The evidence on climate change

photo-consensus-senseThe theory that the earth’s climate is warming has been a highly debated topic in the media for more than a decade. Proponents of the theory point to evidence about melting polar ice caps and increased storm activity, while critics say there’s not enough data to know what’s happening over the long-term.  But what does the evidence really say?

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Are mammograms worthwhile?

breast cancer ribbonThe National Cancer Institute recommends that women age 40 and older have a mammogram to screen for breast cancer every 1 or 2 years.  But now a new study is raising questions about whether mammography is really worthwhile. [Read more…]

Update: New evidence on Parkinson’s disease

According to the National Institutes of Health, at least 500,000 Americans suffer from Parkinson’s disease, and about 50,000 new cases are reported each year. The disease is a progressive neurological disorder that is caused by the degeneration of neurons in a region of the brain that controls movement. Tremors are the most common symptom, but others include rigid limbs and slow movement. [Read more…]

Evidence on child well-being across the globe

Ensuring children grow up to be healthy, productive and fulfilled adults are major goals of every society. Children across the world today face complex risks and challenges including the wide availability of unhealthy foods, the prevalence of bullying and increases in drug and alcohol abuse. [Read more…]

The facts on mold for hurricane victims

Nearly a month after hurricane Sandy battered the east coast, homeowners in New York and New Jersey are still trying to dry out their homes and assess all of the damage.  For those whose homes were flooded, a major problem they will face is mold.

Mold spores thrive in flooded homes, where everything is damp and there is plenty of organic material as a base for them to grow and thrive.  They often cause respiratory problems, irritate the skin and eyes, and can lead to lung infections.

Here at EBL, the topic of mold in homes is not a new one. Just last year, we wrote about a systematic review by the Cochrane Collaboration that details the best ways to prevent respiratory problems caused by mold.

Luckily, there is plenty of solid evidence on effective ways to cope with mold in your home. Joe Laquatra, a professor of design and environmental analysis at Cornell, is an expert in coping with mold in homes and a member of the New York State Center for Indoor Environmental Quality. He has developed a comprehensive, evidence-based information sheet that details the health effects of mold in homes and the best methods for removing it.

Among his recommendations are:

  • Homes that are wet for more than 48 hours are at risk of developing mold.
  • It’s best to discard wet ceiling tiles, cellulose insulation, and often drywall as well.
  • If mold is detected over more than ten square feet of a home, the best course of action is to hire a mold remediation contractor. Another fact sheet offers tips about selecting a contractor.

The take-home message: Mold is a serious issue in homes that have experienced flooding. It’s important to understand all of the facts to avoid health problems caused by mold.

To spray or not to spray?

Lyme disease – an infectious disease spread by ticks that thrive in wooded areas – is on the rise in the Northeast. The disease can be debilitating if undiagnosed, causing chronic fatigue, joint pain andneurological problems.

As a mom, it’s a really worry for me.  My kids are outside every day, often on trails or in wooded areas.  I check them daily for ticks, but one would be easy to miss.

This year, I’ve often debated with other parents the risk and benefits of using bug spray. On one hand, there is clear evidence that the insecticide DEET – or N,N-diethyl-meta-toluamide – effectively repels ticks.  But on the other hand, there are cases where it is clear that DEET has led to health problems including skin problems, hallucinations and seizures.

So I went hunting for some more sweeping analyses on what the evidence says about DEET. The Journal of Family Practice provided a good summary of several systematic reviews on the use of DEET in children. Both found the risk of adverse reactions was low – about 0.1 percent of children exposed experiences an adverse reaction – and that there was no clear dose-dependent relationship between exposure and extent of severity of the reaction.

The U.S. Centers for Disease Control maintains that DEET doesn’t present health concerns if it’s used according to the instructions, including not applying it to open wounds, under clothing, or near eyes or mouth.

As a mother, though, the narrative reports of small children undergoing hospitalization for seizures and neurological problems – even though it’s a very small number of cases over decades – stick in my mind.  So we use bug spray with DEET sparingly.  If I know the kids will be in the woods or fields where there are higher populations of ticks, I’ll give them a light spray – always with a bath that night to wash off all of the spray.  Even though the evidence shows DEET is safe, I still feel uneasy about this issue.

What about you? Are you comfortable using buy spray on a regular basis?

How your working environment impacts your health

Adopting a healthy lifestyle can be tough these days, especially for parents working hard to make ends meet. Yes, there are gyms and organic grocery stores, on-demand yoga and healthy cooking magazines.  But for working parents, long hours and irregular schedules make can make it difficult to eat healthily and exercise.

A cadre of researchers are Cornell’s College of Human Ecology are working on this problem, conducting the research and pulling together the best evidence to help families exercise more and eat healthier.

Among them is nutritional sciences professor Carole Devine, who has created and evaluated a program that helps change workplace environments to support physical activity and healthy eating.

The program, called Small Steps are Easier Together, is an active collaboration between Cornell faculty, Cooperative Extension educators and worksite leadership teams across New York. Pilot studies have been conducted in 23 sites since 2006. It involves worksites creating wellness leadership teams, who work with Cornell researchers to implement evidence-based strategies – like creating walking groups, posting maps, and offering more fruit and vegetable options in the cafeteria – to increase walking and promote healthier eating.

The most recent analysis of the program included 188  participants in 10 rural worksites. It found the percentage of sedentary women had declined to from 42 percent to 26 percent. A total of 35 percent of the women moved to a higher activity level.

Devine is also pulling together the evidence on how working conditions impact food decisions for families at home and on the job.

Her research has found that the stress of a busy job impacts parents’ ability to serve healthy meals, leading them to serve quicker and less healthy meals, such as fast food. She’s investigated a variety of coping strategies such as negotiating a more flexible work schedule and teaming up with a neighbor to take turns preparing meals.

Devine’s work highlights the connections between work environments and health, and provide some evidence-based strategies to improve public health.

New evidence on global warming

An international team of researchers have developed a new plan to slow climate change – one that involves reducing levels of two of the lesser-known contributors to global warming.

Their paper, published this week in the journal Science, recommends 14 actions to reduce emissions of methane gas – a greenhouse gas more powerful than carbon dioxide – and black carbon – the technical term for soot, which absorbs heat from the sun’s rays.

Among the measures they suggest are:

  • encouraging people to use switch cleaner diesel engines and cookstoves
  • building more efficient kilns and coke ovens
  • capturing methane at landfills and oil wells
  • reducing methane emissions from rice paddies by draining them more often.

Adopting the study’s recommendations would reduce projected temperatures by approximately 0.5°C by 2050, as well as avoiding millions of premature deaths due to air pollution and increasing crop yields thanks to reductions in ozone.

The proposal is a projection, to be sure.  But there is a large body of evidence available that shows there are many benefits to reducing these contaminants.

Systematic reviews show that reducing soot levels improves lung function and pregnancy outcomes. And it’s been clearly documented that methane gas warms the atmosphere, and that reducing its levels will boost agricultural yields.

So, in fact, the new study delivers another benefit, as noted in this New York Times column: it offers practical solutions with the immediate benefits of improving health and helping farmers produce more.

To us, it seems like a proposal worth putting into practice.

The best thing for kids: A supportive environment

The vast majority of parents – regardless of their income, education or upbringing – want the best for their children. I know that I never imagined the lengths I would go through for another human being until I held a tiny baby in my arms.

This week, the American Academy of Pediatrics issued a policy statement explaining exactly what parents can do to ensure their children’s health and development: avoid toxic stress.

(Before we go on, a quick word about policy statements:  Similar to systematic reviews, they involved a panel of experts – in this case pediatricians – who review the body of evidence on a given topic and make a recommendation based on the available research. So they’re a big deal.)

The statement explains that personal experiences and environmental factors that activate the physiological stress response for prolonged periods of time disrupt children’s brain circuitry and can have an impact on physiology, behavior and health even decades later. Essentially, too many or too long stressful experiences is bad for kids. The statement is referring to major, lasting problems: verbal abuse in the home, a chronic lack of affection for children, physical threats to family members, an addiction problem.

The statement builds on the research of Cornell faculty member Gary Evans, an environmental psychologist who studies the impact of the physical environment and poverty on children. Evans research has shown that growing up in an environment of poverty can lead to health problems.

In another study, Evans looked at the impact of noisy environments on children’s development.

“People tend to think of noise in terms of how it impacts hearing,” he explained. “But if you are subjected to noise, you’re likely to have elevated blood pressure and elevated stress hormones, and those have real implications for your health. Children who grow up in noisy environments are more likely to have deficits in reading because if you tune out noise in general, you also tune out speech. And language is a fundamental building block for learning to read.”

A third study, published in the journal Pediatrics this month, found children who undergo chronic stress have larger gains in their Body Mass Index, suggesting chronic stress leads to weight gain.

The statement makes the arguments that pediatricians – who hold some responsibility for ensuring children’s health – should do more to ensure kids are growing up in health environments. This could mean developmental screenings, connecting families with social services, and supporting community programs that provide positive environments for children.

You can read more about the policy statement and its implications in this New York Times opinion column. And then take the time to make sure the children in your life – whether they’re your own kids, other relatives or neighbors – feel a little more secure and loved. It can go a long way to making a difference in the rest of their lives.

Got mold? Follow the evidence

Storms, floods and hurricanes are an unfortunate reality in our world – one that often leads to damp buildings, mold and potential health problems.

Here on EBL, we’ve discussed some of the evidence-based tactics for dealing with flooding.  Now a new systematic review by the Cochrane Collaboration reviews the data available on preventing respiratory illnesses due to environmental mold.

The review included eight studies with 6,538 participants. In each study, researchers tracked incidence of asthma and respiratory illnesses after the removal of mold and dampness from family houses, schools and an office building.

The review found some improvements in health. For example, the number of emergency and inpatient visits decreased and students visited the doctor less frequently due to colds.  On the whole, mold remediation decreased the severity and amount of symptoms in patients with asthma and respiratory infections.

But because each study measured different outcomes and designs varied widely, the authors found it “difficult to draw hard conclusions” and recommended better research.

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