September 01, 2011
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AAP council offers tips to beat heat-related illness

Council on sports medicine and fitness and council on school health. Pediatrics. 2011;doi:10.1542/peds.2011-1664.

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Proper monitoring and preparation are both key elements to preventing heat-related illness, according to a policy statement from the American Academy of Pediatrics.

As children return to school and school sports, the AAP recognizes that regular physical activity is a significant part in enhancing and maintaining health, according to the policy statement. However, the authors of the statement said special consideration, preparation, modifications and monitoring are needed when children and adolescents engage in sports or other vigorous physical activities in warm to hot weather.

“Researchers have previously suggested that children are less effective in regulating body temperature, incur greater cardiovascular strain, and have lower exercise tolerance during exercise in the heat compared with adults,” according to the statement. “However, more recent studies, in which both groups were exposed to equal relative intensity exercise workloads and environmental conditions while minimizing dehydration, have compared 9- to 12-year-old boys and girls to similarly fit and heat-acclimatized adults. These newer findings indicate that children and adults have similar rectal and skin temperatures, cardiovascular responses, and exercise-tolerance time during exercise in the heat. Accordingly, modifiable evidence-based determinants of exertional heat-illness risk in youth should be the focus of prevention measures.”

In the statement, Michael F. Bergeron, PhD, and colleagues of the AAP’s Council on Sports Medicine and Fitness and Council on School Health offered several recommendations to minimize heat-related illness, including:

  • Creating awareness of heat-illness risk-reduction strategies.
  • Educating students about adequately hydrating.
  • Emphasizing adequate rest.
  • Emphasizing progressive acclimation to sport participants.
  • Preparing emergency plans.
  • Emphasizing prevention strategies, including training for supervisory staff for quick responses to heat illness.
  • Rescheduling activities, if necessary, during high-risk environmental conditions.

The policy statement also defines differing types of heat illness, including heat exhaustion, which they defined as “moderate heat illness, characterized by the inability to maintain blood pressure and sustain adequate cardiac output,” exertional heat stroke, and heat injury, which they defined as “profound damage to the brain, heart, liver, kidneys, intestine, spleen, or muscle induced by excessive sustained core body temperature.”

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