Coin-sized batteries, often referred to as button batteries, are the reason for seeing double the children’s emergency room visits during the past twenty years.

In an online study in Pediatrics, researchers document serious complications, including deaths, occurring when children swallow “button batteries,” found in items ranging from remote-control devices to children’s toys.

The researchers looked at U.S. National Electronic Injury Surveillance System data concerning all battery-related visits to the ER among children up to age 18.

Four different types of accidental contact with button batteries were found: swallowing and insertion of a battery into the mouth, ear, or nose.

Researchers found that over the 20-year period such contacts translated into nearly 66,000 ER visits, with a dramatic increase over the final eight years. Toddlers and others 5 years and younger faced the highest risk for accidental button-battery contact, with the average age of incoming ER patients just below 4 years.

Boys accounted for more of the ER visits (about 60 percent). Most cases (nearly 77 percent) were the result of swallowing button batteries. Nose contact accounted for roughly 10 percent of cases, followed by mouth exposure (7.5 percent) and ear insertion (almost 6 percent).

The study report carries a message for parents stating that if they suspect that their child has swallowed a battery they need to get to the ER right away. To prevent such accidents, parents need to store and dispose of batteries, especially button batteries, while keeping them out of reach of their children. They need to tape all battery compartments shut.

The study report also carries a message for manufacturers stating that we need to have the industry make battery compartments inaccessible and child-resistant for all products, not just toys.

The study report concludes by advising parents to heed the general advice regarding choking, especially for those 5 years and younger. Children should never be within reach of any object that can fit through a choke tube, which is about the size of a cardboard tube of a toilet-paper roll. This is particularly the case with objects not normally considered dangerous, such as children’s toys that have batteries, and other small parts, and various objects found in the kitchen or the bathroom. Button batteries are small enough to fit in the mouth, the ear and up the nose of a small child.

Bullies often pick on kids with health issues such as allergies and weight problems. Bullies make cruel comments, threaten and tease them about their conditions.

Two studies looking at kids with food allergies and kids going through weight-loss programs reported:

• Eyal Shemesh, MD, of Mount Sinai Medical Center in New York City, and colleagues found that almost 32% of kids with food allergies reported bullies harassing them  about their allergy, which often involved threats with food.

• Rebecca Puhl, PhD, of Yale University, and colleagues reported on a study where 64% of teens at weight-loss camps reported weight-related victimization by bullies who were not not just schoolmates but often friends, coaches, teachers, and parents too.

Shemesh’s group analyzed surveys of 251 established food allergy patients, ages 8 to 17, and their parents at a single allergy clinic in the Enhancing, Managing, and Promoting Well-Being and Resiliency program.

Any bullying or harassment of these kids was reported by 45% of them and 36% of their parents, although with poor agreement when related to reasons other than the food allergy.

Being victimized due specifically to food allergies accounted for most of these cases, with 32% of the food allergic kids and about 25% of their parents reporting such bullying.

Almost all the bullies were classmates (80%), and most bullying happened at school (60%).

The most common form was teasing (42%), followed by waving the allergen in front of the child (30%).

Notably, 12% had been forced to touch the food they are allergic to and 10% had food thrown at them by the bullies.

Bullying was significantly associated with poorer quality of life scores and greater anxiety, which the researchers noted was independent of allergy severity. While most of the kids taunted by bullies said they had told someone about what happened, parents knew in only about half of the cases.

To increase disclosure of bullying, “Clinicians might consider asking a screening question about bullying during encounters with children with a food allergy,” Shemesh’s group suggested.

While it’s hard to compare the results with those of other studies, general population rates appear to be 17% to 35%, suggesting that food-allergic kids may be bullied or harassed more than their peers, they pointed out.

Puhl’s study included 361 kids, ages 14 to 18, surveyed online while at two national weight-loss camps.

34% of the respondents were in the normal weight range, while 24% were overweight and 40% were obese.

The large proportion of healthy-weight kids was unexpected, but “program administrators confirmed that a portion of enrollees had experienced significant weight loss and returned to camp for support with weight-loss maintenance.”

The likelihood of weight-based victimization rose with weight, with odds ratios of 8.7 for overweight and 11.7 for obese kids, although those of a normal weight after weight-loss treatment still were at some risk.

The most common form was verbal teasing (75% to 88%), followed by relational victimization (74% to 82%), cyberbullying (59% to 61%), and physical aggression (33% to 61%).

While bullies can be found most anywhere, these studies found that bullying behavior came most frequently from:

• Peers: 92%

• Friends: 70%

• Physical education teachers or sport coaches: 42%

• Parents: 37%

• Teachers: 27%

“For those youth who are targets of weight-based victimization at school and at home, healthcare providers may be among their only remaining allies,” researchers reported. “Thus, it can be especially helpful for providers to promote adaptive coping strategies (e.g., positive self-talk, social support, problem-focused coping) during patient visits with youth who are targets of weight-based victimization.”

Both groups of researchers acknowledged the limitation of self-reported data about bullies without independent verification or a control group and that their sample populations may not have been representative of the general population.

Source: Pediatrics (online)

Eggs are inexpensive, tasty and nutritious, which makes them so popular. However, they need to be handled, prepared and stored properly to prevent food poisoning. According to the US Food and Drug Administration even eggs with clean, uncracked shells may occasionally contain bacteria called Salmonella that can cause an intestinal infection.

The U.S. Food and Drug Administration (FDA) reports that about 142,000 illnesses each year are caused by consuming eggs contaminated with Salmonella. FDA has put regulations in place to help prevent contamination of eggs on the farm and during shipping and storage. But consumers play a key role in preventing illness associated with eggs. In fact, the most effective way to prevent egg-related illness is by knowing how to buy, store, handle and cook eggs — or foods that contain them — safely.
Most people infected with Salmonella develop diarrhea, fever, abdominal cramps, and vomiting 12 to 72 hours after infection. Symptoms usually last 4 to 7 days and most people get better without treatment. However, in some people, the diarrhea may be so severe that they need to be hospitalized. In these patients, the Salmonella infection may spread from the intestines to the blood stream, and then to other body sites and can cause death unless the person is treated quickly with antibiotics. Certain people are at greater risk for severe illness and include pregnant women, young children, older adults and people with weakened immune systems.

FDA requires all cartons of shell eggs that have not been treated to carry the following safe handling statement: 

Safe Handling Eggs

To prevent illness from bacteria: keep eggs refrigerated, cook eggs until yolks are firm, and cook foods containing eggs thoroughly. Eggs that have been treated to destroy Salmonella — by in-shell pasteurization, for example — are not required to carry safe handling instructions.

You can help keep eggs safe by making wise buying decisions at the grocery store.

• Buy eggs only if sold from a refrigerator or refrigerated case.
• Open the carton and make sure that the eggs are clean and the shells are not cracked.
• Refrigerate promptly.
• Store eggs in their original carton and use them within 3 weeks for best quality.

Before preparing any food, remember that cleanliness is key!

• Wash hands, utensils, equipment, and work surfaces with hot, soapy water before and after they come in contact with eggs and egg-containing foods.

Thorough cooking is perhaps the most important step in making sure eggs are safe.

• Cook eggs until both the yolk and the white are firm. Scrambled eggs should not be runny.
• Casseroles and other dishes containing eggs should be cooked to 160°F (72°C). Use a food thermometer to be sure.
• For recipes that call for eggs that are raw or undercooked when the dish is served — Caesar salad dressing and homemade ice cream are two examples — use either shell eggs that have been treated to destroy Salmonella, by pasteurization or another approved method, or pasteurized egg products. Treated shell eggs are available from a growing number of retailers and are clearly labeled, while pasteurized egg products are widely available.

Bacteria can multiply in temperatures from 40°F (5°C) to 140°F (60°C), so it’s very important to serve foods safely.

• Serve cooked eggs and egg-containing foods immediately after cooking.
• For buffet-style serving, hot egg dishes should be kept hot, and cold egg dishes kept cold.
• Eggs and egg dishes, such as quiches or soufflés, may be refrigerated for serving later but should be thoroughly reheated to 165°F (74°C) before serving.
• Cooked eggs, including hard-boiled eggs, and egg-containing foods, should not sit out for more than 2 hours. Within 2 hours either reheat or refrigerate.

Storing Eggs

• Use hard-cooked eggs (in the shell or peeled) within 1 week after cooking.
• Use frozen eggs within 1 year. Eggs should not be frozen in their shells. To freeze whole eggs, beat yolks and whites together. Egg whites can also be frozen by themselves.
• Refrigerate leftover cooked egg dishes and use within 3 to 4 days. When refrigerating a large amount of a hot egg containing leftover, divide it into several shallow containers so it will cool quickly.

Transporting Eggs

• Cooked eggs for a picnic should be packed in an insulated cooler with enough ice or frozen gel packs to keep them cold.
• Don’t put the cooler in the trunk — carry it in the air-conditioned passenger compartment of the car.
• If taking cooked eggs to work or school, pack them with a small frozen gel pack or a frozen juice box.

Taking steps to handle, prepare and store eggs is critical to preventing food poisoning.

Source: USDA

According to the American Optometric Association (AOA), infants should have their first eye exam at 6 months of age. Children then should have additional eye exams at age 3, and just before they enter the first grade — at about age 5 or 6.

For school-aged children, the AOA recommends an eye exam every two years if no vision correction is required. Children who need eyeglasses should be examined annually or as recommended by their eye doctor.

The AOA stresses early eye exams for children because 5 to 10 percent of preschoolers and 25 percent of school-aged children have vision problems. Early eye exams also are important because children need the following basic skills related to good eyesight for learning:

• Near vision          
  
• Distance vision
• Binocular (two eyes) coordination
• Eye movement skills
• Hand-eye coordination
• Focusing skills
• Peripheral awareness

For these reasons, some states require a mandatory eye exam for all children entering school for the first time.

The American Academy of Ophthalmology (AAO) says on its Web site that your family doctor or pediatrician likely will be the first medical professional to examine your child’s eyes. If eye problems are suspected during routine physical examinations, a referral might be made to an eye doctor for further evaluation. Eye doctors have specific equipment and training to assist them with spotting potential vision problems.

Babies should be able to see as well as adults in terms of focusing ability, color vision and depth perception by 6 months of age. To assess whether a baby’s eyes are developing normally, the doctor typically will use the following tests:

• Tests of pupil responses evaluate whether the eye’s pupil opens and closes properly in the presence or absence of light.
• “Fixate and follow” testing determines whether your baby’s eyes are able to fixate on and follow an object such as a light as it moves. Infants should be able to fixate on an object soon after birth and follow an object by the time they are 3 months old.
• Preferential looking involves using cards that are blank on one side with stripes on the other side to attract the gaze of an infant to the stripes. In this way, vision capabilities can be assessed without the use of a typical eye chart.

 Preschool-age children do not need to know their letters in order to take certain eye tests. Some common eye tests used specifically for young children include:

• LEA Symbols for young children are similar to regular eye tests using charts with letters, except that special symbols in these tests include an apple, house, square and circle.
• Retinoscopy is a test that involves shining a light into the eye to observe the reflection from the back of the eye
• Random Dot Stereopsis testing uses special patterns of dots and 3-D glasses to measure how well your child’s eyes work together as a team.

AAO offers the following reminders:

• Appropriate vision testing at an early age is vital to insure your child has the visual skills he or she needs to perform well in school.
• A child who is unable to see print or view a blackboard can become easily frustrated, leading to poor academic performance.
• Some vision problems, such as lazy eye, are best treated if they are detected and corrected as early as possible while the child’s vision system is still developing.

The following message about keeping your home safe from toxic chemicals, comes from Toxics Use Reduction Institute at the University of Massachusetts Lowell.

If you don’t use a toxic chemical in the first place, then you don’t have to contain it, clean it up, or be exposed to it—which is what preventing pollution is all about. Follow these tips to reduce your exposure to toxic chemicals and create a safer and healthier indoor living environment for you and your family.

1) Household Cleaners: Look for labels that divulge ALL of the cleaner’s chemicals. Besure to avoid using cleaners that contain these suspect hormone disrupter chemicals:Nonyl- and octyl-phenols are used to make alkylphenol ethoxylate (APE) detergents.

2) Disinfectants. Limit the use of disinfecting products in your home. They contain chemical agents that are capable of destroying or inhibiting the growth of microorganisms. Overuse could lead to the growth of ‘superbugs.’ The Environmental Protection Agency (EPA) classifies disinfectants and anti-microbials as pesticides.

3) Lawn Care and Pests: Children and pets in particular are exposed to pesticides tracked inside homes from lawn treatments. Pesticide exposure also occurs from using off-the shelf pest repellents. Use organic lawn care methods like mowing high and adding topsoil. To get rid of pests, remove food sources, use boric acid and traps.

4) Vinyl Floor and Wall Coverings: Flexible vinyl household products like flooring and wallpaper are manufactured using PVC that may have toxic chemical additives including phthalate plasticizers and lead. As these products are used, they create dusts that accumulate these chemicals. Choose non-PVC wall and floor coverings to minimize potential exposure to these toxins.

5) Building Materials: Plywood, oriented strand board, kitchen cabinets and home insulation are all products that can contain formaldehyde, a known human cancer causing chemical. Choose solid woods and formaldehyde-free insulations when constructing or renovating your home.

6) Personal Care and Beauty Products: Choose products that are fragrance free and reduce your use of nail polish and acetone nail polish remover. If you do use these products, be sure to open the windows in your home when you use these products.

7) Dry Cleaning: Ask your dry cleaner if they offer safer alternatives such as liquidcarbon dioxide or “wet cleaning” rather than the commonly used cleanerperchloroethylene, a suspected cancer-causing chemical.

8) Got Moths?: Eliminate the use of mothballs since they contain naphthalene or paradichlorobenzene. Instead, clean and seal wool clothes, use cedar blocks, shavings or oil.

9) Mold: Dry is the operative word. Prevent mold and the overuse of bleach by preventing moisture build up in the first place. Fix leaky pipes and faucets immediately. Make sure that water slopes away from the foundation of your home.

10) Basement: Do not leave a car running even with the garage door open especially if the garage is under the living area. Carbon monoxide can easily seep through walls and floors. When your oil company calls during the slow summer months to clean your boiler, don’t delay. And test your house for radon.

Source: Toxics Use Reduction Institute at the University of Massachusetts LowellThis information is provided as a public service from the Massachusetts Toxics Use Reduction Institute (TURI) at the University of Massachusetts Lowell. Established by the State’s Toxics Use Reduction Act of 1989, TURI provides research, training, technical support, laboratory services and grant programs to reduce the use of toxic chemicals while enhancing the economic competitiveness of local businesses.