Local Groups Focus on an International Public Health Project

Maternal and neonatal tetanus is a major public health concern in 48 countries around the world, mostly in Asia and Africa.  Although easily prevented with a simple vaccine, maternal and neonatal tetanus claims the lives of nearly 180,000 women and children each year. In brief, tetanus is caused by a neurotoxin that fatally infects the nervous system. The bacteria live in soil in nearly every country and enter its hosts by way of open injuries or wounds. Maternal and neonatal tetanus is caused by unsanitary methods of delivery, abortion, or umbilical cord care. In third-world countries, maternal and neonatal tetanus is common because of unsanitary conditions in which children are born.

Studies have shown that maternal and neonatal tetanus can be eliminated – not just reduced – through inoculation. In brief, administering a tetanus shot to pregnant mothers and children in third-world countries not only helps control tetanus – it banishes it!

So what does tetanus and Crawford County have in common? Certainly, we live in an area far removed from the threat of tetanus at this elevated level. But, Meadville and the surrounding area is really playing a key role in working with public health professionals around the world to eliminate maternal and neonatal tetanus. In fact, several groups throughout our region desire to eliminate maternal and neonatal tetanus and have joined UNICEF and The World Health Organization in The Eliminate Project. This project focuses on getting the maternal and neonatal tetanus vaccinations to third world countries. So, who are the groups in our area helping out? They would be all our community Kiwanis Clubs.

Kiwanis International has committed its human and financial resources to work with WHO and UNICEF to deliver tetanus vaccinations to countries suffering from MNT (maternal and neonatal tetanus).  This requires reaching approximately 130 million women to protect them and their unborn babies from the disease.  Without treatment, one out of four people who are infected with the bacteria die. The death rate is much higher for newborns. Tetanus is an ugly disease, and its symptoms include powerful and painful muscle spasms and severe breathing difficulties along with excessive sweating and high fever. These types of symptoms are nearly unbearable for an adult, but for a child, they are impossible to overcome.

It is for this reason that Kiwanis Clubs around the world – including those in Crawford County – have joined forces to combat and eliminate this disease across the world. Kiwanis’ overall mission is about children.  The group’s motto is “Children: Priority One.” Thus, working to save the lives of children by eliminating the presence of a disease fits well with this group’s mission. The Kiwanis Club of Meadville as well as the Meadville Golden K Club has demonstrated full support of this project through financial gifts as well as helping to educate the community about The Eliminate Project. Other Crawford County Kiwanis Clubs have also joined the project. It is the desire of WHO, UNICEF and Kiwanis to rid the world of this disease in a few years.

For more information on The Eliminate Project, visit www.theeliminateproject.org and learn how our small town is assisting the public health world in a large way.

References

Roper, M. H., Vandelaer, J. H., & Gasse, F. L. (2007). Maternal and neonatal tetanus. The Lancet, 370, 1947-1959.

Saetre, J. C. (2011). Eliminate. Kiwanis eliminating maternal/neonatal tetanus. Kiwanis, 96, 1. 14-17.

What you need to know about radiation exposure

The Centers for Disease Control and Prevention reported that people around the world are exposed to small amounts of radiation every day from a variety of sources. In fact, natural sunshine, foods, microwave ovens, and nuclear power plants are all on the list of exposure sources. This abundance of radiation sources begs the question of whether there is a level of radiation exposure that is considered safe. The Environmental Protection Agency reports that there really is no firm basis for setting safe exposure levels. Studies have shown that over time, radiation exposure of any source can lead toward risks of various cancers, especially thyroid carcinomas. 

Radiation is measured in rems, a word that means a large unit of radiation. An mrem is a milli-unit of radiation, which is the scientific measurement for radiation emissions and exposures.

Here is a list of annual radiation exposures from the following sources:

• Cosmic/Atmospheric Radiation: 25 mrem (at sea level…higher mrem at higher levels)
• Soil/Earth: 50 mrem
• Radon: 200 mrem
• Food (carbon-14 and potassium): 20 mrem
• Other People (who naturally contain carbon-14 and potassium): 40 mrem
• Watching TV: 1 mrem
• Wearing False Teeth: 0.1 mrem
• Living Near a Nuclear Power Plant (functioning properly): 0.01 mrem
• Wearing a pacemaker: 75 mrem
• Living with someone wearing a pacemaker: 7.5 mrem

Receiving Medical X-Rays:

• Extremity (arm, leg, etc) Xray: 1 mrem
• Dental Xray: 1 mrem
• Chest Xray: 6 mrem
• Nuclear Medicine (thyroid scan): 14 mrem
• Neck/Skull Xray: 20 mrem
• Pelvis/Huip Xray: 65 mrem
• CAT Scan: 110 mrem
• Upper GI Xray: 245 mrem
• Barium Enema: 405 mrem

The average annual dose rate for Americans is 360 mrems per year. The American Nuclear Society states that the risks of dying from radiation-causing cancers increase if the body accumulates 250,000 mrem in one lifetime. According to the Society, that would mean an annual exposure of 3,000 mrem per year over the course of 80 consecutive years – a highly improbable occurrence.

Unusual radiation exposures:

• Airplane ride (39,000 feet): 0.5 mrem per hour
• Coast-to-Coast Airline Flight: 5 mrem
• Drinking Water: 5 mrem
• Natural gas in the home: 9 mrem
• Three Mile Island Exposure at Meltdown: 80 mrem
• Radiation from Cancer Treatments: 100,000 mrem
• Japan’s Nuclear Power Plant Meltdown Potential: 100,000 to 1,000,000 mrem

Exposures and their associated symptoms, as listed by the Environmental Protection Agency:

Exposure in rem	Health Effect	Time for onset after immediate exposure
5-10	Changes in blood chemistry	Hours
50	Nausea	Hours
55	Fatigue	Hours
70	Vomiting	Hours
75	Hair loss	2-3 Weeks
90	Diarrhea	2-3 Weeks
100	Hemorrhage	2-3 weeks
400	Possible death	Within 2 months
1,000	Destruction of intestinal lining Internal bleeding Death	1-2 weeks
2,000	Damage to central nervous system Loss of consciousness Death	Minutes, Hours or Days (depending on the health of the individual before exposure)

References:

Centers for Disease Control and Prevention. (2011). Frequently asked questions about a radiation emergency. Retrieved March 14, 2011 from http://www.bt.cdc.gov/radiation/emergencyfaq.asp.

Environmental Protection Agency. (2010). Radiation protection: Health effects. Retrieved March 14, 2011 from http://www.epa.gov/rpdweb00/understand/health_effects.html.

Idaho State University. (2011). Radiation and risk. Retrieved March 14, 2011 from http://www.physics.isu.edu/radinf/risk.htm.

Nuclear Detection Products. (2011). What radiation levels are considered safe? Retrieved March 14, 2011 from http://www.blackcatsystems.com/GM/safe_radiation.html.

Torres, M. (2011). Japanese nuclear meltdown means detrimental health effects worldwide. Retrieved March 14, 2011 from http://www.infowars.com/japanese-nuclear-meltdown-means-detrimental-health-effects-worldwide/.

Can Radiation Travel From Japan to the US?

The disaster in Japan has caused more than just a national crisis, it has also created some worldwide public health concerns. These concerns include obtaining clean water, food, medical supplies, and shelter – all the basics of life. Yet, one public health risk is causing the most unrest around the world: radiation exposure from Japan’s nuclear power plants.

The Environmental Protection Agency notes that radiation is energy that travels in the form of waves or high-speed particles. It is a naturally occurring phenomenon found in both sunlight and sound waves. Man-made radiation is a similar entity and is used routinely for X-rays, in your cell phones, and other electronic devices. Exposure to small amounts of radiation over long periods of time does raise your risks for cancer. Exposure to large amounts over short periods of time can cause radiation sickness, including nausea, weakness, hair loss, skin burns, and reduced organ function. The EPA warns that large exposures, such as that from a nuclear power plan meltdown can cause premature aging or death.

With those statistics associated with the word “radiation,” it’s no wonder there are worldwide concerns regarding exposure. Plus, the probable exacerbation of such concern could likely stem from the remembrance of two prior nuclear disasters: Chernobyl and Three Mile Island.  The World Health Organization has clearly stated that although Japan’s nuclear reactor problems are serious, they are not of the same magnitude that were seen in the two prior cases. At the time of the Chernobyl and TMI incidents, the reactors in question were constructed with far less safety regulations than the ones in modern-day Japan. Studies have shown that the radiation levels from Chernobyl occurred because the facility lacked a secondary containment, now required at any modern nuclear power plant. During that incident, radiation that was inadvertently released into the air traveled by wind to affect the northern parts of the Ukraine.

Last weekend’s tragedy does carry some risk of wind that could blow radiation across the Pacific Ocean and onto the west coast of the United States. The question remains how large is the risk to the United States? Can that air actually reach Pennsylvania? On Sunday, March 13, the U.S. Nuclear Regulatory Commission issued an emergency statement that addressed this issue: “Given the thousands of miles between the two countries, Hawaii, Alaska, the U.S. Territories, and the U.S. West Coast are not expected to experience any harmful levels of radioactivity.” A news report out of Fresno, California also confirmed the U.S. NRC’s statement. According to the CEO of the Fresno Nuclear Energy Group, “there is no possibility of enough radiation leaking to get into the air to come that far.” That means that it is even far unlikely that any radiation will linger across the states to the Atlantic Ocean. It will dissipate long beforehand.

Although close to zero percent, the risk of radiation exposure in the United States does exist. A worst-case scenario could cause heavy radioactivity from excessive heat to be carried by both water and air across the Pacific, according to nuclear security experts. Yet, considering that sea water and boric acid are working to keep the reactors cool, this is an unlikely event. Experts say the containments around the reactors were built for protection and are holding. While a meltdown is possible, it is not going to cause the problems seen at TMI or Chernobyl.

If you do have loved ones on the west coast, there is no need for alarm. The Centers for Disease Control and Prevention note that we are exposed to radiation every day from all types of sources. However, in the event of an emergency, advisories may be posted to “shelter in place.” This means that people should stay inside their homes, confine their airflow to indoors and stay away from outdoor air. If this were to happen, it would only last for a short period of time. For more details on radiation exposure, visit the CDC’s website at www.cdc.gov.

References

Centers for Disease Control and Prevention. (2011). Emergency preparedness and response: Radiation emergencies. Retrieved March 14, 2011 from http://emergency.cdc.gov/radiation/.

Doyle, A. (2011). Japan nuclear health risks low, won't blow abroad. Retrieved March 14, 2011 from http://news.yahoo.com/s/nm/20110313/hl_nm/us_japan_quake_health.

Environmental Protection Agency. (2011). Radiation exposure. Retrieved March 14, 2011 from http://www.nlm.nih.gov/medlineplus/radiationexposure.html.

Garma, J. (2011). Japan tsunami creates health concerns… are you prepared? Retrieved March 14, 2011 from http://www.garmaonhealth.com/2011/03/japan-tsunami-health/#.

Williams, D. (2009). Radiation carcinogenesis: Lessons from Chernobyl. Oncogene, 27, S9-S18.

U.S. Nuclear Regulatory Commission. (2011). NRC News Brief No. 11-046. Retrieved March 14, 2011 from http://www.nrc.gov/.

Undestanding the Bed Bug Dilemma

The most recent nationwide public health crisis has revolved around the discovery of bed bugs. According to the Environmental Protection Agency, these little critters are not known to transmit diseases but they come with many other challenges.  Probably the most critical challenge comes from the use of pesticides to eliminate bed bugs from any indoor location. The EPA warns that many pesticides are intended for outdoor use, are highly toxic, and should never be used inside. Furthermore, using such a pesticide will most likely result in sickening you and your family…and not take a bite out of the bed bug problem.

Bed bugs seemingly resurfaced thanks to the increase in international and domestic travel coupled with the general population’s ignorance in keeping them at bay. A recent article in the Journal of Environmental Health reported that six different movie theatre companies found bed bugs in their facilities, and more schools, hospitals, hotels, and other public locations have reported infestations across the states. This infestation has caused the U.S. Government to declare the problem to be an epidemic. On the local front, there are no reports of bed bug infestations in any public location in Crawford County as well as immediate neighboring counties of Erie, Venango, Warren, and Mercer. According to the website bedbugreports.com, which provides an updated list of hotels and apartments and associated bed bug reports across the nation, the closest bed bug infestation was discovered at the end of January in Indiana County. In early February, another infestation was discovered in DuBois, located in Clearfield County. Several other infestations were discovered in the larger metropolitan areas of Pittsburgh and Philadelphia at the end of 2010 and beginning of this year.

Contrary to popular belief, bed bugs are very easy to spot. In addition, bed bug nymphs and eggs are also visible to the naked eye. Bed bugs are also not attracted to dirty areas; they are drawn toward warm spots…which are often hidden by clutter around the house. The EPA suggests that routine use of pesticides as a controlling method has created an increased resistance by bed bugs, which have learned to thrive under the exposure. However, there are methods to reduce the chances of bed bug infestations. Through common-sense practices, people can protect against the pest and live bug-free. The most beneficial method is to perform regular house cleaning, such as laundry, vacuuming, mopping, and spring cleaning. Removing clutter were bed bugs can thrive will prevent the critters from ever showing up in your home. In addition, when you travel, check all clothing for unwanted pests – or simply launder everything after a trip.

There are also non-chemical treatments that you can apply to help kill any bed bugs that might appear in your home – including washing and drying bedding at high temperatures (at least 113-degree Fahrenheit) for one hour. The higher the temperature, the shorter the time needed to kill the bugs at all stages of their life. In addition, very cold washings can also kill the bugs – below 0-degrees Fahrenheit for at least four days.

Although pesticides are undesirable, there are some safe chemicals approved for consumer use by the EPA. The EPA’s website includes a ‘bed-bug search tool’ that offers a means of finding the appropriate chemical to rid your area of bed bugs. The product to be used highly depends on the location of any infestation (i.e. mattresses, couches, carpets). This interactive tool is available at http://cfpub.epa.gov/oppref/bedbug/. In the event of an emergency, you are requested to phone Poison Control at 800-222-1222.

References

Bedbugreports.com. (2011). Latest bed bug reports. Retrieved February 17, 2011 from http://www.bedbugreports.com/state/pennsylvania.

Berg, R. (2010). Bed-bugs: The pesticide dilemma. Journal of Environmental Health, 72(10), 32-35.

Environmental Protection Agency. (2011). Bed bug information. Retrieved February 17, 2011 from http://www.epa.gov/pesticides/bedbugs/.

Environmental Protection Agency. (2011). EPA-registered bed bug products. Retrieved February 17, 2011 from http://cfpub.epa.gov/oppref/bedbug/.

Getting High on Nutmeg

Recently, Dr. Tom Arno reported on his Cool-101 radio show that children and youth had found nutmeg to be a readily available and safer alternative to cannabis for “getting high.” As ridiculous as this sounds, there is empirical evidence supporting his report.  According to the Human & Experimental Toxicology journal, a study performed in Texas found that of the calls to poison centers regarding nutmeg overdose, 65% were caused by intentional ingestion with all of them being males, mostly under age 19. Other research also showed that nutmeg has been abused over many years by people of all ages, mostly the younger generations, but the numbers of abusers are small.

Nutmeg abuse does have a long-standing history thanks to its main ingredient, myristicin. Myristicin is a natural organic compound classified as a phenylpropene (elements found in essential oils). Myristicin is also a naturally occurring compound found in insecticides and pesticides and does have psychotropic effects when consumed in large quantities over a short period of time. According to clinical research, the “nutmeg high” comes in the form of mild hallucinations and warmth in the limbs; it does not come with the euphoria feeling typically associated with the “high” of their illegal drug counterparts. But, don’t let that scare you into eliminating the spice from your kitchen cabinet. The truth about nutmeg may be more of a deterrent for use as a psychotropic drug than an attraction.

Clinical research shows that there are numerous unpleasant side effects that include loss of coordination, dry mouth lasting for days, sore throat, decreased body temperature, double-vision, blurred vision, extreme paranoia, and difficulty urinating.  According to food and financial blog writer Mary Rice, “those who have tried a nutmeg high report it comes with a hangover that is ‘legendary.’” With memorable symptoms like these, the long-lasting negative side-effects far outweigh the short-term desirable psychotropic effects of nutmeg.

Because of this fact, nutmeg is not a primary focus for public health professionals nationwide. It is also most likely for this reason that the National Poison Control Center and the American Association of Poison Control Centers’ websites do not include information on nutmeg dangers or overdoses. Of interest, the two Pennsylvania Poison Control Centers (Pittsburgh and Philadelphia) also have not added nutmeg as a dangerous poison on their websites.

Rice also noted that while there is a need for parents to be aware of the dangers of nutmeg, it is not a cause for panic. Most spices contain some sort of volatile compound, which is what creates the flavor sensations in our food. As she noted, “There is a fuzzy line between food and medicine,” so there is no reason to toss out the spice rack. Being aware of the potential dangers of all elements in your home is the best defense against abuse of them – whether accidental or intentional. Should an emergency or overdose occur with your child, the first step is a trip to the emergency room. Let your healthcare provider guide you through the rest.

References:

American Association of Poison Control Centers (http://www.aapcc.org)

Forrester, M.B. (2005). Nutmeg intoxication in Texas: 1998-2004. Human & Experimental Toxicology, 24, 563-566.

National Poison Control Center (http://www.poison.org)

Philadelphia Poison Control Center (http://www.chop.edu/service/poison-control-center/home.html)

Pittsburgh Poison Control Center (http://www.chp.edu/CHP/poisoncenter)

Rice, M. (2010). Nutmeg high: Hallucinogenic spice produces legendary hangover. Retrieved January 15, 2011 from http://personalmoneystore.com/moneyblog/2010/12/02/nutmeg-high/.