- The Washington Times - Sunday, June 9, 2002

What is summer without sunscreen and bug spray? Families can have a safe summer if they take precautions. Fortunately, they don't have to worry too much about sharks lurking in the water.

Highly publicized shark attacks in the United States earned summer 2001 the moniker "the summer of the shark," but the truth is it was just an average season in U.S. coastal waters. A beachgoer is more likely to be killed by a falling coconut than a shark attack, says George Burgess, director of the International Shark Attack File, part of the Florida Museum of Natural History that tracks shark incidents worldwide.

Falling coconuts kill 150 persons a year worldwide, 15 times more than the number of shark fatalities, he says.

"The reality is that on the list of potential dangers encountered in aquatic recreation, sharks are right at the bottom of the list," Mr. Burgess says. International Shark File statistics show that unprovoked shark attacks in 2001 were actually down, from 86 worldwide to 76 last year. Deaths were down, too, from 12 in 2000 to five in 2001. Shark incidents in general have been rising in the past decade, though, mainly due to human population increase and better reporting of shark incidents, he says.

With that in mind, families can go about summer fun being concerned with the basics staying away from searing sun rays, disease-carrying insects and making sure to pay attention to the rules of the pool, beach and bike path.

Following simple tips can go a long way in keeping children out of danger, says Angela Mickalide, program director of the National Safe Kids Campaign.

At the beach

No real reason exists to fear a shark attack, but ocean swimmers can take some precautions to ensure their safety, says Alexia Morgan, assistant director of the International Shark File.

"Don't be afraid," she says, "but do be careful of what is around you."

Ms. Morgan advises swimmers to stay in groups, as sharks are more likely to attack a solitary individual. It is during dawn and dusk, when sharks are most active and looking to feed.

Other tips:

• Do not enter the water if bleeding. Sharks have an acute sense of smell that can detect blood.

• Do not wear shiny jewelry. The reflected light resembles the sheen of fish scales.

• Avoid waters with known sewage and those being used by sport or commercial fishermen, especially if there are signs of bait fishes or feeding activity. Diving seabirds are good indicators of such action.

• Use caution when occupying the area between sandbars or near steep drop-offs these are favorite hangouts for sharks.

Safety rules, of course, are different when swimming in a pool, but these should not be taken lightly just because swimmers are in the back yard rather than the beach, Ms. Mickalide says.

Drowning is the second-leading cause of accidental injury for children and the leading cause of death for children younger than 4, she says.

In 1999, the most recent year for which statistics are available, 927 children under age 14 drowned. Sixty percent of those victims were under age 4, according to National Safe Kids statistics.

"Two-thirds of children who drown in a year do so between May and August," Ms. Mickalide says. "The best intervention is adult supervision. Drownings and near-drownings can happen in a matter of seconds. Most of the time, a child just goes under, which decreases his ability to scream. It just takes less than a minute for a child's mouth and nose to go under water."

Ms. Mickalide urges parents to never leave children unsupervised near a pool, even for a moment. She also says not to rely on swimming lessons or a personal flotation device to substitute for supervision.

The American Academy of Pediatrics says children are not developmentally ready for swim lessons until after age 4, so any water classes taken before that should be seen as fun and not a way to decrease the risk of drowning.

Dr. John Straumanis, a pediatric intensive care physician at the University of Maryland Hospital for Children, says parents and older children can be overconfident in their swimming ability.

"Swimming lessons definitely increase the level of safety in the water," Dr. Straumanis says, "but knowing how to swim does not decrease the risk. Children from elementary school on down should never swim unattended; and even middle school children are not able to process safety."

On a bike

Helmets are the most effective way to prevent a head injury after falling from a skateboard, scooter or bicycle. So why aren't more children wearing them?

Ms. Mickalide estimates that just 15 percent to 25 percent of children are wearing helmets when they ride. That may be why more than 373,000 children under age 14 were treated in hospital emergency rooms for bicycle-related injuries in 2000, according to National Safe Kids statistics.

National Safe Kids recently polled 332 children ages 8 to 12 to find out why they were not wearing helmets. Less than half said they wear a helmet every time they ride.

"They told us they didn't know they were at risk for a brain injury or they didn't know a brain injury was going to be a big deal," Ms. Mickalide says. Nonhelmeted riders are 14 times more likely to be involved in a fatal crash than helmeted riders, she says.

Nearly half of the subjects said they do not wear a helmet because they only ride near home. But Ms. Mickalide says a majority of injuries happen less than a mile from home.

Meanwhile, 19 states and the District have laws mandating that children and teens wear helmets. Enforcing those laws is difficult, however.

"The most compelling reason the children gave to the question, 'What would it take to get you to wear a helmet' was personally knowing someone who was badly hurt," Ms. Mickalide says. "About half said they would if their parents made it a rule."

About 170 children under age 14 are killed in bicycle crashes annually, according to National Safe Kids statistics. The majority of those deaths are due to head injuries, which could be drastically reduced by wearing a helmet, Ms. Mickalide says.

Other safe bicycling tips:

• A helmet should fit comfortably and snugly but not too tightly. It should be level and not rock forward and back or side to side.

• Obey all traffic laws. Ride on the right side of the road, with traffic, not against it. Respect traffic signals and stop at all stop signs.

• Children younger than 10 should be restricted to bike paths. Adult supervision is essential until all the traffic skills and judgment can be learned.

In the woods

The region from Maryland to Maine is the prime area for ticks that carry Lyme disease.

That is why people enjoying outdoor activities in wooded areas should take precautions against tick bites. If a person is bitten by a deer tick carrying the bacteria, he could be exposed to Lyme disease, a potentially debilitating condition, says Chris Malinowski, a spokesman for the Lyme Disease Foundation, a nonprofit advocacy group.

Mr. Malinowski says 18,000 new cases of the disease a record high were reported in 2000, the most recent year for which numbers are available. He estimates, however, that actual Lyme disease cases could be 10 times greater than the reported numbers.

Signs of Lyme disease include a bull's-eye rash around the bite site in some cases. Later symptoms include swollen glands, fever, chills and fatigue, which make Lyme disease difficult to diagnose and often be mistaken for the flu.

If caught early, Lyme disease can be treated with antibiotics.

The best way to prevent Lyme disease is to prevent tick bites, say officials at the Centers for Disease Control. People can do that by:

• Wearing light-colored clothing so ticks can be seen more easily. The immature tick is about the size of a poppy seed; the mature tick, the size of a sesame seed. Ticks tend to migrate toward hidden areas such as the groin, armpit and scalp. Remove clothing and perform tick checks on children and pets after being in the woods.

• Remove leaves and tall grasses nesting spots for ticks from areas around homes and gardens. Discourage plants that attract deer, which attract deer ticks.

• Walk in the center of trails to avoid overhanging bushes and grasses.

• Spray insect repellent containing Deet on clothing and exposed skin or treat clothes with pyrethrin, a substance marketed to kill head lice that also kills ticks on contact. The American Academy of Pediatrics recommends that children should use repellents with no more than 10 percent Deet because the chemical, if absorbed through the skin, can be harmful to youngsters.

In the sun

A growing body of evidence exists that shows the harmful effects of prolonged exposure to the sun. Doctors have been offering advice on sun safety for the better part of a decade, but it will still be many more years before we see the payoff of better sun habits, Dr. Straumanis says.

"People are starting to get there," he says. "Sun sense is better than it used to be especially with infants. But overall, we are not going to see the effects of that until 15 or 20 years from now, when sun damage starts to show up."

The American Cancer Society says 1 million people will be diagnosed with skin cancer this year. About 80 percent of skin cancers, however, could be prevented with sun protection.

The best way to protect children from damaging sun rays is by using a broad spectrum sunscreen with an SPF factor of 15 or more, says Cynthia Jorgensen, a spokeswoman for the CDC's "Choose Your Cover" campaign.

Ms. Jorgensen says many people are still using sunscreen incorrectly.

"An SPF of 15 or higher will give you a good amount of protection," she says, "but many people are using too little. You should put about a palm's worth of sunscreen on 30 minutes before going in the sun. Some people wait until they are turning red, which is too late. Or they go in the water and don't reapply it often enough."

Other sun safety tips:

• Reapply sunscreen every two hours when outdoors, even on cloudy days.

• Look for sunscreens that have both UVA and UVB protection (broad-spectrum coverage).

• Add further sun protection by wearing a wide-brimmed hat and sunglasses.

• Avoid direct sun exposure from 10 a.m. to 4 p.m., when the rays are strongest.

Staying cool

Summer in Washington means heat and humidity, which can lead to heat stroke and dehydration if you are not careful.

The average person loses 2 1/2 quarts of water daily, even when not engaging in stressful physical activity, Dr. Straumanis says. It takes at least eight glasses of water to replace this loss, even more if doing something active such as working or playing sports in the heat.

He says people should drink an additional cup or two of water before exerting themselves. They also should drink water every 20 minutes while they are outside.

The best way to ensure adequate water consumption is to provide it.

"It is critical that children have access to water," Dr. Straumanis says. "If they have access, they will drink it."

Signs of dehydration include increased thirst, a dry mouth and decreased urination, he says.

Dehydration and further heat exposure can lead to the potentially deadly condition of heat stroke, where the body cannot cool itself. Signs of heat stroke include acting disoriented, a quickened pulse and the absence of sweating.

"In heat stroke, the sweat process shuts down," Dr. Straumanis says. "When the body can't cool itself, the person is at extreme risk of brain dysfunction."

While dehydration can be combated by replacing fluids and getting into a cool room, cases of suspected heat stroke need immediate medical attention.

Other tips on beating the heat:

• Do not substitute alcohol for water consumption. Dr. Straumanis says this is a common mistake among concertgoers and boaters. Alcohol is a diuretic and will actually increase the risk of dehydration.

• Never leave children in a car on a hot day, even for a few minutes. About 30 children die in hot cars annually, Ms. Mickalide says.

"Parents simply don't realize how hot a car can get very quickly," she says.

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