Kim’s public health blog

More than 8,700 infants end up in the emergency room each year because their car seats are used improperly outside the car, according to study presented Monday at the American Academy of Pediatrics’ annual meeting in Washington. Babies are spending more time in car seats, which have saved nearly 9,000 lives in the past three decades, both in and out of the car, says author Shital Parikh, a pediatric orthopedist at Cincinnati Children’s Hospital Medical Center.

Researchers at Fred Hutchinson Cancer Research Center have demonstrated that it is possible to successfully recruit and retain a large number of adolescent smokers from the general population into a smoking intervention study and, through personalized, proactive telephone counseling, significantly impact rates of six-month continuous quitting. The trial, funded by the National Institutes of Health, involved 2,151 teenage smokers from 50 high schools in Washington. Half of the schools were randomly assigned to the experimental intervention; teens in these schools were invited to take part in confidential, personalized telephone counseling designed to help motivate them to quit.  COMMENT. Despite the praise for the study, the difference in quit rates for test and control groups was only 4%.  This was despite a highly intensive effort.  No Cost[benefit analysis was done but it is highly unlikely for the process to work in the general population because of cost.

The Los Angeles Times (10/14, Stein) “Booster Shots” blog reported that as bicycles ride a wave of popularity, “cyclists may be suffering more injuries,” according to University of Colorado researchers. After looking at “accident rates and severity from 1996 to 2006,” they noted that “among 329 bicycle accident cases admitted to the Rocky Mountain Regional Trauma Center at Denver Health Medical Center, the length of stay increased substantially over those years.” What’s more, “an increase was seen in chest injuries (up 15 percent), and abdominal injuries tripled over the last five years of the study. About one-third of 118 patients had head injuries.” Comment: Cycling is certainly more dangerous in the US than Europe where most roads have dedicated bicycle lanes, There are very few such lanes on US roads, particularly in housing areas.  This absence in planning oversight contributes to obesity by limiting opportunities for exercise, the same neighborhoods usually lack sidewalks for walking safely, as well.

A study performed at  The University of Rochester Medical School   showed that when adolescents graduate to young adulthood, their preventive care tends to fall by the wayside. A recent study has found that young adults are much less likely to use ambulatory or preventive care, even though their mortality rate is more than twice that of adolescents. COMMENT: I have difficulty understanding why this should surprise anyone when the  various insurance programs, including Medicaid fail to pay for counseling by primary care practitioners. Further once the individual reaches 18 years of age eligibility for Medicaid vanishes.

In this week’s BMJ we find that despite all the medical, public health, social, economic, and political changes over the 20th century, patterns of poverty and mortality and the relations between them remain firmly entrenched. There is a strong relation between the mortality levels of a century ago and those of today. This goes beyond what would have been expected from the continuing relation between deprivation and mortality and holds true for most major modern causes of death. Comment. Most of these deaths are related to chronic diseases and individual behaviors, which have always had an adverse impact on low income groups that have had poorer education

According to a recent study by researchers from the University of Colorado at Boulder, dirty showerheads in homes may well be a potential breeding ground for infectious bacteria – Mycobacterium avium, which can cause lung infections when inhaled or swallowed.  The study, funded by the National Institute of Occupational Safety and Health and the Alfred P. Sloan Foundation, is part of a larger effort that is analyzing the microbiology of the indoor environment and its role in spreading to illness within the house. Comment: BUT, what evidence is there that people have been made ill by taking a shower? This seems to be an example of money looking for a spending source. In a depressed economy it is this kind of research that makes academics look bad,  It is certainly not a random sample of homes in the US. Ivan Illich would have loved this action.

From the  Institute of Medicine: Local governments play a crucial role in the fight against childhood obesity by creating environments that make it either easy or hard for children to eat healthier diets and move more. A new report from the Institute of Medicine and National Research Council provides local officials with action steps that hold the greatest potential to reduce obesity rates among children, such as zoning restrictions on fast-food restaurants near schools, community policing to improve safety around public recreational sites, and publicly run after-school programs that limit video game and TV time.

The AP reports that six cases of childhood lead poisoning “in Maine last year came from an unusual source — lead dust tracked into the family car.” Officials from the CDC and the Maine Department of Health and Human Services said that the cases were “the first ever attributed to lead dust on childhood safety seats. The car seats themselves weren’t the source; the inside of family cars were contaminated through a parent’s workplace.” The CDC explained that children’s parents, who worked in paint removal or metals recycling, did not change and shower before going home, and so tracked lead dust into their cars and onto children’s car seats. Then, “Kids chew on the sides of those seats … Or they put a cookie down” on the seat and then eat it, Mary Jean Brown, chief of the CDC’s Lead Poisoning Prevention Branch said. “Maine officials said they now include checks of cars and child safety seats in their lead investigations.”

An editorial in this week’s Lancet lets the air out of the organic food movement. There is little evidence that the nutritional value of ‘organic’ products is better than food raised by other means,  but If one wants to buy organic food, do so because it might be fresher and taste better, contain less chemical residues, and is kinder to farmed animals. You have to decide if the price is worth the meal.

Studies from this recent HANES survey shows unexpectedly high blood lead levels among Medicaid eligible children . Comment: I wonder why anyone should be surprised. Most children eligible for Medicaid live in old housing, often with multiple layers of lead paint in the home.  The current approach of using children as canaries and deleading homes only after children are poisoned has continued for more than forty years despite evidence that rental housing laws ( Portsmouth, VA and Ypsilanti, Michigan) can ensure that no children are allowed to live in such dangerous homes.  It is high time that communities enforce safe housing for children rather than treating them after brain damage has occurred which will stunt their future development!  Perhaps realtors should not be allowed to run for local political offices.