Assessing 7-year heat-stress exposures and adaptation strategies for children using a real-time monitoring network in Taiwan.

Wet-bulb globe temperature (WBGT) serves as a suitable heat-stress indicator not only for outdoor workers but also for the general public. However, studies on WBGT exposure among the general population are scarce. This research represents the first attempt to assess WBGT exposure of school-aged children. Utilizing a real-time monitoring network in Taiwan, WBGT exposure of school-aged children (7-15 years) were estimated during May to October from 2016 to 2022. Important determinants and spatiotemporal variability of WBGT levels were explored, with hot spots and peak hours of WBGT identified. Macro- and micro-scale adaptation strategies applicable at schools were also evaluated for their effectiveness in reducing heat stress for students. Results showed that the mean daily maximum WBGT (WBGTmax) was 33.1 ± 3.8 °C at 20 stations across Taiwan but could reach/exceed 36 °C (threshold of the dangerous category) at certain hot spots for 42.3-52.0 % of days between May and October. Local geographic features sometimes outweigh the latitude in explaining the spatial variations. Contrary to temperature, WBGT peaked during 10 am to noon rather than from noon to 1:59 pm in most schools, due to clouds blocking solar radiation in the afternoon. This finding has significant implications for scheduling outdoor physical classes/activities to reduce children's heat-health risks. Setting up on-site WBGT monitoring on surfaces that children mostly encounter at schools or utilizing data from nearby weather stations could provide a near real-time heat-health warning. Moreover, providing shades outdoors, relocating outdoor classes indoors, and using air-conditioning would reduce WBGT by 2.1-5.8, 3.7-7.3, and 2.5-5.9 °C, respectively; and would significantly decrease the percentages of WBGT ≥34 °C, which is associated with increased heat-related emergency visits among children in Taiwan. The methodology applied serves as a useful reference for assessing WBGT exposure and adaptation strategies, providing the scientific foundation for heat-health adaptation measures.