Category Archives: Injury Prevention

Dec 4 2013
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Public Health News Roundup: December 4

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NHTSA: Motorcoaches, Large Buses to Require Seatbelts for All Passengers and Driver
New motorcoaches and large buses will be required to provide lap and shoulder seatbelts for all passengers and driver, under a new rule issued by the U.S. Department of Transportation's National Highway Traffic Safety Administration (NHTSA). While the buses are an overall safe way to travel, the large numbers of people they carry and the high speeds at which they travel mean a single collision can lead to a significant number of injuries, according to NHTSA. An average of 7,934 riders are injured each year in motorcoaches, and an average of 21 passengers are killed. "Buckling up is the most effective way to prevent deaths and injuries in all vehicular crashes, including motorcoaches," said Federal Motor Carrier Safety Administrator Anne S. Ferro, in a release. "Requiring seat belts in new models is another strong step we are taking to reach an even higher level of safety for bus passengers." The rule will apply to buses with a gross vehicle weight rating (GVWR) greater than 26,000 pounds,) excluding transit buses and school buses. Read more on transportation.

Study: Women With Breast Cancer Should Get Mammograms Every 12 to 18 Months
Breast cancer patients should undergo mammograms every 12 to 18 months to determine whether their cancer has spread to the lymph nodes, according to a new study to be presented today at the annual meeting of the Radiological Society of North America. Study researcher Lilian Wang, MD, evaluated more than 300 women who were diagnosed with breast cancer because of a routine mammogram, dividing them into three groups based on their treatment history. She found that only 9 percent of the women who had 12- to 18-month intervals between mammograms saw their cancer spread to their lymph nodes; the rates were 21 percent for those who waited one-and-a-half to three years and 15 percent for those who waited three or more years. "If you catch someone with early stage cancer, they are going to need less extensive surgery, and maybe no chemo," said Laura Kruper, MD, director of the Cooper-Finkel Women's Health Center at the City of Hope Cancer Center, in Duarte, Calif., who was not a part of the study. "[The new study] adds more power behind the fact that we do need screening mammograms starting at age 40 and every year.” Read more on cancer.

FDA: Certain HeartStart AEDs May Not Work During Cardiac Emergencies
The U.S. Food and Drug Administration (FDA) announced yesterday that certain automated external defibrillator (AED) devices made by Philips Medical Systems may not function properly when needed. In a new safety communication, FDA revealed that the devices may not deliver the needed shock to restore normal heart rhythm during a cardiac emergency. “The FDA advises keeping all recalled HeartStart AEDs in service until you obtain a replacement from Philips Healthcare or another AED manufacturer, even if the device indicates it has detected an error during a self-test,” said Steve Silverman, director of the Office of Compliance in the FDA’s Center for Devices and Radiological Health. “Despite current manufacturing and performance problems, the FDA considers the benefits of attempting to use an AED in a cardiac arrest emergency greater than the risk of not attempting to use the defibrillator.” Read more on heart health.

Nov 22 2013
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Recommended Reading: Sports Revelry Can Do Serious—and Permanent—Damage to Hearing

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Earlier this year, fans of the National Football League’s Seattle Seahawks set a record for outdoor stadium noise with a volume of 136.6 decibels. That record stood for a mere four weeks—the Kansas City Chiefs hit 137.5.

The fans revel in it—both records were set in part through the encouragement of fan organizations—and this record-seeking behavior is encouraged by teams and the league.

“Fans know they are going to a football game and not searching for a book at a library,” said Brian McCarthy, an NFL spokesman.

file Credit: Harold Hollingsworth

However, according to a recent story in The New York Times, such loud revelry at sporting events comes with severe costs for people’s hearing health. Elliott Berger, an acoustical engineer at 3M, said the average volume during an NFL game hovers at around 90 decibels. Considering the fact that an average NFL game lasts about three hours—and the National Institute for Occupational Safety and Health recommends limiting exposure to levels that high to 60 minutes—by going to football games people are putting themselves at serious risk for partial deafness and ringing, or even hyperacusis, an intolerance to sound that sometimes can cause pain.

While this may be alright (although very unhealthy) for the casual fans who only attend a few games per year, people who already have auditory problems are at substantial risk. And it’s something that even a simple set of earplugs or earmuffs can prevent.

“People think it’s cool or funny or whatever, but there is increasing evidence that if your ears are ringing, damage is happening,” said M. Charles Liberman, a professor of otology at Harvard Medical School and the director of a hearing research lab at the Massachusetts Eye and Ear Infirmary. “There’s something irreversible going on. It’s only going to worsen as you get older.”

Read the full story at The New York Times.

Nov 15 2013
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Public Health News Roundup: November 15

Study: State Car Seat, Seatbelt Laws Leave Children Vulnerable to Injury, Death
Many state laws on car seats and seatbelts are not current with regards to modern research or are inconsistent from state to state, leaving children vulnerable to injuries or even death, according to a new study in the journal Social Science and Medicine. Researchers look at child passenger safety laws from 1978-2010 across all 50 states [Editor’s note: Go here for an interactive map]. “These laws do not keep up with the published evidence, and even when they do, there are some cases where the laws are unclear,” said Jin Yung Bae, JD, MPH, the study’s lead author, and associate research scientist at the Steinhardt School of Culture, Education and Human Development at New York University. Approximately 250,000 children are injured and 2,000 are killed each year in the United States because of vehicle crashes, which many of these preventable, according to the study authors. The study was conducted by a team from New York University in collaboration with Temple University, and supported by the Robert Wood Johnson Foundation through its Public Health Law Research. The National Institutes of Health’s National Institute on Alcohol Abuse and Alcoholism also funded the study. Read more on injury prevention.

USDA Announces Grants to Improve Rural Housing
The U.S. Department of Agriculture (USDA) has announced that organizations in 45 states, the Western Pacific and the Commonwealth of Puerto Rico will receive grants to make housing repairs and improve housing conditions for limited-income rural residents. The funding is through the USDA Rural Development's Housing Preservation Grant program and will be provided to intermediaries such as local governments; public agencies; federally-recognized Indian Tribes; and non-profit, faith-based and community organizations. The organizations distribute the grants to homeowners and owners of multi-family rental properties or cooperative dwellings who rent to low- and very-low-income residents. Grants may be used to make general repairs, such as installing or improving plumbing, providing or enhancing access to people with disabilities and making homes more energy efficient. Read more on housing.

CDC’s Emergency Management Program Receives Full EMAP Accreditation
The U.S. Centers for Disease Control and Prevention (CDC) has become the first federal agency to achieve full accreditation of its emergency management program from the Emergency Management Accreditation Program (EMAP). “Accreditation is a serious accomplishment for CDC and the emergency management community we support,” said Ali S. Khan, MD, MPH, director of the Office of Public Health Preparedness and Response. “Preparing for and responding to emergencies of any kind—natural disasters, bioterrorism events, chemical terrorism or pandemics—is a core function of public health. Everyone at CDC has a hand, at one point in time, in emergency management and execution.” EMAP’s six steps to accreditation are subscription, self assessment, application, on-site assessment, committee review and accreditation decision. Thirty one states; the District of Columbia; and 14 U.S. cities and counties are accredited. Read more on preparedness and accreditation.

Nov 13 2013
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Public Health News Roundup: November 13

Workplace Injuries Cost U.S. Healthcare System $13.1B in 2011
With nearly the highest injury rate of all U.S. industries, workplace injuries cost the U.S. healthcare system approximately $13.1 billion and more than 2 million lost workdays in 2011, according to a new study in the journal Professional Safety. “Healthcare worker injury rates are only less than outdoor wilderness professions, such as commercial loggers and fishermen. The injury rates are sky high," said report author Scott Harris, PhD, MSPH, the director of EHS advisory services for UL Workplace Health and Safety. The study found that 15.2 million employees were injured that year alone, with the most common injuries coming from slips, trips, falls, violence and chemical exposure; nurses experienced the highest rates. The report concluded that hospitals “would benefit from more rigorous and frequent inspections from the Occupational Safety and Health Administration.” Read more on injury prevention.

Even Healthy Overweight People at Increased Risk for Heart Disease
Even overweight people who are otherwise healthy are at increased risk for heart disease, according to a new study in JAMA Internal Medicine. Previous research indicated that higher-than-normal risk was linked to a collection of risk factors known as “metabolic syndrome,” including large waist circumference, high blood pressure, high triglycerides, low "good" cholesterol and diabetes. People have metabolic syndrome if they have at least three of the risk factors. However, in a study of 71,527 adults without heart problems, researchers determined that risk went up as weight went up, even if metabolic syndrome factors were absent. "Whether you call someone as having or not having metabolic syndrome as kind of a yes/no variable, is not helpful clinically and it doesn't make sense biologically," said Meir J. Stampfer, from the Harvard School of Public Health, according to Reuters. "It's basically just that the metabolic syndrome is waiting to happen to those people." Read more on obesity.

New Statin Guidelines Call For Greater Use
New guidelines from the American Heart Association and American College of Cardiology could dramatically increase the number of people taking cholesterol-lowering statins. The guidelines call for people to take statins if they already have heart disease, if their bad (LDL) cholesterol is extremely high (190 milligrams per deciliter of blood or more) or if they're middle-aged with type 2 diabetes. They also advise statins for people who are 40-75 years old with an estimated 10-year risk of heart disease of 7.5 percent or more. Previous guidelines had advised doctors to follow rigid clinical guidelines that trigger statin use when cholesterol levels reach a certain threshold. The new policy "suggests treatment should be individualized and that, depending on your risk, you may need a higher dose of a more potent statin than if your risk is lower," said Hector Medina, MD, a cardiologist at Scott & White Healthcare in Round Rock, Texas, according to HealthDay. Read more on heart health.

Nov 12 2013
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Public Health News Roundup: November 12

Construction Workers Frequently Impacted by Pain and Stress
Construction workers are frequently stressed about work-related injuries and pain, but often fail to get help for either, putting themselves at risk for additional injuries and mental health issues, according to a new study in the Journal of Occupational and Environmental Medicine. The researchers, based at the Harvard School of Public Health, reviewed data compiled by the School’s Center for Work, Health and Wellbeing and found that the construction industry has one of the highest rates of work-related injuries and suicides in the U.S. workplace, as well as a high prevalence of musculoskeletal pain among its workers. The researchers also conducted a mental health survey of 172 New England construction workers at four construction sites. Sixteen percent of the workers reported being distressed, 75 percent had experienced musculoskeletal pain over the previous three months and 42 percent reported one or more work injuries in the preceding month. A follow-up survey found that more than half of those who previously said they felt distressed had not sought professional help—likely, say the researchers, because of fear of stigmatization or job loss. Read more on injury prevention and mental health.

USPSTF: Cannot Recommend For, or Against, Vitamin Supplements to Help Prevent Cancer, Heart Disease
Citing the fact that there is simply too little evidence to make a conclusion either way, the U.S. Preventive Services Task Force (USPSTF) has concluded at this time that it can’t recommend for or against taking vitamin and mineral supplements to help prevent cancer and heart problems. In a draft statement, the panel also ruled that neither beta-carotene nor vitamin E should be taken to prevent heart disease or cancer; beta-carotene was previously found to exacerbate the risk of lung cancer for people who were already at high risk. The researchers analyzed data from 26 studies between January 2005 and January 2013, which included people across an array of demographics, finding no difference between those who took the supplements and those who took placebos. Vitamin supplements are a $12 billion per year industry in the United States. Read more on prevention.

Study: Simple Urine Test Could Identify Young Type 1 Diabetes Patients with Highest Risk of Heart, Kidney Disease
A basic urine test could help doctors prevent heart and kidney disease in kids who are at higher risk due to their type 1 diabetes, according to a new study in the journal Diabetes Care. As many as 40 percent of youth with type 1 diabetes may be at increased risk for the health problems. Researchers at the University of Cambridge, in England, analyzed data on more than 3,300 diabetes patients between the ages of 10 and 16; an estimated 490,000 kids worldwide have type 1 diabetes. "Managing type 1 diabetes is difficult enough without having to deal with other health problems," study lead author David Dunger. "By using early screening, we can now identify young people at risk of heart and kidney disease. The next step will be to see if drugs used to treat heart and kidney disease—such as statins and blood-pressure-lowering drugs—can help prevent kidney and heart complications in this young, potentially vulnerable population.” Read more on pediatrics.

Nov 5 2013
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Public Health News Roundup: November 5

Study: Acetaminophen Use and Even Light Drinking Dramatically Raises Kidney Dysfunction Risk
Acetaminophen use when paired with even moderate or light drinking can increase the risk of kidney dysfunction by 123 percent, according to a new study released today at the American Public Health Association’s 141st Annual Meeting in Boston. Using data from the 2003-2004 National Health and Nutrition Examination Survey, researchers analyzed data on more than 10,000 people who were asked questions about their alcohol consumption, use of acetaminophen and health conditions. “Pain is the most common symptom among the general public and is also most frequently self-treated with acetaminophens,” noted Harrison Ndetan, lead researcher of the study. “Where this becomes a greater concern is among young adults, who have a higher prevalence of alcohol consumption. These findings highlight a serious concern among health professionals who deal frequently with pain patients, particularly those with mild pain who are more susceptible to consuming both.” Read more on substance abuse.

Flight Attendants: Expanded Use of Electronic Devices In-flight Needs Reworked Safety Messaging for Flyers
The decision by the Federal Aviation Administration (FAA) last week to let passengers use electronic devices—but not make cell phone calls—during all phases of a flight has flight attendants concerned that the ruling could compromise passenger safety if flyers are distracted by the devices when the cabin crew makes its safety announcements before takeoff.

Most airlines will introduce the new rule on devices by the end of the year. To qualify they have to assure the FDA that their fleet’s airplanes can tolerate any potential radio interference from the devices. Flight attendants would like heavy devices stored under seats or in the overhead bins during takeoff and landing for added safety. In a statement released just after the FAA ruling, the  Association of Flight attendants said “AFA will work diligently alongside the FAA and industry to find creative, science-based approaches to ensure that passengers comply with the new operator policies and that their attention is not diverted from the important safety information provided by cabin crew during routine pre-flight briefings and unexpected emergencies, and that risks posed by loose items in the cabin are safely managed during the most critical portions of [a] flight.” Read more on injury prevention.

Two Questions Could Help Diagnose Strep, Reduce Unnecessary Antibiotic Prescriptions
“Do you have a cough and have you had a fever in the last 24 hours?” These two simple questions could help people determine whether they need to see a doctor for strep throat, which could in turn limit unnecessary antibiotic prescriptions, according to a new study in the Annals of Internal Medicine. While high fevers can indicate strep, coughs do not. The study found the questions, when paired with an accounting of how common strep infections were in a particular area, where nearly as effective as lab tests at determining whether a patient actually had a strep infection. "This enables us to use the test of time," said co-study author Dr. Kenneth Mandl, a professor of bioinformatics at Harvard. "If we determine that you're low risk and most cases will not have an important complication from strep anyway, then you can be followed clinically rather than come in for a test right away, and you may improve." About 15 million people in the United States see a doctor for a sore throat each year, with 70 receiving antibiotics; estimates indicate that only 20-30 percent of children and 5-15 percent of adults actually benefit from the medications. Read more on prescription drugs.

Oct 31 2013
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Public Health News Roundup: October 31

New York City Council Votes to Raise Tobacco-purchasing Age to 21
With studies repeatedly showing that the earlier someone begins smoking, the more likely they are to become addicted, the New York City Council has voted to raise the age minimum required to buy tobacco products from to 21 years, up from 18 years. The bill passed 35-11. Mayor Michael R. Bloomberg has already announced he will sign the bill. The law would apply to all tobacco products, including cigarettes, electronic cigarettes, cigars and cigarillos. “This is literally legislation that will save lives,” said Christine C. Quinn, the Council speaker, according to The New York Times. The Council also voted to increase the penalties for retailers who evade tobacco taxes; for a prohibition on discounts for tobacco products; and for a minimum price of $10.50 a pack for cigarettes and little cigars. Read more on tobacco.

Analysis: Sports-related Youth Concussion Diagnoses Climbing
The growing number of diagnosed concussions in young athletes and their reluctance to admit when they have suffered a head injury—despite ever-growing awareness of the dangers of concussions—demonstrates the need for sports leagues and government agencies to become more active in preventing traumatic brain injuries, according to a new report from the Institute of Medicine and the National Research Council. In 2009, about 250,000 youth ages 5-21 were treated for sports-related concussions and other brain injuries in U.S. hospitals, up from approximately 150,000 in 2001. The analysis pointed to Hannah Steenhuysen, a high school soccer goalie in Rehoboth, Massachusetts, as an example of why relying on youth to report their head injuries on their own is not always an effective strategy. "You don't tell anyone usually when you get a headache because you don't want to be out of the game," she said. "I couldn't watch TV or text or even read—it was really tough. When I tried to go back to school, I couldn't keep up and everything got jumbled in my head." Read more on injury prevention.

Tips for Kids with Food Allergies on Halloween
Trick-or-treating and Halloween parties can be difficult for kids with food allergies. However, there are steps both kids and parents can take to make sure kids with food allergies still have a full night of fun, according to Joyce Rabbat, MD, a pediatric allergy specialist with the Loyola University Health System, in Chicago. "The key is education,” she said. “Make sure your child knows what he or she can eat. When in doubt, throw it out." Among her tips:

  • Plan parties and events that do not include food, candy or other edible treats.
  • Inform the host of any Halloween party if your child has a food allergy. You can also provide a list of foods that may trigger an allergic reaction.
  • Clean all cooking utensils, pans or other dishes if they have been in contact with a food allergen. Also make sure to wipe down surfaces.
  • Read labels to find out whether foods contain allergens or have been made on the same machine as other products that contain an allergen.
  • Carry self-injectable epinephrine.

Read more on food safety.

Oct 28 2013
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Public Health News Roundup: October 28

Pediatricians: Parent’s Religion Should Not Stand in the Way of Child’s Medical Care
While noting that parents have the right to determine a child’s medical care, a parent’s religious beliefs should not stand in the way of necessary medical care when the child is at risk for serious disability or death, according to a new policy statement from the American Academy of Pediatrics Committee on Bioethics. The organization is also calling for a repeal of all state exemptions to child abuse and neglect laws, as well as an end to funding for any religious or spiritual healing. "I think it's important that all children get appropriate medical care, that state policies should be clear about the obligations to provide this care and that state monies directed toward medical care should be used for established and effective therapies," said Armand Antommaria, MD, directors of the Ethics Center at Cincinnati Children's Hospital Medical Center in Ohio and one of the statement’s lead authors. Many religious groups currently decline mainstream and proven medical treatments. For example, Christian Scientists advocate prayer over medical treatment, and Jehovah’s Witnesses opposed blood transfusions. Read more on pediatrics

Study: Low-cost Football Gear as Effective as High-tech, High-cost Equipment at Preventing Head Injuries
A group of experts has performed an extensive study to determine which football helmets and mouth guards are best at preventing youth concussions: none of them. The researchers compared high-tech and custom equipment to low-cost, off-the-shelf equipment, finding no difference in the number of concussions for 1,300 players at 36 high schools during the 2012 football season. There are approximately 40,000 sports-related concussions in U.S. high schools every year. "We're certainly not saying that helmets and mouth guards aren't important. They do what they are supposed to do. Mouth guards prevent dental injuries, and helmets prevent skull fractures and scalp and face lacerations," said Margaret Alison Brooks, MD, the study's lead co-investigator. "But I don't think the manufacturing companies have the data to support [the claim that] if a parent buys a specific model, their child will have a reduced risk of concussion." The findings will be presented today at an American Academy of Pediatrics meeting in Orlando, Fla. Read more on injury prevention.

FDA: Recall of Certain Kraft and Polly-O String Cheese Products
Kraft Foods Group has announced a voluntary recall of some varieties of Kraft and Polly-O String Cheese and String Cheese Twists products because they might spoil before their “Best When Use By” code dates. Approximately 735,000 cases of the product will be affected throughout the United States, each with code dates between October 25, 2013 and February 11, 2014. Kraft announced the recall after receiving several reports of premature spoilage and ceasing the production and distribution of the questionable products. For full refunds, customers can return the products to the store where they were purchased or call Kraft Foods Consumer Relations at 1-800-816-9432 between 9 am and 6 pm (Eastern). Read more on food safety.

Oct 25 2013
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Disaster Response: Should Tourniquets Be Used in Disasters?

Use of tourniquets—a piece of tightly tied cloth used to keep a victim with an arm or leg wound from bleeding to death—has been discouraged over the last few decades out of concern that the method can save the life, but lose the limb. But a new article in The Wall Street Journal finds that multiple examples of successful use of tourniquets on battle fields in Iraq and Afghanistan, as well as after the bombing at the Boson Marathon earlier this year, has reopened the debate. The pros and cons of tourniquet use is on the agendas of several upcoming medical meetings and preparedness conferences.

Read the full story here.

>>Bonus Link: Read a NewPublicHealth post on new approaches to teaching more people CPR.

Sep 30 2013
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Public Health News Roundup: September 30

New NIH Study to Look at House-to-House HIV Testing, Other Measures, to Reduce HIV Burden in Africa
A study in South Africa and Zambia is assessing whether house-to-house voluntary HIV testing and prompt treatment of HIV infection, along with other proven HIV prevention measures, can substantially reduce the number of new HIV infections across communities. The trial is funded primarily by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), administered by the Office of the Global AIDS Coordinator. “Through this new study, we aim to learn whether the treatment of HIV-infected individuals as a form of HIV prevention, an approach previously tested in roughly 1,800 heterosexual couples where one partner was infected, will be just as effective when implemented across an entire adult population,” said NIAID Director Anthony S. Fauci, MD. “The study also will tell us whether this method of delivering population-wide HIV treatment as prevention is feasible and cost-effective.” The trial is being conducted in South Africa and Zambia because the HIV prevalence in those countries is among the highest in the world. An estimated 12.5 percent of adults in Zambia and 17.3 percent of adults in South Africa are infected. The study team will measure the impact of the two HIV prevention packages by determining the number of new HIV infections among a representative sample of 52,500 adults drawn from the 21 study communities and followed for three years. The study is expected to end in 2019. Read more on AIDS.

Study: Better Awareness Likely Reason for Increase in ER Visits for Youth Concussions
Improved awareness of the signs and symptoms of traumatic brain injuries (TMI)—such as concussions—is likely the cause of a noticeable increase in TMI-related emergency department visits by children, according to a new study from doctors at the Cincinnati Children's Hospital Medical Center. The study appeared in the journal pediatrics. Visits for these types of injuries climbed about 92 percent from 2002 to 2011, while the overall severity of the injuries decreased and the hospitalization rate remained at around 10 percent. "We are doing a better job at educating ourselves and educating the public about concussion," said Dr. Holly Hanson, lead study author and an emergency medicine fellow. "People and doctors are recognizing sports-related concussions more. People are recognizing the signs and symptoms. People are more aware of the complications. So people are coming in more." According to the U.S. Centers for Disease Control and Prevent, each year TMI accounts for about 630,000 emergency department visits, 67,000 hospitalizations and 6,100 deaths in children and teens annually. Read more on injury prevention.

HHS Developing New Burn Treatments to Improve Disaster Response, Daily Care
Through its Biomedical Advanced Research and Development Authority (BARDA), the U.S. Department of Health and Human Services (HUD) is working to develop five new types of burn treatments for disaster response and daily emergency medical care. The thermal burn medical countermeasures—which could take the form of drugs, vaccines or medical products—will be for chemical, radiological or nuclear incidents. Developing new measures is critical, because with only 127 burn centers in the country, a mass casualty event could quickly overwhelm the public health response. “Sustainability of these medical countermeasures for thermal burns is critical for their availability when they are needed most,” said BARDA Director Robin Robinson, PhD. “Our repurposing and multi-purpose strategy facilitates development, ensures availability, and reduces overall costs for thermal burn medical countermeasures.” Read more on disasters.