Category Archives: Injury Prevention
American College of Preventive Medicine Releases Recommendations to Curb Texting While Driving
The American College of Preventive Medicine (ACPM) has released guidelines aimed at reducing death and injuries linked to texting while driving. According to the National Highway Traffic Safety Administration, 12 percent of all fatal crashes involving at least one distracted driver are estimated to be related to cell phone use while driving. “Given the combination of visual, manual and cognitive distractions posed by texting, this is an issue of major public health concern for communities,” the ACPM said it its statement. The guidelines include:
- Encourage state legislatures to develop and pass legislation banning texting while driving, while simultaneously implementing comprehensive and dedicated law enforcement strategies, including penalties for these violations.
- Legislatures should establish a public awareness campaign regarding the dangers of texting while driving as an integral part of this legislation.
- Promote further research into the design and evaluation of educational tools regarding texting while driving that can be incorporated into the issuance of driver’s licenses.
- Provide primary care providers with the appropriate tools to educate patients of all ages.
- Conduct additional studies investigating the risks associated with cell phone usage while driving—particularly texting—with motor vehicle crashes.
Read more on injury prevention.
Skin Cancer Costs Rise
The costs associated with skin cancer increased five times as fast as treatments for other cancers between 2002 and 2011, according to a study by researchers at the U.S. Centers for Disease Control and Prevention (CDC) and published in the American Journal of Preventive Medicine. The average annual cost for skin cancer treatment increased from $3.6 billion during 2002-2006 to $8.1 billion during 2007-2011, or 126 percent. The average annual cost for treatment of all other cancers increased by 25 percent during the same time period. “The findings raise the alarm that not only is skin cancer a growing problem in the United States, but the costs for treating it are skyrocketing relative to other cancers,” said the lead author of the report, Gery Guy, PhD, of the CDC’s Division of Cancer Prevention and Control. “This also underscores the importance of skin cancer prevention efforts.” Read more on cancer.
Childhood Obesity Often Continues into Teen Years
A new study published in the journal Pediatrics reviewed data on close to 4,000 public school students who were measured for height and weight in 5th and 10th grades. In 5th grade, one percent of students were underweight, 53 percent were normal weight, 19 percent were overweight and 26 percent were obese. Sixty-five percent of obese 5th-graders remained obese in 10th grade, 23 percent transitioned down to overweight and only 12 percent became normal weight. The study found that obese 5th graders were more likely to remain obese in 10th grade if they perceived themselves to be much heavier than ideal or came from a less-educated household. However, overweight 5th-graders were more likely to become obese by 10th grade if they had an obese parent or watched more television. The study authors say obese children face many challenges in reducing obesity in adolescence and that health care professionals should be encouraged to educate parents and caregivers to address obesity at a very young age, including advice on healthy eating and physical activity. Read more on childhood obesity.
Deaths and injuries from falls in people older than age 65 have doubled in the last decade. Last year, 24,000 older people died after a fall and more than two million sustained severe injuries—which can often lead to permanent disability. To find ways to prevent those falls and the injuries, deaths and costs that come with them, earlier this year the National Institutes of Health (NIH) and the Patient-Centered Outcomes Research Institute (PCORI) joined forces on the Falls Injuries Prevention Partnership, which will fund clinical trials at ten U.S. centers over the next five years.
The trials include some implementation of proven fall prevention strategies at the ten research sites. NIH researchers say a key goal is to help change physician behavior about fall prevention, because recent education efforts through conventional medical education channels and other methods have not been very effective.
“With this trial, we will be able to evaluate interventions on a comprehensive and very large scale,” said Richard J. Hodes, MD, director of the National Institute on Aging, which is a division of NIH. “This study will focus on people at increased risk for injuries from falls, the specific care plans that should be implemented—including interventions tailored to individual patients—and how physicians and others in health care and in the community can be involved.”
Each person in the trial will be assessed for their risk of falling, and receive either the current standard of care—information about preventing falls—or individualized care plans first shared with the trial participant’s primary care physician for review, modification and approval. They will include proven fall risk reduction interventions that can be implemented by the research team, physicians and other health care providers, caregivers and community-based organizations.
The trial directors hope to enroll 6,000 adults age 75 and older who have one or more risk factors for falls. The first year of the study is a pilot phase; if the go-ahead is given by NIH and PCORI to proceed with the study after that, enrollment for the full trial will start in June 2015, with participants followed for up to three years. The main goals of the trial are reductions in serious injuries from falls.
“With active input from patients and other stakeholders from the very beginning of this study, we think we can have a major impact, changing practice to make a real difference in the lives of older people,” says PCORI Executive Director Joe Selby, MD, MPH.
The ten trial sites and regions they serve are:
- Essentia Health, Duluth, Minnesota (Midwest)
- HealthCare Partners, Torrance, California (Southern California)
- Johns Hopkins Medicine, Baltimore (Mid-Atlantic)
- Mount Sinai Health System, New York City (Northeast)
- Partners HealthCare, Waltham, Massachusetts (Northeast)
- Reliant Medical Group, Worcester, Massachusetts (Northeast)
- University of Iowa Health Alliance, Iowa City (Midwest)
- University of Pittsburgh Medical Center (Mid-Atlantic)
- University of Texas Medical Branch, Galveston Health (Southwest)
- University of Michigan, Ann Arbor (Midwest)
Data management and analysis will be coordinated by the Yale School of Public Health.
EBOLA UPDATE: UN’s Secretary-General Calls Travel Bans ‘Unnecessarily’ Strict
(NewPublicHealth is monitoring the public health crisis in West Africa.)
U.N. Secretary-General Ban Ki-moon again came out strongly against travels bans related to Ebola, calling them “unnecessarily” strict in a Monday news conference. Some U.S. state officials have imposed quarantines on health workers returning from West Africa, but there is no federal ban; Canada and Australia have barred citizens from Liberia, Sierra Leone and Guinea. "The best way to stop this virus is to stop the virus at its source rather than limiting, restricting the movement of people or trade," said Ban, according to Reuters. "Particularly when there are some unnecessarily extra restrictions and discriminations against health workers. They are extraordinary people who are giving of themselves, they are risking their own lives." Read more on Ebola.
HUD Accepting Cities’ Applications for Economic Revitalization Assistance
The U.S. Department of Housing and Urban Development (HUD) is now accepting applications for cities looking to spur economic revitalization through the National Resource Network, which brings together national experts to work with cities to improve economic competiveness while reversing population decline, job loss and high poverty rates. “Knowledge is fuel for progress and innovation,” said HUD Secretary Julián Castro, in a release. “The National Resource Network will be a valuable tool in helping local governments address their challenges and achieve their goals. It will provide on-the-ground technical assistance and human resources that cities can use to build for the future.” Eligibility is based on economic and demographic criteria, with approximately 275 cities eligible to apply. Read more on community development.
Study: High School Football Players Need More Education on Concussion
More needs to be done to educate high school football players on the dangers of concussions, according to a new study in the Journal of Athletic Training. Researchers surveyed 334 varsity players from 11 Florida schools. Based on a written questionnaire, while most know that headache, dizziness and confusion were potential concussion signs, they did not know the link to other signs such as nausea, neck pain and difficulty concentrating. In addition, 25 percent said they had no education about concussions at all. "Our results showed that high school football players did not have appropriate knowledge of concussion. Even with parents or guardians signing a consent form indicating they discussed concussion awareness with their child, nearly half of the athletes suggested they had not," study co-author Brady Tripp, from the University of Florida, said in a National Athletic Trainers' Association news release. Emergency rooms treat more than 300,000 people for brain injuries related to sports each year. Read more on injury prevention.
Over the weekend, NewPublicHealth conducted an email interview with Tarik Jasarevic, a spokesperson for the World Health Organization (WHO), on Ebola efforts on the ground in West Africa and the impact on the global effort of the cases recently diagnosed in the United States.
NewPublicHealth: Is there concern among global health leaders that the attention on a handful of cases is taking away attention from the thousands of cases in West Africa?
Tarik Jasarevic: While countries need to be vigilant and prepared for a possible case of Ebola, we need to focus on getting all possible resources—trained health workers, medical facilities with beds and money—to the affected countries in West Africa.
NPH: Several weeks ago global health leaders had a checklist of things, including money and personnel, needed to stem the outbreaks in the various countries. Where do things stand now, and what is still needed?
Jasarevic: We need a lot of resources if we’re going to get the virus under control. WHO and partners constructed 12 Ebola Treatment Centers in Liberia, 15 in Sierra Leone and 3 in Guinea—30 out of the 50 that are needed. These facilities contain more than 1,100 beds for patients, out of the more than 4,000 needed. There are more than 2,500 beds becoming available in the next few weeks, but we still need more. We also need international health workers to come work alongside national health workers to manage and run the health facilities. WHO has set up “training academies” in each of the affected countries to train more local health workers, but more are needed.
NPH: What is the current fatality rate?
Jasarevic: The fatality rate for this particular outbreak has always been approximately 70 percent. We are seeing higher numbers of cases and deaths because of the geographic spread of the disease, from urban city centers to rural, hard to reach villages. There is also significant under reporting of cases in the three countries, especially Liberia.
CDC Updates Guidelines on Health Worker Protective Gear when Treating Ebola Patients
The U.S. Centers for Disease Control and Prevention (CDC) announced last night that it is tightening its infection control guidance for health care workers caring for patients with Ebola, with a specific focus on several key steps:
- All health care workers must undergo rigorous training and become practiced and competent with protective equipment, including taking it on and off in a systemic manner.
- No skin exposure is allowed when the equipment is worn.
- All workers must be supervised by a trained monitor who watches each worker taking the equipment on and off.
The CDC is recommending all of the same equipment in its earlier guidance, with the addition of coveralls and single-use, disposable hoods. Single-use face shields are now recommended instead of goggles. Read more on Ebola.
Most People Polled Don’t Know New ACA Enrollment Period Begins in November
A poll just released from the Kaiser Family Foundation finds few people know that open enrollment for 2015 health insurance coverage under the Affordable Care Act begins next month. Other findings of the poll:
- Two-thirds of responders say they know “only a little” or “nothing at all” about the marketplaces where people who don’t get coverage through their employers can shop for insurance.
- Just over half say they know that financial assistance is available to help low- and moderate-income individuals purchase insurance.
Risk Factors for Sexual Assault Need to be Included in Prevention Efforts
Researchers who conducted a Danish study on sexual assault say that certain risk factors for the attacks—including the age of the victim and their prior relationship with the attacker—must be considered when developing strategies to help prevent sexual assaults. The researchers looked at data from more than 250 women who sought help at a Danish center for sexual assault victims between 2001 and 2010. The researchers found that 66 percent of the women were 15-24 years old and 75 percent had met their attacker before the assault. Nearly half of the women reported that the attacker was a current or former boyfriend, a family member or someone they considered a friend. Women who did not know their attacker previously were more likely to report the assault to the police. “We need to raise awareness of the fact that most sexual assaults are perpetrated by someone known to the woman, often in familiar surroundings ... in order to change the general attitudes towards sexual assault, this information should not only target young people, but also the police, health care professionals and the general public,” said Mie-Louise Larsen, of the Centre for Victims of Sexual Assault and the University of Copenhagen and a coauthor of the study, which appeared in BJOG: An International Journal of Obstetrics and Gynaecology. Read more on injury prevention.
Positive Images Improve Function in Older Adults
Older individuals who are subliminally exposed to positive stereotypes about aging showed improved physical functioning that can last for several weeks, according to work done by researchers at the Yale School of Public Health. The study, which will be published in Psychological Science, included 100 older individuals with an average age of 81 years. Some participants saw positive age stereotypes on a computer screen that flashed words such as “spry” and “creative.” Those participants who were exposed to positive messaging displayed both psychological and physical improvements but control participants did not. Read more on aging.
EBOLA UPDATE: Kaiser Infographic Lays Out the Key Statistics
(NewPublicHealth is monitoring the public health crisis in West Africa.)
A new infographic on the current Ebola outbreak produced by the Kaiser Family Foundation and published in the Journal of the American Medical Association breaks down the crisis into key elements, including the disease count so far, the rate of response and the key U.S. government agencies charged with addressing the outbreak. Key numbers include:
- Fatality rate — 53 percent which is lower than in previous outbreaks
- Outbreak geography — In the current outbreak, five West African countries that have never had Ebola cases are now battling the disease including Guinea, Liberia, Nigeria, Senegal and Sierra Leone
- U.S. agencies responding — Department of Defense, Department of States, U.S. Agency for International Development, Centers for Disease Control and Prevention, the Food and Drug Administration and the National Institutes of Health
The World Health Organization also maintains a dedicated Ebola information website that is updated frequently and includes case counts, studies, policy announcements and feature stories about aid in West Africa. Read more on Ebola.
CDC: 2.5M Emergency Department Visits for Vehicle Crashes in 2012
Motor vehicle crashes sent more than 2.5 million people to emergency departments (EDs) and led to more than 200,000 people being hospitalized in 2012, according to a new report from the U.S Centers for Disease Control and Prevention (CDC). All told, the lifetime medical costs for these crash injuries will be $18 billion and the lifetime work lost will be an estimated $33 billion. “In 2012, nearly 7,000 people went to the emergency department every day due to car crash injuries,” said CDC Principal Deputy Director Ileana Arias, PhD, in a release. “Motor vehicle crash injuries occur all too frequently and have health and economic costs for individuals, the health care system, and society. We need to do more to keep people safe and reduce crash injuries and medical costs.” Read more on injury prevention.
Task Force Recommends Diabetes Screening for All Americans Over Age 45
Everyone over the age of 45 should be screening annually for type 2 diabetes and prediabetes, according to new recommendations from the U.S. Preventive Services Task Force. "For people with abnormal blood sugar, changes in their lifestyle, such as eating healthier and exercising more often, can help prevent or delay the onset of type 2 diabetes,” said Michael Pignone, MD, a task force member, in a release. “The best way to do that is to participate in a program that supports these behaviors. That's why we're recommending that people who are at increased risk be screened." According to the U.S. Centers for Disease Control and Prevention, approximately 29.1 million Americans have diabetes, although 8.1 million of those cases are undiagnosed. Read more on prevention.
In connection with Domestic Violence Awareness Month, held each October, the U.S. Centers for Disease Control and Prevention (CDC) recently issued a stark report which found that sexual violence not only results in high rates of injury and death, but also other long-lasting and even lifetime health impacts. To best share the specifics of the report, the CDC created an infographic with the most striking numbers—including how many men are raped each year and how people under the age of five are sexually abused.
>>View the full infographic.
Perhaps most striking, the CDC found that a substantial proportion of U.S. female and male adults have experienced some form of sexual violence, stalking, or intimate partner violence at least once during their lifetimes.
Among the report’s recommended public health actions:
- Prevention of sexual violence must include the protection of young children.
- Strategies to prevent sexual violence must include strategies that address known risk factors for perpetration and emphasize changing social norms and behaviors by using bystander and other prevention strategies.
- Primary prevention of intimate partner violence should be focused on the promotion of healthy relationship behaviors and other protective factors, with the goal of helping adolescents develop positive behaviors before their first relationships.
>>Bonus Link: CDC’s Center for Injury Prevention and Control offers many resources on sexual violence prevention geared toward people of different ages and communities.
The New York Times recently reported on the deaths of two pedestrians killed by bicyclists in the city’s storied Central Park. New York City has recently ramped up efforts to reduce pedestrian deaths—with a focus on car crashes—but anecdotal and police reports in the city find that the growing number of walkers, skaters, cyclists, pedibikers and other people heeding advice to get out and move is resulting in more injuries and deaths. Other cities have also reported increases in accidents linked to increases in physical activity. NewPublicHealth recently reported on efforts launched this year by the U.S. Department of Transportation to prevent and reduce pedestrian injuries.
Several conferences this year—including the annual meetings of the American Public Health Association, the Transportation Research Board and New Partners for Smart Growth—will have sessions looking at pedestrian safety in the wake of communities creating new opportunities for residents to get exercise outdoors. And Sunday Streets, a growing program across the country, shuts down main city streets to give walkers free reign, often with a booth set up by departments of public health or safety on staying safe when sharing the roads.
Read the full story from the New York Times.
A one-of-its-kind pedestrian traffic walk signal recently turned heads in Portugal with a dancing figure that entertained people as they waited for him to tell them when it was safe to cross the street.
The signal—not planned for mass circulation anytime soon—was developed by the manufacturer Smart to advertise its cars’ safety features. And if it saves lives along the way, it’s in sync with the U.S. Department of Transportation (DOT), where the National Highway Traffic Safety Administration (NHTSA) has found that 4,432 pedestrians died in traffic crashes in 2011, up 3 percent from 2010. More than a quarter of the accidents resulting in death happened at traffic intersections, both at marked crosswalks and intersections with traffic lights. Andrea Gielen, PhD, head of the Johns Hopkins Center for Injury Research and Policy at Johns Hopkins University, says the school’s research shows that many of these accidents occur because pedestrians are distracted by music in their earphones or by speaking or texting on cellphones.
NHTSA began a campaign to keep pedestrians safer last year and highlights community projects that improve pedestrian safety in a stories section on its website on pedestrian safety. One project, developed at University of California, San Diego, was a presentation at a low-income elementary public school in San Diego, Calif. The English- and Spanish-language presentation demonstrated dangerous scenarios and how to prevent them, such as kids dressed in only dark clothing, which makes them difficult to see at night. NHTSA is updating the site regularly to help communities develop their own safe walking programs.
As for traffic lights themselves, makeovers could be ahead. The Transportation Research Board of the National Academies of Sciences has a traffic light subcommittee that presents new research on traffic signal safety at the board’s annual meeting each January. Upcoming topics of interest are likely to include computerized traffic signals that can respond to traffic flow by switching to green sooner when there’s no congestion ahead, as well as a recent study from the Massachusetts Institute of Technology (MIT) that found that traffic lights are easily hacked, which could lead to traffic jams and collisions. Preventing some of the hacking could be as simple as strengthening the passwords of the engineers who control the traffic signals, according to computer engineers at MIT.
Wendy Landman, executive director of the pedestrian advocacy group Walk Boston, says intersections could be safer if city agencies talked more. She said the deciding factor for how long a traffic signal should be green for pedestrians is often based on how quickly traffic experts think drivers want to be back on the gas pedal—but that may be too short for many pedestrians, especially at intersections on main roads.
>>Bonus Content: Read a previous NewPublicHealth interview with Andrea Gielen.
Frontline, the Public Broadcasting Service documentary series, has a unique football stats blog, Concussion Watch, which is now in its third year. The blog tallies—game by game—the number of National Football League (NFL) players sidelined by a possible concussion and how soon they return to play.
Based on tracking for the last two years, the blog predicts that 150 players will suffer concussions during the current season, which in many cases could lead to lifetime debilitating problems. This is despite new playing rules and ever-evolving helmets.
The impact of concussions on the players’ heath and lives is startling. Based on Concussion Watch data, 306 players have suffered a combined 323 concussions over the past two seasons. In half of the cases where a concussion occurs, players return to the field without having missed a single game. According to the blog, although there’s no standard recovery time for a diagnosed concussion, guidelines developed by the American Academy of Neurology and endorsed by the NFL Players Association indicate that athletes are at the greatest risk for repeat injury in the first 10 days after a concussion. And the more head injuries a person suffers, the more likely they may be to develop complications later on.
In fact, the NFL is due a decision by mid-October from thousands of league retirees on whether they will accept a proposed settlement in a class-action concussion case brought by more than 4,500 former players. Papers filed in the case show that the NFL expects more than thirty percent of all retired players to develop some form of long-term cognitive problem—such as Alzheimer’s disease or dementia—in their lifetime as a result of head injuries suffered during games. During the preseason and the first week of official play, 15 players suffered head injuries and 12 have already returned to their positions.