Adolescent occupational exposures and pediatric-adolescent take-home exposures.

Thousands of adolescents are employed and routinely incur occupational exposures as part of their work. Case reports of adolescent exposure-related fatalities and illness, coupled with observational studies of chemical and other exposures with potential health risks, create a strong case for better tracking of work-related exposures and illness, better training for all working adolescents, education of their parents about risks, more clinical involvement in the health and safety of working adolescents, and advocacy for safer adolescent work environments. Because adolescents are neither children nor adults, much research is needed to clarify exposure patterns and risks; however, existing data on adolescent occupational injury and knowledge of exposures to adults in similar work environments permit immediate interventions. The most applicable information from the growing knowledge of environmental health in young children also can be borrowed and applied, especially to younger workers, such as those on farms, who may be children rather than adolescents. Crucial to future protection of working youth from occupational exposures are application of knowledge that already is possessed about occupational risks to adults, a cultural change in the way the US population views risks of chemical exposures, and improved occupational health and safety protection for all adult workers. Improving occupational health for working adolescents may be more politically acceptable and thus feasible than starting with adults, but ultimately the two are linked inextricably. These are new realms for pediatricians, but pediatrician input is needed greatly on all of these levels.

Lawn mower-related injuries to children.

Lawn mower-related injuries to children are relatively common and can result in severe injury or death. Many amputations during childhood are caused by power mowers. Pediatricians have an important role as advocates and educators to promote the prevention of these injuries.

American Academy of Pediatrics. Committee on Injury and Poison Prevention. Safe transportation of newborns at hospital discharge.

All hospitals should set policies that require the discharge of every newborn in a car safety seat that is appropriate for the infant's maturity and medical condition. Discharge policies for newborns should include a parent education component, regular review of educational materials, and periodic in-service education for responsible staff. Appropriate child restraint systems should become a benefit of coverage by Medicaid, managed care organizations, and other third-party insurers.

American Academy of Pediatrics. Committee on Injury and Poison Prevention. Transporting children with special health care needs.

Children with special health care needs should have access to proper resources for safe transportation. This statement reviews important considerations for transporting children with special health care needs and provides current guidelines for the protection of children with specific health care needs, including those with a tracheostomy, a spica cast, challenging behaviors, or muscle tone abnormalities as well as those transported in wheelchairs.

Protecting the health and safety of working teenagers.

More than one third of high school students work during the school year, and many more are employed during the summer months. Teenage workers face a variety of health and safety hazards. Occupational injury and illness are largely preventable, and family physicians can play a crucial role in this prevention effort by advising adolescents about common workplace dangers. Physicians who sign work permits and provide ongoing health care to teenagers should counsel them and their parents or guardians about the benefits and risks of work and discuss the regulations governing jobs that are prohibited for adolescents, work hours, protective measures and workers' compensation benefits.

The hospital record of the injured child and the need for external cause-of-injury codes. American Academy of Pediatrics. Committee on Injury and Poison Prevention, 1998-1999.

Proper record-keeping of emergency department visits and hospitalizations of injured children is vital for appropriate patient management. Determination and documentation of the circumstances surrounding the injury event are essential. This information not only is the basis for preventive counseling, but also provides clues about how similar injuries in other youth can be avoided. The hospital records have an important secondary purpose; namely, if sufficient information about the cause and mechanism of injury is documented, it can be subsequently coded, electronically compiled, and retrieved later to provide an epidemiologic profile of the injury, the first step in prevention at the population level. To be of greatest use, hospital records should indicate the "who, what, when, where, why, and how" of the injury occurrence and whether protective equipment (eg, a seat belt) was used. The pediatrician has two important roles in this area: to document fully the injury event and to advocate the use of standardized external cause-of-injury codes, which allow such data to be compiled and analyzed.

Occupational fatalities in Kentucky--1994.

In Kentucky, seven out of nine industry groups exceed the national average fatality rates; in 1994, the agriculture/forestry/fishing industry rate of 80/ 100,000 was more than three times the national average. This paper describes the occupational fatality data collected during the first year of operation (1994) of the Fatality Assessment and Control Evaluation (FACE) Project in Kentucky. Investigators used multiple reporting sources to identify incidents, which were then systematically recorded and updated. On-site investigations were conducted for certain categories of fatalities. One hundred sixty-six occupational fatalities were recorded for 1994. Motor vehicle incidents were the most common cause of death, followed by machine-related incidents. Ages of victims ranged from 15 to 86 with a median of 46. Investigators completed 22 on-site visits during the period. In this article, descriptive statistics are presented, as well as suggestions for ways the medical community might contribute to the occupational fatality prevention effort.

Occupational injuries among working adolescents in New York State.

OBJECTIVE: To determine the number, distribution, determinants, and health consequences of occupational injuries among working adolescents in New York State. DESIGN: A retrospective, population-based analysis of New York State workers' compensation award data and the Annual Demographic File, a supplement to the US Bureau of the Census Current Population Survey. PARTICIPANTS: Adolescents, aged 14 through 17 years, who received workers' compensation awards for occupational injury from 1980 through 1987. MAIN OUTCOME MEASURES: (1) Numbers, types, and rates of occupational injuries in working adolescents by age, sex, industry, and occupation; (2) health consequences of injury, especially disability and death; and (3) secular trends in injury award rates. RESULTS: A total of 9656 adolescents were compensated for occupational injuries; 4201 compensated adolescents (43.5%) suffered permanent disability; 31 working adolescents died. The annual mean rate of compensated occupational injury was 28.2 per 10,000 adolescent workers. Rates were higher in males than in females and ranged from 8.2 per 10,000 in 14-year-old male workers to 46.8 per 10,000 in 17-year-old male workers. Highest rates by industry were seen in manufacturing (49.0/10,000 adolescent workers) and agriculture (46.2/10,000). Unskilled labor was the most dangerous occupation (52.3/10,000). CONCLUSION: Occupational injuries are a substantial and underrecognized contributor to the continuing epidemic of injury among adolescents.