proach of physician, nurse, dietician,
and usually, social worker evaluate the
child and family. Genetic evaluation
of this family and the relationship of
relatives to being possible carriers is
needed to help in awareness and con-
trol of future cases in the family. After
evaluation, diagnosis, and starting of
treatment, the patient is referred back
to his family physician or public health
clinic to be followed locally with per-
iodic visits back to the University Med-
ical Center for consultation and advice
to the local people.
The cooperation between physicians
and public health personnel has been
excellent with the Medical Centers and
in one instance a public health nurse
had an exhausting time counselling one
family in following dietary orders on a
child.
Q. How is PKU treated?
A. By a special diet which is low in
phenylalanine, the offending food sub-
stance. All protein foods in nature, in-
cluding milk, are too high for use as
food in these patients so an artificial
milk formula is made by one of the
drug companies. The taste of the form-
ula and the low phenylalanine diet in
general is not very tasty, so our con-
sulting dietician and nutritionists at the
State Board of Health have helped in
developing a broader variety of better
tasting food combinations. Consultants
at the State Board of Health can be
contacted for help with these PKU
patients. The formula is quite expen-
sive and we help some of the low in-
come families to purchase the formula.
It is felt that the diet will prevent
mental retardation and the other men-
tioned problems in this disease.
Q. What is the future of metabolic
screening in the newborn?
A. There are several diseases that
could be tested for and we now have
two other tests ready that we hope to
add within the next few months. Pos-
sibly we can talk about these at a
later time.
June, 1968
THE HEALTH BULLETIN
13
American Academy
for Sanitarians
Growing
The American Intersociety Academy
for Certification of Sanitarians, Inc., has
shown very encouraging and substan-
tial growth during the current year.
Professional Sanitarians already certified
as Founder Diplomates together with
applications on file number about one
hundred thirty. Through a recent
change in the By-Laws, applicants for
certification as Founder Diplomates
now have until December 31, 1968 to
apply. The original closing date was
June 30, 1968.
The Academy was incorporated in
March 1966 and began accepting appli-
cations in January 1967. The purpose
of the Academy is to certify and give
recognition to professional sanitarians
whose educational background, compe-
tence and leadership have been demon-
strated to be of outstanding quality in
the field of Environmental Health.
For certification as Founder Diplo-
mate, the minimum qualifications are a
baccalaureate degree with not less than
forty semester hours of academic cred-
it in the physical and biological sciences
plus twelve years of acceptable experi-
ence, eight of which have been in
responsible charge of work. Other pro-
visions are made for professional sani-
tarians holding a Masters or higher
degree in which the number of years
experience is reduced but an examina-
tion must be successfully passed in the
general field of Environmental Health.
The Academy is an outgrowth of
recommendations by the Sanitarians
Joint Council the membership of which
is composed of representatives from
the International Association of Milk,
Food and Environmental Sanitarians,
the National Association of Sanitarians
and the American Public Health Associ-
ation.
Pofessional sanitarians wishing more
complete information about the Acade-
my, its m.embership requirements and
its objectives should address a request
to Darold W. Taylor, Secretary, 2101
Wakefield Street, Alexandria, Virginia
22308.
MEMBERS OF THE NORTH CAROLINA STATE BOARD OF HEALTH
James S. Raper, M.D., President Asheville
Lenox D. Baker, M.D., Vice-President Durham
Ben W. Dawsey, D.V.M. Gastonia
Ernest A. Randleman, Jr., B.S.Ph. Mount Airy
Paul F. Maness, M.D. Burlington
A. P. Cline, Sr., D.D.S. Canton
Joseph S. Hiatt, Jr., M.D. Southern Pines
J. M. Lackey Rt. 2, Hiddenlte
Howard Paul Steiger, M.D. Charlotte
EXECUTIVE STAFF
Jacob Koomen, M.D., M.P.H. State Health Director
W. Burns Jones, M.D., M.P.H. Assistant State Health Director
J. M. Jarrett, B.S. Director, Sanitary Engineering Division
Martin P. Hines, D.V.^L, ALP.H. Director, Epidemiology Division
Ronald H. Levine, M.D., M.P.H. Director, Community Health Division
E. A. Pearson, Jr., D.D.S. , M.P.H. Director, Dental Health Division
Lynn G. Maddry, Ph.D., M.S.P.H. Director, Laboratory Division
Ben Eaton, Jr., A.B., LL.B. Director, Administrative Services Division
Theodore D. Scurletis, ^LD. Director, Personal Health Division
14
THE HEALTH BULLETIN
June, 1968
Healfh
Notes
The percentage of people 65 and
over enrolled in the doctor bill insur-
ance part of Medicare went up from 92
to 95 percent during the 6-month open
enrollment period that ended April 1,
Robert AA. Ball, Commissioner of Social
Security, announced.
The Board of Directors of the North
Carolina Heart Association meeting in
Winston-Salem on May 29 approved the
proposed budget of $122,500 for re-
search. These funds w\\\ be allocated to
support cardiovascular research in
North Carolina.
In addition to the $122,500 Heart
Fund dollars designated by the North
Carolina Heart Association, additional
research funds from the American
Heart Association v/ill also be used in
North Carolina.
The majority of the funds approved
by the Board for research will be
awarded in Grants-ln-Aid.
Recommendations for vaccination of
travelers against three internationally
important diseases— cholera, plague, and
typhus— have been released by Dr.
Robert Q. Marston, Chief of the Health
Services and Mental Health Admini-
stration of the Public Health Service.
These recommendations result from
recent study of the diseases by the
Public Health Service Advisory Commit-
tee on Immunization Practices. They
have been developed in accordance
with international requirements and
have become the accepted standards for
the Foreign Quarantine Program of the
Public Health Service.
N. C. Heart Association
Elects State Officers
Dr. James A. McFarland of the Duke
University Medical Center in Durham
was elected President of the North
Carolina Heart Association at its Annual
Luncheon at the Robert E. Lee Hotel
during the 19th Annual Meeting and
Scientific Sessions held in Winston-Sa-
lem. Dr. McFarland succeeds Dr. Madi-
son S. Spach of Durham.
Dr. McFarland, an internist who
recently joined the Duke Staff and
Regional Medical Program, was previ-
ously in practice in Rutherfordton,
North Carolina.
Dr. Henry S. Miller, a physician from
Winston-Salem, was elected Vice-Presi-
dent and President-Elect of the Associa-
tion.
Also elected as officers of the Associ-
ation were R. B. Boyd of Charlotte as
Secretary and James F. Lane of Chapel
Hill as Treasurer.
Elected for membership on the Board
of Directors for three year terms were
the following: Dr. L. L. Anthony, Gas-
tonia; Mrs. Paul Collins, High Point;
Mrs. John Grogan, Eden; Dr. James R.
Harper, Chapel Hill; Dr. Robert N. Head-
ley, Winston-Salem; Mrs. W. J. Kenne-
dy, III, Durham; Carlyle Lewis, Madi-
son; Dr. David L. Phillips, Spruce Pine;
Mrs. 1. T. Valentine, Jr., Nashville; and
Jack Watson of Lumberton.
The following members were elected
as Delegates to the 1968-69 Assembly
of the American Heart Association to
represent the North Carolina group:
Dr. J. Logan Irvin, Chapel Hill; Fred W.
Klein, Eden; James F. Lane, Chapel Hill;
and Dr. Henry S. Miller, Winston-Salem.
Dr. J. Logan Irvin of Chapel Hill
will serve as Chairman of the Board of
Directors and Mr. Fred Klein of Leaks-
ville will serve as Vice-Chairman and
Chairman-Elect of the Board.
June, 1968
THE HEALTH BULLETIN
15
THE HEALTH BULLETIN
P. O. Box 2091
Raleigh, N. C. 27602
If you do NOT wish to con-
tinue receiving The Health Bul-
letin, please check here i — i
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^
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Printed by The Graphic Press, Inc., Raleigh, N. C
II
Peanuts'' Warns
Children About
II
Lazy Eye
II
A free comic book featuring the
nationally syndicated "Peanuts" char-
acters that warns children and their
parents about a form of blindness
which strikes the young, has been re-
leased by the U. S. Public Health Serv-
ice's National Center for Chronic Dis-
ease Control.
Public health officials worked close-
ly with Charles AA. Schuiz, creator of
"Peanuts" in preparing the 13 episode
booklet. The cartoons are designed to
encourage early eye examinations for
children as a precaution against am-
blyopia ex anopsia— commonly called
"lazy eye," which can lead to blind-
ness in one eye if left uncorrected.
"Security Is An Eye Patch" shows
cartoon character Sally Brown getting
an eye examination and learning she
has amblyopia ex anopsia. She is given
an eye patch to wear over her good
eye to make her "lazy eye" stronger.
This is a common treatment for "lazy
eye," a condition in which the two
eyes do not see with the same degree
of clarity and the poorer one is not
stimulated to develop.
The booklet follows Sally's daily ad-
ventures with playmates Linus, Snoopy,
and Charlie Brown and tells how the
eye patch helps her win over "lazy
eye".
An eye examination is the only way
to detect "lazy eye" in young children,
public health physicians point out. A
temporary eye patch is often the only
treatment needed to correct the con-
dition if it is discovered early enough.
Blindness in the "lazy eye" can result
if it is left unattended and it is em-
phaszed that the condition must be dis-
covered well before the age of six.
The National Center for Chronic Dis-
ease Control is distributing single free
copies of "Security Is An Eye Patch."
They axQ available by writing to:
"Security Is An Eye Patch"
National Center for Chronic Disease
Control
4040 North Fairfax Drive
Arlington, Virginia 22203
16
THE HEALTH BULLETIN
June, 1968
J u(H I n^<5
(# '*- ^ \ t"^^
**
Child Safety
Here is an accident in the making. This baby should not have been left on an
adult bed with only his little brother to look out for his safety. It's too easy for
the baby to crawl to the edge of the bed or roll over and tumble onto the floor.
And little brother should not be expected to prevent this potential accident (Na-
tional Safety Council Photo).
(See article beginning on page 3)
Hartwell B. Rogers Named
Public Information Officer
Hartwell B. Rogers has been named
Public Information Officer for the North
Carolina State Board of Health, accord-
ing to announcement today by Dr.
Jacob Koomen, State Health Director.
Mr. Rogers assumes his new duties
on August 1, 1968. He succeeds Dr.
Edwin S. Preston who resigned some
months ago.
Mr. Rogers, a native of Henderson,
N. C, has an extensive background in
public information, encompassing writ-
ing, editing, press releases, radio and
television. He was Executive Director
for North Carolinians for Better Lib-
raries, Inc., before this agency was dis-
solved recently. He has served with
North Carolina State University, Caro-
lina Power and Light Company and
WRAL Radio-Television Station in pub-
lic information and public relations
capacities.
Mr. Rogers attended Eton College,
East Carolina University and North Caro-
lina State University. He is a member
of the Raleigh Public Relations Society
and the N. C. Library Association. He
resides at 3508 Woodlawn Drive.
Miss Parrish Is Named
Physical Therapy Chief
Dr. Jacob Koomen, State Health Di-
rector, has announced the appointment
of Miss Anne Parrish as Chief of the
Physical Therapy Section of the State
Board of Health. "Miss Parrish is emin-
ently qualified to assume leadership for
this important public health program,"
Dr. Koomen said.
A native of Franklin County, Miss
Parrish attended Meredith College and
received a B.S. degree from the Uni-
versity of North Carolina at Greensboro.
She received her certificate in Physical
Therapy from the University of Wis-
consin and has been with the North
Carolina State Board of Health for more
than 15 years.
The Physical Therapy Section will
provide consultation, training and di-
rect services in a num.ber of public
health programs, such as Crippled Chil-
dren's services, Chronic Diseases and
Home Health Care.
THE HEALTH BULLETIN
First Published — April 1886
The official publication of the North Caro-
lina State Board of Health, 608 Cooper
Memorial Health Building, 225 North Mc-
Dowell Street, Raleigh, N. C. Published
monthly. Second Class Postage paid at
Raleigh, N. C. Sent free upon request.
Editorial Board
Charles M. Cameron. Jr . M D . M PH.
Raleigh
John C, Lumsden. B.C.H.E.
Jacob Koomen, Jr . M D , M P H.
John Andrews, B.S.
Glenn A Flinchum, B S.
H w Stevens. M.D., M P H., Asheville
Guest Ed.— Edwin S. Preston, M.A.,LL.D.
Vol. 83
July, 1968
No. 7
THE HEALTH BULLETIN
July, 1968
Don't Lef Your Baby Be A Foil Guy
"Don't let your baby be a fall guy."
These words of advice come from Dr. Harvey Kravitz, a pedi-
atrician who has discovered that infants tumble from high places
much more often than has been suspected. Dr. Kravitz's source of
information is a recently completed study financed through a
grant from the National Safety Council.
Of the 536 infants involved in this study, 255, or 47.5% fell
from a high place such as an adult bed, a crib, or an infant
dressing table during their first year of life.
"We were surprised to learn that the percentage was so high,"
says Jerry Driessen, a researcher at the National Safety Council
who worked with Dr. Kravitz. "If all infants in the counttry follow
the same pattern as those in our study, we can assume that during
this year, 1,750,000 babies will fall at least once during their
first year of life."
And falls may be even more frequent than this study shows
. . . Babies who were seriously injured from a fall most likely
were treated in the Neurology Clinic of a hospital. But this study
was partly based on discussion with parents who came to a
general pediatric clinic, and would not have included those
parents who bypassed the Pediatric Clinic to go to the Neurology
Clinic because their child was seriously injured.
There is another reason why falls may be more frequent than
the study indicates.
"If a baby falls while a baby sitter or maid is in charge," says
Dr. Kravitz, "the accident may never be reported, since the
person responsible may be afraid of getting in trouble with the
parents. Likewise, some parents are afraid of telling the doctor
that their baby fell. They think he will blame them for the ac-
cident."
But doctors have another interest in finding out about infant
falls. They know that a fall can be very harmful to a baby . . .
July, 1968 THE HEALTH BULLETIN 3
and he cannot be helped unless the doctor knows he has fallen.
"injury from a fall can be a serious business for an infant,"
says Dr. Kravitz. Unfortunately, babies seem to fall head first.
When a baby is very young his brain is growing rapidly, the
skull has a thinner wall than at any other time of life, and damage
to the head at this early developmental stage may interfere with
all later learning.
Dr. Kravitz and his associates learned that only 34 of the 255
infants who fell, or 13% of them, were less than five months of
age. This is not surprising, though, since babies are not very
active until then. They get into trouble when they begin to roll
over, sit up, and even stand after having been placed lying down.
Once the baby can pull himself to a standing position by holding
on to something, he starts to climb. The trouble comes because
parents are not prepared for all this activity, and they may
underestimate the danger of the baby's falling.
A more surprising result of the study was that 82 babies (or
32% of those who fell) tumbled from furniture designed specific-
ally for infants. Ironically, most of these accidents could be
prevented if manufacturers would pay more attention to infant
safety. The most common preventable accident (35 out of 51 falls
from poorly designed baby furniture) occurred when a baby
climbed out of a crib even though the sides were up. The research-
ers suggest that much more attention be given to designing cribs
that take into consideration the growth and development of in-
fants. They suggest that cribs be designed so that the mattress
can be lowered closer to the floor and the sides raised higher.
To baby-proof cribs already on the market, the researchers offer
these suggestions. Cover the top of the crib with netting. Since
this is often done in hospitals, the local hospital is a good place
to purchase the appropriate netting. Mothers also should be sure
not to put large toys or boxes in the crib with the baby, since he
might stand up on them and get a head start over the side of
the crib.
Another piece of baby furniture involved in accidental falls is
the infant dressing table (27 out of 82 falls from infant furniture),
often used by mothers to place the baby on while he is being
dressed or his diapers are being changed. Dr. Kravitz believes that
manufacturers could make these safer by adding sides to the tatble
surface so that infants could not roll off. The table might also
have a concave surface instead of a flat one.
Dr. Kravitz reminds mothers that when they reach down to get
something out of the drawer while the baby is perched on top
of the table, they should keep one hand firmly planted on the
child. He also suggests, "If the doorbell rings while you are dres-
sing your baby and you must leave the room, strap the baby on
the dressing table. Better yet, take him with you."
But human error is also a crucial factor in infant falls. In fact,
most falls in the study were caused by an error in judgment on
4 THE HEALTH BULLETIN July, 1968
Child
Safety
This mother makes two
mistakes as she goes to
answer the door. First,
she should have strap-
ped the baby in his in-
fant seat before she
turned away. Second,
she could have played
it even safer and taken
the baby with her.
This time the mother has the right idea. She carries the baby with her to answer
the door instead of leaving him alone. (National Safety Council Photos)
July, 1968
THE HEALTH BULLETIN
the part of the mother, an error that she made partly because she
was not aware how dangerous a fall could be to her baby.
"Never, never leave a baby alone unless you are sure that he
cannot hurt himself," cautions Dr. Kravitz. "Don't trust your baby
to keep still for even a few seconds, and don't trust him to the
care of a little brother or sister. Remember that a baby lying
calmly on the middle of your bed can wriggle to the end and
fall off in a much shorter time than it takes for you to answer the
phone. A baby happily playing in an infant seat can rock to the
edge of the table and fall off long before you have time to give
your order to the milkman."
Dr. Kravitz, who is on the staff of Northwestern University
School of Medicine, Chicago, Illinois, was assisted in his study
by Gerald J. Driessen, Ph.D., Director of The Safety Research In-
formation Service, National Safety Council, Chicago, Illinois, and by
Raymond Gomberg, AA.D., and Alvin Korach, AA.D., two pediatricians
on the staff of Lutheran General Hospital, Park Ridge, Illinois.
The researchers conducted their study in two separate parts.
First they questioned parents of 200 children admitted for a variety
of reasons to the general pediatric clinic of a hospital in a large
city (Children's Memorial Hospital, Chicago, Illinois). The children
ranged in age from 10 months to 2 years. Their parents were asked
to recall whether their child had fallen during his first year of life,
and to describe what they remembered about the fall.
In the second part of the study the pediatricians worked with
parents of 336 new infants. The parents were asked to report each
time their child fell during his first year of life, as soon as possible
after the accident. These patients lived in the suburbs and were
seen in the pediatricians' private practice.
The researchers found some differences in the accident histories
of urban and suburban infants. Babies from the city were more
likely to fall from an adult bed (81 urban babies versus 22 sub-
urban ones), while suburban babies were the only ones who fell
from infant dressing tables (27 suburban babies fell from these
tables, but not a single urban baby).
The researchers suspect that this marked difference was caused
by mothers using different kinds of furniture to put the baby on
while dressing him. Surburban homes usually have a dressing table
specifically designed for infants. But people in the city are not
likely to own infant dressing tables, and the mother usually puts
the baby on an adult bed to dress him.
"The most important thing we learned by doing this study was
that many, many infants fall before they reach one year of age,"
concludes Dr. Kravitz.
"Mothers of young infants should be impressed to learn that
their babies have a 50-50 chance of falling before they are 12
months old. But if a new mother will follow the safety precautions
already discussed, there is a good chance that she can prevent her
baby from becoming a 'fall guy.' "
6 THE HEALTH BULLETIN July, 1968
North Carolina Family Life Council, Inc.
Tentative Program 21st Annual Conference
Hotel Robert E. Lee, Winston-Salem Oct. 6-8, 1968
THEME: "IT'S HAPPENING: THE URBAN IMPACT"
October 6-Sunday Evening Opening Session-SPERRY AWARD BANQUET
Address: "Politics and The Family"
THE HONORABLE BROOKS HAYS, Washington, D. C. Special assistant to President
Johnson (and President Kennedy); director Ecumenical Institute, Wake Forest
University; head of Southern Committee on Political Ethics (SCOPE); visiting
professor at University of Massachusetts and professor of government at Rutgers
University; former president Southern Baptist Convention; former congressman
from Arkansas.
October 7— Monday Morning
Address: "Family Trends in North Carolina"— a demographic presentation, DR.
JOSEPH HIAAES,, sociologist. North Carolina College, Durham.
Discussants: Implications— Dr. Clark Vincent, Director, Behavioral Sciences Center,
Bowman Gray School of Medicine, Wake Forest University, Winston-Salem. Dr.
Elizabeth Corkey, Assistant Director, Charlotte-Mecklenburg Health Department
The Reverend Alvard Beardsley, Chaplain, Hollins College, Roanoke, Virginia
Lunch 11:30-1:00 Open for special group meetings, own arrangements
Monday Afternoon
Address: "Urbanization and Changing Family Styles" DR. DAVID MACE, Bowman
Gray School of Medicine, Department of Genetics and Preventive Medicine, Wake
Forest University; President, Sex Education Information Council of the United
States; Vice-President of the International Union of Family Organizations since
1963; formerly co-executive director (with Mrs. Mace), American Association of
Marriage Counselors; noted author; former president. National Council on Family
Relations.
Workshop-Field Trips on the subject of: Poverty, race, mental health, family
planning, sex education and the schools— Mrs. Johnny McLeod, M.D., Charlotte;
recreation and leisure, crime and delinquency, health— Mr. Marshall Abee, Director,
Community Health Services, Greensboro; day care— Miss Mary Elizabeth Keister,
Ph.D., U.N.C. Greensboro; religion.
Monday Evening
Address: "Farm Roots of City Disorders" DR. C. E. BISHOP, Vice President, Greater
University of North Carolina, Chapel Hill; Chief, President's Commission on Rural
Poverty.
October 7— Tuesday Morning
Symposium: "Workshop Leaders Tell It As It Is"
Address: "Emerging Trends in the American Family" DR. WILLIAM KENKEL, Presi-
dent, National Council on Family Relations; professor, sociology and rural socio-
logy, University of Kentucky, Lexington.
President, Mrs. Kate Garner, Greensboro
Publicity Chairman, Leo Hawkins, Raleigh
July, 1968 THE HEALTH BULLETIN 7
THE HEALTH BULLETIN
P. O. Box 2091
Raleigh, N. C. 27602
If you do NOT wish to con-
tinue receiving The Health Bul-
letin, please check here i I
and return this page to
the address above.
UEDlCkL LIBRARY