Percentage of emergency visits related to fire, smoke inhalation rose eightfold after LA wildfires: Report
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(LOS ANGELES) — The percentage of emergency department (ED) visits related to fire and smoke inhalation rose dramatically in the days immediately after the Los Angeles wildfires last month, new data published Thursday shows.
The wildfires broke out in the Pacific Palisades and in Eaton Canyon on Jan. 7. Although several destructive wildfires emerged, the Palisades Fire and the Eaton Fire caused the most damage.
Fueled by strong winds and dry weather, the fires burned more than 57,000 acres, destroyed about 16,000 structures, and killed at least 29 people, according to the California Department of Forestry and Fire Protection.
A team from the Los Angeles County Department of Public Health and the Centers for Disease Control and Prevention reviewed data from the county’s Syndromic Surveillance program, which receives and analyzes real-time data from most county EDs.
By collecting this data, the program can detect early warning signals of a potential public health threat that requires a response and alert health care professionals, according to the department of health.
ED visits, referred to in the report as “encounters,” were classified as being wildfire-associated if fire or smoke inhalation–related terms were listed in the chief complaints or the diagnoses sections.
The team looked at three periods: a three-week period before the wildfires began, the first six days of the wildfires and the week after the wildfires began.
Data showed the average percentage of ED visits associated with the wildfires increased eightfold from 0.06% to 0.52% in the six days after the wildfires. The peak was seen on Jan. 8, with 1.01% of all ED visits related to the wildfires. During the week after the wildfires began, ED visits decreased but still remained elevated at 0.2% compared to baseline.
The average percentage of ED visits was found to be linked to an increase in the average daily Air Quality Index (AQI), which is put out by the Environmental Protection Agency.
Average daily AQI rose from 75, which is classified as “moderate level of concern” to an average of 110, classified as “unhealthy for sensitive groups,” in the six days after the wildfires began. In the week following the outbreak of the fires, average daily AQI returned to “moderate” at 58.
The report found a small increase in the average percentage of burn-related injuries and eye-related injuries but there were no increases seen in the percentage of visits related to asthma or cardiovascular reasons.
In contrast, the report found that immediately after the wildfires began, all-cause ED encounters — meaning visits to the department for any reason — decreased by 9%.
The authors stated that the decrease could for multiple reasons, with some including school closures, business closures, displacements, challenges accessing health care, residents seeking care in clinics or urgent care centers, or residents visiting EDs in neighboring counties.
“Near real-time surveillance of health outcomes during and after wildfires can estimate effects on health care use, serve as an early warning for acute health impacts, and identify opportunities for intervention,” the authors wrote. “Further analyses are planned to identify which illnesses have most affected specific populations.”
(NEW YORK) — Heart disease remains the leading cause of death in the United States, according to a new report.
The American Heart Association (AHA) report, published Monday in the journal Circulation, found that 941,652 Americans died from cardiovascular disease in 2022, the most recent year for which data is available. That’s an increase of more than 10,000 from the just over 931,500 reported to have died from cardiovascular disease in 2021.
It also means that a person in the U.S. dies of cardiovascular disease every 34 seconds, or nearly 2,500 people every day, according to the AHA report.
“The stats are pretty sobering from this report,” Dr. Tara Narula, ABC News chief medical correspondent and a board-certified cardiologist, said on ABC’s “Good Morning America” on Monday. “In fact, cardiovascular disease kills more Americans than all forms of cancer and accidents combined.”
Cancer and accidental deaths continue to remain the second and third leading causes of death, respectively, according to the latest data from the Centers for Disease Control and Prevention (CDC).
The AHA report also found racial and ethnicity disparities, with Black Americans having the highest prevalence of cardiovascular disease. Between 2017 and 2020, 59% of non-Hispanic Black females and 58.9% of non-Hispanic Black males had some form of the disease, according to the report.
In addition, the report showed several heart disease risk factors continue to rise, with nearly 47% of American adults having high blood pressure and more than half, 57%, diagnosed with type 2 diabetes or prediabetes.
Additionally, 72% of U.S. adults have an unhealthy weight, with nearly 42% of adults having obesity, which also is a risk factor for developing cardiovascular disease, according to the AHA report.
In an accompanying editorial, Dr. Dhruv Kazi, associate director of the Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology at Beth Israel Deaconess Medical Center In Boston, said risk factors for cardiovascular disease are expected to rise over the next several years.
“Although we have made a lot of progress against cardiovascular disease in the past few decades, there is a lot more work that remains to be done,” Kazi wrote. “If recent trends continue, hypertension and obesity will each affect more than 180million U.S. adults by 2050, whereas the prevalence of diabetes will climb to more than 80 million.”
Overall, cardiovascular-related deaths have begun plateauing after ticking upward during the COVID-19 pandemic, according to the AHA. The report found death rates dropped during the survey period for all 10 leading causes of death except kidney disease, which increased by 1.5%.
The good news is that 80% of cardiovascular disease is preventable, according to Narula. Ways to lower the risk include eating a heart-healthy diet, getting regular exercise, quitting smoking, managing stress, and getting adequate sleep every night.
(NEW YORK) — A growing number of people under 50 are being diagnosed with more advanced stages of colon cancer, according to the American Cancer Society.
The 2020 death of 43-year-old actor Chadwick Boseman due to colon cancer drew attention to the shift, and “Dawson’s Creek” star James Van Der Beek, 47, announced his Stage 3 colorectal cancer diagnosis in November.
A diagnosis at a younger age was also the case for Brooks Bell, a Raleigh, North Carolina, entrepreneur who ran a data analytics company. At 38, she was alarmed to discover blood after using the rest room.
She said she called a telehealth doctor, who told her it may be hemorrhoids. She decided to get second and third opinions, which led to a colonoscopy referral and diagnosis.
“I found out that it was Stage 3 colon cancer,” Bell told “GMA3.”
In a different case, Los Angeles stylist Sarah Beran’s doctors suspected a parasite could be causing her symptoms. Ultimately, she said a colonoscopy revealed the truth.
“They found over 100 polyps on my colon, a mass on my rectum,” the 34-year-old said. “And that’s when my world changed.”
She had to undergo a colon transplant and 12 rounds of chemotherapy.
Even though the pair lived on opposite sides of the U.S., their experiences brought them together after Bell shared her story online.
“I reached out and asked her how I could get involved and help, so that more people don’t have to go through what we went through,” Beran said. “And we teamed up.”
The duo dreamed up a fashion brand with a cause, Worldclass. The streetwear and athleisure line includes hoodies, crewneck sweatshirts, tees, hats and totes — all designed to break the stigma about colon cancer.
“All proceeds go towards a colonoscopy fund that helps underinsured communities get screened,” Beran said. “So literally saving lives through fashion.”
Convincing people to get screenings has a specific goal, Bell noted.
“With colon cancer, we should be talking about prevention, being able to avoid the entire cancer experience, period, rather than just talking about early detection,” she said.
A proactive approach to health can make a huge difference, according to Beran.
“A colonoscopy is way easier than going through chemo and the surgeries and all the icky stuff that we went through,” she said. “So we’re lucky that we did catch ours in time and that we did advocate for ourselves. And we got in there and got our colonoscopies. And now we’re here now telling our story.”
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(NEW YORK) — As world leaders mourn the death of former President Jimmy Carter and remark on his political and policy legacy, doctors are remembering his efforts to prevent disease, and his legacy in furthering global public health.
The 39th president spent five decades working to eradicate a parasitic disease, helped organize a major-drug donation program, and made advancements addressing the mental health crisis in the U.S.
Dr. Julie Jacobson, currently a managing partner of the nonprofit Bridges to Development, helped to provide funding for the Carter Center’s work in the Americas, Nigeria and Ethiopia while she worked for the Bill & Melinda Gates Foundation for over a decade.
“He was hugely influential, I think particularly for the diseases that most of the world doesn’t appreciate even exist,” Jacobson told ABC News of Jimmy Carter’s work. “He was a true champion for the neglected tropical diseases, which are some of the most common infections of people who live with the least resources. And he found these diseases and then really wanted to do something about them, and used his voice, his influence, his passion, to continue to push forward where others were really not interested.”
Near-eradication of Guinea worm disease
Following his loss to Ronald Reagan in the 1980 presidential election, Carter founded the Carter Center in 1982, a non-profit organization that “seeks to prevent and resolve conflicts, enhance freedom and democracy, and improve health,” according to the Center’s website.
Among the organization’s many efforts, the Carter Center helped spearhead a successful international campaign with the goal of eradicating dracunculiasis, also known as Guinea worm disease, a parasitic infection caused by consuming contaminated drinking water.
Water from ponds or other stagnant bodies of water can contain tiny crustaceans commonly known as water fleas, which in turn can be infected with Guinea worm larvae, according to the Centers for Disease Control and Prevention (CDC).
About one year after infecting a human host, the Guinea worm creates a blister on the skin and emerges from it, which can cause burning pain, fever and swelling, according to the CDC and the World Health Organization.
“Nobody else wanted to take it on,” Jimmy Carter told ABC News’ George Stephanopoulos during a 2015 interview on “Good Morning America”. “So, I decided to take it on.”
In 1986, Guinea worm disease afflicted 3.5 million people every year in 21 African and Asian countries. Disease incidence has since been reduced by 99.99%, to just 14 “provisional” human cases in 2023, according to the Carter Center.
Jacobson said that success is even more remarkable because there are no vaccines available to prevent Guinea worm disease and no drugs to treat it. Tracking Guinea worm disease, according to Jacobson, involves following possible cases for a year to determine if they are infected, checking to see if infected humans have any infected water sources near them, and monitoring the community as a whole.
“To think that you could eradicate a disease without any tools is really still just a crazy idea, but he did it with perseverance and working with people in the grassroots within communities and putting together teams of people to go and work with people in those communities and empower the communities,” Jacobson said.
The Carter Center says if efforts are successful, Guinea worm disease could become the second human disease in history to be completely eradicated, after smallpox, and the first to be done without the use of a vaccine or medicine.
Carter told ABC News during the 2015 interview that eradicating the disease entirely was his goal: “I think this is going to be a great achievement for, not for me, but for the people that have been afflicted and for the entire world to see diseases like this eradicated.”
Mass drug distribution for river blindness
The Carter Center also works to fight other preventable diseases, including the parasitic infections schistosomiasis and lymphatic filariasis – more commonly known as snail fever and elephantiasis, respectively – as well as trachoma, which is one of the world’s leading causes of preventable blindness. It’s also working with the governments of Haiti and the Dominican Republic to eliminate lymphatic filariasis and malaria from the island of Hispaniola, which both countries share and which is “the last reservoir in the Caribbean for both diseases,” according to the Carter Center.
Carter and his organization also played a part in organizing a major drug-donation program to help eliminate onchocerciasis, also known as river blindness, which is transmitted to human through repeated bites of infected blackflies, according to the CDC.
Pharmaceutical company Merck & Co. had been implementing field studies in Africa which showed that the drug ivermectin was effective at treating river blindness in humans. The Carter Center partnered with Merck to mass-distribute ivermectin, brand name Mectizan, “as much as needed for as long as needed” in Africa and Latin America. To date, the Carter Center has assisted in distributing more than 500 million treatments of Mectizan, according to Merck.
In 1995, Carter negotiated a two-month cease-fire in Sudan to allow health care workers there to more safely help eradicate Guinea worm disease, prevent river blindness, and vaccinate children against polio.
“When we have known solutions, it is ethical to make sure they’re available to the people who need it most,” Dr. Usha Ramakrishnan, chair of the Department of Global Health at Emory University’s Rollins School of Public Health, told ABC News. “And that’s where we were with river blindness. There was a treatment, but improving access to medications, making it affordable, reaching the people they need was very much along the lines of the work [the Carter Center] was doing.”
Addressing mental health
Carter was also committed to tackling mental health issues. During his presidency, he created the Presidential Commission on Mental Health, which recommended a national plan to care for people with chronic mental illness.
Although it was never adopted as policy by the Reagan administration, the plan’s recommended strategies were adopted by some mental health advocacy groups to “make gains in the 1980s,” according to one study.
Carter also signed into law the Mental Health Systems Act of 1980, which provided funding to community mental health centers.
After his presidency, Carter and former first lady Rosalynn Carter continued working to improve access to mental health.
Ramakrishnan said the Carters’ work helped to reduce some of the stigma associated with mental health.
“There continues to be a lot of stigma, but they truly got it out [in] the conversation and mainstreaming mental health as an important aspect of health and well-being,” Ramakrishnan said. “There’s still a lot of challenges, and there are many capable people that they have mentored and trained who are carrying that mantle forward.”
