Children's thermoregulation during exercise in the heat: a revisit.

The review revisits some child-adult differences relevant to thermoregulation and offers alternatives to accepted interpretations. Morphologically, children have a higher body surface area to mass ratio -- a major factor in "dry" heat dissipation and effective sweat evaporation. Locomotion-wise, children are less economical than adults, producing more heat per unit body mass. Additionally, children need to divert a greater proportion of their cardiac output to the skin under heat stress. Thus, a larger proportion of their cardiac output is shunted away from the body's core and working muscles -- particularly in hot conditions. Finally, under all environmental conditions and allometric comparisons, children's sweating rates are lower than those of adults. The differences appear to suggest thermoregulatory inferiority, but no epidemiological data show higher heat-injury rates in children, even during heat waves. We suggest that children employ a different thermoregulatory strategy. In extreme temperatures, they may indeed be more vulnerable, but under most ambient conditions they are not necessarily inferior to adults. Children rely more on dry heat dissipation by their larger relative skin surface area than on evaporative heat loss. This also enables them to evaporate sweat more efficiently with the added bonus of conserving water better than adults.