‘Heat-Smart’ schools during physical education (PE) activities: Developing a policy to protect students from extreme heat

Abstract

National and state surveys of school sun protection policies and practices demonstrate that being a member of a SunSmart Program improves sun protection practices in primary schools, often lead by Health and Physical Education (HPE) teachers. Australia’s major Sunsmart program implemented in primary schools has largely focused on limiting children’s exposure to ultraviolet radiation (UVR) to reduce the risk of developing skin cancer later in life. Yet another major hazard during outdoor physical education activities is the impact of extreme heat on school students. With physical education (PE) often occurring in hot environments and involving higher intensities (and heart rates), exposure to heat influences are raised. This research reports on a social-ecological model (SEM) review and text mining analysis of key heat protection policies and practices for the development of a five stage Heat Smart action plan in schools. The five stage action plan of Heat Smart strategies can be used to counteract extreme heat exposure during PE and ensure school students continue to meet key national physical activity and curricular objectives. Introduction It has been demonstrated from state and national evaluation surveys that being involved in Cancer Council’s SunSmart Program can enhance sun protective practices (hats, sunscreen, shade & sunglasses) across Australian primary school settings (Sharplin, Smith & Roth, 2013). Yet another potential weather risk to primary school students is exposure to extreme heat, especially within the ‘outdoor discipline’ of physical education (PE). Although there are guidelines and ‘tips’ for a number of Australian states from organisations such as Sports Medicine Australia (SMA) and the Cancer Council itself (an emphasis on skin cancer prevention) around the protection of students from heat-related influences in schools, broader investigation into heat protective practices in schools is warranted. Exposure to extreme heat can negatively influence students in alternative ways via cardiovascular, thermoregulation, discomfort, cognitive and hydration impairments (McArdle, Katch & Katch, 2006; Tatterson, Hahn, Martini & Febbraio, 2000; Nadel, Cafarelli, Roberts & Wenger, 1979; González-Alonso et al., 1999). If exposure to extreme heat is left untreated or protected, this can lead to severe heat illness, rashes, cramps, exhaustion and heat stroke (Bergeron, McLeod & Coyle, 2007; Cooper, Ferrara & Broglio, 2006; Glazer, 2005; Howe & Boden, 2007). Health and Physical Education (HPE) teachers are the most likely staff within education settings to encourage and administer weather protective practices and programs (Sharplin, Smith & Roth, 2013) due to the outdoor nature of the discipline. As students can have reduced physical activity 57 Learning Communities | Special Issue: 2017 30th AChPER International Conference | Number 21 – November 2017 levels above just 22 degrees (Remmers et al., 2017), ensuring school students are adequately protected from extreme heat during PE has the potential to be a key strategy to improve students’ physical activity engagement. In Australia there is a distinct need to consider a range of physical activity participation strategies with just 19% of students meeting the national physical activity guidelines (Active Healthy Kids Australia, 2016). Literature review In the United States, emergency department admissions over a decade between 1997 and 2006 revealed that children were the most reported age group to hospital with exertional heat influence, largely from physical activity and sport participation (Nelson, Collins, Comstock & Mckenzie, 2011). Statistics from Japan’s Sporting Council have also revealed that accidental death due to heat stroke has occurred on 133 occasions during school hours between 1975 and 2009 from sports such as rugby, baseball, football, kendo, judo, mountaineering and track and field (Hatori, 2013). Previously, it was recognised that students were much more likely to be negatively influenced by the heat than adults due to different physiological makeup with larger surface-to-body heat absorbing ratio, less ability to sweat and a higher level of metabolic heat production. Although recent findings have contrasted children’s susceptibility to heat, deeming such assertions as inconclusive (Somboonwong, Sanguanrungsirikul & Pitayanon, 2012). The increased prevalence and susceptibility of students to illness from heat exposure can be attributed to more behavioural influences, including not receiving adequate hydration during physical activity participation (Decher et al., 2008). It has been reported that students often reach dehydration in hot climates by not hydrating effectively (Somboonwong et al., 2012) and students who are not hydrated suffer from impaired concentration, cognition and ability to remember content (Benton & Burgess, 2009). With PE often occurring in hot environments and involving higher intensity (and heart rates), an exposure to heat influences in schools is raised (Doecke, 1992; Somboonwong et al., 2012). In 1992, Doecke reported that the incidence of heat illness across 17 Australian secondary schools in a tropical climate (for example, sun burn, headache, nausea, dehydration) spiked during the humid, wet season months between October (build up to monsoonal weather) and March (end of the monsoon season). Climates of extreme heat can result in students appearing ‘listless’ or ‘restless’, complain about the heat/humidity and voice negative feelings about physical activity throughout a school year (Doecke, 1992). It has also been established that temperatures above 20-24 degrees Celsius and humidity levels beyond 50% significantly impair student learning (Earthman, 2002). Moreover, higher temperatures can slow the acquisition and retention of information received by individuals (Batra & Garg, 2005). This level of heat exposure is further reinforced by a mandatory requirement in many jurisdictions of at least 100-150 minutes of PE each week (Education & Training Victoria, 2017; Department of Education Western Australia, 2013; Education & Training ACT, 2017) for Australian students to learn in, through and about movement (Arnold, 1979). The risks associated with extreme heat and heat illness are further confounded with predictions of an increased occurrence of heat illness from global warming (Bunyavanich, Landrigan, McMichael & Epstein, 2003; Solomon, 2007), especially for those that participate in outdoor PE within tropical climates and during summer heat wave events. A crowded curriculum, geographical location and timetabling considerations can leave exposure to extreme heat during allocated PE time unavoidable (Doecke, 1992). Students have reported having lower enjoyment for school physical activities in hot conditions (Hyndman & Chancellor, 2015) and during hotter months across a school year (Hyndman, Chancellor & Lester, 2015; Hyndman, 2017). Another major concern for PE is that SMA (20072011) advises that physical activities need to be postponed or cancelled when the ‘wet bulb 58 ‘Heat-Smart’ schools during physical education (PE) activities: Developing a policy to protect students from extreme heat Brendon Hyndman globe index’ (a combination of temperature & humidity readings) reaches a level of 30 and above. Shannon and colleagues (2009) discovered that in tropical areas such as Darwin, the average wet globe bulb temperature (WGBT) exceeds 30 all year round, which would suggest from the SMA index that no physical activity should be undertaken in such climates (other than swimming). With over one million Australians living in the tropical climate of Northern Australia (Australian Government, 2015) and no formal heat protection policy for Australian schools, a national school-based ‘Heat Smart’ program based upon strategies identified within the present study can be highly beneficial. The aim of this research is to therefore review and identify key heat protection practices for the development of a Heat Smart action plan for schools to increase and protect students’ engagement in PE activities during extreme heat.