AUSactive, Australia’s organisation for exercise and active health, has teamed up with Royal Life Saving and SPASA to develop a position statement regarding cold water immersion therapy (CWI).
CWI has experienced a surge in popularity in recent years, due to claims of health benefits ranging from immune system support to tumour suppression and body fat reduction. However, without proper preparations and precautions, CWI can pose risks to participants. As a result, AUSactive, Royal Life Saving and SPASA have created an eight-step approach to equip individuals and businesses with essential safety considerations and practical advice.
The eight-steps are as follows:
- Screening and assessment: Participants should undergo a pre-activity screening to identify any contraindications or underlying health conditions that might increase their risk during CWI. Those at an elevated risk include pregnant women; individuals with any chronic or serious illness; those who are on certain medications and/or with heart problems, circulatory issues, high blood pressure, autoimmune disorders or increased sensitivity to cold (Raynaud’s disease).
- Informed consent: Participants should receive a comprehensive briefing on the potential risks and benefits of CWI. This information is vital in ensuring participants understand what to expect and the precautions they should take and therefore should obtain medical guidance before commencing CWI activities.
- Preparation and warm up: Participants should be trained to regulate their breathing during CWI to minimise the risks associated with shock response. They should also do an adequate warm-up/down before and after CWI to minimise the risk of hypothermia and injury.
- Acclimatisation: Cold water exposure should begin with shorter durations and gradually progress as the participant's tolerance increases. In the context of cold plunge pools, the neck and head should always remain out of the water.
- Water temperature: The water temperature should be carefully monitored and controlled. It should not be so cold as to cause extreme stress on the body. A temperature range of 10-15°C is generally considered safe for most individuals. Colder temperatures can be used but this increases the risk of extreme stress on the body and appropriate risk reduction steps are strongly advised.
- Risk assessment: A thorough risk assessment should be undertaken, and the outcomes should feed into the organisation’s broader risk management plan and other critical safety systems such as emergency management and supervision planning, where applicable.
- Supervision: In the context of an aquatic facility, a qualified and trained professional, e.g. a lifeguard, should be present at all times to monitor participants, provide guidance and respond to any adverse reactions or incidents. The supervision arrangements should be documented in the facility’s supervision plan.
- Emergency management: Well-established emergency procedures should be in place and regularly practised. The emergency plan should document the roles and responsibilities of those responsible for supervision and response as well as access to rescue equipment, oxygen, defibrillators, thermal blankets and medical support.
AUSactive clarified: “This statement does not provide guidance on cold water swimming, the design or construction of facilities used for CWI, or the systems and equipment used to manage the water quality. However, these areas also warrant careful consideration and seeking out separate expert advice.”
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