How to keep your family safe in pools, lakes, streams and oceans

Photo by Marina Kuzminykh, iStock/Getty Images Plus

By Sherri Hannan
Safe Kids Fayette County

Ask any child about the best part of summer, and chances are many will say it’s going to the pool or beach. And even though parents are aware of the risk of drowning, it remains the number one cause of death in children ages 1-4, as well as a leading cause of death among teens. Nearly 1,000 children drown each year, and more than 8,700 children were hospitalized for a near-drowning event. It’s quick and silent, and it can happen to any family.

The American Academy of Pediatrics recommends swimming lessons as a layer of protection against drowning; that can begin for many children starting at age 1. Even if your child has had lessons, they should never be unsupervised in water. Toddlers are the highest risk for drowning; their curious nature will lead them to explore areas that are dangerous for them but seem innocuous to adults. A good rule is “touch supervision,” meaning young children should always be close enough to touch when around water.

Other tips include:

• Choose a safe place to swim. Ensure that swimming pools are enclosed by a fence on all sides. In oceans, be aware of strong currents and waves.
• Instead of “floaties,” have your child wear a Coast Guard-approved life jacket in and around water.
• Watch kids when they are in or around water without being distracted. Young children can drown in as little as one inch of water, so it’s important to keep them within an arm’s reach of an adult. Assign a “water watcher,” an adult who will pay constant attention to children in the water. Switch off with another adult for breaks.
• Children should wear brightly colored swimsuits that contrast against the water, such as yellow, orange and pink.
• Empty small kiddie pools immediately after use. Store them upside down and out of children’s reach.

Kentucky’s numerous lakes are a fun summer getaway. However, teens and adolescents have a greater risk of death or injury in natural bodies of water because they overestimate their abilities and underestimate dangerous situations. They may feel pressure from their friends even if they don’t have strong swim skills or experience. They may also seek out unsafe areas such as waterfalls and rivers. Encourage them to only swim where lifeguards are present.

Familiarize yourself with the signs of drowning. It’s not the dramatic splashing you see in movies but is actually subtle and silent. If you see someone vertical in the water with their mouths near the surface, and they appear to be “climbing an invisible ladder,” get them out of the water as soon as possible.

One of the best ways to prepare for summer safety is to learn CPR. Contact your local community center or the Red Cross to find certification courses near you.

This is the latest weekly health column provided by the University of Kentucky Office of Public Relations and Strategic Communications.

Tips to prevent drowning, No. 1 cause of unintentional injury-related death among children under 5; swim lessons reduce risk

By Melissa Patrick

Kentucky Health News

As summer approaches and people begin to head to pools, lakes, ponds and streams, it's important to remember that drownings can happen to anyone in a matter of seconds – and that they are often preventable. 

CDC photo

Drowning is the leading cause of unintentional injury-related death among children under the age of 5, with most of the drownings happening in swimming pools, according to the Centers for Disease Control and Prevention. It is the second leading cause of unintentional injury death for children between the ages of 5 and 14, behind motor-vehicle crashes. 

In 2022, 15 Kentucky children died from drowning and three experienced "near fatalities," according to the state's 2023 Child Fatality and Near Fatality External Review Panel annual report.

Here are some suggestions from the CDC to prevent drowning, which can happen in seconds and is often silent. 

• Learn and teach children basic swimming skills.
• Build fences that fully enclose pools, with self-closing gates. 
• Designate a responsible adult to supervise children closely and constantly when they are near water – including bathtubs. 
• Children should wear life jackets for all activities around natural water, and weaker swimmers of all ages should also wear them around swimming pools. Do not rely on air-filled or foam toys; they are not safety devices. It's also important to make sure a life jacket fits properly. Click here to learn how to choose the right life jacket. 
• Learn CPR, which could save a person's life in the time it takes paramedics to arrive. Many organizations such as American Red Cross and American Heart Association offer CPR classes.

Swimming lessons reduce risk

From 2016 to 2021, 329 Kentuckians unintentionally drowned, with most of these deaths happening among people 45-54 and 65 and older. There were also 543 visits to the emergency departments related to unintentional drowning injuries and most of these were children under the age of 5, according to the Kentucky Injury Prevention and Research Center.

Nationwide, about 4,000 people a year in the U.S. unintentionally drown, and those deaths disproportionately affect age, racial and ethnic groups, according to a recent CDC report. 

That same study found that the number of unintentional drownings were "significantly higher" during the pandemic (2020-22), than those in the pre-pandemic (2019).  And, it said, the drowning rates during the pandemic included "increases among populations that were already at elevated risk, such as children, older adults and Black persons." 

The report notes that data on drowning-risk factors are limited, but suggests that increased drownings in the pandemic could have been related to infrastructure disruptions, including limited access to supervised swimming settings. 

The report stresses that basic swimming and water-safety skills training can reduce the risk for drowning, but social and structural barriers to accessing this training persist – especially among groups at the highest risk. 

To that point, the study found that just over one half of U.S. adults have never taken a swimming lesson and that this rate was highest among Hispanics (72%), Blacks (63%) and other races or ethnicities (53%). Further, it found that 15% of adults reported not knowing how to swim. 

"Recent increases in drowning rates, including those among populations already at high risk, have increased the urgency of implementing prevention strategies," says the report.  "Basic swimming and water safety skills training can reduce the risk for drowning." 

Headed to the water? Wear a swimsuit with colors that are easy to see, and remember, drowning rarely happens as you see it on TV

This girl is wearing a swimsuit with contrasting colors, easily
seen in the water. (Photo by Alex Bard, iStock/Getty Images Plus)

By Sherri Hannan
University of Kentucky

The temperature is rising, and everyone is heading to the pool, lake or beach to cool off. But did you know the color of your swimsuit plays a big part in water safety? And that drowning rarely looks like how it is represented on television and in motion pictures?

Drowning is the leading cause of death for children ages 1 to 4, and the second leading cause of death for children ages 5 to 14, according to the Centers for Disease Control and Prevention. Black children's chances of drowning are more than seven times greater than white children's.

Even if drowning doesn't cause death, drowning injuries can cause brain damage and other serious outcomes, including long-term disability.

Experts are urging parents and caregivers to avoid putting children in blue and green swimsuits. Even in shallow water, blue and green are very difficult to see. Drowning can happen very quickly and quietly, and visibility is important when supervising kids around water. Stick with bright, neon colors for swimsuits, pool toys and floatation devices.

Remember, drowning doesn’t look like drowning. In TV and movies, a drowning person waves their hands and calls for help. In reality, drowning is silent. A drowning person may appear to be relaxed and quietly treading water. If you see someone with their head tilted back and they look like they are climbing an invisible ladder, call for help immediately.

Here are some other tips to keep kids safe in and around water this summer:

• Use designated swimming areas and recreational areas whenever possible. Look for posted signs about open water hazards. Also look for signs that say when lifeguards will be present.
• Avoid distractions when your child is in or around water. Drowning is often silent and can occur in minutes. Put away phones, books and magazines.
• Choose a water watcher. When there are several adults present, alternate who is responsible for watching children in or near the water.
• Keep your ears open as well as your eyes. If your child gets quiet, find out why.
• Wear a U.S. Coast Guard-approved life jacket when boating or participating in other water activities. Choose a life jacket that is right for your child’s weight and water activity. Weak swimmers and children who cannot swim should wear life jackets when they are in or near water.
• Learn CPR and basic water rescue skills. It is important to know how to respond in an emergency without putting yourself at risk of drowning. Local chapters of organizations such as the Red Cross offer CPR and water safety courses.

In flood cleanup, here's how to stay safe and healthy

Disaster cleanup workers take breaks and keep hydrated
when temperatures are high, as is forecast this week.

Floods can kill, but so can the cleanup, if you aren't careful, says Anna Goodman Hoover, an assistant professor in the University of Kentucky College of Public Health.

"As people try to re-enter flood-damaged properties, the risk of serious injury and even death is high," Hoover told Kentucky Health News. She shares a package of "vetted materials from various agencies and environmental/disaster organizations that provide safety information for re-entering, cleaning up, etc."

The college's Department of Epidemiology and Environmental Health has created a web page with a wide range of resources for people to stay safe and healthy in flooding. Here are selected examples from Hoover's package of how to protect yourself.

• Wash your hands often to avoid exposure to harmful substances.

• Use hand sanitizers frequently.

• Exercise good housekeeping.

• Only drink from proven potable water sources.

• Be careful walking over and handling debris that is covered with water, to avoid risk of slips, trips and falls.

• Remain current with tetanus vaccination (within the past 10 years).

• If exposed to stagnant water, wash and sanitize immediately.
• If injured by sharp or jagged materials, immediately clean out all open wounds with soap and clean water. If a wound gets red, swells, or oozes, seek immediate medical attention.

• Consider steel toe/shank footwear if available and use durable gloves for handling debris.

• Watch for exposed power lines.

• Use hearing protection for noisy environments.

• Use appropriate breathing apparatus to avoid inhaling dust containing asbestos, silica and other lung-damaging substances.

• Avoid sunburn by limiting exposure, using protective eyewear and using sunscreen and lip balm.

To avoid heat stress:

• Drink plenty of fluids, sports drinks if available.

• Monitor yourself and coworkers, use the buddy system.

• Block out direct sun or other heat sources.

• Use cooling fans and/or air conditioning, and rest regularly.

• Wear lightweight, light-colored, loose-fitting clothes.

• Avoid alcohol, caffeinated drinks, or heavy meals.

• Seek medical attention for symptoms of: extremely high body temperature (above 103°F); red, hot, and dry skin (without sweating); rapid, strong pulse; throbbing headache, dizziness or nausea.

• Take shelter in shaded areas and loosen or remove excess protective clothing if feasible.

To avoid traumatic stress:

• Pace yourself and take frequent rest breaks.

• Watch out for each other and identify nearby hazards.

• Be conscious of those around you. Exhausted responders or stressed responders may put themselves and others at risk.

• Maintain as normal a schedule as possible; regular eating and sleeping are crucial.

• Whenever possible, take breaks away from the work area.

• Recognize and accept what you cannot change—the chain of command, organizational structure, waiting, equipment failures, etc.

To avoid eye injury:

• Use safety glasses with side shields; a retainer strap is suggested.

• Consider safety goggles for protection from fine dust particles; can be used over regular prescription glasses.

• Any worker using a welding torch for cutting must have special eye wear to protect against welding flash, which causes severe burns to the eyes and surrounding tissue.

• Use only protective eyewear that has an ANSI Z87 mark on the lenses or frames.

Avoid the hazards of floodwaters:

• There are usually elevated levels of contamination associated with raw sewage and other hazardous substances in floodwaters.

• Minimize human contact with flood water.

• Wear waders and waterproof gloves.

• If skin comes into contact with floodwater, wash thoroughly with soap and water.

• Keep all open cuts or sores as clean as possible.

• Use antibiotic ointment such as Neosporin.

• Stay alert for flash flooding.

• Floodwater may contain chemicals, diesel fuel, gasoline, motor oil, chlorine, liquid oxygen, medical waste, corrosives and industrial and household products in all sizes and quantities.

Watch your work environment:

• Do not enter a structure that shows indication of being unsafe such as walls with large cracks, shifting, or partial collapse.

• Determine if any hazardous substances have been anywhere on the property including pipes and tanks.

• Don’t walk on surfaces you aren’t sure are stable.

• Use other ways to get to work surfaces, such as bucket trucks.

• Erect scaffolding on stable surfaces and anchor it to stable structures.

• Wear protective equipment provided, including safety shoes with slip resistant soles.

• Use fall protection with lifelines tied off to suitable anchorage points, including bucket trucks, whenever possible.

• After flooding, the water creates the perfect environment for mold to grow in homes and other buildings. Exposure to mold can cause wheezing and severe nasal, eye and skin irritation.

• Floods chase animals from their burrows, increasing the risk of snakebite.

At home:

• Reconnect with family, spiritual, and community supports.

• Do not make any big life decisions.

• Spend time with others or alone doing the things you enjoy to refresh and recharge yourself.

• Be aware that you may feel particularly fearful for your family. This is normal and will pass in time.

• Remember that “getting back to normal” takes time.

 • Be aware that recovery is not a straight path but a matter of two steps forward and one back. You will make progress.

• You need to support your family and recognize that you are not going through this along.

• Avoid overuse of drugs or alcohol. 
• Identify and throw away food that may not be safe to eat: Food that may have come in contact with flood or storm water; food that has an unusual odor, color, or texture; meat, poultry, fish, eggs and leftovers that have been above 40 degrees F for two hours or more; food containers with screw-caps, snap-lids, crimped caps (soda pop bottles), twist caps, flip tops, snap-open, and home canned items; these cannot be disinfected if they have been in contact with floodwater

• If power is out, keep the refrigerator and freezer doors closed as much as possible
• Add block ice or dry ice to your refrigerator if the electricity is expected to be off longer than four hours.

• Wear heavy gloves when handling ice
Employers: Federal law "requires employers to provide a safe and healthful workplace free of recognized hazards and to follow Occupational Safety and Health Act standards. Employers' responsibilities also include providing training, medical examinations and record keeping. For more information, go to www.osha.govor call 1-800-321-OSHA(6742).

Employees should "follow the employer's safety and health rules and wear or use all required gear and equipment, and follow safe work practices for your job, as directed by your employer." Report hazardous conditions to a supervisor, and to the state OSHA agency, if employers do not eliminate them.

The above information originated with the Federal Emergency Management Agency, the National Institute of Environmental Health Sciences, the National Institute of Occupational Safety and Health, the Occupational Safety and Health Administration, the Centers for Disease Control and Prevention and the U.S. Army Corps of Engineers.

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.

Most Kentucky hospitals in national safety ratings got Cs again; state's percentage of A grades is 35th in nation, down from 30th

By Melissa Patrick
Kentucky Health News

A nonprofit group that gives letter grades twice a year to hospitals for patient safety has again given grades of C to most Kentucky hospitals on its list. 

The Leapfrog Group, based in Washington, D.C., rated nearly 3,000 general acute-care hospitals. Most of Kentucky's 126 hospitals were not rated. 

The group does not grade small hospitals with "critical access" status because they don't have to report quality measures to the federal government; nor does it grade specialty hospitals, government hospitals, or hospitals that don't have enough publicly reported data.

Lepfrog gave A ratings to 11 Kentucky hospitals, 20% of the 55 it graded; Kentucky ranked 35th among states in A grades, down from 30th in the last report. It gave Bs to 14 Kentucky hospitals, Cs to 25 and Ds to five. 

The grades are based on more than 30 measures that indicate how well hospitals protect patients from preventable errors, injuries, accidents and infections. A Leapfrog news release says the latest grades reflect the impact of the pandemic on patient safety, with several measures showing a significant decline. The latest Hospital Safety Grades are published alongside a new report titled, "Patient Experience During the Pandemic: Adult Inpatient Care." 

The report uses data from the Centers for Medicare and Medicaid Services, Leapfrog's own survey and other supplemental data sources. Hospitals are only graded if they have submitted adequate data for evaluation, Leapfrog says.

The Leapfrog site offers details on a number of  measures, under headings titled Infections, Problems with Surgery, Practices to Prevent Errors, Safety Problems, and Doctors, Nurses and Hospital Staff. It also includes an easy-to-read, color-coded scale that indicates how the hospital is performing.

Screenshot of Leapfrog page for St. Claire Regional Medical Center in Morehead, which fell to a
D rating in the latest six-month report after getting seven Cs in a row. To enlarge an image, click on it. 

High Scores

Hospitals getting As were: Baptist Health in Corbin, Lexington and Richmond; Deaconess Henderson Hospital; Tompkinsville's Monroe County Medical Center; Louisville's Norton Audubon Hospital, Norton Brownsboro Hospital, Norton Hospital, and Norton Women's & Children's Hospital; Mercy Health Lourdes in Paducah; and St. Elizabeth Healthcare-Ft. Thomas. 

Of these, Baptist Health Corbin, Mercy Health Lourdes and St. Elizabeth moved up from a B rating in the last report. The rest maintained their A grade. 

This is the sixth straight grading period that all four Norton Healthcare adult-service hospitals in Louisville have received an A. 

Shifts up and down

After receiving Cs and one D since spring 2016, Ephraim McDowell Regional Medical Center in Danville rose to a B on the latest report. 

The Albert B. Chandler Hospital at the University of Kentucky also moved up to a B after receiving Cs and one D since fall 2018. 

Three others also moved up to a B, after getting a C last time: Baptist Health Deaconess Madisonville; Glasgow's T.J. Samson Community Hospital; and Leitchfield's Twin Lakes Regional Medical Center, which has joined the Owensboro Health system. 

Owensboro Health's main hospital fell moved from A to B, as did three others: Baptist Health Paducah; Bowling Green's TriStar Greenview Regional Hospital and Middlesboro ARH Hospital.  

Other hospitals with B grades are Baptist Health Louisville; Winchester's Clark Regional Medical Center; Frankfort Regional Medical Center; Lexington's Saint Joseph East; and St. Elizabeth Heatlhcare-Edgewood. 

Almost half the 55 Kentucky hospitals graded by Leapfrog got Cs on the latest report. Of those, most of them also got a C on the last report; nine moved down from a higher grade. 

After getting seven and three As in a row, respectively, St. Elizabeth Healthcare-Florence and Flaget Memorial Hospital in Bardstown fell to the C level. 

Seven hospitals dropped to a C after having Bs last time: Advent Health Manchester; Baptist Health La Grange; Lake Cumberland Regional Hospital in Somerset; St. Joseph Mount Sterling; St. Joseph-London; Tug Valley ARH Regional Medical Center in South Williamson; and U of L Health-Sts. Mary and Elizabeth Hospital in Louisville.

After receiving seven Cs in a row, St. Claire Regional Medical Center in Morehead fell to a D. The other four hospitals with Ds got the same grade on the last report: Murray-Calloway County Hospital; Hopkinsville's Jennie Stuart Health; Pikeville Medical Center and Taylor Regional Hospital in Campbellsville.

Kentucky highway fatalities rose again in 2021, by 3%; once more, most of those killed were not wearing their seat belt

Ky. Health News graph from state data shows fatalities not using a seat belt, and in which alcohol, speeding or aggressive driving, and distracted driving were involved, and the total number of fatalities.

Deaths from highway accidents in Kentucky rose 3.3 percent last year, according to the State Police and the Transportation Cabinet. But so far this year, fatality numbers are running below last year. 

Again last year, most of those killed were not wearing a seat belt.

"Of the 806 highway fatalities last year in Kentucky, 54.7 percent were not wearing a seat belt and 15 percent involved alcohol," the agencies said in a press release. "Approximately 26 percent involved speeding or aggressive drivers and 15 percent involved driver distraction."

Those percentages were about the same as in 2020, and those two years showed declines in fatal speeding or aggressive driving and driver distraction from 2019. About 32 percent of deaths in 2019 involved speeding or aggressive driving, and 21 percent involved driver distraction.

Unlike the last two years, 2021 saw deaths of motorcyclists outnumber those of pedestrians and  bicyclists. In 2021, pedestrians and bicyclists accounted for 85 deaths and motorcyclists accounted for 88 deaths. In 2020, pedestrians and bicyclists accounted for 97 deaths and motorcyclists accounted for 74 deaths. In 2019, pedestrians and bicyclists accounted for 79 deaths and motorcyclists accounted for 77 deaths.

“While we pledge to increase our awareness efforts, we need the public’s help,” Transportation Secretary Jim Gray said in the press release. “We’re asking motorists to commit to save driving behaviors when behind the wheel, and everyone – both drivers and passengers – pledge to always buckle up.”

According to the National Highway Traffic Safety Administration, wearing a seat belt gives motorists the best chance of preventing injury or death if involved in a crash. Properly fastened seat belts contact the strongest parts of the body, such as the chest, hips and shoulders. A seat belt spreads the force of a crash over a wide area of the body, putting less stress on any one part, and allows the body to slow down with the crash, extending the time when the crash forces are felt by the occupant.

Most Ky. hospitals in national patient safety ratings got Cs again

By Melissa Patrick
Kentucky Health News

A nonprofit group that grades hospitals for patient safety was able to provide scores for nine more Kentucky hospitals in its latest report, and again gave Cs to most of those it graded. 

The Leapfrog Group, based in Washington, D.C., rated more than 2,900 general acute-care hospitals, the most ever. Most of Kentucky's 126 hospitals were not rated, but those that were have most of the state's hospital beds.

The group does not grade small hospitals with "critical access" status because they don't have to report quality measures to the federal government, nor does it grade specialty hospitals, government hospitals, or hospitals that don't have enough publicly reported data.

Leapfrog gave A ratings to 15 Kentucky hospitals, or about 25% of those it graded, up from 24% in the last report. Kentucky ranked 30th in A grades, up from 33rd in the last report, issued in May 2021.  Leapfrog gave Bs to 17 Kentucky hospitals, Cs to 23, and Ds to four. 

The twice-yearly grades are based on more than 30 performance measures of patient safety that indicate how well hospitals protect patients from errors, injuries, accidents and infections. For the first time, the report includes performance grades for post-operative sepsis, blood leakage and kidney injury. 

The news release notes that post-operative sepsis can result in "suffering, disability and sometimes death for an estimated 160,000 people a year in the United States. It adds that sepsis in all settings kills over 270,000 people a year and is the costliest condition in U.S. hospitals. Further, it says that Black people are twice as likely as white people to be diagnosed with sepsis

The report uses data from the Centers for Medicare and Medicaid Services, Leapfrog's own survey, and other supplemental data sources. Hospitals are only graded if they have submitted adequate data for evaluation, Leapfrog says.

The Leapfrog site offers details on each measures, under headings titled Infections, Problems with Surgery, Practices to Prevent Errors, Safety Problems, and Doctors, Nurses and Hospital Staff. It also includes an easy-to-read, color-coded scale that indicates how the hospital is performing.

Screenshot of Leapfrog page for Hazard ARH Regional Medical Center,
which moved to a C rating after getting five Ds in a row. 

High scorers

Hospitals getting As were: Baptist Health in Lexington, Paducah, and Richmond; Deaconess Henderson Hospital; Flaget Memorial Hospital in Bardstown; Logan Memorial Hospital in Russellville; Middlesboro ARH Hospital; Monroe County Medical Center in Tompkinsville; Louisville's Norton Audubon Hospital, Norton Brownsboro Hospital, Norton Hospital, and Norton Women's & Children Hospital; Owensboro Health; St. Elizabeth Healthcare-Florence; and Tristar Greenview Regional Hospital in Bowling Green. 

Of these, Baptist Health Paducah, Deaconess, Owensboro and Greenview moved up from a B rating in the last report. Logan Memorial, Middlesboro ARH, and Monroe County were not scored in the last report. The rest maintained their A grade. 

Shifts up and down

After receiving Cs and Ds since the Spring of 2016, U of L Health - Mary and Elizabeth Hospital got a B on the latest report.

Four others moved up to a B, after getting Cs in the last report. They were Frankfort Regional Medical Center; Lake Cumberland Regional Medical Center in Somerset and Saint Joseph-East in Lexington.

Four moved down to a B, after getting an A on the last report: Baptist Health LaGrange; Clark Regional Medical Center in Winchester; St. Elizabeth Healthcare-Ft Thomas; and St Elizabeth Healthcare-Edgewood. 

Other hospitals with B grades are Advent Health Manchester; Baptist Health in Corbin and Louisville; Mercy Health Lourdes in Paducah; Paul B. Hall Regional Medical Center in Paintsville; Saint Joseph-London; Saint Joseph Mount Sterling; Three Rivers Medical Center in Louisa; and Tug Valley ARH Regional Medical Center in South Williamson. 

Again, most of the hospitals got Cs, and most on this list got a C on the last report. 

After getting five Ds in a row, Hazard ARH Regional Medical Center moved up to a C. 

Three hospitals dropped to a C, after having Bs on the last report: Baptist Health Madisonville; King's Daughters Medical Center in Ashland; and T.J. Sampson Community Hospital in Glasgow.

Three that got Cs on the last report moved down to a D. They are Jennie Stuart Health in Hopkinsville; Murray-Calloway County Hospital; and Taylor Regional Hospital in Campbellsville. Pikeville Medical Center got its second D in a row after a string of Cs. Only two Kentucky hospitals got a D score in the Spring report.

Most Ky. hospitals in patient-safety survey for national nonprofit's twice-a-year report card again get grade of C; fewer got As

By Melissa Patrick

Kentucky Health News

A nonprofit group that grades hospitals for patient safety gave fewer As in Kentucky than the last time, and again gave Cs to most of the 50 Kentucky hospitals that it evaluates. 

The Leapfrog Group, based in Washington, D.C., rated more than 2,700 general acute-care hospitals. Most of Kentucky's 126 hospitals were not rated, but those that were have most of the hospital beds in the state. 

The group does not grade small hospitals with "critical access" status because they don't have to report quality measures to the federal government, nor does it grade specialty hospitals, government hospitals, or hospitals that don't have enough publicly reported data. 

Leapfrog gave As to 12 Kentucky hospitals, or about 24 percent of those it graded, down from about 36% on the last report. Kentucky ranked 33rd in A grades, down from 21st in the last report, issued in fall 2020. Leapfrog gave Bs to 12 hospitals, Cs to 24, and Ds to two. 

The twice-yearly grades are based on 27 performance measures of patient safety that indicate how well hospitals protect patients from errors, injuries, accidents and infections. The report uses data from the Centers for Medicare and Medicaid Services, Leapfrog's own survey, and other supplemental data sources. Hospitals are only graded if they have submitted adequate data for evaluation, Leapfrog says.

The Leapfrog site offers details on each measures, under headings titled Infections, Problems with surgery, Practices to Prevent Errors, Safety Problems, Doctors, Nurses and Hospital Staff. It also includes an easy-to-read, color-coded scale that indicates how the hospital is performing.

Screenshot of Leapfrog page for Harrison Memorial Hospital in Cynthiana, which moved to a C from 
an A, shows detail for infection issues and tabs for other issues. For a larger version, click on it. 

The report notes that the data from the report does not yet reflect the impacts of the coronavirus pandemic. 

Leah Binder, president and CEO of the group. added that the scores in this report should serve as a proxy for the safety of care provided to Covid-19 patients in many ways, noting that hospitals with strong infection control policies in place are better equipped to protect their patients and workers.

"As we emerge from the pandemic, hospitals need to double down on safety, so they save lives, strengthen their organizations, and position themselves to withstand the next crisis. Putting safety first should be the priority of every hospital CEO," she said in a news release. 

High scorers

St. Elizabeth Healthcare-Edgewood has received As on every Leapfrog report card since spring 2014, the first year it was graded.

Other hospitals on the A list are: Baptist Health in La Grange, Lexington, and Richmond; Clark Regional Medical Center in Winchester; Flaget Memorial Hospital in Bardstown; Louisville's Norton Audubon Hospital, Norton Brownsboro Hospital, Norton Hospital, and Norton Women's & Children Hospital; St. Elizabeth Healthcare-Ft. Thomas; and St. Elizabeth Hospital-Florence.

All of the hospitals that got As in this report also got an A on the last report. 

Shifts up and down

Baptist Health Madisonville moved down to a B, after moving up to an A in the last following a string of Cs since fall 2017. 

After two As in a row, Mercy Health Lourdes in Paducah moved down to a B and Saint Joseph London moved back to a B, after moving up to an A in the last report. 

Two hospitals got Bs after not getting a score in the fall of 2020: King's Daughters Medical Center in Ashland and Tug Valley ARH Regional Medical Center in South Williamson. After having no scores reported in the fall, both hospitals had received Cs since fall 2018. 

Other hospitals on the B list are Baptist Health hospitals in Corbin, Louisville and Paducah; Deaconess Henderson Hospital (formerly Methodist Hospital of Henderson); Owensboro Health; T.J. Samson Community Hospital in Glasgow; and TriStar Greenview Regional Hospital in Bowling Green. 

Most of the hospitals got Cs, and most of the hospitals on this list got a C on the last report. 

Georgetown Community Hospital moved down to a C after getting a B in the last report and As since spring 2018. 

Harrison Memorial Hospital in Cynthiana dropped to a C, after getting all As and only one B in the spring 2020 report since fall 2018. 

Highlands Regional Medical Center in Prestonsburg moved up to a C after getting a D in the last report. Since spring 2016, this hospital has received either a C or a D on each report. 

After not being graded since fall 2018, both Jennie Stuart Health in Hopkinsville and Twin Lakes Regional Medical Center (now part of Owensboro Health) in Leitchfield got Cs. 

After getting six Cs in a row, Pikeville Medical Center moved down to a D.  Hazard ARH Regional Medical Center also got a D, its fifth in a row. 

Click here for a list of Kentucky hospitals and their Leapfrog safety grades. Click here for a list of frequently asked questions about the report.

Bill to require Kentucky drivers to pass a vision screening exam at each driver's license renewal nears the legislative finish line

Update 4/9/2021: This story has been revised to reflect that when this law goes into effect July 2024, all drivers license and any vision testing requirements will be done through the Kentucky Department of Transportation, and not the circuit court clerks. 

By Melissa Patrick

Kentucky Health News

Kentucky is close to becoming the 43rd state to require drivers to have a vision screening every time they renew their license. The rule is in a House bill that has passed the Senate is back in the House for consideration of changes made to it in the Senate.

Photo: Depisteo

“House Bill 439 is a commonsense piece of legislation that will save lives by ensuring drivers on Kentucky roadways have the necessary visual acuity to operate a vehicle," Senate Republican Caucus Chair Julie Raque Adams of Louisville told the Senate. “Kentucky only requires a screening when you get your license the first time, even though studies show that visual acuity declines with age.”

If the bill becomes law, its effect would be delayed until July 2024 to allow circuit court clerks, who issue licenses, the Department of Transportation,  time to prepare for it.

Kentuckians would continue to have the choice of renewing their license every four or eight years, and a vision screening test would be required at each renewal. Drivers would have the choice of getting their screening at the renewal office or by a medical provider. Anyone who failed the screening would be referred to a vision specialist for further evaluation. The visual acuity standard in Kentucky is 20/40 or better. 

“It is time for us to join the 42 other states and protect Kentuckians and our roadways,” Adams said. “House Bill 439 does that and makes it convenient for the driver at renewal.”

Adams said HB 439 was supported by ophthalmologists, optometrists, nurse practitioners, transportation officials, state police, the Kentucky Medical Association and the American Automobile Association. She added that AARP didn’t oppose the bill because it does not target older drivers.

Sen. Robin Webb, D-Grayson, said that as a daughter of an optometrist, she was voting for HB 439,  but also shared some concerns. 

"I'm going to vote yes and hold my nose on this bill," she said. “This just to me comes across as another layer of bureaucracy and maybe even prompted by insurance companies, and it's going to be a hardship. There are open-ended fees and administrative allowances that I think we just have to . . . continue to monitor this program and make sure there's valid avenues for appeals." 

Sen. Ralph Alvarado, R-Winchester, noted that it had taken seven to eight years to get all of the stakeholders to agree upon the same language for the bill.

“If you are on the road having trouble reading signs, please get those exams done prior to 2024,” said Alvarado, a physician. 

When HB 439 passed out of the House on Feb. 25, on a 89-5 vote, sponsor Kim Moser, R-Taylor Mill, said the state Transportation Cabinet has said it expects any increase in fees to be "nominal" and will largely be used to cover the cost of equipment. 

Citing several studies, Moser said every state that has implemented a vision screening requirement has seen a reduction in crash-related deaths and hospitalizations.  

The bill passed the Senate 31-4 on March 12 with a committee substitute that clarifies which applicants get a vision test administered by the cabinet or the State Police. If the House approves the changes, the bill would go to Gov. Andy Beshear. If not, the Senate would have to drop the change or send the bill to a House-Senate conference committee. 

Pastor says the pandemic is like driving: Distancing and masking are analogous to wearing a seat belt and watching your speed

Paul Prather

Paul Prather of Mount Sterling, a Pentecostal minister and former Lexington Herald-Leader religion reporter who still writes a column for the paper, has a Facebook page with a diverse set of friends and followers. Recently, he asked them, "Are my wife and I alone in still taking precautions against covid-19? I'm beginning to feel as if we are. Are you wearing masks and practicing strict social distancing or have you returned to your pre-pandemic lifestyle? Either way, what's your rationale? . . . I've ever experienced what I feel now—that those around me could not care less whether they kill me. That the lives of those who are older or have chronic illnesses apparently mean nothing."

Prather reports in the newspaper, "The responses weren’t what I’d anticipated, in volume or content. What I learned from my Facebook friends (mostly) lifted my soul." He estimates that 98 percent those who responded said they wear a mask, but suspects that "way more than 2 percent of my friends aren’t wearing masks or social-distancing now, if they ever did. Apparently, for whatever reasons, these folks didn’t feel comfortable declaring themselves."

That's what Kentucky Health News reporter Melissa Patrick found this month when she interviewed shoppers in the parking lot of Walmart on Nicholasville Road in Lexington. "Most who weren't wearing a mask also didn't want to be interviewed, and of the few who did, most didn't want to share their name," she reported. "But every person who had a mask on and was asked for an interview agreed to it and all but one gave their name."

Prather writes that he has the impression that "hardly anybody was taking precautions," but "After my post, I realized far more people are acting cautiously than I’d imagined. . .. The reason it seemed they weren’t there was that—duh!—they weren’t there. That is, they weren’t the folks cramming into Walmart or Lowe’s or massing on Florida beaches. They were home."

As for his own attitude, Prather says he approaches the pandemic much like driving -- an inherently risky proposition but one that can be managed safely.

"Any 4,000-pound machine hurtling down a road is a lethal threat. People die or are maimed in crashes every day. So I wear my seatbelt. I obey the speed limit (kind of, more or less). I don’t drink and drive. I don’t text while driving. I maintain a comfortable distance between my vehicle and the one ahead of me. If it’s raining, snowing or icy, I slow down. I hope to decrease my odds of having—or causing—a wreck. I want to protect you and me alike," he writes.

"This is how I approach wearing a mask, social distancing and hand washing. I do what I can. I don’t quake with fear. I see it as using good sense and being a good citizen. If you want to risk your life by getting drunk and driving 90, or by failing to take reasonable precautions against covid-19, yes, theoretically that’s your right. Until you start endangering others’ lives. That’s not your right."

With less than half the year gone, Kentucky has already had more drownings than it had all last year; top cause of death, ages 1-4

Photo from The Indianapolis Star 

With public swimming pools closed due to the pandemic, and some families having more free time from work, the number of drownings in Kentucky this year, 33, has already surpassed the number for all of last year, 32, according to the state Department of Fish and Wildlife Resources.

The causes aren't clear, but "With pools now scheduled to open at the end of June, parents and guardians need to keep an eye on their children to ensure their safety in any body of water," Norton Healthcare says in a news release, citing the state figures.

The fish-and-wildlife agency says there have been 14 drownings in lakes, reservoirs and streams in Kentucky since May 23, the start of the Memorial Day weekend.

“It’s concerning that we’ve seen a rise in drownings even before many pools are open,” said Brit L. Anderson, pediatric emergency medicine physician at Norton Children’s Hospital in Louisville. “While many people are aware of the risks of swimming pools, it’s important to remember that other bodies of water can be dangerous, including ponds, rivers, drainage ditches and even bathtubs or backyard wading pools.” 

Drowning is top cause of accidental death in children ages 1 to 4 in the U.S., according to SafeKids.org. Two-thirds of toddlers' drownings occur from May to August, so the summer is the time to safeguard children, the Norton release says. And the safeguarding need to be vigilant; the National Drowning Prevention Alliance says nearly 90 percent of child drownings happen when at least one adult is present.

“Children require constant, attentive supervision when they are in water,” Anderson said. “If there are multiple adults, they need to communicate to make sure someone is watching the water without distraction. Drowning is often silent and can happen quickly.”

Here are safe swimming reminders from Norton:

• Don’t swim alone, especially children. Use the buddy system so there’s always someone looking out for you and loved ones.
• At least one adult should supervise children around water at all times. Don’t let yourself get distracted by talking with friends, reading, drinking alcohol or using your phone when it’s your turn to supervise. Adult supervisors should be trained in CPR.
• If you own a pool, make sure it has a fence completely surrounding it, separating it from the house.
• Teach children lifesaving skills, such as how to float on their back, tread water and move to the side of the pool to climb out.
• Don’t rely on inflatable toys and water wings to keep a child safe. Children can easily fall off of toys or slide out of wings and slip under the water. If the child is using inflatables, you should be right there with a child, especially if he or she cannot swim.
• Kentucky law requires each occupant of a boat to have ready access to a U.S. Coast Guard-approved life jacket. Children younger than 12 must wear a life jacket while in the open portion of a boat that is underway.
• Most boating accidents, particularly among teens, are related to alcohol. Be sure teens know about the dangers of alcohol, on and off the water.

Use of hand sanitizers and homemade cleaners for covid-19 apparently causes an increase in calls to poison-control centers

Increased use of hand sanitizers and homemade cleaners appears to have caused a spike in household poisonings in Kentucky and other states.

Kentucky Poison Control Center logo

Last month, the Kentucky Poison Control Center of Norton Children’s Hospital in Louisville "saw a 30 percent increase in overall exposure calls related to disinfecting agents, including a 56% increase in poisonings from household cleaners and a 30% increase in poisonings from hand sanitizers," Norton Healthcare said in a news release.

Nationwide, the U.S. Centers for Disease Control and Prevention says poison-control centers got more than 45,000 calls related to cleaners and disinfectants in the first three months of the year, "about a 20% increase," Norton reports. "While the increase affected all age groups, children ages 5 and under were impacted the most. Complaints included shortness of breath, dizziness and vomiting."

“The data shows many of the exposures are from consuming or inhaling these products,” said Maria Chapman, poison-prevention coordinator for the Poison Control Center. “We’ve had reports of young kids drinking hand sanitizer, as well as adults breathing in toxic fumes as they mix together combinations of cleaners.” She said parents and caregivers can protect children by:

• Storing all household products out of a child’s sight and reach. Young kids often are at eye level with items under the kitchen and bathroom sinks.
• Installing child safety locks on cabinets containing poisonous items.
• Always following all instructions and warnings, and wearing eye protection.
• Not mixing chemicals.
• Not leaving poisonous products unattended while in use.
• Never putting a potentially poisonous product in something other than its original container where it could be mistaken for something else.

The Poison Control Center's free, confidential hotline is 800-222-1222. It is also Kentucky’s covid-19 hotline. “It’s important to protect against covid-19,” Chapman said, but also make sure in your race to prevent the virus, you’re not also putting yourself and your family in another dangerous situation.”

50 Kentucky hospitals get semi-annual ratings on how well they protect patients from infections, injuries and other safety issues

More Kentucky hospitals are doing better at protecting patients from infections, injuries and other in-hospital threats, according to the latest national rankings, on an A-to-F scale. The ratings improved slightly from the spring; two additional hospitals got As, and fewer got Cs and Ds.

However, two of the University of Kentucky's hospitals dropped to a D, as did Sts. Mary & Elizabeth Hospital in Louisville, which is being renamed U of L Health – Mary & Elizabeth Hospital after its purchase by the University of Louisville.

Louisville's Jewish Hospital, which will also get a U of L prefix as part of the university's purchase of some KentuckyOneHealth units, got an F on patient safety in the latest rankings by the Leapfrog Group, a nonprofit watchdog organization.

Other Kentucky hospitals with Ds were the Hazard ARH Regional Medical Center and Highlands Regional Medical Center in Prestonsburg.

Methodist Hospital of Henderson, which got an F in the spring, got a C, the most common grade for the 50 Kentucky hospitals rated. Most of Kentucky's 125 hospitals were not rated, since rural hospitals with "critical access" status don't have to report quality measures to the federal government.

Leapfrog bases its grades on data about "infections; surgery and safety problems; error-prevention practices; and metrics on doctors, nurses and staff to determine its rankings and grades twice a year," the Lexington Herald-Leader notes. Leapfrog says its data come from the Centers for Medicare & Medicaid Services (CMS), its own surveys and other sources.

One tab rating The Medical Center at Bowling Green,
which got a C overall, breaks down how it did on infections.
(For a larger version of the chart, click on the image.)

The Leapfrog site offers details on each of the measures under headings titled infections, problems with surgery, practices to prevent errors, safety problems, doctors, nurses & hospital staff. It also includes an easy-to-read, color-coded scale that indicates how the hospital is performing.

UK's Albert B. Chandler Hospital and Good Samaritan Hospital got Ds this fall after Cs in the spring. "In other rankings, UK does very well," the Herald-Leader notes. "Chandler Hospital was ranked as the No. 1 regional facility in Kentucky by U.S. News and World Report and has been for four years.

Dr. Mark Newman, UK’s executive vice president for health affairs, told the Herald-Leader, “Like many academic medical centers, UK HealthCare serves a disproportionate number of patients with complex medical needs, which is not accurately represented by Leapfrog. . . .The quality of care and safety of our patients is of utmost importance at UK HealthCare and we continue to invest in substantial resources to continually improve in these areas.”

Chandler Hospital's rating cited surgery problems such as objects left in patients' bodies; surgical wounds that split open; death from serious treatable complications; collapsed lungs; serious breathing problems; and dangerous blood clots. It also got lower marks for antibiotic-resistant infections and surgical-site infection after colon surgery. "Dangerous bedsores and patient falls/injuries also were issues," the Herald-Leader notes. "Good Samaritan received below-average scores in many of the same areas."

The Centers for Disease Control and Prevention reports that the U.S. has about 35,000 deaths a year from drug-resistant infections. That's one about every 15 minutes, CNN notes.

Jewish Hospital also had problems with infections, surgery, bedsores patient falls and injuries, and communication with patients. U of L Health told the Courier Journal that the ratings of some of its hospitals (U of L Hospital got a D, as usual) didn't reflect "the complex nature of the patient cases they handled or the high-risk population they serve," CJ reporter Morgan Watkins writes.

U of L "noted that some of the information Leapfrog took into account dates back to early 2016," when its hospital was managed by KentuckyOne Health. "The university resumed control of U of L Hospital in mid-2017 and officially acquired Jewish and other Louisville-based KentuckyOne facilities on Nov. 1."

Chief Medical Officer Jason Smith said, "Since 2018, U of L Hospital has reported almost perfect compliance with the Leapfrog Safe Practices. We have reviewed our publicly reported data since July 2017, and utilizing the Leapfrog Group’s own calculator for scoring with that data, our calculated grade would have been a C."
On the positive side, two Kentucky hospitals earned As for the first time: Flaget Memorial Hospital near Bardstown and Jewish Hospital-Shelbyville. The other As went to Baptist Health Lexington, Clark Regional Medical Center in Winchester, Georgetown Community Hospital, Cynthiana's Harrison Memorial Hospital, Louisville's four Norton Healthcare hospitals, and the St. Elizabeth Healthcare hospitals in Edgewood, Florence and Fort Thomas.

The most common grade was a C, given to 20 hospitals. The 10 with B grades are Owensboro Health, Glasgow's T.J. Samson Community Hospital, the three CHI Saint Joseph Health hospitals in Lexington and London, Baptist Health Paducah and Mercy Health Lourdes in Paducah, and Whitesburg ARH Hospital.

Medicare open enrollment begins Tuesday, Oct. 15

The open enrollment period for Medicare begins Tuesday, Oct. 15 and runs through Dec. 1. This is the period in which Medicare beneficiaries can select new health-insurance plans and adapt to changes in costs and coverage and their health-care needs. If they do nothing, their current coverage will continue in 2020.

The new year will see the end of the Medicare Part D "donut hole." Beneficiaries will pay no more than 25 percent of the cost of brand-name and generic prescription drugs after any deductible, until they reach the limit on out-of-pocket spending. Also, some Medicare Advantage (Part C) plans will offer nontraditional services, such as transportation to a doctor's office, home safety improvements, or services of nutritionists.

"Because Medicare is such a large program — serving close to 60 million or almost one in five Americans — it’s also a big target for scammers," the Danville Advocate-Messenger says in an editorial. It notes that the Kaiser Family Foundation "recommends using the Medicare.gov website or calling 1-800-MEDICARE (633-4227) to find a Medicare plan you like."

The foundation has many frequently asked questions about Medicare, with answers. It advises, “If you are covered by Medicare, and you are interested in reviewing and comparing your Medicare options, make sure the plans you are considering during the Medicare open enrollment period are Medicare plans, not Marketplace plans. Medicare plans are not sold through the federal or state Marketplace websites,” which are used to sell federally subsidized insurance under the Patient Protection and Affordable Care Act, often called Obamacare.

National Preparedness Month's theme is 'Prepared, Not Scared. Be Ready for Disasters.' Here are tips to help you be prepared.

Because emergencies and disasters can happen without notice, the state Department for Public Health is offering tips on how to always be prepared in a campaign called "Prepared, Not Scared. Be Ready for Disasters" during National Preparedness Month, which falls in September.

“Emergencies and disasters can happen anytime and anywhere, often without notice and can leave us scared and confused,” Jim House, manager of the department's preparedness branch, said in a news release. “By taking the time to follow the ten steps outlined below, we all can better prepare ourselves and our communities should emergencies or disasters strike.” The state campaign encourages households, businesses and organizations to take the following 10 steps to prepare for a disaster:

• Assemble a "Go Bag" packed with essential items to have in the event of an emergency evacuation of your home. Go to ready.gov/build-a-kit for a list of what to put in a go-bag.
• Prepare digital forms of important documents for an emergency, including your ID and passport. You could also make copies of these documents and put them in a waterproof pouch or zip-lock bag.
• Have extra supplies in case of an emergency.
• Download the Federal Emergency Management Agency app (https://www.fema.gov/mobile-app) to provide emergency information about disaster resources, weather alerts and safety tips.
• Have an alternative power source for devices during emergencies.
• Set up an In Case of Emergency (ICE) emergency contact in your cell phone.
• Choose an emergency contact when out of town.
• Find a local, pet-friendly evacuation center.
• Update your social media to tell loved ones you are safe during an emergency.
• Text, don’t call, in an emergency. Phone lines will be clogged with calls reporting important information.

FEMA also offers a wealth of information to help people prepare for a disaster, including a "Family Emergency Communication Plan" form. FEMA suggests keeping some cash on hand in case of emergencies, since ATMs and credit card readers won't always be available; small bills are best.

Centers for Disease Control and Prevention graphic; click it to enlarge

The Centers for Disease Control and Prevention offers tips to address health needs during a disaster, including: gathering enough food, water and medical supplies to last at least 72 hours; preparing a seven- to 10-day supply of prescription medications; making copies of important documents and medical records, including an up-to-date list of all prescription drugs for each person in the household, with dosage and a list of each person's known allergies; and learning life-saving skills, such as cardiopulmonary resuscitation (CPR) to use until help arrives.

In addition, don't forget to prepare for pets' needs, including making sure they wear their collars and tags with up-to-date information or are microchipped to increase the chances that you will be reunited if you are separated.

And most importantly, make sure everyone, including children, knows what the disaster plan is since you might not be together when the disaster happens. The CDC offers "Ready Wrigley," a children's activity book series, to help parents talk to children about disasters.

"Remember that preparedness is a shared responsibility - it takes a whole community to prepare and respond to emergencies," said House.

National Preparedness Month was started after Sept. 11 and is organized by the U.S. Department of Homeland Security. For more information about preparing for and responding to emergencies, visit http://www.ready.gov.

Workshop offers tips to keep kids safe on farms; biggest injury-causers are falls (often from tractors), animals and machinery

By Melissa Patrick
Kentucky Health News

Growing up on a farm gives children the opportunity to play in ways that few others get to experience, and gain a set of useful skills, but agricultural safety experts caution that farm life also comes with safety challenges that all too often can result in injury or even death.

According to the National Ag Safety Database, 33 children sustain agriculture-related injuries every day, and every three days a child dies from an agriculture-related incident.

"A lot of these ag-related injuries, work-related injuries in ag, are related to the fact that children are doing work that does not match their capabilities or their abilities," youth agricultural safety specialist Marsha Salzwedel said at the Child Agricultural Injury Prevention Workshop in Lexington Aug. 6-7.

The three most common causes of non-fatal injuries are falls, animals and machinery, such as tractors; and the top three causes of fatal injuries are machinery, other vehicles and drowning.

Salzwedel, of the National Children's Center for Rural and Agricultural Health and Safety, added that advances in technology are changing the types of farm injuries found in children. She told the story of a child who lost an eye after being hit by a drone.

Page from guidelines book; for a larger version, click on the image.

Salzwedel suggested that parents use the Agricultural Youth Work Guidelines to help determine whether a youth has the physical and cognitive abilities to safely perform a job.

The guidelines have a checklist for 51 ag-related jobs detailing what youth between 7 and 16 need to perform a job safely. The list also gives adult responsibilities, suggestions for the level of adult supervision, and hazards and protective strategies.

Salzwedel noted that tractors are the leading cause of fatalities for youth and children, but added that all-terrain vehicles and skid-steer loaders "are coming up fast behind them."

The National Children's Center for Rural and Agricultural Health and Safety reports that tractors are responsible for more than 40% of unintentional farm-injury deaths of children under 15. It also reports that four out of five farm children regularly ride on them.

Tractors are notorious for turning over, but CultivateSafety.org says there are many ways a rider can fall and be injured while riding on a tractor, including "sudden stops, driving over holes, stumps and debris, or a sharp turn." It adds that tractors with cabs are no guarantee of injury prevention, because children have fallen out cabs after hitting a door than then opened.

The Childhood Agricultural Safety Network, a 60-member coalition that includes the American Farm Bureau Federation, has launched a "Keep Kids Away from Tractors" campaign with the message: "It's easier to bury a tradition than a child."

Dennis Murphy, a professor emeritus at Penn State University, said ATVs present a number of safety challenges when it comes to keeping kids safe on farms. For example, he noted that all too often young children are at risk of getting hurt on them because they are driving a machine that is too big for them, riding with passengers, not wearing helmets, operating on paved roads, which they are not designed for, or driving on slopes and uneven ground.

He added that a recent survey shows that upwards of 90% of youth say they drive an adult-sized machine and that another study found that 90% of kids have never received any training on ATV use.

Murphy also noted that 60% of child ag-related injuries happen to children who are not working, including infants, toddlers and pre-schoolers. He stressed that "childcare is the best option" to keep children safe on farms, but said when this isn't possible it's important to provide a "safe play area."

The National Children's Center for Rural and Agricultural Health and Safety offers an online book that shows how to create safe play areas on farms. Suggestions include making sure the area has designated physical boundaries and is away from traffic and machinery; age-appropriate equipment for the children using it; and competent supervision.

Several speakers noted that some obstacles to a safer farming culture for children is that parents and farm supervisors often underestimate the risk of injury or assume that decisions about safety are "obvious" or are "common sense," and believe "It will happen to someone else."

Joe Grzywacz, a Florida State University professor who has researched immigrant farmworkers and their families, told the workshop attendees, "Families don't think of this as an occupational risk; they are thinking about this as . . . this is the way we live our lives."

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.