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Efforts To Prevent Injuries in Schools Advocated

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Slightly more than one-third of injuries to children and adolescents can be attributed to sports and recreation, and almost 30 percent of those occur at school, researchers have found.

Because school settings offer a high degree of adult involvement and control over sports activities, schools would be good places to work on preventing injuries, concludes the study by researchers at the Albert Einstein College of Medicine in New York City and several other institutions.

There are nearly 4.4 million sports- and recreation-related injuries to children ages 5 to 17 each year, the authors say, or about 10 incidents resulting in injury for every 100 children.

The study, believed to be the most comprehensive on the topic, appeared in the September issue of the Archives of Pediatrics and Adolescent Medicine published by the American Medical Association.

The study was based on information from interviews with parents of 11,840 children ages 5 to 17 as part of the Child Health Supplement to the 1988 National Health Interview Survey. The National Center for Health Statistics conducted the survey.

Sports and recreational activities are to blame for almost half of all childhood fractures and dislocations, which the researchers note are likely to be severe. They account for 60 percent of the sprains and 29 percent of the head injuries.

The use of bicycles, skates, and skateboards accounted for a large portion of the injuries that occurred at home and almost half the head injuries that occurred during sports and recreation.

The researchers emphasized that youngsters should wear helmets when using that equipment, even if there is no nearby traffic.

Eighty-five percent of U.S. parents believe that their children are in very good or excellent health, but many still need to take measures to improve their children's health, a nationwide survey released last week says.

Nearly all parents--97 percent--reported that their children are up-to-date on their immunizations, according to Prevention magazine's second annual Children's Health Index. But immunization records indicate that only three-quarters of children are fully immunized, in part because parents may not know about new vaccines or revised schedules for immunizing children, according to the telephone survey of 766 parents of children younger than 18.

Princeton Survey Research Associates conducted the study for the magazine last November.

The study also found that 43 percent of children live in households where someone smokes tobacco. Regardless of income level, parents reported healthier children in nonsmoking households.

The survey also found that 86 percent of children always wear a seat belt or are strapped in a car seat, one in four children is overweight, and just 27 percent of children always wear a helmet when riding a bicycle.

Fewer babies are being born infected with the virus that causes aids, slowing what had been a steady increase in those births during the 1980s, federal researchers report.

After 1989, the number of HIV-infected women in the United States who passed the virus to their babies leveled off through 1993, the most recent year studied. The number of HIV-infected babies born peaked in 1991 with 1,760 cases. From 1978 to 1993, there were nearly 15,000 cases.

Writing in the Sept. 27 issue of The Journal of the American Medical Association, researchers from the Centers for Disease Control and Prevention said they could not explain the change. They speculated that perhaps fewer HIV-infected women were becoming pregnant or more were having abortions.

And as many as two-thirds of all HIV transmission from mother to infant could possibly be prevented each year, the researchers said, if all HIV-infected pregnant women received the drug zidovudine, or AZT.

A new estimate puts the costs of cerebral palsy and 17 other birth defects at $8 billion nationwide--just for the babies born in one year. The figure represents a "substantial" economic burden, according to the Sept. 22 Morbidity and Mortality Weekly Report, published by the federal Centers for Disease Control and Prevention.

Special education and developmental services--nonmedical services provided outside the education system--accounted for $887 million of the total.

The study based estimates on both national data and California data adjusted to provide national estimates. The total cost estimate included both indirect and direct costs, such as medical care and education.

For each new case involving a birth defect, costs ranged from $75,000 to $503,000. The conditions with the highest costs were cerebral palsy, $503,000; Down syndrome, $451,000; and spina bifida, $294,000.

--Millicent Lawton

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