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PubMedDate not supplied

Prevention of childhood injuries. Part II: Recreational injuries.

This is the second of two articles on the prevention of childhood injuries. Here, interventions to reduce death and disability among children from recreational injuries are identified. The major categories of recreational injury are listed, the magnitude of the problem defined, the risk factors described, and selected interventions of the National Committee for Injury Prevention and Control summarized. Recommendations for practice are discussed.

Accidental Falls↗
PubMed1992

Trampolines revisited: a review of 114 pediatric recreational trampoline injuries.

A search of the medical literature failed to reveal any articles that discuss pediatric injuries acquired on privately owned recreational trampolines. This study was undertaken to quantify and qualify pediatric injuries from recreational trampoline use. A group of 114 patients who presented to the Emergency Department at Primary Children's Medical Center in Salt Lake City, Utah, with injuries directly related to use of a trampoline are discussed. There was a 1.2:1 male-female ratio. The average age was 8.0 years. Forty-eight percent of the patients were injured on their family's trampoline, with the remainder injured on a friend's, neighbor's, relative's, or gymnasium's equipment. The majority of injuries involved group use of the trampoline and the youngest person in a group was most often the injured participant. Extremity injuries were seen in 55% of the patient and head or neck injuries in 37%. Seventy-five percent of the patients required radiographs, 23% hospitalization, and 17% operative intervention. The history of the trampoline and medical literature discussions concerning injuries and safety are reviewed.

Athletic Injuries↗
PubMed2005

Leptospirosis after recreational exposure to water in the Yaeyama islands, Japan.

Leptospirosis is a global zoonotic disease with a variety of clinical manifestations. We report an outbreak of leptospirosis in the Yaeyama Islands, Japan, in the summer of 1999 associated with heavy rainfall. Fourteen people were diagnosed with leptospirosis and required hospitalization. All cases were found to have exposure to contaminated soil or water. A history of recreational activities involving water sports was more frequent (71%) than occupational risk factors related to agriculture or construction (29%). Fever was the primary symptom in all cases, followed by chills (93%), headache (86%), myalgias (57%) and conjunctival suffusion (57%). All cases were successfully treated with antimicrobial therapy except one patient who improved spontaneously. Jarisch-Herxheimer reactions were seen in six cases (43%). The increasing incidence of leptospirosis related to recreational sports is an important public health problem in resort areas. A high-index of suspicion, early treatment, and prevention are crucial in this latently endemic area.

Adolescent↗
PubMed1990

[The epidemiology of escherichiosis at recreation areas].

A study of epidemiological and microbiological data (2073 epidemiological examinations of patients with escherichiosis and carriers of pathogenic Escherichia and microbiological examination of 2156 strains of pathogenic Escherichia) in two recreation zones with different types of industry (clean recreation zone and that with developed industry) revealed differences in the incidence of the escherichiosis morbidity and carrier state of Escherichia, age structure of patients and carriers, seasonal distribution of the patients and proportion of the serogroups of pathogenic Escherichia isolated in the zones. It is concluded that above findings are of importance for planning antiepidemic measures in case of escherichiosis.

Age Factors↗
PubMed1979

Death caused by recreational cocaine use.

Sixty-eight deaths associated with the recreational use of illicit cocaine were investigated by the Medical Examiner's Office of Dade County in Florida. Most fatalities occurred since 1975. Although 29 involved the use of other drugs (usually heroin), 24 persons died directly of the toxic effects of cocaine. Respiratory collapse and death occurred rapidly after the intravenous injection of cocaine. Oral or nasal ingestion resulted in a symptom-free interval lasting as long as an hour followed suddenly by generalized seizures and death. Toxicological analysis could not causally relate lidocaine hydrochloride or other adulterants to the untoward reactions. The data suggest that the rate of absorption, the peak blood concentration, and the prior use of cocaine all contribute to the possibility of a fatal reaction. Despite current belief, cocaine cannot be considered a safe recreational drug.

Adolescent↗
PubMed1984

[Isolation and quantification of Salmonella in the waters of the Río de la Plata destined for recreation].

Thirty three samples from recreational waters from different areas of Río de la Plata were tested for Salmonella (Fig. 1). A 200 ml sample filtered through a diatom bed as well as 2 and 20 ml samples without filtering were studied using a simple and economical technique. The isolation probability was directly dependent on the water volume analyzed. Best results were obtained when tetrathionate broth with novobiocin and Salmonella shigella agar were used (Table 3). Salmonella was isolated from 36% of the samples studied and 12 serotypes were identified (Table 5). The relation between the NPM of each bacteriological indicator used and the NPM of Salmonella are shown in Table 4. Correlation values were calculated by relating mean point logarithms of the classes in Table 4 with the isolation percentages of Salmonella for each class. These values were low, except for fecal Streptococcus (R2 = 0.94). The high density of fecal coliforms found in Bagliardi and Pescadores Beaches (rarely less than 10.000 bacteria/100 ml) and the incidence of Salmonella, lead us to conclude that these waters are unsafe for bathing and swimming, specially for children, according with the international recommendation on the quality of recreational waters. Waters with the characteristics described here should be periodically analyzed for Salmonella concentration. The lack of correlation values between the MPN of total and fecal coliforms and the MPN of Salmonella, also supports this advise.

Argentina↗
PubMed1980

Total hip replacement: its influence on spontaneous recreation exercise habits.

The effect of total hip replacement (McKee-Farrar or Brunswik prosthesis) on recreational exercise habits was evaluated with a retrospective interview of 539 patients operated on at the orthopaedic Hospital of the Invalid Foundation, Helsinki, Finland. The mean age of the patients was 63.8 years and the mean follow-up time 4.2 years. The proportion of those who engaged in regular walking increased from 2 to 55%, in cycling from 7 to 29%, in swimming from 13 to 30% and in skiing from 0 to 9%. Prolonged use of the prosthesis (up to 9 years) had no significant deteriorating effect on the intensity of the recreation exercises. The number of those who were able to cycle or swim preoperatively was greater than that of those who were able to walk at that time. Cycling and swimming are especially valuable forms of physical exercise after total hip replacement because the load placed by the body weight on the hip joint is reduced.

Adult↗
PubMedDate not supplied

[The routes of helminth egg appearance on the territory of recreational areas and sites of the lower Don River].

Sanitary and parasitologic problems of recreation use of water bodies and coast lines are still to be studied. The author has examined the routes of invasion at recreation areas by the lower Don river. The river bed depositions and water as well as coastline soil were found contaminated with helminthic eggs. These eggs were brought by sewage water, feces, and surface flow. Effective ecologically justified measures should be developed to prevent it.

Animals↗
PubMed1993

Working at play. The role of recreation in healthcare.

The therapeutic effects of recreation for people with mental health problems in institutions are often ignored by carers and managers. However, with adequate planning, recreation can provide pleasure to both patients and carers, and for the former the benefits extend to their rehabilitation in the community.

Humans↗
PubMed1993

Lead exposure during recreational use of small bore rifle ranges.

AIMS: Following detection of symptomatic lead toxicity in two users of an indoor small bore rifle range, we studied users of several similar facilities to determine if significant recreational lead exposure occurred. METHOD: Red cell lead levels were measured at the end of a six month (winter) indoor shooting season and prior to commencement of shooting in the following year. Lead levels in air and dust sampled at one range were also measured. RESULTS: REd cell lead levels were elevated at the end of season (mean 2.64 mumol/L) and lower (mean 1.60 mumol/L) in the preseason samples. The average red cell lead level of the male shooters was 2.4 times normal and is comparable to the levels found in many occupationally exposed groups. Maximum air lead levels were 210 micrograms/m3, more than 2 times the Department of Labour OSH workplace exposure standard TWA of 100 micrograms/m3. Analysis of dust samples showed that dust at this range contained 24% to 36% lead. CONCLUSION: Although the mean time spent shooting was only 70 minutes per week the blood lead levels are similar to those previously reported for full time instructors at pistol ranges. This data confirms that lead exposure in recreational users of indoor small bore rifle ranges is a significant problem.

Adolescent↗
PubMed1996

Risk of human exposure to vector ticks (Acari: Ixodidae) in a heavily used recreational area in northern California.

The risk of humans encountering vector ticks along hiking trails or in picnic grounds in a Lyme disease-endemic area was evaluated in a multipurpose recreational area (Tilden Regional Park) in the populous San Francisco Bay region of California. Four hillside hiking trails (two high-use, two low-use) were sampled by dragging and walking through low vegetation biweekly for one year; four heavily used picnic areas were sampled concurrently by dragging. Adults of three human-biting ticks were enumerated (n = 1,911) along all trials: Dermacentor occidentalis (63.6% of total), Ixodes pacificus (26.2%), and D. variabilis (0.2%). Subadults (n = 1,669) of D. occidentalis (0.06% of total) and two nonhuman-biters, D. albipictus (70.3%) and Haemaphysalis leporispalustris (29.7%), also were collected. Dragging yielded many more adult ticks than walking year-round for all trials. These methods were significantly correlated during periods of peak tick abundance, but the associations were not sufficiently strong or consistent to allow prediction of captures for either method based on the other. Adult ticks were distributed largely in clusters along the uphill sides of trails. Several adult ticks collected adjacent to trails were found to contain spirochetes identified with polyclonal antibodies as Borrelia burgdorferi (D. occidentalis, 0 of 861; D. variabilis, 2 of 126 [1.6%]; I. pacificus, 1 of 609 [0.2%]). Picnic areas produced low numbers of adult D. occidentalis and I. pacificus, which prohibited testing them for spirochetes. Two measures for evaluating risk were calculated, the encounter distance (= mean number of meters traveled before encountering a vector tick by either dragging or walking) and the mean number of spirochete-infected ticks encountered by these methods per kilometer of trial. These measures revealed that the risk of exposure to spirochete-infected adult ticks along trails was low year-round irrespective of usage, and risk was even lower in picnic areas. Future studies evaluating human exposure to vector ticks in recreational areas should incorporate, whenever possible, testing for multiple pathogens because most ixodid ticks that commonly bite people in the United States are capable of transmitting two or more microbial disease agents.

Animals↗
PubMed1995

Comparison of BGB-MUG and LSTB-MUG in microbiological surveillance of recreational waters.

Recreational water surveillance is an important tool to prevent health hazards for the population. Therefore distinct guide and imperative values for fecal indicators are listed in the EC directive about water quality control. The detection methods, however, give laboratories some room to choose their own method, which has led to difficulties in the comparability of results. In 1989 an ad-hoc working group of the coastal countries of Germany established detection methods, which by now are obligatory for these countries. Fecal and total coliforms (FC and TC) are detected by a triplicate mpn-procedure using brilliant green-bile-lactose broth supplemented with tryptophane and 4-methylumbelliferyl-beta-D-glucuronide (BGB-MUG) as selective medium. Gas-, fluorescence- and indole-positive cultures are considered fecal coliform-positive. In the last years rises in TC but not in FC counts were observed in fresh waters. A study was carried out to evaluate the official method in another bathing season, to determine bacterial species leading to false-positive TC cultures and to compare BGB-MUG with laurylsulphate-tryptophane-MUG (LSTB-MUG). Water samples of different salinities and nutrient input were collected in weekly intervals from April to October. FC and TC concentrations were determined and all TC-positive cultures were differentiated further. The FC counts obtained by enrichment in BGB-MUG or LSTB-MUG were nearly identical, the rate of fluorescence-positive, indole-negative tubes being approximately 0.6%. Differentiation of FC-negative cultures showed a false-negative rate of 2.87% for BGB-MUG and of 8% for LSTB-MUG. During the summer months TC counts in BGB-MUG exceeded FC counts by far at most of the sampling sites. This effect was much less pronounced in LSTB-MUG; the difference between both enrichment media being significant. Differentiation of presumptive TC from BGB-MUG resulted in a high percentage of Aeromonas spp. in fresh waters. LSTB-MUG was clearly more selective for TC than BGB-MUG, but still with an average of 10% of the test tubes being false TC-positive (BGB-MUG 46%). The sensitivity of BGB-MUG was below 60% (LSTB-MUG 89%). LSTB-MUG should be preferred as enrichment medium in mpn-examination of recreational water, if no further differentiation is carried out. The selectivity for TC is better than in BGB-MUG and the only slight inhibitory effects can be tolerated.

Aeromonas↗
PubMedDate not supplied

Recreational physical activity and risk of postmenopausal breast cancer based on hormone receptor status.

BACKGROUND: Physical activity is a potentially modifiable breast cancer risk factor. There is considerable recent evidence to suggest that risk factors for breast cancer differ based on its subtype, particularly estrogen receptor (ER)/progesterone receptor (PR) status, but this has been less well studied for physical activity. The objective of this study was to examine the association of physical activity with breast cancer incidence based on ER/PR status of the tumor. METHODS: The Iowa Women's Health Study is a prospective cohort study of 41 836 postmenopausal women. Recreational physical activity was self-reported on the baseline questionnaire, and 3 levels (high, medium, and low) were defined. Breast cancer incidence and ER/PR status, through 18 years of follow-up, were ascertained by linkage with the Iowa Surveillance, Epidemiology, and End Results Cancer Registry. Cox proportional hazards models were used to estimate multivariate relative risks (RRs) and 95% confidence intervals (CIs) of breast cancer, adjusting for other breast cancer risk factors. RESULTS: During 554 819 person-years of follow-up, 2548 incident cases of breast cancer were observed. Compared with low physical activity, high physical activity levels were inversely associated with risk of breast cancer (RR, 0.86; 95% CI, 0.78-0.96), and there were inverse associations for ER-positive (ER+)/PR-positive (RR, 0.87; 95% CI, 0.75-1.00), ER+/PR-negative (PR-) (RR, 0.67; 95% CI, 0.47-0.96), and ER-negative/PR- (RR, 0.80; 95% CI, 0.56-1.14) tumors. Further adjustment for body mass index attenuated the overall association with breast cancer (RR, 0.91; 95% CI, 0.82-1.01) and for ER+/PR-positive tumors (RR, 0.94; 95% CI, 0.81-1.08), while there was no change for ER+/PR- tumors (RR, 0.66; 95% CI, 0.46-0.94). CONCLUSIONS: Higher recreational physical activity might reduce the risk of postmenopausal breast cancer overall. Risk reduction varies by ER/PR status of the tumor, being most marked for ER+/PR- tumors, which, in general, have been associated with a clinically more aggressive tumor phenotype. If confirmed in additional studies, these results would suggest that additional mechanisms, besides an effect on body mass, may account for observed protective effects of physical activity in reducing breast cancer.

Aged↗
PubMed2001

Maternal and paternal recreational drug use and sudden infant death syndrome.

OBJECTIVE: To determine whether maternal or paternal use of cocaine, opiates, or marijuana during conception and pregnancy and postnatally increases the risk of sudden infant death syndrome (SIDS) during the first year of the infant's life. This is an important issue and may prove useful in further decreasing the rate of SIDS. METHODS: A case-control study was conducted consisting of 239 infants who died of SIDS in southern California between 1989 and 1992, and 239 healthy infants who were matched on the basis of birth hospital, date of birth, age, and sex. Specific drug use at the period of conception, during pregnancy and breastfeeding, and in the presence or vicinity of the infant was ascertained by telephone for the white, African American, Hispanic, Asian American, and Pacific Islander case and control fathers and mothers. RESULTS: Maternal recreational drug use during pregnancy was not associated with the risk of SIDS after adjusting for maternal smoking during pregnancy (adjusted odds ratio [OR] = 2.0; 95% confidence interval [CI], 0.6-6.5). There were statistically significant differences between case and control fathers' use of marijuana during conception (OR = 2.2; 95% CI, 1.2-4.2; P =.01), during pregnancy (OR = 2.0; 95% CI, 1.0-4.1; P =.05), and postnatally (OR = 2.8; 95% CI, 1.1-7.3; P =.04) and the risk of SIDS, while adjusting for paternal smoking and alcohol use. CONCLUSIONS: There was no association between maternal recreational drug use and SIDS. Paternal marijuana use during the periods of conception and pregnancy and postnatally were significantly associated with SIDS. The role of paternal psychoactive drug use, especially the relationship between marijuana and SIDS, is an understudied area; however, before any definitive role for the father can be confirmed, these findings should be investigated and replicated in future studies.

Adult↗
PubMed2003

Fine-needle aspiration cytology in lesions related to ornamental body procedures (skin tattooing, intraoral piercing) and recreational use of drugs (intranasal route).

Body adornment through tattooing and body piercing and the use of recreational drugs are on the increase, producing a variety of secondary lesions, the etiology of which often remains undetected, as the medical community is not yet aware of the extent of the morbidity of such procedures and practices. Three cases are presented, which underscore the problem and also the role that fine-needle aspiration (FNA) can play in clarifying the etiology of such lesions. Two of these cases were lymphadenopathies, one secondary to tattooing and the other to tongue piercing, while the third was a deep intranasal lesion, which in all probability had resulted from intranasal use of recreational drugs. Although the clinical diagnosis of these lesions was problematic, the FNA performed by a pathologist, by associating the cytologic findings with the corresponding clinical setting, was quite indicative of their relation to the aforementioned procedures or practices.

Administration, Intranasal↗
PubMed2002

Ecstasy/MDMA attributed problems reported by novice, moderate and heavy recreational users.

RATIONALE: The recreational use of MDMA/Ecstasy (3,4-methylenedioxymethamphetamine) is associated with many psychobiological problems, but there is a paucity of data on how these relate to the level of past use. OBJECTIVES: to assess the incidence of Ecstasy-attributed problems as reported by novice, moderate and heavy users. METHODS: 763 unpaid volunteers took part in a WWW study of recreational drug use. This report is based on the 282 Ecstasy users from that sample, who comprised 109 novice users (1-9 occasions), 136 moderate users (10-99 occasions), and 36 heavy users (+100 occasions). Yes/no responses were automatically recorded to a series of questions covering psychobiological problems experienced when drug-free, which were attributed by the respondents to their Ecstasy use. RESULTS: Depression, memory problems, anxiety, mood fluctuation, poor concentration, infections, tremors/twitches and weight loss, were all significantly associated with the extent of Ecstasy use. Thus memory problems attributed to Ecstasy were reported by 19% of novice users, 52% of heavy users and 73% of heavy users (chi-square 42.74, df=2, p<0.001); many of the other variables showed similar trends. CONCLUSIONS: The incidence of problems attributed to Ecstasy use, is directly related to the number of occasions it has been used.

Anxiety↗
PubMed2002

Recreational physical activity and ovarian cancer in a population-based case-control study.

Results from epidemiologic studies of physical activity and ovarian cancer have been inconsistent, with 2 prospective studies reporting a modest positive association. We evaluated this relationship in a population-based case-control study conducted in Massachusetts and Wisconsin. Incident cases diagnosed between 1991 and 1994 were identified through statewide tumor registries. Community controls were selected randomly from lists of licensed drivers and Medicare recipients. Participation in moderate and vigorous recreational physical activity at age 12, age 20 and 5 years prior to diagnosis was assessed by telephone interview. Data were available for 327 cases and 3,129 controls. Results were adjusted for age, parity and other ovarian cancer risk factors. Total and vigorous physical activity were not associated with a substantial decrease in ovarian cancer risk at any age. The relative risk (RR) for women reporting > or = 7 vs. 0 hr/week of recent vigorous activity was 0.85 [95% confidence interval (CI) = 0.39-1.86; p for trend = 0.31]. When metabolic equivalent task (MET) hours of activity were estimated, only women in the highest category had any reduction in risk (RR for > 42 MET-hours/week at the reference age = 0.70; 95% CI = 0.36-1.35; p for trend = 0.41). Overall, our results provide only limited support for an inverse association between recreational physical activity and risk of ovarian cancer.

Adult↗
PubMed2004

Self-reported psychopathological symptoms in recreational ecstasy (MDMA) users are mainly associated with regular cannabis use: further evidence from a combined cross-sectional/longitudinal investigation.

RATIONALE: 3,4-Methylenedioxymethamphetamine (MDMA, ecstasy) has become a widely used recreational drug among young people. This is of great concern, since MDMA is neurotoxic in animal studies and its use has been associated with psychological distress and a variety of self-reported psychiatric symptoms. However, exploring the origins of psychopathology in ecstasy users is hampered by the frequent polydrug use and by the cross-sectional design of all investigations, so far. OBJECTIVES: The present study combines a cross-sectional with a longitudinal approach to further clarify the impact of the use of other illicit drugs on psychopathological symptoms reported by ecstasy users. METHODS: At baseline, we administered self-rating scales for impulsivity, sensation seeking and general psychological complaints to 60 recreational ecstasy users and 30 matched controls. From the initial sample of ecstasy users, 38 subjects were re-examined 18 months later. RESULTS. At baseline, ecstasy users reported significantly more psychological complaints than controls. However, self-reported psychopathology was mainly associated with regular cannabis use. At follow-up, subjects who had abstained from ecstasy use during the follow-up period did not differ from those reporting continued consumption. In contrast, subjects with regular concomitant cannabis use during the follow-up period reported more anxiety, interpersonal sensitivity and obsessive-compulsive behaviour than cannabis-abstinent users. Finally, higher levels of obsessive-compulsive behaviour, interpersonal sensitivity, depression, anxiety, phobic anxiety and paranoid ideation were significantly correlated with the duration of regular interim cannabis use. CONCLUSIONS: The present findings suggest that self-reported psychopathology in ecstasy users is predominantly attributable to concomitant use of cannabis. Abstinence from cannabis and not ecstasy seems to be a reliable predictor for remission of psychological complaints in ecstasy users.

Adult↗