ATVs, Children and ERs

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With summer temperatures hitting much of the US this week, this is a timely topic.

In the most recent year for which data is available (2013), there were 99,600 ATV accidents in the US that required treatment at an Emergency Room. One-quarter of these involved riders younger than 16. That’s approximately 25,000 kids.

Five states account for 80% of child deaths on ATVs: Texas, California, West Virginia, Pennsylvania and Kentucky.

The Consumer Products Safety Commission actually warns against having kids drive or ride as a passenger on an adult ATV. That and the lack of safety gear are what make this a public health nuisance and a contributor to health insurance rates.

ATVInfographicStates


Sources:

 

  • Wake Forest Baptist Medical Center. “ATV-related injuries in children remain large public health problem.” ScienceDaily. ScienceDaily, 15 April 2017. <www.sciencedaily.com/releases/2017/04/170415182157.htm>.
  • US Government Accountability Office, “All Terrain Vehicles,” April 2010.
    US Consumer Products Safety Comission, “ATV Safety Center.” https://www.cpsc.gov/Safety-Education/Safety-Education-Centers/ATV-Safety-Information-Center/
  • US Consumer Products Safety Comission, “Five States Account for 25 Percent of All Reported ATV-Related Deaths in the United States,” 17 Feb. 2017.

More on Diabetes

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The US is seeing modest, steady growth in the incidence of diabetes among children and teens. A new analysis of data from 2012 to 2012 shows

  • An increase in Type 1 Diabetes of 1.8% per year and
  • An increase in Type 2 Diabetes of 4.8% per year.

While there’s a genetic component, diabetes risk is associated with

  • Family history
  • Immune system issues
  • Diet and weight (and exercise)
  • Blood pressure

Europeans understand that how you care for yourself affects health care costs and health insurance rates for everyone around you. It’s not just about you. Teaching a child to veg in front of a computer or TV simply shortens the child’s life.

However, one of the frustrations with public health data is lack of currency. Has the situation gotten better or worse in the last five years?  My guess is worse, but we simply don’t know.


Sources:

  1. Elizabeth J. Mayer-Davis, Jean M. Lawrence, Dana Dabelea, Jasmin Divers, Scott Isom, Lawrence Dolan, Giuseppina Imperatore, Barbara Linder, Santica Marcovina, David J. Pettitt, Catherine Pihoker, Sharon Saydah, Lynne Wagenknecht. Incidence Trends of Type 1 and Type 2 Diabetes among Youths, 2002–2012. New England Journal of Medicine, 2017; 376 (15): 1419 DOI: 10.1056/NEJMoa1610187
  2. NIH/National Institute of Diabetes and Digestive and Kidney Diseases. “Rates of new diagnosed cases of type 1 and 2 diabetes on the rise among children, teens: Fastest rise seen among racial/ethnic minority groups.” ScienceDaily. ScienceDaily, 14 April 2017. <www.sciencedaily.com/releases/2017/04/170414105821.htm>.
  3. International Diabetes Foundation, “Risk Factors.” http://www.idf.org/about-diabetes/risk-factors
  4. Mayo Clinic, “Diabetes.” http://www.mayoclinic.org/diseases-conditions/diabetes/basics/risk-factors/con-20033091

Environmental Causes of Illness

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The battle about whether environmental pollution causes cancer seems to mirror the long fight to establish acceptance of the link between cigarettes and lung cancer.   It wasn’t accepted  until we had documentation of the specific mechanics of cell transformation into cancer. Even with that documentation, there remain a few skeptics.

A new study from Lehigh university links birth defects and low birth weight babies to emissions from coal-powered power plants. The plant in question is now partially closed and has been converted to run on other fuels. However, the emissions from that plant appear to have injured newborns in four NJ counties. That is another demonstration of the broad reach of pollution from a single plant.

This raises an interesting quandary. Can one be pro-life and pro-coal?


Sources:

  1. Muzhe Yang et. al. “The Impact of Prenatal Exposure to Power Plant Emissions on Birth Weight: Evidence from a Pennsylvania Power Plant Located Upwind of New Jersey,” Journal of Policy Analysis and Management, 4 April 2017, DOI: 10.1002/pam.21989. http://onlinelibrary.wiley.com/doi/10.1002/pam.21989/full

More on Strep Throat

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This isn’t Halloween, and this story isn’t funny.  Here’s the short version:strepthroat_456px

  • Father contracts step throat in early March.
  • Family is tested for strep.
  • Six-year old daughter has bacteria even though she has shown no symptoms, and is given a ten-day course of antibiotics.
  • Daughter starts exhibiting flu-like symptoms on March 25th, and is misdiagnosed has having Influenza A.
  • On March 27th, she has pain and swelling on left leg, and is rushed to Arkon Children’s Hospital. She is now diagnosed with necrotizing fasciitis, commonly referred to as flesh-eating bacteria.
  • Her leg is amputated below the knee.

Strep throat normally affects the tonsils and throat. The cause is Streptococcus bacteria. If the bacteria enters the bloodstream, it can then cause necrotizing fasciitis, which is life threatening.

What the CDC says about how you get strep:

Strep throat is an infection in the throat and tonsils caused by group A Streptococcusbacteria (called “group A strep”). Group A strep bacteria can also live in a person’s nose and throat without causing illness. The bacteria are spread through contact with droplets after an infected person coughs or sneezes. If you touch your mouth, nose, or eyes after touching something that has these droplets on it, you may become ill. If you drink from the same glass or eat from the same plate as a sick person, you could also become ill. It is also possible to get strep throat from touching sores on the skin caused by group A strep. (2)

This is the third published report in recent weeks about amputations related to strep.

What you need to consider:

  • Strep bacteria can live in the nose for weeks without symptoms. It’s possible that a saline nasal spray may help reduce the risk of infection or ease symptoms once infection starts.
  • If someone in your family gets it, everyone needs to be tested. Same for the workplace.
  • Don’t expose others to strep unnecessarily. Stay home from work or school.

Sources:

  1. Brian Zimmerman, “6-year-old loses leg after complication from strep throat,” Becker’s Infection Control and Clinical Quality, 5 April 2017. http://www.beckershospitalreview.com/quality/6-year-old-loses-leg-after-complication-from-strep-throat.html
  2. Centers for Disease Control and Prevention, “Worried your sore throat may be strep?” https://www.cdc.gov/features/strepthroat/
  3. eMedicine Health, “Strep Throat: Home Treatment.” http://www.emedicinehealth.com/strep_throat_home_treatment-health/article_em.htm

Photo courtesy CDC website.

Autism and Parenting

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OK, this finding isn’t rocket science, but it makes sense, and has all sorts of implications for the people involved and their friends and relatives. (1)

Parents of children with autism tend to be less satisfied with their marriage, have less time for each other, and are more prone to divorce. The time issue may be the key of the three items: autistic children place more demands on their parents.  Time demands add stress to what is in many cases a less than happy situation.

It’s one thing if there are others who know what’s happening and offer to help.  Still another if the healthcare system offers respite care (relief for caregivers — something common in Europe and almost nonexistent in the US).

These parents need understanding and they need help. Where they have a strong support system to help them, they’re very lucky.  Many don’t.

What you need to consider:

  • Do you know someone with an autistic child?
  • If yes, find a way to share the load. It matters.

Sources:

  1. Sigan L. Hartley, Leann Smith DaWalt, Haley M. Schultz. Daily Couple Experiences and Parent Affect in Families of Children with Versus Without Autism. Journal of Autism and Developmental Disorders, 2017; DOI: 10.1007/s10803-017-3088-2
  2. University of Wisconsin-Madison. “Insight into day-to-day lives of parents raising children with autism.” ScienceDaily. ScienceDaily, 21 March 2017. <www.sciencedaily.com/releases/2017/03/170321092728.htm>.

Flame retardants, household dust, and thyroid cancer

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A new report from Duke University finds an explanation for increases in the frequencyth of thyroid cancer in household dust.

“Thyroid cancer is the fastest increasing cancer in the U.S., with most of the increase in new cases being papillary thyroid cancer” [PTC], said the study’s lead investigator, Julie Ann Sosa, M.D., MA, professor of surgery and medicine at Duke University School of Medicine in Durham, N.C. “Recent studies suggest that environmental factors may, in part, be responsible for this increase.” (1)

Prior studies have shown that some flame retardants used in the home and in vehicles have a similar chemical structure to thyroid hormones and can disrupt thyroid function.

The study measured the content of household dust as well as the incidence of chemicals in blood samples taken from occupants.  The study used a post facto experimental design with test and control groups.  All of the 140 participants lived in their homes for more than 11 years.

This study established that these flame retardants

  1. Appear in household dust in measurable quantities, where they can be inhaled by occupants and
  2. The level of two of them found in dust and blood samples are associated with the probability of having PTC.

The two problem chemicals identified in the study as elevating cancer risk belong to a class of chemicals, polybrominated diphenyl ethers (PBDEs).

  • Decabromodiphenyl ether (BDE-209). This is the most commonly used retardant, and appears to double the risk for thyroid cancer.
  • Tris(2-chloroethyl) phosphate (TCEP).

Participants with high levels of TCEP in their house dust were more than four times as likely to have larger, more aggressive tumors that extended beyond the thyroid, according to the study.

Participants with high levels of BDE-209 in their blood were 14 times more likely to have a version of the cancer that tends to be more aggressive.

Why should you care?  These chemicals are used as flame retardants in plastics (including TV cabinets), furniture, drapery backing, some carpets and in consumer electronics, both in home and in automobiles.  Both exposure to these chemicals and the prevalence of thyroid cancer are increasing.

Note:  This research was funded by Fred and Alice Stanback, the Duke Cancer Institute, and the Nicholas School of the Environment at Duke University, and not by industry sources.

What you need to consider:

  • Do you have a home air purification system? Not something that makes the air smell nice, but something that removes dust and other particles from what you breath. Maybe it’s time to invest or upgrade.
  • Read the labels on what you buy.

 


Sources:

  1. The Endocrine Society. “Exposure to common flame retardants may raise the risk of papillary thyroid cancer.” ScienceDaily. ScienceDaily, 2 April 2017. <www.sciencedaily.com/releases/2017/04/170402111311.htm>.
  2. US Environmental Protection Agency, “Technical Fact Sheet — Polybrominated Diphenyl Ethers (PBDEs) and Polybrominated Bophenyls (PBBs),” January 2014.
  3. Wikipedia, “Decabromodiphenyl ether.” https://en.wikipedia.org/wiki/Decabromodiphenyl_ether

The Employee Benefits Divide

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There are immense divisions in US society:ben_franklin

  • Rich versus poor
  • More educated versus less
  • Old versus young (ageism lives)
  • Urban versus rural (fading since most people live in urban areas, but still very real)
  • Ethnic and racial

We can add big employer versus small business to the list.

Large employers are adding benefits for employees that small businesses simply can’t afford.

American Express announced an increase in paid parental leave to five months with added surrogacy and IVF benefits, and Ernst & Young expanded parental leave from three to four months for parents of all genders and added adoption, fertility and surrogacy benefits.

Basically, if you have fertility issues, it really pays to work for one of these large financial services firms.

The larger division is a shift in focus in large companies from the cost of benefits to the total well-being of the employee. That shift has benefits for these companies in terms of worker retention and productivity.

Small companies pay a price for their focus on cost in terms of employee turnover, learning curves for new employees that affect productivity, and errors that affect customer relationships. However, they simply can’t afford some of the benefits that large companies can offer. Nor do they get the favorable pricing for benefits that insurers give to their largest clients.

The size divide isn’t clean. There are small companies that recognize how important their employees are.  I know of one diner (a class of eatery for which New Jersey is famous) that offers a good benefits package to staff, but that’s unusual in food service establishments.

Conversely, large retailers tend to treat employees as replaceable. In one recent study by the ACSI, retailers closing stores were seeing improvements in customer satisfaction ratings. My guess is the stores that were  under-performing had the lowest individual store ratings for customer satisfaction, but the ASCI data aren’t sufficient to address that.  Why not? Minimum wage employees with limited benefits and no career path aren’t motivated to deliver for customers. People do what they are incented to do.

What you need to consider:

  • Students need to think about the kind of company for which they will work in the future.  College is less optional if benefits matter.
  • Small businessmen need to get creative about ways they can invest in employees. The old mentality that “having a job is sufficient motivation” is simply a way to guarantee mediocre staff. Good people can always find another job. When there is turnover, the best are the first ones out the door.

Sources:

  1. Ann Clark, “Top 5 best work benefit trends for 2017,” BenefitsPro, 6 March 2017. http://www.benefitspro.com/2017/03/06/top-5-best-work-benefit-trends-for-2017?kw=Top+5+best+work+benefit+trends+for+2017&et=editorial&bu=BenefitsPRO&cn=20170312&src=EMC-Email_editorial&pt=Benefits+Weekend+PRO&t=employee-paid&page=2
  2. American Customer Satisfaction Institute, “ACSI: Retailers Improve Customer Satisfaction Amid Store Closings,” 28 February 2017. http://www.theacsi.org/news-and-resources/press-releases/press-2016/press-release-retail-2016