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Handlebars Pose a Costly Threat to Child Cyclists


Bike helmets have reduced the number of children's head injuries, but there's still nothing to protect a child from rupturing an abdominal organ. During a fall, the front wheel can turn so that the handlebars are perpendicular to the body, creating a blunt spear that can rupture the intestine, liver, spleen or other abdominal and pelvic organs.

Now, researchers at the Children's Hospital of Philadelphia along with colleagues at the Pacific Institute for Research and Evaluation have calculated the annual cost of these often serious injuries.

By reviewing hospital discharge data, researchers estimate that more than a thousand young bicyclists had serious abdominal or pelvic organ injuries in 1997 and that handlebars caused nearly 900 of them. None of the accidents in the study involved cars. Factoring in the costs of hospital stays (ranging from three to 47 days), ambulance use, medical care after discharge, work lost by parents or another caregiver, quality of life differences, even the filing of insurance claims, the researchers concluded that children's handlebar-related injuries amounted to more than $500 million in 1997.

The researchers hope that awareness of the high cost of these injuries will lead to regulating bicycle design and prompt bike manufacturers to make a safer handlebar. Working with bioengineering students at the University of Pennsylvania, the researchers have designed a retractable handlebar that would absorb the energy of impact with a child's body. The design has a patent pending, but it has yet to be licensed by a manufacturer.

Lead author Dr. Flaura K. Winston says that, until a safer handlebar is produced, parents should be sure the bicycle fits the child and that the bike is in good condition. When sitting on the seat, the child should be able to put both feet on the ground. Keeping tires fully inflated and the chain well oiled will make the bike easier to steer, she says. Also, the wheels should be aligned and handlebar grips should cover the metal ends.

Archives of Pediatric and Adolescent Medicine 156: 922-928


Link Between Diet, Cancer Doubted

The first study to look closely at the link between diet and a key indicator of prostate cancer casts doubt on the value of a low-fat diet in preventing the disease, at least in the short run.

Researchers at Memorial Sloan-Kettering Cancer Center in New York found that after four years, there was no difference in prostate specific antigen, or PSA, levels among 689 men who ate a diet made up of 20% fat and five to eight servings of fruits and vegetables a day and 661 men who were just given written instructions on a healthy diet.

Several previous studies had implicated diet, particularly fat, in the development of prostate cancer, but this was the first to look at the effect of diet on a biological marker for prostate cancer over time. "As randomized studies go, four years is a long time, but in the lifespan of a man it is a short time," says lead author Dr. Moshe Shike, director of cancer prevention at Memorial Sloan-Kettering Cancer Center in New York. "If a person starts eating a diet like this in childhood, it may have an effect. If you are middle-aged or past middle age, [eating this diet] for a few years doesn't seem to affect the risk. But this study doesn't mean people shouldn't change their diet. We still believe a low-fat, high fruit and vegetable diet is the best overall," he says.

Journal of Clinical Oncology 20 (17): 3570-3571, 3592-3598


Travel Poses Risk to Asthmatics

Californians sensitive to tobacco smoke may take for granted the laws that prohibit smoking in most public places--until they travel to areas that don't have such restrictions. A study of more than 300 people with asthma found that the intermittent exposure they encounter when traveling is enough to cause breathing problems. Eye and nose irritation may even be worse.

About 30% of those participating in the study reported being exposed to tobacco smoke while traveling in the year prior to being interviewed, says the lead author, Dr. Mark D. Eisner, assistant professor of medicine at UC San Francisco. "And the number who had respiratory symptoms or asthma attacks [as a result] was quite high," he says.

Eisner reported that about two-thirds of those exposed to smoke complained of coughing, wheezing or chest tightness. More than half who had symptoms needed extra inhalation medication.

Whether a person lived with a smoker or was somehow regularly exposed to secondhand smoke didn't seem to make a difference in the respiratory symptoms they encountered on the road. However, those who didn't have such regular exposure were more likely to suffer from eye or nose irritation.

Chest 122:826-828


'Heat Strain' Bothers Athletes Less

Most people know when they're too hot to keep exercising, Canadian researchers have found, but athletes are better able to tolerate heat strain--the combination of increased heart rate and core temperature in response to heat--than are untrained men and women.

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