Heat Stress & Exercise

HEAT STRESS/ILLNESS IN EXERCISING CHILDREN AND ADOLESCENTS

Heat induced illness in young children and adolescents is preventable. Exertional Heatstroke is the leading cause of preventable death in high school athletes.

Heat induced illness as a result of exercise or physical activity presents in a wide spectrum of ways ranging from muscle cramps, and heat exhaustion symptoms of weakness, dizziness, headache, nausea, syncope and increased core body temperature (but less than 104F) to those of severe heat stroke with delirium, tremors, coma, circulatory collapse and body temperatures above 104F and subsequent death from multiple organ failure seen with heat injury. Certain factors and pre-existing conditions may increase a young athlete’s risk for such illness:

 

TABLE OF RISK FACTORSHeatStressTable1

Heat Stress Table

However it should be pointed out that it’s extremely difficult apply appropriate universal measures to maintain safety for all athletes while “sensibly allowing sports participation and other physical activities to continue.” General recommendations made my The American Academy of Pediatrics (listed fully in an article link below) include:

–   Allowance of a graduated acclimatization over 10-14 days to adapt to preseason practice and conditioning in the heat with respect to duration and intensity of activity.

–   Sufficient, sanitary and appropriate fluid intake before during and after activity to maintain adequate hydration with water adding electrolyte supplemented liquids when activity duration exceeds 1 hour or repeat same day exercises occur in hot environments, while avoiding over drinking.

–   Consider pre and post daily activity weight checks

–   Avoiding or limiting athletes from exercise with current or recent illness or in the recovery phase.

–   Modifying exercise activity durations or intensity in relation to degree of environmental heat stress from air temp, humidity or solar radiation as indicated by heat index.

–   Immediate cessation from exercise and further evaluation of any athlete exhibiting deterioration in performance, mental state, or changes in personality and other complaints such as dizziness, headache, vomiting pallor, flushing, fatigue or feeling cold amongst others.

–   Emergency Action Plan Protocols for Staff to address severe condition of heat related condition which should include:

Whole Body Cooling if suspecting body temp 104F or more (ice packs to neck, arm pits, groin areas and rotating ice water soaked towels to areas of body) until temp decreases or improvement is noted.  Removal of any protective equipment and/or tight fitting clothing, especially rubbery garments. If alert enough, push oral fluids.

–   Adequate rest and recovery periods of at least 2 hours between same day contests during warm weather and, rescheduling activities in extreme heat/humidity conditions.

HEAT ACCLIMATIZATION AND HEAT ILLNESS PREVENTION POSITION STATEMENT (National Federation of State H.S. Associations)