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Glenn D. Braunstein, M.D.

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Surfer Dude Health Hazards -- Just When You Thought It Was Safe To...

Posted: 05/24/10 06:13 PM ET

If you're a surfer kid from California, every season is surfing season. But with summer on the way, the waves are likely to get a lot more populated in the coming weeks, and moments of exuberance and bliss along the coastline can be ruined by heath hazards that lurk beneath the surface of even the most beautiful waters.

Ocean Creatures
Besides sharks, the ocean has plenty of critters that can be hazardous to a surfer's health. Top among them are coelenterates, which are animals like jellyfish and stingrays that have dangling tentacles with venom-filled cells that inject toxins in response to chemical or mechanical stimuli. Because coelenterates are bottom-dwelling creatures, surfers are usually advised to shuffle their feet as they enter or leave the water. Stings from these animals can produce burning pain, redness, swelling, elevated patches of redness, itching and blistering. Wet suits can protect surfers, but some coelenterates can sting though the insulating material. Stings may cause puncture wounds or lacerations, usually in the lower extremities and result in pain disproportionate to the wound's appearance. Hot water immersion of the affected area is generally recommended, as it deactivates the toxin. Again, it's important to remove retained animal parts. As for those pesky sharks, though the chances of being attacked by one is small compared to other hazards, it's still important to keep eye out, and surf with a friend or in populated areas.

Structural Injuries
Sprains, muscle strains, dislocations and fractures are among the most common types of surfing injuries. As in any sport, these inflictions can occur from over-exertion, fatigue or incorrect form. Surfers, however, face an increased risk of these types of injuries due to the inevitable encounters with rocks, reefs, and even the plants and animals that live on them. Should any of these injuries occur, it is best not to ignore them and attempt to "ride through the pain." That would only make the injury worse. See a medical professional and follow the prescribed treatment plan. You might be beached for a bit, but proper rest and treatment will prevent the injury from becoming a chronic problem.

Infections
Lacerations are also common, but can be further complicated by infection from the stunning array of bacteria present in marine life. Because lacerations can occur from multiple sources, they should be cultured to determine if the wound warrants antibiotic treatment or if the surfer should receive tetanus immunization. If the laceration occurred in conjunction with a sting from a marine animal, it's important to make sure the stinger or any foreign body has been removed to prevent further release of toxins.

Fungal species like aspergillus and Candida can cause ear infections, especially in people with diabetes. These infections can be treated with topical antibacterial drops for five to seven days

Water Quality
Coastal waters can have high levels of bacteria, like E. coli and other pollutants, which multiply after storms. Waiting a few days afterward is usually recommended, as well as checking water quality advisories at the beach and online.

Skin Conditions
Because of increased sun exposure, surfers have a higher incidence of basal-cell skin cancer. Using sunscreen with ultraviolet A and ultraviolet B protection is important. Also try to avoid sun between 10:00 am and 4:00 pm, and wear protective clothing. For more tips on staying safe in the sun, see my previous post here.

Surfers are also particularly vulnerable to Sunbather's Eruption, which occurs with exposure to the larvae of certain coelenterates. It causes extreme itchiness and a rash that can last from two to 28 days, and in children can cause fever, nausea, vomiting and headache. Topical steroids and oral antihistamines are typically used to treat Sunbather's Eruption, but it's important to see a physician for the proper treatment plan.

Ear Problems
Surfer's Ear, also known as auditory exostosis, is bone growth in the ear canal caused by the cooling effect of cold water and wind. Cold-water surfers are more prone to this than warm-water surfers. Consistent use of earplugs helps prevent these bony growths from forming. Nevertheless, if you have pain, popping or crackling in your ear, impaired hearing or water trapped in the inner ear, see a medical professional.

Tympanic membrane eruption is another problem that occurs when a surfer is struck by a strong wave or hits the water with sufficient force after a fall. This condition causes ear pain, conductive hearing loss, tinnitus, vertigo and bloody discharge from the ear. Most ruptures heal spontaneously, but infection is common, and can be treated by a short course of topical antibiotic.

Hypothermia
To protect against hypothermia, which is a life-threatening lowering of the body's core temperature from exposure to cold, make sure you have an appropriate wetsuit and other heat retaining clothing. Remember that water conducts heat away from the body 25 to 30 times faster than air, and don't overdo exposure to the cold by staying out too long.

So, as you paddle out to those waves, be careful, be smart, and most importantly, have fun!