Competitive Safeguards and Medical Aspects of Sport (CSMAS)

NCAA increases THC testing threshold

The NCAA Committee on Competitive Safeguards and Medical Aspects of Sports has decided to bump the THC testing threshold for student-athletes from 15 to 35 nanograms per milliliter.

CSMAS recommends drug-testing penalty change

The committee proposed a change to the language of the legislated penalty for use of performance-enhancing drugs.

CSMAS recommends NCAA drug classes reflect worldwide standard

The NCAA’s banned drug classes may soon more closely mirror the prohibited list governing sports organizations around the world.

Air Quality

In September 2018, the NCAA Committee on Competitive Safeguards and Medical Aspects of Sports updated its 2016 guidance related to student-athlete practice and competition activities in poor air quality conditions: This guidance is provided below:

There are three reasons why otherwise healthy athletes are at special risk for inhaling pollutants. First, as physical activity increases minute ventilation, the number of pollutants that are inhaled relative to when the athlete is at rest are increased. Second, during activity, a larger proportion of air is inhaled through the mouth, which bypasses the body’s built-in nasal filtration system. Third, pollutants are inhaled more deeply and may diffuse into the bloodstream more quickly during physical activity. These risks are heightened in athletes with pre-existing pulmonary or cardiac conditions.1

An important and standardized national air quality resource is the National Weather Service’s (NWS) Air Quality Forecast System. This system “provides the US with ozone, particulate matter and other pollutant forecasts with enough accuracy and advance notice to take action to prevent or reduce adverse effects.” (Accessed 7/14/18; ).

A key component of this forecast system is the NWS Air Quality Index (AQI).2The AQI provides real-time monitoring and alerts in response to changing air quality levels. The AQI accounts for five different pollutants, including: 1) ground-level ozone; 2) particle pollution (also known as particulate matter); 3) carbon monoxide; 4) sulfur dioxide; and 5) nitrogen dioxide. Of these, ground-level ozone and particulate matter are the most common and most concerning pollutants for outdoor physical activity. The AQI is a single number, presented on a scale of 0 – 500, where 0 indicated no air quality problems and 500 indicates the most hazardous levels of air pollution. A specialized version of the AQI for particle pollution is also available and should be consulted in those situations when threats to air quality come from wildfires, road dust, and agricultural operations.2

When threatening or dangerous air quality levels are present the AQI increases, and the National Weather Service (NWS) issues a corresponding air quality alert. Those alerts and their corresponding behavioral modification recommendations for particle pollution can be found at

Consistent with this information, the Committee on Competitive Safeguards and Medical Aspects of Sports offers the following general guidance to member institutions trying to make decisions about the appropriateness of practice or competition in degrading air quality situations:

  • Attentive monitoring of local AQI and associated air quality alerts, especially during times of extreme environmental conditions, is recommended. This monitoring is best performed by the primary athletics healthcare providers trained to monitor environmental impacts on student-athlete health and safety. However, schools may choose to delegate this responsibility to another staff member with knowledge and training about environmental monitoring.
  • Member schools should consider shortening or canceling outdoor athletic events (practices and competitions) in accordance with AQI guidance. Exposure should be managed more conservatively for student-athletes with pre-existing pulmonary or cardiac conditions, which may exacerbate the complications of these conditions and lead to an acute medical emergency. Specifically, at an AQI of 100 or higher, schools should consider removing sensitive athletes from outdoor practice or competition venues and should closely monitor all athletes for respiratory difficulty.2 Reduce heavy or prolonged exertion in sensitive individuals.
  • At AQIs of over 150, outdoor activities should be shortened, and exertion should be minimized by decreasing the intensity of activity. Sensitive athletes should be moved indoors.2
  • At AQIs of 200 or above, serious consideration should be given to rescheduling the activity or moving it indoors. Prolonged exposure and heavy exertion should be avoided.2 Avoid all outdoor physical activity for sensitive individuals .
  • At AQIs of 300 or above, outdoor activities should be moved indoors or canceled if indoor activity is not an option.2
  • School emergency action plans should guide the emergency care response in these circumstances, and staff should rehearse the plan at a minimum of once a year.


1. Carlisle AJ, Sharp NC. Exercise and outdoor ambient air pollution. Br J Sports Med. 2001;35(4):214-222.

2. United States Environmental Protection Agency. Air quality guide for particle pollution. 2016; Accessed July 18, 2018.

Health and safety data collection poised to expand

Athletics administrators in all NCAA divisions may soon be able to benchmark their school’s health and safety procedures, staffing levels and other pertinent practices against comparable schools across the country.

Inclement/Hazardous Weather

The NCAA Committee on Competitive Safeguards and Medical Aspects of Sports released the following statement in June 2016 on inclement/hazardous weather for athletics departments.

Inclement weather poses unique challenges to athletics operations, partly because of the seasonal and geographic frequency of such events, and because of the disparate impact on members of the athletics team. Student-athletes, most of whom live on or very close to campus, are impacted differently than coaches, support staff, and athletics administrators, who may live at some distance from campus, and who are, therefore, subject to weather conditions that may be very different than those occurring on campus. They may also have the additional difficulty of a commute.

In recent years, the committee has fielded complaints from athletics support staff who report having to journey to campus during inclement weather to attend practices or other non-competition events, even when the campus has been effectively shut down and classes canceled. These complaints become more pronounced when athletics personnel believe themselves to be exposed to personal risks to attend what are perceived as non-essential activities, and especially for practices and other obligations for sports outside of the traditional season. Consequently, the committee provides member institutions the following guidance for inclement winter weather conditions:

  1. Athletics department personnel must recognize that decisions affecting the broader institutional community also apply to them. Serious consideration should be given to the appropriateness of requiring student-athletes, coaches, and support staff to come to campus when the campus is otherwise closed and classes canceled. Local traffic authorities should be consulted about the safety of local roadways.
  2. Decisions about continued athletics activity should be centrally made, preferably by the athletics director or his/her designee. Coaches should not make such decisions for their own sports in isolation and independent of athletics administrators. Decisions should be made with the ultimate goal of protecting the well-being and safety of all athletics personnel and student-athletes. A full accounting of the disparate impact of inclement weather on athletics personnel and participating student-athletes should be made as part of the decision-making process.
  3. When a decision is made to open athletic or recreational facilities and to conduct athletics activities, standardized steps should be taken to ensure the safe access to those facilities and those parts of campus in which the activities will take place.
  4. Athletics personnel who determine that their personal safety might be jeopardized by commuting to campus in inclement and/or hazardous weather should be excused from all responsibilities without fear of reprisal or punishment, and reasonable accommodations for their absence should be made.

CSMAS supports increasing its student-athletes’ votes

The NCAA’s health and safety committee supported giving each of its student-athlete representatives a vote on the group’s decisions.

CSMAS proposes the expansion of independent medical care

During its meeting June 15-17 in Dallas, the Committee on Competitive Safeguards and Medical Aspects of Sports approved a series of recommendations that build on legislation passed by the NCAA’s five autonomy conferences earlier this year...

CSMAS recommendation empowers medical staffs

The NCAA’s committee responsible for student-athlete health and safety took steps at its summer meeting to better establish medical personnel as authoritative decision-makers in college sports. During its meeting June 15-17 in Dallas, the...

Competitive safeguards finalizes Division II strength and conditioning coach proposal

The committee’s proposal regarding Division II strength and conditioning coach certification has begun making its way through the division’s governance structure.


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