Heat alert for England World Cup fans as opening match leaves Three Lions supporters 'at risk of heart attacks'
Fas unprepared may even be at risk of heart attacks, according to one academic
England supporters travelling to Texas for next month's World Cup opener against Croatia are those most at risk of health issues caused by the extreme heat, experts have warned.
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The Three Lions will kick off their tournament at The AT&T Stadium in Arlington on June 17, which is air-conditioned meaning players and spectators within the venue will be protected from the high temperatures.
However, the World Weather Attribution (WWA) group of academics are especially concerned about the impact of climate on spectators on their way to matches, queuing to get in and attending outdoor fan festivals.
The WWA has found there is a one in three chance of the Wet Bulb Globe Temperature (WBGT) exceeding 28 degrees Celsius in Dallas for the match.
WBGT is an index that considers how effectively the body can cool itself, with world players' union FIFPRO saying matches should be postponed where the WBGT exceeds 28 degrees.
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Altogether, WWA expects nine of the 104 matches to be played above 26 degrees, where FIFPRO advises that safety measures be implemented, with around five expected to occur where the WBGT exceeds 28 degrees.
Dr Chris Millington, from Imperial College London, said that spectators are most at risk.
He said: "They’re more medically diverse, maybe older or very young. They may have cardiovascular disease, kidney or metabolic disease.
"They may be taking medications that affect heat tolerance and they may be unacclimatised visitors.
"They may also be exposed for much longer than the match itself, walking to the stadium, queuing in direct sun, attending fan zones, sitting in exposed seats and travelling home on crowded transport.
"People who have got medical comorbidities, such as heart disease, will go into that situation. They’ll probably not hydrate very well the night before.
"They might not sleep very well the night before, and then they might have some beer during the day. And gradually they’ll get hotter and hotter and hotter.
"They probably won't wear a hat. They may wear their sports shirt, or as they sometimes do, they might be not wearing a top.
"Exposing themselves to those risks as well, and then what happens is, someone who has got that blocked coronary suddenly finds they’re dehydrated and they’re pushing all their blood flow to their skin, and suddenly not enough blood flow is going to their heart, and they suffer a heart attack that they wouldn’t have suffered were they not in that situation."
FIFA has not publicly given an indication of the WBGT threshold which would trigger postponement.
It has, however, introduced three-minute hydration breaks midway through each half at every match at this summer’s finals as a player welfare measure.
Dr Millington suggested that does not go far enough to mitigate the heat impact on players, and said a longer half-time break should be implemented.
A FIFA spokesperson said a tiered heat mitigation model would be in place at this summer’s finals, where temperatures exceed defined thresholds.
In those circumstances, "spectators will be permitted to bring one factory-sealed water bottle, and venues will activate additional cooling capacity, including shaded areas, misting systems, cooling buses and expanded water distribution," the spokesperson said.
FIFA has also developed a medical set piece protocol for exertional heat illness for players that includes the use of bespoke cooling bags by trained match doctors that will allow immediate treatment at any location.