Associated factors for exertional heat exhaustion-related symptoms among amateur golfers in Japan: A retrospective case-control study

The associated factors for exertional heat stroke among amateur golfers remain poorly understood. We conducted a case-control study to examine exertional heat exhaustion (EHE) - related symptoms among amateur golfers in Japan using a self-administered questionnaire. Retrospective case-control study design. A web-based questionnaire was administered from September to November 2024. Data were collected on basic attributes, lifestyle habits, perceived health factors, perceived playing conditions, changes in eating behavior, and EHE-related symptoms. We performed a case-control analysis using a multivariate conditional logistic regression model. The explanatory variables included lifestyle habits, health factors, playing conditions, and eating behavior; the objective variables were EHE-related symptoms. Our study included 194 participants with EHE-related symptoms and 252 control participants. The following factors were significantly associated with EHE symptoms: perceived dehydration (adjusted odds ratio [AOR], 4.65, 95% confidence intervals (CI) 3.08-7.03); sleep deprivation (AOR, 4.38, 95% CI 2.84-6.77); loss of appetite (AOR, 4.32, 95% CI 2.84-6.58); accumulated fatigue (AOR, 3.26 95% CI 1.17-1.31); mental stress (AOR, 2.71, 95% CI 1.78-4.12); average rounds of golf (AOR 1.88, 95% CI 1.14-3.13); increased sports drink consumption (AOR 2.07, 95% CI 1.20-3.56); increased consumption of salt tablets and candies (AOR 1.99, 95% CI 1.29-3.05); and increased dietary supplement intake (AOR, 1.88, 95% CI 1.14-3.11).These findings suggest that amateur golfers should assess their physical condition before play and adjust their schedules accordingly, particularly in hot weather, to minimize the risk of heat-related illnesses.