June 24, 2008
This Summer, a List of Old and New Safety Precautions
By MELISSA HEALY, LOS ANGELES TIMES
The idea that fresh vegetables can bear the same contami- nants long attributed to meat and mayon- naise can really crash a picnic.
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:
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 www.fda.gov. 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's 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.
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 appears to be the most common swimming-related cause 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 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. A laryngeal spasm might resolve itself when the victim is removed from the water and his muscles relax somewhat. If not, a few quick rescue breaths are in order to get the flow of air past the blockage.
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 becomes extremely sleepy, behaves unusually or appears to have continuing difficulty breathing. Any of those things could be a sign that the victim is not getting enough oxygen to the brain, possibly because his lungs damaged from the aspiration of water are filling with fluid.
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 Dr. 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."
Add to that the federal Centers for Disease Control and Prevention's latest warning of other dangers of recreational swimming including cryptosporidium, a microscopic parasite impervious to the effects of chlorine that can cause stomach upset, diarrhea and worse.
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