Occupational, Environmental, and

Public Health News

December 18, 2019

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

Outbreak of E. coli Infections Linked to Romaine Lettuce: Based on new information, CDC is advising that consumers not eat and retailers not sell any romaine lettuce harvested from the Salinas, California growing region. AS of November 22, 2019, there are 40 reported cases across 16 states, involving 28 hospitalizations. No deaths have been reported. https://www.cdc.gov/ecoli/2019/o157h7-11-19/index.html

Influenza Prevention- Information for Travelers: Everyone 6 months and older should get a flu vaccine yearly, preferably in the fall before the U.S. flu season begins. People should get vaccinated at least 2 weeks before travel because it takes 2 weeks for vaccine immunity to develop after vaccination. https://www.cdc.gov/flu/school-business/travelersfacts.htm

Outbreak of Lung Injury Associated with the Use of E-Cigarette, or Vaping, Products: As of November 20, 2019, 2,290* cases of e-cigarette, or vaping, product use associated lung injury (EVALI) have been reported to CDC from 49 states (all except Alaska), the District of Columbia, and 2 U.S. territories (Puerto Rico and U.S. Virgin Islands). Forty-seven deaths have been confirmed in 25 states and the District of Columbia (as of November 20, 2019): Alabama, California (4), Connecticut, Delaware, District of Columbia, Florida, Georgia (3), Illinois (5), Indiana (4), Kansas (2), Louisiana, Massachusetts (3), Michigan, Minnesota (3), Mississippi, Missouri (2), Montana, Nebraska, New Jersey, New York (2), Oregon (2), Pennsylvania, Tennessee (2), Texas, Utah, and Virginia. The median age of deceased patients was 53 years and ranged from 17 to 75 years (as of November 20, 2019). More deaths are under investigation.

CDC recommends that you do not use e-cigarette, or vaping, products that contain THC. CDC also recommends that people should not: Buy any type of e-cigarette, or vaping, products, particularly those containing THC, off the street; Modify or add any substances to e-cigarette, or vaping, products that are not intended by the manufacturer, including products purchased through retail establishments; Since the specific compound or ingredient causing lung injury are not yet known, the only way to assure that you are not at risk while the investigation continues is to consider refraining from use of all e-cigarette, or vaping, products.  https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html

Prevent Norovirus: You can help protect yourself and others from norovirus by washing your hands thoroughly with soap and water and following other simple prevention tips. Wash your hands thoroughly with soap and water, especially after using the toilet or changing diapers; always before eating, preparing, or handling food, and before giving yourself or someone else medicine. https://www.cdc.gov/norovirus/about/prevention.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Ffeatures%2Fnorovirus%2Findex.html

People at High Risk For Flu Complications: Most people who get sick with flu will have mild illness, will not need medical care or antiviral drugs and will recover in less than two weeks. Some people, however, are more likely to get flu complications that can result in hospitalization and sometimes death. Pneumonia, bronchitis, sinus infections and ear infections are examples of flu-related complications. Flu also can make chronic health problems worse. For example, people with asthma may experience asthma attacks while they have flu and people with chronic congestive heart failure may experience a worsening of this condition triggered by flu. Below are the groups of people who are more likely to get serious flu-related complications if they get sick with flu.https://www.cdc.gov/flu/highrisk/index.htm

Ground Beef Recall: On November 15, 2019, Central Valley Meat Co. in Hanford, Calif., recalled external icon 34,222 pounds of ground beef that may be contaminated with Salmonella Dublin. Recalled beef was produced on July 23, 2019 and shipped to retail locations in California.  As of November 19, 2019, a total of 11 people infected with the outbreak strain of Salmonella Dublin have been reported from seven states. There have been 8 hospitalizations and 1 death,

Travel Health Notices: Travel notices are designed to inform travelers and clinicians about current health issues related to specific destinations. These issues may arise from disease outbreaks, special events or gatherings, natural disasters, or other conditions that may affect travelers’ health. https://wwwnc.cdc.gov/travel/notices/


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/

If you are a worker under age 25, you are more likely than more experienced workers to be injured: our supervisor should help you to stay safe by giving safety training in a language and words that you can understand.  https://www.cdc.gov/niosh/topics/retail/

NIOSH-OSHA Hazard Alert: Health and Safety Risks for Workers Involved in Manual Tank Gauging and Sampling at Oil and Gas Extraction Sites:  https://www.cdc.gov/niosh/docs/2016-108/

OSHA/NIOSH Hazard Alert: Worker Exposure to Silica during Countertop Manufacturing, Finishing and Installation: (NIOSH) have identified exposure to silica as a health hazard to workers involved in manufacturing, finishing and installing natural and manufactured stone countertop products, both in fabrication shops and during in-home finishing/installation. This hazard can be mitigated with simple and effective dust controls in most countertop operations.  https://www.cdc.gov/niosh/docs/2015-106/

OSHA/NIOSH Hazard Alert: Worker Exposure to Silica during Countertop Manufacturing, Finishing and Installation: (NIOSH) have identified exposure to silica as a health hazard to workers involved in manufacturing, finishing and installing natural and manufactured stone countertop products, both in fabrication shops and during in-home finishing/installation. This hazard can be mitigated with simple and effective dust controls in most countertop operations.  https://www.cdc.gov/niosh/docs/2015-106/

Prevent Hypothermia & Frostbite: Hypothermia (abnormally low body temperature) and frostbite are both dangerous conditions that can happen when a person is exposed to extremely cold temperatures. Stay safe this winter by learning more about hypothermia and frostbite, including who is most at risk, signs and symptoms, and what to do if someone develops hypothermia or frostbite. https://www.cdc.gov/disasters/winter/staysafe/hypothermia.html

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

Holiday Workplace Safety:  With the increase in merchandise sales during the holiday shopping season comes an increase in potential hazards for workers in the wholesale, transportation, and retail industries. Employers should take appropriate actions to protect workers fulfilling customer orders, delivering packages, and managing crowds of shoppers. OSHA has resources to help keep workers safe at every step along the way in getting gifts from the warehouse to your home. https://www.osha.gov/holidaysafety.html

If You Work Around Lead, Don’t Take It Home: Did you know that if you work with lead you could be bringing this toxic metal home on your clothes, shoes, skin, hair and hands? Take-home lead can cause lead poisoning in children and other family members. Stop lead from getting into your home and vehicle by always washing, showering, and changing out of your work clothes and work shoes before leaving work. OSHA has regulations to protect workers from lead exposure in both general industry (1910.1025) and construction (1926.62) https://www.osha.gov/Publications/OSHA3680.pdf#page=2

Emergency Preparedness and Response: Preparing before an emergency incident plays a vital role in ensuring that employers and workers have the necessary equipment, know where to go, and know how to keep themselves safe when an emergency occurs. https://www.osha.gov/SLTC/emergencypreparedness/index.html

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

More than 140,000 die from measles as cases surge worldwide. Infants and young children most at risk of fatal complications, health agencies warn.  https://www.who.int/news-room/detail/05-12-2019-more-than-140-000-die-from-measles-as-cases-surge-worldwide

More than one in three low- and middle-income countries face both extremes of malnutrition: Twin presence of obesity and undernutrition reflects shifts in food systems. https://www.who.int/news-room/detail/16-12-2019-more-than-one-in-three-low–and-middle-income-countries-face-both-extremes-of-malnutrition

Ebola in the Democratic Republic of the Congo Health Emergency Update:   Total of 3348 cases, including 2210 deaths, 1089 survivors, and patients still under care as of December 17, 2019. https://www.who.int/emergencies/diseases/ebola/drc-2019

WHO commemorates the 40th anniversary of smallpox eradication: Historic milestone underscores urgent need to invest in global health security and universal health coverage. https://www.who.int/news-room/detail/13-12-2019-who-commemorates-the-40th-anniversary-of-smallpox-eradication

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

Vaping Nicotine Linked To Increased Risk Of Chronic Lung Disease:  https://www.npr.org/sections/health-shots/2019/12/16/788540191/vaping-nicotine-linked-to-increased-risk-of-chronic-lung-disease

Chipotle pays nurses to distinguish hangover from contagious illness: Nobody gets into the back of the restaurant without going through a wellness check. https://www.foxbusiness.com/lifestyle/chipotle-nurses-sick-days

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

Terpenes in marijuana vaping products may produce toxic chemicals: https://www.upi.com/Health_News/2019/12/10/Terpenes-in-marijuana-vaping-products-may-produce-toxic-chemicals/6861575932260/

There have been at least 1,300 flu deaths in the US so far this season, CDC estimates: At least 1,300 people have died from the flu so far this season, according to a preliminary estimate released Friday by the U.S. Centers for Disease Control and Prevention. There have been at least 2.6 million flu illnesses and 23,000 flu-related hospitalizations, according to the analysis. Flu activity is being caused mostly by influenza B/Victoria viruses, which is unusual for this time of year, according to the CDC, and B strains tend to hit children particularly hard. Influenza A/H1N1 viruses are increasing in proportion relative to other flu viruses in some regions. https://www.wpbf.com/article/there-have-been-at-least-1300-flu-deaths-in-the-us-so-far-this-season-cdc-estimates/30228537#

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

Breast cancer risk from menopause hormones may last decades:   Women are prescribed hormones in combination because taking estrogen alone raises the risk of uterine cancer. https://www.wkbn.com/news/national-world/breast-cancer-risk-from-menopause-hormones-may-last-decades/

Montana health department to enforce temporary flavored e-cigarette ban next week:  The Montana health department announced Friday it will start enforcing a temporary ban of all flavored e-cigarette products statewide next Wednesday as new cases of vaping-related injuries have emerged.  The restrictions include sales of flavored nicotine, THC and CBD e-cigarette products, both in stores and online, according to a release from Montana Department of Public Health and Human Services. Stores will not be required to destroy existing inventory. https://www.ktvq.com/news/montana-news/montana-health-department-to-enforce-temporary-flavored-e-cigarette-ban-next-week

PrEP’s unexpected side effect: reduced ‘HIV anxiety’: Use of the HIV prevention drug is associated with lower levels of anxiety about contracting HIV. But for gay men who remember AIDS, the specter of HIV is a hard ghost to shake. https://www.nbcnews.com/feature/nbc-out/prep-s-unexpected-side-effect-reduced-hiv-anxiety-n1101891

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

Measles outbreak in Samoa kills 72, most of them children:  The Samoa measles outbreak has not slowed down, prompting the government to extend a state of emergency on Saturday to December 29. Over 5,100 measles cases have been reported since the outbreak, with 74 recorded in a recent 24-hour period alone, according to Samoa’s government.  More than two percent of the island nation’s population has been infected, and 72 measles-related deaths have been recorded. Most of those who have died have been under five-years-old, according to the United Nations. https://www.cbsnews.com/news/samoa-extends-measles-state-of-emergency-as-death-toll-climbs-2019-12-14/

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