SMOKE THIS! PUBLIC HEALTH IMPACTS OF E-CIGARETTES
From the FMS Global News Desk of Jeanne Hambleton Released: 11-Sep-2014
Source Newsroom: Kids + Chemical Safety Science Outreach & Initiative
Newswise — Smoking (or “vaping”) with an e-cigarette creates an inhalable form of nicotine that the user can breathe in, just like a normal cigarette. In fact, many e-cigarettes are designed to look just like a regular cigarette, cigar, or pipe. However, one big difference between an e-cigarette and a regular cigarette is that an e-cigarette does not contain tobacco. Instead, an e-cigarette contains a compact, battery-powered device that heats a replaceable cartridge containing a liquid mixture. The liquid mixture is vaporized by an anodizing device, and delivered to the user as an inhalable vapor.
The liquid mixture in the cartridge usually contains nicotine, which is the highly addictive drug that is also present in traditional tobacco products. Therefore, an e-cigarette is designed to deliver a dose of nicotine to the user, while greatly reducing or eliminating exposure to many (albeit not all) of the other harmful substances that are present in traditional tobacco products.
E-cigarette use is becoming more popular among teenagers, so it is important for parents to understand how their use may be harmful to children. According to a Centers for Disease Control and Prevention (CDC) study using data from the 2012 National Youth Tobacco Survey, during the period from 2011 – 2012, e-cigarette use doubled among middle school females, high school females, and middle school males, and increased more than 60% among high school males.
This increase was attributed, in part, to increased availability and marketing of e-cigarettes, as well as the perception amongst young adults that the devices are safer than traditional cigarettes and other tobacco products.
Furthermore, the liquid nicotine used in e-cigarettes very often contains flavoring additives and other sweeteners. This type of marketing can convince young adults to try e-cigarettes for the first time, which can lead to nicotine addiction. There is currently a debate among health experts as to whether e-cigarettes may be considered a “gateway drug” and encourage children and young adults to also experiment with traditional tobacco products and marijuana.
A recent study published in the Journal of the American Medical Association reviewed survey data from nearly 40,000 US middle and high school students, and found that adolescents who use e-cigarettes are more likely to smoke conventional cigarettes. Further study is clearly warranted to comprehensively address the “gateway drug” concern.
A laboratory analysis was conducted on samples of e-cigarettes by the U.S. Food and Drug Administration (FDA) in 2009. Several findings raised concern regarding the safety of e-cigarettes. The liquid mixture added to e-cigarette cartridges contained detectable concentrations of several chemicals, including nitrosamines, anabasine, myosmine, beta-nicotyrine, and diethylene glycol, all of which are known to be toxic to humans.
Furthermore, although many e-cigarette liquid cartridges are labeled as containing low amounts of nicotine, the FDA analysis found that the actual amount of nicotine contained within the “e-liquid” or “liquid nicotine” used to fill the e-cigarette cartridges was highly variable and unpredictable compared to the level of nicotine specified on the labels of liquid nicotine bottles.
There are currently no safeguards or quality controls in place to confirm that the level of nicotine advertised on the label of a liquid nicotine bottle is the actual amount present.
The FDA has stated its intention to regulate e-cigarettes, which would include banning the sale of e-cigarettes to children under 18, requiring manufacturers to register with the FDA so they can be monitored for safety and quality, and further requiring manufacturers to substantiate marketing claims using scientific evidence. However, this regulatory action is only in its initial stages, so these products are effectively unregulated and manufacturers may market them to individuals of any age.
Perhaps even more concerning is a noticeable increase in the frequency of accidental exposure to the e-cigarette cartridge liquid among young children. The CDC analyzed data on e-cigarette related calls to U.S. poison control centers from September 2010 through February 2014, and found that e-cigarette exposure calls increased on a per month basis from one call in September 2010 to 215 calls in February 2014.
Approximately 51% of these calls related to accidental exposure to children of less than six years of age, and 68.9% of the calls were related to accidental ingestion of the liquid mixture. Ingestion of nicotine at high doses can lead to nausea, rapid heart rate, and perspiration, followed by a slowing of the heart rate with a fall in blood pressure.
At very high concentrations, nicotine can cause paralysis of the muscles that control breathing, which can lead to death. Exposure via contact with the skin is also of concern, which can cause irritation, redness, or an allergic reaction in addition to the symptoms listed above, due to absorption of nicotine from the surface of the skin into the bloodstream.
It is important to remember that the safety claims being made by e-cigarette manufacturers have not been validated by any scientific or regulatory body, and that there have been serious questions raised in regard to the marketing of these products to children and teenagers, the potential of e-cigarettes to serve as a “gateway drug” among teenagers, and the demonstrated toxicity of the liquid nicotine mixture in young children following accidental exposure through ingestion and/or the skin.
Parents can encourage their children to avoid e-cigarette use by talking to them about the dangers of smoking in general, and including e-cigarettes in an overall discussion of avoiding cigarette and tobacco use.
Parents should also consider avoiding use of e-cigarettes and instead use FDA recommended products for smoking cessation such as nicotine patches and nicotine gum. If e-cigarettes are used in the household, extreme care must be exercised in keeping the e-cigarette cartridges and the liquid nicotine refills safely stored out of the reach of young children to prevent accidental exposure.
AIR POLLUTION MAY AFFECT LEVELS OF OBESITY-RELATED HORMONE
Higher Exposure to Traffic Pollutants Linked to Increased Leptin Levels
From the FMS Global News Desk of Jeanne Hambleton Released: 8-Sep-2014
Source: Journal of Occupational and Environmental Medicine By Dr G Wellenius Citations Journal of Occupational and Environmental Medicine`
Newswise —Higher exposure to one measure of traffic-related air pollution is associated with higher levels of the obesity-related hormone leptin in older adults, reports a study in the September Journal of Occupational and Environmental Medicine, official publication of the American College of Occupational and Environmental Medicine (ACOEM).
Gregory A. Wellenius, ScD, of Brown University and colleagues analyzed the relationship between measures of traffic-related air pollution and blood leptin levels in 765 Boston-area older adults. Higher levels of leptin, an “inflammatory cytokine,” have been linked to increased rates of heart disease, obesity, and diabetes.
The results showed a significant association between exposure to black carbon—a measure of fine-particle air pollution from traffic sources—and leptin levels. Participants with higher exposure to black carbon were less likely to be white, had lower incomes, and had higher rates of high blood pressure and diabetes.
But even after adjustment for these differences, average leptin levels were 27 percent higher for older adults in the highest category of black carbon exposure. An alternative measure of exposure to traffic-related pollution—residential distance to the nearest major roadway—was unrelated to leptin levels. The estimates of black carbon exposure “likely reflect contributions from traffic on a wider range of roadways in the immediate vicinity of each participant’s home,” the researchers write.
While the study cannot prove any causal link, the link between black carbon exposure and leptin levels may help to explain observed increases in cardiovascular disease risk associated with air pollution—especially from traffic.
Dr Wellenius and colleagues conclude, “If confirmed, these findings support the emerging evidence suggesting that certain sources of traffic pollution may be associated with adverse cardiometabolic effects.”
ACOEM is the official journal of the American College of Occupational and Environmental Medicine. Edited to serve as a guide for physicians, nurses, and researchers, the clinically oriented research articles are an excellent source for new ideas, concepts, techniques, and procedures that can be readily applied in the industrial or commercial employment setting.
MEDITATION MAY MITIGATE MIGRAINE MISERY
From FMS Global News Desk of Jeanne Hambleton Released: 11-Sep-2014 Source: Wake Forest Baptist Medical Center Citations Headache
Newswise — WINSTON-SALEM, N.C. – Meditation might be a path to migraine relief, according to a new study by researchers at Wake Forest Baptist Medical Center.
“Stress is a well-known trigger for headaches and research supports the general benefits of mind/body interventions for migraines, but there has not been much research to evaluate specific standardized meditation interventions,” said Rebecca Erwin Wells, M.D., assistant professor of neurology at Wake Forest Baptist and lead author of the study published in the online edition of the journal Headache.
The study was designed to assess the safety, feasibility and effects of a standardized meditation and yoga intervention called mindfulness-based stress reduction (MBSR) in adults with migraines.
Nineteen adults were randomly assigned to two groups with 10 receiving the MBSR intervention and nine receiving standard medical care. The participants attended eight weekly classes to learn MBSR techniques and were instructed to practice 45 minutes on their own at least five additional days per week.
Study participants were evaluated before and after the trial period using objective measures of disability, self-efficacy and mindfulness. They also maintained headache logs throughout the trial to capture the frequency, severity and duration of their migraines.
“We found that the MBSR participants had trends of fewer migraines that were less severe,” Wells said. “Secondary effects included headaches that were shorter in duration and less disabling, and participants had increases in mindfulness and self-efficacy — a sense of personal control over their migraines. In addition, there were no adverse events and excellent adherence.”
Specifically, the MBSR participants had 1.4 fewer migraines per month that were less severe, effects that did not reach statistical significance. The participants’ headaches were significantly shorter as compared to the control group.
Based on these findings, the research team concluded that MBSR is a safe and feasible therapy for adults with migraines. Although the sample size of this pilot study was too small to detect statistically significant changes in migraine frequency or severity, secondary outcomes demonstrated this intervention had a beneficial effect on headache duration, disability, self-efficacy and mindfulness.
Future studies with larger sample sizes are planned to further evaluate the impact and mechanisms of this intervention in adults with migraines, Wells said.
“For the approximate 36 million Americans who suffer from migraines, there is big need for non-pharmaceutical treatment strategies, and doctors and patients should know that MBSR is a safe intervention that could potentially decrease the impact of migraines,” Wells said.
The study was supported financially by the American Headache Society Fellowship and the Headache Research Fund of the John Graham Headache Center, Brigham and Women’s Faulkner Hospital.
Co-authors are Timothy T. Houle, Ph.D., of Wake Forest Baptist; Rebecca Burch, M.D., Elizabeth Loder, M.D., Randall H. Paulsen, M.D., and Peter M. Wayne, Ph.D., of Brigham and Women’s Hospital, Harvard Medical School.
See you tomorrow. Jeanne