Pediatricians call for stricter controls of all-terrain vehicles
Written by Priscilla Ring
The U.S. Consumer Product Safety Commission (CPSC) proposed a weak solution in June that would formally adopt the voluntary industry standards currently in place regarding all-terrain vehicles (ATVs) that do little, if anything, to reduce child injury and death from ATV crashes. The Academy considers the proposal to be a missed opportunity for the agency.
“The CPSC ATV Safety Review represents a fundamental lack of leadership for keeping out nation’s children safe,” said AAP President Eileen M. Ouellette, M.D., J.D., FAAP. “Over the past 20 years the CPSC has passed up multiple opportunities to address the rising rates of ATV injuries and deaths among children. As a result, we have an inconsistent regulation that will not protect children from the grave risks of ATV riding.”
Between 1982 and 2004, more than 2,000 children were killed in ATV crashes. One hundred thirty children died and 44,700 were sent to emergency departments in 2004 because of ATV-related crashes.
Mary Aitken, M.D., M.P.H., FAAP, a member of the AAP Section of Injury and Poison Prevention, testified June 6 before the U.S. Senate Commerce Subcommittee on Consumer Affairs, Product Safety and Insurance regarding the continuing safety problems associated with children and ATVs. Dr. Aitken testified to her experience as a practicing pediatrician in Arkansas, a rural state where ATV use is very common. She emphasized the need to support meaningful restrictions on children riding or operating ATVs.
“If no further action occurs this year, we can expect over 100 children to die and over 40,000 to be treated in emergency rooms again next year due to ATV-related incidents alone,” said Dr. Aitken.
Dr. Aitken offered the Academy’s recommendations, which include:
- Children younger than 16 years should not operate ATVs.
- A driver’s license should be required to operate an ATV.
- Appropriate protective gear should be required to operate an ATV.
- Manufacturers should redesign ATVs to improve safety, including but not limited to installing safety belts and requiring that all vehicles have a roll bar to prevent the driver from being crushed by the weight of the vehicle in the event of a rollover.
Despite the grave risks of ATV riding for children, strong government regulation continues to be absent. The proposed CPSC changes do not include any of the Academy’s ATV policy recommendations, and as a result they are expected to have little, if any, impact on ATV-related injuries or deaths among children.
At press time, the CPSC commissioners had not yet voted on the proposed standards. For more information on ATVs and AAP-related action, contact Cindy Pellegrini, in the AAP Department of Federal Affairs, at 800-336-5475, ext. 3007.
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Use of DEET on children
AAP Committee on Environmental Health
Insect repellents containing DEET (N, N-diethyl-m-toluamide, also know as N, N-diethyl-3-methyl-benzamide) with concentration of 10% appear to be as safe as products with a concentration of 30% when used according to the directions on the product labels. DEET is not recommended for use on children under 2 months of age.
DEET-containing products are the most effective mosquito repellents available. DEET also is effective as a repellent against a variety of other insects, including ticks. It should be used when there is a need to prevent insect-borne disease.
The concentration of DEET in products may range from less that 10% to over 30%. The efficacy of DEET plateaus at a concentration of 30%, the maximum concentration currently recommended for infants and children. The major difference in the efficacy of products relates to their duration of action. Products with concentrations around 10% are effective for periods of approximately two hours. As the concentration of DEET increases, the duration of activity increases; for example, a concentration of about 24% has been shown to provide an average of five hours of protection.
The safety of DEET does not appear to relate to differences in these concentrations. A prudent approach would be to select the lowest concentration effective for the amount of time spent outdoors. It is generally agreed that DEET should not be applied more than once a day.
There are no specific data on the skin absorption of DEET as a function of age. However, data on skin absorption of similar substances suggest that absorption through the skin would not differ after an infant has reached a month or two of age.
DEET should not be used in a product that combines the repellent with a sunscreen. Sunscreens often are applied repeatedly because they can be washed off. DEET is not water-soluble and will last up to eight hours. Repeated application may increase the potential toxic effects of DEET.
Other precautions:
- Apply DEET sparingly on exposed skin; do not use under clothing.
- Do not use DEET on the hands of young children; avoid applying to areas around the eyes and mouth.
- Do not use DEET over cuts, wounds, or irritated skin, Wash treated skin with soap and water after returning indoors; wash treated clothing.
- Avoid spraying in enclosed areas; do not use DEET near food.
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Thousands of kids injured by fireworks each year
Written by Jeff Stone
On the Fourth of July, thousands of people will end up in the emergency department with fireworks-related injuries. While some injuries will be minor, others can result in blindness or death.
Regardless of annual warnings about the dangers of letting kids use fireworks, many of those injured will be children.
According to 2002 data from the U.S. Consumer Product Safety Commission (CPSC), about 8,800 Americans were treated for fireworks-related injuries at emergency departments; half of these injuries occurred in children under 15 years. A closer look at these injuries showed:
About 5,700 of the 8,800 injuries occurred between June 21 and July 21.
- The body parts most frequently injured were hands (about 1,800 emergency department visits), eyes (1,200 visits) and the head/face/ear region (1,000 visits).
- About three times as many males were injured as females.
- Sparklers accounted for about half the injuries to children under 5 years. Sparklers injured children ages 5 to 14 years old more frequently that any other fireworks device.
The CPSC reminds parents that while sparklers may seem “innocent”, they can cause serious injury. Sparklers burn at up to 2,000 degrees Fahrenheit and a stray spark can cause permanent eye damage.
The American Academy of Pediatrics supports a ban on the private use of fireworks. Instead, families should attend public fireworks displays, which pose less of a danger.
Recognizing that people will continue to use fireworks until bans are established, the CPSC and the National Council on Fireworks Safety recommend taking the following safety precautions:
- Never allow children to touch fireworks of any kind, including sparklers.
- Always have an adult present.
- Read and follow label directions.
- Never throw or point fireworks at other people.
- Never shoot fireworks in metal or glass containers.
- Buy only from reliable sellers.
- Only use fireworks outdoors and always have water accessible.
- Light only one firework at a time.
- Never re-light a “dud” firework. Instead, wait 15 to 20 minutes and then soak it in a bucket of water.
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Skin wound do’s and don’ts
Written by John Tsarouchas
Despite your efforts to protect you children from injury, accidents happen.
Cuts, bruises, and burns to your child’s skin can be an inevitable part of childhood. Knowing how to treat skin wounds properly is important to fight off infection.
The American Academy of Pediatrics offers the following advice for treating your child’s skin wounds.
Burns and scalds
- Remove the child from contact with the hot object or hot water.
- Remove clothing around the burned area, unless it is firmly stuck to the skin.
- Run cool water over the burned skin until pain stops.
- Do not apply ice, butter, grease, medications or any other ointments to burns.
- Do not break any blisters that form.
- For large or deep burns, call 911 or an emergency number. After stopping and cooling the burn, keep the child warm with a clean sheet and blanket.
- For electrical burns, disconnect the power. Do not touch the victim with your bare hands; pull the victim away from the power source with a wooden pole. See a physician for all electrical burns.
Bruises
- Apply cold compresses.
- Call the pediatrician if the child has a crush injury, large bruises, continued pain or swelling
Cuts
- Wash small cuts with water until clean and apply pressure to stop the bleeding.
- Apply an antibiotic ointment and cover with a clean bandage.
- For large, deep or gaping cuts, call the pediatrician because stitches may be required.
Scrapes
- Rinse scrapes with an antiseptic soap and water to remove dirt and germs. Do not use detergents, alcohol or peroxide.
- Apply an antibiotic ointment and a bandage that will not stick to the wound.
Splinters
- Remove small splinters with tweezers. Wash and clean the area with an antiseptic.
- Call the pediatrician for splinters that you are unable to remove completely.
Puncture wounds
- Do not remove large objects such as sticks and knives from puncture wounds. Instead, call for emergency medical assistance.
- Call the pediatrician for all puncture wounds.
For all open skin wounds, ask the pediatrician whether the child needs a tetanus booster.
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