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A look at Child Safety Tips for Biking

Aired May 29, 2004 - 08:30   ET


HOLLY FIRFER, GUEST HOST: Good morning and welcome to HOUSE CALL. I'm Holly Firfer in for Dr. Sanjay Gupta.
Memorial day weekend is here, which means summer is just around the corner. And for the millions of Americans expected to hit the vacation trail this year, it's the season for hiking, biking, swimming, and of course, fun the sun.

But summer is also the busy season for hospital emergency rooms. The months between May and August are especially dangerous for children. More accidental deaths and injuries occur during this time of year than any other. For example, in 2002, nearly 300,000 kids under the age of 14 were treated in hospital emergency rooms for bike related injuries. Now with 70 percent of children ages 5 to 14 riding bikes, helmet safety is critical. Believe it or not, a fall of just two feet can result in a brain injury.

So, here to give us tips to stay safe this summer on those bikes and keep healthy all summer long is Dr. Angela Mickalide, the program director of the National Safe Kids Campaign.

Welcome, Angela, glad to have you here. Tell us, why is summertime such the most dangerous time for our kids really?

DR. ANGELA MICKALIDE, DIR., NAT'L SAFE KIDS CAMPAIGN: Well, summer truly is trauma season for kid. They are out of school; they're not behind the relative safety of their desks. Many of our parents are working today, so the children are less supervised. And the daylight hours are longer, so there's more time for them to be out playing by the pool, riding their wheels, and having a good time with their friends.

FIRFER: And we want them to stay safe. So let's get back to bikes and bike helmets. Bicycles, as we said, cause more injuries to children than any other consumer product, except automobiles.

MICKALIDE: That's right.

FIRFER: Now, with head injuries being the leading cause of death in bad bicycle accidents, helmet use, can reduce the risk, we know, of death and injury in those accidents by more than 80 percent. But a new study says less than half of all kids 5 to 14 actually wear their helmets, when on bikes, skateboards, scooters and other wheeled toys. Nineteen states and the District of Columbia have helmet laws on the book. So let's go to an e-mail now. Angela, thanks for letting us get that information out. Beth in North Carolina writes, "My daughter only rides her bike around our yard. There's no paved driveway and she never rides on the street. Should she still wear a helmet?"

What do you say, Angela?

MICKALIDE: Absolutely. A bike helmet is one of the most effective safety interventions that we have for kids. And you need to tell your daughter that the asphalt, or the gravel in front of her house is no softer than anywhere else around the neighborhood. In fact, we know that most of our bicycle related crashes among children happen in their own back yard.

FIRFER: And we know then that helmets are important for safety, as you said. So let's talk about how they fit you, and how to buy the right one, and how to wear it. First of all, are helmets one size fits all? How do you go about buying a helmet that's right for you?

MICKALIDE: Well, the first thing you have to do is take the child with you so that they like the helmet, the color, the fit, the style. That's going to be one of the most important features to getting them to wear it every time they ride.

But then, we have another technique that we call The Eyes, Ears and Mouth Test. And essentially what that means is when you are fitting a child for a helmet, you need to make sure that no more than two fingers are between their eyebrows and the top of the helmet. So if they look up, they can see. In addition, the straps have to fit well underneath the ears, in sort of a V-shape pattern, like this. And finally, make sure that the straps themselves are snug.

Safe Kids and Bell Sports collaborated on a study of more than 8,000 kids around the country. And what we found was while 40 -- less than 50 percent, 41 percent of the children were wearing helmets when they rode. One-third of those who were wearing the helmets were wearing them incorrectly, with the helmet tipped too far back, or too far forward on the head, and with straps that were either too loose or entirely unbuckled.

FIRFER: Good to know. OK. Thank you Angela.

And we know that bicycles aren't the only wheels kids are riding. Scooters, rollerblades, skateboards, they're everywhere. And doctors say accidental injury is by far the greatest risk for your children.

So Angela, what other kind of protective gear do kids need to be wearing? Elbows, chins, you know, got to protect their teeth. What else should they be using?

MICKALIDE: Well, when they're on their skateboards, and on their scooters, and inline skates they need to be wearing elbow pads and kneepads so that they are safe. And for some of those wrist pads as well.

It's so important that parents let their children understand that protecting their body is one of the most important things they can do at this age. And that traumatic brain injury has lasting consequences. They'll never think the same way, be able to play with their friends, go to dances. And so by reducing the risk of traumatic brain injury, they are doing themselves a great favor.

FIRFER: Terrific. OK. We have a lot of questions coming up. And when HOUSE CALL returns, we have a beach vacation plan, perhaps; or just hanging out by the pool maybe. We're going to talk about water safety right after the break.


UNIDENTIFIED FEMALE (voice-over): Splish, splash. To get relief from soaring summer temperatures, children head to the beach or local pool. Sounds like a safe way to stay cool, but is it? We'll ask our safety expert and answer more of your e-mails.

But first, today's "Daily Dose" quiz. When is a child ready for swim lessons? A: birth, B: two years, C: four-plus years? The answer when we come back.


UNIDENTIFIED FEMALE: Checking "The Daily Dose" quiz. We asked when is a child ready for swim lessons? The answer is, C. According to the American Academy of Pediatrics, children are not developmentally ready for swim lessons until after their fourth birthday. They AAP recommends that children under age 4 not be given formal swimming lessons, especially as a primary means to prevent the risk of drowning.

FIRFER: Welcome back. We're talking about summer safety this morning, and whether enjoying the waves from the beach or taking a dip at the community pool, water offers a cool refuge from summer's blistering heat.

But as CNN's Christy Feig reports there are many potential dangers associated with water activities that parents should be conscious about.


CHRISTY FEIG, CNN CORRESPONDENT (voice-over): As a mother, Gina Trant wants to keep her 7-year-old daughter Catherine safe in the water. In her mind, that means swimming lesson.

GINA TRANT, CATHERINE'S MOTHER: It will build her confidence and make her feel more safe and secure in the water.

FEIG: And experts agree with that part of her plan.

ANDREW MASON, AQUATIC DIR., YMCA: The first thing I think they should teach them is how to float. Because if a child gets in danger and they don't know how to float on their back, they can't save themselves. FEIG: But there's another swimming pool danger that Gina and many mothers like her may not have thought about. The water could be making you and your children sick.

MICHAEL BEACH, CDC: This is a communal bathing situation. You are swimming with everybody in there. This isn't sterile water.

FEIG: Chlorine kills most of the germs in the water, except one.

BEACH: It's a parasite called cryptosporidium, and once it gets into the pool it's resistant to the levels of chlorine that normally are found in pools. So it will survive for days in there.

FEIG: It's brought into the pool by people who haven't washed well after going to the bathroom. The CDC says a few simple steps can prevent it. Never swim if you have diarrhea and shower before getting in the pool. Change diapers away from the poolside. Take your kids for bathroom breaks often, and teach your kids not to swallow pool water. And a pool that smells strongly of chlorine doesn't mean it's super clean.

BEACH: When we smell that strong chemical smell, and our eyes sting, and it kind of burns, that's from everybody urinating and bringing in all of this dirt and debris and so on into the pool. And chlorine binds to it.

FEIG: And chlorine that's busy binding to contaminants isn't killing germs.

Christy FEIG, CNN, Washington.


FIRFER: Some good information from Christy. Thank you.

Well, getting sick from your pool is one of the many risks associated with water safety. A day at the beach or a pool party can turn into a day in the emergency room in a matter of seconds. Two- thirds of childhood drownings occur from May through August, making drowning the biggest summertime risk.

So, here are basic water safety tips. Always swim with a buddy. Never run, push or jump on others around the water. And of course, like your mother always told you, never dive into rivers, lakes or even the ocean because you just don't know what's under there. And also, if you are out on the water, always wear a Coast Guard approve life jacket. And remember, inflatable inner tubes and those water wings are not safety devices.

Now, we're talking with Dr. Angela Mickalide, program director of the National Safe Kids Campaign.

And Angela, you brought a life jacket with you. So let's go over some of the safety features that parents need to be looking for. Give us some tips. MICKALIDE: Well, we have four water safety wisdoms that the National Safe Kids Campaign and Johnson & Johnson have developed this year. The first of these is that it's important that children wear the appropriate gear when in and around water. A life vest, such as this one, can reduce the risk of drowning in a boating related incident by 85 percent. Make sure that when you buy one it's U.S. Coast Guard approved.

Our second water safety wisdom is the importance of active supervision of children around water. Safe Kids and J&J conducted research on 500 drowning deaths among children over a two-year span, in conjunction with child death review teams around the country. And what we found is that 9 out of 10 of the children who died, were under the supervision of someone at the time of their drowning.

And when we ask parents what they typically did when they were supervising children in a related poll, they told us some alarmingly distracting behaviors such as talk on the cell phone, supervising other children, eating. And even some of them were closing their eyes and relaxing, when they were supposed to be actively supervising their kids. That's defined as you are within arm's reach if you have young children or children who can't swim, and you are watching your child at all times when they are in or near water.

We need to develop water safety watchers -- water watchers in this country. For 20 minutes, Holly, you would watch the children. For the next 20 minutes, I would watch the children. In this way, the children are fully protected because the adults are not distracted.

Our third water safety wisdom is the appropriate environment, safe environments for kid. This means if you have a back yard pool, make sure that you have four-sided fencing with a self-latching and self-closing gate, and that you keep a cell phone and emergency numbers poolside.

And finally, the importance of swimming lessons cannot be underestimated.

FIRFER: Right.

MICKALIDE: Every child in this country needs to have formal swimming lessons by the time they are about eight. Somewhere between 4 and 8. Because three quarters of the children who died in our research had never had a swimming lesson.

FIRFER: And Angela, we did send our cameras out to get some questions on the topic. Here's one woman who had a question very similar to that. Let's take a listen.


UNIDENTIFIED FEMALE: I would like to know what would he or she recommend to parents to make them feel more comfortable with their kids in the water?

(END VIDEO CLIP) FIRFER: So Angela, what would you tell people as far as -- I mean we already know that it should be four years plus, and what to be outfitted, and watch them vigilantly. As far as, what if a child is scared to do it. Should you push them?

MICKALIDE: Absolutely not. Children should be acclimated to the water as soon as they are read. But they really do need to have these swimming lessons. We asked parents around the country, has your child had a swimming lesson? And we found out that only 2 out of 5 had ever sent their children 5 to 14 years of age for these lessons.

Parents need to understand that drowning is a silent killer. It happens in just a few minutes, silently and suddenly.

FIRFER: Right.

MICKALIDE: And there's a misconception that if you -- your child is drowning you'll be able to hear them cry out for help or see them waving their arms for assistance. When in actuality, children need all of their breath in order to simply breathe.

FIRFER: Good information.

OK. We have to take a quick break. We'll be right back with a lot of questions. And water isn't the only thing to worry about poolside. Do you know what to look for in your sunscreen?


UNIDENTIFIED FEMALE (voice-over): Planning on taking in some rays? You may want to think again. A day in the sun can leave lasting effects, especially for children. We'll tell you what you need to know about protecting your kid from the summer heat and a look at SPF fashion. More on that coming up.



DR. CHARLES BALCH, PROFESSOR, JOHNS HOPKINS UNIV.: Twenty years ago, it was very rare that we would see children, or teenager, or young adults with melanoma. But honestly, I'm really alarmed that today we are regularly seeing young people with melanoma.


FIRFER: Well, with the great weather summer brings you, may be tempted to spend more time outdoors basking in the sunshine. But at this time of year, the sun is at its most dangerous in terms of skin damage. And here's a frightening statistic for parents. If a child gets a single blistering sunburn, the chances of developing skin cancer later on in life double; scary statistic, indeed.

Dr. Angela Mickalide is here to help us answer all your sun safety questions. Angela, we've got some questions lined up. So let's get to an e-mail, first from Michael in New York who writes, "I have a 4-month-old baby with fair skin. How much sun is she allowed to have? We like to take her for walks outside. But is there a sunscreen safe for her or should we keep her out of direct sunlight?"

What do you say?

MICKALIDE: Well, your baby should enjoy the benefits of being in the great sunshine. But you need to choose a sunscreen that has both UVA and UVB protection, with a sun protection factor or SPF of at least 15.

FIRFER: OK. Now, according to the American Cancer Society, we know that skin cancer is the most common of all cancers in the United States. And experts suggest wearing a sunscreen that offers UVA and UVB protection and has an SPF of 15 or higher is recommended for children. Apply the sunscreen in a thick coat at least 30 to 45 minutes before going outside and then reapply every two hours.

So let's get to our roving camera now with another question. Angela and everybody, take a listen.


UNIDENTIFIED FEMALE: Even if a sunscreen is waterproof, how often would I need to reapply it to assure that my child is safe?


FIRFER: Angela, that's a pretty common question. How often to reapply, especially with waterproof sunscreens, and kids going in and out of the water; and even just sweating as they run around in the sun?

MICKALIDE: Right. Absolutely. Best practice is that you apply the sunscreen at least 30 to 45 minutes before the child goes out into the sun, so the skin can fully absorb its benefits in the SPF. But then you need to reapply it every couple of hours. because, as you said, the child will sweat, they'll go in and out of the water and you want to keep them maximally safe.

FIRFER: OK. And we should tell everybody, don't forget protective clothing. Though, even if it's hot, the best thing to keep on is a T-shirt, as well as hats and sunglasses. And there is even protective swimwear for kids. We have a couple of examples here. They look like little wet suits; kind of cute. And they have an SPF of 50 protection. So for more information on these, log on to And quite stylish, indeed, we should add.

Angela, I remember when I was a kid; I spent countless hours outside by the pool, running around. Now we hear about all these warnings about protecting your kids early on. So, we're going to get to that information. I know that that's very important. We wanted to talk to you more about that.

And we're not done yet because more HOUSE CALL is coming up after the break.


UNIDENTIFIED FEMALE (voice-over): The face of breast cancer may be changing, literally. A new study just ahead.

And be sure to grab a pen. We'll give you a list of web sites where you can find more helpful tips on keeping your kids safe this summer. That's just a click away.


FIRFER: Welcome back to HOUSE CALL.

So let's take a look at some of this week's medical headlines in today's edition of "The Pulse."


FEIG (voice-over): A new study from the M.D. Anderson Cancer Center found breast cancer in men is on the rise, although it remains extremely rare. Male breast cancer rates rose from 8.6 cases to 10.8 per 1 million men between the 1970s and the 1990s. About 1600 cases are predicted for 2004.

Another study from the New England Journal of Medicine says as many as 15 percent of men, whose tests are normal, actually have prostate cancer. But experts say it's too early to recommend biopsies be done routinely among these men, because those cancers are usually small and there's no evidence treating them improves survival.

Christy Feig, CNN.


FIRFER: We've been talking about summer safety. And for more information on how to keep your kids safe this summer, check out the National Safe Kids Campaign web site at You'll find safety tips from ranging water to biking, and special sections on babies and toddlers. And for more information on swimming safely, click on That's the Centers for Disease Control and Prevention web site, which has a special on its main page about swimming healthy this season.

We're talking to Dr. Angela Mickalide.

And Angela, I want to talk about something parents may forget about. Kids are outside all day; it's in the sun, or at the pool, or running around with their friends at camp. They are hot. But they -- you have to be careful that they don't become dehydrated. Give us advice on that.

MICKALIDE: Absolutely. Safe Kids and Gatorade have partnered on the Defeat the Heat Program to encourage kids to be mindful of how quickly children get dehydrated when they're out playing sports, and riding their bike, and having a great time this summer. So it's fundamentally important that kids remember to drink fluids before, during, and after they are out at play. FIRFER: And for parents to notice if a child looks thirsty, even if they are not thirsty, to make sure that they are getting enough water, go ahead and drink this anyway, just for me.

MICKALIDE: Absolutely.

FIRFER: OK. And let's talk about something else. That's a danger we forget about and it's also children and cars. They become extremely hot in the summer and it can take just a matter of seconds to heat up to some dangerous temperatures. Tell us about that as well.

MICKALIDE: Children have died left in motor vehicles in temperatures in the 60-degree range this year. In fact, according to research Safe Kid and General Motors have collaborated on, more than 230 children have died over the last nine years by being left in motor vehicles by parents.

Parents have to understand that a car is not a baby-sitter. Children should never be left in a motor vehicle, while a parent runs a quick errand. In addition, make sure you lock your car when it's in your driveway, or in front of your House. And hide the keys from the kids because they like to go into the car sometimes and play. And then they become entrapped and they die very rapidly, even in warm weather.

FIRFER: OK. Good information to know.

And quickly, if you are hitting the road, buckle up with your kids. We know a lot of people may be taking summer vacations and driving across the country.

MICKALIDE: Every time everyone in the motor vehicle needs to be buckles up either in a child safety seat or in a safety belt, depending on their age.

FIRFER: Good reminder. Thank you so much for joining us, Dr. Angela Mickalide. We appreciate your time today. And we hope that everybody has a safe and healthy summer. We appreciate you answering our questions.

And make sure to tune into CNN this week. The U.N. hears from doctors and researchers on the controversial topic of stem cells. Plus, why are more kids getting skin cancer? You can find out Monday, right here on CNN.

Remember, this is the place where you can ask the experts all of your medical questions. We thank so much for watching.

I'm Holly Firfer, stay tuned now for more news on CNN.


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