Kudos to Canada

This morning, SRxA’s Word on Health salutes the Canadian city of Hamilton, Ontario, for its pioneering lead in anaphylaxis safety. Hamilton is destined to become the first city in the world to require all food service outlets to have life-saving epinephrine auto-injectors on hand for people with severe food allergies.

The move is being led by Hamilton Councillor  – Lloyd Ferguson, in hopes of avoiding sudden and tragic deaths like one this past spring of a Stoney Creek girl.

Twelve-year-old Maia Santarelli-Gallo had what her doctor said was a mild allergy to eggs and milk that had only ever caused her a runny nose. But last March, while eating an ice cream cone at a Hamilton-area mall with her father and older sister, Maia experienced a sudden, severe allergic reaction.

Her sister found someone with an epinephrine injector, but by the time it was administered, it was too late. Emergency crews took Maia to hospital but she was pronounced dead.

When Councillor Ferguson heard about Maia’s death, he decided to draft a ground-breaking motion to get epinephrine auto-injectors in every restaurant and mall in the city.

He says it’s high time that food providers have access to medicines that could help their customers who develop allergic reactions. He says if automated external defibrillator (AEDs) are now being installed in arenas and other community centers, it makes sense to have epinephrine injectors in areas where food allergy reactions are most likely to occur.

“It took us about 40 years to get defibrillators into public facilities and they have been a great success. This is the next step,” he says.

Allergy specialist Dr. Mark Greenwald, Allergist, and Chief Medical Officer of EpiCenter Medical would like to go further and see public awareness campaigns that would train the public on how to use epinephrine injectors, just as there have been campaigns encouraging people to learn CPR.

Greenwald has developed an online course called EpiPenTraining.com, to offer training on how to recognize allergic reactions, and how to use the injectors. He says such training is vital because during anaphylaxis, seconds count.

And anaphylaxis isn’t rare.  Allergic disease is the 5th most prevalent chronic disease among all ages, and the 3rd most prevalent among children. Every 3 minutes in North America, a food allergic reaction sends someone to the Emergency Room. Every 6 minutes, that Emergency Room visit is for anaphylaxis, that’s 10 patients per hour!

In 25% of people requiring treatment, the reaction is their first episode, and they are completely unprepared.  And for 50% of the people who die from anaphylaxis, the victims had life-saving epinephrine, but it wasn’t used or it wasn’t used in time. The other 50% didn’t carry epinephrine despite their previous allergic episodes.

Participants in the online course become SAVE certified – Save Anaphylaxis Victims in an Emergency.

Debbie Bruce of the Canadian Anaphylaxis Initiative was part of a program this past spring to get epinephrine injectors on all fire trucks in Mississauga. She says that like Maia, up to one-third of people who have allergic reactions outside the home did not realize they had a severe allergy and didn’t carry an epinephrine injector. She is now petitioning politicians  to come up with a national allergy plan.

“I think it is a new reality,” she says. “Reactions happen and we need to be prepared.”

Maia’s mother, Leah Santarelli, backs all efforts to make the public more aware of anaphylaxis and hopes the Hamilton city council passes Ferguson’s motion.

“There’s no guarantee that an EpiPen will save your life 100 per cent of the time, just like a defibrillator won’t save you 100 per cent of the time, but it is there as a safety measure,” she says.

The motion is currently being reviewed by the city’s health team; if approved, it should go before Hamilton city council in October.

We certainly hope that it does and that this trend will rapidly spread across the borders.  As Greenwald says – every second counts!

Staying Healthy this Halloween

SRxA’s Word on Health wishes all of our readers a Happy and Healthy Halloween.  For the 50 million or so people living on the Atlantic Seaboard of America affected by Mondays’ Frankenstorm we hope you are staying safe and recovering from the devastation wreaked by Sandy.

Although the United States experiences hurricanes almost every year and most people have a rudimentary knowledge of the dangers, there are a number of health risks that people seem to forget about in every storm. And frequently, it’s these things that cause unnecessary deaths, injuries, and illnesses.

While many people believe that high winds are the greatest risk from a hurricane, that’s simply not true. According to Ready.gov the majority of deaths are from flooding.   Flooding deaths often result from people trying to wade or drive through moving water or water of unknown depth.  Six inches of water will stall most vehicles – a foot of water may float a vehicle. Sadly, many flood deaths happen as a result of misadventure. Victims who chose to ignore warnings and drive around barricades set up to restrict travel in flood danger areas.

Other deaths happen when people walk or drive through flood water and discover that the ground has been washed away or the water is too deep to cross. Falling trees and tree limbs are another cause of hurricane deaths and injuries. Wait until the storm passes to begin any work on these hazards, even if they have fallen on a house or car. And even then take extreme care.  The Centers for Disease Control (CDC) warns that tree parts can move without warning by a mistaken cut of a saw.  If in doubt call your local fire department or check out the CDC’s advice on preventing chain saw injuries.

High winds and flood produces power outages and electrical dangers. Electrical providers suggest that all downed wires should be considered as live. Stay ten feet away, at minimum. And remember don’t touch tree limbs, fences or other objects that a power line is touching since they can conduct electricity, sometimes for hundreds of feet.

Flooded homes and flooded appliances inside homes represent another electrical hazard. Don’t use power outlets or lights in a building that was flooded until the electrical system has been inspected by an electrician. Carbon monoxide poisoning is another oft overlooked danger after a hurricane. Carbon monoxide is colorless and odorless and exposure can be deadly. Please remember that generators, charcoal grills, hibachis and other similar cooking methods should only be operated outside.

And even when the worst of the storm is over, as things start to dry out, those that got wet in the flooding will begin to mold. The CDC offers a web page about how to reenter a flooded home and another on dealing with the dangers of mold. You should also keep in mind that any surface that was flooded, especially basements may be contaminated with sewage.

Also consider the dangers from food spoiled by loss of power. If the power is out for less than 2 hours, then the food in your refrigerator and freezer should be safe to consume. However, if the power is out for longer than 2 hours, then you should remember the following:

A freezer that is half full will only hold food safely for up to 24 hours. A full freezer will hold food safely for 48 hours. Beyond that you will need to toss the contents.

So whether you hunkering down, bailing out or trick-or-treating today, please stay safe and healthy.

Heightened Scrutiny of Food & Supplement Health Claims

Health claims made by food and nutritional supplement manufacturers should face the same level of regulatory scrutiny as those made by drug and medical device manufacturers, says a new report from the Institute of Medicine (IOM).

Food and nutritional supplement marketers often make health claims based on how individual ingredients in their products affect biomarkers (physiological characteristics that can be measured and evaluated objectively) such as cholesterol or glucose levels or tumor size. Thus, the manufacturer of a breakfast cereal that contains a cholesterol-lowering ingredient, such as fiber, might boast that its cereal has heart health benefits without clinical proof of improved outcomes.

Faced with a proliferation of health claims being made by food and supplement manufacturers, the FDA’s Center for Food Safety and Applied Nutrition asked the IOM in 2008 to recommend a framework for the evaluation of biomarkers.

Commenting on the report, IOM member Harlan Krumholz, MD said, “This is a groundbreaking report that tells us we should really think carefully about the use of biomarkers and surrogates.”

SRxA’s Word on Health is pleased to hear that the food we eat will be given as much attention as the drugs we take, but hopes that the process can be somewhat faster!