Category: Disease

Soot Happens

A new study released from the Queen Mary University of London has shown for the first time that air pollution exposure can affect a pregnant woman’s placenta. The placenta is a vital organ which develops during a woman’s pregnancy. It is responsible for providing nutrients and oxygen to a developing baby. In addition, it also serves as an immune system barrier for the baby, which is vulnerable during pregnancy. Any injuries inflicted on the placenta can have serious health effects on the unborn child.

The Queen Mary study examined placenta cells of five women who were exposed to air pollution. Within the samples, researchers found evidence of the presence of soot. Soot is a common air pollutant classified as particulate matter. This type of pollution is made of large damaging particles, and can often be found coming from power plants, manufacturing sites, and motor vehicles. Soot exposure is dangerous, and it is the cause of thousands of premature deaths annually. The findings of this study are novel and alarming – it demonstrates that inhaled particulate matter can travel from the lungs to the placenta.

Placental immune cells are necessary to keep an unborn baby healthy. If the placental immune system is compromised, so is that of the growing baby. It is still unclear what this study’s findings mean for fetal-placental health in the long term. However, researchers on this study are particularly concerned about how soot exposure may disrupt this system.

One thing is clear – this news is disturbing. The study demonstrated that air pollution damage does not stop at the lungs. The conversation about air pollution is not always an environmental one; many pollutants like soot affect human health dramatically. Going forward, it is important to consider how these findings should influence policy. Regulating air pollution is a necessary step to take in order to protect the health of people worldwide.

 

 

https://www.momscleanairforce.org/soot-facts/

https://www.qmul.ac.uk/media/news/2018/smd/first-evidence-that-soot-from-polluted-air-may-be-reaching-placenta.html

https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/placenta/art-20044425

https://www.nichd.nih.gov/research/supported/HPP/default

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3025805/

 

 

Hurricanes & Our Health

As Hurricane Florence approaches, there are many worries on the minds of those who live in its path. Residents in the South Eastern United States are anxious about the wellbeing of their property, belongings, surrounding environment and loved ones. Along with these concerns, it’s important to be weary of how a destructive hurricane can also have serious implications on medicine and public health. Considering these risks before the onset of the storm could eliminate smaller preventable problems and render larger issues easier to address.

Before the hurricane arrives, it’s advised that any medical prescriptions be refilled and retrieved promptly. Resultant power outages and infrastructural damages may limit a pharmacy’s ability to operate and supply their patients’ needs. If you know you are at risk of power outages, it’s important to stock up on non-perishable foods, water, and anything else necessary for your individual health. Along with this, following proper safety precautions to protect your home from water and wind damage can also prevent a number of storm-related injuries.

In North Carolina, the magnitude of rain expected to come with Hurricane Florence is especially worrisome. Excessive rainfall could cause flooding in farmland which contain animal manure lagoons. Such lagoons could overflow, spreading waste and increasing risk of disease transmission. Additionally, North Carolina is home to a number of dangerous coal-ash ponds. If these sites flood, it could unleash this waste into the surrounding environment. Coal-ash is toxic, and if released from ponds could contaminate people’s public drinking water.

 

https://www.wltx.com/article/news/local/make-preparations-for-your-health-ahead-of-hurricane-florence/101-592900265

 

http://time.com/5392478/hurricane-florence-risks-sludge-manure/

 

https://www.nationalgeographic.com/environment/natural-disasters/hurricane-safety-tips/

 

 

 

New things to know about your cup of joe

The general public loves to scrutinize the coffee drinking habit. Multitudes are drinking it (in relatively large amounts) – so what does that mean for us? In recent years, research and public opinion has begun to favor the pros of drinking coffee. Some studies have even shown that there are significant health benefits which may be associated your daily cup of joe.

Despite this trend, news has recently surfaced which may upset these well-received findings. When coffee beans are roasted at a high temperature, they produce a chemical called acrylamide. It has been shown that higher doses of acrylamide can be harmful, and has been linked to cancer. This chemical cannot be separated from a coffee product; if someone drinks coffee, they are likely exposed to the chemical.

This evidence appears grim, but don’t dismay coffee drinkers. There are a few silver-linings to this story. The formal research on acrylamide is still inconclusive, as exposure has not been directly linked to any specific cancer. Along with this, the amount of acrylamide in coffee appears to be minute. Due to this, California has recently pushed back against labeling coffee as a cancer-causing substance. Acrylamide intake can also be avoided by considering the amount and type of coffee consumed. Drinking a little less coffee means a little less exposure. Additionally, opting for dark-roasted beans tends to minimize exposure to chemical.

https://www.bmj.com/content/359/bmj.j5024

http://time.com/5222563/what-is-acrylamide/

https://www.healthline.com/nutrition/acrylamide-in-coffee#section3

https://www.usnews.com/news/healthcare-of-tomorrow/articles/2018-09-04/cancer-schmancer-in-california-coffee-is-king

 

 

 

 

Revised Cervical Cancer Screening Guidelines Offer Women More Options

New recommendation guidelines for cervical cancer screening were published this month in the Journal of the American Medical Association (JAMA). These guidelines are an update to the U.S. Preventive Services Task Force (USPSTF) 2012 recommendations on cervical cancer screening. The new screening guidelines now offer women more options and longer screening intervals when it comes to their preventative care. One of the most notable guideline changes is that women aged 30-65 can now get an HPV test alone every 5 years instead of just a Pap smear alone every 3 years, or in combination with a Pap smear every 5 years.

According to the guidelines:

  • Women aged 21-29 years should get a Pap smear every 3 years
  • Women aged 30-65 years can get:
    • A Pap smear alone every 3 years
    • An HPV test alone every 5 years
    • A combination of a Pap smear and HPV test every 5 years

The USPSTF does not recommend screening for women younger than 21 years as well as women older than 65 years who have received adequate screening before and are not at high-risk for cervical cancer.

Cervical cancer was once a major cause of death among women. However, with the advent of screening tests, such as Pap smears, cervical cancer rates have fallen considerably over the years. Still, the American Cancer Society estimates 13,240 women will be diagnosed with cervical cancer in 2018.

Almost all cervical cancers are caused by the human papillomavirus (HPV), a common sexually transmitted infection. There are many types of HPV, some low-risk and some high-risk. Low-risk HPV types can cause warts that can be treated. High-risk types, however, can cause cancer. While the body can often fight off HPV infection, this is not always the case. Some HPV infections can become chronic, and chronic infections with high-risk HPV types can lead to cancer in both men and women if left untreated. However, there are vaccines that can prevent cancers, like cervical cancer in women, caused by HPV. The Centers for Disease Control (CDC) recommends that all children get vaccinated against HPV at age 11 or 12. For young women in particular, the CDC recommends they get vaccinated through age 26.

Because it can take years for cancer caused by HPV to develop and for symptoms to appear, the CDC encourages women to regularly screen for cervical cancer. This includes both women who have and have not vaccinated against HPV, as the HPV vaccine does not protect against all types of HPV that can cause cancer.

References

U.S. Preventive Services Task Force. (2018). Cervical Cancer Screening. Retrieved from  https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/cervical-cancer-screening2

Centers for Disease Control and Prevention. (2017, December 16). The Link Between HPV and Cancer. Retrieved from https://www.cdc.gov/hpv/parents/cancer.html

National Institutes of Health. (2018, June 30). Cervical Cancer. Retrieved from

https://report.nih.gov/nihfactsheets/viewfactsheet.aspx?csid=76

American Cancer Society. (2017, November 1). What Are the Risk Factors for Cervical Cancer? Retrieved from

https://www.cancer.org/cancer/cervical-cancer/causes-risks-prevention/risk-factors.html

U.S. Preventive Services Task Force. (2012). Archived: Cervical Cancer: Screening. Retrieved from

https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/cervical-cancer-screening

Centers for Disease Control and Prevention. (2018, August 23). HPV Vaccines: Vaccinating Your Preteen or Teen. Retrieved from

https://www.cdc.gov/hpv/parents/vaccine.html

American Cancer Society. (2015, February 19). HPV and Cancer. Retrieved from https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-fact-sheet

American Cancer Society. (2017, October 9). HPV and Cancer. Retrieved from

https://www.cancer.org/cancer/cancer-causes/infectious-agents/hpv/hpv-and-cancer-info.html

Dirty Lungs: the Affordable “Clean” Energy rule

The U.S. Environmental Protection Agency recently proposed the Affordable Clean Energy (ACE) rule. In spite of the word “clean”, the plan will likely lead to an increase in coal emissions across the United States. ACE will grant states the individual responsibility of policing their own air pollution. Without federal regulation, this may lead to a net increase in green house gas emissions. The policy also aims to cut other protocols which limit emissions from coal plants.
 
The consequences of this legislation concern many health professionals. The EPA’s own impact analyses has shown what health effects can be expected by 2030. Changes in air quality could lead to as many as 1,400 new premature deaths per year. Along with this, increases in asthma, cardiovascular disease, and respiratory problems are expected. The same report projected 15,000 new upper-respiratory cases yearly. These grim side effects are due to the expected increase in fine particulate matter in the air. Particulate matter is a type of air pollution which comes from burning fuels like coal and oil.
 
When creating new legislation, the EPA must consider studies on effects of air pollution on human health. With this in mind, a new policy by the EPA worries scientists and health professionals. It states that the EPA will not consider research unless all original data is made public for scientists and industry. Although transparency is good in theory, this new policy would exclude a large number of studies which use human health data. Much of this research relies on confidential patient health information. Data like this often remains private to protect patients’s rights. Excluding this research may lead to misinformation and underestimates of premature death. This new provision would interfere with ethical creation of air pollution policy.

Resources:

Dr Lisa on the Streets: An approach to improve health literacy

Health literacy has become a buzzword not only in the public health world but in general. As the technologies, treatments and advancements are improving the quality of medicine, the way that these new discoveries are communicated are not. One physician and public health professional has made it her mission to increase the awareness of the health literacy crisis here in the United States by taking it to who it affects the most, Americans. She has launched a “Dr. Lisa on the Streets” campaign to increase awareness and gather support to improve the way health information is communicated. In her TedX talk “Are you confused about health information? You’re not alone” she discusses the economic consequences of low health literacy and how as a nation we can attempt to improve this. She refers to the “grapevine” (casual conversations, internet etc.) as one of the most powerful educators and needing to capitalize on this as a means of sharing health information.

Here are few strategies mentioned in the video about improving health literacy:

  • Manage the grapevine, it’s like ivy if it isn’t maintained it will get out of control
    • Need grapevine to counteract misinformation through verification before spreading information
  • Doctors need to embrace technology
    • Change is inspired by the masses
  • Health literacy is up to you!
    • Avoid gaps in care
    • Find your provider
    • Be persistent

To learn more about this movement and health literacy watch the full TedX talk: https://www.youtube.com/watch?v=-x6DLqtaK2g

Free Lyft to the Pharmacy

Blue Cross and Blue Shield Institute has started a partnership with the ride sharing company Lyft to provide their members with free rides to pick up their medications. The Blue Cross Blue Shield Institute is a new organization that’s mission is to reduce the barriers of accessing healthcare. One of the largest identified barriers to accessing healthcare is transportation. Last year, their big initiative was a similar program with Lyft to provide free transportation for their patients to their doctors’ appointments. By investing in these types of programs, the organization is hoping to reduce costs in the long -term and improve the health outcomes of their consumers. With this newest imitative they are also partnering with pharmaceutical organization such as CVS Health and Walgreens to increase medication adherence. These programs are still under pilot testing and are currently funded by CVS and Walgreens in Chicago and Pittsburgh with patients who are living in “transportation deserts”. These types of unique partnerships are allowing for creative solutions and addressing the social determinants of health in order to solve the most dire healthcare problems. Let’s hope to see more of these types of collaborations in the future.

References

https://www.forbes.com/sites/brucejapsen/2018/03/14/cvs-and-walgreens-partner-with-lyft-to-get-blue-cross-patients-to-pharmacies/#34f4fa0f76c8

https://www.bcbs.com/news/press-releases/blue-cross-and-blue-shield-and-lyft-join-forces-increase-access-health-care

Discrimination and Health Part II: People of Color

Last week, I talked about how discrimination faced in healthcare settings can impact LGBTQ+ individuals’ attitudes towards healthcare, and how facing discrimination in everyday life can negatively impact their health outcomes. People of color (PoC) in the U.S., including immigrants, refugees, and Indigenous Peoples, face this double-barreled oppression as well.

Of course, one way racism affects health is through the broad structures that have placed many PoC groups at disadvantaged positions, intersecting with poverty – one study found that almost 100,000 black people die prematurely each year who would not die were there no racial disparities in health.

But discrimination itself, even on an individual level, can impact the health and healthcare experiences of PoC. Microaggressions, or everyday interactions rooted in racism, are a daily stressor for PoC, and these stressors can lead to premature illness and mortality.

Of course, this discrimination doesn’t just happen in daily interactions, but also in medical settings, which rightfully leads to mistrust and under-use of healthcare for PoC. Language and cultural barriers faced by immigrants can have similar effects.

Because race, socioeconomic status, and health are so intertwined, it may never be possible to know what levels of discrimination have the greatest ultimate effects on health outcomes. But we know they all have at least some, which should be enough to demand action.

Sources: https://www.ncbi.nlm.nih.gov/pubmed/12042611

https://www.hindawi.com/journals/tswj/2013/512313/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2821669/#!po=2.38095

https://health.usnews.com/health-news/patient-advice/articles/2016-02-11/racial-bias-in-medicine-leads-to-worse-care-for-minorities

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2696665/

https://www.ncbi.nlm.nih.gov/pubmed/17001262

Doctors are humans too

In binge watching the newest medical show “The Resident” this past weekend, the show made me consider the role of medical error and transparency. The show portrays an arrogant surgeon with a secret tremor unwilling to give up his career despite his inability to perform successful surgeries. While the story plot line is dramatized and designed to pull viewers in for higher ratings, it highlights the importance of medical error and transparency. According to The BMJ, medical error is the third leading cause of death in the United States. Examples of medical error include medication errors (wrong dose, wrong drug) and hospital infections. Medical errors are challenging to comprehend since healthcare providers are only human and they are bound to make mistake just like the rest of us. The amount of stress and pressure these providers face all while working at all hours undoubtedly will result in mistakes. However, their mistakes have much more severe consequences. The show discusses transparency as a way to address the stigma surrounding medical error and by having more transparency could result in lower rates of medical error. An interesting fact to note is that these are errors are not recognized as cause of death on death certificates. To me, this further stigmatizes the errors and places blame on the healthcare provider and doesn’t change the narrative that providers are human and errors will happen. We treat these healthcare providers as superhuman but we need to remember that they are just like us and as a humans we make mistakes and hopefully we learn from them.

References:

https://health.usnews.com/health-news/patient-advice/slideshows/5-common-preventable-medical-errors?slide=4

https://www.bmj.com/content/353/bmj.i2139.full

App Grindr under scrutiny over privacy concerns

In an article published yesterday by BuzzFeed News, it was released that Gay Dating App Grindr has been sharing its users’ HIV status with two outside companies, a move which many consider dangerous to the queer community that the app claims to serve.

The sites, Apptimize and Localytics, work with Grindr to optimize the app and user experience. While it has been noted that these companies do not share information with third parties, there are still concerns with the sharing of sensitive information of a historically vulnerable population. This could raise flags for users sharing their HIV status on the app, which could negatively impact public health interventions that work to reduce HIV transmission and stigma.

Grindr recently announced that they would remind users to get tested for HIV every three to six months, offering a cue to action for users to be more aware of their HIV status. Knowing ones status is a crucial component for reducing the number of new HIV infections, such as by offering the opportunity to those who are living with HIV to be connected to care and achieve viral suppression.

 

Sources:

BuzzFeed News: Grindr Is Sharing The HIV Status Of Its Users With Other Companies –https://www.buzzfeed.com/azeenghorayshi/grindr-hiv-status-privacy?bfsplash&utm_term=.eu9v16ZaQ#.akvOQgNJj