Health clubs not fit for cardiac emergencies

November 12, 2000

NEW ORLEANS, Nov. 13 - Many gyms fail to pre-screen members for heart disease and don't have a written and practiced medical emergency response plan in place, according to a study released today at the American Heart Association's Scientific Sessions 2000.

Both practices are recommended in the 1998 American Heart Association Recommendations for Cardiovascular Screening, Staffing, and Emergency Policies at Health/Fitness Facilities.

"There has been a dramatic change in health club demographics in America, with more than 50 percent of fitness clubs now having a membership base of people over age 35. The fastest-growing health club membership segment is in the over-55 age group," says Kyle J. McInnis, Sc.D., associate professor of exercise physiology at the University of Massachusetts and lead author of the study. "This group is hardly the same as younger healthy people in their 20s, and 30s who typically went to health clubs in the past."

Researchers randomly surveyed 122 fitness clubs in Ohio with more than 110,000 members each. They found that 28 percent failed to conduct pre-entry screenings of members, as recommended by the American Heart Association, to identify cardiovascular problems. Seventeen percent of the clubs reported at least one heart attack or sudden death at their facilities during the past five years.

The screening questionnaire asks such questions as whether a person has had a heart attack, chest pain or dizziness. Participants are directed to contact their personal physician if they answer "yes" to one or more questions.

"Even more worrisome was the low level of emergency preparedness at many of these facilities, which flies in the face of American Heart Association recommendations," says McInnis, who is also director of research at the Rippe Lifestyle Institute in Shrewsbury, Mass.

Ninety-two percent of health clubs in the study failed to conduct quarterly emergency response drills and nearly 60 percent had no written medical emergency response plans available. Eighty-two percent of the health club staffs were unaware of the American Heart Association recommendations, which were published in two medical journals. However, McInnis says his research indicates a need for other methods of distribution to increase awareness and compliance with the recommendations.

"There is a lot more that health clubs can do than simply call 911," says McInnis.

Besides having a written medical emergency response plan, club staff should routinely practice the plan. Staff members should be certified in CPR, know how to recognize and respond to conditions such as chest pain, low blood sugar or dizziness, and have a plan for who stays with the patient until the medical team arrives, he says.

Automated external defibrillators that shock the heart when it is in ventricular fibrillation are becoming increasingly used in heavily trafficked places, such as airports, train stations and shopping malls. Survival is directly linked to the amount of time between the onset of sudden cardiac arrest and defibrillation. Chances of survival are reduced by 7-10 percent with every minute of delay. McInnis says these devices could save lives in gyms as well, enhancing safe exercise.

McInnis was careful to say that the trend toward greater use of gyms by older individuals was by no means something that should be discouraged because exercise does protect the heart. However, he stresses that gyms need to appreciate the increased risk for heart disease and diabetes that goes along with the increased age of their membership base.

"We can make these places safer," he says.
The 1998 screening guidelines are available on the American Heart Association's website at

Co-authors of the study are William Herbert, Ph.D.; David Herbert, J.D.; Jason Herbert, B.A.; Paul Ribisl, Ph.D.; and Barry Franklin, Ph.D.

NR00-1182 (SS2000/McInnis)

American Heart Association

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