Most episodes of heat-related illness in youngsters can be prevented by preparation, attention to modifiable risks, and appropriate monitoring, according to recommendations from the American Academy of Pediatrics (AAP).
Recent studies have shown that children are no more susceptible to heat-related health conditions than are adults.
As a result of the newer evidence, most strategies to reduce heat-related illness in adults apply to children as well, Michael F. Bergeron of the University of South Dakota in Sioux Falls and coauthors wrote in a policy statement published online in the journal Pediatrics.
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In addition to poor hydration, the principal determinants of heat illness in youths include "undue physical exertion, insufficient recovery between repeated exercise bouts or closely scheduled same-day training sessions or rounds of sports competition, and inappropriately wearing clothing, uniforms, and protective equipment that play a role in excessive heat retention."
Given the current lack of field evidence to guide optimal decision-making, responsible adults and organization "should always emphasize and use suitable prevention strategies, to the best of their ability, to improve safety and appropriately minimize the risk of exertional heat illness for all children and adolescents during exercise," the authors wrote in their introduction.
In the policy statement, the AAP offers 11 recommendations to minimize the risk of heat-related illness in children and adolescents. Throughout the statement, the authors emphasize the need for awareness and education.
The recommendations include:
Have trained personnel and facilities to respond quickly to heat illness at all youth sports activities or vigorous exercise
Graduated exposure to physical activity in the heat to ensure appropriate and progressive acclimatization
Ready access to appropriate fluids and consumption at regular intervals before, during, and after activities
Modification of physical activity in response to environmental heat stress (air temperature, humidity, and solar radiation)
Training for supervisory staff to facilitate quick and appropriate response to symptoms of heat illness
Development of an emergency action plan with clearly defined written protocols
Allow for adequate rest and recovery (two hours or more between same-day contests or activities)
Cancel or reschedule activities, if necessary, during high-risk environmental conditions
"In conditions of extreme heat or humidity when children or adolescents can no longer maintain thermal balance, safety should be the priority," the authors wrote.
The policy statement includes definitions and symptoms of different types of heat illness. The publication also includes a table that summarizes risk factors for heat-related illness in children and adolescents and actions that can be taken to reduce the risk.
The AAP developed the policy statement at a time when heat-related illness and death have attracted national attention. Within the past two weeks, three high-school football players and a football coach have died of heat illness.
Moreover, Bergeron coauthored a recent study of heat-related deaths in football and found that the rate has increased since the mid-1990s.