Occupation-Specific Physical Demands And Physiological Strain Of American Football Referees While Officiating

Abstract

Occupational incidences of sudden cardiac death (SCD) are greater among workers that experience high levels of physical exertion, physiological strain, and extreme thermal environments. American football referees fall under this distinction, yet are underrepresented in occupational research. PURPOSE: To bridge this gap by quantifying the physical demands and physiological strain they experience while officiating. METHODS: Twelve male officials (mean±SD; age=43±11 y, body mass index [BMI]=31.9±7.2 kg/m2, 67% white), across 3 games, provided urine samples for urine specific gravity (USG) determination, ingested core temperature (Tc) pills, and wore GPS-enabled performance monitoring systems. Outdoor conditions were monitored using a weather meter. Analyses included descriptive statistics and bivariate correlations. RESULTS: Games lasted ≈2.5 h and evening weather conditions were typical of the Southeastern US (wet bulb globe temperature: 23.5±2.2°C, relative humidity: 72.5±9.2%). Across all 3 games, 58% of officials were hypohydrated (USG>1.020); they covered an average of 5.5±1.6 km (total distance) at a speed of 1.9±0.3 kmph, with corresponding Tc and heart rate (HR) values of 37.4±0.4°C (peak Tc=38.3±0.4°C) and 132±16 bpm (peak HR: 169.2±17.5 bpm), respectively, across all referees and over the entire sampling period. Higher relative humidity at the start of each game was associated with greater physiological strain (average HR: r=0.61, P=0.04; peak HR: r=0.56, P=0.06). Pre-game hydration status (r=0.50, P=0.09) and BMI (r=0.50, P=0.09) tended to elicit greater physiological strain (defined as the proportion of the game spent above 85% of age-predicted maximal HR). CONCLUSIONS: Football referees experience elevated levels of physiological strain while performing officiating duties. Individual and environmental factors appear to influence levels of strain and should be explored in a larger and more diverse sample of referees to identify patterns and develop strategies to best mitigate strain and prevent SCD.