Summer Survival Guide

A look at this summer's hazards, which include dry drowning, contaminated tomatoes and bunk beds
Friday, June 27, 2008 | 12:00 p.m. CDT; updated 11:39 a.m. CDT, Tuesday, July 22, 2008

Ready to enjoy the simple pleasures of summer? Let’s get started.

Hat, sunscreen and shades to protect from skin cancer-causing UVA and UVB rays? Check. Insect repellent with DEET to ward off mosquitoes carrying West Nile virus and ticks bearing Lyme disease? Check. Bike helmet, hand sanitizer and a wireless Internet device to check for air-quality advisories and beach closings? Check, and ready for takeoff.

Not so fast there, sport. Those precautions will protect against last year’s threats to health and safety. But as the mercury rises and the final school bell rings, summer 2008 promises a few new dangers.

Here’s how to protect against some of them.

Contaminated food

Ah, the unique summer pleasure of fresh tomatoes from the farmers market, a fat slice of tomato on a burger off the grill, a platter of sliced tomatoes topped with buffalo mozzarella, basil and olive oil.

Since April, however, more than 200 Americans have been sickened by an unusual and virulent strain of salmonella linked to raw red Roma, red plum and round red tomatoes.

Add that to lingering concerns about spinach tainted with E. coli, scallions fouled by hepatitis A and bean sprouts tainted with Listeria monocytogenes ­— indeed, the still-hard-to-accept idea that fresh vegetables can bear the same contaminants long attributed to meat and mayonnaise — and you’ve got a real picnic-crasher.

What to do? For starters, use that hand-held device (or your home computer) to read the alerts, warnings and recalls issued by the nation’s guardians of food safety at The links are all there on the home page under “recalls & alerts” or under the heading “FDA for You/Consumer Health Information.” Better yet, sign up to have the FDA automatically notify you of safety alerts and recalls under “Get Updates” on the right side of the agency’s home page. Especially helpful are the FDA’s “Frequently asked questions,” updated every few days. Among the details supplied is the advice that cooking affected tomatoes probably will not lessen a person’s risk of becoming sick.

Expert recommendations: Refrigerate all fresh produce and, when ready to use it, wash it thoroughly, even if the bag says it has already been washed. The FDA, which is beefing up its food safety surveillance with an influx of funds granted by Congress, is expected to become a more vigilant watchdog of tainted food, so keep checking its Web site for updates.

Bunk beds

The joys of camp: falling asleep to the sound of crickets, the rustle of nocturnal creatures, the creak of the springs in the bunk above you.

It turns out to be a summer pleasure rife with danger, especially at camps whose bunk beds predate new safety specifications issued in 2000.

A study published in the June issue of the journal Pediatrics reviewed 16 years of data collected on injuries and found, on average, 36,000 bunk bed injuries happen every year. More than one in four involve head and neck injuries, generally caused by falls from the top bunk or the ladder. Accidents are more common still when the child in the top bunk is younger than 5; one in five bunk bed injuries led to a broken bone.

Children are at risk of suffocation, as well. If they are small and the spaces between guardrail slats are more than the 3 1/2 inches allowed by current regulation, their heads — still large compared with their bodies — can get caught as they try to wiggle down. But though three-quarters of those injured are 10 or younger, the researchers from the Nationwide Children’s Hospital in Columbus, Ohio, found a surprising rise in injuries among young adults 18 to 21 — more of whom may be bunking in college dorms, military units and other group residences.

Injury researcher Lara McKenzie, one of the authors of the study, said that parents dropping kids at camp should do a quick safety check of the upper bunk before they say goodbye. Guardrails should not be less than 5 inches over the top surface of the mattress, she says; rails should surround the entire bed, and any gaps in the rails — except for the spot where the ladder securely meets the bed — should be less than 3 1/2 inches wide to prevent entrapment injuries. The top bunk should be well away from any ceiling-mounted fan or light fixture. And no one younger than 6 should sleep in a top bunk.

Dry drowning

Although water always has been a hazard to be wary of, the idea that someone could drown hours after visiting a swimming pool might seem new to many. On June 1, 10-year-old Johnny Jackson of Charleston, S.C., died while napping more than an hour after returning home from the pool with his mother. The incident has drawn attention to the phenomenon of dry drowning, a danger long recognized by other names by emergency department physicians.

Medical examiners have found that as many as 15 percent of drowning fatalities are dry drowning victims, those whose respiratory distress comes after an incident in the water. But it comes in different forms and from different causes.

In one form, a muscle spasm of the larynx causes the victim to suffocate. Such spasms are most often associated with cold water forcefully hitting the epiglottis, the flap at the base of the tongue that helps keep food and drink from entering the lungs. Hitting the water after a long, fast slide or from a high diving board appear to be the most common swimming-related causes of such a spasm, which can happen minutes or hours after the impact.

Jackson’s dry drowning, however, appeared to have been caused by a delayed reaction to aspirating a large amount of water while swimming, the other main form of dry drowning. In cases where a near-drowning has occurred during swimming, the lungs can be damaged, allowing them to fill with fluid. Because this can take time, the victim might become progressively more oxygen-deprived over time, causing him or her to have breathing difficulties, become sluggish or tired and to behave oddly.

The appropriate responses to signs of trouble — sputtering, choking, bluish tinge — might differ depending on what has caused the interrupted flow of oxygen to the body. But experts warn that if a person has aspirated a large amount of water, it is unwise to consider the emergency over. If the incident was minor, a victim should be monitored closely and brought to an emergency department promptly if he or she becomes extremely sleepy, behaves unusually or appears to have continuing difficulty breathing. In such cases, called “post-immersion syndrome,” the reduced airflow can cause organs to begin to fail in the hours or days after a near-drowning.

“If somebody has been involved in a drowning situation or a near-drowning situation, they should be evaluated by a physician,” says William H. Shoff, an emergency department physician and associate professor of emergency medicine at the Hospital of the University of Pennsylvania. “All kinds of things can happen. They may feel OK, but as a clinician, I’ve certainly seen people who said they were fine and they were not.”

Golf Carts

Last week, McKenzie of Nationwide Children’s Hospital and her colleagues released a second sobering study, showing a growing threat of golf cart injuries, as families in planned communities across the country rely more on these small, unregulated vehicles to zip around terrains that include asphalt and hilly fairways. The incidence of golf cart injuries — usually where passengers fall out of or overturn a cart — has risen steadily since 1990, when 5,800 injuries were reported. In 2006, there were 13,000 injuries and the average age of victims was 33, McKenzie said.

Not enough sun

Just when you were beginning to think it might be best to just stay inside this summer, here’s an unexpected twist on past years’ health and safety advice. The folks at the Linus Pauling Institute at Oregon State University want to remind you that a little sunshine — without the sunscreen — is good for you.

Victoria Drake, a research associate at the institute, notes that deficiencies in vitamin D, an essential nutrient available in some foods and made by the body in response to sunshine, appear to be on a steep rise — possibly, in part, because skin cancer worries have prompted such widespread avoidance of the sun. Deficiencies in vitamin D have been linked to increased risk of a wide range of cancers, cardiovascular disease and autoimmune diseases.

Drake says that 10 to 15 minutes of sun exposure on your arms and face is probably necessary to help the body generate adequate vitamin D stores.

Got all that? Go ahead and enjoy the summer.

Just be careful out there!

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