skateboard can be called the originator of the history of extreme sports, extreme sports are a number of projects extending from skateboarding. 50 20th century by the late 60's early surfing skateboarding evolved in the planet and have now become the "coolest" of the movement. Skateboarding skills include: The AerialL, The Invert, THE Ollie, these technologies can be said that the most important addition to skateboard outside flap action. Skate the world's two major international organizations: INTERNATIONAL ASSOCIATION OF SKATEBOARD COMPANIES, IASC and the WORLD CUP SKATEBOARDING, WCS.
With regard to the use of commercially available References dietary fluids, the message from Wendland and Arbus 1. ROHDE JE, NORTHRUP RS: Taking science where the should be clear: Don't administer unspecified "clear" diarrhoea is, in A cute Diarrhoea in Childhood, Ciba fluids to babies with diarrhea. The administration of Foundation Symposium 42, Elsevier, New York, 1976, some prepared clear soups can be hazardous because p 339 2. GALL DG, HAMILTON JR: Infectious diarrhoea in infants of their high salt content. In theory, many products and children. Cliii Gastroenterol 6: 431, 1977 that are hyperosmolar or have a high sugar content 3. CARLSON JAK, MIDDLETON PJ, SZYMANSKI MT, et al: can worsen and prolong diarrhea unless they are Fatal rotavirus gastroenteritis - analysis of 21 cases. diluted to the point where their osmolarity approaches Am J Dis Child 132: 477, 1978 that of plasma. Thus, many soft drinks and fruit juices 4. BISHOP RF, DAVIDSON GP, HOLMES IH, et al: Virus particles in epithelial cells of duodenal mucosa from should be diluted to at least half-strength. children with acute non-bacterial gastroenteritis. Lancet 2: 1281, 1973 None of these dietary fluids can meet the nutritional 5. MIDDLETON PJ, SZYMANSKI MT. ABBOTT GD, et al: requirements of the infant, but during the acute phase Orbivirus acute gastroenteritis in infancy. Lancet 1: 1241, of severe infectious diarrhea one has no practical op- 1974 6. DAVIDSON GP, GALL DG, BUTLER DG, et al: Human tion other than to restrict energy and protein intake. rotavirus enteritis induced in conventional piglets - in- However, nutritional reserves are limited in infants,9 testinal structure and transport. J Clin invest 60: 1402, and, undoubtedly, nutrients are important for repair 1977 after enteric infection.10 Within 24 to 48 hours ade- 7. TELCH J, SHEPHERD RW, BUTLER DG, et al: Jejunal quate energy and protein intake should be provided. glucose transport in acute invasive viral enteritis (abstr). Cliii Res 26: 852A, 1978 These objectives are met not by giving hyperosmolar 8. TALLETT 5, MACKENZIE C, MIDDLETON P, et al: Clinical, sugar solutions but by instituting a balanced diet. laboratory and epidemiologic features of a viral gastro- Fortunately, there seems to be a considerable margin enteritis in infants and children. Pediatrics 60: 217, 1977 for error and most sick babies, even those with acute 9. HEIRD WC, DRISCOLL JM JR, SCHULLINGER JN, et al: enteritis, recover, whatever their treatment. Neverthe- Intravenous alimentation in pediatric patients. J Pediatr 80: 351, 1972 less, in this "modern" era of nutritional ignorance a 10. HAMILTON JR, GALL DG, BUTLER DG, et al: Viral gastro- careful assessment of what we feed these fragile pa- enteritis: recent progress, remaining problems, in A cute tients seems appropriate. Diarrhoea in Childhood, op cit, p 209 Skateboard injuries ROBERT G. SMITH,* MD, FRCP[C] With summer in full swing the fractures and sprains information about the dangers of skateboarding, pro- from winter skiing have been replaced in hospital pose tactics to reduce the frequency of injury and emergency departments by skateboard injuries. In consider the wisdom of restricting the use of skate- 1977, 184 persons with skateboard injuries were boards. treated at the Hospital for Sick Children in Toronto1 Half of all reported skateboard injuries are fractures and 53 were seen during a 4-month period at the of limbs. Fatalities are rare, but in the United States Children's Centre in Winnipeg (The Medical Post, Feb. there were 24 deaths in a 3-year period, most due 14, 1978, p 63). No cross-Canada figures are avail- to head injuries or contact with moving vehicles.2 able, but it has been estimated that more than 87 000 Further analysis of injuries reveals some interesting skateboard injuries were treated in emergency depart- facts.2 One third of accident victims had been skate- ments in the United States in 1978.2 Because of our boarding for less than 1 week, and most of them were colder climate and the availability of other attractive injured the first time they tried skateboarding. Two summer activities, the Canadian rate of skateboard of five injured persons had borrowed skateboards. One injuries is probably less than the customary 10% of third of accidents occurred when a board struck irre- the American figure. However, skateboard accidents gularities in the riding surfaces; in one quarter of are still a cause for concern among parents and pedia- accidents the victims lost their balance. Most skate- tricians, some of whom are putting pressure on legisla- boarders, it is believed, are between 10 and 17 years tors to "ban the boards". of age; 14- and 1 5-year-olds are the primary users of Before someone sums up this summer's skateboard skateboards. Of all persons injured 45% are between injuries toll it would be wise to review the available 10 and 14 years of age. Thus, the inexperienced young skateboarder who tests his or her skill on an irregular riding surface, or on unfamiliar or unrepetitive terrain, *Member, child health committee, Manitoba Medical is at the greatest risk of injury. Association Are skateboards safe to use? Some may validly Reprint requests to: Dr. Robert G. Smith, Selkirk Medical argue that skateboards are inherently unstable and Centre, 353 Eveline St., Selkirk, Man. RiA lN1 are thus unsafe to use. Be that as it may, product 510 CMA JOURNAL/SEPTEMBER 8, 1979/VOL. 121 failure accounts for only 1 % of all injuries.2 Some larity of such parks shows that the idea is a good one. features, nevertheless, do make some skateboards safer It matters not that the parks are soon abandoned by to use than others. Basically, skateboards consist of many experienced skaters because the repetitive sur- three parts: the deck, the wheels and the trucks. faces no longer challenge their skills. At least for The deck of the skateboard is usually 60 to 75 cm inexperienced and part-time skaters the environment long and is constructed of wood, plastic, fibreglass or is controlled and reasonably safe. In Canada, however, aluminum. The more flexible the deck, the more skill such parks are scarce. The climate in most parts of needed to maneuver the skateboard. Fibreglass decks Canada makes skateboarding a seasonal sport. Indoor are the most flexible and wooden ones the least. parks are expensive to build and insure, and private Skateboards with short decks are the best for doing entrepreneurs have not rushed to fill the demand. tricks and gaining speed. Those with relatively long Some cities in Canada are in the process of establishing inflexible decks and a nonslip covering are the safest small outdoor public parks, but there are problems for beginners. The aluminum boards are not recom- not only in the reluctance of those who control the mended because the edges of their decks wear to a public purse, but also in the free exchange of ideas razor-like sharpness. on the most functional and safest designs. For example, Wide wheels (stokers) are from 5 to 6 cm wide and when individuals in Winnipeg were attempting to make the board more stable; although narrow wheels design outdoor parks, they could not, after several (slicks), which are from 3 to 4 cm wide, are less stable, enquiries, obtain any information from those who had they increase maneuverability. The best wheels are established parks in the United States. The industry made of plastic or polyurethane, not rubber. The is competitive and secretive. wheels should have sealed steel bearings and should What are the answers? At present, parents and con- be held on the axle by lock nuts that can be tightened cerned groups can only ensure that the sport is made without limiting the motion of the wheel and will not safer. In other words, parents should insist that their loosen with use. children have the most reliable skateboards and that The trucking mechanism is the device by which the they use safety equipment. Safe skating areas (e.g., wheels are attached to the deck. It should be so con- temporarily closed residential streets and supermarket structed as to allow side-to-side movement and there- parking lots) must be provided until parks can be fore steering. Trucks should be adjustable according established. An ongoing program of consumer educa- to the weight of the rider and should be attached to tion should be initiated. Rather than pressuring gov- the deck with lock nuts. ernments to attain unreachable objectives such as ban- Experience notwithstanding, riders can make skate- ning the use of skateboards from the streets, we should boarding safer by using a helmet, knee and elbow pressure them to study the phenomenon of skateboard- pads, and heavy gloves. These may be ineffective in ing in Canada and determine the problem areas and reducing the incidence of fractures, but they can reduce the risks, to promote consumer education and, finally, the incidence of head injuries, contusions and abra- to set safety standards regarding the construction of sions. Thus, the incidence of injuries due to skate- skateboards sold in Canada. At present, we allow the boarding can be reduced, perhaps by as much as one sale of unsafe equipment, we make no demands that third,2 if skateboard riders use their equipment in a manufacturers package their product with warnings or controlled environment such as an area where they instructions on its safe use and we raise no objections will not come into contact with automobiles, where when the media show persons skateboarding without there are smooth riding surfaces, and where the riding safety equipment or in an unsafe environment. These surface is repetitive and familiar, and if riders can are areas in which governments can act and in which be encouraged to wear protective equipment and have we should encourage them to do so. periodic safety checks of their equipment. With the Perhaps skateboards will go the way of the hula- use of helmets and the avoidance of collision with hoop. I don't think so and I hope not. For the present, automobiles, death can be eliminated. Since experience however, let us encourage participants to use them plays an important part in the prevention of injury, safely. consumer education is obviously important. Should skateboards be banned? No, they should not. References Certainly attempts should be made to discourage their 1. HAFFEY H: Annual Report - Accident Survey, Hospital use on dangerous surfaces such as roadways. Attempts for Sick Children, Toronto, 1978 have been made to ban the use of skateboards on 2. Hazards Analysis Reports. Injuries Associated with Skate- the streets, but the regulations have proved unenforce- boards (product code 1333), economic analysis, hazard able. However, the goal should be to encourage riders identification and analysis directorate, US Consumer Prod- to enjoy and develop this sport safely. After all, uct Safety Commission, Washington, 1977 doesn't skateboarding develop the attributes we would Recommended reading like to see our children attain - grace of motion, MADDOX D: Skateboarding: the spill-and-skill sport. Physician agility, coordination and a sense of achievement in Sports Med 6: 108, 1978 a sport they enjoy? Idem: Skateboards: zip-and-zap riders. Physician Sports Med The means to achieve safety may seem simple - 4: 24, 1976 the development of parks for skateboarding compar- ATIENZA F, SIA C: The hazards of skateboard-riding. Pedia- trics 57: 793, 1976 able to ice-skating rinks, where the rigid regulation of JACOBS RA, KELLER EL: Skateboard accidents. Pediatrics safety standards and the compulsory use of safety 59: 939, 1977 equipment are enforced. In the United States the popu- Skateboards. Which Dec: 643, 1977 512 CMA JOURNAL/SEPTEMBER 8, 1979/VOL. 121
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