Category Archives: Child & Youth Health

Don’t get stung!


From the Washington State Department of Health


Several tips to lower the risk of bee, wasp and hornet stings

To many, pesky bee stings typically only cause temporary throbbing. That doesn’t mean you’ll never have a bad reaction.

Public health officials warn that having one type of reaction after a sting doesn’t mean a person will always have the same reaction next time.

While it’s crucial for people who’ve had an allergic response to avoid the insect of concern, a previously non-reactive person can develop sensitivity at any time.

Insect stings can cause different symptoms, ranging from brief pain to a severe allergic reaction. First-aid kits should contain an antihistamine to help prepare for an unexpected serious reaction to a bite or sting.

There are several steps one can take to lower the risk of bee, hornet, wasp and other insect stings:

• Avoid insect encounters: slowly move away; don’t wave your arms or swat at them.

• Cover exposed skin and wear shoes.

• Don’t use products with strong perfumes such as soaps, shampoos, and deodorants; they can attract insects.

• Avoid wearing bright colors or flower-patterned clothing.

• Watch out for insects around flowers, outdoor areas where food is served, and garbage and compost areas. Remove fallen fruit in your garden, and keep a well-fitting lid on your garbage can.

• Never disturb insect nests. Arrange to have a nest removed by a professional pest control service if it’s in or near your home.

• Keep food and drinks covered when outside. Meats and sugary drinks attract wasps and bees. Both can get into open bottles or cans that you’re drinking from.

Insect stings typically don’t require a visit to a doctor. However, call 911 if you’re having any symptoms that suggest a severe allergic reaction (anaphylaxis).

Signs of anaphylaxis include skin reactions in parts of the body other than the sting area. Hives, itching, and flushed or pale skin are almost always present.

People may also have difficulty breathing; swelling of the throat and tongue; a weak and rapid pulse; nausea, vomiting, or diarrhea; dizziness or fainting; or a loss of consciousness.

Any of these symptoms should be treated as a medical emergency.

If you have a prescribed epinephrine injector (EpiPen, Twinject), use it immediately as directed by your health care provider. And get medical care immediately if you’ve been swarmed by bees and have been stung multiple times.

This is especially important for children, older adults, and people who have breathing or heart problems.

Remember, most insects are usually not aggressive and play a very beneficial role in nature. By taking a few precautions most stings can be avoided.

The Department of Health website has more information about avoiding insect stings and the role of insects in our lives. The Mayo Clinic website also has information on symptoms and treatment of insect stings.


Birth defects study in south central Wa finds no common causes, Department of Health


From the Washington State Department of Health

Birth defects study in south central WA is inconclusive — no common causes

Magnifying GlassOLYMPIA - A state-led study into several cases of a rare birth defect in Yakima, Benton, and Franklin counties has revealed no common exposures, conditions, or causes.

State and local public health investigators found no significant differences between women who had healthy pregnancies and those affected by anencephaly, a rare neural tube defect.

Anencephaly is a fatal birth defect that results from incomplete formation of the brain during the first month of pregnancy. An unusually high number of anencephaly cases in Washington prompted the study, which was led by the state Department of Health in cooperation with local health officials and the Centers for Disease Control and Prevention.

Typically, one or two anencephaly cases would be expected in about 10,000 annual births. The investigation found about eight cases per 10,000 births in the three-county area of Yakima, Benton, and Franklin.

Anencephaly and a related spinal cord disorder known as spina bifida are often caused by a lack of the B-vitamin folic acid in the mother’s diet.

Other factors include certain medications, diabetes, pre-pregnancy obesity, or previously having a child with a neural tube defect.

The study examined medical records from January 2010 through January 2013 and looked at possible risk factors including family history, pre-pregnancy weight, health risk behaviors such as supplemental folic acid and medication use, and whether the woman’s residence received drinking water from a public or private source.

No significant differences were found when comparing cases of anencephaly with healthy births in the three county area. Although the number of affected pregnancies was large for this area, larger numbers are often needed to identify causes. Medical record reviews might not have captured all information, preventing a cause from being identified.

The higher than expected number of anencephaly births in the region could be coincidental. Still, state health officials will keep monitoring births in the region through 2013 to see if the elevated number of affected pregnancies continues and if more can be learned about causes.

State and local health officials say women of childbearing age should follow the U.S. Preventive Services Task Force recommendation of taking 400-1000 micrograms of folic acid daily, either from foods fortified with folic acid or a supplement.

They also advise seeing a health care professional when planning a pregnancy or as soon as pregnancy is recognized, and making sure to provide a list of all medications and nutritional supplements that are being used.

Women who are pregnant or planning pregnancy should be sure that drinking water from private wells is tested at least annually for nitrate and bacteria. If levels exceed standards, an alternate source of drinking water should be used.

More information on anencephaly is available on the Centers for Disease Control and Prevention Birth Defects website. Information on testing private well water is on the state Department of Health Drinking Water website.


Snohomish parents get a B+ for kids’ back-to-school shots


child wincing while be given a shot injectionFrom Snohomish Health District 

More 5 and 6 year olds in Snohomish County had all the vaccines they needed to enter school last year, according to recent data released by the state Department of Health.

For the 2012-2013 school year, 86.3 percent of local kindergarteners were up to date on their shots, better than past years and higher than the state average of 85.6 percent

Vaccines are required for school children because they prevent disease in a community setting. The rate of vaccination has continued to climb since an all-time low in 2008-2009.

School districts report vaccination rates to the state. The highest immunization rates for all grades (K-12) in Snohomish County last school year were in Lakewood (94.8%) and Everett (94.7%) school districts.

A small percentage of families seek exemption from the vaccination requirement, an average of 5.3 percent in Snohomish County schools compared to 4.5 percent statewide for children entering kindergarten.

In 2011 the process for parents or guardians to exempt their child from school or child care immunization requirements was changed.

Parents need to see a medical provider to get a signature on the Certificate of Exemption form for their child’s school. 

More information about the form and the law is available online at

Although exemptions are allowed for medical, religious, or personal reasons, the best disease protection is to make sure children have all their recommended immunizations.

Children may be sent home from school, preschool, or child care during outbreaks of diseases if they have not been immunized.

Summer is a good time to make sure your children are up to date on required shots. The cost of childhood vaccines is subsidized by federal and state government so that every parent can choose to have their child protected without regard to cost.

Required childhood vaccines are available for the school year 2013-2014.

 Two doses of chickenpox (varicella) vaccine or doctor-verified history of disease is required for age kindergarten through grade 5. Students in grade 6 are required to have one dose of varicella or parental history of disease.

 The whooping cough (pertussis) vaccine, Tdap, is required for students in grades 6-12 who are 11 years and older.

Recommended vaccines also are available.

 Varicella vaccine for children in grades 7-12 who have never had chickenpox.

 Meningococcavaccine for adolescents age 11-12. A second (booster) dose at age 16-18 if first dose was given at ages 11-15.

 A three-shot series of human papillomavirus (HPV) for both adolescent boys and girls age 11 and older.

 Children 12 months and older should receive hepatitis A vaccine, a two-shot series.

 Flu vaccine for all people age 6 months and older.

Snohomish Health District promotes routine vaccination of children and adults.

Snohomish Health District’s Immunization Clinic will serve you if your family does not have a health care provider. A visit to a Health District clinic includes a check of your child’s record in the Washington Immunization Information System, the state’s immunization registry.

Parents should beat the rush by making appointments now with their child’s health care provider. At the Health District, parents can make an appointment during normal clinic hours at either the Lynnwood or Everett office.

A parent or legal guardian must accompany a child to the clinic, and must bring a complete record of the child’s immunizations. 

You need to fill out a Snohomish Health District authorization form to have another person bring your child to the clinic. Ask the clinic staff to mail or fax a form to you.

Health District clinics request payment on the day of service in cash, check, debit, or credit card. Medical coupons are accepted, but private insurance is not.

The cost can include an office visit fee, plus an administration fee per vaccine. Reduced fees are available by filling out a request based on household size and income.

Teens also occasionally require travel vaccines for out-of-country mission work or community service. The Health District offers those immunizations and health advice for traveling in foreign countries.

Please call if you have questions, concerns or to schedule an appointment: SHD Immunization Clinic 425.339.5220.

Back-to-school shots hours:

SHD Everett Immunization Clinic, 3020 Rucker Ave, Suite 108, Everett, WA 98201


By appointment: 8 a.m.-noon and 1-4 p.m. Monday-Wednesday-Friday

SHD Lynnwood Immunization Clinic, 6101 200th Ave SW, Lynnwood, WA 98036


By appointment: 8 a.m.-noon and 1-4 p.m. Tuesday and Thursday

NOTE: Both clinics will be closed on weekends and on Labor Day, Sept. 2.



Number of children in US drops


kids children playgroundFrom the National Institutes of Health

The number of children living in the United States declined slightly, as did the percentage of the U.S. population who are children, according to the federal government’s annual statistical report on the well-being of the nation’s children and youth.

The percentage of children living in the United States who are Asian, non-Hispanic increased, as did the percentage of children who are of two or more races, and the percentage of children who are Hispanic.

The percentages of children who are white, non-Hispanic, and black, non-Hispanic declined.

By 2050, about half of the American population ages under 17 is projected to be composed of children who are Hispanic, Asian, or of two or more races, the report stated.

The report projected that, among children under age 17, 36 percent will be Hispanic (up from 24 percent in 2012); 6 percent will be Asian (up from 5 percent in 2012); and 7 percent will be of two or more races (up from 4 percent in 2012).”

These and other findings are described in America’s Children: Key National Indicators of Well-Being, 2013. The report was compiled by the Federal Interagency Forum on Child and Family Statistics, which includes participants from 22 federal agencies as well as partners in several private research organizations.

The forum fosters coordination, collaboration, and integration of federal efforts to collect and report data on children and families.

The report, the 16th in an ongoing series, presents key indicators of children’s wellbeing in seven domains: family and social environment, economic circumstances, health care, physical environment and safety, behavior, education, and health.

Among the findings in this year’s report:

  • A drop for the fifth straight year in the percentage of infants born preterm, from 12.8 percent in 2006 to 11.7 in 2011.
  • A drop in the percentage of children ages 4–11 with any detectable blood cotinine level, a measure for recent exposure to secondhand smoke, from 53 percent in the years 2007 and 2008 to 42 percent in 2009 and 2010).
  • A drop in births to adolescents, from 17 per 1,000 girls ages 15 to 17 in 2009 to 15 per 1,000 in 2011 (preliminary data).
  • A drop in the percentage of births to unmarried women ages 15 to 44, from 40.8 percent in 2010 to 40.7 percent in 2011.
  • A rise in the percentage of male and female 12th graders who reported binge drinking — consuming five or more alcoholic beverages in a row in the past two weeks — from 22 percent in 2011 to 24 percent in 2012.
  • A drop in the percentage of children from birth to 17 years of age living with two married parents, from 65 percent in 2010 to 64 percent in 2011.
  • A drop in the percentage of children from birth to 17 years with no usual source of health care, from 5 percent in 2010 to 4 percent in 2011.
  • A rise in the percentage of households with children from birth to 17 years that reported housing that costs more than 30 percent of household income, crowding, and/or physically inadequate housing, from 45 percent in 2009 to 46 percent in 2011.
  • A rise in the percentage of children from birth to 17 years of age living with at least one parent employed year round full time, from 71 percent in 2010 to 73 percent in 2011.
  • A drop in the percentage of children ages 5–17 with untreated dental caries (cavities or tooth decay) over the past decade, from 23 percent in 1999 – 2004 to 14 percent in 2009 – 2010.
  • A rise in the percentage of children ages 5–17 with a dental visit in the past year from 85 percent in 2010 to 87 percent in 2011.

The percentage of youth ages 12–17 who had a major depressive episode was unchanged in the previous year (8.2 percent in 2010 and 2011).However, this figure was lower than the 2004 high of 9 percent.

The report notes that adolescent depression can affect school and work performance, impair peer and family relationships, and exacerbate other health conditions, such as asthma and obesity.

The Healthy Eating Index score, a measure of overall dietary quality did not differ significantly from recent years. For children ages 2-17, total scores ranged between 47 and 50 percent in 2003-2004, 2005-2006, and 2007-2008, . The report noted that the diet quality of children and adolescents fell considerably short of recommendations.

“Poor eating patterns can lead to childhood obesity and contribute to chronic diseases starting in childhood, such as type 2 diabetes, and those that emerge throughout the life cycle, such as cardiovascular disease,” the report stated.

The report added that the diet quality of children and adolescents would be improved by an increase in vegetables, especially dark greens and beans, replacing refined grains with whole grains, substituting seafood for some meat and poultry, and decreasing the intake of sodium, solid fats, and added sugars.

This year’s report includes a special feature on the kindergarten year, described as a pivotal marker for children’s development..Three and a half million children entered kindergarten for the first time in the fall of 2010.

On average, girls received higher scores than boys on kindergarten entry assessments in reading and approaches to learning. There were no differences between girls and boys in mathematics and science.

The special feature was based on data from the Early Childhood Longitudinal Study, Kindergarten Class of 2010 — 2011 (ECLS-K:2011), conducted by the National Center for Education Statistics.

The report noted that the ECLS-K:2011 will follow the children’s progress through the fifth grade, providing information on how the children’s development may be shaped by such factors as child care, home educational environment, teachers’ instructional practices, and class size.

About the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD): The NICHD sponsors research on development, before and after birth; maternal, child, and family health; reproductive biology and population issues; and medical rehabilitation. For more information, visit the Institute’s website at


Protect babies from whooping cough – CDC infographic



Protect Babies from Whooping Cough (Text Version)

If you’re pregnant get a Tdap shot!

Whooping cough is deadly for babies

[Picture of a nurse holding a baby beside a hospital]
Whooping cough (pertussis) is a respiratory infection that can cause severe coughing or trouble breathing.
About half of infants who get whooping cough are hospitalized!
[picture of arrow saying “1 out of 2” pointing to hospital]
Whooping cough cases across the U.S. have been on the rise since the 1980s.

Pregnant women need to get a Tdap shot

[Picture of a pregnant woman talking to a mother holding a baby]
Pregnant woman: I got my whooping cough vaccine and will encourage everyone caring for my baby to get a shot, too!
Mom: This vaccine helps protect you from whooping cough and passes some protection to your baby.

Create a circle of protection around your baby

4 out of 5 babies who get whooping cough catch it from someone at home*
[Picture of a baby surrounded by his parents, brother and sister, grandparents, and childcare providers]
Everyone needs whooping cough vaccine:

  • Parents
  • Brothers & sisters
  • Childcare providers
  • Grandparents

* When source was identified

Make sure your baby gets all 5 doses of whooping cough vaccine on time

Your baby needs whooping cough vaccine at:

  • 2 months
  • 4 months
  • 6 months
  • 15 thru 18 months
  • 4 thru 6 years

You can get whooping cough vaccines at a doctor’s office, local health department, or pharmacy

[Picture of a nurse and a doctor]
Like it? Tell a friend! It’s important! Pinit! Tweet it! Share it on Facebook!
[Picture of parents with a newborn baby and young daughter]

U.S. Department of Health and Human Services, Centers for Disease Control and Prevention

Blue sky and white clouds (Panorama)

Hot weather: How to stay cool and safe


Blue sky and white clouds (Panorama)

Hot weather tips from Public Health – Seattle & King County

When outside temperatures are very high, the danger for heat-related illnesses rises. People’s bodies are not able to cool themselves quickly enough, and they overheat.

In severe instances, people can suffer heat stroke, which can cause death or permanent disability if emergency treatment is not provided.

Older adults, young children, and people with mental illness and chronic diseases are at highest risk for heat-related illness. But even young and healthy individuals can suffer in heat if they participate in strenuous physical activities during hot weather.

You can protect yourself and loved ones against very hot temperatures by following these recommendations:

Stay cool

  • Spend more time in air conditioned places. If you don’t have air conditioning, consider visiting a mall, movie theater or other cool public places.
  • Cover windows that receive morning or afternoon sun.
  • Dress in lightweight clothing.
  • Take a cool shower or bath, or place cool washcloths on your skin.
  • Check up on your elderly neighbors and relatives to take these precautions too.

Drink liquids:

  • Drink plenty of water. Avoid drinks with caffeine, alcohol and large amounts of sugar because they can actually de-hydrate your body.
  • Have a beverage with you at all times, and sip or drink frequently. Don’t wait until you’re thirsty to drink.

If you go outside:

  • Limit the time you’re in direct sunlight.
  • Do not leave infants, children, people with mobility challenges and pets in a parked car, even with the window rolled down.
  • Avoid or reduce doing activities that are tiring, or take a lot of energy.
  • Do outdoor activities in the cooler morning and evening hours.
  • Avoid sunburn. Use a sunscreen lotion with a high SPF (sun protection factor) rating.

Water safety:

Some people turn to local rivers to cool off, but drowning is a real concern. Please use caution and wear a personal flotation device (PFD) on the water. Find deals on affordable lifejackets. And if you want to swim, choose a safer location – visit a local pool or lifeguarded beach instead.

Certain medications may increase sensitivity to the heat. If you are concerned about the heat and the medications you are taking, check with your doctor. Do not take salt tablets unless your doctor tells you to.

Hot Weather fact sheets in other languages by the Washington State Dept. of Health:

Recognizing heat exhaustion and heat stroke

When people’s bodies can’t cool themselves quickly enough it can cause heat exhaustion. Symptoms of heat exhaustion include muscle cramps, weakness, dizziness, headache, nausea and vomiting.

If you see someone with signs of overheating, move the person to a cooler location, have them rest for a few minutes and then slowly drink a cool beverage. Get medical attention for them immediately if they do not feel better.

Heat exhaustion can lead to heat stroke, which can cause death or permanent disability unless treated immediately. Symptoms of heat stroke include:

  • An extremely high body temperature (above 103°F)
  • Red, hot, and dry skin
  • Rapid, strong pulse
  • Nausea, confusion and unconsciousness

For more information, visit these websites:

Photo by Sanja Gjenero

Salmonella in eggs: An unwelcome summer visitor

Photo by Sanja Gjenero

Photo by Sanja Gjenero

CDC Features

Eggs and summer go together: deviled eggs, homemade ice cream, and potato salad.

But, just a few hours outside of the refrigerator and your eggs can create lasting memories that you’d rather forget.

This summer, make sure that eggs carrying Salmonella don’t come to your next outing.

Summer is the perfect season for Salmonella, a germ that commonly causes foodborne illness–sometimes called food poisoning.

Warm weather and unrefrigerated eggs or food made from raw or undercooked eggs create ideal conditions for Salmonella to grow.

Many germs grow to high numbers in just a few hours at room temperature.

Although anyone can get Salmonella food poisoning, older adults, infants, and people with weakened immune systems are at increased risk for serious illness.

A person infected with Salmonella usually has a fever, abdominal cramps, and diarrhea beginning 12 to 72 hours after consuming a contaminated food or beverage.

The illness usually lasts 4 to 7 days, and most people recover without antibiotic treatment. But, in rare cases, people become seriously ill.

In the United States, Salmonella infection causes more hospitalizations and deaths than any other germ found in food, resulting in $365 million in direct medical costs annually.

Wondering if you haveSalmonella food poisoning?

salmonella on cultured human cells

Salmonella / CDC

See your doctor or healthcare provider if you have:

  • Diarrhea along with a temperature over 101.5°F
  • Diarrhea for more than 3 days that is not improving
  • Bloody stools
  • Prolonged vomiting that prevents you from keeping liquids down
  • Signs of dehydration, such as
    • Making very little urine
    • Dry mouth and throat, and
    • Dizziness when standing up

Salmonella can be sneaky

You can get Salmonella from perfectly normal-looking eggs. Salmonella can live on both the outside and inside of eggs that appear to be normal. Chicken feces on the outside of egg shells used to be a common cause of Salmonella contamination. To counter that, regulators in the 1970s put strict procedures into place for cleaning and inspecting eggs. Now, Salmonella is sometimes found on the inside of eggs; it gets there as the egg is forming.

Good news for egg lovers

Professionals from public health, government, and the food industry are continually working to reduce the risks of Salmonella in eggs. Here are just a few contributions made thus far:

Be proactive. Reduce your risk.

Did You Know?

Eating raw or undercooked eggs can be especially dangerous for young children, pregnant women, older adults, and those with weakened immune systems.

Salmonella can contaminate more than poultry and eggs. It sneaks its way into many foods—ground beef, pork, tomatoes, sprouts—even peanut butter. Here are six tips to make eggs and other foods safer to eat.

  1. Like other perishable foods, keep eggs refrigerated at or below 40° F (4° C) at all times. Buy eggs only from stores or other suppliers that keep them refrigerated.
  2. Discard cracked or dirty eggs.
  3. Do not keep eggs or other foods warm or at room temperature for more than two hours.
  4. Refrigerate unused or leftover foods promptly.
  5. Avoid restaurant dishes made with raw or lightly cooked unpasteurized eggs. Although restaurants should use pasteurized eggs in any recipe containing raw or lightly cooked eggs –such as Hollandaise sauce or Caesar salad dressing—ask to be sure.
  6. Consider buying and using shell eggs and egg products that are pasteurized. These are available for purchase from certain stores and suppliers.

 Photo of eggs courtesy of Sanja Gjenero

More Information

For more information about Salmonella, foodborne illness, and food safety, call 1-800-CDC-INFO, e-mail, or visit these web sites:


Doctor offers 8 tips to keep kids safe while biking


Bike ThumbBy Kathryn Bluher
From Seattle Children’s On the Pulse blog

The long, sunny days of summer are the perfect time to get the bikes out of the garage, but parents should hit the brakes and talk to children about bike safety first.

Bike accidents are the second-leading cause of serious injury in school-age children.

According to the Centers for Disease Control, in 2010, 800 bicyclists were killed in the U.S. and an estimated 515,000 sustained bicycle-related injuries that required emergency department care.Roughly half of these cyclists were children and adolescents under the age of 20.

Tony Woodward, MD, MBA, medical director of emergency medicine at Seattle Children’s Hospital, says most biking injuries occur because a child either isn’t wearing a helmet or is putting themself in a potentially dangerous situation. “Children may see themselves as invincible when they are on a bike, which is not the truth,” says Woodward.

Biking is a great summer time activity for children and families, incorporating both physical fitness and family time, but proper safety measures are important to keeping kids injury-free. Accidents can and will happen while biking, even on the quietest roads and safest sidewalks, but these tips can help reduce the risk of serious injuries.

Top tips for keeping kids safe while biking

Wear a helmet every time. Children should wear a helmet every time they ride a bike. “Most of the serious and life-threatening injuries we see are head injuries,” says Woodward, but that risk can be reduced by wearing a properly fitted helmet. By simply wearing a helmet that fits correctly, children can reduce their risk of serious injury up to 85 percent. It doesn’t matter if a child is biking across town or across the driveway, children should wear a helmet every time they ride their bike, says Woodward. “Children shouldn’t be allowed on their bike unless their helmet is on their head first.”

Make sure you have the right helmet and the right fit. Not all helmets are made for biking. For instance, football helmets or hard hats are not acceptable for biking. Bike helmets are made specifically for head-first falls and should be properly fitted on a child. Helmets should meet safety standards and should have a CPSC (U.S. Consumer Product Safety Commission) or Snell sticker inside. Proper fitting is also important. “Helmets only work if they are the right size,” says Woodward. If you can move the helmet from side to side, the helmet should be adjusted. Helmets should fit solidly on a child’s head and feel level. Due to the type of built-in protection, helmets are also only good for one crash. Remember, after a crash consider it trash!

Wear proper clothing. Kids should wear bright clothes while biking to be more visible to other bikers, pedestrians and cars. Reflectors or lights on the front and back of a bike and helmet are also a great way to increase visibility and ensure safety. Avoid wearing loose-fitting clothing that could catch in the bike’s chain and mechanics, and wear proper shoes. “Wearing closed toed shoes while biking can reduce the risk of losing a toe and long sleeves can help guard against road rash if a child falls off their bike,” says Woodward. Flip-flops or shoes with heels are also hazardous.

Ride a bike that is right for you. Bikes come in all shapes, colors and styles. Choose a bike that fits your child’s skill level and style, but most importantly, find a bike that is the right size. Don’t purchase a bike that a child will grow into. A properly sized bike is a safer bike. Your child should be able to sit on the seat with their feet flat on the ground and the handlebars should be no higher than their shoulders.

Perform a safety check before every ride. Before every ride check to make sure a bike’s seat, handlebars and wheels are all adjusted correctly and in good shape. Nothing should be loose or falling apart. Check the chain of the bike and the brakes, and make sure the tires have enough air.

Be aware of surroundings while biking. Set clear guidelines with your child about where it is safe to ride their bike – on the street or on the sidewalk – and how far is too far away from home. Woodward recommends kids younger than 10 not ride without an adult in the street. Bike paths are a great option for children, free from motor vehicles. However, bike paths are not free from potential hazards, like sticks, rocks, protruding objects and other potential obstacles such as dogs, people and faster bikers. Also, bike paths are meant to be shared. Teach children to be respectful of walkers and other bikers and to always pay attention to their surroundings.

Proper supervision is key. Supervision is key, but it isn’t just when kids are on their bike, says Woodward. Supervision starts by preparing kids for their bike, with proper equipment and modeled behavior.

Follow road rules. Most pediatricians recommend not allowing children under 10 to bike on the roads, but if a child is deemed old enough and mature enough to ride on roads, make sure they understand the rules of the road:

  • Ride with traffic, never against traffic
  • Always stop and check for traffic in both directions when exiting a driveway
  • Stop at all stop signs and obey traffic lights
  • When riding on the road, act as a car
  • Use bike lanes and bike routes
  • Avoid riding too close to parked cars to avoid car doors opening suddenly
  • Use proper hand signals, when safe to do so

Accidents can happen anywhere – on the sidewalk, in the driveway, even on a quiet bike path – that’s why being prepared, supervised and aware of surroundings are so important. Biking is fun, but safety comes first!


Upcoming events:

Seattle Children's Whale Logo


Tips to keep kids and teens safe this Fourth of July


From Seattle Children’s On The Pulse blog

Photo by Johnny BergThe Fourth of July is a time for fun and celebration; however, families should follow precautions to ensure a safe and enjoyable occasion.

Not only do parents need to worry about firework safety, but families should also keep in mind alcohol and sun safety, too.

Tony Woodward, MD, MBA, medical director of emergency medicine at Seattle Children’s, says that inadequate preparations for what might happen is the standard issue on Fourth of July.

To keep your kids out of the emergency department this year, Woodward recommends some basic safety tips.

Photo: Courtesy of JohnNyberg

Stay safe around fireworks

First and foremost: The main event on July Fourth is fireworks. Even though they are fun and exciting, they can be dangerous ifprecautions aren’t taken around kids.

The best way to avoid injury is to leave the pyrotechnics to the professionals and attend public fireworks displays. But if you plan to use fireworks at home, Woodward has some suggestions to keep your kids safe.

Children should never be allowed to use fireworks, including the popular sparklers. Woodward says the majority of firework-related injuries to children under the age of 5 are caused by sparklers.

“We often see kids with preventable burns and injuries from sparklers,” he says. Sparklers burn at a very high temperature (up to 2,000 degrees Fahrenheit).

Another important tip is to only light fireworks on level ground. “At least 50 percent of kids that we see are not the people who are setting off the fireworks, but the bystanders,” Woodward says.

Anticipate the consequences and provide adequate supervision to minimize any chance of injury. Never re-light or touch a firework that has not exploded.

If a child is injured by fireworks, Woodward says, “Remove them from the area and stop the burning. If it is serious, you are unsure or it involves face, eyes or hands, the child should be seen by a medical professional.”

Avoid heat illness

Don’t forget that July can have particularly hot weather, says Woodward. During a long day in the sun, he recommends that parents be on the lookout for symptoms of heat cramps, heat exhaustion, and heat stroke. Kids can become very ill if proper safety measures are not taken.

Woodward recommends that parents make sure kids drink plenty of fluids and wear lightweight, loose clothing. Stay indoors during the hottest part of the day, usually the afternoon.

If your child is experiencing heat cramps, be aware that they can be painful, says Woodward. Stop activity, take a break, and encourage your child to drink small amounts of water. In serious cases, heat cramps can lead to heat exhaustion, with symptoms such as pale skin, headache, dizziness, exhaustion, and nausea.

The third and most dangerous stage of heat illness is heat stroke. Parents should be alert to symptoms such as vomiting, decreased alertness or loss of consciousness, extremely high body temperature, rapid or weak pulse, and shallow breathing. Heat stroke can be life threatening, so be prepared to call 9-1-1 if symptoms worsen.

Talk to your teen about drunk driving dangers

According to the National Highway Traffic Safety Administration, Fourth of July is the deadliest holiday of the year – even deadlier than New Year’s Day. Many teens find themselves in dangerous driving situations during July Fourth celebrations, especially when alcohol is involved.

Research has shown that nearly 80 percent of high school kids have tried alcohol. In a recent Teenology 101 blog postYolanda Evans, MD, MPH, with Seattle Children’s adolescent medicine division, offers tips for parents of teens to help keep them safe during summer celebrations.

Evans recommends parents keep an open line of communication with their teens, as well as the parents of their teens’ friends. She also encourages a “free phone call” policy, so teens know they can call any time of night if they need a ride home. Visit Teenology 101 for more tips on talking to teens about alcohol and drugs.

Photo: Courtesy of JohnNyberg

More safety tips from On the Pulse:

Seattle Children's Whale Logo


Upcoming free child car seat check-up events in King County


Child safety seat car seatChild safety seats can be lifesavers for our most precious cargo when used properly. To support parents and caregivers so that their children fit securely in car seats, Public Health – Seattle & King County is hosting four free child car seat check-up events over the late spring and summer, starting in Newcastle on May 31.

Events details

  • Newcastle: May 31, 10 a.m. to 2 p.m., Coal Creek Family YMCA, 13750 Newcastle Golf Club Rd
  • Renton: June 14, 10 a.m. to 2 p.m., Renton Public Health Center, 3001 NE 4th St.
  • Bellevue/Factoria: July 19, 10 a.m. to 2 p.m., Eastgate Public Health Center, 14350 SE Eastgate Way
  • Federal Way: August 7, 2 p.m. to 6 p.m., Steel Lake Park, 2410 S. 312th St.

For all events, bring your car, car seat and child and learn how to properly install your car seat. 

Parents and caregivers will have their child safety seat checked by a certified child safety seat technician for safe installation; soon-to-be parents/caregivers welcome as well. Educational materials will also be on hand.

The American Academy of Pediatrics recommends keeping children up to two years old in rear facing seats or until they have reached the maximum height and weight limits of the car seat, as allowed by the manufacturer.

Child safety seats reduce fatal injury by 71 percent for infants younger than one year old and by 54 percent for toddlers in passenger cars, according to national research.

By one estimate (2009), 309 lives were saved nationally by child safety seat use.

For more information about the Public Health sponsored events, please contact Alan Abe, King County Emergency Medical Services Division, at 206-263-8544.

For ongoing child safety seat check-up locations in the Puget Sound area, check the National Highway Traffic Safety Administration website at



Teens have unsupervised access to prescription drugs


By Stephanie Stephens, HBNS Contributing Writer
Research Source: Journal of Adolescent Health

A new study in the Journal of Adolescent Health found that 83.4 percent of teens had unsupervised access to their prescription medications at home including 73.7 percent taking pain relief, anti-anxiety, stimulant and sedative medications that have the potential for abuse.


“It was surprising to me that parents were not storing medications securely because I expected them to be locked up and for parents to administer the medications,” said Paula Ross-Derow, Ph.D., of the University of Michigan’s Institute for Research on Women and Gender.

She and her colleagues explored the supervision of prescribed medications among 230 adolescents in 8th and 9th grade, using an online survey and in-person interview.

Emergency room visits for non-medical use of prescription narcotic pain relievers are increasing in people under age 21, and death by poisoning due to prescription overdoses is up 91 percent in less than a decade among adolescents ages 15 to 19, note the researchers.

They acknowledge that it is possible that parents and guardians may not believe that their children would engage in non-medical use or give away their prescription medications and therefore do not take steps to secure them.

“Dr. Ross-Durow’s paper shows that the majority of adolescents who are prescribed controlled medications have easy, unsupervised access to them,” said Silvia Martins, M.D., Ph.D., associate professor of epidemiology at Columbia University. “This is of great concern, since it not only can lead to the possibility of overdose of medications with potential abuse liability, but also can contribute to diversion of these medications and nonmedical use by their peers.”

“Parents don’t recognize that other kids come into their homes and can open a cabinet or see meds on the kitchen counter and take them,” Ross-Durow explained. “Teenagers may give them away—thinking they’re helping a friend—and they don’t see this as a risky behavior, or some may sell the medications. Visitors in the home may simply steal them.”

The researchers admit they don’t know whether providers are adequately educating parents and encourage more studies around this topic. “Plus, what we did not ask, but realized when examining our findings, is about other medications prescribed to parents and how those are stored. What we want to know is when medications are readily available in the home; does that lead to nonmedical use? We believe unsupervised access lays the groundwork for that,” said Ross-Durow.

Journal of Adolescent

Paula Lynn Ross-Durow, Ph.D., Sean Esteban McCabe, Ph.D., and Carol J. Boyd, Ph.D. (2013). Adolescents’ Access to Their Own Prescription Medications in the Home, Journal of Adolescent Health.

Health Behavior News Service is part of the Center for Advancing Health

The Health Behavior News Service disseminates news stories on the latest findings from peer-reviewed research journals. HBNS covers both new studies and systematic reviews of studies on (1) the effects of behavior on health, (2) health disparities data and (3) patient engagement research. The goal of HBNS stories is to present the facts for readers to understand and use for themselves to make informed choices about health and health care.

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CDC takes a closer look at kids’ mental health


By Jenny Gold

Somewhere between 13 and 20 percent of kids in the United States experience some sort of mental illness, according to a new report from the Centers for Disease Control and Prevention.

That adds up to millions of children suffering from disorders like ADHD, depression, autism and illicit drug use.

The total annual cost of the illnesses?

About $247 billion a year.

Kids Mental Illness CDC

The CDC put together this handy infographic to chart the prevalence of various illnesses. ADHD is the most common diagnosis, followed by behavioral and conduct problems.

The study, published as part of the CDC’s weekly journal MMWR, is the first time that federal researchers have sought to compile estimates of how many children have specific mental disorders and describe federal efforts for monitoring the issue.

The prevalence of mental disorders in kids seems to have increased over the past 15 years as well (though the growth could reflect better monitoring and awareness, rather than more kids actually being sick).

And they seem to be sicker: inpatient hospital admissions for mental health and substance abuse issues increased by nearly a quarter from 2007-2010.

Suicide was the second leading cause of death for kids aged 12-17.

This article was reprinted from with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.


Learn about summer safety at “Safe Kids Day” events – May 18


life-jacket-float Summer fun can land kids in the emergency room

Injury prevention for kids the focus of Safe Kids Day, May 18 and all year long

Kids wait all year for spring and summer to bring the longer days and warmer weather that’s now here, but that fun can lead to a trip to the doctor or even the emergency room.

A few common safety precautions can keep the action fun and avoid possible serious injuries, and this week the precautions are the focus of  Safe Kids Day, May 18.

The US Consumer Product Safety Commission says bicycle accidents crash-land more kids into emergency rooms than any other sporting activity. Children between the age five and 14 are injured more often than bikers of any other age.

Sometimes these injuries can be fixed with a simple bandage at home, but many times it’s much more serious – broken bones or concussions.

In Washington, one child dies or is hospitalized every day because of a preventable injury. This has an immeasurable, lasting effect on families and our community. Many of these tragedies can be prevented if children wear helmets while biking, rollerblading, or skateboarding; wear life jackets while out in or near the water; and ride in a properly installed car seat.

Accidents happen when least expected. Wearing an approved and properly fitted bicycle helmet reduces the risk of brain injury by 88 percent. As kids get older helmet use goes down.

The 2012 Healthy Youth Survey reports 59 percent of eighth graders in our state who rode a bicycle in the past month rarely or never wore a helmet.

Safe Kids Washington works to promote safe biking, water sports, and car seat use, among other safety tips that help prevent injuries. It supports 18 county-based Safe Kids coalitions that serve 95 percent of children up to 14 years old in Washington.

Proper helmet use, water safety advice that includes using personal floatation devices, and proper installation of child car seats are common prevention tools promoted by Safe Kids Washington and the Department of Health.

In 2012, local Safe Kid coalitions in our state distributed more than 900 car seats and 6,000 bike helmets to local families in need.

Other lesser-known tips are available through Safer in 7, and information on Safe Kids Coalitions in our state can be found on the Department of Health website. An example of a less common safety tip: jiggle a child car seat; if it moves more than an inch, it must be tightened.

The Washington State Safe Kids Coalition invites parents to take part in Safe Kids Day on Saturday, May 18. Local coalitions are holding several events across the state to help parents learn ways to keep kids.


Children, teens should not use tanning lamps – FDA


Sun TanningA Consumer Update from the FDA

Using ultraviolet (UV) tanning lamps, like those used in indoor tanning beds, increases the risk of skin damage, skin cancer and eye injury, according to the Food and Drug Administration (FDA) and numerous other health organizations.

According to the American Cancer Society, melanoma—the deadliest form of skin cancer—accounted for 75,000 cases of skin cancer in 2012.

According to the American Academy of Dermatology, indoor tanners are 75 percent more likely to develop melanoma than those who have never tanned indoors, and the risk increases with use.

To help protect consumers from the risks of indoor tanning, FDA is proposing changes in its regulation of sunlamps. The proposals are to enhance oversight of these devices, and to require labeling to include a recommendation designed to warn young people under the age of 18 not to use these devices.

This is due to concerns about long-term effects of exposure to dangerous UV rays. Because the effects add up over a lifetime, UV exposure in children and teenagers puts them at greater risk for skin and eye damage later in life.

Proposed Changes

FDA regulates sunlamp products (including tanning beds and booths) both as medical devices and radiation-emitting products. Manufacturers of sunlamps must comply with FDA regulations regarding these devices.

Based on new risk information and recommendations from experts at an earlier FDA Medical Device Advisory Committee meeting, the agency is proposing to reclassify these devices from Class I to Class II. FDA can exert more regulatory control over Class II devices, notes FDA medical device expert Neil Ogden.

For example, sunlamps would have to undergo premarket review and comply with requirements relating to performance testing, software validation and biocompatibility. “We believe the reclassification will not only strengthen oversight of sunlamp products, but also will ensure that consumers are better informed about and protected from this sort of exposure,” he explains.

In addition, FDA is proposing that manufacturers add a label to the sunlamp warning young people not to use these devices. The World Health Organization, the American Academy of Pediatrics, the American Academy of Dermatology, the American Medical Association and other organizations have previously supported what the FDA is now proposing: a recommendation that minors refrain from indoor tanning.

The proposed order will be published in the Federal Register at and FDA will take public comments for 90 days.

FDA also is proposing that sunlamp product labeling include a warning that people who are repeatedly exposed to sunlamp products see their health care professional on a regular basis to check for possible skin cancer.

Skin Cancer Risk

“There is increasing evidence that tanning in childhood to early adult life increases the risk of skin cancer, including melanoma,” says FDA dermatologist Markham Luke, M.D.

In fact, according to an overview of studies recently published in the journal Pediatrics, melanoma is the second most common cancer in women in their 20s and the third most common cancer in men in their 20s in the U.S. Luke adds that many experts believe that at least one cause is the increased use of sunlamp products by U.S. teenagers and young adults.

The overview in Pediatrics suggests that doses of UV-A ultraviolet radiation emitted by high pressure tanning units may be up to 10 to 15 times higher than that of the midday sun, an intense exposure not found in nature.

UV-A rays penetrate to the deeper layers of the skin and are often associated with allergic reactions, such as a rash. This is not to say that tanning outdoors is a safe activity. WHO has classified all UV radiation as carcinogenic (cancer causing).

Practices to Avoid

FDA’s proposal seeks to provide a reasonable assurance of safety and to make prospective users of sunlamps aware of the risks they face. Certain practices involving sunlamps are especially dangerous. These include:

  • failing to wear goggles—this can lead to short- and long-term eye injury.
  • starting with long exposures (close to the maximum time for the particular sunlamp), which can lead to burning. Because sunburn takes 6 to 48 hours to develop, you may not realize your skin is burned until it’s too late.
  • failing to follow manufacturer-recommended exposure times on the label for your skin type (some skin types should not tan with UV radiation at all, for example those with skin that burns easily and doesn’t readily tan).
  • tanning while using certain medications or cosmetics that may make you more sensitive to UV rays. Talk to your doctor or pharmacist first.

This article appears on FDA’s Consumer Update page, which features the latest on all FDA-regulated products.

May 7, 2013

Related Consumer Updates

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Teens overeat at Subway, too


subwayBy Katherine Kahn, HBNS Contributing Writer
Research Source: Journal of Adolescent Health

Adolescents are just as likely to consume too many calories at Subway as at McDonald’s, a new study inJournal of Adolescent Health finds, despite the fact that they think Subway offers healthier food.

Adolescents purchase about 1,000 calories worth of food for an afternoon meal at both fast food restaurants—150 calories more per meal than the Institute of Medicine recommends for this age group.

“We were interested in looking at how the restaurant marketing environment affects what adolescents purchase,” said Lenard Lesser, M.D., the study’s lead author and a family physician and researcher at the Palo Alto Medical Foundation Research Institute.

Lesser and his colleagues asked adolescents where they would go for an unhealthy meal and for a healthy meal.

“When we asked them where they would go for a healthy meal, most of them said Subway,” Lesser said. “Our study was really designed to look at what adolescents actually ordered at the restaurants, not simply what was offered on the menu.”

The study enrolled 97 adolescents ages 12 to 21 to purchase meals at both restaurants on different days in the South Los Angeles area. They purchased an average of 1,038 calories from McDonald’s and 955 calories from Subway, which researchers found to not be a significant difference.

Nutritionally, the meals purchased from McDonald’s differed somewhat from Subway meals. The adolescents purchased more calories from sugary drinks and French fries and fewer cups of vegetables from McDonald’s.

The McDonald’s meals contained more grams of carbohydrates and sugars than the Subway meals. However, overall sodium amounts were greater in the Subway meals, probably due to more processed meats and breads, Lesser said.

There was no significant difference in fat content between meals from the two restaurants. The study authors stated that while Subway “may be ‘healthier’, it still may not be healthy.”

Brian Saelens, Ph.D., of the Seattle Children’s Hospital Center for Child Health, Behavior and Development commented, “At Subway, there are a few opportunities to make more healthful choices, but there’s lots of opportunities to make unhealthful ones. If the general mantra at these restaurants and other restaurants is to eat a lot and eat unhealthily, just sticking healthful things [on the menu] is not going to change a lot of people’s behavior.”

“Restaurants will announce initiatives to make kids’ menus more healthy, government and legislators will announce policies to make food healthier, but until we have policies from government or initiatives from industry that really improve the outcome of what people are eating and how healthfully they’re eating, we’re not going to succeed in solving the crisis of poor eating,” Lesser said.

For More Information:

  • Reach the Health Behavior News Service, part of the Center for Advancing Health, at (202) 387-2829 or
  • Lesser, LI, et al. Adolescent purchasing behavior at McDonald’s and Subway. Journal of Adolescent Health. May 2013.

Health Behavior News Service is part of the Center for Advancing Health

The Health Behavior News Service disseminates news stories on the latest findings from peer-reviewed research journals. HBNS covers both new studies and systematic reviews of studies on (1) the effects of behavior on health, (2) health disparities data and (3) patient engagement research. The goal of HBNS stories is to present the facts for readers to understand and use for themselves to make informed choices about health and health care.