Efficacy of the FIFA cooling break heat policy during an intermittent treadmill football simulation in hot conditions in trained males

Objective To evaluate the efficacy of the Fédération Internationale de Football Association (FIFA) cooling break policy against alternative cooling configurations in attenuating thermal strain during simulated football in the heat. Methods 12 males (age: 27±6 years, V̇ O _2peak: 61±7 mL/kg/min) completed five 90 min intermittent treadmill football match simulations in 40°C and 41% relative humidity (32°C wet-bulb globe temperature) with different cooling configurations: regular match without cooling breaks (REG), 3 min breaks without cooling (BRK _no-cool), 3 min breaks with cooling (BRK _cool: current FIFA policy; chilled fluid ingestion and ice towel across neck and shoulders), 5 min extended half-time without cooling breaks (ExtHT _only) and 3 min cooling breaks with 5 min ExtHT (ExtHT _cool). Rectal temperature (T _re), heart rate, whole-body sweat rate (WBSR) and rating of perceived exertion (RPE) were recorded. Data are presented as mean (95% CIs). Results Final T _re was lower in BRK _no-cool (0.20°C (0.01, 0.39), p=0.038), BRK _cool (0.39°C (0.21, 0.57), p<0.001) and ExtHT _cool (0.40°C (0.22, 0.58), p<0.001) than REG (39.1°C (38.8, 39.3)). Mean T _re was lower in ExtHT _cool (38.2°C (38.0, 38.4)) than BRK _cool (38.3°C (38.1, 38.5), p=0.018), BRK _no-cool and ExtHT _only (38.4°C (38.2, 38.6), p<0.001) and REG (38.5°C (38.3, 38.7), p<0.001). Mean heart rate was lower during BRK _cool (6 beats/min (4, 7), p<0.001) and ExtHT _cool (7 beats/min (6, 8), p<0.001) compared with REG. WBSR was comparable across trials (p≥0.07) and RPE was attenuated during BRK _cool (0.4 (0.1, 0.7), p=0.004) and ExtHT _cool (0.5 (0.2, 0.7), p=0.002), compared with REG. Conclusion BRK _cool and ExtHT _cool attenuated thermal, cardiovascular and perceptual strain during a simulated football match in the heat. Additional strategies may be required in field settings or under harsher conditions.