Handlebars Pose a Costly Threat to Child Cyclists
Bike helmets have reduced the number of children’s head injuries, but there’s still nothing to protect a child from rupturing an abdominal organ. During a fall, the front wheel can turn so that the handlebars are perpendicular to the body, creating a blunt spear that can rupture the intestine, liver, spleen or other abdominal and pelvic organs.
Now, researchers at the Children’s Hospital of Philadelphia along with colleagues at the Pacific Institute for Research and Evaluation have calculated the annual cost of these often serious injuries.
By reviewing hospital discharge data, researchers estimate that more than a thousand young bicyclists had serious abdominal or pelvic organ injuries in 1997 and that handlebars caused nearly 900 of them. None of the accidents in the study involved cars. Factoring in the costs of hospital stays (ranging from three to 47 days), ambulance use, medical care after discharge, work lost by parents or another caregiver, quality of life differences, even the filing of insurance claims, the researchers concluded that children’s handlebar-related injuries amounted to more than $500 million in 1997.
The researchers hope that awareness of the high cost of these injuries will lead to regulating bicycle design and prompt bike manufacturers to make a safer handlebar. Working with bioengineering students at the University of Pennsylvania, the researchers have designed a retractable handlebar that would absorb the energy of impact with a child’s body. The design has a patent pending, but it has yet to be licensed by a manufacturer.
Lead author Dr. Flaura K. Winston says that, until a safer handlebar is produced, parents should be sure the bicycle fits the child and that the bike is in good condition. When sitting on the seat, the child should be able to put both feet on the ground. Keeping tires fully inflated and the chain well oiled will make the bike easier to steer, she says. Also, the wheels should be aligned and handlebar grips should cover the metal ends.
Archives of Pediatric and Adolescent Medicine 156: 922-928
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Link Between Diet, Cancer Doubted
The first study to look closely at the link between diet and a key indicator of prostate cancer casts doubt on the value of a low-fat diet in preventing the disease, at least in the short run.
Researchers at Memorial Sloan-Kettering Cancer Center in New York found that after four years, there was no difference in prostate specific antigen, or PSA, levels among 689 men who ate a diet made up of 20% fat and five to eight servings of fruits and vegetables a day and 661 men who were just given written instructions on a healthy diet.
Several previous studies had implicated diet, particularly fat, in the development of prostate cancer, but this was the first to look at the effect of diet on a biological marker for prostate cancer over time. “As randomized studies go, four years is a long time, but in the lifespan of a man it is a short time,” says lead author Dr. Moshe Shike, director of cancer prevention at Memorial Sloan-Kettering Cancer Center in New York. “If a person starts eating a diet like this in childhood, it may have an effect. If you are middle-aged or past middle age, [eating this diet] for a few years doesn’t seem to affect the risk. But this study doesn’t mean people shouldn’t change their diet. We still believe a low-fat, high fruit and vegetable diet is the best overall,” he says.
Journal of Clinical Oncology 20 (17): 3570-3571, 3592-3598
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Travel Poses Risk to Asthmatics
Californians sensitive to tobacco smoke may take for granted the laws that prohibit smoking in most public places--until they travel to areas that don’t have such restrictions. A study of more than 300 people with asthma found that the intermittent exposure they encounter when traveling is enough to cause breathing problems. Eye and nose irritation may even be worse.
About 30% of those participating in the study reported being exposed to tobacco smoke while traveling in the year prior to being interviewed, says the lead author, Dr. Mark D. Eisner, assistant professor of medicine at UC San Francisco. “And the number who had respiratory symptoms or asthma attacks [as a result] was quite high,” he says.
Eisner reported that about two-thirds of those exposed to smoke complained of coughing, wheezing or chest tightness. More than half who had symptoms needed extra inhalation medication.
Whether a person lived with a smoker or was somehow regularly exposed to secondhand smoke didn’t seem to make a difference in the respiratory symptoms they encountered on the road. However, those who didn’t have such regular exposure were more likely to suffer from eye or nose irritation.
Chest 122:826-828
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‘Heat Strain’ Bothers Athletes Less
Most people know when they’re too hot to keep exercising, Canadian researchers have found, but athletes are better able to tolerate heat strain--the combination of increased heart rate and core temperature in response to heat--than are untrained men and women.
Scientists at Defense Research and Development Canada in Toronto put 26 men and women through their paces on treadmills in a hot room wearing the research version of a rubber suit. While the volunteers exercised, their deep body, or core, temperature and heart rate were measured.
Initially, both trained and untrained people had a nearly identical increase in core temperature, but the untrained group had a higher heart rate. The untrained subjects also felt hotter than the trained ones.
The endurance-trained subjects tended to underestimate the heat throughout their time on the treadmill, which ranged from 75 to 135 minutes. “Trained people are routinely exposed to physically stressful conditions, and so they can tolerate higher levels of strain--a higher core temperature and heart rate,” says Peter Tikuisis, the lead author of the study.
The increased tolerance doesn’t usually get an athlete into trouble, says Tikuisis, unless they ignore their body and keep pushing beyond a safe limit because of peer pressure or desire to win a race. “Swallow your pride and watch for symptoms like nausea, lightheadedness, headache, impaired coordination and muscle cramping,” he says.
Medicine & Science in Sports & Exercise 34(9):1454-1461
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Cats as Disease Spreaders
Cat fanciers may not want to hear that their pets are anything but perfect, but their feline companions are capable of transmitting serious infections. In a review of cat-associated diseases in humans, doctors at Yale University School of Medicine and the VA Connecticut Health Care System in West Haven. Conn., tick off about a half-dozen illnesses, from the trivial to the life-threatening. With cats calling a third of American households home, the potential for sickness is no small thing.
Bites are by far the most common cause of cat-associated infection, and, 90% of the time, those injuries are because the cat was provoked in some way. (Dogs, in contrast, don’t bite just to defend themselves.) The long, sharp teeth of a cat can create a puncture wound that carries microbes in the cat’s mouth to dangerous depths in the victim’s flesh. Between 28% and 80% of cat bites become infected. The authors recommend that “all persons with a cat bite should be treated with prophylactic antibiotic therapy.”
Another common, but more benign, infection that usually resolves itself within a couple of months is cat-scratch disease. In one study, 41% of San Francisco Bay Area cats harbored the bacteria responsible for the infection. Children are the most common victims of the illness, which is usually transmitted by a cat bite or scratch or via a fleabite.
Preventing these illnesses is a matter of common sense, the authors say: Wash your hands before eating, take your cat to the vet for appropriate vaccinations and whenever it is sick--and don’t give the cat reason to bite you.
Archives of Internal Medicine 162:1945-1952
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Dianne Partie Lange can be reached at Dianne Lange@cs.com.
