AAP Revises Statement on Outdoor Play

ELK GROVE, Ill. — When children participate in sports and other physical activities during hot weather, adults who run these programs must follow certain guidelines, according to the American Academy of Pediatrics.

 

In a revised policy statement titled “Climatic Heat Stress and Exercising Children and Adolescents,” published in the September 2011 issue of Pediatrics, the Academy recommends that youth sports programs implement comprehensive strategies to safeguard against heat illness.

 

“Most healthy children and athletes can safely participate in outdoor sports and activities in a wide range of warm to hot weather, but adults sometimes create situations that are potentially dangerous,” said Dr. Stephen Rice, co-author of the policy statement and a former member of the executive committee of the Academy’s Council on Sports Medicine and Fitness. “Heat illness is entirely preventable if coaches and other adults take some precautions to protect the young athletes.”

 

The recommendations outlined in the statement include providing risk-reduction training for coaches, trainers, and other adults; ensuring trained staff are available on-site to monitor for and promptly treat heat illness; and educating children about preparing for the heat to improve safety and reduce the risk of heat illness.

 

Officials said children should be allowed to gradually adapt to physical activity in the heat and should also be given time and encouragement for sufficient fluid intake before, during, and after exercise.

 

While a previous policy statement in 2000 suggested that children are less able to tolerate and adapt to heat stress than adults, more recent research has determined that children and adults have similar physiological responses when exercising under the same conditions.

 

The revised policy has been updated, recognizing that children can tolerate and adapt to exercise in heat as well as similarly fit adults, as long as adequate hydration is maintained.

 

Although the revised policy describes ways adults can modify youth athletic activities to minimize heat illness risk and also provides a detailed list of risk factors and possible modifications, unlike the previous statement, it does not give precise rules about whether games or practices should be canceled if temperatures reach a certain level.

 

“While coaches should make on-the-field decisions to improve safety for a team or event as a whole, individual participants may require more or less concern based on their health status and conditioning,” said co-author Michael F. Bergeron, a doctor and director of the National Institute for Athletic Health & Performance at Sanford USD Medical Center in Sioux Falls, S.D.

 

The policy statement explains how a healthy 12-year-old who is fit and used to the heat would be fine playing soccer on a 95-degree day, but an overweight football player who has recently recovered from diarrhea and is running wind sprints at the end of the second three-hour workout on the first warm day of preseason football would be at a higher risk of heat-related illness even if it’s only 85 degrees.

 

“Athletic directors, coaches, teachers, and other adults who are overseeing children exercising in the heat should make themselves aware of ways to reduce the risk of heat illness, and they should develop an emergency action plan,” said Dr. Cynthia Devore, co-author of the statement and chairperson of the Academy’s Council on School Health. “This is especially important as we head into high school preseason football.”