Category Archives: Injury Prevention
Less than a month ago cities in Oklahoma were struck by some of the most powerful tornadoes in the state’s history, killing more than 40 people, injuring scores more and destroying thousands of homes and other structures.
As part of an ongoing series on how public health responds to disaster, NewPublicHealth recently spoke with Gary Cox, director of the Oklahoma City-County Health Department.
NewPublicHealth: What roles has your health department had following the tornadoes?
Gary Cox: We do many things. For example, a lot of people are out cleaning up and come into contact with nails and other sharp objects and they get cuts and puncture wounds. We partnered with Blue Cross Blue Shield and we have three mobile vans staffed those vans with nurses who go out into the affected areas and give tetanus shots and minor first aid. Mental health services can also be provided out of the vans. In fact, we put out a call for assistance and many trained professionals signed up within just a couple of days to volunteer their services to work with individuals and with families, particularly over the stress issues related to these tornados and floods. We have a very broad and deep layer of partnerships, and of course we rely on those. And what we try to do is to take a holistic type so that people in need can get a whole range of services from one location.
One important mission has been to deploy food safety inspectors out into all those areas affected to look at each one of those restaurants and to help them assess their food spoilage and food safety and work with them to get back to business if they can and as soon as they can.
Racial and Ethnic Minorities Face Greater Subtle Housing Discrimination
Blatant acts of housing discrimination faced by minority prospective home buyers are declining in the United States, but more subtle forms of housing denial persist, according to a new study by the U.S. Department of Housing and Urban Development (HUD) and the Urban Institute. The study found that African-Americans, Hispanics and Asians learn about fewer housing options than equally qualified whites. According to the study, which sent out pairs of “mystery home buyers” — one white and one minority — to contact real estate agents and rental housing providers, the minority pairs were recommended and shown fewer available homes and apartments, which can increase their costs and restrict housing options, according to HUD. “Fewer minorities today may be getting the door slammed in their faces, but we continue to see evidence of housing discrimination that can limit a family’s housing, economic and educational opportunities,” said HUD Secretary Shaun Donovan. Read more on housing.
After Second or Third Concussion Kids Take Longer to Recover
Children and adolescents who suffer a concussion have a much longer recovery time if they have had a concussion in the past, according to a new study in Pediatrics. The study authors evaluated 280 patients between the ages of 11 and 22 who were treated for concussion symptoms in emergency departments. Children who had a second concussion within a year had nearly three times the average duration of symptoms compared to children whose concussions occurred more than one year apart. The number of previous concussions also affected recovery time. Two or more prior concussions resulted in a much longer duration of symptoms compared to those who experienced no or one previous concussion. Other factors that resulted in a longer recovery time included being age 13 or older and having more severe symptoms at the time of the emergency room visit. Read more on injury prevention.
Hearing Loss in Seniors Can Increase Hospitalizations and Poor Health
A new study published in JAMA finds that seniors with hearing loss are at increased risk for hospitalization, illness, injury and depression. The study authors reviewed records of more than 1,000 men and women age 70 and older with hearing loss, finding that over a four-year period they were 32 percent more likely to have been admitted to the hospital than a comparison group the same age with normal hearing. The hearing-impaired seniors in the study were also 36 percent more likely to have extended stretches of illness or injury and 57 percent more likely to have extended episodes of stress, depression or bad mood. According to the researchers, hearing loss affects two-thirds of men and women aged 70 and older. Among their recommendations to reduce the health burdens of hearing loss are expanding Medicare and Medicaid reimbursement for hearing-related services; increased installation of amplification technology in more facilities; and more accessible and affordable approaches for treating hearing loss. Read more on aging.
Britain to Regulate, Improve Quality of E-Cigarettes
The British government plan to regulate electronic cigarettes as non-prescription medicine starting in 201, according to Reuters. E-Cigarettes are battery-operated devices that contain cartridges filled with nicotine, flavor, and other chemicals. They turn nicotine, which is highly addictive, and other chemicals into a vapor that can be inhaled. The U.S. Food and Drug Administration (FDA) has warned that, "As the safety and efficacy of e-cigarettes have not been fully studied, consumers of e-cigarette products currently have no way of knowing:
- whether e-cigarettes are safe for their intended use,
- how much nicotine or other potentially harmful chemicals are being inhaled during use, or
- if there are any benefits associated with using these products."
The devices do not contain any health warnings comparable to FDA-approved nicotine replacement products or conventional cigarettes. Currently, e-cigarettes that are marketed for therapeutic purposes are regulated by the FDA. According to Reuters, "Under the new British system, manufacturers will have to prove the quality of their products and demonstrate that they deliver the correct amount of nicotine. But they will not need to conduct clinical trials." Read more on tobacco and nicotine.
Even Hands-Free Devices Create Unsafe, Distracted Driving Conditions
A new report from AAA finds that even hands-free mobile devices create mental distractions that can drain attention away from focusing on the road and safe driving. The study found that mentally-distracted drivers—those who may not have even taken their eyes off the road but were distracted by speaking with someone through a hands-free device—missed visual cues, had slower reaction times, and even exhibited a sort of "tunnel vision" by not checking side- and rear-view mirrors or actively scanning the full roadway for potential hazards. Activities like listening to the radio or an audio book was mildly distracting (but likely not enough to effect driving safety); conversing with others (whether with fellow passengers, with someone via hand-held device or with some via hands-free device) was moderately but significantly distracting; and using a device with speech-to-text technology to send text messages or e-mails was highly distracting. Researchers hope these findings can be used to help craft science-based policies on driver distraction. Read more on safety.
CDC Partners with 104 Businesses to Improve Employee Health
The Centers for Disease Control and Prevention (CDC), through its partner Viridian Health Management, has identified 104 employers in eight counties across the nation that have voluntarily chosen to participate in the National Healthy Worksite Program, a new initiative aimed at reducing chronic disease and building a healthier, more productive U.S. workforce—while also cutting health care costs. The initiative primarily focuses on small and mid-sized employers. a national evaluation will document best practices and models on how to successfully implement workplace health programs in small worksites more broadly. Read more on what businesses are doing to create healthier communities.
As school winds down and camps and sports prepare for the summer season, a new study funded by the Robert Wood Johnson Foundation and published in the American Journal of Public Health on sports-related traumatic brain injuries in youth sports, is generating deserved attention.
The study, by Hosea Harvey, JD, PhD, Assistant Professor of Law at the Temple University Beasley School of Law, found that while forty four states and Washington, D.C., passed youth sport TBI laws between 2009 and 2012, none of the laws focus on preventing the injuries in the first place. The laws on the books deal primarily with increasing coaches’ and parents’ ability to identify and respond to traumatic brain injuries and reducing the immediate risk of multiple brain injuries.
>>Read more in a Q&A with the Babe Ruth League Inc. about how youth sports leagues are making strides to prevent injuries.
Harvey’s conclusion is that continued research and evaluation is needed to develop a more comprehensive reduction in youth sport traumatic brain injuries.
NewPublicHealth: What did your study address?
Hosea Harvey: I looked at traumatic brain injury (TBI) laws that were passed at the state level that purported to deal with the problem of youth TBIs in sports statewide. I looked at every related state law passed between 2009 through the end of 2012, though most states only had one law that they passed that dealt with youth sports TBIs during that period.
NPH: And your study found that no state that right now has a law that says this is what you have to do in order to prevent these concussions in the first place?
While a growing number of major league sports teams have policies on concussion assessment and return to play, many youth and school sports leagues and teams do not have similar rules, despite thousands of sports-related traumatic brain injuries (TBIs) reported in children and adolescents every year.
Hosea H. Harvey, PhD, JD, Assistant Professor of Law in Temple University’s Beasley School of Law, has just published an article in the American Journal of Public Health analyzing how this health issue is being addressed across the country. He found that there are laws dealing with concussions in youth sports in 44 states and D.C.—but none are focused on preventing the injuries. The laws only address detecting the injuries or preventing an additional injury after one has already occurred.
The study also revealed that many laws don’t draw on evidence around what works. For example, most state laws establish a minimum 24-hour period of youth athlete removal, but there is no scientific agreement about the optimal minimal time someone who has suffered a sports-related TBI should be removed from play. The study utilized an open source dataset from Robert Wood Johnson Foundation grantee Public Health Law Research called LawAtlas.
>>Read the full study.
NewPublicHealth previously spoke with Harvey and Kerri McGowan Lowrey, JD, MPH, Senior Staff Attorney with the Network for Public Health Law — Eastern Region, about legal and legislative approaches to addressing concussions in youth sports. The previous interview is included below:
One in Five Kids At Risk for Suicide Live in Homes with Guns
Nearly one in five children and teens found to be at risk for suicide report that there are guns in their homes and fifteen percent of those with guns in their home said they know how to access both the guns and the bullets, according to a study presented at the Pediatric Academic Societies annual meeting in Washington, D.C.
The study researchers recommend that emergency department doctors screen all children and teens for suicide risk. Suicide is the second leading cause of death among young people ages 10 to 24 years in the United States, according to Centers for Disease Control and Prevention. Nearly half of young people who die by suicide use a gun. Read more on injury prevention.
Teen Girls Who Exercise Are Less Likely to be Violent
A study from the Columbia University Mailman School of Public Health finds that high school girls who play sports or run have a lower risk of being in fights or in a gang. Researchers at the school reviewed results of a 2008 survey completed by 1,312 students at four inner-city high schools in New York to determine if there was an association between regular exercise and violence-related behaviors.
The survey results found that girls who had exercised more than 10 days in the last month had decreased odds of being in a gang, those who did more than 20 sit-ups in the past four weeks had decreased odds of carrying a weapon or being in a gang and those who reported running more than 20 minutes the last time they ran had lower odds of carrying a weapon. Girls who participated in team sports in the past year had decreased odds of carrying a weapon, being in a fight, or being in a gang.
Among boys, none of the exercise measures were linked to decrease in violence-related behaviors. But the researchers say that a connection may not have been found because a smaller percentage of boys than girls completed the survey and that more research is needed to see if exercise interventions can reduce youth violence. Read more on violence.
USDA Announces New Rules to Fund Broadband Service in Underserved Rural Communities
The USDA has announced new rules that simplify the proposals to request funds for internet broadband access in rural areas. USDA broadband funds have provided internet access for nearly 65,000 rural households, businesses, and community organizations such as libraries, schools and first responders. Read more on preparedness.
While residential use of lead-based paint has been banned in the U.S. since 1978, millions of homes still have the paint, and the health dangers it brings with it, on their walls. Lead paint has been linked to cognitive and behavior issues as well as anemia and even death, especially in young children because their brains are still developing. But according to the Centers for Disease Control and Prevention, about half a million children ages 1 through 5 have potentially dangerous blood lead levels.
In Philadelphia, according to the 2009 American Housing Survey data, 91.6 percent of the housing units were built before 1978. Exacerbating the issue, close to 30 percent of families live in poverty, which can delay household maintenance and lead to peeling paint—a major lead risk to children in older homes. Studies also show that the number of children in Philadelphia with elevated blood levels is higher than the national average.
“This problem requires a public health solution since [preventing childhood] lead exposure…involves multiple stakeholders, including the child and parents, the property owner, and the local authorities who make and enforce laws, ordinances and codes,” says Carla Campbell an associate teaching professor in the School of Public Health at Drexel University. Campbell is the author of a new study on a lead court established in Philadelphia in 2003. The lead court is designed to speed the cleanup of lead hazards in apartments and rented homes. Campbell’s research was funded by the Public Health Law Research, a project of the Robert Wood Johnson Foundation, based at the Temple University School of Law. Campbell’s study appears in a special issue of the Journal of Health Politics, Policy and Law focused on public health law research.
NewPublicHealth recently spoke with Carla Campbell about Philadelphia’s lead court and the implications of its success for other public health issues.
NewPublicHealth: What did your study find?
Did you know that consumers are supposed to call a three-digit number, 811, before starting any digging on residential property? Many would-be diggers don’t, which is why the U.S. Department of Transportation’s Pipeline and Hazardous Materials Safety Administration (PHMSA) began an 811 public education campaign last month.
PHMSA has good reason for getting the word out. Striking buried lines is a leading cause of pipeline-related death and injury and can lead to service outages in whole neighborhoods. Over the last 20 years, property damage costs were over $500 million nationwide from such strikes.
PHMSA estimated that three out of ten households will begin residential construction or renovation projects this spring. A call to 811, which connects would-be diggers to a local utility’s call center, a few days before planned digging generates a visit from a local representative who will mark the approximate location of nearby underground lines, pipes and cables, so workers can dig safely.
“We want 811 to become as well-known as 911, because digging without getting your utilities marked is not only dangerous, it can also cut off services to an entire neighborhood and cost you money[in fines],” said PHMSA Administrator Cynthia Quarterman.
Since 811 debuted six years ago, serious pipeline incidents from unsafe digging have decreased by more than 45 percent, according to PHMSA.
Study: Minor Injuries in Some Children May Indicate the Possibility of More Serious Child Abuse Later On
A study in Pediatrics finds that relatively minor abuse injuries often precede more serious abuse of children. The study refers to “sentinel” injuries—a previous injury reported in a child’s medical history that was suspicious or had an implausible explanation. Researchers examined records of infants seen by the child protection team at Children’s Hospital of Wisconsin between March 2001 and October 2011. Of the 200 children who were definitely abused, 55 (27 percent) had a sentinel injury. Of those, 80 percent had a bruise, 11 percent had an injury inside the mouth, and 7 percent had a fracture. Of 100 children where abuse was suspected but not confirmed, 8 had a sentinel injury. None of the infants in the control group—who had no history of abusive injuries—had a sentinel injury. The study authors say their findings suggest that in more than a quarter of cases of definite physical abuse, there may be escalating and repeated violence toward the infant instead of a single event of momentary loss of control by a frustrated or angry caregiver. Improved recognition of sentinel injuries and interventions would prevent additional cases of child abuse, according to the researchers. Read more on injury prevention.
HUD Renews Grants for Local Communities’ Response to Homelessness
The U.S. Housing and Urban Development Department (HUD) is renewing funding for 7,000 local homeless housing and service programs across the country. The funding ensures the programs will remain open for at least the coming year, according to HUD, which has challenged local communities to review their response to homelessness and to emphasize proven strategies including “rapid re-housing” for homeless families and permanent supportive housing for people who experience chronic homelessness. The amount of renewed funding is $1.5 billion in grants that will support programs including street outreach, client assessment and direct housing assistance. HUD expects to award additional grants later this year. HUD recently announced its 2012 “point in time” estimate of the number of homeless persons in America. Approximately 3,000 cities and counties reported 633,782 homeless persons on a single night in January of 2012. Read more on housing.
Policy and Practice Changes Needed to Improve Survival in People who have Heart Attacks in the Hospital
Policy and practice changes by healthcare institutions, providers and others could greatly improve survival for people who have a have a heart attack in the hospital, according to an American Heart Association (AHA) consensus statement in its journal, Circulation. Each year, more than 200,000 adults and 6,000 children have in-hospital cardiac arrests, and survival has remained essentially unchanged for decades, according to the AHA. Only 24.2 percent of in-hospital cardiac arrest patients survive to hospital discharge.
Key recommendations include:
- Establishing competency of all hospital staff in recognizing a cardiac arrest, performing chest compressions and using an automated external defibrillator or AED.
- Ensuring that best practices are used in all stages of care for cardiac arrest.
- Requiring that all in-hospital cardiac arrests be reported, with survival data, using consistent definitions across hospitals. Definitions currently are not standardized, according to the researchers.
- Modifying billing codes to allow collection of more specific and accurate data for in-hospital cardiac arrest.
- Separate guidelines for in-hospital versus out-of-hospital cardiac arrests.
Read more on heart health.
Judge Strikes Down N.Y. City’s Sugary Drink Limit; Bloomberg to Appeal
“The loopholes in this rule effectively defeat the stated purpose of this rule,” wrote State Supreme Court Justice Milton Tingling when striking down New York City’s 16-ounce limit on sodas and other sugary drinks just hours before it was set to go into effect. He also called the law “arbitrary and capricious.” Still, Mayor Michael Bloomberg says he expects to win on appeal. “As far as we have come, there is one public health crisis that has grown worse and worse over the years, and that is obesity," he said at a news confernce. "Five thousand people will die of obesity this year in New York. The best science tells us that sugary drinks are a cause of obesity." Read more on obesity.
NFL, GE Partner in $60M Effort to Study and Prevent Brain Injuries
The National Football League and General Electric Co have announced a $60 million partnership to advance research into brain injuries while also developing new technologies to help limit injuries to athletes. It includes $40 million for research into imaging technologies and $20 million for researchers and businesses working on injury prevention, identification and management. The NFL has faced multiple lawsuits related to concussions, including a class action on behalf of 4,000 former players. "We're trying to do this with the best minds anywhere in the world," said GE Chairman and CEO Jeff Immelt at a news conference. Each year, U.S. emergency rooms see about 173,000 temporary brain injuries related to sports and recreation in people age 19 and under, according to the U.S. Centers for Disease Control and Prevention. Read more on injury prevention.
Ovarian Cancer Patients Who Don’t Receive Recommended Treatment More Likely to Die in 5 Years
Ovarian cancer patients who do not received the treatment recommended by the National Comprehensive Cancer Network (NCCN) clinical practice guidelines—or as many as two-thirds of patients—have a 30 percent greater risk of dying within five years, according to new findings to be presented at the annual meeting of the Society of Gynecologic Oncology. The study found that low-volume hospitals that treat fewer ovarian cancer patients are less likely to follow the treatment guidelines. "The high-volume hospitals, which did 20 or more cases a year, and high-volume physicians, which did 10 or more a year, were significantly more likely to administer treatment that was adherent to NCCN guidelines," said Robert Bristow, MD, director of gynecologic oncology at the School of Medicine of the University of California, Irvine. According to the American Cancer Society, in the United States, approximately 22,000 new cases of ovarian cancer are diagnosed each year and 15,000 women die from the disease. Read more on cancer.