Regional Archives — The Altamont Enterprise, October 6, 2005
Safety beyond the womb
Protecting your children on car rides
By Nicole Fay Barr
Over the past four months, it’s been nearly impossible to concentrate on work.
All I do is think about the tiny baby growing inside me. It’s even harder to focus now that I have my ultrasound picture taped to my computer. My little, blurry, lima-bean shaped child seems to be saying, "How important is the zoning board when I’m here""
So, as I know the zoning board is important to some people, I write. But, I keep thinking of my baby. I wonder if he or she will be a quiet writer like I am or a charming salesman like my husband. I wonder what his or her laugh will sound like and who he or she will resemble.
Then I think of my lack of experience with babies and wonder how I will handle it all. Will I know what my baby’s cry means and what to do"
And, what baby supplies will I need" This weekend we cleaned out a spare bedroom for the baby. But, I only have one thing so far. My best friend, a photographer, sent us a photo album.
Before March, I will have to go shopping and pick out many more supplies. But, how do I know what to select"
This week, I interviewed Roger Dames to help me with one worry — choosing a car seat. I was amazed at how complicated it was, not to choose the seat, but how to properly use it. Dames gave great advice that every parent should follow.
Serious selection
Dames, a retired police officer, is the traffic-safety coordinator for traffic-safety services at the Capital District Bureau of the American Automobile Association. He’s seen many accidents in his career, he said, and he’s passionate about making sure babies and children are properly secure when traveling.
"Seat belts and children really aren’t made for each other," Dames said. "Seat belts are made for adults."
Therefore, he said, safety seats for babies and booster chairs for children are necessary.
Hospitals won’t let new mothers leave with their babies unless they have a federally-approved car seat. Dames told me I have two choices for my baby.
One is an infant carrier. These are small seats with handles that can be taken in and out of the car and used to transport the baby. The downside to these seats, Dames said, is that, after the baby is four to six months old, he or she will outgrow the infant carrier.
The other choice is a convertible car seat, which remains in the car. This can be used for a child weighing up to 100 pounds, Dames said.
Until the baby weighs 20 pounds, the car seat should face the back of the car, Dames said. Facing the back of the car is safer for babies, he said, because, if there is a crash, the plastic shell of the car seat is designed to protect and cushion the baby. The seat reinforces the baby’s neck and spine, he said.
As the baby gets bigger, the car seat can face forward, Dames said. But, he said, it should always be in the middle of the back seat, to give the baby more protection if the car is struck on the sides.
A car seat should never be placed in the front seat of a car, he said.
Every car seat sold in a store now is federally approved, Dames said. The law requires that babies travel in federally-approved car seats.
In March of this year, the state also passed a law requiring that children up to age seven ride in a booster seat.
Dames recommends that children even older than that ride in a booster seat. At a recent AAA safety check, he said, "I put a 12-year-old in a booster seat because she was so tiny and small and brittle."
Five questions should be asked to determine if a child needs a booster seat, Dames said. They are:
— Does the child sit all the way back against the seat in the car"
— Do the child’s knees bend comfortably around the seat"
— Does the seat belt cross the child’s shoulder between his neck and arms"
— When the seat belt is fastened, does it extend across the child’s hips and not his abdomen"
— Can the child stay seated comfortably during the whole trip"
If the answer to any of these questions is "no," Dames said, the child needs a booster seat.
Common mistakes
AAA, as do many local police agencies, offers free checks of car seats to make sure they are being properly used.
On one held on Sept. 24 by AAA Hudson Valley, Dames and another specialist checked 28 cars seats. Of the 28, he said, only two were being used properly.
I was amazed at AAA’s statistics — four out of five child-safety seats are used incorrectly, with an average of three mistakes per seat.
In 2001, nearly 500 children under age five were killed in car crashes. Over 200 of those deaths were of children in car seats designed to save their lives. Also that year, 31,700 children were injured in their car seats.
One of the biggest problems with the car seats is that they are too loose, Dames said. When a seat is properly hooked in, he said, a parent shouldn’t be able to move the car seat more than an inch from side to side.
"It should be cemented in," he said.
Another mistake is that the harness of the car seat is too loose, Dames said. Some parents are afraid of strapping their children in too tightly, he said, but, if they don’t, and an accident occurs, the child can be seriously injured or killed.
Also, he said, the retainer clip, or harness that comes down over a child’s head, should be fastened in the child’s chest area or "armpit to armpit."
Some car seats are equipped with a new system called LATCH (Lower Anchors and Tethers for Children). It’s a system of hooks and clips so the seat can be strapped into the car without using a seat belt, Dames said.
A problem, however, is many parents use the LATCH system and also fasten a seat belt over the car seat, he said. This secures the car seat too much, he said, so, if there is an accident, the seat can’t tilt into a position to protect the child.
Also with the LATCH system, some cars aren’t equipped to accommodate the hooks in the middle of the back seat, Dames said. Parents should read their driver’s manuals first, he said, for information on car-seat installation.
But, he said, neither the LATCH system or using a seat belt across the car seat is more effective than the other.
Rear-facing car seats have to sit at a 45-degree angle, Dames went on, but the seats of many vehicles can’t accommodate this. He suggested parents place Styrofoam under their children’s car seats to position the seats at 45-degree angles.
People also don’t realize that the seat belts and harnesses of car seats are twisted when they fasten them, Dames said. When a parent takes her child out of the car seat, she should fasten the harness, so it doesn’t get tangled, he said.
After I select my car seat, Dames told me, I shouldn’t buy toys or pillows or other accessories that are sold separately. The car seat wasn’t designed to be used with these items and they can interfere with the child’s safety, if an accident occurs, he said.
Also, he said, if it’s still cold in March, I shouldn’t put my baby in a snow suit.
"Nothing should be between the baby’s body and the seat," Dames said.
Rather, he said, I should dress the baby warmly and then cover him or her with blankets or, after the baby is fastened in the seat, put his or her winter coat on backwards.
After speaking to Dames, I now feel confident about driving my baby anywhere, be it Altamont to see friends or Pennsylvania to visit family. I told him I’d visit the AAA safety check next year, so he could tell me my child is perfectly safe.
Making homes safe by taking simple precautions
By Melissa Hale-Spencer
Injuries are killing children, leading to more deaths in our country than all other causes combined, including disease. Many of those injuries happen at home.
"If a disease were killing our young people in the proportion that injuries are," said C. Everett Koop, the former surgeon general, "the public would be outraged and demand that this killer be stopped."
Children cannot be constantly supervised but changes can be made in a household to reduce the chance of injury.
The New York State Department of Health grounds its approach to injury prevention in the perspective that injuries are not "accidents" but can be predicted and therefore can be prevented.
"The tragedy of injury is that most of the resulting deaths, disabilities, and disfigurements need not happen at all," states the health department in "Injury Prevention in New York State," posted on its website. "With injury, there is a direct connection between prevention and outcome....
"Although the greatest cost of injury is in human suffering and loss, the financial cost is staggering as well both in health-care dollars and in losses to society. Despite these great costs, it is only within the past decade that the injury problem has been accorded sufficient national and state attention to make a lasting difference."
Each week, an average of 164 New York residents die from injury and another 3,023 are hospitalized. In one year, hospital charges alone for injuries occurring in New York totaled more than $1.6 billion, according to the health department.
The very young and the very old are particularly vulnerable. Seventy percent of fatal falls occur among persons aged 70 or older. Nonfatal falls among those over 70 are more frequent, more severe, and are increasing each year.
Fire is the leading cause of injury death for children one to four years old. Scalds are the second-leading cause of injury hospitalizations for children under the age of one.
Each year, more than 5,000 New Yorkers are hospitalized due to unintentional poisonings; more than 300 die.
The state’s Department of Health isolated for The Enterprise the top 10 causes of hospitalization due to unintentional injuries occurring in the home, based on the most recent figures available, from 2001 to 2003.
Falls are first, nearly 10 times as frequent as the second-ranked, with a mean annual frequency of 33,729. Second is poisoning, with a frequency of 3,470. Third is scalding at 1,470 and fourth is environmental at 1,187. Fifth is cutting or piercing at 872 and sixth is being struck at 787. Seventh is overexertion at 681 and eighth is fire or flame at 595. Ninth is suffocation at 325 and 10th is injury caused by machinery at 141.
The good news is that simple changes in the home can prevent these injuries from occurring. Advice follows, compiled from the United States Consumer Product Safety Commission, the Centers of Excellence funded by the National Center for Injury Prevention and Control, and the New York State Department of Health.
Window blinds
Window blinds top the "Most Wanted" list put out by the United States Consumer Product Safety Commission.
From 1991 to 2000, the commission received reports of 160 strangulations involving cords on window blinds; 140 strangulations involved the outer pull cords and 20 involved the inner cords that run through the blind slats.
In 1994, the commission worked with the window-covering industry to redesign new window blinds to eliminate the outer loop on the end of the pull cords and provide free repair kits so consumers could fix their existing blinds. Window blinds sold since 1995 no longer have pull cords ending in loops.
In 1999, the commission reviewed the deaths related to window blinds and found that children would also become entangled in the inner cords used to raise the slats of blinds. This happens when a young child pulls on an inner cord and it forms a loop that a child can hang in.
All of these deaths involved children in cribs or playpens placed next to windows. In most cases, the outer pull cords were placed out of reach, but the children still strangled when they pulled on the inner cords of the blinds. The strangulation victims ranged in age from nine months to 17 months.
As a result of the investigation, the industry has further redesigned window blinds; those sole since November of 2000 have attachments on the pull cords so that the inner cords can’t form a loop if pulled by a young child.
Consumers with blinds bought before November of 2000 should repair them. They can call 800-506-4636 for a free repair kit for each set of blinds. The repair kit includes small plastic attachments to prevent inner cords from being pulled loose; the repair can be done in minutes without removing the blind.
Old cribs
Old cribs are also on the commission’s "Most Wanted" list.
The commission advises that there should be no more than two-and-three-eighths of an inch, about the width of a soda can, between crib slats so a baby’s body cannot fit through the slats. There should be no missing or cracked slats.
No corner posts should be over one-sixteenth of an inch high so a baby’s clothing cannot catch.
And, there should be no cut-outs in the headboard or foot board so a baby’s head cannot get trapped.
The crib’s mattress should be firm and tight-fitting, and, to prevent suffocation, there should be no stuffed toys or pillows in the crib.
For mesh-sided cribs or playpens, the mesh openings should be smaller than one-quarter of an inch in size, smaller than the tiny buttons on a baby’s clothing. The mesh should not have tears, holes, or loose threads that could entangle a baby. And the mesh should be securely attached to the top rail and floor plate.
Also, the top rail cover should have no tears or holes and staples should not be missing, loose, or exposed.
Preventing falls
To prevent falls, households with children should have safety gates on stairways.
Window guards are the most effective tool for preventing children’s falls from windows. The New York City Health Department’s "Children Can’t Fly" program reduced window falls by 50 percent.
Infants should never be left unattended on a table, bed, or other elevated surface. And safety straps should be used to secure children in strollers, shopping carts, and infant carriers.
Children should be given only stationary walkers. The number of injuries associated with mobile infant walkers led the American Academy of Pediatrics to call for a ban on their manufacture and sale.
To help avoid falls for any age group, but especially the elderly, handrails should be installed on stairways. And a step-stool and grab bar should be used to reach objects on high shelves.
Common-sense safety
Firearms and bullets should be stored in a locked cabinet or safe when not in use.
Knives and sharp utensils, frequently found in kitchens, should be kept out of reach of children. Knife blades should be pointing down when placed in a dishwasher’s cutlery basket. Safety locks should be installs on drawers that contain sharp or hazardous items.
Shelving, bookcases and heavy furniture should be secured. Heavier items should be placed on lower shelves and in bottom drawers.
Swimming pools should be surrounded by four-sided fences to prevent drowning.
Glass doors should have decals to avoid collision injuries.
Toilet safety locks keep children from falling in and drowning.
Non-skid strips in bathtubs and showers avoid slipping.
Wall outlets should have plug protectors when not in use. And ground-fault interrupters should be installed for electrical circuits in bathrooms and kitchens to avoid electrical shock when in contact with water.
Scalding and burning
To avoid scalding, the thermostat on the hot-water heater should be set no higher than 120 degrees Fahrenheit. It takes just three seconds to sustain a third-degree burn at 140 degrees.
Risk factors for scalds include bath water that is too hot and hot pans and pots on front burners of stoves. Back burners should be used when cooking and pot handles should be turned towards the back of the stove.
Hot foods and liquids should be kept away from children. The vast majority of microwave burns among children are scald burns.
The very old and the very young are at the highest risk for serious burn injuries.
Functional smoke detectors can prevent smoke inhalation deaths. A smoke detector effectively provides early warning of a fire and is the single most cost-effective measure for reducing fire-related injuries and deaths. Working alarms should be installed on each level of the home and they should be tested regularly; batteries should be replaced once a year.
Detectors for the colorless and odorless carbon monoxide also save lives.
Poisons
Locked cabinets should be used to store medicines. Even items that may seem harmless, like nail polish, can be dangerous. Whenever possible, child-resistant packaging should be used.
Toddlers are at the highest risk for poisoning as they learn to walk and explore their surroundings; males are at greater risk than females. Children in this age group are most frequently poisoned by medicines, particularly those containing iron and pain relievers; toxic plants, flowers, and berries; household cleaning products; alcohol, including liquor, cosmetics, and liquid cough and cold medicines; pesticide residues found along baseboards and on rugs.
Poisonous house plants should be kept out of the reach of children. This includes English ivy and philodendron, which can cause skin reactions, diarrhea, vomiting, and convulsions.
About 70 percent of poisonings in New York State are routinely treated safely and effectively over the telephone by trained poison information specialists in the six regional poison control centers.
Proven prevention strategies include: use of child-resistant packaging; proper disposal of old medicines; secure storage of medications, alcohol, and pesticides; education about reading all labels and following directions for property use of chemical products; age-appropriate poison prevention counseling by primary-care providers; and first-aid supplies to combat poisonings.
A list of emergency contacts such as doctors, poison control, fire departments, police, and neighbors should be kept by the phone.
A gardener’s advice on avoiding Lyme disease
By Ellen Zunon
GUILDERLAND — It started out like any other summer evening; after dinner I did my usual hour of gardening, trying to clean the weeds out of one of the flower beds that had been sadly neglected during the last few weeks of rain and sun. Was it that night or the next that I woke up with chills and fever, and muscular aches that made me think I had the flu or a staph infection"
Another 24 hours later, I woke again at 3 a.m., with chills, aches, a fever of close to 102 degrees, and a slowly-growing circular red patch on my left foot. These are, in case you haven’t already guessed, the classic symptoms of Lyme disease.
Lyme disease, you say" Not me.
Not me, who survived 17 years of life in tropical Africa with nary a hint of malaria, yellow fever, or dengue fever. Not me, who hiked the rattle-snake-infested wilds of the Tongue Mountain range near Lake George, and brought home a rattler skin to prove it.
Not me, I thought, to be laid so low by a tiny bug in my own backyard, right here in the suburbs. But somewhere in between the holly and the hardy hibiscus in my perennial bed lurked a nasty little beast that attached itself to my foot long enough to infect me with the bacterium Borrelia burgdorferi, which is the cause of Lyme disease.
You may have heard that deer ticks carry Lyme disease, and this is true. But that’s not the whole story.
Actually, according to the Centers for Disease Control, the Lyme disease bacterium normally lives in the bodies of mice, squirrels, and other small animals. It is transmitted to humans when a tick feeds on an infected animal and then feeds on a human.
So it is not just the deer that eat your shrubbery that help spread the disease, it is also the squirrels that you may toss peanuts to, and the field mice that your cat may catch. Deer do not become infected with the disease, but they are important in trans-porting ticks and maintaining tick populations.
Most cases of Lyme disease can be cured with antibiotics, usually doxycicline or amoxicillin. However, since only 60 to 80 percent of people who have been exposed to Lyme disease develop the characteristic bull’s-eye rash, Lyme disease is often missed or misdiagnosed.
If you develop the other flu-like symptoms — fever, chills, aches, swollen glands — and think you may have been exposed to Lyme disease, even if you don’t have the circular rash, be sure to tell your doctor. He or she may order a blood test to be sure of a diagnosis of Lyme disease.
However, you need to be aware of this: If your exposure was too recent to allow your immune system to produce antibodies to the Lyme disease bacterium, the test may produce a negative result. This is another reason the disease is often missed or misdiagnosed.
In my case, I was actually lucky to notice the red circle beginning to show on my foot, because that’s the real telltale sign of Lyme disease. I never even saw or felt the tick that bit me.
If I hadn’t had the bull’s-eye rash, my doctor might have tested me for any number of other infections, and thus lost time in prescribing the proper treatment.
That would have been very dangerous, because, if left untreated, Lyme disease can have severe and long-term neurological effects. According to the website of the New York State Health Department, these later effects can include severe fatigue, headaches, tingling or numbness in the arms or legs, swelling of the joints, and heart and central nervous-system problems. These problems may not appear until weeks, months, or even years after the initial infection, so it may be difficult to connect them with Lyme disease.
Avoiding ticks
So much for diagnosis and treatment. What about that ounce of prevention I should have used in the first place" Preventive measures I looked into fell into three categories: avoiding ticks, removing ticks, and controlling ticks. In case you haven’t guessed, the key word here is ticks.
I had already been aware of the need to wear long pants, use insect repellent, and stick to the middle of the trail when hiking in tick-infested areas, but honestly — I can’t wear a full-body biohazard suit every time I step out my back door to pull a few weeds. So here are the measures I have decided to use when gardening or doing yard work on my own premises:
— I wear long sleeves, long pants, and socks and sneakers when mowing or gardening. No more weeding in flip-flops! I tuck my pant legs into my socks, especially when stepping into the flower beds to trim or gather plant debris.
— I use insect repellent with Deet on exposed skin (but not near my eyes or mouth, of course). The brand I found at Eastern Mountain Sports (EMS) is Ben’s Wilderness Formula and it contains 30 percent Deet. The label claims it will repel ticks and deer flies as well as mosquitoes.
A friend of mine recommended a plant-based repellent with oil of lemon eucalyptus in case I was worried about side effects of Deet, but I decided to go with Ben’s Wilderness Formula after having already been bitten by a tick once. In my case, I felt that the risk of side effects was the lesser of two evils as compared to being re-infected with Lyme disease.
And, by the way, you don’t develop an immunity after having had the disease; it is possible to get it again. Whatever type of repellent you decide to use, be sure to read the directions carefully and, especially, keep it out of the reach of your children.
— I also purchased a product called Permanone at EMS. This is a repellent that you spray on your clothes, not on your skin. It contains the active ingredient Permethrin, which apparently not only repels ticks, but also kills them. I plan to treat my pant legs and long sleeves before the leaf-raking season starts.
According to the label instructions, one treatment holds up through several machine washings. Again, if you decide to use such a product, read the label and follow the directions carefully.
Removing ticks
Even while using all these precautions, I have learned the hard way that I need to check my clothing and skin for ticks when I come in from working outside. But how do you know what to look for"
A tick is not an insect; it has eight legs, not six, but it is not a spider either. It is more closely related to a dust mite. (Another annoying little pest!)
In the spring and early summer, it is the tick nymphs that are active and that are most likely to infect people. The nymphs are the size of poppy seeds, so they are easier to spot if you wear light-colored clothing. In the late summer and fall, ticks have progressed to the adult phase of their life cycle; the adults are about the size of sesame seeds, and they can still be dangerous.
The New York State Department of Health recommends checking yourself all over for ticks every evening if you are outside regularly in areas where ticks are likely to be found. In my case, that means my own yard.
And what should you do if you do find a tick attached to your skin" I inquired at EMS about tick-removal kits that I had heard about, but none were available that day. I presume the kit consists of pointed tweezers and disinfectant.
The health department has this advice about removing ticks: "Using tweezers, grasp tick near the mouth parts, as close to the skin as possible. Pull tick in a steady, upward motion away from skin." And then, as common sense would already tell you, disinfect your skin with soap, water, and rubbing alcohol.
I hope I’m not too squeamish to follow these instructions if I do find a tick on myself or on a family member!
Controlling ticks
The third type of preventive measure I had mentioned deals with controlling or discouraging ticks on your premises. In my case, an expensive automatic misting system that sprays bug repellent periodically into every corner of my yard, or an eight-foot deer fence are not options.
So what can I do to reduce the chance of ticks making my yard their home" First of all, ticks thrive in shady moist areas at ground level. They like our lawns and gardens, especially on the edge of wooded areas.
They do not jump or fly — they get on you only by direct contact. So it stands to reason that, if I mow and trim regularly so that there is less long grass and brush around, there may be fewer ticks.
This fall I will also make sure to clear away leaves and tall grass around my house, and trim and dispose of the remains of my perennial beds. Next spring, when I plant my garden, I will try to create a barrier between my lawn and my wooded area by placing a swath of wood chips or crushed stones between the lawn and the trees.
You can find other landscaping tips and a Tick Management Handbook developed by the Connecticut Agricultural Experiment Station free of charge on line — remember Lyme, Conn. was the Ground Zero of Lyme disease, so these folks have done a lot of research.
As deer are the other part of the deer tick equation, I also tried to find out what else I could possibly do to cut down on deer using my yard as a thorough-fare. The state’s Department of Environmental Conservation estimates that there are about a million deer in New York, and I know that their main highway goes straight through my property.
I see their valentine cookie-cutter footprints in the snow in winter, and occasionally meet them eye to eye at dusk in any other season — those glowing fireball eyes reflect off my headlights eerily when I pull into my driveway just after dusk.
I called a local garden center to inquire whether the staff knew of any plants that discourage deer. The answer was not very encouraging.
The employee I spoke to, who gave her name as Rosemary, cited only daffodils as a common garden plant that deer are sure to leave alone. I know that they do love tulips, but some people try putting mothballs around their tulips to discourage deer from making a dessert of them.
Rodale’s Illustrated Encyclopedia of Perennials, my gardening bible, also cites astilbe, bleeding heart, columbine, fox-glove, iris, periwinkle, lavender and sunflowers as possibilities of plants that deer are not fond of. This winter, while the snow flies outside and freezing rain taps at my window, I’ll plan next summer’s garden around these tips — out with the tulips, in with the lavender and sunflowers — and plenty of crushed stone to separate lawn and perennial beds from woods.
In the meantime, now that it’s time to rake leaves, I’ll follow my own advice about insect repellent and long sleeves. Oh yes — and my daily mantra spoken aloud to the rest of the family — "Did you check yourself for ticks""