympic Games: “Heat stroke is one of the leading causes of death for athletes, they must prepare for it””

Ébastien Racinais, head of the “environmental stress” unit at Creps de Montpellier in the brand new “hot room” where athletes can train in hot, cold, or hypoxia conditions, such as at altitude. Midi Libre – Richard Gougis

Responsible for the 'environmental stress' unit at Creps de Montpellier, Montpellier resident Sébastien Racinais also worked for 17 years in Qatar on the effects of heat on athletes. He will be at the Paris Olympics in a group of IOC experts.

How did you become a researcher into the effects of heat?

I have a basic academic profile with studies in Staps. I left Montpellier in 2000 to complete a DEA and a thesis in environmental physiology in Guadeloupe. It was there that I began to become interested in the effects of heat. I then worked there for 17 years in Qatar. Practicing sports in hot conditions was a theme that seemed local to me and has become current in many places.

You have also joined a group of IOC experts on the issue?

Yes, a working group created in 2018 before the Tokyo Olympics which were shaping up to be the hottest in history. After these games, we realized that it was going to become a recurring problem. Paris 2024 is not safe from a heat wave. In 2026 we will have the Youth Games in Dakar, a first in Africa, then the Football World Cup in Central and North America and the 2028 Olympics in Los Angeles. California holds the world record for highest temperature at a resort with 54 degrees.

Which aspects are you working on?

Firstly on prevention and education, through campaigns set up at the Olympic level and with the federations. In 2015, at the Beijing World Athletics Championships, only 15% of athletes had prepared for the heat. They were 63% four years later. We know that these campaigns work. Then we work on countermeasures: ensuring that we provide everything necessary for hydration, shade, water, ice… It’s complex to manage on the scale of the Olympics. We also have a look at the games calendar to advance or postpone events. But here, the one in Paris was almost perfect.

How to spot when an athlete has heat stroke?

The intensity and duration of the effort are risk factors. You have to be vigilant in the 10,000 meters, the marathon, the walk, the triathlon… Heat stroke is the second leading cause of death in athletes, almost at the same level as sudden death linked to heart problems. The symptoms are an internal temperature above 40.5 degrees, and a dysfunction of the central nervous system resulting in discomfort or confusion, agitation, violent behavior, coordination problems.

What is the support?

We set up specific medical cells, the  "heat deck". Emergency treatment is very simple: a cold water bath to cool the athlete. If you do it within half an hour, he can have a beer with his colleagues in the evening. If you take an hour or two hours, there is a risk of complications. Beyond two hours, he risks organ transplants or even death. It costs nothing to have an inflatable pool with ice cubes but you have to anticipate it and provide dedicated staff. We worked on this with the organizers of the Olympic Games for risky sports.

Also read: Paris 2024 Olympic Games: heatwave, heatstroke… organizers are preparing for the worst to protect spectators and athletes

What is the critical outdoor temperature threshold ?

It also depends on the level of radiation from the sun and the humidity level, which can prevent the athlete from evaporating his sweat. Each federation has an index that allows these three factors to be combined. A threshold which allows it to authorize or not the event or to set up refreshment breaks as Fifa does. At the Olympics, each federation can apply its rules, which complicates things. But everything is relative. For me, 32 degrees in April is more dangerous than 38 in August, especially for amateurs, because it will be the first heat wave of the year ;year and we will not be acclimatized.

How to prepare an athlete for heat?

First of all, we must remember that humans are one of the animal species that have the greatest tolerance and ability to adapt to heat. This is what allowed prehistoric men to hunt faster and stronger prey. To prepare for it, two weeks of exposure to heat allow us to develop a certain number of adaptations. Training in a hot environment for an hour and a half per day for two weeks is excellent preparation. The effects will be beneficial on health and performance. A podium depends on the millisecond, but heat stroke causes a colossal drop in performance.

What are the techniques?

Either do an internship in a hot country or expose yourself to artificial heat. Here at Creps, a brand new hot room allows us to simulate all the conditions that exist on earth, temperatures, humidity, oxygen levels to simulate altitude… This helps prepare the athlete, including in winter, if they have a competition in a warm environment. It’s for this project that I returned to Montpellier. We work with a lot of athletes like triathletes but also BMX riders. It’s a short test but the heat can dizzy you in mid-air.

Create a reference center in Montpellier and Font-Romeu

Sébastien Racinais is at the head of a project which aims to implement a global solution for preparing for environmental stresses in Montpellier-Font-Romeu.

"In Montpellier, our environmental chamber, commissioned at the beginning of May, also produces hypoxia, simulating altitude, says the researcher.  Font-Romeu is expanding her room and she will also be able to provide heat. We can offer courses to athletes from all backgrounds with à la carte services and support for athletes, advice on training, hydration and dietetics. The idea is to put in place good practices and individualized solutions for the athlete and their coach."

This summer, you will have to worry if the thermometer reaches 40 degrees ?

Yes, at 40 we will worry, maybe even before then. This will depend on the day, the event, and the level of preparation. From July 17, I will be on site, in Paris, with the Games Group, representatives of the IOC Scientific and Medical Commission. This is where I will know whether to worry or not. We had meetings almost every month with the organization, I think they will be ready.

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