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Car Safety

In this day and age, most people have a driver’s license or regularly use a motor vehicle in the United States. Becoming 16 and getting your license is a right of passage among modern Americans. In order to become a driver, everyone must pass a driver’s safety test- and with good reason. The CDC states that there were “22,441 passenger vehicle occupants died in motor vehicle traffic crashes in 2015.” Additionally, more than 2.5 million passengers and drivers were treated in the Emergency Room for injuries related to motor vehicle collisions in that same year. So, for this week’s post, I am going to explore motor vehicle safety. Hopefully we can reduce the number of collisions and injuries on the road, one smart choice at a time!

First up is car seat safety! The National Highway Safety Administration has information about the types of car seats and recommendations regarding their use. A rear facing car seat should be used, at minimum, for all children under 12 months. If your child is still below your car seat’s maximum height and weight requirements when they are 12 months of age, continue to keep your child in the rear facing car seat until they reach that limit, or until they reach 3 years of age. Follow whichever happens first. Why? This is because rear facing car seats are the safest for your infant or toddler. The only notable exception to this rule is if your child was born premature. Since it may be more difficult for a premature child to breath in the inclined position of a car seat, he or she may need to use a car bed or have an adult attend to them in the back seat during car rides. Parents of premature infants should consult their pediatrician for the best and safest practice for their child. Most children are ready to move up to the next seat around 2 years of age. After using a rear facing car seat, a child should move to a forward facing car seat until they reach your car seat’s maximum height and weight limits or until they reach 7 years of age. After a child has outgrown his or her forward facing car seat, he/she should move to a booster seat that is forward facing and uses a seat belt. Your child may use a booster seat until 8-12 years of age, or until the seat belt fits properly without it.

Remember that a car seat or booster seat should always be placed in the rear seat of the car and never in the front seat. The safest place for a car seat is away from airbags, ideally in the center seat of a row of seats. This is safer than positioning the car seat near a door. Additionally, always fully buckle the car seat as instructed by the manufacturer and as instructed in your vehicle’s manual. A car seat or booster seat should be installed securely and properly, and a safety seat should only be used in the vehicle, not outside of it (ie: not as a place for a baby’s nap in the house). Ensure that the safety belts fit snug across the body. Shoulder belts should go across the chest and shoulder, not the neck, and the lap belt should go across the thighs, not the stomach. The back seat is the safest place for your child until they are 13 years old.

Adults and older children should also follow safety belt rules and regulations to protect themselves. According to the CDC, “every day, about 6,400 adults are injured in a crash.” Young adults (18-24) are less likely to wear seatbelts than any other age group and men are less likely to wear a seat belt than women. This is despite the fact that there are primary or secondary seatbelt laws throughout the country. This is despite the fact that seat belts “reduce serious crash-related injuries and deaths by about half.” For those who don’t know, a primary seat belt law is one that allows a police officer to pull over a car for a driver or passenger not wearing a seatbelt, whereas a secondary seat belt law means that if a driver is pulled over for a different offense, the officer can issue a ticket for not wearing a seat belt.

If you are interested in your particular state’s facts and figures regarding seat belt use and motor vehicle collisions, the CDC has a list available here.(There are more visual aids and state comparisons here.)

Beyond safety belt use are concerns over the driver’s condition. These include things such as drunk driving or distracted driving. In 2010, the CDC reported that 112 million adults drove while intoxicated. 4 out of 5 of these drunk drivers were men and those who binge drink were more likely to get behind the wheel than those who don’t. While many teens and young adults may argue in favor of a younger drinking age, by keeping the legal limit to 21 years old, we are able to keep inexperienced and drunk drivers off the road. Choosing a designated driver, drinking wisely (not binge drinking) and preventing others from drinking and driving can reduce the problem nationally. The National Safety Council also notes that driving the speed limit, using extra precaution in locations where children might be present (especially while driving in reverse), as well as refraining from driving after consuming illicit drugs or prescription medications, especially those that may make you drowsy.

You are the best advocate for safe driving. Wearing a seat belt, being a proactive driver, and making smart decisions about your role as a driver or passenger can help prevent accidents, injuries, and even potential death.

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Famous Names · Uncategorized

Bernardino Ramazzini

Hello everyone!

I hope you all had a great summer. You may have noticed that I took quite a hiatus from the blog. I started my MPH classes in May (which took up a LOT of my time), visited some family, and moved across the state! Now that some of this craziness has passed, I am glad to be back on the blog as I start medical school. However, instead of posting on a weekly basis, I will likely post every other week. Ideally, there will be a few personal or medical school related blog posts in the mix as well, but I can’t make any promises this early in the game.

Let’s start this month with a popular section, “Famous Names in Public Health!” This month’s figure is known as the father of occupational health. His name is Bernardino Ramazzini.

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Ramazzini was born in Italy in 1633. He studied medicine at Parma University where he developed a particular interest in worker’s health and the prevalence of disease among specific professions. During his career he published De Morbis Artificum Diatriba (Disease of Workers) which was a collection of works regarding detailed and specific information regarding worker’s diseases, notes of his observations, and advice. Much of this information was collected through observation, interviews, and interaction with the workers.

Since 1700, Ramazzini’s work has remained popular around the world and has been translated into many languages (although it is important to note that it wasn’t until it’s re-printing in 1940 that his writings on occupational diseases truly gained traction in the public health field). He has been cited numerous times throughout history by prominent members of society including Karl Marx, Cotton Mather (the Puritan minister), and Alice Hamilton (considered the founder of toxicology). (1). In these works, Ramazzini made some interesting insights. He condemned smoking tobacco by noting that it contributed to illnesses among tobacco workers and he made many important observations about the effects of posture and movements on physical health (an important component of ergonomics). An overview of many of the observations that Ramazzini makes in his collection can be viewed here.

Rammazzini’s continued interest in worker-related illness contributed to a lifelong commitment to the field of worker’s health and served as the foundation of the field of occupational medicine. (2). His recognition of the impact that occupations can have on a person’s health has revolutionized our understanding of illness and disease. Without his notable works, organizations like OSHA would not exist to protect workers today.

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Lice

Ever wonder why people hesitate to share hair brushes or hair ties? Why is hair hygiene is such a big deal? Why do people just others by how clean their hair appears? While the basis of these questions is about hygiene and self care rituals that we value in our society, part of the concern is related to one, tiny issue. That tiny issue is lice.

What are lice? Firstly, the singular form of lice is louse. These tiny insects often infect hairy places (like the scalp) and feed on our blood. They are mostly spread by head to head contact, but they can also be spread through personal items such as headwear, hats, combs, or brushes. I was relieved to find out that lice cannot fly, so near but non-touching contact to an infected person does not put you at significant risk. Additionally, these little guys can only live for 1-2 days without feeding, so getting lice from furniture or the floor is limited. The reason there is so much fuss about lice is that these little bugs can cause itching, scalp irritation, or sores. You may have an allergy to them or by scratching the itch, you could introduce a secondary infection that will worsen your symptoms! It is surprising to note that head lice are not a sign of poor hygiene because people of every cleanliness level can be affected by lice. Additionally, although lice can cause symptoms like itchiness and discomfort, they don’t carry diseases. You can read (and see) more about lice here (beware, there are pictures!)

Head lice prevention: School aged children are at the highest risk of lice because close contact and play with others means that they are more likely to come into personal contact with another person. (As an adult, I can’t think of the last time I shared a hat with a coworker! It just doesn’t happen as frequently as it does with children.) There is no current FDA approved lice prevention product available. Most suggestions are not well regulated and should be undertaken with the understanding that there can be significant risks involved. Do not try homeopathic solutions without checking with your doctor first. Mayo Clinic notes that many formularies include “plant oils such as rosemary, citronella, eucalyptus, tea tree and lemon grass.” You can also disinfect brushes by cleaning them and soaking them in hot water. However, the best tool for prevention is behavior. Limit head to head contact with others. Don’t share personal belongings, especially items that come into contact with your head or hair. Also, avoid coming into contact with clothing, sheets, and materials that a known infected person has used. This will lessen the possibility of the lice being transferred to you. It is important to note that the CDC warns against using fumigation sprays or fogs because they are not effective against lice.

Head lice treatment: It is currently recommended by the CDC that any person with an active lice infection be treated. Additionally, any person who has knowingly come into contact with the infected person should also be treated so that they limit the outbreak and reduce the spread of lice. First and foremost, if you think you may have a lice infection, consult your physician. They will be able to guide your treatment plan and may be able to tell you if the lice in your area is resistant to standard treatments. Lice treatments can be bought over the counter or prescribed. These medications usually come in a combination of 2 categories, pediculicides and ovicides. Pediculicides kill only the lice. Ovicides kill the eggs. For the best treatment, it is ideal to choose a formulation that does both. Follow the instructions on the packaging and be aware that some methods require more than a one time treatment (often a repeat treatment a few days after the first one). Using a fine tooth comb in conjunction with this is also ideal to ensure that all of the nits have been removed from the hair. Additionally, anything that has had contact with the infected person in the past 2 days should be washed in hot water to kill the lice. (Anything used more than 2 days ago is considered safe because lice cannot live longer than that without a host for food). Any item that cannot be washed should be quarantined in a plastic bag for 2 weeks. As always, there are natural and homeopathic alternatives for lice treatment readily available by a simple search on the internet. This list Health.com list contains both over the counter lotions such as Spinosad and alternatives such as olive oil. The American Academy of Dermatology reminds us that some treatments fail because of population resistance and unregulated treatments, although effective, can have unforeseen risks. This could include unsafe ingredients, reactions with other products you have used, or even toxic effects. As always, do not undergo treatment without the guidance of your physician. If necessary, he or she can provide a referral to a dermatologist.

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Lead paint, lead pencil, lead bullet

Do you remember the ordeal in Flint, Michigan? The city decided to change its water supply from Lake Huron to the Flint River to save money. Furthermore, the city was not treating the water properly with an anti-corrosive agent so not only was the iron from the main water pipes leaching into the water supply, it was also pulling water from the residents’ pipes as it flowed into their houses. As a result, the community members were being exposed to levels of lead. The children here started suffering from lead exposure and lead poisoning. Their blood lead levels were sometimes double or triple what their records showed their previous toddler blood lead levels to be. This event reignited the national conversation about lead poisoning and environmental health.

Flint is not isolated in their lead level problems. In April, 2018, news broke about elevated lead levels in the Chicago water supply. Even though many of us think of lead exposure as an “old fashioned” problem affecting our parents or even our grandparents, recent studies have shown that this is not the case. Lead and metal exposure should still be part of our discussion when it comes to health and safety today.

Lead is a metal that is a natural part of our earth. It is used in many manufactured items such as paint, pipes, toys, glassware, and even gasoline around the world. The problem with this element is that it can accumulate in the body and cause dangerous changes in our health. This is why some lead containing products, such as paint and gasoline, are banned in the United States. However, there is still possibility of lead exposure to products made before regulation was put into place or from objects that are imported into our country.

There is no safe blood level of lead. According to the CDC “at least 4 million households have children living in them that are being exposed to high levels of lead.” Lead exposure can have negative effects on almost all body systems. The WHO states that lead can be “distributed to the brain, liver, kidney and bones.” Lead also decreased vitamin D levels in our body. The biggest risk is to the brain and nervous system. It can accumulate in stores found in the teeth and bones. This means that small exposures over time can have a compounding effect. These affects are particularly dangerous for children because they are still developing and their digestive tract can absorb over 50% of the lead they are exposed to (as opposed to 15% in adults).

In children, lead poisoning can cause brain damage, slowed development, learning and behavior problems as well as hearing and speech problems. These symptoms can contribute to decreased attention span and lower IQ scores. As a result, these children may struggle in school and may be prevented from reaching their full potential as adults.

There are some treatments available for patients who have elevated lead levels. If someone is acutely affected by the ingestion of a large amount of lead over a short time, a gastric lavage (stomach pump) can be used to remove lead containing material. For chronic treatment, chelation therapy can be used. These molecules bind to lead in the body to prevent its absorption. However, there is little information about the treatment available to manage the developmental and behavioral affects of lead poisoning. There is also very little information available about how beneficial those types of treatments may be.

In fact, lead exposure is so important that it is an objective of the Healthy People 2020 campaign. There is education on their website as well as detailed plans to mobilize and implement changes. There is also a National Lead Poisoning Prevention Week every year. (This past year it was October 22-28). The goal of this event is to raise awareness as lead exposure as a preventable issue and to encourage the implementation of programs and outreach in the community.

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Achoo!

If you live in Texas, like I do, you are probably more than aware that this Spring has been a terrible allergy season. Hopefully the rest of the country has been able to avoid the abundant amount of pollens, grasses, and molds that cause allergy symptoms that have been plaguing Texas over the past few weeks. But, if you are like many of us Texans and suffering from allergy symptoms, let’s learn a little more about what causes these seasonal reactions.

In the United States, spring allergy season usually runs from February to early summer as trees and plants transition from winter conditions to the warm summer weather. Additionally, a wet and rainy spring can encourage plant growth, increasing pollen counts and leading to a worse allergy season. However, there is also an allergy season in the later summer and fall as the weather transitions from warm to cool. Some regions have worse allergy symptoms than others. Apparently, Knoxville, Tennessee is the worse place in the US for spring allergies. Pollen is the biggest aggravator of seasonal allergies and every year, the pollen count continues to rise.

Some traditional medications for seasonal allergies include antihistamines, nasal steroid sprays and decongestants. According to the FDA, “Antihistamines reduce or block symptom-causing histamines and are available in many forms, including tablets and liquids.” Nasal steroids are usually sprayed into the nose to treat nasal inflammation. Decongestants are used to treat congestion symptoms. There are natural practices that can also be used to treat allergies, with some possible (although inconsistent) effectiveness. For instance, some probiotics may affect the immune system, including the body’s allergy response. Probiotics can be found in foods like kefir, kimchee, sauerkraut, yogurt and kombucha. Another possible treatment is honey. The concept reasons that since honey contains small amounts of pollen, honey ingestion can help someone increase their tolerance of pollen. Thus, making them less sensitive to pollen and lessening their allergy symptoms. An alternative school of thought is that honey may have antihistamine or anti-inflammatory effects that can counteract your body’s histamine response. Congestion and runny nose can be managed with the use of a neti pot which rinses the nasal sinuses. However, it is important to use only filtered or sterile water in these devices. Improper use can lead to serious illness or possibly death. This was the case of a Louisiana man and woman who died from a brain eating amoeba infection in 2011 after using tap water in their neti pot.

For people who suffer from seasonal allergies, tracking pollen counts and knowing what types of grasses, trees, and pollens aggravate your symptoms can be a great help and indicator of your symptoms. On high pollen count days, it may be better to keep windows closed and stay inside. Additionally, if your allergies continue to progress for a long time, knowing what the allergy season is like in your area may help advise your decision to meet with your doctor to discuss additional symptom management. A great website to track pollen and allergy demographics in your area is pollen.com.

Famous Names

Florence Nightingale

A few weeks ago, when I was composing my draft of post topics for the upcoming month, I chose to write about a well known but often under recognized figure, Florence Nightingale, as my public health figure. Little did I know just how suiting this choice would be given that May 6 is National Nurses Day. (National Nurses Week is from May 6-12). This month’s “Famous Name in Public Health” was a game changer in the structure of our health care system. It is because of her that the field of nursing became such an invaluable profession and why all of us should treat every day like Nurse’s day. So, let’s get started!

Florence Nightingale was born in 1820 to a wealthy family. In 1851, she completed her nursing training in Germany. At the time, the was not a well respected profession and her choice to pursue the career went against the norm for women of her status at the time and concerned her parents. You see, nursing was poorly paid and widely considered to be a job for the poor. There was a negative, unprofessional reputation surrounding nurses at the time. So why did Ms. Nightingale choose nursing? Her profound Christian beliefs made her feel that helping the poor and needy was her moral duty and that nursing was a call from God.

When the Crimean War broke out in 1854, Florence became one of the many nurses that tended to the soldiers. She traveled to Constantinople from London where she worked at Scutari hospital, an under equipped facility. Ms.Nightingale was in charge of the female nurses working in Turkey. She worked in aiding the sick and wounded soldiers, as well as tending to their needs. Her staff improved the sanitation and conditions of the facility. They provided food, blankets, and even wrote to the soldier’s families. It was during this time that she earned her name, “Lady of the Lamp” because she would tend to soldiers by lamplight after the medical officers had retired for the night. Her endless care and morality improved the conditions of the hospital and of the patients. Her role and active leadership made the use of nurses in military hospitals an outstanding success.

When Florence returned to England at the end of the war, in 1856, she campaigned for nursing reforms and increased sanitation in hospitals. Donations that she collected for the Nightingale Fund were used to start a nursing school at St. Thomas’ Hospital in 1860. She continued to campaign to improve health conditions in hospitals through advocacy and numerous publications. She authored more than 200 books regarding nursing, hospital planning, and facility organization, both in management and in literal floor plan designs of hospital wards. Florence used her prior education (a luxury of her family’s wealthy status) to evaluate and then revolutionize hospital systems. She set up a systematic record keeping system and found a causal link between sanitation levels and death rate. Her work was one of the first to recognize that social phenomena could be objectively measured and analyzed. She was determined to reform the health care system so the issues she encountered during the Crimean War would never impact civilians at home.

Florence Nightingale’s reform efforts were so successful that soon there were nursing schools teaching her methods around the world. She was also involved in the creation of the International Red Cross. Through her work, she transformed nursing into a respected profession and her efforts did not go unnoticed. Florence received the Royal Red Cross in 1883 and then she became the first woman to earn the Order of Merit in 1907.

Florence Nightingale passed away in 1910, but her legacy lives on.

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Barbara Bush’s Literate America

This week’s post is in honor of the lovely former first lady, Barbara Bush. She passed away on Tuesday, April 17, 2018. Known as the nation’s “first grandmother” or even “America’s grandmother” due to her motherly nature and white locks, she was respected by millions of Americans, regardless of race, class, or ethnicity. Throughout her husband’s presidency, she became an advocate of family literacy, with a passion for books and reading.

In 1991, Lady Bush helped pass the National Literacy Act. The goals of this act are to,

“(1) conduct specified research and demonstrations; (2) assist Federal, State, and local agencies in developing, implementing, and evaluating literacy policy by establishing a national data base and providing technical and policy assistance and development model systems; (3) provide program assistance, training, and technical assistance for literacy programs throughout the United States; (4) collect and disseminate information on a variety of promising methods; (5) review and make recommendations on uniform reporting, performance measures, and program standards; and (6) provide a toll-free long-distance telephone line for literacy providers and volunteers.”

The Literacy Act established a literacy center that focused on adult education through state grants and monitoring of local programs. The goal was to amend the Adult Education Act so it could provide educational resources to adults through eligible programs, such as commercial drivers in partnership with educational agencies, colleges, or universities. It also set up parameters for literacy programs for incercerated adults. Additionally, it amended the Elementary and Secondary Education Act to allow for better distribution of inexpensive reading materials to children with special needs and provide grants for public literacy programs- especially those functioning in areas with low education levels or areas with few financial resources. Additionally, it provided amendments for the Higher Education Act, as well as the Domestic Volunteer Service Act.

In addition to this, Lady Bush founded the Barbara Bush Foundation for Family Literacy. The mission of this organization is “providing access to family literacy programs in which both parents and children work toward their educational goals.” This is a noble goal because a reported 36 million adults in the United States have low literacy skills, and 1 in 4 cannot read above a 5th grade level. Due to this information, the foundation has worked in community outreach with goals to improve our nation’s literacy levels. As a matter of fact, the Foundation, “has raised and provided more than $110 million in support to create or expand family literacy programs in all 50 states and the District of Columbia” in addition to supporting more than 160 programs, creating positive results throughout the nation.

Why does literacy matter so much? Well, not only does a parent’s literacy level predict their child’s future literacy level, it also plays a major role in their health and functioning in society. For instance, this study indicates that individuals with low literacy levels are “unable to adequately prepare for or respond to an emergency” because most health information is written at an 8th grade reading level or beyond. This is much higher than the average 5th grade reading level of many Americans. This is so much of a public health issue that even a Canadian study recommended that physicians give written instructions to patient at a 5th grade reading level or below. A great example of the impact illiteracy has on someone’s health and wellness can be found here.

Lady Bush was not alone in her passion for creating a literate nation. The United Nations has recognized the issue as public health problem to be addressed. The American Public Health Association has a very definitive stance on the issue, stating that communities, organizations, and the government should be involved in improving health literacy rates because “limited health literacy affects Americans of all ages, races, incomes, languages, cultures, and education levels.” As such, Barbara Bush was not alone in her stance, but rather a national leader for a movement that is backed both at home and globally. Her efforts pushed the envelope and fueled the national efforts to improve our country’s literacy, for all.

The former first lady and “first grandmother” will be missed by many, but her efforts will continue to move forward. Even in death, she still contributes to the improvement of the lives of millions of Americans through her various organizations.