Fun in the sun

Most people love sunny, warm days, when they can get outside for fun and soak up the sun. But sun is one good thing you can have too much of – and not even know you've had too much until much later, when, like about 80,000 Canadians every year, you're diagnosed with skin cancer. Fortunately, 19 out of 20 cases of diagnosed skin cancer are less aggressive forms called basal cell or squamous cell cancers, which are fairly easy to treat. But 6% are melanoma, a more serious form of skin cancer that can spread to other parts of the body.

Know it like the back of your hand

It's important to know your skin and the signs of skin cancer. If you notice any unusual moles or marks on your skin, watch them closely. The most common skin cancers (basal and squamous cell) can look like a small, skin-coloured or red knob. The more dangerous melanoma usually begins as a mole that seems to change colour or size. What are the signs that tell you to have a doctor look at a mole? Just remember ABCD:

• Asymmetry: The mole is not round.
• Border: The border is irregular with jagged edges, not smooth.
• Colour: The colour can be uneven across the mole, it can change, or it may seem very different from the other moles on your body.
• Diameter: Cancerous moles are usually larger than 6 mm (the size of a pea or a pencil eraser).

Protect them while they're young

Skin cancer is usually caused by the skin's exposure to ultraviolet rays from the sun. The more sun you're exposed to over your lifetime, the higher your risk of developing cancer.

It's estimated that up to 80% of a person's total exposure to the sun happens before 18 years of age. Because of this, it's good to teach children healthy sun habits from the start. One serious sunburn in childhood can increase future cancer risk by as much as 50%.

Babies under six months old are especially susceptible to the glare of sunshine and should be kept out of the sun completely. They're too young for sunscreen, so keep the baby in the shade and covered as much as possible. Don't forget that the sun can reflect off shiny surfaces and swimming pools, so keep babies well shaded from all directions at all times.

No such thing as a healthy tan

There is a common myth that if a person tans well, they're protected from these harmful rays. Not true! While it is true that fair-haired, blue-eyed people are most prone to burning, and therefore are more susceptible to the sun's rays, even "healthy" tans are really just damage control – they're your body's way of trying to protect itself from the sun. But the damage is already done and can't be reversed. Years of sun worshipping, be it outside or in a tanning salon, will eventually show up later on in life as wrinkles, poor skin elasticity, and possibly skin cancer.

The sun, however, is also very important to our health. It provides us with vitamin D (which we need for our bones), and it can lift our spirits. In fact, there's a form of depression called seasonal affective disorder (or SAD) that can happen when there's more darkness than daylight – those experiencing SAD feel "down" during the winter months and much better when summer comes. So staying holed up deep inside isn't the way to go either.

As with most good things, moderation and good sense are the keys. The goal is to have fun outside but to stay safe at the same time. Here are some basic rules:

• Cover up whenever possible. A longer cotton skirt, for example, might feel cooler on a hot day than a pair of shorts, and will help guard you from the sun.
• Wear a hat. Hats keep the sun's rays off the scalp, face, and back of the neck, prime areas for skin cancer. A good hat will also shelter and protect your eyes from the sun's powerful rays.
• Apply sunscreen at least 20 minutes before you go out, even if the sun doesn't seem particularly strong, or it is cloudy. Damaging ultraviolet rays can still penetrate clouds, so don't take a chance. Always apply sunscreen that has a minimum SPF (sun protection factor) of 30 and protects you from both UVA and UVB light. Be sure to follow the directions closely and reapply the sunscreen on a regular basis throughout the day, especially after you've been swimming or sweating, even if your sunblock advertises that it is sweat or water resistant. Ask your pharmacist or doctor for their product recommendations and advice on proper application. Do not forget that your lips, ears, nose, and toes can burn just as easily as any other part of your exposed body, so apply sunblock to them as well. Some lip balms with SPF can be purchased from your local pharmacy. For more information on choosing a sunscreen, read " Sunscreen: a user's guide

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• Avoid the sun when it's at its peak. It's strongest between 11 a.m. and 4 p.m., so use that time to do activities indoors if possible.
• If you are applying other products to the skin, double check with your pharmacist about which product to use first. For example, sunscreen should be applied first before applying insect repellent.
• If you use prescription medications, such as certain skin creams or blood pressure medications, check to see if they can make you more sensitive to the sun. If you're not sure, ask your pharmacist.

If, despite being careful, you still get a sunburn, treat it as you would any other kind of burn:

• Apply cool, wet compresses for 24 to 48 hours.
• Don't apply skin creams within the first two days.
• Drink a lot of water to keep from feeling dehydrated.
• You can use over-the-counter painkillers such as acetaminophen or ibuprofen if there is some minor pain or discomfort due to the burn.

Very severe burns, the kind that produce blisters, are often treated in clinics with dressings. If you're not sure if your burn is severe, have it checked. Do not break burn blisters yourself, as this can lead to a skin infection if not properly treated.

For more information, read our condition factsheet on sunburn

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Water fun

Spending a week at the cottage, going fishing or sailing, or just having fun in your backyard pool can make for a great summer. But water needs to be treated with respect or accidents can happen. By paying attention to certain safety rules and by knowing what to do in case of an emergency, you will greatly reduce your risk of accidents.

Every year, we hear tragic stories of children who escape even watchful eyes and drown in a swimming pool, lake, or river. The sad part is that most of these accidents could have been prevented if certain safety precautions had been followed. These include:

• Never leave a child alone in or around water. Don't leave to answer the phone, even if it's just for a moment. Accidents can happen in the blink of an eye.
• Fence the pool area with self-latching/locking gates.
• Keep safety equipment such as a life preserver and a "shepherd's hook" (long pole with a hook on one end) close by at all times.
• Have life jackets available for use, especially in children's sizes. While water wings can be helpful in aiding a swimmer to stay afloat, they do not prevent drowning if the swimmer is face down in the water.
• Encourage swimming lessons for all children, but don't rely on them for "drown-proofing."
• Don't allow running or rough-housing on the pool deck.
• Unless your pool is deep enough, don't allow diving. Water should be at least 9 feet (2.7 metres) deep to permit diving from the poolside, and at least 12 feet (3.7 metres) deep if there's a diving board.
• Learn cardiopulmonary resuscitation (CPR).
• If you're having a party, make one adult responsible for the kids and the water area. Accidents have happened when people thought others were watching the children.

People who like to dive find lakes and swimming very tempting, but diving can be dangerous unless the area is deep enough. A dive in water that's too shallow can result in a broken neck or other serious injuries. Don't assume that an area is safe, even if it's been so in the past. Water levels in rivers and lakes can change, so always check first. To dive safely, you need a minimum of 9 feet of clear, unobstructed water – more if you're diving from an elevated position. Jump in feet first before any diving to check it out and make sure it's okay.

If you enjoy boating, don't forget your life jackets – and wear them. A boat can flip for many reasons, but if you're prepared, you'll probably be safe. Having a life jacket under the seats won't prevent you from drowning.

Finally, don't drink alcohol and operate a boat. Drunk drivers can cause fatal accidents whether they're operating a car or a boat. Even one drink can affect your awareness and reaction time. Don't get in a boat if the person taking the wheel has been drinking.

How to protect yourself against West Nile Virus

Are you heading to the cottage this summer or planning on camping? Worried about being exposed to the West Nile virus? The risk of becoming infected with the West Nile virus is greatest during mosquito season. In Canada, this can start as early as mid-April and last until late September or October. Here are suggestions to help you avoid mosquitoes:

• Apply a bug repellent that contains no more than 30% DEET (chemical name N,N-diethyl-meta-toluamide) to your clothes:
• Adults can also apply 30% (or less) DEET-containing repellent to any exposed skin, but children should use the least concentrated DEET products (less than 10%).
• Children should not have DEET-containing repellent on their face or hands.
• Children under 2 years of age should usually not have DEET applied to clothes or skin. In situations where there is a high risk of complications from insect bites, repellent containing 10% or less DEET may be applied once daily for children aged 6 months to 2 years. Infants under 6 months of age should not have DEET applied to their skin or clothes.
• Children between the ages of 2 and 12 years can use insect repellent containing less than 10% of DEET - it can be applied up to 3 times per day.
• Products with a lower concentration of DEET are just as effective as higher-concentration products, but they remain effective for a shorter period of time.
• Apply DEET sparing to exposed skin or on top of clothing (not under clothing).
• Do not apply DEET to open wounds or to skin that is irritated or sunburned.
• Avoid getting DEET in the eyes (for this reason, it is recommended not to put DEET on children's hands) - flush the eyes immediately with water if this happens.
• There are no data to suggest that DEET is harmful for pregnant or breast-feeding women. However, these women may want to use non-chemical methods (such as protective clothing and avoiding times and places where mosquitoes are likely to be present).

• Wear light-coloured clothes, including long-sleeved shirts and pants. Mosquitoes tend to be attracted to dark-coloured clothes.
   
• Minimize your time outside from dusk to dawn, which are peak periods when mosquitoes are most active. Enjoy the summer weather inside a screened-in patio or enclosure during these hours.
   
• Make sure there is no stagnant water (including bird baths) or standing water on your lawn. As part of your spring and summer lawn cleanup, regularly (twice a week) drain rain barrels, bird baths, swimming pool covers, eavestroughs, flowerpots, and planters. Keep wheelbarrows and wading pools overturned when not in use. The most common places for mosquitos to nest are bird baths, old tires, unused containers, flower-pot saucers, swimming pool covers, wading pools, clogged gutters and eavestroughs, clogged drainage ditches, and unused children's toys.
   
• Around your yard and lawn: Throw away lawn cuttings, raked leaves, and fruit or berries that fall from trees immediately. Place them in sealed garbage bags. Turn over compost piles regularly, and remove dense shrubbery, where mosquitoes are liable to breed and rest.
   
• Purchase an aerator or ornamental pond that keeps the surface water moving. This environment will be less attractive for mosquito larvae.
   
• Check all your window and door screens for holes.
   
• Doing some barbecuing this summer? There are products available at some camping stores that repel mosquitoes by emitting sounds that imitate the sounds of the mosquito's natural enemies.
   
• Environmentally friendly ways to reduce mosquitoes include installing bat- and birdhouses and encouraging species such as dragonflies, frogs, and beetles.
   
• Natural oil-based repellents using plant-based ingredients are available. Oil of lemon eucalyptus has been found to be as effective as DEET when used at similar strengths. Other plant-based repellents, such as citronella or soybean oil, may be used. Keep in mind that they are not as effective as chemical-based repellents, that products containing essential oils need to be tested for skin sensitivity, and that they need to be applied frequently. In general, they are more appropriate if you are spending less than 30 minutes outside. Not all products may be safe for young children. Check with your doctor or pharmacist for more information.

For more information on mosquito-proofing your home, visit Health Canada at www.hc-sc.gc.ca.

Touring and travelling tips

One of the best parts of summer is having the time to do some of the things you really enjoy. This can mean long bike rides, playing football, golfing, camping, hiking, and all kinds of fun activities. Whichever ones you and your family are involved in, you'll have more fun and be safer if you prepare ahead of time and try not to overdo it.

To stay healthy, it's important to take precautions. Some examples are:

• While walking and taking in the sights, be sure to drink plenty of water to stay hydrated. Don't wait until you start to feel thirsty – the need for water starts before you're aware of it. On average, try to drink a cup (240 mL) of water about 15 minutes before starting out, and then, depending on how hot it is and how fast you're walking, drink 4 to 8 ounces (120 mL to 240 mL) every 15 to 20 minutes. Consider keeping a sports drink handy to help replenish lost electrolytes from excess sweating.
• Stay out of the sun during the hottest times (usually between 11 a.m. and 4 p.m.) and cover up when in the sun.
• If cycling, wear a proper bicycle helmet.
• Stretch before and after physical activities to avoid muscle cramps and soreness.

If you're driving places, be sure your children are buckled up in an approved car seat or booster seat. Don't forget to buckle up yourself!

If you take prescription medications, be sure to have enough on hand when you travel, plus a bit extra in case of delays. If you're travelling by air, don't pack your medications in your check-in luggage – luggage may get delayed or lost. Many people recommend not packing them in luggage at all, no matter how you travel, in case your bags get lost or stolen. Be sure to keep the medications in their original containers, especially if you're crossing borders. Not only is this the safest thing to do to avoid medication mix-ups, but it also shows border inspectors what medications you're carrying with you in case you're questioned about them.

For some families, travelling and touring means camping and hiking. Enjoying the outdoors can have a few risks, however; take some simple precautions so you won't have to cut your vacation short.

Bug bites:

• Mosquito bites, although not serious for most people, can be uncomfortable. Prevent bites by using insect repellant or oil of lemon eucalyptus on your skin, placing citronella candles around you, and covering as much skin as possible. Avoid being outside at sundown, when mosquitoes are at their worst, and stay away from areas of stagnant water – breeding grounds for mosquitoes. If you do get bitten, antihistamine pills or lotions can help with the itch, as can applying a cool compress to the swollen area.
   
• Stinging insects are a common outdoor problem both at home and away, and unfortunately, they aren't deterred by insect repellants! Wasps love sweet food, so keep foods and drinks covered while outside and don't wear sweet-smelling perfumes or hairsprays. Bees travel in a straight line back and forth from their hives; avoid getting in their line of flight. Don't allow children to disturb nests or hives – many children have been stung after throwing rocks at nests. If you do get stung, check to see if the stinger is still in the skin (bees sting only once, leaving their stingers), but don't pull it out because this allows more venom to escape. Gently scrape it off with a flat object like the dull edge of a knife or the edge of a credit card. For pain and swelling, try applying a paste of baking soda and water. For itching and swelling, use an antihistamine cream. If the bitten area swells up quite a bit and turns red and antihistamines don't help, consider seeking medical attention.
   
• Deer ticks are a major concern in some parts of North America because they can be Lyme disease carriers. Found most commonly in the American Northeast, Midwest, and West, these ticks hide mostly in shady, tall grass, although they can be found in shrubs, lawns, and gardens as well. To avoid being bitten by a tick, wear long pants tucked into socks or boots to keep ticks off your legs. Wear closed-toe shoes (no sandals). After your hike, check your body for ticks, especially the insides of knees and elbows and the neck just below the hairline. If you find a tick, don't panic! Don't grab at it or squeeze it off. Instead, using small tweezers, grab the tick by the head and pull it out, then kill it by placing it in alcohol. Don't cover it with anything or try to kill it while it's on the skin, as this could release more toxin. Once the tick is removed, watch the site for a rash – it can begin up to one month following the bite. If you're concerned, call your doctor.

Food smarts

Friends, family, and food play a large role in summer fun. Barbecues, picnics, and family get-togethers can provide us with some great memories. But summer heat can play havoc with some of our food – a delicious steak or burger (or even a cool salad) can be a breeding ground for bacteria. It's important to take some simple precautions to avoid getting sick from bacteria that can spoil our food.

The most basic rule of food safety is simple: hot food should be hot and cold food should be cold. If you're transporting hot food to another location, the safest way is to cool it down completely (in the fridge), keeping it cool in transit (in a cooler), and warm it up at your destination. If that's not possible, the food should be warmed up and then kept in a thermos-type container or something that helps retain heat. Cold food should be kept in coolers, out of the sun and inside the car with the passengers rather than in a hot trunk. Full coolers stay cold longer than empty ones, so pack it as full as possible (or use the appropriate size cooler for the amount of food). Items that need to be kept cold should be kept below 4.4°C (40°F).

When barbecuing, be sure that all meat is thoroughly cooked. The best way to check if meat is cooked enough is with a meat thermometer – don't go by how the food looks. Use one set of utensils to put the uncooked meat on the barbecue and a clean set to remove the cooked meat. Using separate utensils prevents transferring bacteria from the raw meat onto the cooked food.

General temperature guidelines are:

• hamburgers and ribs: 71.1°C (160°F)
• hot dogs: 73.9°C (165°F)
• all poultry (ground, breast, whole, thigh): 73.9°C (165°F)
• ground meat: 71.1°C (160°F)
• pork, beef, lamb and veal (pieces, or whole cuts): 62.8°C (145°F)

If you're camping or hiking near water, no matter how crystal clear the water looks, it's not a good idea to drink it without treating it because it may have bacteria that can make you sick. Be sure to take some water purification tablets with you if you plan on drinking water from streams.

Finally, protect yourself and your campsite by storing your food in animal-proof containers such as sealed plastic coolers. Don't leave food on picnic tables or in your tent. This is an open invitation to the local wildlife to help themselves!