Earth Day 2018: Making the Connection Between Environmental and Human Health

Trafalgar Square during the Great London Smog of 1952. Photo © TopFoto / The Image Works.

This Sunday is Earth Day, an annual event started by a bipartisan group of citizens and congressional representatives in 1970 to highlight the need for a healthier environment and the importance of legislative protections.

Along the mighty Hudson—beautiful, but still contaminated

Growing up just north of New York City, along one of the most beautiful but contaminated sections of the Hudson River, I’ve seen up close the effects of industrial pollution before environmental protections were put in place. In addition to producing electrical wire, cables, munitions, and other products, the factories that lined my town’s waterfront for much of the 20th century were also responsible for extensively contaminating the surrounding area with polychlorinated biphenyls (PCBs) and petroleum hydrocarbons.

For many decades, the environmental damage caused by such industry was accepted as the price of progress. Raw sewage and oil slicks in the waters of the Hudson were not unusual sights, and relatives tell stories of a popular spot along the river, from which swimmers in the 1960s would emerge covered in the dye produced—and dumped—by a nearby riverfront […]

2018-04-21T08:49:06-04:00April 21st, 2018|environmental health, Nursing, Public health|0 Comments
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On Ethical Short-Term Medical Missions: An Argument from Experience

“In the absence of clearly articulated intentions and approaches, how can we be sure that short-term medical missions won’t have unintended long- or short-term consequences?”

Garrett Matlick

That’s the central question posed by Garrett Matlick’s Viewpoint essay, “Short-Term Medical Missions: Toward an Ethical Approach,” in the April issue of AJN. Matlick, currently enrolled in the Family Nurse Practitioner/Master of Public Health Program at Johns Hopkins University School of Nursing, Baltimore, had an opportunity to observe short-term medical missions (STMMs) that succeeded as well as some that failed.

What works and what doesn’t?

Having considered the current paucity of quality research on STMMs and their effects, Matlick both calls for more rigorous future research and offers a few basic considerations that he believes should be applied to all STMMs that offer direct care to local communities. His case is immensely strengthened by the use of multiple real world examples he observed or participated in while in Cambodia.

AJN sometimes receives Reflections essay submissions from nursing students and others about their experiences in STMMs in various countries. (Unlike the Viewpoint column discussed in this post, Reflections essays tend to focus more on personal reflections and story than on making an argument.) Some submissions reflect a nuanced awareness of limitations and benefits […]

2018-04-11T11:53:31-04:00April 11th, 2018|Ethics, nursing students, Public health|0 Comments
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It’s Spring. Time to Think about Lyme Disease

Ticks Ixodes pacificus (shown here in CDC image) and Ixodes scapularis are known vectors of Borrelia burgdorferi (Lyme disease)

National data confirm that diagnoses of Lyme disease begin to rise each year during the month of April, then rapidly reach their peak in June and July. Just in time for “Lyme season,” readers can learn more about the disease in “Lyme Disease: Diagnosis, Treatment, and Prevention” in this month’s AJN.

Lyme disease was first recognized in 1975 in Lyme, Connecticut. From 492 confirmed cases in 1982 (the first year in which Lyme was a reportable disease) to more than 35,000 confirmed and probable cases in 2016, the causative organism, Borrelia burgdorferi, has continued to expand its geographic reach. The CE article notes that these numbers may be undercounts and cites analysis of laboratory and medical claims data from 2008 suggesting that the true number of annual diagnoses may actually be between 240,000 to 444,000.  […]

2018-04-04T09:11:38-04:00April 4th, 2018|climate change, infectious diseases, Nursing, Public health|0 Comments
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The 1918 Influenza Epidemic’s Long Reach in Time

“It would be impossible to relate all the sad and terrible scenes . . . all night long . . . witnessing death scenes, seeing weeping relatives and trying to take care of emergencies . . . “

A mother’s death remembered.

Litter carriers at Red Cross Emergency Ambulance Station in Washington, D.C., during influenza pandemic of 1918.

When my grandfather was six years old, his mother went to sleep one night and never woke up. She was one of the nearly 700,000 Americans who died during the 1918–1919 influenza pandemic, which killed an estimated 50 million people worldwide. The rest of her young family—my grandfather and his twin brother, their seven-year-old sister, and my great-grandfather—survived. The shock of losing his mother so suddenly was still evident when my grandfather talked about her 70 years later. She was 29 years old and healthy, and then she was gone.

High mortality, even among healthy young adults.

My family was not alone as it mourned. The CDC estimates that one-third of the world’s population was infected by what’s become known as the “Spanish flu.” (The origin of this name is unclear: some sources suggest it’s due to a misunderstanding about […]

2018-03-07T09:08:45-05:00March 7th, 2018|infectious diseases, Nursing, Public health|1 Comment
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Late in a High Anxiety Season, Some Flu and Vaccine Basics

After what has seemed like constant media scrutiny for months, influenza hasn’t been in the news as often in recent days. Still, CDC data indicate that flu activity remains “widespread” across the country, so it’s still too early to eliminate flu from your list of “differential diagnoses,” at work or at home.

Maybe it’s the general state of our national psyche, but this year the “flu” seems to have caused more than its usual share of anxiety. This is not a pandemic; there are no brand-new strains of flu in circulation to which no one is immune. But the H3N2 strain that has been predominant this year does tend to lead to a harsher-than-usual season. (The 2014-2015 season was also severe, but the public heard relatively little about it because media were focused on the Ebola outbreak.)

Influenza surveillance basics.

How do we know how bad a flu season really is? Since the 1997–1998 flu season, lab data and clinical reporting have facilitated real-time flu surveillance in the U.S. Public health laboratories in every state, in collaboration with National Respiratory and Enteric Virus Surveillance System laboratories, track the types (A or B) and subtypes (H3N2, H1N1, etc.) of flu in circulation.

To complement these data, the U.S. Outpatient Influenza-Like Illness Surveillance Network (ILINet) tracks the percentage of […]

2018-02-28T12:20:28-05:00February 28th, 2018|infectious diseases, Nursing, Public health|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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