Category Archives: Poisoning & Environmental Health

Naloxone kits for overdoses now available in Snohomish County

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Snohomish CountyNaloxone kits for treating opioid overdoses are now available at a number of pharmacies in Snohomish County.

These kits are available just by asking the pharmacists, there is no need to see a doctor to obtain a prescription.The cost of the kits is around $125.

Pharmacists will provide education to those being given a Naloxone kit on how to use it and when to use it.

In 2013 there were 86 opioid drug overdoses in Snohomish County, and 580 within Washington State.

The availability of naloxone (sold under the brand name Narcan) could potentially cut down on deaths due to heroin and prescription opioid drugs (morphine, oxycodone/OxyContin, methadone, hydrocodone/Vicodin, and codeine).  Continue reading

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States Seek to Protect Student Athletes from Concussions, Heat Stroke

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A Wet Bulb Globe Temperature calculator in use last week during a football practice of the Oconee County High School in Watkinsville, Georgia. The device, which measures temperature, humidity and radiant temperature is used to govern sports activities at all Georgia high schools. Photo © Stateline

By Michael Ollove
Stateline

Athens, Georgia—When Georgia public high schools were asked several years ago to devise a policy to govern sports activities during periods of high heat and humidity, one school’s proposal stood out: It pledged to scale back workouts when the heat index reached 140.

Those who understood the heat index, the combined effects of air temperature and humidity, weren’t sure whether to be appalled or amused. “If you hit a heat index of 140,” said Bud Cooper, a sports medicine researcher at the University of Georgia who examined all the proposed policies, “you’d basically be sitting in the Sahara Desert.”

The policy reflected an old-school, “no pain, no gain” philosophy, a view that athletes need to be pushed to their physical limits—or beyond them—if they and their teams are to realize their full potential.

In some places, state, school and sports officials are recognizing that the zeal of coaches, players, and parents for athletic accomplishment must be subordinated to safety. Increasingly, they are adopting measures to protect student athletes from serious, even catastrophic injuries or illnesses that can be the consequence of a blinkered focus on competitiveness. Continue reading

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Keep your cool in hot weather – CDC

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Sun Orange Orb by Cris DeRaudGetting too hot can make you sick. You can become ill from the heat if your body can’t compensate for it and properly cool you off.

Heat exposure can even kill you: it caused 7,233 heat-related deaths in the United States from 1999 to 2009.

Learn about heat-related illness and how to stay cool and safe in hot weather

.Main things affecting your body’s ability to cool itself during extremely hot weather:

  • High humidity. When the humidity is high, sweat won’t evaporate as quickly, which keeps your body from releasing heat as fast as it may need to.
  • Personal factors. Age, obesity, fever, dehydration, heart disease, mental illness, poor circulation, sunburn, and prescription drug and alcohol use can play a role in whether a person can cool off enough in very hot weather.

Continue reading

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Health system needs to prepare for global warming

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Climate change is happening, and with that will come more deaths from heat-related illness and disease, according to a report released Tuesday.

The report, spearheaded and funded by investor and philanthropist Thomas Steyer, former Treasury Secretary Hank Paulson, and former New York Mayor Michael Bloomberg, examines many of the effects of climate change for business and individuals.

“One of the most striking findings in our analysis is that increasing heat and humidity in some parts of the country could lead to outside conditions that are literally unbearable to humans, who must maintain a skin temperature below 95°F in order to effectively cool down and avoid fatal heat stroke,” the report’s authors wrote.

The average will be miserable. When your sweat can’t evaporate, you have no way to moderate core body temperature, and some people will die.

They use a “Humid Heat Stroke Index” that combines heat and humidity levels to measure how close they come to the point where the body is unable to cool its core temperature. So far the nation has never reached that level, “but if we continue on our current climate path, this will change, with residents in the eastern half of the U.S. experiencing 1 such day a year on average by century’s end and nearly 13 such days per year into the next century.”

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Dr. Al Sommer (Photo:Francis Ying/KHN

Dr. Al Sommer, the dean emeritus of the Bloomberg School of Public Health at Johns Hopkins University in Baltimore, was on the committee that oversaw the development of the report.

He says that often overlooked in the current debate about greenhouse gases and climate change is the effect of global warming on individuals and hospitals. Continue reading

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Pollution halts Vaughn Bay shellfish harvest: 14 other areas threatened

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Pollution to close shellfish harvest in one area; 14 others listed as threatened
Fecal bacteria levels force new restrictions to protect shellfish consumers

From the Washington State Department of health:

Alert Icon with Exclamation Point!OLYMPIA — The state Department of Health has closed harvesting in part of Vaughn Bay in Pierce County due to high levels of fecal bacteria. Health officials also identified 14 more of Washington’s 101 commercial shellfish growing areas that could be closed in the future if fecal pollution continues to get worse.

“The good news is that the pollution problems in almost all these areas can be found and fixed,” said Bob Woolrich, Growing Area section manager. “There have been many successful pollution correction projects using partnerships with local and state agencies, Tribes, and others.”

The agency shellfish program evaluates the state’s shellfish growing areas every year to see if water quality is approaching unsafe limits. If so, areas are listed as “threatened” with closure.

Shellfish harvesting areas threatened with closure include:

Continue reading

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App lets you determine your neighborhood’s radon risk

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Screen Shot 2014-01-21 at 11.28.29From the Washington State Department of Health

Olympia, January 21, 2014 – Washington residents now have a new online map to check and see if their neighborhood has a geological risk for the cancer-causing gas, radon, using a new state app. The new app is offered by the state Department of Health’s Washington Tracking Network.

Some areas of the state, such as Spokane and Clark counties, are well-known for having higher levels of radon, but the new online map shows that there are some areas around the Puget Sound such as Pierce and King counties that might come as a surprise.  Continue reading

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Over-the-counter pills left out of FDA acetaminophen limits

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By Jeff Gerth and T. Christian Miller
ProPublica

January 16, 2014 – Earlier this week, the U.S. Food and Drug Administration urged health care providers to stop writing prescriptions for pain relievers containing more than 325 milligrams of acetaminophen, the active ingredient in Tylenol.

The agency’s announcement was aimed primarily at popular prescription medicines that combine acetaminophen with a more powerful opioid such as hydrocodone.

Agency officials said they had determined that “there are no available data” to show that the benefits of having more than 325 milligrams of acetaminophen in a single pill outweighed the risks from taking too much of the drug. Continue reading

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Don’t use grills or gas generators in enclosed areas – Department of Health warns

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From the Washington State Department of Health

Power outages may raise risk of carbon monoxide poisoning

Charcoal grillDon’t use grills or gas generators in enclosed areas

January 10, 2014 — Barbecue grills and gas generators may seem like they could double as an indoor furnace during a power outage, but that can be downright dangerous.

Neither should be used inside to heat homes, as families could get sick and even die from carbon monoxide poisoning.

Carbon monoxide, or CO, is a poisonous gas that can’t be seen or smelled and can kill a person in minutes. Carbon monoxide is produced whenever any fuel such as gas, oil, kerosene, wood, or charcoal is burned. It can quickly build up to unsafe levels in enclosed or semi-enclosed areas.  Continue reading

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Seattle Children’s doctor offers tips to keep kids safe this holiday season

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Photo courtesy of Jay-Simmons

Photo courtesy of Jay Simmons

From Seattle Children’s On the Pulse blog

Tis the season for mistletoe, gingerbread and carefully strung lights. It’s the most wonderful time of the year, but also a potentially dangerous one for children. And although festivities, candles and garland may make the holiday season more cheerful, with them come some serious safety concerns.

Tony Woodward, MD, MBA, medical director of emergency medicine at Seattle Children’s Hospital, says the most important thing to remember this holiday season is supervision.

“The holidays are a fun and exciting time, but there are a few more things inserted into the environment, like holiday plants, electrical cables, new toys and festive beverages, which are potentially dangerous,” says Woodward.

Holiday safety tips

To keep kids out of the emergency room this year, Woodward recommends some basic safety tips to ensure an injury-free, but still festive holiday season.

Lights, trees and décor. Sparkly ornaments, shiny holiday decorations and small holiday figurines are potential choking hazards for small children. If an object can fit through a toilet paper tube, it can obstruct the airway of a small child and prevent breathing.

“Think like a child,” says Woodward. “Get down on your hands and knees and look around the house. If something looks shiny and enticing, a child may want to put it in their mouth. Keep decorations high and out of reach.”

Make sure trees and decorations are properly secured, either by a sturdy stand or to the wall. Also, talk to children about holiday decorations and explain that they are not toys. Set limits and supervise children.

Poisoning potential. Holiday plants like mistletoe, holly and poinsettias are commonly used as decorations, but they can be hazardous to children. These plants are considered potentially poisonous and should be kept away from children and out of reach. If a child ingests any part of these plants call a pediatrician or the Poison Help Line immediately at (800) 222-1222. Symptoms from poisoning may include vomiting, diarrhea, nausea or rash.

Medicines and vitamins can also be hazardous for children. Keep an eye out for medicine, vitamins and other personal products found in purses or suitcases that guests visiting for the holidays may bring into the home. Also, be aware when visiting other houses this holiday with your family, especially households without young children because the house may not be child proofed.

Be cautious of raw or undercooked foods during the holidays. Wash hands frequently when handling raw meat or eggs, and don’t leave foods out in reach of children.

Holiday parties. Hosting a holiday gathering this year? Plan for a party’s youngest guests first. Take small children into consideration when planning a party’s food and beverage menu, and before adorning the home with festive décor.

“Decorating the home with garland and strung beads may look great for the holidays, but children can mistake the brightly colored beads and floral arrangements for candy or food, which may cause choking or poisoning,” says Woodward.

Alcohol is another common risk for children around the holidays and during holiday gatherings.

“Kids see adults drinking alcohol and become curious. If glasses are left sitting out in reach of children they may ingest the alcohol, which even in small amounts can be dangerous to kids. Use common sense and always keep an eye on children,” says Dr. Woodward.

Also, stay home from parties or gatherings if children aren’t feeling well. Don’t risk spreading germs to others. Talk to children about proper hand washing and coughing techniques. Germs are easily spread, but these techniques can help prevent the transmission of germs from one person to another.

Fire safety. Keep decorations and trees away from heat sources within the home, which includes fireplaces, radiators, space heaters or electrical outlets. Also, avoid using candles if there are small children in the home.

When buying an artificial tree, make sure it is “fire retardant,” and also make sure a child’s sleepwear is labeled “fire retardant” as well. Be sure to also remove dry trees after the holiday season to reduce fire risk.

Use socket covers to baby-proof electrical outlets and make sure extension cords are well hidden and out of reach. Ensure cords are all the way in the outlets so kids don’t get shocked. Also, do not have water around outlets and wires.

Cooking is the leading cause of home fires in the U.S. Try to keep small children out of the kitchen while cooking or preparing food. Turn pot handles in so they can’t be accidently knocked over and stay in the kitchen while frying, grilling and broiling.

Toy safety. Many toys and holiday decorations require button batteries, which can pose fatal risks for young kids. Be sure batteries cannot be removed easily from toys and gadgets. If a battery is swallowed, it can cause life-threatening injuries. Also, avoid magnets. Toys that contain small magnets are especially dangerous for young kids. If swallowed, magnets can attract to one another in a child’s intestine and cause serious complications and even death.

“Make sure toys are appropriate for the age of a child, but also think about other children,” says Woodward. “Think about the worst case scenario. If a 1-year-old or 2-year-old will be in the home visiting for the holidays, ask if there are toys that could potentially be harmful to them.”

Just like checking a food’s ingredient list, parents should read toy and product labels. Avoid toys and products that contain PVC plastic, xylene, toluene or dibutyl phthalate.

Cold weather. With temperatures dropping, make sure children are properly dressed for the weather with hands, feet and heads covered. Dress children in layers and make sure they come in out of the cold periodically. The nose, ears, feet and hands are at the biggest risk of frostbite if temperatures are below freezing.

Supervise children while they play. Activities like sledding can be dangerous without proper supervision and safety gear. Also, be extremely cautious around water. Never allow children to walk across frozen lakes or ponds.

Lastly, wear sunscreen. It may be cold, but children are still at risk for sunburn.

The holidays are a time for celebration and fun. By following these simple safety tips, families can enjoy the holiday season without injury. Happy Holidays!

Photograph courtesy of Jay Simmons

Resources:

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When temperatures dip, air quality often does as well

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Illustration of the lungs in blueFrom the Washington State Department of Health

You may have noticed spectacular evening skies this winter, yet those sunsets frequently are a sign of air quality problems that occur this time of year. Winter weather patterns can trap air pollution – especially from wood stoves and fireplaces – near the ground, where it can build-up and may threaten people’s health.

The state Department of Health is reminding people air pollution can be harmful to their health. It can be especially harmful for people who have a lung condition like asthma, chronic obstructive pulmonary disorder (COPD), or with heart disease.

Air pollution has fine particles that can cause immediate and long-term health effects when inhaled. It’s a good idea to check local air conditions and limit outdoor activities when air quality conditions are poor.

The amount of air pollution that causes immediate health problems varies from person-to-person. For people who are sensitive to air pollution, even a short outdoor stroll can cause wheezing or shortness of breath.

Others may not have problems until they do more strenuous activities like yard work, running, or shoveling snow. Kids and adults over 65 are among those who should limit their activity during periods of poor air quality.

Air pollution often can’t be seen or smelled, but the state Department of Ecology monitors air conditions and posts them online across the state. More information and statistics on air quality in your community can be found on our website.

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FDA warns of rare acetaminophen risk

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A Consumer Update from the US Food and Drug Administration

ucm363013Acetaminophen, a fever and pain reliever that is one of the most widely used medicines in the U.S., can cause rare but serious skin reactions, warns the Food and Drug Administration (FDA).

Although rare, possible reactions to acetaminophen include three serious skin diseases whose symptoms can include rash, blisters and, in the worst case, widespread damage to the surface of skin.

If you are taking acetaminophen and develop a rash or other skin reaction, stop taking the product immediately and seek medical attention right away.

Used for decades by millions of people, acetaminophen is the generic name of a common active ingredient included in numerous prescription and non-prescription medicines.

Tylenol is one brand name of the pain reliever sold over the counter, but acetaminophen is also available as a generic under various names.

It is also used in combination with other medicines, including opioids for pain and medicines to treat colds, coughs, allergy, headaches and trouble sleeping.

“This new information is not intended to worry consumers or health care professionals, nor is it meant to encourage them to choose other medications,” says Sharon Hertz, M.D., deputy director of FDA’s Division of Anesthesia, Analgesia and Addiction. “However, it is extremely important that people recognize and react quickly to the initial symptoms of these rare but serious, side effects, which are potentially fatal.”

Other drugs used to treat fever and pain, such as nonsteroidal anti-inflammatory drugs including ibuprofen and naproxen, already carry warnings about the risk of serious skin reactions.

Advil and Motrin are among the common brand names that include ibuprofen as an active ingredient. Aleve and Midol Extended Relief are among the best-known brand names that include naproxen as an active ingredient.

FDA is requiring that a warning about these skin reactions be added to the labels of all prescription medicines containing acetaminophen.

FDA will work with manufacturers to get the warnings added to the labels of over-the-counter (OTC) medicines containing acetaminophen.

On OTC medicines, the word “acetaminophen” appears on the front of the package and on the Drug Facts label’s “active ingredients” section.

On prescription medications, the label may spell out the ingredient or use a shortened version such as “APAP,” “acet,” “acetamin” or “acetaminoph.”

Ingredient Linked to Several Conditions

Stevens-Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN) are the two most serious skin reactions linked in rare cases to acetaminophen. They usually require hospitalization and can cause death.

Problems usually begin with flu-like symptoms followed by rash, blistering and extensive damage to the surfaces of the skin. Recovery can take weeks or months, and possible complications include scarring, changes in skin pigmentation, blindness and damage to internal organs.

A third skin reaction, acute generalized exanthematous pustulosis (AGEP), usually resolves within two weeks of stopping the medication that caused the problem.

A serious skin reaction can occur at any time, even if you’ve taken acetaminophen previously without a problem. There is currently no way of predicting who might be at higher risk.

If you’ve ever had a skin reaction when taking acetaminophen, don’t take the drug again and discuss alternate pain relievers/fever reducers with your health care professional.

Evidence of Link

Prior to deciding to add a warning about skin reactions to products containing acetaminophen, FDA reviewed medical literature and its own database, the FDA Adverse Event Reporting System (FAERS).

A search of FAERS uncovered 107 cases from 1969 to 2012, resulting in 67 hospitalizations and 12 deaths. Most cases involved single-ingredient acetaminophen products; the cases were categorized as either probable or possible cases associated with acetaminophen.

A small number of cases, just over two dozen, are documented in medical literature, with cases involving people of various ages.

FDA has examined—and continues to examine—acetaminophen for safety issues, just as it does with all approved drugs. The warning comes two years after FDA took new steps to reduce the risk of liver injury from acetaminophen.

In that case, FDA asked all makers of prescription products to limit acetaminophen to 325 milligrams per tablet or capsule. FDA also required all prescription acetaminophen products to include a Boxed Warning—FDA’s strongest warning, used for calling attention to serious risks.

The agency continues to consider the benefits of this medication to outweigh the risks.

“FDA’s actions should be viewed within the context of the millions who, over generations, have benefited from acetaminophen,” says Hertz. “Nonetheless, given the severity of the risk, it is important for patients and health care providers to be aware of it.”

This article appears on FDA’s Consumer Updates page, which features the latest on all FDA-regulated products.

August 1, 2013

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Hot weather: How to stay cool and safe

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Blue sky and white clouds (Panorama)

Hot weather tips from Public Health – Seattle & King County

When outside temperatures are very high, the danger for heat-related illnesses rises. People’s bodies are not able to cool themselves quickly enough, and they overheat.

In severe instances, people can suffer heat stroke, which can cause death or permanent disability if emergency treatment is not provided.

Older adults, young children, and people with mental illness and chronic diseases are at highest risk for heat-related illness. But even young and healthy individuals can suffer in heat if they participate in strenuous physical activities during hot weather.

You can protect yourself and loved ones against very hot temperatures by following these recommendations:

Stay cool

  • Spend more time in air conditioned places. If you don’t have air conditioning, consider visiting a mall, movie theater or other cool public places.
  • Cover windows that receive morning or afternoon sun.
  • Dress in lightweight clothing.
  • Take a cool shower or bath, or place cool washcloths on your skin.
  • Check up on your elderly neighbors and relatives to take these precautions too.

Drink liquids:

  • Drink plenty of water. Avoid drinks with caffeine, alcohol and large amounts of sugar because they can actually de-hydrate your body.
  • Have a beverage with you at all times, and sip or drink frequently. Don’t wait until you’re thirsty to drink.

If you go outside:

  • Limit the time you’re in direct sunlight.
  • Do not leave infants, children, people with mobility challenges and pets in a parked car, even with the window rolled down.
  • Avoid or reduce doing activities that are tiring, or take a lot of energy.
  • Do outdoor activities in the cooler morning and evening hours.
  • Avoid sunburn. Use a sunscreen lotion with a high SPF (sun protection factor) rating.

Water safety:

Some people turn to local rivers to cool off, but drowning is a real concern. Please use caution and wear a personal flotation device (PFD) on the water. Find deals on affordable lifejackets. And if you want to swim, choose a safer location – visit a local pool or lifeguarded beach instead.

Certain medications may increase sensitivity to the heat. If you are concerned about the heat and the medications you are taking, check with your doctor. Do not take salt tablets unless your doctor tells you to.

Hot Weather fact sheets in other languages by the Washington State Dept. of Health:

Recognizing heat exhaustion and heat stroke

When people’s bodies can’t cool themselves quickly enough it can cause heat exhaustion. Symptoms of heat exhaustion include muscle cramps, weakness, dizziness, headache, nausea and vomiting.

If you see someone with signs of overheating, move the person to a cooler location, have them rest for a few minutes and then slowly drink a cool beverage. Get medical attention for them immediately if they do not feel better.

Heat exhaustion can lead to heat stroke, which can cause death or permanent disability unless treated immediately. Symptoms of heat stroke include:

  • An extremely high body temperature (above 103°F)
  • Red, hot, and dry skin
  • Rapid, strong pulse
  • Nausea, confusion and unconsciousness

For more information, visit these websites:

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Photo by Sanja Gjenero

Salmonella in eggs: An unwelcome summer visitor

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Photo by Sanja Gjenero

Photo by Sanja Gjenero

CDC Features

Eggs and summer go together: deviled eggs, homemade ice cream, and potato salad.

But, just a few hours outside of the refrigerator and your eggs can create lasting memories that you’d rather forget.

This summer, make sure that eggs carrying Salmonella don’t come to your next outing.

Summer is the perfect season for Salmonella, a germ that commonly causes foodborne illness–sometimes called food poisoning.

Warm weather and unrefrigerated eggs or food made from raw or undercooked eggs create ideal conditions for Salmonella to grow.

Many germs grow to high numbers in just a few hours at room temperature.

Although anyone can get Salmonella food poisoning, older adults, infants, and people with weakened immune systems are at increased risk for serious illness.

A person infected with Salmonella usually has a fever, abdominal cramps, and diarrhea beginning 12 to 72 hours after consuming a contaminated food or beverage.

The illness usually lasts 4 to 7 days, and most people recover without antibiotic treatment. But, in rare cases, people become seriously ill.

In the United States, Salmonella infection causes more hospitalizations and deaths than any other germ found in food, resulting in $365 million in direct medical costs annually.

Wondering if you haveSalmonella food poisoning?

salmonella on cultured human cells

Salmonella / CDC

See your doctor or healthcare provider if you have:

  • Diarrhea along with a temperature over 101.5°F
  • Diarrhea for more than 3 days that is not improving
  • Bloody stools
  • Prolonged vomiting that prevents you from keeping liquids down
  • Signs of dehydration, such as
    • Making very little urine
    • Dry mouth and throat, and
    • Dizziness when standing up

Salmonella can be sneaky

You can get Salmonella from perfectly normal-looking eggs. Salmonella can live on both the outside and inside of eggs that appear to be normal. Chicken feces on the outside of egg shells used to be a common cause of Salmonella contamination. To counter that, regulators in the 1970s put strict procedures into place for cleaning and inspecting eggs. Now, Salmonella is sometimes found on the inside of eggs; it gets there as the egg is forming.

Good news for egg lovers

Professionals from public health, government, and the food industry are continually working to reduce the risks of Salmonella in eggs. Here are just a few contributions made thus far:

Be proactive. Reduce your risk.

Did You Know?

Eating raw or undercooked eggs can be especially dangerous for young children, pregnant women, older adults, and those with weakened immune systems.

Salmonella can contaminate more than poultry and eggs. It sneaks its way into many foods—ground beef, pork, tomatoes, sprouts—even peanut butter. Here are six tips to make eggs and other foods safer to eat.

  1. Like other perishable foods, keep eggs refrigerated at or below 40° F (4° C) at all times. Buy eggs only from stores or other suppliers that keep them refrigerated.
  2. Discard cracked or dirty eggs.
  3. Do not keep eggs or other foods warm or at room temperature for more than two hours.
  4. Refrigerate unused or leftover foods promptly.
  5. Avoid restaurant dishes made with raw or lightly cooked unpasteurized eggs. Although restaurants should use pasteurized eggs in any recipe containing raw or lightly cooked eggs –such as Hollandaise sauce or Caesar salad dressing—ask to be sure.
  6. Consider buying and using shell eggs and egg products that are pasteurized. These are available for purchase from certain stores and suppliers.

 Photo of eggs courtesy of Sanja Gjenero

More Information

For more information about Salmonella, foodborne illness, and food safety, call 1-800-CDC-INFO, e-mail cdcinfo@cdc.gov, or visit these web sites:

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