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." 

State doctors' group calls for more gun control, repeal of Second Amendment 'sanctuary' law; passes resolutions on many topics

By Melissa Patrick

Kentucky Health News

The Kentucky Medical Association called mass shooting and gun violence "a public-health crisis" and called for more gun control in one of nine resolutions on the topic at its annual convention.

Voting delegates representing the state's doctors also adopted resolutions addressing sex education, abortion care and more at their meeting Aug. 25-27 in Louisville.

Kentucky has the “14th-highest rate of gun deaths” in the nation, according to one of the resolutions.

 

KMA joined several other groups in declaring the public-health crisis, in a resolution that supports "A ban of assault (semi-automatic) weapons and killing-enhancement features, including high-capacity magazines, rapid-fire increases ('bump stocks'), silencers, and guns without serial numbers ('ghost' and 3-D printed guns)."

The resolution also calls for background checks without loopholes, waiting periods and safety training on all firearm transfers (retail, internet, gun-show purchases, lending and gifts); and extreme-risk protective orders ('red flag' laws) "to disarm persons who pose risks of gun violence to self or others."

Before the convention, Alex Acquisto of the Lexington Herald-Leader talked to KMA Executive Vice President Patrick Padgett about how KMA passes resolutions and what it means. 

Padgett said the association, by definition, is an advocacy organization to promote the well-being of patients, doctors and the community at large, and the resolutions represent the consensus of an organization that represents thousands of doctors statewide. Padgett said KMA members regularly conduct grassroots advocacy with legislators about health-related bills.

The group's rules say any KMA member can propose a policy change, which is then reviewed by a group of more than 100 doctors in KMA’s House of Delegates, which votes on resolutions in deliberations that are closed to the public. KMA is a private organization, not a public agency coveregd by the state Open Meetings Act.  

Acquisto notes that the KMA's suggested firearm legislation goes against the long-prevailing views in the General Assembly. 

Other resolutions support creation of a statewide gun-safety office to reduce firearm-related deaths;  eliminating ghost-gun loopholes; supporting legislation that promotes the implementation of "domestic violence prohibition laws;" screening during medical visits for presence of guns in the home; and research and educational campaigns about firearms, including safe storage.

"Gov. Andy Beshear, a Democrat, has called for the legislature to pass  to this end multiple times since he became governor — as far back as 2019 after two mass shootings in El Paso, Texas, and Dayton, Ohio, left dozens of people dead, and again this year, after a gunman in downtown Louisville killed five people," Acquisto reports.

Such laws are not popular "in a state that has historically championed the proliferation of and freedom to possess firearms," she adds. "Beshear’s predecessor, Republican Gov. Matt Bevin, said in 2019 that red flag laws are an 'erosion of our constitutional rights' and signed" into a law a bill repealing the requirement for a separate permit or training to carry a concealed deadly weapon.

"In 2020, a bipartisan bill to enact a red-flag law in Kentucky failed to get traction," Acquisto notes. "Earlier this year, legislators enacted a law making Kentucky a 'Second Amendment Sanctuary' state."

The legislation, which Beshear allowed to become law without his signature, says local and state officials and their employees shall not "enforce, assist in the enforcement of, or otherwise cooperate in the enforcement of a federal ban on firearms, ammunition, or firearm accessories."

One of the KMA resolutions calls for Kentucky to repeal the law, saying it and one to ban local gun laws "substantially weaken protection of our schoolchildren, citizens and police officers from mass shootings and gun violence." 

Abortion resolutions

Last year's KMA meeting, two months after the U.S. Supreme Court overturned federal abortion protections, allowing Kentucky's trigger law banning abortion except to save the life of the mother to become law, "could not reach consensus to take a bold stance in opposition to state laws restricting it," Acquisto reports. 

Five abortion-related resolutions were proposed at that meeting, and most were not adopted. This year, the KMA House of Delegates passed two of three abortion-related proposals. 

The first one "supports the protection of OB/GYN residents in Kentucky to have comprehensive education and training in obstetrics and gynecology," stating that without such training, "residents will compromise the future of OB/GYN health care and failure to incorporate abortion training in the resident curriculum will lead to a generation of physicians ill-equipped to fulfill their duty to care for patients." 

The other resolution calls for "revisions to relevant state statutes that restrict access to abortion-inducing medications for women who experience underlying medical conditions concurrently with life-threatening pregnancies."

That is aimed at 2022 House Bill 3, which "prohibits doctors from providing abortion-inducing medication to patients with certain medical histories, including if they have a history of ectopic pregnancies, are taking steroid hormones for rheumatoid arthritis, or are on a blood thinner medication for a heart condition, for example," Acquisto writes.  

The resolution says “The unintended consequences of HB 3 could adversely impact women and risk their lives during a life-threatening pregnancy.” 

A resolution to support comprehensive reproductive health care for women, including the opportunity to choose a medical or surgical abortion, was not adopted. 

Transgender health care and sex education 

Acquisto reports that last year, before most Republican-controlled states "began outlawing gender-affirming care for transgender youth, KMA adopted a policy supporting access to hormones and puberty blockers, and the preservation of the doctor-patient relationship in such settings, devoid of political tampering. According to the current policy handbook, KMA 'advocates against any prohibition of physicians or other health care providers (from) socially affirming gender identity or discussing evidence-based therapies for management of gender dysphoria with their patients and their parents.' The association also supports behavioral-health options and "non-surgical treatment provided to youth by appropriately trained and experienced health-care providers."

This year, the General Assembly passed Senate Bill 150, outlawing all forms of gender-affirming medical care for trans youth, contradicting the advice of the KMA and all oyther major U.S. medical associations.

None of this year's KMA resolutions addressed gender-affirming care, but two dealt with sex and health education in direct response to SB 150. One says "KMA supports legislation to remove age limits for health education in schools."

The other says "SB 150 . . . has raised the question of whether teaching students human health-related curriculum, including puberty and menstrual health education, is permitted in Kentucky before 6th grade." It amended KMA policy to say the group opposes the sole use of "abstinence-only education by providing information about condoms, birth control, and other means of preventing pregnancy and sexually transmitted diseases," and "supports age-appropriate anticipatory education related to menstruation and puberty for elementary school students," as well as "age-appropriate sexual education in schools to include information on sexual assault, consent communication, and dating violence prevention" and "age-appropriate sexual education in schools to include reference to non-traditional (LGBTQIA) practices for safe sex, in the interests of equality and prevention of sexually transmitted disease."

The resolution says KMA "will work with appropriate agencies, including but not limited to the public-school system, to ensure that sex education is age-appropriate, evidence-based, led by well- trained individuals, and subject to periodic evaluation and improvement." 

Other resolutions 

The House of Delegates also adopted resolutions to :

• Encourage swimming lessons for children, promotion of fences around swimming pools and direct supervision of children around water by a responsible individual, amid increased focus on an increased drowning risk of children with autism.
• Encourage caution in pediatric melatonin consumption and to promote physician-led education to caregivers regarding pediatric use of melatonin. 
• Increase skin cancer prevention, noting that "from 2016 to 2020, Kentucky was in the top 10 states with incidence rates of melanoma." 
• Support efforts to educate health care professionals and the public about the frequency and severity of eating disorders and weight stigma, and stated that it supports evidence-based treatment for eating disorders and the removal of insurance barriers designed to deny or restrict such treatment. 
• Promote efforts to decrease the rate of physicians' moral injury in Kentucky, defined as “the challenge of simultaneously knowing what care patients need but being unable to provide it due to a variety of constraints that are beyond a physician’s control.”
• Support improvements in mental health care services for the postpartum period to improve maternal and infant health outcomes; and supports advocating for funding of programs that aid postpartum depression research.
• Support use of anti-obesity medications if they are safe, effective and have a sustained impact with lifestyle modifications; and to advocate for better access to anti-obesity medications for all patients appropriately prescribed those medications.
• Urge an increase research on the safety and efficacy of Kratom and to support increased regulation on the sale and purchase of Kratom. The resolution states that while Kratom is legal to buy, sell and own in Kentucky, "The opioid and stimulant properties of Kratom make it an option for treating opioid withdrawal, but subsequently comes with risk for abuse, addiction, and overdose." It also supported a resolution to ban over-the-counter sales of Kratom in Kentucky and that it supports increased education regarding its misuse and negative health effects.
• Encourages and support expanding representation of darker skin tones in medical education, especially in printed texts and textbooks. 

Click here for a list of the adopted resolutions and for the "Kentucky Medical Association Gun Violence and Firearm Safety Work Group Report to the 2023 KMA House of Delegates."

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.

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.

Index of readiness for disasters and health emergencies has Ky. about same as U.S.; slips in environmental, occupational health

By Melissa Patrick
Kentucky Health News

Is Kentucky ready to manage a natural disaster or a health emergency? Just as much as the nation as a whole is, according to a recently released Robert Wood Johnson Foundation report.

The annual report, called the 2018 National Health Security Preparedness Index, gives Kentucky an score of 7.1 on a 10-point scale for preparedness, the same as the national average. The state and nation saw a slight improvement from the previous year's score, following continuous improvements since 2013.

"Five years of continuous gains in health security nationally is remarkable progress," Glen Mays, who leads researchers at the University of Kentucky who develop the index, said in a news release. "But achieving equal protection across the U.S. population remains a critical unmet priority."

Kentucky was one of 11 states more or less at the national average. Those below average were largely in the Deep South, Southwest and Mountain West regions. Maryland had the top score of 8.0 and Alaska and Nevada shared the bottom number of 6.4.

Such numbers are becoming more important. "The United States experienced the most active and expensive year on record for disasters and emergency events in 2017, with total economic damages exceeding $300 billion," the report begins, adding that the "uneven pace" of improvement for health security across the U.S. is "leaving large and growing segments of the American population under-protected."

The index analyzes 140 measures, such as the number of pediatricians, flu-vaccination rates, bridge safety and food and water safety, to calculate a composite score of health security for each state and the nation as a whole.

The measures are then grouped into six larger categories including, health security surveillance; community planning and engagement; information and incident management; health-care delivery; countermeasure management; and environmental and occupational health.

Kentucky improved or stayed about the same as the national averages in all but one of those broad areas -- environmental and occupational health, which measures state's ability to maintain the security and safety of water and food supplies, to test for hazards and contaminants in the environment, and to protect workers and emergency responders. Kentucky's score for this measure dropped about 5 percent from the prior year, to 6.0. The national score is 6.6.

Kentucky saw its greatest improvement in health security surveillance, which rose 13.2 percent between 2013 and 2017. This measure looks at the state's ability to monitor and detect health threats, and to identify where hazards start and spread so that they can be contained rapidly. Kentucky's score for this domain was 8.6, compared to the national average of 8.1.

The state's lowest score, 5.2, is in health-care delivery, but that is the same as the national average. This category measures a state's ability to ensure access to high-quality medical services across the continuum of care during and after disasters and emergencies.

Suggestions from the report to to improve health security include: improving data sources and metrics; strengthening networks and coalitions; improving workforce policies, like offering paid leave and health insurance; improving health care delivery preparedness; assuring a dedicated and adequately resourced health security emergency response is in place; assuring adequate funding for an established health security infrastructure; and allowing for flexibility in the existing health security funding mechanisms.

Electric-shock drowning happens most often around marinas and docks; here are tips on how to avoid it

A sign warns boaters and swimmers at the
marina at Lake Barkley State Resort Park.

By Melissa Patrick
Kentucky Health News

Electric shock in water can't be seen or heard, but it can be deadly.

Electric-shock drowning occurs when electricity from faulty wiring, equipment or damaged cords on a boat or dock seeps into water where people are swimming. The electricity can paralyze muscles, causing drowning, and in some cases is strong enough to electrocute, says a Kentucky State Parks news release.

The Electric Shock Drowning Prevention Association notes that while shock drowning can happen anywhere electricity is provided near water, most deaths occur near marinas and docks. Shock drowning is called a "silent killer" because there are no visible warning signs to indicate when water has electricity.

The association was created by Kevin Ritz, whose son Lucas was electrocuted while swimming near a dock in 1999.

Electric Shock Drowning Prevention Association

The association explains that water may be safe when a swimmer enters the water, but electricity on a dock or boat can trigger an electric fault, causing the swimmer to become paralyzed and drown. And unless a witness is nearby to experience and report the sensation of electric shock in the water, the death is usually judged to be a common drowning.

More than 3,000 people drown each year from non-boating related drownings, according to the federal Centers for Disease Control and Prevention. It is unclear how many of those drownings are caused by electric shock.

Here are tips to prevent electric-shock drowning:

• Never swim around marinas, boats or docks that use AC electrical power for any purpose;
• Make sure all electrical devices on your boat are working properly, have problems repaired immediately. To locate a certified electrical inspector near you, see https://ky.joportal.com/License/Search;
• Have your boat and dock inspected annually by an electrician with a current American Boat and Yacht Council electrical certification;
• If you suspect an electric shock drowning is taking place, turn off the power, throw a life ring to the victim and call 911. Do not jump in the water! You could become a victim;
• Make sure there is a ground fault circuit interrupter at the dock;
• Know where the power cutoff is and make sure those not in the water also know where it is;
• Plastic or wooden ladders are preferable to metal or aluminum ones;
• Turn off the power to your dock when you are swimming;
• Wear a life jacket.

The ESDPA adds that it's important to share the dangers of electric shock drowning with marina operators and others, because most people have never heard of it.

Tips were gathered from a variety of sources including: the Kentucky State Parks, ESDPA , the U.S. Cost Guard Auxiliary and a University of Alabama news release.

CDC finds health problems are common at public pools; state requires local health departments to inspect each one twice a year

By Melissa Patrick
Kentucky Health News

Thousands of public pools, hot tubs and water playgrounds are forced to close every year for serious health and safety violations, according to a new study by the federal Centers for Disease Control and Prevention.

Kentucky requires local health departments to conduct two full inspections of each public swimming pool during the operating season, once every six months for its continuous-operation indoor facilities, and monthly water chemistry inspections, according to the state Department for Public Health.

"The local health department environmentalists are the ones who do these inspections and monitors, so the records for these inspections are kept with each local health department, Beth Fisher, spokesperson for the Cabinet for Health and Family Services, said in an e-mail.

But you might want to do your own inspection if you go on vacation out of state, because that's not the case everywhere.

"Almost one third of local health departments do not regulate, inspect, or license public pools, hot tubs, and water playgrounds,” Michele Hlavsa, chief of the CDC's Healthy Swimming Program, said in a news release. “We should all check for inspection results online or on site before using public pools, hot tubs, or water playgrounds and do our own inspection before getting into the water.”

And even if states are checking their pools, that doesn't mean they are always safe.

A 2013 CDC study of inspection data from the five large states containing 40 percent of the nation's public aquatic venues found that almost 80 percent of them had at least one violation. It found that one in eight inspections resulted in immediate closure because of serious health and safety violations and that one in five kiddie or wading pools were closed due to violations. Most of the violations were related to improper pH (15 percent), lack of proper safety equipment (13 percent) and inadequate disinfectant levels (12 percent).

"Young children who are still learning their toileting skills are more likely to contaminate the water. They're more likely to swallow the water. Both of which can lead to outbreaks of diarrheal illness," Michael Beach, the CDC's associate director for healthy water, told Dennis Thompson at HealthDay News. He said pH levels are "critical because it determines how effective the disinfectant is killing germs."

The CDC recommends that parents change their infants' diapers often and in the bathroom, not poolside, to take children to the bathroom every hour, and to teach children to spit out any pool water they get in their mouth.

Beach said most contamination of public pools and hot tubs are the result of people swimming while suffering from diarrhea. He said adults should not swim while recovering from diarrhea, and if they do, should shower before getting in the water.

The CDC recommends individuals do a self-inspection of all public pools before getting in them and offers this checklist that identifies some of the most common swimming pool health and safety problems:

• Use a test strip (available at most superstores or pool-supply stores) to determine if the pH and free chlorine or bromine concentration are correct.
• Make sure the drain at the bottom of the deep end is visible.
• Check that drain covers appear to be secured and in good repair.
• Confirm that a lifeguard is on duty at public venues. If not, check whether safety equipment like a rescue ring with rope or pole is available.

If you find problems, do not get into the water and tell the person in charge so the problems can be fixed, says the release.

Tips for staying healthy and safe on Kentucky's waters

Brad Molnar on Taylorsville Lake
(Courier-Journal file photo, 2003)

The state Division of Water and Department for Public Health offer tips to help Kentuckians stay safe and healthy as they go boating, fishing, swimming or otherwise recreate in the state's waterways this summer:

• Avoid ingesting or inhaling the water.
• Thoroughly clean hands and other areas that have come in contact with the water.
• Avoid allowing open wounds to have direct contact with the water.
• Avoid areas where swimming or harmful algal bloom advisories have been issued.
• Avoid water with obvious odors or surface scums.
• Avoid getting in water after heavy rainfall, especially in dense residential, urban and agricultural areas.
• Avoid areas below wastewater-treatment outfalls, animal feedlots, straight pipes or other obvious sources of pollution.
• Restrict pets and livestock from drinking the water if a bright green or blue-green surface scum is present.

James Bruggers, environmental reporter for The Courier-Journal, reminds us: "The Clean Water Act of 1972 declared that all waterways in the United States were to be 'fishable and swimmable' by 1985. We've made progress, but we have a long way to go. Be safe out there."

Summer and water recreation offer fun and risk at the same time; prevention is the key to decrease the risk

One of the best parts of summer is splashing in a pool, playing in the back yard sprinkler or swimming in a lake or stream, but recreational water activity always comes with a risk of drowning.

It's important not to lose sight of this risk as you strive to keep your children and adolescents safe, writes Susan Pollack, director of the Pediatric and Adolescent Injury Prevention Program at the Kentucky Injury Prevention and Research Center at the University of Kentucky.

"Every year in Kentucky, an average of 14 children die by drowning. About half the drowning deaths occur among children ages 1 to 4," Pollack writes in the Lexington Herald-Leader. "From 2009-11, 80 percent of childhood drowning deaths occurred at the child’s residence or someone else’s home. A quarter of drowning deaths occurred among adolescents, mostly while swimming, boating or fishing on lakes and rivers."

Prevention requires constant supervision of toddlers and children around all types of water. This not only includes the obvious such as pools, swift-flowing creeks and large bodies of water, but also bath-tubs, car-washing buckets and ornamental ponds, Pollack says. Toddlers can fall in and drown even in just a few inches of standing water in a bucket. It is also important to empty baby pools immediately after use.

Drowning can happen "swiftly and silently," Pollack writes. This requires a responsible adult to supervise children at all times, even if lifeguards are present. And if a child can't swim, this adult should be within arms-reach. Supervision is needed even if the child is wearing an appropriately sized Coast Guard-approved life vest. Floaties and water-wings are not sufficient life-saving devices.

It is also important to create barriers to water sources. This can be accomplished by putting a four-sided, 4-foot-high fence with a self-closing gate around backyard pools or removing the ladder from above-ground pools that are not fenced.

While teaching children to swim does not replace supervision, it is an important life-saving skill children should learn, Pollack writes. The YMCA, Red Cross and university swim programs all offer lessons.

Adolescents should be reminded to never swim without a buddy and that alcohol and boating never mix, Pollack says. They should also be reminded of the dangers of swimming while fatigued and the importance of wearing a U.S. Coast Guard-approved life jacket when boating. (Read more)