- Copyright © 2011, The American Academy of Pediatrics
Preventing heat stress
Children regulate body temperature, tolerate exercise in the heat as well as adults, says AAP policy
- Robert Musinski, Correspondent
When playing outdoors on a hot day, children usually figure out when to go inside and cool down.
But when kids play multiple games in dangerously hot, humid conditions at a soccer tournament or when they’re melting under heavy pads at a preseason football practice, adults run the show.
The newest AAP policy statement about heat stress directs adults to keep young athletes out of danger by using common sense.
“Adults who engage children in sports activities sometimes create situations that are potentially dangerous but entirely preventable,” said Stephen G. Rice, M.D., Ph.D., FAAP, co-author of the policy statement Climatic Heat Stress and the Exercising Child and Adolescent (http://pediatrics.aappublications.org/cgi/doi/10.1542/peds.2011-1664).
For example, Dr. Rice witnessed a soccer team that had to play five games on a brutally hot day, with only a 15-minute break between the last two games.
“This paper is really saying that you have to know better,” said Dr. Rice, former member of the AAP Council on Sports Medicine and Fitness Executive Committee. “It’s your responsibility to care for the well-being of the kids.”
Updated statement, different findings
The previous statement released in 2000 suggested that children were less able to handle the heat and deserved special treatment, even though the authors found little scientific evidence to support that advice.
In this statement, “we take the attention away from any purported disadvantage between kids and adults and put it on what puts kids at risk, and what is modifiable,” said lead author Michael F. Bergeron, Ph.D., director of the National Institute for Health and Performance at Sanford USD Medical Center, Sioux Falls, S.D. “If we do a lot of things right, kids can tolerate environmental extremes.”
Also, unlike the previous statement, this updated one does not provide recommendations on whether games or practices should be canceled if the temperature reaches a certain level.
“You can’t be precise for every person,” Dr. Rice said. “Advice needs to be general.”
Managing risk factors
Exertional heat illness usually is preventable, the authors emphasize, which means adults need to make sure the level of exertion, clothing and equipment, and recovery time are appropriate for young athletes.
The statement makes recommendations aimed at preventing, monitoring and treating heat illness, including:
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providing risk-reduction training for all administrators, coaches and training staff;
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making sure facilities and personnel are available on site to treat all forms of heat illness;
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educating children about heat illness risk factors;
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offering time for sufficient fluid intake before, during and after all physical activities;
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limiting participation if an athlete is ill or recovering from an illness; and
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developing an emergency action plan.
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One of the most important recommendations is to provide adequate breaks between periods of physical exertion.
Dr. Bergeron recalled a summer tennis tournament in Georgia several years ago in which several young athletes were taken away by ambulance because of severe heat illnesses. The next year, the tournament director asked Dr. Bergeron for advice, and he recommended that organizers provide at least two hours of rest between matches.
The result? No incidents of heat illness.
Giving longer breaks has a huge influence on a child’s ability to recover from heat stress, Dr. Bergeron said.
The statement is a valuable tool for pediatricians, who play an influential role in educating the public. For example, they can work with local school and park district program administrators to develop prevention and management strategies and be advocates for heat safety, the authors said