How Does One Differentiate Between an Exertional Heat Illness and an Exertional Sickling Event?

Sickle cell trait (SCT) is common, with millions of affected individuals. In the United States it is found in 8% of Blacks, 0.5% of Hispanics, and 0.2% of Whites. 1 SCT is an inheritable condition that is generally benign and of little consequence to the affected individual. Two parents who carry SCT, however, have the potential to give birth to a child with sickle cell disease, which can be an extremely challenging-medical condition for the affected individual. Accordingly, screening for SCT is historically important, in particular with regard to preconception counseling. Recently, however, deaths among athletes associated with SCT, in particular collegiate football players, have been well documented in the medical literature and the media. Once thought to be inconsequential in the sports setting, SCT has been shown to have a 22 times increased risk for sudden death among Black Division 1 National Collegiate Athletic Association (NCAA) football players. 2 In 2010, the NCAA initiated a policy requiring documentation of sickle cell status or having the athlete sign a waiver forgoing testing.