CIF Sports Medicine Advisory Committee Statement on Air Quality and Sport Participation

Updated 10/19/23

Recent catastrophic and historical fires in California continue to raise numerous questions regarding safe participation in sport and practice for young athletes. This position statement serves as a resource to coaches, administrators, parents, and students who have questions about participation in outdoor activity during periods of diminished air quality for California high school sport.

Healthy athletes are at increased risk for inhaling pollutants in the air. Physical activity increases ventilation and the number of pollutants that are inhaled are increased compared to periods of rest. During physical activity, air is often inhaled directly into the mouth, bypassing the built-in nasal filtration system. Deep inhalation diffuses pollutants into the bloodstream more quickly during exercise.   These risks are increased if an athlete has a pre-existing medical condition such as asthma or a cardiac condition.

A valid and reliable standardized national air quality resource is the National Weather Service (NWS) Air Quality Forecast System.  This system provides constant monitoring of ozone, particulate matter, and pollutants with accurate and advanced notice to prevent the adverse effects of decreased air quality.

The key component of the standardized air quality resource is the NWS Air Quality Index (AQI). The AQI provides real-time monitoring and alerts in response to changing air quality levels. Five different pollutants are tracked in this system including the following: 1) ground-level ozone 2) particle pollution 3) carbon monoxide 4) sulfur dioxide 5) nitrogen dioxide. Ground-level ozone and particulate matter are the most concerning pollutants for outdoor physical activity. The AQI is reported as a single number based on a scale of 0 to 500 with 0 being completely safe and 500 indicating the most hazardous levels of air pollution.

Consistent with this national reporting system and consistent with the National Collegiate Athletic Association Committee on Competitive Safeguards and Medical Aspect of Sport, the CIF Sports Medicine Advisory Committee offers the following general guidance to institutions seeking to make decisions about the appropriateness of practice or competition in questionable air quality situations. With recent severe fires within the state of California, both regional and statewide authorities have often established alerts to canceling sports events or practices because of local risk.  CIF recommends following these guidelines.  If specific guidelines have not yet been provided, the following are useful guidelines consistent with NCAA and NFHS position statements on air quality.

  1. Monitoring of local AQI and associated air quality alerts, especially during times of extreme environmental conditions is recommended. Advice and monitoring is best done by the primary athletics health care providers (athletic trainers, school nursing staff, team physicians) who have training in such monitoring. Schools may choose to delegate this responsibility to a staff member with knowledge of AQI.
  2. Member schools should consider shortening or canceling outdoor athletic events (practices or competitions) in accordance with AQI recommendations. Exposure to air should be managed more carefully for students with pre-existing lung or heart conditions. When the AQI rises above 100 schools should consider removing such athletes at risk from practice or competition.
  3. At AQI values above 150 serious consideration should be given to rescheduling the activity or moving it indoors if possible. Prolonged exposure and heavy exertion should be avoided.
  4. School Emergency Action Plans may guide the emergency care response in these circumstances and the staff should be made aware of this plan.
  5. The Preparticipation Physical Examination for Sport will be used as a tool to identify students at risk for smoke inhalation exposure such as asthma, cardiac disease, and respiratory disease.
  6. Emphasize to student-athletes that the wearing of masks, such as for protection against COVID-19 does not protect against exposure to hazardous air quality. Consequently, wearing masks will not allow competition or practices when AQI is at hazardous levels.

There are now validated online applications to smartphones which can track not only AQI in a town or city, but also AQI regionally near each neighborhood within each town or city.  Consistent with NFHS, California Air Quality Board and California Environmental Protection Agency, the CIF recommends using the www.airnow.gov application for this purpose. The AQI may even be checked periodically during a day of competition or practice in case of changing conditions. The application was created with the collaboration of the Environmental Protection Agency and contains not only air quality data but also current fire conditions, webcams, and email notifications consistent with local and regional up-to-date conditions.

References

  1. Air Quality Position Statement. NCAA Sports Science Institute, Sept 2018
  2. NFHS Position Statement on Physical Activity, Air Quality, and Wildfires, April 2019
  3. CIF North Coast Section. Air Quality Index Rules, Bylaw 1003H.
  4. US Environmental Protection Agency. Air Now website www.airnow.gov