Whether swimming in the ocean or on a boat in a lake, follow these tips for staying safe by the water.

• Anticipate ocean stings: Stings from contact with jellyfish, fire coral, hydroids, or anemones can range in severity from mild burning to severe pain with generalized illness. Make sure your beach bag includes a small bottle (labeled) of half vinegar, half rubbing alcohol that can be used to decontaminate wounds and provide pain relief. Seawater can also be used to rinse a sting, but fresh water or ice can worsen the effects of sea-life venom. Also, adults and children can both use a combination sunblock and jellyfish protective lotion to help prevent the stings of many species.
• Avoid shark attacks: One of the most obvious ways to avoid shark attacks is to avoid swimming in shark-infested waters, particularly at dusk and after dark. When swimming in the ocean, swim in groups. Sharks tend to attack single swimmers. When diving, avoid deep drop-offs, murky water, or areas near sewage outlets.  If you do encounter a shark, do not provoke it.  Leave the water with slow, purposeful movement and do not splash or panic.
• Manage motion sickness: Most boaters and divers adapt to motion after a few days, but may require treatment until they do. If you become nauseated on board a ship, stay on deck. Splash your face with cold water and keep your eyes fixed on a steady point in the distance. Anti-nausea medications can be taken as a preventive, and wristbands that apply pressure or electrical stimulation to acupuncture points can be used before or after symptoms begin.

Check in tomorrow for tips on how to be prepared for your outdoor adventure.

Get out your watch. How many hours a child spends in a chlorinated swimming pool before age 2 appears to influence the risk of that child later developing asthma and nasal allergies.

We’ve known for years that when you smell chlorine, the chlorine fumes in the air can trigger an asthma attack in a child who already has asthma. But recently, a new understanding is emerging, that chlorine can actually cause asthma in a child who never had it. The American Academy of Pediatrics sent a bulletin to pediatricians about this late in 2009.

Now, early in 2010, a new study of 430 kindergarteners tightens the link. The children who spent more than 20 hours in a chlorinated indoor pool were 3.5 times more likely to develop a lung infection called bronchiolitis than their peers who hadn’t. And those who spent more than 20 hours in a chlorinated outdoor pool were still more than twice as likely to have had bronchiolitis.

And the added risk from chlorine exposure was even higher for those without a family history of allergies or asthma.

Among all children who had bronchiolitis, those who had been exposed to chlorine pools were almost 4 times as likely to develop asthma. And the same goes for hay fever.

Physical activity such as swimming is great for kids. And disinfection is important, especially in public pools. The researchers suggest choosing pools with other methods of disinfection, such as ozone, or at least pools that don’t smell as strongly of chlorine.

I’d go a step beyond this and encourage parents to be sure their homes don’t contain the fumes of chlorine either, whether from the laundry or from other cleaning products.

Whether you’re pregnant now, or have young children in the home, this is another good reason to take the plunge, and do take a fresh look at your cleaning cabinet.

Bernard, A., Nickmilder, M., Voisin, C., and Sardella, A. “Voisin, C., Sardella, A., “Impact of Chlorinated Swimming Pool Attendance on the Respiratory Health of Adolescents.” Pediatrics, Oct 2009; 124:1110-1118.

Marcucci, F., and Bernard, A.”Infant Swimming in Chlorinated Pools and the Risks of Bronchiolitis, Asthma and Allergy” European Respiratory Journal, pre-pub Jan 14 2010, doi:10.1183/09031936.00118009

Splash! Getting our kids physically active is a top priority for their short and long-term health, and swimming is a wonderful, fun way to do it. Public pools are typically treated with chlorine-based disinfectants to help keep kids safe from the spread of infectious diseases while swimming. A careful study published in the June 2003 issue of Occupational and Environmental Medicine demonstrated a downside of these chlorines.

The layer of chlorine gases hovering just above the water has the potential to damage the lungs and cause asthma, if the levels are high enough. The chlorine that stings the eyes can also ‘sting’ the sensitive tissue of the lungs. At some pools the chlorine smell is oppressive. The risks are highest in indoor pools, and the lower the ceiling, the higher the risk.

In looking at 1,881 children, the researchers found a consistent direct correlation between the total cumulative time a child had spent splashing in an indoor pool and the risk that the child developed asthma. They also found that blood levels of lung proteins rose immediately after swimming; the protective membranes in the lungs had become temporarily open passages.

This doesn’t make me want to limit swimming – far from it! — but it does make me want to urge clean, fresh air. This means better ventilation at swimming pools, and exploring gentler methods to prevent infection such as better swimmer hygiene, better water circulation, and non-chlorinated disinfectants.

Related concepts:

Giardiasis

Introduction to giardia lamblia:

What do mountain streams and day-care centers have in common? They are both places where kids can catch Giardia.

What is giardia lamblia?

Giardia is a tiny single-celled parasite with a whip-like tail. It infects the GI tract of humans and many other mammals.

Who gets giardia lamblia?

Giardia occurs throughout the world. People can get it from drinking water contaminated with the stool of animals. It is also found commonly in day-care centers.
In some studies, up to 1 in 5 children had Giardia in their stools.

What are the symptoms of giardia lamblia?

Some children with Giardia have acute gastroenteritis, with abdominal pain and watery diarrhea.
Others have a prolonged illness, often with symptoms that come and go. They may have recurrent stomachaches, foul-smelling stools, increased gas, decreased appetite, anemia, or slow growth. Sometimes periods of constipation alternate with periods of diarrhea. The diarrhea generally does not contain blood, pus, or mucus. The diarrhea may be watery – but more often is thick and frequent.
Many people with Giardia have no symptoms at all.

Is giardia lamblia contagious?

Giardia is spread from person to person via the fecal-oral route. It commonly spreads through day-care centers. It has been known to spread when diapered toddlers swim in inadequately chlorinated pools or water parks. And Giardia can spread when the parasites get into food or drinking water, either from animal stools, or from food preparers who have not washed their hands adequately.

How long does giardia lamblia last?

Symptoms usually do not begin for 1 to 4 weeks after the person swallows the parasites. The infection may resolve on its own, or may persist until the person is treated.

How is giardia lamblia diagnosed?

The diagnosis is suspected based on the child’s story. It is confirmed by stool tests specifically looking for Giardia.

How is giardia lamblia treated?

Anti-parasite medications are used to treat the infection.

How can giardia lamblia be prevented?

Careful cleaning and hand washing, especially before preparing food, before eating, and after toileting or diapering can prevent many cases of Giardia – especially in day-care centers.
Children with diarrhea should be kept out of swimming pools.
Avoid drinking directly from lakes, rivers, or streams. Boiling the water first will kill the Giardia. Filtration and chlorination can also remove the parasites.

Related A-to-Z Information:

Adenovirus, Appendicitis, Campylobacter, Celiac Disease, Clostridium Perfringens, CMV (Cytomegalovirus), Contact Transmission, Dehydration, Diaper Rash, Diarrhea, Diphtheria, E. Coli, Fecal-Oral Transmission, Fomites, Gastroesophageal Reflux, Giardia Lamblia, Hepatitis A, Hepatitis B, Hernia (Inguinal hernia), HIV, Influenza (Flu), Intussusception, Norwalk Virus, Pinworms, Plague, Pyloric Stenosis, Rotavirus, Salmonella, Staph (Staphylococcus aureus), Toxoplasmosis, Vomiting

Memorial Day Weekend. Picnics. Hot weather. Summer fun.

To keep swimming safe and fun, the Centers for Disease Control and Prevention (CDC) is urging parents to teach their children not to swallow pool water. It’s best to try to keep water out of the mouth, but if water does get in, it’s important not to swallow.

Swallowing water that contains traces of stool is the number one way that infections are spread in a swimming pool. Frequent bathroom breaks, and careful washing before entering the pool, help stop the spread of infection. And of course, anyone with diarrhea should avoid swimming.

Swimming is a great way to enjoy active fun! These precautions make it even better.

Dr. Greene’s Answer:

Swimmer’s ear is an infection of the skin lining the ear canal. Bacteria normally live on the surface of this skin with no ill effect. If there is a break in the skin’s normal barrier, however, the bacteria can get inside and cause an infection called external otitis or swimmer’s ear (this is different from otitis media ). If the ear is wet for a long period of time, the skin can become prune-like in the same way one’s fingers and toes become soft and wrinkled when they are in water for a long period of time. Bacteria can easily move into the soft skin. Tiny scratches in the ear canal (usually from sticking a finger or some other object into the ear) also leave the skin vulnerable to infection. The skin can even be breached as a result of the ear’s becoming extraordinarily dry, causing the skin to crack. Ironically, swimmer’s ear can be the result of spending time in desert conditions.

Swimmer’s ear is more common in water with higher bacterial counts, which generally include lakes or other unchlorinated bodies of water. For unclear reasons, swimmer’s ear is not common in infants, but it is particularly prevalent in pre-school and school-age children.

There are a couple of ways to prevent swimmer’s ear. One is to make sure the ears get dry after being in the water. This can be facilitated by turning the head and gently pulling the ear in different directions to help drain the water out of the ear. It is also very helpful to dry the opening of the ear very carefully as far as you can reach with a towel or even try using a blow dryer. If swimmer’s ear becomes a recurrent problem, you can put a few drops of rubbing alcohol in each time it becomes wet, to facilitate drying. Another good alternative is instilling a few drops of white vinegar. The acetic acid inhibits the growth of bacteria in the skin. Wearing ear plugs may also prevent swimmer’s ear.

The symptoms of swimmer’s ear are itchy and/or painful ear. This is often accompanied by a small amount of clear discharge. The ear is particularly sensitive to the ear lobes being moved up and down. Most cases of swimmer’s ear are easily treated with antibiotic drops. For very serious infections, oral antibiotics may be necessary.

Swimming is generally not associated with the other type of ear infections — otitis media. This is true even if a child has ear tubes .