Healthy Living: Heat Related Illness & Sports 

By: Dr. Amy MoviusThe summer Olympics are over but for many children and adolescents the next big event is just beginning: preseason training for school sports. Maine is known for its hot and sometimes sticky summers and this one has been no exception. As some kids abruptly increase their exercise with onset of school sports practice it is important to be aware of the potential for climatic heat stress and how this risk can be minimized. Heat related illness occurs when the body has increased heat production (as occurs with exercise), and decreased heat transfer to the environment (uniforms/equipment). It can be fatal. Cramping is often one of the first signs. Heat exhaustion is more severe and happens when the body has lost excessive water and salt. It is characterized by profuse perspiration, cold and pale and clammy skin. Heat stroke is extreme and occurs when the body temperature is so high that cells are damaged. These patients are red and hot, with dry skin and confusion. Measures to decrease body temperature need to be done as soon as any symptoms are recognized.Heat and humidity, two major risk factors for developing heat related illness, are obviously out of our control. Fortunately, there are plenty of other factors that can be optimized to keep children and adolescents safe while exercising under hot and humid conditions. A summary of the AAP recommendations to reduce the chance of child/adolescent athletes from developing heat related illness is as follows:1. Anyone in any type of leadership position involving youth sports should emphasize awareness, education, and implementation of exertional heat illness risk-reduction strategies to staff that oversee and assist with these sports2. There should be capable staff and facilities readily available for treatment of all forms of heat illness.3. Child/Youth athletes should be educated on proper sports preparation, prehydration/hydration, honest reporting of any symptoms, and other issues such as recovery and rest that can reduce their risk of heat stress.4. Athletes should be given opportunity to acclimatize to preseason practice and conditioning in the heat, typically over a 2 week period. There are specific guidelines for American youth football available.5. Appropriate fluids should be readily accessible to athletes and consumed at regular intervals before, during and after exercising.6. Activity should be modified for safety in relation to the degree of heat. This may include lowering intensity, shortening duration, or increasing breaks during sessions. 7. Athletes should avoid or limit participation when currently ill or recovering from illness.8. Staff needs to receive training to monitor athletes for signs and symptoms of heat illness and stop participation of any individual they are suspicious may have any such signs or symptoms. They should be treated immediately and not return to practice/game/session that day.9. An emergency action plan should be clearly in place.10. There should be at least 2 hours of rest between separate events occurring on the same day.11. In extreme conditions, sessions should be canceled or rescheduled.For more information on heat related illnesses, please consider the references below.1. Climatic Heat Stress and Exercising Children and Adolescents. Council On Sports Medicine and Fitness and Council on School Health Pediatrics 2011: 128:e7412. Luke et al. Heat Injury Prevention Practices in High School Football. Clin J Sport Med. 2007:17(6):488-4933. Jardine. Heat Illness and Heat Stroke. Pediatrics in Review 2007:28:249-2584. – Heat Related Illness