Disaster Preparation and Recovery Update
MedlinePlus sent this bulletin at 12/21/2012 01:10 PM EST New on the MedlinePlus Disaster Preparation and Recovery page:12/20/2012 10:35 PM EST
Report Studies Link between World Trade Center Exposure and Cancer Risk Source: American Cancer Society
12/19/2012 12:00 PM EST
States Lagging in Emergency Preparedness: Report: MedlinePlus Budget cuts, complacency threaten gains in U.S. readiness, public health experts warn
Source: HealthDay
Source: HealthDay
12/18/2012 04:00 PM EST
Some Cancer Risks Higher in 9/11 Recovery Workers: Study: MedlinePlus Cases of prostate, thyroid, multiple myeloma cancers seen over years
Source: HealthDay
Source: HealthDay
12/17/2012 08:32 PM EST
CDC - Emergency Preparedness for Special Groups, Women and Pregnancy - NCBDDD Source: Centers for Disease Control and Prevention
Report Studies Link between World Trade Center Exposure and Cancer Risk
Article date: December 20, 2012
By Stacy SimonA study of people exposed to Ground Zero has found that early responders and recovery workers at the site of the World Trade Center terrorist attack do not appear to have an increased risk of cancer overall so far. The workers were more likely to be diagnosed with certain types of cancer: prostate, thyroid, and multiple myeloma. However, the researchers caution that it’s not certain exposure to the site caused the increased risk.
Researchers from New York and Chicago analyzed data up through 2008 from the World Trade Center Health Registry, which contains health-related information about 21,850 rescue and recovery workers, and 33,928 people who lived, worked, or attended school in the area. Their findings were published December 19, 2012 in the Journal of the American Medical Association.
According to the report, rescue and recovery workers did not have a significantly increased risk of cancer overall when compared to the general population of New York State. However, the workers had a 43% higher risk of prostate cancer. They also had double the risk of thyroid cancer and almost triple the risk of multiple myeloma, a type of cancer formed by malignant plasma cells.
But these findings have some important limitations. For one, the increases were based on small numbers of cases, so it’s not clear how reliable these numbers are. Higher than average rates of cancer screening among the workers, especially for prostate and thyroid cancer, could account for some of the additional diagnoses. The researchers also did not have information on other cancer risk factors, such as family history or occupational exposures before or after September 11 that might have played a role for anyone who developed cancer.
Intensity of exposure to the site did not increase cancer risk. Those in the study who were not rescue or recovery workers did not have an increased risk of any specific cancer.
Experts caution this isn’t the last word on cancer risk from Ground Zero debris, as longer follow-up is needed.
American Cancer Society national vice president, intramural research, Elizabeth Ward, PhD, chairs the Science/Technical Advisory Committee for the Centers for Disease Control and Prevention's World Trade Center Health Program, created by Congress to provide medical services and compensation for first responders working at Ground Zero.
Ward said: "It is important to recognize that the relatively short time since the exposure limits what we can currently conclude from this type of data. A lack of evidence for increased cancer incidence does not rule out the possibility that increased risks will be observed in the future. In addition, the nature, intensity and duration of exposure varies widely among rescue and recovery workers and others in the registry, so lack of increases in the overall population does not rule out excesses in specific subgroups. Nonetheless, the study results are reassuring that there does not appear to be a large increase of cancer in WTC-exposed populations at this time."
The dust and smoke from the collapse of the twin towers contained asbestos, lead, and other cancer-causing materials. However, it’s not easy to prove a diagnosis of cancer came from exposure to the dust and smoke, and not from some other cause. Last year, medical researchers from New York City published a study showing that firefighters who responded to the attacks had about a 19% greater risk of developing cancer than firefighters who did not work at the site. But they were cautious about the results because they followed the firefighters for just 7 years after 9/11, and many types of cancer can take decades to develop.
Fifty-eight cancer types are on the list of covered illnesses for people who were exposed to toxins in the aftermath of the September 11 attacks. Researchers say longer follow-up of those exposed is needed, especially for types of cancer—such as lung cancer—that typically take a very long time to develop.
Citation: Association Between World Trade Center Exposure and Excess Cancer Risk. Published in the December 19, 2012 issue of the Journal of the American Medical Association (Vol. 308, No. 23). First author: Jiehui Li, MBBS, MSc, New York City Department of Health and Mental Hygiene, Long Island City, New York.
Reviewed by: Members of the ACS Medical Content Staff
States Lagging in Emergency Preparedness: Report: MedlinePlus
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National Institutes of Health
National Institutes of Health 
States Lagging in Emergency Preparedness: Report
Budget cuts, complacency threaten gains in U.S. readiness, public health experts warn
Wednesday, December 19, 2012
WEDNESDAY, Dec. 19 (HealthDay News) -- While significant progress has been made in the past 10 years, many states still fall short in their preparedness for public health emergencies such as disease outbreaks, natural disasters and bioterrorist attacks, according to a new report.It found that 35 states and Washington, D.C. scored 6 or lower on 10 key indicators of public health preparedness. Kansas and Montana scored lowest -- 3 of 10 -- while Maryland, Mississippi, North Carolina, Vermont and Wisconsin scored highest, with 8 of 10.
The scores of other states were:
- Score of 7: Alabama, Arkansas, California, Delaware, Nebraska, New Hampshire, New Mexico, New York, North Dakota and Virginia.
- Score of 6: Connecticut, Idaho, Iowa, Kentucky, Louisiana, Maine, Massachusetts, Missouri, Ohio, Oklahoma, South Carolina, Tennessee, Utah, Washington and Wyoming.
- Score of 5: Alaska, Arizona, Washington, D.C., Florida, Illinois, Indiana, Michigan, Minnesota, Oregon, Pennsylvania, Rhode Island, South Dakota, Texas and West Virginia.
- Score of 4: Colorado, Georgia, Hawaii, Nevada and New Jersey.
Among the key findings:
- 29 states cut public health funding from fiscal years 2010-2011 to 2011-2012, with 23 of these states cutting funds for a second year in a row and 14 for three consecutive years.
- Federal funds for state and local preparedness have decreased 38 percent from 2005 to 2012. States report that gains in public health preparedness achieved since Sept. 11, 2001, are eroding, and that budget cuts since 2008 have resulted in more than 45,700 job losses at state and local health departments.
- Two states alone have met the national goal of vaccinating 90 percent of young children, ages 19 to 36 months, against whooping cough (pertussis). This year Washington state has had one of the largest whooping cough outbreaks in recent history, the release noted.
- Thirty-five states and Washington, D.C. do not currently have complete climate change adaptation plans, which include planning for health threats posed by extreme weather events
- Twenty states do not mandate all licensed child care facilities to have a multi-hazard written evacuation plan.
- Thirteen state public health laboratories would not have sufficient capacity to work five, 12-hour days for six to eight weeks in response to an infectious disease outbreak.
"But, for some reason, as a country, we haven't learned that we need to bolster and maintain a consistent level of health emergency preparedness. Investments made after Sept. 11, the anthrax attacks and Hurricane Katrina led to dramatic improvements, but now budget cuts and complacency are the biggest threats we face," Levi said.
"Public health preparedness has improved leaps and bounds from where we were 10 years ago," Paul Kuehnert, director of the public health team at the RWJF, said in the news release. "But severe budget cuts at the federal, state and local levels threaten to undermine that progress. We must establish a baseline of 'better safe than sorry' preparedness that should not be crossed."
The report offers a number of recommendations to fill many of the major gaps in preparedness for public health emergencies:
- Reauthorize the Pandemic and All-Hazards Preparedness Act, which expires at the end of 2012.
- Guarantee sufficient funds for public health preparedness to ensure that public health departments have the basic capabilities to respond to threats they face every day and have trained experts and systems in place to act quickly in case of major, unexpected emergencies.
- Provide continuing support to communities so they can better cope and recover from emergencies.
- Improve biosurveillance to better detect and respond to problems.
- Take stronger action against antibiotic resistance.
- Improve research, development and manufacturing of medical countermeasures.
- Increase readiness for extreme weather events, and update the nation's food safety system.
HealthDay
Copyright (c) 2012 HealthDay. All rights reserved.
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National Institutes of Health Some Cancer Risks Higher in 9/11 Recovery Workers: Study
Cases of prostate, thyroid, multiple myeloma cancers seen over years
Tuesday, December 18, 2012
TUESDAY, Dec. 18 (HealthDay News) -- The workers who toiled at the World Trade Center site after the Sept. 11, 2001, attacks may have higher-than-average risks of certain cancers, health officials reported.Using data from an ongoing health study of World Trade Center survivors and recovery workers, researchers found that, overall, people's risk of developing cancer was no higher than the norm.
But among the nearly 22,000 rescue and recovery workers, there were elevated risks of three cancers: prostate cancer; thyroid cancer; and multiple myeloma, a type of blood cell cancer.
The findings, reported in the Dec. 19 issue of the Journal of the American Medical Association, are based on small numbers. Overall, 67 men developed prostate cancer, while only 13 workers developed thyroid cancer, and seven developed multiple myeloma. That makes it tougher to reach statistically solid findings.
And it's not certain that exposure to toxic compounds at the site caused the excess cancer risks, said senior researcher Steven Stellman, research director for the New York City health department's World Trade Center Health Registry.
He noted that the study is "observational," which means the researchers looked at cancer rates in the group and tried to account for other factors in anyone's cancer risk -- such as age and smoking habits.
Even with those factors weighed, rescue and recovery workers still had elevated risks compared with the norms for New York state: a 43 percent higher risk of prostate cancer, and more than double the risk of thyroid cancer and multiple myeloma.
But there's still a lot to be learned, according to Stellman. It will take years for researchers to understand the extent of any cancer risks from exposure to the World Trade Center wreckage.
"It's really too early to make any definitive statements," Stellman said.
Other experts agreed. "It is important to recognize that the relatively short time since the exposure limits what we can currently conclude from this type of data," said Elizabeth Ward, national vice president for intramural research for the American Cancer Society.
Screening could have something to do with the heightened rates of prostate and thyroid cancers, Ward noted. If recovery workers had more cancer screening tests than the general public, then they may have had more prostate and thyroid tumors detected.
On the other hand, Ward said, the lack of increased odds for other cancers -- or cancer overall -- "does not rule out the possibility" that risks could emerge in the future.
Dr. Michael Crane, who directs the World Trade Center Health Program at Mount Sinai Medical Center in New York City, said, "We're just at the beginning [of research] when you're talking about cancer."
As a doctor on the ground, Crane was not surprised to see an excess risk of certain cancers. A few years ago, doctors at Mount Sinai reported an unexpectedly high number of young multiple myeloma patients among World Trade Center responders in their program.
Out of more than 28,000 responders, there were four cases of multiple myeloma among people younger than 45 -- when, statistically, only one case would be expected.
Still, Crane said big-picture studies like the current one are needed, in order to know if the risks really are higher than normal.
The findings are based on nearly 56,000 people enrolled in the World Trade Center Health Registry, an ongoing study of the physical and mental health effects of the disaster. Almost 22,000 of those people were rescue and recovery workers.
Overall, there was no evidence of a higher cancer risk among workers or people who lived or worked near the towers, Stellman said.
It was only when the researchers focused on individual cancers that they found elevated odds for three cancers among rescue and recovery workers.
Dozens of cancers were just recently added to the list of ailments covered by a government fund for first responders and survivors of the 9/11 attacks.
In September, the U.S. National Institute for Occupational Safety and Health announced that cancer treatment will be covered under the Zadroga 9/11 Health and Compensation Act, which was passed into law two years ago.
Officials originally left cancer off the list of covered ills, citing a lack of scientific evidence linking exposure to the toxic fumes at the World Trade Center site to any cancers.
While the new findings suggest at least certain cancers are increased among workers, Ward and Crane also emphasized the brighter side: "The study results are reassuring that there does not appear to be a large increase of cancer in WTC-exposed populations at this time," Ward said.
"It's important to remember that most of these people are not going to develop cancer," Crane said.
He also noted that people exposed to the disaster site can take steps to reduce their cancer risks. "Do not smoke. Eat a healthy diet. Folks should keep doing what they can to maintain a healthy lifestyle."
HealthDay
Copyright (c) 2012 HealthDay. All rights reserved.
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Effects of Disasters on Pregnant Women
A natural disaster is devastating for anyone affected, but pregnant women often have special concerns, such as:- Infections can affect a pregnant woman more severely than those who are not pregnant or she might be more susceptible to getting an infection. Click here to read more about infections
- Certain medications used to treat infections and other illnesses might not be recommended for use during pregnancy.
- Some immunizations are recommended during pregnancy, while others are not because of the potential effect on the unborn child.
Click here to read more about immunizations
- Pregnant women might be concerned about effects on their unborn children of toxins like carbon monoxide or of the increased stress related to the hurricane and its aftermath. Click here to read more about environmental exposures.
What You Need to Know if you are pregnant Frequently Asked Questions
- Infections can affect a pregnant woman more severely than those who are not pregnant or she might be more susceptible to getting an infection. Click here to read more about infections
- Occupational Health
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