Occupational, Environmental, and

Public Health News

August 2020

Global Highlights of Potential Biologic, Chemical,

and Ergonomic Risk Issues, Affecting Our Workplaces and Communities

Centers for Disease Control and Prevention (CDC) http://www.cdc.gov

Coronavirus Disease 2019 (COVID-19) https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html

How to Protect Yourself & Others

Older adults and people who have severe underlying medical conditions like heart or lung disease or diabetes seem to be at higher risk for developing serious complications from COVID-19 illness. More information on Are you at higher risk for serious illness.

Know how it spreads

There is currently no vaccine to prevent coronavirus disease 2019 (COVID-19).The best way to prevent illness is to avoid being exposed to this virus. The virus is thought to spread mainly from person-to-person.

    • Between people who are in close contact with one another (within about 6 feet).
    • Through respiratory droplets produced when an infected person coughs, sneezes or talks.
    • These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.
    • Some recent studies have suggested that COVID-19 may be spread by people who are not showing symptoms.

Everyone Should

Wash your hands often

  • Wash your hands often with soap and water for at least 20 seconds especially after you have been in a public place, or after blowing your nose, coughing, or sneezing.
  • It’s especially important to wash:
    • Before eating or preparing food
    • Before touching your face
    • After using the restroom
    • After leaving a public place
    • After blowing your nose, coughing, or sneezing
    • After handling your cloth face covering
    • After changing a diaper
    • After caring for someone sick
    • After touching animals or pets
  • If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub them together until they feel dry.
  • Avoid touching your eyes, nose, and mouth with unwashed hands.

Avoid close contact

Cover your mouth and nose with a cloth face cover when around others.

You could spread COVID-19 to others even if you do not feel sick.

  • The cloth face cover is meant to protect other people in case you are infected.
  • Everyone should wear a cloth face cover in public settings and when around people who don’t live in your household, especially when other social distancing measures are difficult to maintain.
    • Cloth face coverings should not be placed on young children under age 2, anyone who has trouble breathing, or is unconscious, incapacitated or otherwise unable to remove the mask without assistance.
  • Do NOT use a facemask meant for a healthcare worker. Currently, surgical masks and N95 respirators are critical supplies that should be reserved for healthcare workers and other first responders.
  • Continue to keep about 6 feet between yourself and others. The cloth face cover is not a substitute for social distancing.

Cover coughs and sneezes

  • Always cover your mouth and nose with a tissue when you cough or sneeze or use the inside of your elbow and do not spit.
  • Throw used tissues in the trash.
  • Immediately wash your hands with soap and water for at least 20 seconds. If soap and water are not readily available, clean your hands with a hand sanitizer that contains at least 60% alcohol.

Clean and disinfect

Monitor Your Health Daily

  • Be alert for symptoms. Watch for fever, cough, shortness of breath, or other symptoms of COVID-19.
  • Take your temperature if symptoms develop.
    • Don’t take your temperature within 30 minutes of exercising or after taking medications that could lower your temperature, like acetaminophen.
  • Follow CDC guidance if symptoms develop.

Traveler Advice – https://wwwnc.cdc.gov/travel/notices/ 

Optimizing Supply of PPE and Other Equipment during Shortages

  • Personal protective equipment (PPE) is used every day by healthcare personnel (HCP) to protect themselves, patients, and others when providing care. PPE helps protect HCP from many hazards encountered in healthcare facilities.
  • The greatly increased need for PPE caused by the COVID-19 pandemic has caused PPE shortages, posing a tremendous challenge to the U.S. healthcare system. Healthcare facilities are having difficulty accessing the needed PPE and are having to identify alternate ways to provide patient care.
  • Surge capacity refers to the ability to manage a sudden, increase in patient volume that would otherwise severely challenge or exceed the present capacity of a facility. While there are no commonly accepted measurements or triggers to distinguish surge capacity from daily patient care capacity, surge capacity is a useful framework to approach a decreased supply of PPE during the COVID-19 response. To help healthcare facilities plan and optimize the use of PPE in response to COVID-19, CDC has developed a Personal Protective Equipment (PPE) Burn Rate Calculator. Three general strata have been used to describe surge capacity and can be used to prioritize measures to conserve PPE supplies along the continuum of care.
  • Conventional capacity: measures consisting of engineering, administrative, and PPE controls that should already be implemented in general infection prevention and control plans in healthcare settings.
  • Contingency capacity: measures that may be used temporarily during periods of anticipated PPE shortages. Contingency capacity strategies should only be implemented after considering and implementing conventional capacity strategies. While current supply may meet the facility’s current or anticipated utilization rate, there may be uncertainty if future supply will be adequate and therefore, contingency capacity strategies may be needed.
  • Crisis capacity: strategies that are not commensurate with U.S. standards of care but may need to be considered during periods of known PPE shortages. Crisis capacity strategies should only be implemented after considering and implementing conventional and contingency capacity strategies. Facilities can consider crisis capacity strategies when the supply is not able to meet the facility’s current or anticipated utilization rate.
  • CDC’s optimization strategies for PPE offer a continuum of options for use when PPE supplies are stressed, running low, or absent. Contingency and then crisis capacity measures augment conventional capacity measures and are meant to be considered and implemented sequentially. As PPE availability returns to normal, healthcare facilities should promptly resume standard practices.
  • Decisions to implement contingency and crisis strategies are based on these assumptions:
  • Facilities understand their current PPE inventory and supply chain
  • Facilities understand their PPE utilization rate
  • Facilities are in communication with local healthcare coalitions and federal, state, and local public health partners (e.g., public health emergency preparedness and response staff) to identify additional supplies
  • Facilities have already implemented conventional capacity measures
  • Facilities have provided HCP with required education and training, including having them demonstrate competency with donning and doffing, with any PPE ensemble that is used to perform job responsibilities, such as provision of patient care
  • HCP and facilities—along with their healthcare coalitions, local and state health departments, and local and state partners—should work together to develop strategies that identify and extend PPE supplies, so that recommended PPE will be available when needed most. When using PPE optimization strategies, training on PPE use, including proper donning and doffing procedures, must be provided to HCP before they carry out patient care activities.

Skin Cancer Awareness

      • Exposure to ultraviolet (UV) rays causes most cases of melanoma, the deadliest kind of skin cancer. To lower your skin cancer risk, protect your skin from the sun and avoid indoor tanning.
      • Summer is full of outdoor activities. You probably put sunscreen on yourself and your kids when you go to the pool or the beach. But do you know you should protect your skin with more than just sunscreen anytime you’re outside?
      • Sun protection is important all year round, and it’s best to use several different kinds. When you’re working in the yard, watching a ballgame, or taking an afternoon walk, make sun safety an everyday habit so you can avoid getting a sunburn and lower your chance of getting skin cancer.
      • What’s In Your Tote Bag?
      • Here’s an easy tip to help make sure you and your family stay sun-safe. Get ready for summer with a tote bag full of different ways to protect your skin. Keep the tote bag handy so you can grab it whenever you head out for summer fun!
      • Some important things to pack—
      • A lightweight long-sleeved shirt or cover-up.
      • A hat with a wide brim that shades your face, head, ears, and neck.
      • Sunglasses that block both UVA and UVB rays.
      • Sunscreen with SPF 15 or higher and both UVA and UVB (broad spectrum) protection.
      • Join the conversation to raise awareness about the benefits of sun protection!
      • More Sun Safety Tips
      • Stay in the shade, especially during late morning through mid-afternoon.
      • Can’t stay in the shade? Wear a long-sleeved shirt and pants to protect your skin.
      • Remember to reapply sunscreen at least every 2 hours and after swimming, sweating, or toweling off.
      • Fast Facts About Skin Cancer
      • Skin cancer is the most common cancer in the United States, and includes different types.
      • Unprotected skin can be damaged by the sun’s UV rays in as little as 15 minutes.
      • Even if it’s cool and cloudy, you still need protection. UV rays, not the temperature, do the damage.
      • Anyone can get skin cancer, but some things put you at higher risk.
      • The most common signs of skin cancer are changes on your skin, such as a new growth, a sore that doesn’t heal, or a change in a mole. https://www.cdc.gov/cancer/dcpc/resources/features/skincancer/

FDA

  • FDA/CBER Current Product Shortages Include: APLISOL, Gammagard, SHINGRIX, Hepatitis B Vaccine (Recombivax), BCG Live (Intravesical), Immune Globulin Subcutaneous (Human), 20% Solution Cuvitru, Immune Globulin Intravenous (Human) Gammaplex 5%, Yellow Fever Vaccine (YF-VAX), Zoster vaccine (recombinant), Anticoagulant Sodium Citrate Solution (Fenwal), and many antivenoms. https://www.fda.gov/BiologicsBloodVaccines/SafetyAvailability/Shortages/ucm351921.htm

National Institute for Occupational Safety and Health (NIOSH) http://www.cdc.gov/niosh/

  • Lyme Disease Named after the town in Connecticut where it was first recognized, Lyme disease is an infection you get from the bite of a deer tick (also called a blacklegged tick), if the tick carries the bacterium Borrelia burgdorferi. Lyme disease is the most common tickborne infectious disease in the United States, but 95 percent of all cases have occurred in only nine states, mostly in the Northeast and upper Midwest.

    To infect you, the tick must be attached to you for 36 to 48 hours or more. So if you remove the tick before then, in most cases, you won’t get Lyme disease. The Centers for Disease Control and Prevention (CDC) recommends that if you develop a rash or fever within several weeks after removing a tick, you should see your health care provider and tell the provider about the tick bite.Symptoms of Lyme disease may include fever, headache, fatigue, and a rash that sometimes looks like a bull’s eye.

    Generally, a short course of antibiotics cures Lyme disease, although people with complicated cases need antibiotics for 3 to 4 weeks. If not properly treated with antibiotics, Lyme can cause a wide range of potentially serious symptoms.

    Beware of products offering “natural” or other alternative “cures” for Lyme disease, such as oxygen, energy, nutritional, or herbal therapy. They haven’t been shown to be effective, and they may be dangerous. Antibiotics are the only known effective treatment for Lyme disease.

    Patients treated with antibiotics in the early stages of Lyme disease usually recover quickly and completely. However, some people have lingering symptoms of fatigue, pain, or joint and muscle aches. These symptoms cannot be cured by additional antibiotic treatment, but they generally improve on their own over time. If you have been treated for Lyme disease but you still don’t feel well, consult your health care provider.

  • EMERGENCY RESPONSE RESOURCES: Disaster site management can be made easier by being prepared. This page provides links to work plan essentials and site safety and team leader checklists that can help you get prepared for such an event. The page also includes links to information on potential hazards (e.g. silica, asbestos, carbon monoxide, electrocution, falls, confined spaces, and chemical, structural, and mechanical hazards) and recommendations to reference in the event of a disaster. https://www.cdc.gov/niosh/topics/emres/sitemgt.html
  • NIOSH Pocket Guide to Chemical Hazards: The NIOSH Pocket Guide (NPG) clearly presents key data for chemicals or substance groupings such as cyanides, fluorides, and manganese compounds, that are found in workplaces. https://www.cdc.gov/niosh/npg/ ; PDFGUIDE  ; MOBILE VERSION

Occupational Safety and Health Administration (OSHA)   www.osha.gov

 

World Health Organization (WHO) http://www.who.int

  • WHO gets new advice on curbing deadly noncommunicable diseases: The Commission highlighted that noncommunicable diseases still account for more than 70% of deaths and stressed that, “progress against NCDs and mental health conditions must be greatly accelerated if the 2030 Agenda is to succeed.” It also noted that many countries face challenges and need more support to implement solutions. The report laid out a set of 8 recommendations for WHO. https://www.who.int/news-room/detail/10-12-2019-who-gets-new-advice-on-curbing-deadly-noncommunicable-diseases
  • Adopting a healthy lifestyle helps reduce the risk of dementia:  People can reduce their risk of dementia by getting regular exercise, not smoking, avoiding harmful use of alcohol, controlling their weight, eating a healthy diet, and maintaining healthy blood pressure, cholesterol and blood sugar levels, according to new guidelines issued by WHO. “In the next 30 years, the number of people with dementia is expected to triple,” said WHO Director-General. “We need to do everything we can to reduce our risk of dementia. The scientific evidence gathered for these Guidelines confirm what we have suspected for some time, that what is good for our heart, is also good for our brain.” https://www.who.int/news-room/detail/14-05-2019-adopting-a-healthy-lifestyle-helps-reduce-the-risk-of-dementia

Scholarly Journals

Physical activity trajectories and mortality: population-based cohort study: Conclusions -Middle aged and older adults, including those with cardiovascular disease and cancer, can gain substantial longevity benefits by becoming more physically active, irrespective of past physical activity levels and established risk factors. Considerable population health impacts can be attained with consistent engagement in physical activity during mid to late life. https://www.bmj.com/content/365/bmj.l2323

Public News Sources

3 Hours of Exercise a Week May Lower Your Depression Risk: Walking, jogging, yoga or any type of exercise may help to ward off depression, even in those with a genetic susceptibility.  https://www.nytimes.com/2019/11/20/well/move/3-hours-of-exercise-a-week-may-lower-your-depression-risk.html?auth=login-email&login=email&smid=nytcore-ios-share

Being tired or fatigued is common. Sometimes, however, it can be a sign of a health issue: “Sleep seems to be a canary in the coal mine, where it’s sensitive to all these things going on in your body,” Grandner says. “So, when it starts changing, you want to ask, ‘Well, what’s going on?’. https://www.washingtonpost.com/health/being-tired-or-fatigued-is-common-sometimes-however-they-can-be-a-sign-of-a-heath-issue/2019/12/13/43b6302c-1b6b-11ea-8d58-5ac3600967a1_story.html

Malaysia Plans to Vaccinate Overseas Visitors to Combat Polio:  Malaysia will vaccinate overseas visitors in the country in a bid to prevent the proliferation of infectious diseases, state news agency Bernama reported, citing Ministry of Health Director-General. https://www.bloomberg.com/news/articles/2019-12-15/malaysia-plans-to-vaccinate-overseas-visitors-to-combat-polio

Cinnamon for weight loss: How to make cinnamon tea to lose weight:  If you are worried about your bulging stomach, we suggest adding a piping hot cuppa of cinnamon tea to your daily diet. This bitter-sweet spice is known to aid metabolism, regulate blood sugar levels and improve insulin function–all this collectively can help you lose weight. https://timesofindia.indiatimes.com/life-style/health-fitness/diet/cinnamon-for-weight-loss-how-to-make-cinnamon-tea-to-lose-weight/photostory/72533003.cms

No such thing as too much exercise in later life: Getting fit slashes your risk of an early death – ‘even if you’ve been inactive your whole life’:  Two-and-a-half hours of exercise a week ‘could prevent 46 per cent of deaths’; In people aged 40-79 it slashed heart disease deaths by 30% and cancer by 11%; Results were similar in those with and without a history of the health conditions. https://www.dailymail.co.uk/health/article-7183803/Taking-exercise-middle-age-slashes-risk-early-death.html

Older adults on RX meds increase dementia odds: A new study found that older adults prescribed antidepressants, bladder antimuscarinics, antipsychotics and antiepileptic drugs are at a higher risk of being diagnosed with dementia. According to this new research, an adult who took an anticholinergic medication daily for at least three years had a 50% higher chance of being diagnosed with dementia. https://www.aol.com/article/news/2019/06/25/older-adults-on-rx-meds-increase-dementia-odds-study/23756119/?guccounter=1

With Rural Health Care Stretched Thin, More Patients Turn To Telehealth: A recent NPR poll of rural Americans found that nearly a quarter have used some kind of telehealth service within the past few years; 14% say they received a diagnosis or treatment from a doctor or other health care professional using email, text messaging, live text chat, a mobile app, or a live video like FaceTime or Skype. And 15% say they have received a diagnosis or treatment from a doctor or other health professional over the phone. https://www.npr.org/sections/health-shots/2019/07/07/737618560/with-rural-health-care-stretched-thin-more-patients-turn-to-telehealth

Infectious Disease: Global Health Concerns

Ebola virus disease (EVD), formerly known as Ebola hemorrhagic fever, is a severe, often fatal illness in humans. The average EVD case fatality rate is around 50%. Case fatality rates have varied from 25% to 90% in past outbreaks. As of December 17, 2019 there are atotal of 3348 cases including 2210 deaths, 1089survivors, and patients still under care.https://www.who.int/news-room/fact-sheets/detail/ebola-virus-disease https://www.who.int/emergencies/diseases/ebola/drc-2019/

Legionella bacterium – was named after an outbreak in 1976, when many people who went to a Philadelphia convention of the American Legion got sick with pneumonia. About 6,100 cases of legionella were reported in 2016, however, because Legionnaires’ disease is likely underdiagnosed, this number may underestimate the true incidence.  1 in 10 people who contract legionella die. Legionella can be prevented by properly treating water systems in buildings. http://www.cdc.gov/legionella/fastfacts.html http://www.cdc.gov/legionella/outbreaks.html

Lyme disease – is caused by the bacterium Borrelia burgdorferi and is transmitted to humans through the bite of infected blacklegged ticks: Typical symptoms include fever, headache, fatigue, and a characteristic skin rash called erythema migrans. If left untreated, infection can spread to joints, the heart, and the nervous system. Lyme disease is diagnosed based on symptoms, physical findings (e.g., rash), and the possibility of exposure to infected ticks.  Laboratory testing is helpful if used correctly and performed with validated methods. Most cases of Lyme disease can be treated successfully with a few weeks of antibiotics.  It is the most commonly reported vector borne illness in the U.S. While there are 30,000 reported cases of Lyme disease in the U.S. each year, the estimated number of actual cases in the U.S is about 300,000 annually.  96 percent of reported Lyme disease cases in the U.S. occur in 14 States. These states are primarily in the Northeast and Upper Mid-West. The cases occur due to heavy deer and deer tick populations. Lyme disease can be treated with antibiotics with full recovery if caught early. Permanent physical damage may occur if Lyme disease diagnosis and treatment are delayed. This damage can include deafness and in extreme cases, brain damage. http://www.cdc.gov/lyme/ http://www.cdc.gov/lyme/stats/humancases.html

MalariaEvery year, millions of US residents travel to countries where malaria is present. About 1,700 cases of malaria are diagnosed in the United States annually, mostly in returned travelers. Travelers to sub-Saharan Africa have the greatest risk of both getting malaria and dying from their infection. However, all travelers to countries where malaria is present may be at risk for infection. Globally, an estimated 3.2 billion people in 97 countries and territories are at risk of being infected with malaria and developing disease. In 2017 there were 219 million cases of Malaria. Most cases occur in Africa. 2 of 4 major strains of Malaria have become drug resistant to anti-malarial medication worldwide, increasing mortality with this disease.  Obtain a detailed itinerary including all possible destinations that may be encountered during the trip and check to see if malaria transmission occurs in these locations. The Malaria Information by Country Table https://www.cdc.gov/malaria/travelers/country_table/a.html provides detailed information about the specific parts of countries where malaria transmission does or does not occur. http://www.who.int/campaigns/malaria-day/2018/en/ https://www.cdc.gov/malaria/travelers/index.html http://www.who.int/gho/malaria/en/

 

Middle East respiratory syndrome (MERS) – is a viral respiratory disease caused by a novel coronavirus (MERS‐CoV) that was first identified in Saudi Arabia in 2012. 2,468 cases and 851 deaths have been reported in 27 Countries as of 9/30/2019. The cases are predominantly in Saudi Arabia. Incidence and Mortality totals are cumulative starting with the September 2012 outbreak. In total, cases have been reported from 27 countries in the Middle East, North Africa, Europe, the United States of America, and Asia. As of 12/17/2019 there are no further reported cases or deaths.   http://www.who.int/emergencies/mers-cov/en/ 

Zika Virus – is spread mostly by the bite of an infected Aedes species mosquito (Ae. aegypti and Ae. albopictus). These mosquitoes bite during the day and night. Zika can be passed from a pregnant woman to her fetus. Infection during pregnancy can cause certain birth defects. There is no vaccine or medicine for Zika. Local mosquito borne Zika virus transmission has been reported in the continental United States as well as its territories. In 2018 and 2019, no local mosquito borne Zika virus transmission has been reported in the continental United States. http://www.cdc.gov/zika Learn about which countries are affected by Zika.  https://wwwnc.cdc.gov/travel/page/world-map-areas-with-zika