Fireworks are fun, but they can be dangerous

U.S. Consumer Product Safety Commission graphic; click on it to enlarge

By Melissa Patrick
Kentucky Health News

While it wouldn't feel like the Fourth of July without fireworks, it's important to remember that all fireworks, even sparklers, can be dangerous.

"The safest way to view fireworks is to watch professional displays,”  Consumer Product Safety Commission Chair Alex Hoehn-Saric said in a news release. “If you choose to light your own, make sure you only buy legal fireworks intended for consumer use from a reputable retailer."

A new CPSC report says that in 2023, the commission received reports of eight deaths and an estimated 9,700 injuries involving fireworks. Out of the eight deaths, five were associated with firework misuse, two with a device malfunction, and one involved unknown circumstances.

A CPSC analysis of the injury data found that in the four weeks leading up to and including Independence Day in 2023, teens aged 15-19 had the highest estimated rate of emergency-department visits visits for fireworks-related injuries, followed by children aged 5-9.

Of those ED visits, the analysis found that an estimated 800 of the injuries were associated with firecrackers and 700 were associated with sparklers. The report says sparklers accounted for 51% of the total estimated injuries in children under the age of 5. 

"Never allow children to play with or ignite fireworks, including sparklers. Sparklers burn at temperatures of about 2,000 degrees Fahrenheit -- hot enough to melt some metals," says the release.  

For using sparklers, here are safety tips from Michigan Medicine: 

• Hold sparkler away from face.
• Wear shoes when using sparklers.
• Only use one sparkler at a time.
• Stay six feet apart from others.

First-aid tips for burns, from Michigan Medicine: 

• Be prepared to use first aid. For a minor burn, place a towel soaked in cool water over the area for about five minutes. Then cover with a clean bandage and give your child acetaminophen to reduce pain and swelling.
• For a major burn, or if the burn involves eyes, take the child to the emergency room promptly.

Here are some overall safety tips from the Kentucky state fire marshal: 

• Use fireworks outdoors only.
• Obey local laws. If fireworks are not legal where you live, do not use them.
• Always keep a bucket of water or a working water hose nearby.
• Only use fireworks as intended. Don't try to alter them or combine them.
• Never relight a "dud" firework. Wait 20 minutes and then soak it in a bucket of water.
• Use common sense. Spectators should keep a safe distance from the shooter and the shooter should wear safety glasses.
• Alcohol and fireworks do not mix. Have a "designated adult operator."
• Do not use homemade fireworks or illegal explosives -- they can kill you!
• Report illegal explosives to the fire or police department in your community.
• Never allow children to play with or ignite fireworks.
• Read and follow all instructions on the label.

Ky. ranks low in benefits for the poor; health secretary says he reminds legislators of the impact programs have on communities

Health Secretary Eric Friedlander

Update, Dec. 4: This story has been updated with additional information from state Health and Family Services Secretary Eric Friedlander's office. One number has been corrected.

By Melissa Patrick
Kentucky Health News

In a national webinar on safety-net programs, state Health and Family Services Secretary Eric Friedlander said he would mention the state's low ranking in assistance to needy families in his discussions with legislators who will soon write the state budget. 

The webinar was held Nov. 28 by the Brookings Institution, a leading think tank that does in-depth, nonpartisan research to improve policy and governance at local, national and global levels.

The webinar opened with an introduction to Brookings' new tool, State Safety Net Interactive, showing the evolution of safety-net benefits over 21 years for a hypothetical sample of non-disabled, non-immigrant, single-mother families if they had full access to major safety-net programs, based on each state's rules.

Screenshot of Brookings Institution interactive map

The interactive tool shows that in 2022, Kentucky ranked 49th in cash and food assistance for this theoretical family, providing $4,810 in assistance. That was lower than any state but Arkansas and Mississippi. Adjusted for the cost of living in each state, Kentucky ranked 44th.

Friedlander told the webinar audience that he looked forward to using this interactive tool in his policy discussions with the state's lawmakers: "I appreciate getting the additional data and support from the tool that Brookings is rolling out today and I think it will be helpful in my discussions with the General Assembly."

Friedlander said it's important to recognize that Kentucky has a "blue governor" and a "very red General Assembly" and that there are often differing narratives when it comes to safety-net benefits and policy.  

He said that when it comes to safety-net programs, his cabinet tries to recognize that whatever happens to an individual in any community impacts everyone in the community, and he tries to convey this to policymakers. One example he used is the Supplemental Nutrition Assistance Program, formerly food stamps.

"I've taken an approach with the General Assembly, which is, if it weren't for SNAP, we wouldn't have the amount of grocers that we have across the state. If it wasn't for Medicaid, we wouldn't have a health-care system at all. If it wasn't for child-care support, we wouldn't have child care," he said. "So I also take it from an angle of the economic support to communities . . . but what happens to communities when we're able to provide support for these individuals in their communities."

Kentucky increases benefits to the most needy families

Friedlander said his cabinet recently increased Temporary Assistance for Needy Families, a federal program that provides cash assistance to families with children and very low incomes.

In a follow-up email, Friedlnader spokeswoman Susan Dunlap said Kentucky's TANF program is called the Kentucky Transitional Assistance Program and stressed that the interactive Brookings tool does not yet reflect the changes made to Kentucky's program. 

"The funding level changed earlier this year, and adjustments do not yet show up in the interactive tool, which reflects data through 2022," Dunlap said in an email. "The tool, soon, should reflect the change in income eligibility level."

Dunlap said the benefit and income eligibility levels for this program had not changed since at least 1995, when the one and two-person household income categories were last increased, and the last increase for larger households was even earlier. 

She offered this example: "Accounting for inflation having risen 92 percent between 1995 and 2022, the maximum benefit level for a household of three would have been $503 had it just kept up with inflation. The current benefit reflected in the interactive tool is $262 for a household of that size. The recent increase in funding doubles the benefit level to $524 for a household of three – just above the inflation-adjusted equivalent for 1995."

Dunlap added that the income eligibility limit has been frozen for the past 27 years. "Had it kept up with inflation, it would have been $1,870 per month last year," she wrote. "The current limit for a household of this size reflected in the interactive tool is just $974 per month." 

Friedlander said Kentucky had not changed TANF in 20 27 years and that the recent changes increased payments and reduced some administrative barriers. When legislators asked why, the cabinet showed them the economic impact of SNAP, TANF and Medicaid for each county, beyond the numbers for individuals.

"And it actually made an impact," Friedlander said, adding later, "There are these dependence narratives that are out there, and I don't believe that they're backed up by evidence. But we have to be able to show the evidence that this is not the case within the Cabinet for Health and Family Services." 

He said it is possible to work across partisan lines "as long as we are being honest and evidence-based about what's happening." He added that such talks generally take place "off-stage" and require "relationship building." 

Friedlander pointed to the state's efforts to use the Kynect website to reduce the administrative burden of safety-net programs. "We have an integrated eligibility system, meaning you can go and you can sign up for different programs -- TANF, SNAP, Medicaid, child care -- under one umbrella."

Friedlander said Kentucky discovered this system could work really well during the pandemic. He said other lessons from the pandemic include learning that CHFS could be "nimble" and "can make changes quickly" and can deliver services in a different, but often "more effective and efficient way."

"As of December 2023, there were approximately 12,514 families participating in the KTAP program, made up of approximately 6,242 adults and 21,534 children. Since 2016 alone, the total number of Kentuckians receiving KTAP had fallen by 54 percent," according to the CHFS.

Tips for keeping children safe in the 'deadliest days of summer'

Yobro10, iStock / Getty Images Plus

By Sherri Hannan
University of Kentucky

The season from Memorial Day weekend to Labor Day is known as the "100 deadliest days of summer." The summer months, while a highlight for kids, can also expose them to greater injury risk. Kids spend time in the water, walking or riding bikes in their neighborhood and just enjoying their summer break from school. All that can change quickly without the use of safety devices or following safe practices.

Here are some tips and trips to keep kids safe while they have fun in the sun.

Outdoors:

• Apply sunscreen when kids will be outdoors, even on cloudy day. Reapply every two hours and after your child has been swimming.
• Kids are at a higher risk for dehydration. Combined with the summer heat, the lack of water can lead to muscle cramps, heat exhaustion or heatstroke. Have them drink water before, during and after physical activity.
• Fireworks are a fun way to celebrate, but every year, more than 3,000 children under the age of 15 visit the emergency department because of fireworks. Give children glowsticks instead of sparklers, and always keep fireworks away from children. If possible, attend a public fireworks display instead, and leave the firepower to the professionals.
• Keep a first aid kit handy, and give your children a few first aid basics such as when to use a bandage, what a tick might look like and how to spot poison ivy.

In the water or on a boat:

• Actively supervise children in and around water, giving them your undivided attention.
• Teach children to swim with an adult. Older, more experienced swimmers should still swim with a partner every time. From the first time your kids swim, teach children to never go near or in water without an adult present.
• Swimming aids such as water wings or noodles are fun toys for kids, but they should never be used in place of a U.S. Coast Guard-approved life jacket.
• A large portion of boating accidents each year involve alcohol consumption by both boat operators and passengers. To keep you and your loved ones safe, it is strongly recommended not to drink alcoholic beverages while boating.

Bicycling:

• Wear a properly fitted helmet. It is the best way to prevent head injuries and death. Learn how to properly fit a helmet for your children in seconds.
• Ride on the sidewalk when you can. If not, ride in the same direction as traffic as far on the right-hand side as possible.
• Use hand signals and follow the rules of the road. Be predictable by making sure you ride in a straight line and don’t swerve between cars.
• Wear bright colors and use lights, especially when riding at night and in the morning. Reflectors on your clothes and bike will help you be seen.
• Ride with your children. Stick together until you are comfortable that your kids are ready to ride on their own.

To 'celebrate' or not to celebrate Halloween; that is the question

As Halloween 2020 approaches, many families want to know if it's safe to let their children go trick-or-treating in the middle of a pandemic. There is no easy answer to this question, but here is some expert advice on how to make the experience as safe as possible.

  

Step 1: Figure out how much health risk your household is comfortable assuming.

Do you live or regularly interact with people who are especially vulnerable to covid-19? Then you'll want to err on the side of caution and consider staying in on Halloween. That's always the safest option, of course, but there are still reasons some families might want to observe the High Holiday of American Children.

"Not having a routine really impacts kids, and as we come into the holidays, trick-or-treating and participating in Halloween activities can help kids with their minds,” Phoenix pediatrician Kristin Struble said in a recent Perspective article for The Washington Post.

Step 2: Try to figure out the general risk level in your community. Infection rates are trending up in most U.S. states right now, but what really matters are the specifics of your trick-or-treat route, which for most people will be their neighborhood. For example “the risk may be higher in a crowded apartment building than spread-out houses in the suburbs,” the article says.

What you really need is public-health data for your area, but this isn't always easy or possible to find. Jon McGreevy, chief of pediatric emergency medicine at Phoenix Children’s Hospital, told The Post that some form of trick-or-treating would be acceptable so long as your community's daily rate of positive tests does not exceed 10 percent. 

Kentucky offers a regularly updated color-coded map that shows the coronavirus incidence rate in each county as well as a daily statewide positivity rate. Both can be found on kycovid19.ky.gov. 

  
Step 3: After weighing the amount of covid-19 risk your family can afford to take on against your kids' mental health and the infection level in your community, the Post offers some safety tips if you do go trick-or-treating:  

• Have kids wear a face mask. (Many costumes could easily incorporate one.)
• Adhere to social-distancing guidelines by standing six feet apart.
• Have a parent accompany children, regardless of age, to hold them accountable with mask-wearing and social distancing.
• Avoid congregating around doorsteps and porches.
• Use hand sanitizer after receiving candy from each house.
• Do not eat candy while trick-or-treating: Parents should make certain hands are clean before kids start touching their faces and eating candy.
• Make sure kids wash their hands as soon as they get home.
• Have kids remove their costumes and shower.
• No need to disinfect candy wrappers.

If you don't, check out the article for suggestions from experts and parents to make Halloween a treat for your kids, even without the walkabout. They can still dress up and show off their costumes, for example! There are also tips for how to hand out candy without putting you or your neighbors at unnecessary risk. 

Dr. Kevin Kavanagh, a retired Somerset physician who heads Health Watch USA, which focuses on infection control, reminded Kentuckians on the Jack Pattie Show on Lexington's WVLK that just because an activity is outdoors doesn't mean it's safe. He noted that the Centers for Disease Control and Prevention has declared traditional trick-or-treating, in which treats are handed to children who go door to door, a high-risk activity. 

Don't think that wearing a Halloween mask, is going to protect you from the coronavirus, Kavanagh said. "If screaming will likely occur, greater distancing is advised," he said. "The greater the distance, the lower the risk of spreading a respiratory virus.” 

The CDC also advises against wearing both a regular mask and a costume mask: "Do not wear a costume mask over a cloth mask because it can be dangerous if the costume mask makes it hard to breathe. Instead, consider using a Halloween-themed cloth mask."

The state Department for Public Health has issued Halloween safety guidance at https://chfs.ky.gov/agencies/dph/covid19/cv19halloweenguidance.pdf.

While children's cases are often asymptomatic or less severe than adults, it's important to remember that they can spread it to others unknowingly. 

As of Oct. 8, more than 697,633 children had tested positive for the coronavirus, according to the American Academy of Pediatrics. Children represented 10.7% of all cases. The report says between Sept. 24 and Oct. 8, there was a 13% increase in child cases. 

As of Oct. 14, 12,950 Kentucky children between the ages of 1-19 have tested positive for the coronavirus, making up 15.8% of the total cases, according to the state health department. 

The bottom line, there's no easy answer to this question and whatever you choose will involve tradeoffs. But that's life in a pandemic.

Unanimous Senate sends female genital mutilation ban to House

By Melissa Patrick
Kentucky Health News

A bill to ban female genital mutilation in Kentucky unanimously passed the Senate Jan. 22 and went to the House Judiciary Committee for consideration.

Sen. Julie Raque Adams

The sponsor of Senate Bill 72, Majority Caucus Chair Julie Raque Adams of Louisville, told senators that FGM has no health benefits and  creates life-long physical and physiological harm. It is usually performed on girls between 4 and 14.

“Female genital mutilation is one of the most egregious forms of child abuse," Adams said. "It is internationally recognized as a violation of human rights and a form of discrimination against women."

Kentucky is one of 15 states where FGM is still legal. A federal ban that had been in place for more than two decades was found unconstitutional in 2018, putting the responsibility on states.

The United Nations Population Fund estimates that 200 million women and girls have suffered FGM. The federal Centers for Disease Control and Prevention estimates that 513,000 American females are at risk of FGM or have undergone it. In Kentucky, that number is estimated at 1,845, according to the Population Reference Bureau.

An FGM survivor named Jenny, who asked that her last name remain private, gave several reasons for the bill at the Jan. 15 Senate Health & Welfare Committee meeting.

She said a law banning the practice would offer support to women who are surrounded by people who still believe in it, but want to give their daughters "an out;" prompt women who have had FGM to ask questions, since many think it is done to all females; let people in other states know that Kentucky is not a "safe haven" for it; and promote badly needed education about it.

The bill would make FGM a felony if performed on a female under 18. It would ban trafficking girls across state lines for FGM, and revoke the licenses of medical providers convicted of the practice. It classifies FGM as a form of child abuse and would require mandatory reporting of it.

It would also mandate training for law enforcement and require the state Department for Public Health to produce and disseminate educational materials about it, and allow victims of the practice to file civil lawsuits up to 10 years after turning 18.

The bill had 12 sponsors, representing both parties. Click here for a fact sheet about FGM.

3 children die, 33 are injured per day in accidents on U.S. farms; prevention workshop to be held in Lexington Aug. 6-7

The National Children's Center for Rural and Agricultural Health and Safety will host a workshop will be held in Lexington Aug. 6-7 on preventing injuries of children on farms and ranches.

The workshop website says, "Learn how you can help safeguard children and youth who live, work and play on farms and ranches. This information can be used to develop and enhance childhood agricultural safety strategies for your organization. Interactive sessions will be facilitated by safety experts and leaders in the field of childhood agricultural injury prevention."

Registration is limited to 60 participants. Registration is $249. Click here for more information or to register.  Another workshop will be held in Hershey, Pa., Sept. 17-18.

Joan Mazur of the University of Kentucky, who is helping with the Lexington workshop, attended an earlier one in Iowa, and The Rural Blog asked her to write about it and her work. Here's her report:

By Joan Mazur
     I have been at the University of Kentucky College of Education since 1993 and have been associated with the Southeast Center for Agricultural Health & Injury Prevention with continual federal funding since 1994. The interdisciplinary nature of this center, housed at the UK College of Public Health, as well as its focus on solving real-world issues on family farms, has supported my research interests at the intersection of public education and public health. My husband and I also own a 70-acre farm in Washington County, Kentucky, so my interests in farm safety and health are also personal.

     Over the years I have developed with colleagues many educational programs, most of which involve technology and are targeted at a high at-risk group of teenagers from 14 to 19. Narrative simulations, digital games and other online interventions for preventing injuries and fatalities have been used at schools in farming and rural communities in the Southeast.

     While many of our more horrifying statistics on youth injury and fatality and injury in agriculture are decreasing, one segment of the at-risk younger population has resisted efforts. Every day on farms in the U.S., three children die and 33 are injured. These injuries and fatalities are preventable, and there are guidelines and best practices to assure that children can take advantage of the many benefits of living or working on family farms in safe and healthy ways.
     Recently I attended a Childhood Agricultural Injury Prevention (CAIP) Workshop in Iowa hosted by the National Children’s Center for Agricultural Safety & Health, whose national mission is to prevent agricultural injuries and fatalities to children. Many of us in all fields over the years have attended workshops, even entire conferences that disappointed despite a promise of improved professional learning. However the CAIP Workshop was excellent!

     Every session was highly informative -- delivered to the entire group, with many interactive small-group components to practice and absorb the various techniques and approaches to engaging stakeholders in preventing injuries to children, whether working or non-working, on farms or even in specialized settings such as agritourism sites (orchards, farms, petting zoos etc).

     We have now scheduled a CAIP for Lexington Aug. 5-7. I hope some of you can consider going, as journalists, teachers, counselors and other educators or others such as insurance personnel, FFA, bankers or other community member in positions to influence individual families and policy makers in decision making that can promote the economic, social, educational and personal mental and physical health of rural farm families and children.
     This KY-CAIP workshop is also a partnership between the National Childrens Center for Ag Safety & Health, the North Carolina Agromedicine Institute and the Florida Coastal Center for Agricultural Safety & Health, which will be providing expertise for regional agricultural safety and health issues.

Study of Ky. kids' well-being finds less smoking in pregnancy, fewer low-birthweight babies and pregnant teens; has local data

By Melissa Patrick
Kentucky Health News

Kentucky continues to make progress in expanding the number of children with health insurance, having fewer low-birthweight babies, and lowering rates of teen pregnancy and smoking during pregnancy, but it has high rates of children living in out-of-home care because of abuse or neglect, according to the annual Kentucky Kids Count report. It shows those rates vary widely by county.

The report, released Tuesday by Kentucky Youth Advocates and the Kentucky State Data Center at the University of Louisville, is part of the 28th annual release of the County Data Book, which provides data on overall child well-being through 17 measures in four areas: economic security, education, community strengths, and health and family. Nearly one in four Kentuckians are children.

Kids Count Data Center map of births to mothers who
smoked during pregnancy, 2014-16.

A bright spot in the report is that fewer Kentucky women are smoking during pregnancy.

Statewide, the report found that rates of smoking during pregnancy dropped to 18.1 percent in 2014-16, from 21.3 percent in 2009-11, with 110 of the state's 120 counties showing improvement.

"Tobacco addiction is so difficult to break, but this report is proof positive that women all over Kentucky are finding a way to protect their babies from the dangers of smoking while pregnant," Ben Chandler, president and CEO of the Foundation for a Healthy Kentucky, said in a news release. "They're reducing the risk that their babies will be born with birth defects or die suddenly without explanation during infancy. And they're increasing the chances their babies will be born full-term and at a healthy weight."

Seventy-three counties saw a reduction in low-birthweight babies. Statewide, this rate dropped to 8.8 percent in 2014-16, from 9 percent in 2009-11.

But amid the good news, there is bad news. Since 2009-11, 45 counties have seen an increase in their percentage of low-birthweight babies. Ten counties saw higher rates of women smoking during pregnancy, including: Allen (23.9 percent in 2014-16), Carroll (28.3), Clinton (28.8), Estill (33), Fulton (23.7), Graves (17.7), Henderson (21.2), Lewis (30.9), Magoffin (31.9) and Wayne (28.1).

And while smoking during pregnancy declined in Lee and Owsley counties, more than 40 percent of expectant mothers in those counties smoked in 2014-16 -- and 22 counties had smoking-during-pregnancy rates of 30 percent or higher.

The state's teen-pregnancy rate continues to drop. It declined to 31.7 teen births per 1,000 females aged 15-19 in 2014-16, down almost a third from 45.9 per 1,000 five years earlier. Kentucky's rate still remains about half again as high as the national rate, 20.3 teen births per 1,000.

Differences between counties remained great, ranging from a low of 7.9 teen births per 1,000 in Oldham County to a high of 79.5 teen births per 1,000 in Elliott County. And while 108 counties saw a drop in their teen-birth rates, several of the remaining 12 had large increases, including: Lawrence County by 14 points, to 52.4 per 1,000; Lee County, up 10 points to 49.6 per 1,000; and Menifee County, up by 12, to 59.6 per 1,000.

Other key findings about Kentucky's children in the report:

• Nearly 97 percent of Kentucky's children have health insurance, and all 120 counties showed improvement.
• One in four Kentucky children live in poverty, defined as annual household income of $24,339 or less for a family of four. The good news is that this rate decreased in 93 of the 120 counties.
• The rate of children in out-of-home care increased in 92 counties, "fueled by parents struggling with addiction." Elliott County had the highest rate, with 118.2 in out-of-home care per 1,000 children aged 10-17. The state rate is 43.7 per 1,000.
• The number of children being raised by a relative has increased by 75 percent, from 55,000 in 2012-14 to 96,000 in 2016-18.
• 119 of 167 school districts saw an increase in the rate of students graduating on time; graduation rates declined in 46 districts. About 90 percent of Kentucky's high-school students graduate on time.

This year's report also explores the issue of child abuse in Kentucky, noting that 20 of every 1,000 children in the state experienced abuse and neglect in 2016, more than twice the national average. As part of a five-page essay, titled "Putting a Plug in the Abuse to Prison Pipeline," the report calls for "collective engagement across systems" to tackle the issue.

“These pressing challenges call for smart policies, innovative solutions, and focused attention on our priorities,” Dr. Terry Brooks, executive director of KYA, said in a news release. “The more we support all Kentucky children to grow up healthy, hopeful, and contributing to the community, the brighter our future looks.” 

The Kids Count Data Center is also available for a deeper dive into the data. It offers a profile sheet for every county that shows rankings and can be used to create maps and charts for comparisons.

KYA will hold "Kids Count Conversations" in Paducah, Glasgow, Louisville, Manchester and Covington to help community leaders use local data to inform policy that impacts their youth. E-mail KYA at kidscount@kyyouth.org if you would like to have such a conversation in your community.

The 2018 County Data Book was made possible with support from the Annie E. Casey Foundation and local sponsors Passport Health Plan, Delta Dental of Kentucky and Kosair Charities.

Study: Infants are not as susceptible as older children to food allergens, and if exposed early, less likely to develop allergies

Med Shadow image

If you're wary of exposing an infant to food that might be allergic, think again. New medical guidelines say that infants should be exposed to potentially allergic foods because that makes them less likely to develop allergies.

A study done in conjunction with the new guidance  found that food-induced, multiple-symptom allergic reactions that can cause death in older children and toddlers have a much milder effect in infants.

The study published in Annals of Allergy, Asthma and Immunology out of Ann & Robert H. Lurie Children’s Hospital of Chicago shows that infants under the age of 1 are much less susceptible to the severe side effects of food-induced allergic reactions, such as death, than their older peers.

The study was a reaction to new guidelines from the National Institute of Allergy and Infectious Diseases that encourage parents to introduce their children to foods with peanuts between four and six months. This new recommendation contrasts with previous advice to avoid introducing young children to peanut products. Now, the institute claims that if introduced early on to potential allergens, children are less likely to develop food allergies.

Waheeda Samady, a doctor at Lurie Children's Hospital, said in a press release that with the new guidelines, "It is understandable that parents might be fearful of triggering a serious reaction", but said the new research should be "reassuring."

The researchers examined 357 cases of children with food-induced allergies i 2015-17. Of these, 47 were infants (under the age of 1), 43 were toddlers between 1 and 2; 96 were 2 to 6; and 171 were school-aged children over 6. They found that 83 percent of the infants in the study experienced vomiting due to exposure, but none died. Still, the researchers warned that anytime an infant has a negative reaction to trying a new food, the child's primary doctor should be consulted or 911 should be called.

Half of parents in poll admit to indulging in risky behavior of using phone and texting while driving with children in the car

Alamy Stock Photo

About half of Americans in a survey said they talk on cell phones while driving with children aged 4 to 10. Worse yet, a third said they read text messages, a fourth of them sent such messages, and one out of seven said they used social media while driving with children.

"The study also found a correlation between cell phone use while children were in the car and other risky driving behaviors, such as not wearing a seat belt and driving under the influence of alcohol whether or not children were present in the car," said a press release from Children's Hospital of Philadelphia, which did the research with the University of Pennsylvania School of Nursing. It was published in the Journal of Pediatrics.

The study was conducted online among 760 adults in 47 U.S. states who said they were a parent or routine caregiver of a child between the ages of 4 and 10, and had driven their oldest child between those ages at least six times in the preceding three months. The poll found that 52.2 percent of parents had talked on a hands-free phone while driving with a young child in the car, while 47 percent had done so with a hand-held phone. It also found that 33.7 percent read text messages, 26.7 percent sent text messages, and 13.7 percent reported using social media while driving with children.

"The results from this research reinforce that risky driving behaviors rarely occur in isolation, and lay the groundwork for interventions and education specifically aimed at  parents who drive with young children in their cars," said lead author Catherine McDonald, of the hospital's Center for Injury Research and Prevention and the university's Community Health Department.

McDonald said doctors need to warn parents about such risky behaviors. "This type of education is especially pivotal today, as in-vehicle technology is rapidly changing and there is increased – and seemingly constant – reliability on cell phones," she said. "However, it is also important to note that even parents who did not engage in risky behaviors, such as not wearing a seat belt as a driver or driving under the influence of alcohol, still used their cell phones while driving."

Kentuckians are encouraged to let the pros handle the fireworks; even sparklers, firecrackers and bottle rockets are dangerous

By Melissa Patrick
Kentucky Health News

Fireworks are often synonymous with the Fourth of July, but they are also a common cause of injury, so the state Division of Fire Prevention recommends attending a community firework event instead of celebrating with fireworks at home.

"Let the professionals entertain your family," Mike Haney, state fire marshal and director of fire prevention for the Department of Housing, Buildings and Construction, said in a news release. "By celebrating at a public event instead of at home, you reduce the risk of injury and property damage. You may also avoid violating the law."

Consumer Product Safety Commission graphic, using data from the 2017 Fireworks Annual Report

The latest U.S. Consumer Product Safety Commission fireworks report found that in 2017, 12,900 consumers were treated in U.S. emergency rooms for fireworks-related injuries and eight people died from them, with  victims ranging from age four to 57. Seven of the deaths were a result of direct impact from fireworks and one of them was the result of a house fire caused by misusing a firecracker.

The report adds that children between the ages of 10 and 14 were seen most often in emergency rooms for fireworks injuries, followed by young adults between the ages of 20 to 24.

Haney also reminded Kentuckians to pay attention to state and local fireworks laws.

For example, state law prohibits people under 18 from buying fireworks, and from selling them unless supervised by a parent or guardian. The law bans fireworks from being used within 200 feet of a structure, vehicle or other person; and fireworks cannot be sold to anyone who is under the influence of drugs or alcohol.

"Local governments set their own firework ordinances, so be aware of the regulations in your own town," Haney said.

Here are some safety tips from the National Council on Fireworks Safety:

 * Read and follow the instructions on the label.
 * A responsible adult should supervise all firework activities.
 * Never allow children to play with or ignite fireworks.
 * Alcohol and fireworks do not mix. Have a "designated adult shooter."
 * Wear safety glasses when shooting fireworks.
 * Light one firework at a time and then quickly move away.
 * Never light fireworks in a container, especially a glass or metal container.
 * Use fireworks outdoors in a clear area away from buildings and vehicles.
 * Always have a bucket of water and charged water hose nearby.
 * Never relight a "dud" firework; wait 20 minutes and soak in a bucket of water.
 * Do not experiment with homemade fireworks.
 * Wet down used fireworks and place them in a metal trash can.
 * Place disposed of fireworks away from buildings or combustible materials.
 * Report any illegal explosives to the fire or police department.

The CPSC report says that on average,  280 people went to the emergency room every day with fireworks-related injuries in the month around the July 4th holiday in 2017, with about 1,200 of those visits related to sparkler injuries, 800 of them relate to firecrackers and 300 related to bottle rockets.

Michael Spencer, a pilot from Bowling Green, told attendees of a CPSC fireworks event about the dangers of fireworks, having lost several fingers on both hands in 2015 from a shell-and-mortar style firework device. Spencer is now committed to making sure this doesn't happen to anyone else, CPSC writes in a news release about its latest fireworks report, released June 27.

 “Fireworks can be extremely dangerous, even if they are legal,” Spencer said in the release.“My advice would be to leave them to the professionals.”

KidsHealth also stresses that kids should "never play with fireworks," writing that this includes "firecrackers, rockets and sparklers" because they are "just too dangerous."

"If you give kids sparklers, make sure they keep them outside and away from the face, clothing and hair," they write. Sparklers can burn at nearly 2,000 degrees Farenheit and bottle rockets are known to stray off course or to throw shrapnel when they explode.

If a person is injured by fireworks, KidsHealth says to immediately seek medical care.

If the injury is to an eye, KidsHealth says not to rub it, since that may cause more damage; don't flush the eye with water or to put any ointment on it. Instead, cut out the bottom of a paper cup, place it around the eye, and get medical care right away, because your eyesight may depend on it.

If a person is burned, KidsHealth recommends removing the clothing from the burned area and to call your doctor immediately.

No-penalty bill to require kids under 12 to wear bicycle helmets falls 1 vote short in panel; advocates say it will be called up again

By Melissa Patrick
Kentucky Health News

A House bill to require children under 12 to wear bicycle helmets came up one vote short in the Senate Transportation Committee March 14, but advocates say the panel will take up the bill again Wednesday, March 21.

Mary Hass, advocacy director of the Brain Injury Alliance for Kentucky, told Kentucky Health News that two senators who were expected to vote for the bill voted against it, but it would still pass with votes of those who were absent.

House Bill 52, sponsored by Rep. Regina Huff, R-Williamsburg, would require children under 12 to wear a helmet when they ride a bicycle. Violation would result in a courtesy warning, not a fine.

Heather Floyd and her son TJ spoke at the March 14 Senate
Transportation Committee meeting in support of "TJ's bill"
to require children up to age 12 to wear a bicycle helmet.

HB 52 is called "TJ's bill" for TJ Floyd of Oldham County, who sustained a traumatic brain injury in 2010 when he flipped over his handlebars when he was 7 while not wearing a helmet. It passed the House 77-5 on Feb. 2.

"This bill just makes helmets part of bicycle safety," Hass told advocates at a rally after the committee meeting. "There are no fines. It is not meant to be punitive in any way to parents. But BIAK's membership is telling us it gives parents another tool in their toolbox to keep their children safe."

The bill needed seven votes to clear the committee, but only got six. After some off-microphone discussion about what to do next, committee chair Ernie Harris of Oldham County told members that he might call it up again. BIAK said in an email alert the next day that Harris would have the committee hear the bill again Wednesday, March 21 at 9 a.m. in Room 154 of the Capitol Annex. Kentucky Health News has not confirmed that with Harris.

Haas said advocates went into the March 14 meeting thinking they had enough votes, but one supporter, Sen. Jared Carpenter of Berea, was caught in a traffic jam, and another, President Pro Tem Jimmy Higdon of Lebanon, left before the vote was taken. Democratic Sen. Johnny Ray Turner of Prestonburg was also absent.

The "no" votes came from Republican Sens. Joe Bowen of Owensboro, C.B. Embry of Morgantown and Paul Hornback of Shelbyville. A BIAK alert said the group expected Hornback to vote for the bill but he changed his mind before the meeting.

Haas and TJ's mother, Heather Floyd, said Embry had said he would vote for the bill. Embry disputed that, telling Kentucky Health News, "I didn't tell them I was voting for it. I said I would give it consideration." He said the bill probably has enough votes to get out of committee if all members attend.

Embry said he voted no because he didn't think the bill is necessary, especially because it has no penalties. He also voiced concerns about liability if a child was injured while not wearing a helmet on someone else's property or under the care of someone who was not a family member.

"I think they should wear a helmet," Embry said. "I think that parents should require them to wear a helmet. I think they should have enough sense to do that on their own, without the government demanding it."

Sen. Mike Wilson, R-Bowling Green, voiced similar liability concerns during the meeting, but voted for the bill.

At the meeting, Floyd urged the panel to pass the bill to prevent similar injuries to other children. She shared a long list of cognitive and physical struggles that plague TJ and others with brain injuries and that have stripped him of his ability to live an independent life. She said the bill is about bringing awareness to traumatic brain injuries, which affect more than 5 million Americans, and the importance of protecting children's brains.

BIAK says 384 American children die annually from bicycle crashes and 450,000 more are treated in emergency rooms for bicycle related injuries, with about 135,000 of those seen in the ER related to head injuries. Hass said after the rally that bicycle helmets are about 85 percent effective in preventing traumatic brain injuries when used properly.

Mary Hass of the Brain Injury Alliance
for Kentucky spoke at the March 14 rally.

Floyd told the committee, "The biggest and most important point is that this bill can save a child's life."

BIAK Executive Director Eddie Reynolds said after the rally that opposition to the bill often stems from concerns about personal freedoms.

Haas said motorcycle advocates have opposed the bill out of concerns it would lead to restoration of an old law requiring Kentucky adults to wear helmets while riding motorcycles. Current state law requires both operators and passengers on a motorcycle under the age of 21 to wear a helmet.

"There is no will in this legislature to want to put helmets on people who ride motorcycles. We feel that is their choice," Haas said. "This bill is only about protecting children and doing what our membership has asked us to do."

Similar bicycle helmet legislation has been considered in the House for several years. Last year, HB 122 passed the House 90-6 but was not heard in the Senate.

Kentucky's decade-old program to help children who are at risk from drug-using adults is becoming a model for other states

Recovered opioid addict Raven Mosser credits her success in staying sober to Kentucky's START program. She moved to Ohio to become a recovery coach for other parents struggling with addiction. (Kaiser Health News photo by Sholten Singer)

Kentucky's program to help children placed at risk by adults' drug use has become a model for other states. Ohio's new plan is modeled explicitly on Kentucky's, and Indiana and North Carolina are launching initiatives too, Shefali Luthra reports for Kaiser Health News.

"Kentucky was a pioneer, starting in 2007, when opioid addiction first emerged as a public health concern. The program, called 'Sobriety Treatment and Recovery Teams' — or START — emphasizes a wraparound approach for at-risk parents that includes frequent home visits, vouchers for child care and transportation and mentorship from people in recovery," Luthra writes. "Under the Kentucky model, when child protection specialists learn a child is at risk, authorities specifically assess whether substance abuse could be a factor. If so, the parent is fast-tracked into treatment and assigned a 'recovery team,' which coordinates among agencies such as children’s aid, mental health, social services and recovery mentors."

One of the less-discussed effects of the opioid epidemic has been the strain it places on foster-care systems. Ohio, which has the nation's highest rate of heroin-overdose deaths, has been particularly hard hit. "Ohio's opioid epidemic is seen as the direct cause of an 11 percent increase in children in state custody over the past six years, according to the Public Children Services Association of Ohio," Dina Berliner reports for The Athens News.

Only 7,200 families are registered as foster parents in Ohio, but there are 15,000 children in the state's foster-care system, says state Attorney General Mike DeWine. And half of those kids are in foster care because one or both of their parents are opioid addicts, according to a 2016 survey by the Public Children Services Association.

It's a trend seen in other states. "Data from the U.S. Department of Health and Human Services show that from October 2012 to September 2015, as addiction surged, the number of kids entering the foster system rose 8 percent," Luthra reports.

With swim season upon us, here are water-safety tips; drowning is the top cause of accidental death among young children

Photo: cdc.gov

Summer fun often includes heading to the swimming pool or lake, but it's important to remember that all water activities come with a risk of drowning.

The federal Centers for Disease Control and Prevention reports that every day, about 10 people die from unintentional drowning. Of these, two are children under 15 and most are between 1 and 4.

That doesn't mean you shouldn't enjoy the water, it just means you need to take some safety precautions and stay vigilant, experts advise.

The American Academy of Pediatrics recommends swimming lessons for most children 4 and older because that is when they are developmentally ready to learn to swim. The academy once advised against swimming lessons before age 4, but has has relaxed that recommendation.

Why learn to swim? “Most children are around water in some form, whether it’s a pool, a river, a pond, a lake or the ocean, so learning to swim isn’t just for fun. It’s also important for safety,” says K.J. Hales, author of a book about children and swimming. “For some children, the idea of getting in the water and trying to swim can be a bit frightening,” Hales says. “But with the proper positive reinforcement, they can overcome their fears and discover just how much fun swimming can be.” 

The pediatricians' academy cautions that "swimming lessons will not provide 'drown-proofing' for children of any age" and notes that swimming lessons are just one part of a preventive strategy to keep children safe in or near the water.

The academy offers several water- and pool-safety tips for parents and caregivers, including:

• Never leave children alone or in or near the water, even for a moment. This includes bathtubs, pools, spas,wading pools, or near irrigation ditches or standing water.
• Less experienced swimmers and children under 5 should have an adult, preferably one who knows how to swim and perform CPR, within arm's reach of the child.
• Don't leave a child in or near the water under the care of another young child.
• Never swim alone. Always swim with a buddy, even at a public pool or a lifeguarded beach.
• Designate a "water watcher" when swimming.
• Because drowning can be quick and quiet, the water watcher should pay constant attention and be undistracted while supervising children, even if lifeguards are present.

Pool safety tips:

• If a child is missing, look for him or her in the pool or spa first.
• Install a fence at least 4 feet high around all four sides of the pool.
• Make sure pool gates open out from the pool, and self-close and self-latch at a height children can't reach. Consider alarms on the gate, or underwater alarms as an added layer of protection.
• If the house serves as the fourth side of the pool fence, install an alarm on the exit door to the yard and pool. As an added protection, install window guards on windows facing the pool.
• Remember, some drowning victims have used pet doors to gain access to the pool.
• Keep rescue equipment, a shepherd's hook, a life preserver, a first aid kit and a portable telephone, near the pool. Choose rescue equipment made of fiberglass or other materials that do not conduct electricity.
• "Floaties" and other inflatable swimming aids are not substitutes for approved life jackets and often offer parents a false sense of security.
• Do not use a pool or spa if there are missing drain covers, since drains cause suction that can trap a swimmer under water. Replace old drains with anti-entrapment drain covers or other similar systems.
• Large, inflatable above-ground pools can be dangerous and need to be surrounded by an appropriate fence. Also, remove access ladders and any structures that provide easy access to the pool when not in use. Children have also fallen in these pools simply by leaning on them.
• Share safety instructions with family, friends and neighbors.

2/3 of wrecks that kill children occur on rural roads

New York Times photo

Unintentional injury is the most common cause of death in children under the age of 15; car wrecks are the most common cause of unintentional injury; and rural roads were the most deadly: 67 percent of deaths among children occurred on roads classified as rural by the Federal Highway Administration. Possible culprits include poor lighting, distance to trauma centers and urban residents’ lack of familiarity with rural roads.

Between 2010 and 2014, 2,885 children died in car wrecks nationwide, an average of 11 kids per week, Nicholas Bakalar writes in The New York Times. That figure does not include pedestrians, those who died in motorcycle or bicycle wrecks or those who died riding in an unenclosed cargo area or trailer. "Most of the children who died were not wearing seat belts — nationwide, 43 percent were unrestrained or improperly restrained. Another 15 percent were sitting inappropriately in the front seat, and 13 percent were riding in cars driven by somebody under the influence of alcohol," Bakalar notes.

Researchers at Brigham and Women’s Hospital in Boston and at the University of Texas Southwestern Medical Center in Dallas carried out this research, which was published in The Journal of Pediatrics.

Researchers also found significant variations in children’s deaths from state to state, Bakalar writes. In New Hampshire, all of the five children who died during the study period were properly restrained. In Mississippi, however, 56 of the 99 who died were not wearing seat belts, or weren't wearing them properly. There were 0.25 deaths per 100,000 children in Massachusetts, compared with 3.23 per 100,000 in Mississippi.

A 2005 study published in Injury Prevention found that rural roads have an overall higher percentage of fatal wrecks than do urban roads: 0.9 percent of wrecks on rural roads are fatal, while only 0.2 percent are fatal in urban areas.

Nationally, poisonings of youth from opioids rose 165% from 1997 to 2012, 205% among those aged 1 to 4

More than 13,000 Americans age 19 and under were hospitalized for opioid poisonings from 1997 to 2012, says a study at the Yale School of Medicine, published in JAMA Pediatrics. The incident rate rose from 1.4 per 100,000 people in 1997 to 3.7 per 100,000 in 2012, an increase of 165 percent. The study found that 176 of the victims died during hospitalization. (Yale graphic: Hospitalizations for opioid poisonings for people under 20 from 1997-2012)

The study, which analyzed U.S. pediatric hospital discharge records every three years from Jan. 1, 1997, through Dec. 31, 2012, found 13,052 instances of opioid poisoning for people between the ages of 1 to 19. Hospitalization rates were highest in older adolescents 15 to 19—they increased from 3.69 per 100,000 to 10.17 per 100,000—but the largest increase was among toddlers, with incidences among those 1 to 4 years old increasing 205 percent, from 0.86 to 2.62 per 100,000, for a total of 1,531.

Epidemiologist Julie R. Gaither, the study's lead author, said research points to the likelihood that the majority of incidences among those 1 to 4 were accidental, from children getting into drugs prescribed to their parents, Ariana Eunjung Cha reports for The Washington Post. There were few cases of poisonings among those 5 to 9, with researchers saying children at these ages were able to tell the difference between candy and a dangerous drug. But once children hit 10, incident rates began to climb, and are more likely attributed to suicide or self-inflicted injury, Gaither said.