The Health Consequences of Smoking-50 Years of Progress

The Health Consequences of Smoking-50 Years of Progress: A Report of the Surgeon General was released on Jan. 17, a half century after the historic 1964 Surgeon General's report that concluded that cigarette smoking causes lung cancer. Since that time, smoking has been identified as a cause of serious diseases of nearly all the body's organs. 

Today, scientists add diabetes, colorectal and liver cancer, rheumatoid arthritis, erectile dysfunction, age-related macular degeneration, and other conditions to the list of diseases that cigarette smoking causes. In addition, the report concludes that secondhand smoke exposure is now known to cause strokes in nonsmokers.

For the full report, executive summary, consumer guide and PSA, visit http://www.surgeongeneral.gov/library/reports/50-years-of-progress/index.html.

For free help quitting smoking, visit www.tobaccofreemaine.org or call 1-800-207-1230

Prevent adult-onset occupational asthma

Isocyanates (eye-so-sigh-a-nates) are chemicals that can cause asthma and cancer, irritate the skin, eyes, nose and throat, and even cause death.  It is important for medical providers to know the health risks associated with isocyanates and be aware that patients who work in certain industries are in danger of being exposed.  The risks are so well documented that the Occupational Safety and Health Administration (OSHA) has announced an emphasis program to protect workers from exposure to isocyanates.

  

Patients potentially exposed to isocyanates may have:

• Persistent or recurring eye irritation
• Nasal congestion
• Dry or sore throat
• Cold-like symptoms
• Cough
• Shortness of breath
• Wheezing
• Chest-tightness

Direct skin contact can cause:

• Sensitization
• Inflammation
• Rash
• Itching
• Hives
• Swelling

Isocyanates are found in the following compounds:

• Paints
• Varnishes
• Foams
• Sealants

They are used in the following industries:

• Residential/commercial construction to coat cement, wood, fiberglass, steel and aluminum
• Automotive painting and spray on bed-liners
• Commercial manufacturing of ridged and flexible foams
• Boatbuilding coatings to protect boats

  

When dealing with a patient, medical providers should consider that patient's occupation and work environment. Isocyanates are powerful irritants to the eyes, gastrointestinal, and respiratory tracts. Isocyanates can sensitize a patient through skin contact which means a patient could be subject to a severe asthma attack if they come into contact again (death from severe asthma in some sensitized subjects has been reported).  Isocyanates cannot easily be washed off skin or clothing because they are not water soluble.  OSHA is hoping that by focusing on this problem it will raise physician awareness of the risk, reduce employee exposure, and lessen the overall negative health effects associated with isocyanates. 

  

For more on the National Emphasis Program, visit: http://go.usa.gov/Zp7h (See appendix C for a patient questionnaire.)

 

Maine Youth and Suicide Prevention

Maine youth are making healthier choices, including smoking and drinking less, but are increasingly struggling with their emotional wellbeing.

Those findings and other insights directly from tens of thousands of Maine students about their health and habits are detailed in the newly released results of the 2013 Maine Integrated Youth Health Survey (MIYHS).

The survey, which has been given every odd year since 2009, is a collaboration of the Maine Department of Education and the Maine Center for Disease Control and Substance Abuse and Mental Health Services in the Department of Health and Human Services. The results inform prevention and program planning, as well as future funding proposals.

While students largely feel more supported by parents, teachers and their communities, they also admit they are increasingly struggling with feelings of sadness and hopelessness. At the high school level, 14.6 percent of students said they have seriously considered attempting suicide, and 16.8 percent of seventh and eighth graders said the same. 

In October, Maine was one of six states awarded a 3-year federal Substance Abuse Mental Health Services Administration grant, which will expand statewide education, training, and outreach services and offers new screening, assessment, treatment and follow-up services for youth to age 24 at risk for suicide.

The Maine Suicide Prevention Program is collaborative initiative among: the Departments of Health and Human Services, Education, Corrections, Labor, Public Safety, and Veteran's Affairs; advocacy organizations like American Foundation for Suicide Prevention, NAMI ME; crisis agencies; parents, survivors and young adults.

Although suicide is a rare event, we must encourage and support our youth and young adults who may be feeling overwhelmed and hopeless to reach out to a trusted adult who will provide support and connect them to helping resources, such as:

• Statewide Crisis Hotline: 1-888-568-1112 - connects callers to crisis service provider in area from which they are calling. This is for ALL individuals in crisis to provide immediate, local assistance in a crisis situation. The crisis worker will ask what is going on and ask about everyone's safety to help figure out what kind of help is need. If you believe a person might be in danger of suicide, call the statewide crisis hotline or the police (911) to keep the person safe if needed.

• Statewide Information Resource Center (IRC): 1-800-499-0027 Office of Substance Abuse and Mental Health Services IRC has suicide prevention informational materials for adults and teens including: print and audio/visual educational materials, Maine and national data, etc.

For more information:

• Maine Suicide Prevention Program: www.maine.gov/suicide

• Maine Integrated Youth Health Survey summary results and press release: at http://mainedoenews.net/category/news-views/press-releases/

• 2013 Maine Integrated Youth Health Survey result: https://data.mainepublichealth.gov/miyhs/

Update on tickborne diseases

The deer tick can remain active in its adult stage from fall to spring as long as the temperature is above freezing. The tick will remain alive, but inactive when temperatures are below 40 degrees Fahrenheit.

Maine CDC saw increased numbers of tickborne disease reports in 2013, including multiple cases with onset of symptoms as late as December and the first documented case of Powassan encephalitis in the state since 2004. Providers should continue to consider tick borne illnesses, even during the winter months.

For more information, see the update from Dec. 18 at http://go.usa.gov/ZpAG 

Cervical Cancer

January is Cervical Cancer Awareness Month.

Before the development of the Pap test, cervical cancer was one of the most common causes of cancer death for American women.  As an available, accepted, and cost-effective screening test, the Pap test can detect cervical cancer early when treatment is most effective. If women receive regular screenings, the Pap test can detect cervical cell changes before they become cancerous.

Help is available for qualifying women age 40 and older who are in need of breast or cervical screening tests. The Maine CDC Cancer Prevention and Control programs can provide information about cancer screening tests as well as resources for free cancer screenings.

Interested women are encouraged to call 1-800-350-5180 or 1-207-287-8068. TTY users should call Maine Relay at 711. 

For more information, visit http://go.usa.gov/ZpFh 

Flu update 1/9/14

Influenza activity in Maine is widespread with laboratory confirmed influenza reported in all counties. Influenza A/pH1N1, Influenza A/H3, and influenza B have been confirmed in Maine indicating all three strains are circulating.  Maine CDC has followed up on six outbreaks of influenza as of Tuesday, January 7th. Influenza vaccination is still strongly encouraged and is widely available, especially to protect those persons at risk of severe disease.  The vaccine appears to be a good match to the circulating strains this year, and it is not too late to get vaccinated.  

For more information, see the Health Alert from Dec. 26 about Early Reports of pH1N1-Associated Illnesses for the 2013-14 Influenza Season at http://go.usa.gov/Zp6w and the Health Alert from Jan. 8 about Widespread Influenza Activity in Maine at http://go.usa.gov/ZdAj

Weekly updates on flu activity are available online:

• for Maine: http://go.usa.gov/NoK
• for the US: http://go.usa.gov/ITB
• for the world: http://go.usa.gov/ITK

In addition, people and clinicians may review or anonymously report flu at www.flunearyou.org  

Prevention 

Take everyday preventive measures against the flu:

• Wash your hands frequently with soap and water, but especially after coughing and sneezing. Alcohol-based hand gels can also be used.
• Avoid touching your nose, mouth, and eyes. Germs can spread this way.
• Consult your health care provider about getting a pneumococcal vaccine for anyone who is younger than 5, between ages 5 and 64 with high risk conditions, or age 65 and older.
• Avoid contact with sick people. If you are at very high risk for complications, you may want to avoid large crowds.

Vaccination

There is still time to get vaccinated against the flu for this season. Full immunity develops 7-10 days after the vaccine is administered. To find locations where vaccine is available, contact your health care provider or pharmacy, call 211, or visit www.211maine.org  or www.flu.gov 

Maine CDC recommends that Health Care Providers continue vaccinating to protect against influenza this year. To ensure that vaccine is available for all Maine people who are seeking it, please use the following as guidelines:

Health Care Providers should use state-supplied vaccine for patients in the following circumstances:

• The patient is a child ages 6 months through 18 years;
• The patient is pregnant or the partner of a pregnant patient;
• The patient's insurance does not cover vaccinations;
• The patient is uninsured.

Health Care Providers may use state-supplied vaccine for other patients only if:

• The Health Care Provider has already vaccinated all eligible patients listed above and has excess state-supplied vaccine; and
• Privately purchased vaccine is not available.

Please remember that providers may not charge for state-supplied vaccine. It is reasonable and allowable to charge an administration fee for administration of state-supplied vaccine in some circumstances provided that:

1. MaineCare-eligible children are not charged an out of pocket administration fee;
2. Administration fees do not exceed the regional Medicare maximum; and
3. No one is denied vaccine because of their inability to pay an administration fee.  

Treatment

If you have the flu:

• Stay home if you are sick, until you are fever-free for a full 24 hours without taking fever-reducing medicine.
• Cough and sneeze into your elbow or into a tissue. Throw the tissue away.
• Although most people can stay home to recover without seeing a health care provider, it is possible for healthy people to develop severe illness from the flu. Anyone with the flu should seek medical attention for:
• Dehydration
• Trouble breathing
• Getting better, then suddenly getting a lot worse
• Any major change in condition

For more information, visit www.maineflu.gov. 

Birth Defects

January is National Birth Defects Prevention Month and this year’s theme is “Birth defects are common, costly, and critical.”

Every 4.5 minutes, a baby is born in the U.S. with a birth defect. Major birth defects are conditions present at birth that cause structural changes in one or more parts of the body. They can have a serious adverse effect on health, development, or functional ability. Babies who survive and live with birth defects are at increased risk for developing many lifelong physical, cognitive, and social challenges. Medical care and support services only scrape the surface of the financial and emotional impact of living with birth defects.

Not all birth defects can be prevented, but a woman can increase her own chances of having a healthy baby by managing health conditions and adopting healthy behaviors before becoming pregnant. This is important because many birth defects happen very early during pregnancy, sometimes before a woman even knows she is pregnant. Here are some steps a woman can take to get ready for a healthy pregnancy:

• consume 400 micrograms of folic acid daily
• manage chronic maternal illnesses such as diabetes, seizure disorders, or phenylketonuria (PKU)
• reach and maintain a healthy weight
• talk to a health care provider about taking any medications, both prescription and over-the-counter
• avoid alcohol, smoking, and illicit drugs
• see a health care provider regularly
• avoid toxic substances at work or at home
• ensure protection against domestic violence
• know their family history and seek reproductive genetic counseling, if appropriate

For more information, visit http://go.usa.gov/Zd8w or http://go.usa.gov/Zd9x