Below are news releases and briefs on statements appearing in the July issue of Pediatrics, the peer-reviewed, scientific journal of the American Academy of Pediatrics (AAP).

For Release: July 2, 2007, 12:01 am (ET)

AAP SAYS TO LEAVE FIREWORKS TO THE PROS THIS JULY 4TH HOLIDAY

Every year fireworks used by consumers cause thousands of injuries, fires and even deaths. Again this year, the American Academy of Pediatrics (AAP) joins with the Alliance to Stop Consumer Fireworks in urging the public to avoid using these readily available fireworks this July 4th.

In 2005, the Consumer Product Safety Commission had reports of four deaths from fireworks, and 10,800 injuries treated in U.S. hospital emergency departments. Injuries to children under 15 years of age accounted for 45 percent of these. Such injuries can be extremely serious, causing burns, blindness, disfigurement and other tragic effects.

The Alliance to Stop Consumer Fireworks is a group of 22 health and safety organizations, coordinated by the National Fire Protection Association. To see a video about a young boy who was killed by a legal consumer firework during a family celebration, go to www.nfpa.org/fireworks

For more information about fireworks injuries and other summer safety information, visit www.aap.org

IT’S NOT JUST ATVS

Authors of the study, “Children Plus All Non-automobile Motorized Vehicles (Not Just All-Terrain Vehicles (ATVs)) Equals Injuries” analyzed national injury data to compare ATV-related injuries with other types of non-automobile motorized vehicle-related injuries. More than one million children were treated in hospital emergency departments for non-automobile motorized vehicle-related injuries between 1990 and 2003. Over half of these injuries were caused by non-automobile motorized vehicles other than all-terrain vehicles (ATVs), including 2-wheeled off-road vehicles, 2-wheeled on-road vehicles, go-carts/buggies, and grass/farm, snow and water-related vehicles. Children age 12 or older had a greater proportion of ATV-related injuries than children under age 12. Conversely, the proportion of other non-automobile motorized vehicle-related injuries was greater among children under 12. Although most public health and legislative attention to date has been focused on ATVs, the authors want parents, children and public officials to know about the injury risks that all types of non-automobile motorized vehicles pose to children.

OH CANADA…ANALYZING YOUTH ICE HOCKEY INJURIES

Nearly 10,000 youth ice hockey injuries were reported among 10-15 years olds by the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) and the Hockey Canada Insurance Database (HCID). Results from the study, “Injuries in Canadian Youth Ice Hockey: The Influence of Relative Age,” found that older players in a certain age cohort (i.e. those born from January to March) were at increased risk of injury than their younger peers (those born from October to December). The increased risk of injury for relatively older players was greatest for those playing at the highest levels of competition. Increased susceptible to injury could be because these players are playing longer and more often. Ultimately, however, future research is required to find out the reason for this increased risk of injury. The type and severity of injuries did not change from one age group to another.

EQUIPMENT IN CHILD CARE CENTERS CAN REDUCE ILLNESS

Seventy percent of US children are in non-family child care or early education settings. Children in non-family care have an increased rate of infectious diseases, including diarrheal illnesses. The study, “Hand-Washing and Diapering Equipment Reduces Disease Among Children in Out-of-Home Child Care Centers,” compared 23 pairs of child care centers in North Carolina. In each pair, one randomly selected center was given new diapering, hand-washing and food preparation equipment, along with training on sanitation and hygiene. The control group did not receive new equipment, but did receive the training. The new equipment incorporated cast polymer tabletops with seamless surfaces. It also featured automatic faucets and foot-activated, rollout waste bins for diaper disposal. After monitoring the children’s illnesses and teachers ’ absences due to diarrheal illnesses, researchers found that the group who received new equipment had a reduced rate of diarrheal illnesses and reduced absences due to diarrheal illnesses.

TO TEST OR NOT TO TEST FOR TB

The health care system in California could save nearly $1.3 million a year with few adverse public health effects if universal tuberculosis skin testing of children entering kindergarten was discontinued, according to a study conducted by researchers at the University of California, San Francisco. The study, "Cost-effectiveness of Alternative Strategies for Tuberculosis Screening Before Kindergarten," found that over a 20-year period only two additional cases of TB would result from eliminating universal screening. The study found that testing should only be routine in the few parts of California where more than 7 percent of the kindergarten population routinely test positive for the disease. Savings should be redirected to more cost-effective methods to prevent tuberculosis, which poses a persistent health threat in California.

EDITOR’S NOTE: As stated in the 2006 issue of Redbook, the AAP discourages routine tuberculin skin testing (TST) administration, including programs based at schools, child care centers, and camps that include populations at low risk.

NATUROPATHIC PEDIATRIC CARE

Naturopathic medicine is currently licensed and practiced in 14 U.S. states, including Washington state. Naturopathic physicians (ND’s) provide care to patients through natural means such as exercise, proper nutrition, herbal medications and vitamins. The study, “Frequency and Characteristics of Pediatric and Adolescent Visits in Naturopathic Medical Practice,” found that pediatric care by most NDs is limited, but there is a group of children in Washington state for whom pediatric NDs are their sole health care providers. Common reasons for these visits include health supervision (27.4%), upper respiratory infections (18.4%), and otitis media (5.9%). Immunizations were given during 18.6 percent of health supervision visits by children under two years of age. The authors recommend that efforts be made to enhance collaboration between naturopathic physicians and conventional providers so that optimal care can be provided for children. 

EDITOR’S NOTE: A related study, “Use of Complementary and Alternative Medicine (CAM) in a General Pediatric Clinic,” identifies the factors that influence the use of CAM, particularly for children with chronic diseases.

AAP ISSUES NEW RECOMMENDATIONS FOR HEPATITIS A AND VARICELLA VACCINES

The American Academy of Pediatrics now recommends that all children should receive hepatitis A vaccine at 1 year of age (12 –23 months) as a 2-dose regimen. The 2-dose series should be administered at least 6 months apart.

In addition, the AAP now recommends 2-doses of the varicella vaccine for children 12 months through 12 years of age, separated by at least 3 months; if the second dose inadvertently is administered between 28 days and 3 months after the first dose, the second dose does not need to be repeated. Children 13 years of age or older without evidence of immunity, should receive two doses of varicella vaccine separated by at least 28 days.

The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well being of infants, children, adolescents and young adults.