Football practices started Wednesday for many high schools throughout the area and with them began state-mandated safety regulations prompted by the 2008 death of a Louisville student.
House Bill 383 requires high school sports teams to have at least one coach who passed a four- to five-hour online sports course present at all practices and games.
Nationally, six football players died in 2008 from heatstroke, the highest number since 1972, said Dr. Frederick Mueller of the University of North Carolina, whose research focuses on sports injuries and deaths.
One of those players, Max Gilpin from Louisville's Pleasure Ridge Park High School, collapsed during practice in 94-degree heat and died three days later. Gilpin's coach, David Jason Stinson, remains at Pleasure Ridge Park in a non-teaching position. He pleaded not guilty to a charge of reckless homicide.
Gilpin's death put players and coaches on notice about health risks even before the legislature acted.
Andre McCall, a senior lineman for Montgomery County High School, said coaches became more concerned about players' safety when Gilpin died.
Water breaks became more frequent, and players practiced more often without pads or helmets, he said. With the heightened emphasis on safety, coaches give more breaks and look for ways to keep players cool, McCall said.
"The coaches put in a new water spigot," McCall said. "Now we don't all have to go to one side of the field to get water. It helps us to avoid injuries or cramping."
McCall said when players get tired or thirsty they can pull themselves out of drills, and anyone feeling lightheaded knows to tell the coaches.
All high school head coaches in football, soccer, volleyball, cross-country and golf were required to complete the online safety course by July 15, and many Kentucky high schools also require assistant coaches to take the course.
The course comprises seven modules that address the prevention of a variety of sports-related injuries and a test after each module, said Julian Tackett of the Kentucky High School Athletic Association. As of 5 p.m. Wednesday, 3,206 people had completed the course, KHSAA data showed.
"We've always required first-aid training," he said. "However, as far as we know, Kentucky is one of the few states to mandate such a comprehensive training program. This is a health and safety issue, so we don't anticipate any compliance issues."
Lonzo Moore, athletics director for Jackson County schools, said many safety precautions came before HB 383 passed.
Gilpin's death "was kind of a wake-up call for everybody," Moore said. "We made sure that at every football practice we had an ice bath. We went ahead and said that every 20 minutes players had to take a water break. And if any of our kids feel they need to rest, we just don't question that."
Moore said that many of the bill's safety-education requirements fall within a medical symposium already required, aside from added safety instruction for coaches.
And, Moore said, the district places a big emphasis on the heat index.
To avoid heat-related health issues, Jackson County High School practices at 8 a.m., and when "two-a-days" begin, the second practice occurs in the evening, he said.
The KHSAA provided schools with a heat-index chart coaches must use. The chart outlines four stages of heat safety based on humidity and temperature combinations. The first stage requires coaches to have water with optional water breaks, while the final stage requires stopping all activities.
Moore said the safety course requirement won't prevent all safety problems.
"But all in all, it is probably a positive thing for coaches to be aware of because they are the ones out there with the kids every day," Moore said.
Mueller's research found the first two weeks of practice most dangerous for football players because they haven't acclimated to practicing in summer heat.
"During that period, you really need to watch kids and make sure they aren't overheating," Mueller said. "They need to take a lot of water breaks. If a kid gets dangerously overheated, there isn't much time to cool them down before damage occurs."
Mueller said that while the incidence of injury per 100,000 participants is higher in both gymnastics and ice hockey than in football, football gets more attention because more students participate in the sport.
"The new law in Kentucky sounds like a good idea," Mueller said. "It's very important for coaches to be involved in student safety. In most cases these deaths are all preventable."
However, Mueller would like even more stringent safety measures.
"I would like all the country's schools to have an athletic trainer who doesn't have to teach but is responsible only for the sports teams," he said.
"And I would like to see a physician available full-time. If you really had a lot of money, then the new computer chips that monitor players' body temperatures might really make a difference."
Nevertheless, the consensus is that the law helps.
"We think it's a good move," said Vince Mattox, Fayette County schools' director of school, community and government support.
"There is no cost difficulty to us, and the safety measures explained in the course make sense. We are also asking Kentucky middle school coaches to take the course, too."
Mattox said Fayette County always made an effort to ensure sports safety at practices, including scheduling breaks.
Chad Luhman, athletics director at Bryan Station High School, agreed.
"Our district is very proactive, and we've always made sure that if something should happen on the field the coaches could handle it," he said. "Our coaches receive CPR training every other year, and we always have plenty of ice and cold water on the field."
McCall, the Montgomery County player, sees long-term benefits, too.
"I think that later in the season guys are more tired," he said. "Taking more breaks is going to give us time to rest and help us stay more focused throughout the season."