There were a number of chronic medical conditions listed for the 10 percent of sick campers reporting them. The order was: 33 percent allergic 20 percent cardio-respiratory 15 percent endocrinologic 13 percent inflammatory or infectious 13 percent miscellaneous 3 percent mechanical 2 percent gastrointestinal 1 percent musculo-skeletal 1 percent psychiatric Types of illness.-The most common illness affecting campers was an upper respiratory infection or cold, and this was the diagnosis for 30 percent of the illness reports. Other types of problems included: 8 percent earache or infection 6 percent gastroenteritis 4 percent poison oak or ivy 4 percent insect tibe 3 percent rash, hives 3 percent psychological disorders (including homesickness) 1 percent strep throat 1 percent conjunctivitis 1 percent dental 1 percent athletes' foot 1 percent asthma 1 percent hay fever 9 percent miscellaneous The illness remained undiagnosed in 2 percent of the cases and a quarter of the patients suffered from vague conditions such as headache, fatigue, or abdominal pain. Treatment. The camp infirmary or first aid station treated 94 percent of the illnesses. For 2 percent, no treatment was required, and 5 percent were treated in hospitals or physicians' offices. The types of treatment included: 23 percent topical antiseptic-antibiotic 20 percent anti-inflammatory/analgesic 13 percent supportive (bed rest, physiotherapy) 11 percent gastrointestinal 9 percent antihistamine decongestant 5 percent antibiotic 1 percent bronchodilators Laboratory work was done for only 3 percent of the illnesses. Only 3 percent of the campers had to be sent home because of illness. Restricted activity was ordered for 20 percent while 75 percent were able to return to full activity. These percentages are based on the 4,099 forms on which this information was noted. No information or disposition was provided on half of the forms and it is quite possible that most of these were for minor illnesses and hence indicated return to normal activity. Thus, 75 percent is probably an underestimation. It was not considered necessary to notify parents or guardians for 89 percent of the illnesses. It is obvious that most of the illnesses reported to the infirmary are minor and require limited treatment and restriction. Health rules and illness.-It was found that the illnesses were related to rule violations in only 1 percent of the cases. These violations included: 28 percent not using ear drops after swimming 14 percent not avoiding poison ivy 14 percent not obeying curfew 10 percent not reporting illnesses immediately 10 percent withholding or giving wrong information on the medical form 7 percent not wearing shoes 7 percent indulging in horseplay 3 percent not keeping head-to-foot bunk arrangement 3 percent not taking soap shower after hiking In 3 percent of the cases, camp environments or operations were changed following a particular illness. The changes made were reported as: 20 percent rest periods increased 16 percent supervision or further training in good hygiene 15 percent bunks rearranged 12 percent poison ivy destroyed 11 percent ill campers isolated 6 percent activities, attention increased 6 percent kitchen hygiene improved 6 percent miscellaneous other (better food, purified water, etc.) 5 percent hives or insect sprayed or removed 5 percent pool checked, chlorine increased 5 percent alcohol or ear drops used in ears after swimming 2 percent gargling for all campers 1 percent salt tablets given during heat spell Environmental survey Water supply.-It was found that most youth camps do not use a municipal water supply. Of those surveyed, 88 percent were supplied by some other source. For a private source, 89 percent used wells. Figure 27 shows that twice as many camps in the South/East group had a municipal supply as those in the West group, and that more Law group camps than Comparison camps were municipally supplied. Over half the camps with private water supply did not treat the water in any way as shown in Figure 28. More Comparison camps treated their water than camps in the Laws group. Chlorination was used by 27 percent of the camps and of those employing this method, 38 percent kept daily logs of the chlorine residuals. Very few camps (6) used gas chlorination. The private water sources were found to be in an unsatisfactory location in 8 camps, and poorly protected in 21 percent of those inspected. Over a quarter of the West group had a poorly protected supply. None of the camps in the Comparison group had supply systems that were considered deficient in any way except for three camps with reported unsatisfactory source locations. Table 10 shows that only 4 percent of the camps had no check on the bacterial content of their water supply. One analysis a year was reported by 30 percent of the camps and a fifth had 2 to 5 checks a year. TABLE 10.-NUMBER OF BACTERIOLOGICAL ANALYSES OF CAMP WATER SUPPLY Sewage disposal.-Most of the camps (88 percent) did not use a municipal system for disposing of their sewage, as shown in Figure 29. More South/East camps than those in the West (12 vs. 4 percent) and more Law camps than Comparison (8 vs. 2 percent) were connected to a municipal system. For those using a private disposal system. 87 percent had septic tanks. The capacity of the tanks was larger for the Laws camps (median 5,500 gallons) than for the Comparison group (median just under 2,000 gallons). Almost a quarter of the camps used pit privies to some extent; 30 percent of the West group and 29 percent of the Comparison had pit privies. Since many of the camps had septic tanks, it was not surprising that 83 percent reported no further treatment of their sewage. Figure 28. Percentage of camps with private sources of water which do not treat their water and which treat it by chlorination. Only 5 percent of the camps discharged their sewage within a mile of their water source. Offensive odors around privies and sewage treatment areas were noted in 15 percent of the West camps, twice the average for the camp total. Insects and rodents around these areas also were observed more often in the West, although there were only nine camps where they were noted. Of the camp total, 7 percent were found to have sewage on the ground near septic tanks. Excessive weeds in the treatment area were noted more often for the Laws caLips (10 vs. 0-5 percent for the other groups). Solid waste disposal.-Off-site disposal for a portion of the camps' solid wastes was reported for 86 percent of the camps as shown in Table 11. Only 12 percent of the Laws group disposed of any waste on site contrasted to 22 percent of the Comparison group, 42 percent of the South/East group and 31 percent of the camps in the West. Methods of on-site disposal were often used in combination, the open dump being one common solution (37 percent). However, only one camp in the Comparison group used a dump. One fifth of the camps with on-site disposal used sanitary landfill. TABLE 11. PERCENTAGE OF CAMPS USING EACH OF SEVERAL METHODS OF SOLID WASTE DISPOSAL Insects and rodents were observed around the disposal areas in more West and South/East camps than Laws or Comparison camps, but the first two groups had a higher frequency of on-site disposal and perhaps this contributed to the greater infestation rate. However, only 11 camps were observed to have this problem. Trash was stored in covered metal containers by 50 percent of the camps. None of the Comparison group used uncovered containers, although 10 percent of the Laws group, 13 percent of the West, and 20 percent of the South/East camps stored trash in that fashion. Trash collections for off-site disposal were made more than twice a week for 48 percent of the camps; 31 percent had twice a week collections and only 9 percent, once a week, as illustrated by Figure 30. Camp site.-One problem in analyzing the data on camp site and facilities is that the Western group of camps were inspected for defects more frequently than the other groups, There were consistently fewer Western camps for which "no answer" or "not inspected" were checked. Therefore, the percentages listed in these sections are based on the number of camps inspected rather than the total number of camps in each group. Very few camps were observed to have site defects of any sort. Only 5 camps had drainage problems. Proximity to a swamp or dump was a problem for 15 percent of the inspected South/East camps, but this percentage refers to only 5 camps. Loose trash also was observed more often in the South/East camps (19 percent) than in the other groups. Six (14 percent) of the Western camps were reported to have sharp structural objects and 20 percent (9 camps) had hazardous grounds or trails. The only equipment that received many bad marks were trash containers. One-fourth of the camps were judged poorly equipped in that respect. Camps in the West group were the only ones to have improperly constructed or located fire pits (24 percent). |