Protection of Children from Injury Due to Cold Weather
INDIANA CHAPTER OF THE AMERICAN ACADEMY OF PEDIATRICS

Introduction: Children are more prone to develop hypothermia (lowered body temperature) when the body’s rate of heat loss is greater than the rate of producing heat. Children also have a relatively larger body surface area that contributes to more rapid heat loss. Also, 50% -60% of the body’s heat loss may take place from the head and hands. Hypothermia is present when the core body temperature drops below 35 degrees Centigrade. Early symptoms of hypothermia include shivering, euphoria and possibly the appearance of intoxication. Some specific diseases or conditions including seizure disorders and sickle cell anemia are associated with impaired thermoregulation. Some medications may also affect the body’s ability to tolerate cold weather.

Wind-chill factor: The effective temperature is the air temperature multiplied by the wind velocity, commonly known as the wind-chill factor. The danger zone (shaded area on the Wind Chill Chart below) shows weather conditions that increase chances for hypothermia and frostbite, including time periods of exposure. Conditions in the shaded zone make it dangerous for doing exercise outdoors. Immersion in water or wearing wet clothing create even more dangerous conditions due to increased conductive loss of heat. Also children cool more rapidly than adults due to their relatively greater surface area to body mass ratio.

Protection from cold weather and its effects: Appropriate amounts and types of clothing are the most important method of providing protection from cold-related injury. This includes layering of clothes to provide insulation and conserve body heat, and a warm head covering, gloves or mittens, and warm socks inside boots or heavy shoes to prevent heat loss from the head, hands and feet.

School policies regarding cold weather: School systems must be flexible in making decisions about the extent of childhood exposure to low temperatures. Although ideally children can wear enough clothing to provide adequate protection from very cold temperatures and wind-chill factors, students frequently do not take care to dress warmly enough to provide adequate protection. It is not unusual to see students without hats and gloves, and with coats unbuttoned despite the cold weather. Because of this unreliability of childhood behavior, school systems must take extra caution and lean toward the side of safety for all children (poorly-dressed or otherwise) in cold-weather situations. There is no inherent value to having children go outdoors for school activities or recess in very cold weather, thus indoor activities are a preferable substitute. Waiting for busses is also a consideration, as brief cold exposures in very cold weather can be harmful (resulting in hypothermia) and unpredictable events may happen (bus breaks down) greatly extending the time of exposure to the cold. School policies should take into account such unforeseen circumstances in their decision-making.

Statement developed by Graves, MD and Nancy Slater, MD, 1995, revised in 2004
(Cold Injury Protection-IAAP)
References: Pediatric Clinics of North America, October 1990, Sports Medicine
Clinics in Sports Medicine, April 1992, Environmental and Thermal Injury

Note: This chart is not specific to children. However it appears that a wind-chill factor below minus ten (–10) degrees would work as a parameter to use for children to avoid cold injury.