HEALTH ALERT: Heat/Air Quality Cautions for Schools

HEALTH ALERT: Heat/Air Quality Cautions for Schools

TO: Superintendent of Schools
FROM: Angela Faherty, Ph.D., Commissioner, and Dora Anne Mills, MD, MPH, Director, Maine CDC
DATE: September 1, 2010
SUBJECT: HEALTH ALERT: Heat/Air Quality Cautions for Schools

Summary: The Maine Center for Disease Control and Prevention (Maine CDC) and the Maine Department of Education advise extreme caution regarding school activities and high heat.

*** Please share this with Athletic Directors and School Nurses, as well as others.

Maine is expected to see high heat, increasing humidity, and some of the worst air quality we have seen in several years over the next several days. It is important that schools assure the health of their students and staff in these unhealthy conditions.

High ozone levels, such as what is being seen in Maine, cause people, especially those suffering from a respiratory disease such as asthma or exerting themselves, to experience reduced lung function and irritation. They may have shortness of breath, coughing, throat irritation, and/or experience an uncomfortable sensation in their chest.

The impact of the heat and humidity is measured by the Heat Index (HI), which provides a measurement of what the conditions feel like (in the shade), analogous to the wind chill factor (see Heat Index Chart at http://www.weather.gov/om/heat/index.shtml ). Heat kills more people in the United States than any other weather-related event, and New England has some of the highest mortality rates associated with heat events.

Children and those with underlying conditions (such as obesity, physical immobility, asthma, diabetes, heart disease, and mental illness) are very susceptible to the ill effects of prolonged heat and humidity. Getting susceptible people to air conditioned space is the single most important strategy to prevent heat illness when high heat and humid conditions are expected for three days or more. Other strategies to keep them cool, hydrated, and lying low are also effective in reducing heat illness.

What schools can do:

Monitor zip code specific weather forecasts and advisories (including heat index) by checking the National Weather Service at: http://www.erh.noaa.gov/er/car/ .

When the Heat Index is 90 to 95:

Reduce the intensity of physical activity lasting more than 15 minutes;
Require student athletes to take fluid breaks before practice and every 15 – 60 minutes during practice – even if they are not thirsty;
Require student athletes to take regular shade and rest breaks;
Encourage them to take additional rest and fluid breaks ANY time they feel the need to do so; and
Recognize that even conditioned athletes may be more susceptible to heat stroke because they have a larger body mass.

When the Heat Index is 95 or higher:

All physical activities lasting more than 15 minutes should be cancelled.

Recognize signs of heat illness and dehydration in children. Dehydration early on can present as: dry or sticky mouth, thirst, headache, dizziness, cramps, excessive fatigue.
Schools are advised to consider cancellation based on the heat index inside the building. While there is no formal State or Department policy on closing school buildings due to heat, you may wish to reference the State of Maine policy for closing State buildings due to heat, which can be found at this link: http://www.maine.gov/education/statebuildingsheatstresspolicy.html

For questions on the health issues above, school officials may refer to:
Maine CDC’s website on heat http://www.maine.gov/dhhs/boh/heat/index.shtml or call the Maine CDC’s 24x7 consultation line at 1-800-821-5821
American Academy of Pediatrics Policy Statement: http://aappolicy.aappublications.org/cgi/content/full/pediatrics;106/1/158
National Athletic Trainers’ Association:
http://www.nata.org/health-issues/heat-illness

Mayo Clinic:
http://www.mayoclinic.com/health/dehydration/SM00037