Study: E-cig use raises risk of early development of asthma 252%

Studies show vaping may contribute to the development of asthma. (Image from Very Well Health) 

Kentucky Health News

There is a significant link between vaping and asthma in adults, according to a new study published in the Journal of the American Medical Association Network Open.

The study found that adults who did not have any asthma symptomps at the beginning of the study and reported e-cigarette use in the past 30 days increased their risk of developing asthma at an earlier age by 252%.

“While previous studies have reported that e-cigarette use increases the risk of asthma, our study was the first to examine the age of asthma onset,” said first author Adriana Pérez, professor of biostatistics and data science at the University of Texas-Houston School of Public Health. “Measuring the potential risk of earlier age of asthma onset as it relates to past 30-day e-cigarette use may help people from starting use or motivate them to stop.”

The study used data from the Population Assessment of Tobacco and Health Study, a national longitudinal study of tobacco use and how it affects the health of adults and youths in the U.S.

“The findings of the study underscore the need for further research, particularly regarding the impact of e-cigarette use on youth and its association with early age of asthma onset and other respiratory conditions,” Pérez said in a news release. The study says the lack of youth impact "could be due to a lack of statistical power."

"Pérez said the study highlights the need to address the health burden of asthma, which results in $300 billion in annual losses due to missed school or workdays, mortality, and medical costs according to the Centers for Disease Control and Prevention," the release says. "Tobacco regulations, prevention, intervention campaigns, and cessation programs are needed to prevent early age of asthma onset due to e-cigarette use, the authors wrote."

Sneezing? Sniffling? Climate change means U.S. allergy seasons last a month longer than in 1990 and have 21% more pollen

Medical News Today photo

By Laurel Swanz
Kentucky Health News

With allergy season in full swing in Kentucky, those suffering from nasal allergies and asthma may feel as though the pollen gets worse every year.

The American College of Allergy, Asthma and Immunology says there is some truth to this – and climate change, which is causing warmer temperatures, longer growing seasons and decreased air quality, is to blame.

Pollen season starts earlier and lasts longer than in previous years, according to research led by William Anderegg of the University of Utah School of Biological Sciences and the National Institute of Food and Agriculture.

Andregg’s research found that pollen seasons “start 20 days earlier, are 10 days longer, and feature 21% more pollen than in 1990.”

Kentucky has had a longer pollen seson this year because it had an unseasonably warm February, putting parts of the state in bloom for months, according to Lexington's WKYT-TV.

“The strong link between warmer weather and pollen seasons provides a crystal-clear example of how climate change is already affecting peoples’ health in the U.S.,” Anderegg said in a report for the National Institute of Food and Agriculture.

According to Anderegg’s research, the warming temperatures confuse plants’ internal timing, or phenology, causing them to start producing pollen earlier in the year.

That means people who suffer from seasonal allergies and asthma and their health-care providers must start preparing sooner, as many treatments take varying amounts of time before becoming effective.

For example, immunotherapies to treat allergies through dissolving tablets or shots can take anywhere from 12 weeks to years to become effective, so knowing when allergy season is coming is essential to the timing and effectiveness of these treatments.

The Mayo Clinic offers several strategies to relieve seasonal allergies before resorting to allergy shots, including staying indoors when pollen counts are high to reduce exposure and using over-the-counter remedies such as antihistamines, decongestants and nasal irrigation.

The American College of Allergy, Asthma and Immunology reports that allergies and asthma often go hand in hand. And because climate change leads to heightened symptoms of both conditions, people need to know what they’re dealing with and how to treat it.

“What many people don’t realize is that the same things that trigger your seasonal ‘hay fever’ symptoms – things like pollen, dust mites, mold and pet dander – can also cause asthma symptoms,” allergist Kathleen May said in an ACAAI news release. “If you have allergies, and you are wheezing or coughing, an allergist can determine if you also have asthma. Allergists are specialists at treating asthma and can put together a treatment plan to help you deal with both conditions.”

Anderegg’s research found that climate change’s contribution to increasing pollen counts is only rising.

“Climate change isn’t something far away and in the future. It’s already here in every spring breath we, and increasing human misery,” Anderegg said in the report. “The biggest question is — are we up to the challenge of tackling it?”

Bedbugs, long thought to pose no risk to human health, produce large amounts of inflammatory histamines, UK researchers find

Bedbugs in an entomology lab (Photo by Matt Barron, UK)

By Haley Simpkins
University of Kentucky

Bedbugs produce large amounts of histamine that may pose risks to humans, entomologists at the University of Kentucky and North Carolina State University have discovered in a study. 

Histamines are naturally produced chemical compounds that may cause inflammation and alert the immune system to threats. They can cause allergic reactions, rashes and respiratory problems. A previous study showed links between excess histamines and headaches, gastrointestinal issues, irregular heart rate and asthma, especially in people with histamine intolerance.

Sudip Gaire, a post-doctoral scholar in the UK Department of Entomology, and Zach DeVries, assistant professor of entomology, led the latest study. It looked at levels of histamines excreted by bedbugs across the bugs’ different life stages, different populations and varying lengths of time, and the effects that feeding on blood had on the bugs’ histamine production levels.

The study, recently published in The Journal of Medical Entomology, showed bedbugs can produce large amounts of histamine. It found that a hypothetical infestation of 1,000 bugs could produce up to 40 milligrams a week, more than 2 grams per year without even considering natural population growth of the infestation.

“That's an amount you can actually see, and we don't see that with any other containment,” DeVries said. “When we talk about pesticides, allergens, any other thing in our home that some invading organism is producing, it's always on microscopic levels, not something where you could actually hold it in your hand.”

Scientists typically haven't considered bedbugs a great risk to human health, aside from their bites, because they are not known to carry pathogens. However, high-level histamine production reveals a potential risk. While scientists don’t know the specific health impacts of histamine produced by non-human animals, DeVries, Gaire and their fellow entomologists do suspect that it may have negative clinical effects.

“It’s not only the fact that they’re producing histamine, but they’re producing it right next to where you spend the most time, generally speaking, within our homes, which is in our beds or sleeping areas,” DeVries said.

The research also has social-justice implications, DeVries said: “Anybody can get bedbugs, but it’s only those who have the means and resources who can actually get rid of the problem. There is a significant portion of the population who either don't have the money or the resources to do this, and so they're left to deal with bed bugs on their own. So, we have disadvantaged communities, who are not only having to deal with bed bugs, but maybe dealing with the health ramifications of them as well.”

One important discovery of the study was that blood-fed bed bugs produced “significantly higher” amounts of histamine than those feeding on saline or those that were starved. “Blood is the primary factor for histamine production, but we don’t know how exactly they are producing the histamine,” Gaire said.

Gaire said close exposure to histamine is also a concern for agriculture. Bedbugs are common in poultry houses, and previous studies have found histamines reduce egg production.

DeVries and Gaire said that while their study answered important questions, scientists need to do more research before sounding an alarm. DeVries received funding for the study through his 2019 National Institutes of Health Director’s Early Independence Award, which will fund similar future studies through 2024.

State's poor health rankings are a caution flag in pandemic, but virus shouldn't keep you from making regular visits to doctors

Ben Chandler

By Ben Chandler
President and CEO, Foundation for a Healthy Kentucky

A new state-by-state comparison of the nation’s health ranks Kentucky near the bottom in a variety of significant categories. Though the 2020 America’s Health Rankings Annual Report from the United Health Foundation may underscore Kentucky’s longstanding position as a state with serious health challenges, this year’s rankings also provide a great service by raising a caution flag related to Kentucky’s battle against Covid-19.

First, consider that Kentucky is ranked 49th among all states for percentage of residents (15 percent) who suffer from three or more of these chronic conditions: arthritis, asthma, chronic kidney disease, chronic obstructive pulmonary disease (COPD), cardiovascular disease, cancer, depression and diabetes.

Though the study was performed prior to the Covid-19 pandemic, its findings spark concern related to the current crisis. Notably, the Centers for Disease Control and Prevention states that adults with any of these chronic conditions are at increased risk of severe illness from the virus that causes Covid-19.

Also, the United Health Foundation study shows 36.5% of Kentucky adults are obese (compared to 31.9% nationally). And the CDC reports that adults who are obese also face increased risks related to the virus.

Of course, more broadly, the rankings are a reminder that chronic health conditions and generally poor health make us more susceptible to a wide range of risks – and not just during this current global pandemic. So these rankings are also a call to action: a rallying cry to each of us as individuals and community leaders to continue addressing Kentucky’s chronic health conditions and other health needs despite the pandemic.

As Covid-19 cases have climbed in Kentucky, one major concern is that Kentuckians still may be skipping preventive and non-Covid-related visits to the doctor to reduce their risk of exposure to the virus. But the decision to delay such visits – which may include screenings such as mammograms and colonoscopies, as well as annual wellness exams – could have serious health consequences, especially for those with chronic conditions that require regular, ongoing medical attention.

We don’t have to skip these important visits. In recent months, health providers and clinics have taken a variety of steps to reduce the risks of contracting Covid-19. In addition to mask requirements, doctors’ offices are implementing strict social distancing policies, limiting the number of people in waiting rooms, and instructing patients to wait in their cars until their appointments begin. And many providers are offering telehealth options, where patients can meet their providers without leaving their homes.

So, while Kentuckians must remain vigilant in their efforts to avoid contracting or spreading the coronavirus, we cannot neglect our broader health care needs.

For the record, America’s Health Rankings also include some positive observations about Kentucky. They note that the commonwealth’s air pollution has decreased 12.6% from 2009 to 2019. We are ranked third in percentage of adults who are high school graduates (90.3%), which is important because education attainment generally equates with more secure employment, higher earnings and better health. Our poverty rate also has been declining, from 19.4% in 2012 to 16.3% in 2019. These represent movement in the right direction. And though Kentucky has dropped slightly in recent years, we are ranked 14th in percentage of residents (93.6%) covered by private or public health insurance.

In this Covid-19 era, managing our health is a multi-pronged approach. We need to keep ourselves safe and prevent the virus from spreading, yet also ensure we aren’t adding to its toll through delayed care or missed diagnoses. And then there is the even bigger picture: Challenging ourselves, our loved ones and our communities to improve our state’s health through policies that increase access to health care, reduce exposure to health risks and improve health equity. As we close out a year full of turmoil and uncertainties, there has never been at better time to pursue a healthier Kentucky.

Are there medical exceptions for mask wearing? Very few.

The Washington Post

A so-called “mask loophole” has been circulating on social media. It suggests that people who don't want to wear masks should tell store workers that they have a medical condition, and if challenged they should cite the privacy section of HIPAA, the Health Insurance Portability and Accountability Act.

To be clear, the Americans with Disabilities Act doesn't apply to people without disabilities, and HIPAA only applies to the flow of medical information through health-care providers and insurers.

“This social-media post doesn’t relay a ‘mask loophole’ so much as it encourages people to exploit a law designed to provide protections to disabled people,” the fact-checking website Snopes wrote.

There are very few conditions that would prevent someone from being able to wear a mask. The Centers for Disease Control and Prevention says people who should not wear a mask are: 1) children younger than 2 years old; 2) anyone who has trouble breathing; 3) anyone who is unconscious, incapacitated, or otherwise unable to remove the mask without assistance.

“Anyone who has trouble breathing” is ambiguous, and this seems to be where people like to point if they don't want to wear a mask.  In an article in the medical journal JAMA, a legal expert and a medical expert wrote that “few medical conditions are truly incompatible with all forms of mask wearing.”

People with facial deformities that are incompatible with masks is one example the authors raised. People with sensory or processing disorders was another. But less clear were the cases of people with chronic lung illnesses who weren't experiencing an acute attack. There is some evidence that masks protect the wearer to a certain extent, which would be beneficial to those with underlying lung disease. Having a chronic cough is also a really good reason to wear a mask.

For asthma, it depends on the severity. For people with mild or well-controlled asthma, masks shouldn't be a problem, according to the Asthma and Allergy Foundation of America. For those with severe asthma that involves many hospital visits and medications, wearing a mask for long periods might not be best.

Health experts warn people with asthma and chronic lung conditions to be careful when spring cleaning; here are their tips

Asthma.net image

Spring has arrived in Kentucky, prompting many to tackle the annual chore of spring-cleaning, but health experts caution people who suffer from asthma or other chronic lung conditions to proceed with caution because some cleaning supplies can be hazardous to your health, according to a Penn State Health news release.

The key to cleaning safely, if you have one of these conditions, is to take proper precautions when using cleaning supplies such as air fresheners, rug cleaners, bleach, oven cleaners and floor polish, because they can produce vapors that may irritate the nose, throat, eyes and lung, the release says.

“For most people, using chemical cleaners occasionally would not create clinically significant reductions in lung function,” Dr. Timothy Craig, an allergist and immunologist at Penn State, says in the release. “But repeated exposure to harmful chemicals over a lifetime could lead to significant disability later in life, especially for people with asthma, chronic obstructive pulmonary disease or Alpha 1 antitrypsin deficiency, a genetic disorder that may cause lung or liver disease.”

About 11.6% of Kentucky adults have asthma, and rates are significantly higher among women than men: 16% and 6.9% respectively. About 11.4% of Kentucky adults have chronic obstructive pulmonary disease, and those rates are also significantly higher in women, 13.3% to 9.4% for men, according to the 2018 Kentucky Behavioral Risk Factor Survey annual report.

Here are six safety tips that the experts say should be on everyone’s spring cleaning checklist:

1. Don’t combine chemical cleaners, especially not ammonia and bleach.
2. Create proper ventilation. Open a window or door, or run a fan, while cleaning.
3. Wear rubber gloves and a mask.
4. Seek old-fashioned cleaners like warm water, baking soda,and vinegar.
5. Read labels. Look for volatile organic compounds and other potential irritants, even in products labeled as “green” or “healthy.”
6. Look for the “Safer Choice” logo. It’s found on 2,000 products, including cleaners, that the Environmental Protection Agency deems as “safer for human health and the environment.”

"People who experience any coughing, wheezing, throat soreness or eye watering while using chemical cleaners should step into another room or walk outside. If the symptoms persist even after leaving the room, call a doctor," says the release.

Report shows race and ethnicity matter when it comes to health

When it comes to health, your race and ethnicity matter, says a recent Foundation for a Healthy Kentucky report.

A study of federal and state polling data found that multiracial and black Kentuckians tend to report higher rates of smoking, obesity, asthma and poor mental health than their white counterparts, and that black and Hispanic Kentuckians are less likely to have health insurance than white Kentuckians.

"This report helps us see how race and ethnicity make a difference in how healthy you are, just as previous Foundation reports have shown that where you live and your education and income levels affect your health status," Susan Zepeda, outgoing president and CEO of the foundation, said in a news release.

Findings from the report, Health Disparities in the Commonwealth, A Report on Race and Ethnicity and Health in Kentucky, are based on federal and state Behavioral Risk Factor Surveillance System polling from 2011 through 2013. It is the third in a series of reports exploring health disparities in the state, with the first focusing on geographic disparities and the second on socioeconomic disparities.

The report looked at access to health care and preventive services, a variety of social and behavioral health indicators and health outcomes of Kentucky adults of different racial and ethnic groups.

Access to health care and preventive services

The report said there are "significant associations" between racial and ethnicity and access to care in Kentucky.

Lines atop bars indicate confidence intervals, or possible range
of percentages. The percentage given is the most likely one.

It found that white Kentuckians were less likely to forego medical care due to cost and Hispanics were most likely. Although, overall Kentucky adults forego medical care due to cost at a higher rate than the rest of the nation.

"Nearly 1 in 5 Kentucky adults (19.1 percent) reported that there was a time in the prior year when they needed to see a doctor but could not because of the cost," says the report. "Access to care was considerably more limited for Hispanic adults in Kentucky, with nearly 1 in 3 adults (28.9 percent) unable to afford needed medical care."

It also found that white Kentuckians were more likely to have a personal doctor than other races and ethnicities; and that black (25.6 percent) and Hispanic Kentuckians (34.1 percent) were less likely to have health insurance than white Kentuckians (16.7 percent).

Black Kentuckians reported they were less likely to have an annual flu shot (34.3 percent) than white Kentuckians (40.1 percent), whereas white Kentuckians were "significantly less likely" to have been tested for HIV than other racial or ethnic groups in Kentucky, 28.8 percent.

"The Centers for Disease Control and Prevention recommends that HIV screening be provided to everyone, as part of their routine health care, unless they decline to be tested," says the report.

Social and Behavioral Health

As for risky behaviors, except for binge drinking, Kentucky adults were more likely to smoke, be physically inactive, have limitations due to other health conditions and be overweight or obese than the rest of the nation. And these risky behaviors were higher in some racial and ethnic groups than others.

For instance, multiracial Kentuckians reported the highest rate of smoking in the state, 41.3 percent, between 2011-2013. The state's smoking rate, 27.9 percent, was significantly higher than the nation's rate of 19 percent. This group was also most likely to have activity limitations due to health conditions.

"Smoking increases the risk of cancer, heart disease,stroke and other chronic conditions, exacerbates asthma, and reduces overall health status," says the report.

The report also noted that while 66.9 percent of Kentucky adults were overweight or obese, black Kentuckians were "significantly more likely" to be overweight or obese (72.9 percent) than whites (66.8 percent), Hispanics (62.8 percent) and others (51.1 percent). The national average was 63.5 percent.

"Obesity is both a chronic disease and a risk factor for other diseases,including heart disease, stroke, type 2 diabetes and certain cancers," says the report.

On a positive note, Hispanics in the state reported getting more physical activity than other Kentucky adults or the average American.

Health outcomes

Overall, Kentucky adults reported poorer health status than the national average (23.2 percent and 18.1 respectively). Although Hispanic Kentuckians reported fair or poor health at a similar rate as other Americans.

Multiracial (24.4 percent) and other race (22.6 percent) adults in Kentucky were more likely to report poor mental health than white (15 percent) or black Kentuckians (14.8 percent).

Multiracial Kentuckians also reported slightly more asthma diagnosis (27.2 percent) compared to white (14.7 percent) and black (17.1 percent) Kentuckians.

Hispanic and other race Kentuckians were slightly less likely to report having diabetes.

The report says the foundation "believes that health disparities can be eliminated, and that they must be eliminated," and that this report helps to understand and monitor where they exist.

Zepeda said, "Understanding these disparities is an important step in enacting the policy changes and programs that can reduce and ultimately eliminate them."

UK research project will create strategies to improve respiratory health for those living in Appalachian Kentucky

Public health researchers at the University of Kentucky will undertake a five-year long research project called "Community-Engaged Research and Action to Reduce Respiratory Disease in Appalachia," Sarah Noble writes in a UK press release.

Funded by the National Institutes of Health's National Institute of Environmental Health Sciences, the project will involve creating strategies to improve respiratory and environmental public health. Kentuckians living in Appalachian counties have the state's highest rates of serious respiratory illness.

"Adults in Appalachian Kentucky are 50 percent more likely to develop asthma or chronic obstructive pulmonary disease than the overall U.S. population," Noble writes. "As many as one in five adults in the region have received a diagnosis of asthma, and rates of COPD are nearly two-and-a-half fold the incidence of the disease in other parts of the country.

Although studies show associations between respiratory health problems and environmental contaminants, data doesn't yet include individual-level assessments or behavioral risk factors common in the area—such as smoking, poor diet and insufficient physical activity. The "Community Response to Environmental Exposures in Eastern Kentucky" project will fill those gaps.

The CREEEK project will include three steps. A community-based assessment will "identify the relationships between indoor air pollutants, behavioral and social determinants and the effects these factors have on risk of respiratory disease," Noble writes. That information "will be shared with local stakeholders in an effort to increase understanding of the environmental exposures present in the region," then the project will put in place "an environmental public health action strategy and will evaluate that strategy's ability to impact short-and long-term outcomes for respiratory health."

Midwest pollen count indicates that seasonal allergies are expected to be worse than usual this year

Seasonal allergy sufferers beware. Allergy season is officially here and is predicted to be worse than usual, says a news release from Chicago's Loyola University Health System.

image from healthguru.com

After weeks of evaluation, the Gottlieb Allergy Count, which is the official daily allergy count for the Midwest, has detected moderate pollen in the air at a time that is typically low.

Dr. Joseph Leija,  retired allergist who continues to conduct the official daily allergy count, said in the release that the long cold winter with heavy snow is likely to cause "a bad allergy season."

“The prolonged, fierce winter may mean that tree, grass and mold spores appear simultaneously early in the season, causing a triple threat," he said in the release. "Heavy snow means lots of moisture to nourish budding trees and plant life. The continued dampness also fosters the growth of mold."

Here are some allergy relief tips from WebMD :

• Take your shoes off at the door.
• Wipe down your dog's coat before it comes in the house.
• Wash your hair before bed.
• Close the windows and doors, especially on high-pollen days.
• Use the "recirculate" option in the car.
• Service the filters in your furnace and air conditioner.
• Use a dehumidifier to maintain a humidity level of less than 60 percent in your home.
• Check the daily pollen count and plan accordingly.
• If possible, have someone else mow the lawn.
• Avoid sitting outside around freshly cut grass.
• Dry your clothes in a clothes dryer, not on an outdoor line. 

“People with allergies or breathing difficulties should be proactive now to preserve health," Leija said in the release. "Consult your allergist, have the ducts cleaned on your air conditioning system and start taking your allergy medicine so that when things really heat up, you are protected."

Click here to get the daily pollen count in your county from pollen.com.

KET will discuss asthma Monday night: living with it, its environmental affects, and available resources to deal with it

KET's current "Health Three60" program is "Easing the Burden of Asthma," discussing a disease that hospitalizes more than 6,000 Kentuckians a year. After debuting on KET Sept. 29 at 9 p.m., it will air on KETKY Sept. 30 at 2 p.m., again on KET Oct. 1 at 3 a.m., again on KETKY Oct. 1 at 9 a.m., again in KET Oct. 2 at 4 a.m. and KETKY Oct. 2 at 4 p.m. (all times EDT).

Host Renee Shaw and guests discuss what it means to live with asthma, daily asthma management and the need for better education and support. They will also explore how the environment affects asthma, both outdoors and indoors.  One segment will look at a pioneering initiative at the Ashland-Boyd County Health Department, which sends health professionals into the homes of people with asthma to help them improve their indoor air quality and reduce asthma triggers. It will also discuss how smoke-free laws help people with asthma. Another segment will look at how to access and utilize resources to help with asthma, such as the Kentucky Asthma Partnership.

Guests on the program include Beth VanCleave, asthma educator at Kosair Children's Hospital, Louisville; Connie White, deputy commissioner of the Kentucky Department for Public Health; David Mannino, professor, University of Kentucky College of Public Health; James Sublett, co-founder of Family Allergy and Asthma and president-elect of the American College of Allergy, Asthma and Immunology.

Lots of research has established that children with egg allergies can still get a flu shot; those with asthma especially should

Flu season can start as early as October, and  children with egg allergies are now encouraged to get a flu shot, especially if they have asthma, according to a news release from the American College of Allergy, Asthma and Immunology.

Children with egg allergies may have been told in the past to not get a flu shot because of a possible reaction to trace amounts of eggs in which the vaccine is produced, but recent research now says that the vaccine is safe for these kids.

“We now know administration is safe, and children with egg allergies should be vaccinated,” Michael Foggs, president of the American College of Allergy, Asthma and Immunology, said in the news release. “We recommend that, as with any vaccine, all personnel and facilities administering flu shots have procedures in place for the rare instance of anaphylaxis, a life-threatening allergic reaction.”

The release says "a large number of research studies published over the last several years have shown that thousands of egg-allergic children, including those with a severe life-threatening reaction to eating eggs, have received injectable influenza vaccine as a single dose without a reaction."

More than 21,100 children under the age of five are hospitalized annually because of the flu, with only 55 percent of children ages 5-17 getting a flu shot, according to the Centers for Disease Control and Prevention, says the release.

Foggs especially recommended that children with asthma get the vaccine, because even though they are not more likely to get the flu, it can be more serious for those with asthma, says the release.

"Children with asthma really need to get the flu vaccine," Foggs said in the release. “Asthma sufferers are among the most vulnerable because the flu compromises their airways even further than they already are.”

Prevention and preparation is the key to a productive year at school for kids with asthma (and that's 1 in 10 students)

By Melissa Patrick
Kentucky Health News

As the beginning of a new school year approaches, parents of children with asthma and allergies need to make sure that not only does their child recognize what triggers their symptoms and how to treat a flare-up, but also that their school knows what to do.

One of every 10 school-aged children in Kentucky has asthma, and these students miss an average of four school days each year, according to the Cabinet for Health and Family Services. Kentucky has one of the highest rates of asthma in the United States.

Nationally, more than 10 million kids under age 18 have asthma, 11 percent have respiratory allergies and about six percent have food allergies, according to according to the American College of Allergy, Asthma and Immunology. And on any given day, more than 10,000 kids miss school due to asthma.

Preventative care and avoiding triggers will help children miss fewer days in the classroom and will also allow them to be more productive in all of their activities, the college said in a news release.

“Parents need to be advocates for their kids, to help ensure they’re breathing well with clear minds and able to navigate the triggers that sometimes stand in their way,” Michael Foggs, president of the college. “If kids are having difficulty breathing, are sneezing, have runny noses and itchy eyes, and haven’t slept well the night before, they won’t perform at their best.”

Here are some tips to help with symptom-free days in the classroom and outdoors:

• Create an action plan with your allergist specific to your child's needs. Include medications, doses, triggers, early symptoms of flare-up and what to do if there is a flare up.&

• Share your child’s action plan with your child's teacher and whoever else might come into contact with your child every day. Discuss how independently your child is able to deal with their asthma, give them contact numbers for you and your child's doctor and be sure your child and school staff knows how to work the peak flow meter and how to administer medications, especially if your child needs assistance.

• Assess any triggers for your child at school: mold, dust mites, cockroaches, chalk dust, perfumes, cleaning products or other chemicals, animal dander, saliva or urine. Work on a plan to minimize these triggers.

• Discuss how to handle emergencies. Children who are at risk for a life-threatening allergic reaction (anaphylaxis) also should have epinephrine to use. Be sure your child and school staff know how to use emergency medications.

• If your child has food allergies, send a bagged lunch to school every day and instruct your child to not share foods, napkins or utensils.

• Make sure you have a plan for recess and sports activities. The American College of Allergy, Asthma, Asthma and Immunology says in the release that "asthma symptoms during exercise may indicate poorly-controlled medications."

• Pay attention to the pollen counts if your child is allergic to pollen; it is suggested to start medications two weeks prior to when the levels are at their worst.

Proper asthma control helps kids sleep better at night, spend more time in the classroom, experience less anxiety about their condition and fully participate in all school activities, according to kidshealth.org.

In selling proposed limits on CO2, Obama administration emphasizes health improvement, not climate-change fight

By Melissa Landon and Al Cross
Kentucky Health News

As it announced its plan to reduce carbon dioxide emissions from power plants by 30 percent by 2030, the Obama administration emphasized the health angle, not climate change, which has been the driving force for the proposed regulations but is a more controversial cause than improving health.

"For the sake of our families' health and our kids' future, we have a moral obligation to act on climate," EPA administrator Gina McCarthy said in her announcement.

Juliet Eilperin and Steven Mufson note in The Washington Post that when a climate bill stalled in the Senate four years ago, environmental and public health activists began pressuring Preisdent Obama to mandate carbon limits. Opponents to the measure include coal producers, some utilities and many Republicans, who say that the EPA has not proposed a plan that can work using current technology.

Under the new rules, states would use different strategies—such as energy efficiency, shifting from coal to natural gas, investing in renewable energy and making power plant upgrades—to achieve state-by-state goals. The reductions will be measured from 2005 levels; Environmental Protection Agency data reveal that power plants in the U.S. have already diminished carbon dioxide emissions by almost 13 percent since 2005, The Associated Press reports.

EPA estimates the rules will prevent as many as 6,600 premature deaths, 150,000 asthma attacks in children, up to 490,000 missed work and school days—saving $93 billion, Connie Hedegaard writes for EurActiv. The federal Centers for Disease Control reports that "exposure to particle pollution may cause worsening asthma symptoms, breathing problems, adverse birth outcomes, lung cancer and early death," Healio reports.

The new rules are intended to assist Washington in achieving international obligations to reduce U.S. greenhouse gas emissions deemed responsible for global warming, but Obama is focusing on the human health benefits to encourage Americans to adopt the movement, Jeff Mason wres for Reuters.

Although federal law has been employed to regulate other pollutants—such as soot, mercury and lead—this is the first time it has been applied to greenhouse gases, Fox News reports, quoting Obama: "We limit the amount of toxic chemicals like mercury, sulfur and arsenic that power plants put in our air and water. But they can dump unlimited amounts of carbon pollution into the air. It's not smart, it's not safe, and it doesn't make sense."

Kentucky gets $1.75 million in national settlement with big drug maker; marketing and promotional practices reined in

Kentucky will receive approximately $1.75 million from a $105 million national settlement with GlaxoSmithKline to resolve allegations that the pharmaceutical manufacturer unlawfully promoted its asthma drug, Advair, and its antidepressant drugs, Paxil and Wellbutrin, according to a press release from Attorney General Jack Conway's office.

The complaint and consent judgment alleges that GSK violated state consumer-protection laws by misrepresenting the uses and qualities of these drugs. Conway said in the release that this settlement will change the way pharmaceutical sales teams are motivated and paid.

The consent judgement requires GSK to reform its marketing and promotional practices, stating the company shall not: make any false, misleading or deceptive claim about its products; make claims not approved by the U.S. Food and Drug Administration; present information or conclusions from inadequate clinical studies; provide samples to health care professionals if they know it is being prescribed for non-approved use; or provide information describing any off-label use of a GSK product, unless consistent with applicable Food and Drug Administration regulations.

They must also continue a program through March 2019 that decreases financial incentives for sales representatives who use deceptive marketing practices, says the release.  In addition, scientifically trained personnel will be responsible for providing unbiased and non-promotional information to health care providers.

Kentucky joined 43 other states and the District of Columbia in reaching the national settlement with GSK.

This is Asthma Awareness Month, more important in Kentucky than in most states; we have one of the nation's highest rates

In May the Kentucky Department for Public Health is observing Asthma Awareness Month by cultivating awareness about the disease's impact and working with the Kentucky Asthma Partnership to reach both health care providers and schools to assist people with asthma.

Asthma sometimes creates disability, reduces quality of life and diminishes work productivity.  "While there is no cure for asthma, the burden of the disease can be lessened with proper management. With the right tools and resources, the numbers of missed schools days and work days, emergency room visits and hospitalizations can be greatly reduced," Public Health Commissioner Stephanie Mayfield, M.D., said in a news release from the Cabinet for Health and Family Services.

Kentucky has one of the nation's highest rates of asthma: one in 10 children and one in 11 adults. The disease costs Kentucky $399 million every year in direct medical costs, estimates the federal Centers for Disease Control and Prevention. Asthma also causes loss of money through work absenteeism and is one of the top reasons children miss school.

This month the state health department will collaborate with the Kentucky Asthma Partnership to encourage providers, schools and communities to both assist people with asthma and create an asthma action plan. "Educational tools will be made available, including Creating Asthma Friendly Schools, the EPR-3 Asthma guidelines and Asthma 1-2-3 Training. In addition, the American Lung Association of the Midland States will be sponsoring the Fight for Air Walk June 7 at Iroquois Park in Louisville," according to the press release.

According to health department staff, people need to know what to do in response to asthma attacks. "An asthma action plan helps patients identify when asthma is out of control and what steps need to be taken to respond to asthma attacks," said Pam Spradling, manager of the state asthma program. "Parents and caregivers can help schools identify children with asthma, make sure medications are available to the child and that an asthma action plan is on file," Spradling said. "Schools and workplaces can help reduce the risk of exposure to indoor asthma triggers year round by improving air quality and reducing exposure to second hand smoke."

To learn more, go to the Kentucky Asthma Program's website or the CDC's National Asthma Control Program website.

Study in Ky., 3 other states indicates exposure to secondhand smoke in vehicles can cause asthma attacks in non-smokers

Kentucky adults who have never smoked are more likely to have an asthma attack when exposed to secondhand smoke in a vehicle than those who are not exposed, according to a research paper recently published in Tobacco Control, an international, peer-reviewed journal.

The study looked at 17,863 adults in Indiana, Kentucky, Louisiana and Mississippi who said they had never smoked; 7.4 percent reported having asthma, and 12.3 percent reported exposure to secondhand smoke in a vehicle in the past seven days.

As expected, the study found that adults with asthma in vehicles in which smoking was voluntarily prohibited had less exposure to secondhand smoke, 9.5 percent, than those in vehicles without such a prohibition, 56.7 percent.

The conclusion was that adults exposed to secondhand smoke in a vehicle had a higher odds of having current asthma compared to unexposed adults, says the study's lead author, Kimberly Nguyen of the Office on Smoking and Health in the National Center for Chronic Disease Prevention and Health Promotion, part of the U.S. Centers for Disease Control and Prevention.

Data for the research came from the CDC's Behavioral Risk Factor Surveillance System and was restricted to states that offered information on secondhand smoke. The data, from 2011, was gathered via telephone from adults aged 18 or older. The article is available for purchase here.

10 years ago, Lexington's smoking ban started creating a healthier city and a movement among others in Kentucky

A decade ago, Lexington took a bold step by enacted the state's first public smoking ban, in a city that once proudly touted its status as the "World's largest burley tobacco market." As smoke-free supporters and Lexington residents celebrate the ordinance's 10th anniversary Monday, a recent editorial in the Lexington Herald-Leader highlights the dramatic benefits that have followed this historic step.

After the smoking ban took effect in April 2004, the city had 22 percent fewer emergency room visits for asthma in the next 32 months, and the Fayette County smoking rate has dropped from 26 percent to 17.5 percent, the editorial notes. These positive changes have yielded health-care savings of $21 million a year, says the University of Kentucky's Tobacco Policy Research Program.

"There is nothing quite as cost effective as smoke-free policies," the editorial quotes Ellen Hahn, a UK nursing professor and director of the Kentucky Center for Smoke-Free Policy, as saying. "We predict a 32 percent decline in smoking rates if Kentucky were to go smoke-free. That would save billions in health care costs and reduce premature death and suffering from the chronic diseases that plague Kentucky."

The editorial also says Lexington led the way for Louisville and 20 other municipalities to protect citizens from secondhand smoke; a third of the state's population now lives in a smoke-free environment, and many of the initial fears about a smoking ban are now extinguished.

Kentuckians feared economic harm, the shunning of Lexington restaurants and bars and suffering tourism or downtown attraction, but the opposite predictions came true, says the editorial. The scene in downtown Lexington is "far richer than 10 years ago... It once was an article of faith that tobacco would always be king in Kentucky, yet tobacco declined and agriculture has thrived."

Childhood obesity is linked to more immediate health problems than doctors formerly realized

While a plethora of research on childhood obesity has linked it to long-term health problems, a new UCLA study focuses on the condition's more proximate consequences, showing that obese children are at a greater risk for immediate health problems than previously thought. That's important for Kentucky, which ranks poorly in many health measures and is third highest in child obesity. (Photo by Tara Kaprowy)

"This study paints a comprehensive picture of childhood obesity, and we were surprised to see just how many conditions were associated with childhood obesity," said lead author Dr. Neal Halfon, a professor of pediatrics, public health and public policy at UCLA.

Compared to kids who are not overweight, the study found that obese children have nearly twice the risk of having three or more reported medical, mental or developmental conditions. Specific medical conditions included bone, joint and muscle problems; asthma; allergies; headaches; and ear infections. Obese children also reported a greater tendency toward emotional and behavioral problems, higher rates of grade repetition, missed school days and other school problems, ADHD, conduct disorder, depression, learning disabilities, and developmental delays.

The study provides the first comprehensive national profile of associations between weight status and a broad set of associated health conditions, a UCLA release said. Halfon said these findings should serve as a wake-up call to physicians, parents and teachers, who should be better informed of the risk for health conditions associated with childhood obesity. (Read more)

Electric cooperatives' monthly magazine looks at the poor health of our state's children

Courtney Cagle, 14, of Clinton learns
how to cook healthy spaghetti in UK's
Cooperative Extension nutrition program

The November issue of Kentucky Living magazine, published monthly for member-customers of the state's electric cooperatives, focuses on children's health. Editor Paul Wesslund writes that the stories and statistics on the current state of the state's kids are "scary."

Reporter James Nold Jr. writes that when experts were asked about their concerns for the state, childhood obesity was front and center. The state ties Georgia and Arkansas for the second highest share of children (37 percent) who are obese, and it trails only Mississippi among children 10 to 17. That’s more than one in three kids who are grossly unfit.

Also of concern are Kentucky children's high rates of asthma, abuse, neglect, and cigarette smoking. The numbers for these are so bad and so seemingly out of control now that health professionals would be happy just to see them remain stable in the future, instead of continuously rising.

Nold writes that the experts' urgency on these matters was palpable. A lot of them talked about the way poor nutrition can harm children now and throughout the rest of their lives.  They also expressed deep concern for the lack of dental education and care, the need for more exercise and for more parent involvement in all of their children's choices.

The magazine, which has a Health Club for children, notes that the University of Kentucky's Cooperative Extension Service provides nutrition education to students in all 120 counties. For more information on the club, or to join, go to www.KentuckyLiving.com and click on "KL Health Club." (Read more)

Use of pacifiers could lead to very sick babies, study finds

Oklahoma State University researchers report that they have found a wide range of disease-causing bacteria, fungus and mold on pacifiers that young children had been using.

In research presented at the American Society for Clinical Pathology, scientists have shown that pacifiers can also grow a slimy coating of bacterial film that alters the normal bacteria in a baby or toddler's mouth, increasing the likelihood of colic and ear infections. It gets worse, according to study author Tom Glass, a professor of forensic science, pathology and dental medicine: The same types of bacteria found on a common pacifier have been linked to cardiovascular disease, metabolic syndrome, allergies, asthma and autoimmune diseases.

HealthDay reporters Barbara Bronson Gray writes that Glass said the problems associated with pacificers are also applicable to any removable orthodontic appliance like retainers, mouth guards and dentures. Glass said his researchers were particular concerned about their findings when they discovered that "many of the bacteria growing from the used pacifiers were resistant to commonly used antibiotics such as penicillin and methicillin. The development of such resistance to certain antibiotics does not cause the organism to be more infectious than other strains that have no antibiotic resistance, but it can make the infection more difficult to treat." Glass told Gray that he does not recommend that pacifier use. use. "After doing the study, I say why take a risk?" (Read more)