Alzheimer’s: The Bad News And The Good
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Dr. Devi’s Spectrum of Hope
This is Dr. Gayatri Devi. She’s a neurologist, board-certified in neurology, pain medicine, psychiatry, brain injury medicine, and behavioral neurology.
She’s also a Clinical Professor of Neurology, and Director of Long Island Alzheimer’s Disease Center, Fellow of the American Academy of Neurology, and we could continue all day with her qualifications, awards and achievements but then we’d run out of space. Suffice it to say, she knows her stuff.
Especially when it comes to the optimal treatment of stroke, cognitive loss, and pain.
In her own words:
❝Helping folks live their best lives—by diagnosing and managing complex neurologic disorders—that’s my job. Few things are more fulfilling! For nearly thirty years, my focus has been on brain health, concussions, Alzheimer’s and other dementias, menopause related memory loss, and pain.❞
Alzheimer’s is more common than you might think
According to Dr. Devi,
❝97% of patients with mild Alzheimer’s disease don’t even get diagnosed in their internist offices, and half of patients with moderate Alzheimer’s don’t get diagnosed.
What that means is that the percentage of people that we think about when we think about Alzheimer’s—the people in the nursing home—that’s a very, very small fraction of the entirety of the people who have the condition❞
As for what she would consider the real figures, she puts it nearer 1 in 10 adults aged 65 and older.
Source: Neurologist dispels myths about Alzheimer’s disease
Her most critical advice? Reallocate your worry.
A lot of people understandably worry about a genetic predisposition to Alzheimer’s, especially if an older relative died that way.
See also: Alzheimer’s, Genes, & You
However, Dr. Devi points out that under 5% of Alzheimer’s cases are from genetics, and the majority of Alzheimer’s cases can be prevented be lifestyle interventions.
See also: Reduce Your Alzheimer’s Risk
Lastly, she wants us to skip the stigma
Outside of her clinical practice and academic work, this is one of the biggest things she works on, reducing the stigma attached to Alzheimer’s both publicly and professionally:
Alzheimer’s Disease in Physicians: Assessing Professional Competence and Tempering Stigma
Want more from Dr. Devi?
You might enjoy this interview:
Click Here If The Embedded Video Doesn’t Load Automatically!
And here’s her book:
Enjoy!
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Should I get a weighted vest to boost my fitness? And how heavy should it be?
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Exercise training while wearing a weighted vest is undergoing somewhat of a renaissance. Social media posts and trainers are promoting them as a potential strategy for improving fitness and health.
Exercising with additional weight attached to the body is nothing new. This idea has been used with soldiers for many centuries if not millennia – think long hikes with a heavy pack.
The modern weighted vest comes in a range of designs that are more comfortable and can be adjusted in terms of the weight added. But could one be helpful for you?
ZR10/Shutterstock What the research says
One of the earliest research studies, reported in 1993, followed 36 older people wearing weighted vests during a weekly exercise class and at home over a 20-week period. Wear was associated with improvements in bone health, pain and physical function.
Since then, dozens of papers have evaluated the exercise effects of wearing a weighted vest, reporting a range of benefits.
Not surprisingly, exercise with a weighted vest increases physiological stress – or how hard the body has to work – as shown by increased oxygen uptake, heart rate, carbohydrate utilisation and energy expenditure.
Adding weight equal to 10% of body weight is effective. But it doesn’t appear the body works significantly harder when wearing 5% extra weight compared to body weight alone.
Does more load mean greater injury risk?
A small 2021 study suggested additional weights don’t alter the biomechanics of walking or running. These are important considerations for lower-limb injury risk.
The safety considerations of exercising with weighted vests have also been reported in a biomechanical study of treadmill running with added weight of 1% to 10% of body weight.
While physiological demand (indicated by heart rate) was higher with additional weight and the muscular forces greater, running motion was not negatively affected.
To date no research studies have reported increased injuries due to wearing weighted vests for recreational exercise. However a 2018 clinical study on weight loss in people with obesity found back pain in 25% of those wearing such vests. Whether this can be translated to recreational use in people who don’t have obesity is difficult to say. As always, if pain or discomfort is experienced then you should reduce the weight or stop vest training.
Better for weight loss or bone health?
While wearing a weighted vest increases the energy expenditure of aerobic and resistance exercise, research to show it leads to greater fat loss or retaining muscle mass is somewhat inconclusive.
One older study investigated treadmill walking for 30 minutes, three times a week in postmenopausal women with osteoporosis. The researchers found greater fat loss and muscle gain in the participants who wore a weighted vest (at 4–8% body weight). But subsequent research in obese older adults could not show greater fat loss in participants who wore weighted vests for an average of 6.7 hours per day.
There has been considerable interest in the use of weighted vests to improve bone health in older people. One 2003 study reported significant improvements in bone density in a group of older women over 32 weeks of weighted vest walking and strength training compared to a sedentary control group.
But a 2012 study found no difference in bone metabolism between groups of postmenopausal women with osteoporosis walking on a treadmill with or without a weighted vest.
Making progress
As with any exercise, there is a risk of injury if it is not done correctly. But the risk of weighted vest training appears low and can be managed with appropriate exercise progression and technique.
If you are new to training, then the priority should be to simply start exercising and not complicate it with wearing a weighted vest. The use of body weight alone will be sufficient to get you on the path to considerable gains in fitness.
Once you have a good foundation of strength, aerobic fitness and resilience for muscles, joints and bones, using a weighted vest could provide greater loading intensity as well as variation.
It is important to start with a lighter weight (such as 5% bodyweight) and build to no more than 10% body weight for ground impact exercises such as running, jogging or walking.
For resistance training such as squats, push-ups or chin-ups, progression can be achieved by increasing loads and adjusting the number of repetitions for each set to around 10 to 15. So, heavier loads but fewer repetitions, then building up to increase the load over time.
While weighted vests can be used for resistance training, it is probably easier and more convenient to use barbells, dumbbells, kettle bells or weighted bags.
The benefits of added weight can also be achieved by adding repetition or duration. Geert Pieters/Unsplash The bottom line
Weighted vest training is just one tool in an absolute plethora of equipment, techniques and systems. Yes, walking or jogging with around 10% extra body weight increases energy expenditure and intensity. But training for a little bit longer or at a higher intensity can achieve similar results.
There may be benefits for bone health in wearing a weighted vest during ground-based exercise such as walking or jogging. But similar or greater stimulus to bone growth can be achieved by resistance training or even the introduction of impact training such as hopping, skipping or bounding.
Exercising with a weighted vest likely won’t increase your injury risk. But it must be approached intelligently considering fitness level, existing and previous injuries, and appropriate progression for intensity and repetition.
Rob Newton, Professor of Exercise Medicine, Edith Cowan University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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World Menopause Day Health News Round-Up
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In order to provide variety in this week’s round-up, not all of this is menopause-related, but it is all important:
Menopause & CVD
Untreated menopause is associated with higher incidence of heart disease, and higher mortality. People often forget about how much estrogen does for us (well, for those of us with a physiology running on estrogen, anyway; gentlemen, your testosterone is fine for you), and think it is “just” a sex hormone, but it’s a lot more.
Read in full: Menopause transition linked to increased heart disease risk
Related: What Menopause Does To The Heart
Extraterrestrial medical technology
The much lower gravity in Earth orbit has allowed for tissue engineering techniques that Earth’s normal gravity imposes limitations on. This is big news, because it means that rather than replacing a whole liver, tissue implants could be grafted, allowing the extant liver to repair itself (something livers are famously good at, but they need enough undamaged base material to work with).
Read in full: How liver tissue from the International Space Station may transform tissue engineering
Related: How To Unfatty A Fatty Liver
One thing and then another
As if endometriosis weren’t unpleasant enough in and of itself, the endothelial dysfunction inherent to it also raises cardiovascular disease risk. This is important, because while endometriosis has (like many maladies predominantly affecting women) generally been shrugged off by the medical world as an unhappy inconvenience but not life-threatening, now we know it comes with extra existential risks too:
Read in full: Understanding cardiovascular risks in endometriosis patients
Related: What You Need To Know About Endometriosis
Push-button meditation
Unlike mindfulness meditation, listening to music is a very passive experience, and thus requires less effort from the user. And yet, it has been associated with lower perceived pain levels, lower self-reported anxiety levels, less opioid use, and measurably lower heart-rate.
Read in full: Listening to music may speed up recovery from surgery, research suggests
Related: Nobody Likes Surgery, But Here’s How To Make It Much Less Bad
Cholesterol in menopause: quality over quantity
Much like previous research has shown that the quantity of LDL is not nearly so predictive of health outcomes in women as it is in men, this study into HDL and menopausal women shows that quantity of HDL does not matter nearly so much as the quality of it.
Read in full: HDL quality, not quantity, contribute to the first sign of Alzheimer’s disease in women
Related: Statins: His & Hers? ← consistent with the above, statins (to lower LDL cholesterol) generally help more for men and produce more adverse side effects for women. So again, a case of “the actual amount of cholesterol isn’t so important for women as for men”.
Take care!
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Debunking the myth that vaccines cause autism
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The myth that autism is linked to childhood vaccines first appeared in a 1998 study by British physician Dr. Andrew Wakefield. The study was later retracted, and Wakefield was discredited. But nearly three decades after the study’s publication, the myth persists, championed by activists, political leaders, and even potential health officials.
There is overwhelming evidence that there is no link between vaccines and autism. “No one has any real or solid evidence that vaccines cause autism,” says Catherine Lord, a psychologist and autism researcher at the University of California, Los Angeles.
Here are just some of the many reasons that we know vaccines don’t cause autism.
The Wakefield study has been thoroughly discredited
In 1998, the Lancet published a study describing a small group of children who reportedly had bowel inflammation and developed autism within a month of getting the measles, mumps, and rubella (MMR) vaccine. The study proposed that the vaccination triggered bowel inflammation and developmental delays, including autism. Lead author Andrew Wakefield coined the term “autistic enterocolitis” to describe the condition he and his colleagues claimed to have discovered.
The study received significant media attention and immediate criticism from scientists, who pointed out the study’s small size, lack of controls, and insufficient evidence to support its conclusions.
Subsequent research published over the next few years refuted Wakefield’s findings. A 1999 Lancet study found no link between autism and the MMR vaccine, and a 2001 study found no evidence of a link or the existence of so-called autistic enterocolitis.
In 2010, the Lancet finally retracted Wakefield’s fraudulent study, noting that “several elements” of the study were “incorrect” and that the experiments carried out on children had not been approved by an ethics board. The journal’s editor called the paper’s conclusions “utterly false.”
A few months later, Wakefield was stripped of his medical license by the United Kingdom’s General Medical Council. The council deemed Wakefield “dishonest and irresponsible” and concluded that he conducted unethical experiments on children.
The committee’s investigation also revealed that, less than a year before he published his study claiming that the MMR vaccine was linked to bowel inflammation that triggered autism, Wakefield filed a patent for a standalone measles vaccine and inflammatory bowel disease treatment.
Thimerosal was removed from childhood vaccines in 2001—with no effect on autism rates
A 2003 study published by a conservative group known for promoting anti-science myths—including that HIV doesn’t cause AIDS—first proposed that the preservative thimerosal in childhood vaccines is linked to autism. This supposed link was subsequently disproven.
Thimerosal is added in small amounts to some vaccines to prevent dangerous bacterial and fungal contamination. The substance contains ethylmercury, a form of mercury that the body quickly and safely processes in small doses.
Ethylmercury is different from methylmercury, a far more dangerous form of mercury that is toxic at low doses. By contrast, the small amount of thimerosal in some vaccines is harmless to humans and is equal to the amount of mercury in a can of tuna.
The preservative was removed from childhood vaccines as a precautionary measure in 2001. With the exception of some flu shots, no childhood vaccine contains the preservative and hasn’t for more than two decades. Autism rates have not decreased as a result of thimerosal being removed from childhood immunization vaccines. While some types of the annual flu vaccine contain thimerosal, you can get one without it.
Extensive research also shows that neither thimerosal nor methylmercury at any dose is linked to autism. A 2008 study of statewide California data found that autism rates “increased consistently for children born from 1989 through 2003, inclusive of the period when exposure to [thimerosal-containing vaccines] has declined.”
Autism rates are the same in vaccinated and unvaccinated children
Vaccine opponents often falsely claim that vaccinated children are more likely than unvaccinated children to develop autism. Decades of research disprove this false claim.
A 2002 analysis of every child born in Denmark over eight years found that children who received MMR vaccines were no more likely to be diagnosed with autism than unvaccinated children.
A 2015 study of over 95,000 U.S. siblings found that MMR vaccination is not associated with increased autism diagnosis. This was true even among the siblings of children with autism, who are seven times more likely to develop autism than children without an autistic sibling.
And a 2018 study found some evidence that children with autism—and their siblings—were more likely to be unvaccinated or under-vaccinated than children without autism.
Vaccination also has no impact on autism rates at the population level, regardless of the age at which children get vaccinated.
“In comparing countries that have different timing and levels of vaccination … there’s no difference in autism,” says Lord. “You can look at different countries with different rates of autism, and there’s no relationship between the rates of autism and vaccinations.”
Countries such as Taiwan, Tunisia, Turkey, and Morocco, which have some of the world’s lowest autism rates, have childhood immunization rates that are nearly identical to countries with the highest autism rates, including Sweden, Japan, Brunei, and Singapore.
Improved awareness and diagnosis play a role in rising autism rates
Autism was first described in 1911 when it was considered to be a form of severe schizophrenia. Over a century later, our understanding of autism has changed drastically, as have diagnostic standards.
A 2013 scientific article describing how medical and social perceptions of autism have evolved explains that “the diagnoses of schizophrenia, psychosis and autism in children were largely interchangeable during the 1940s and 1950s.” Beginning in the 1960s, methods of diagnosing autism improved, “increasing the number of children who were considered to display autistic traits.”
The autism diagnosis was changed to autism spectrum disorder in 2013. “This category is now very broad, which was an intentional choice to help provide services to the greatest number of people who might need them,” writes Gideon Meyerowitz-Katz, an epidemiologist and creator of the popular Health Nerd blog.
“Rather than the severe intellectual disability of the 1940s and 50s, [autism spectrum disorder] is a group of behaviours that can be any severity as long as they are persistent and impact people’s daily functioning in a significant way.”
For more information about autism, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Laugh Often, To Laugh Longest!
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Putting The Abs Into Absurdity
We’ve talked before about the health benefits of a broadly positive outlook on life:
Optimism Seriously Increases Longevity!
…and we’re very serious about it, but that’s about optimistic life views in general, and today we’re about not just keeping good humor in questionable circumstances, but actively finding good humor in the those moments—even when the moments in question might not be generally described as good!
After all, laughter really can be the best medicine, for example:
From the roots
First a quick recap on de-toothing the psychological aspect of threats, no matter how menacing they may be:
Hello, Emotions: Time For Radical Acceptance!
…which we can then take a step further:
What’s The Worst That Could Happen?
Choose your frame
Do you remember when that hacker hacked and publicized the US Federal no-fly list, after already hacking a nationwide cloud-based security camera company, getting access to more than 150,000 companies’ and private individuals’ security cameras, amongst various other cyber crimes, mostly various kinds of fraud and data theft?
Imagine how she (age 21) must have felt, when being indicted. What do you suppose this hacker had to say for itself under such circumstances?
❝congress is investigating now 🙂
but i stay silly :3 ❞
…the latter half of which, usually rendered “but I stay silly” or “but we stay silly” has since entered popular Gen-Z parlance, usually after expressing some negative thing, often in a state of powerlessness.
Which is an important life skill if powerlessness is something that is often likely.
It’s important for many Gen-Zs with negligible life prospects economically; it’s equally important for 60-somethings getting cancer diagnoses (statistically the most likely decade to find out one has cancer, by the way), and many other kinds of people younger, older, and in between.
Because at the end of the day, we all start powerless and we all end powerless.
Learned helplessness (two kinds)
In psychology, “learned helplessness” occurs when a person or creature gives up after learning that all and any attempts to resist a Bad Thing™ fail, perhaps even badly. A lab rat may just shut down and sit there getting electroshocked, for example. A person subjected to abuse may stop trying to improve their situation, and just go with the path of least resistance.
But, there’s another kind, wherein someone in a position of absolute powerlessness not only makes their peace with that, but also, decides that the one thing the outside world can’t control, is how they take it. Like the hacker we mentioned earlier.
Sometimes the gallows humor is even more literal, laughing at one’s own impending death. Not as a matter of bravado, but genuinely seeing the funny side.
But how?
Unfortunately, fortunately
The trick here is to “find a silver lining” that is nowhere near enough to compensate for the bad thing—and it may even be worse! But that’s fine:
“Unfortunately, I didn’t have time to do the dishes before leaving for my vacation. Fortunately, I also forgot to turn the oven off, so the house burning down covered up my messy kitchen”
Writer’s personal less drastic example: today I set my espresso machine to press me an espresso; it doesn’t have an auto-off and I got distracted and it overflowed everywhere; my immediate reaction was “Oh! I have been blessed with an abundance of coffee!”
This kind of silly little thing, on a daily basis, builds a very solid habit for life that allows one to see the funny side in even the most absurd situations, even matters of life and death (can confirm: been there enough times personally—so far so good, still alive to find the remembered absurdity silly).
The point is not to genuinely value the “silver lining”, because half the time it isn’t even one, really, and it is useless to pretend, in seriousness.
But to pretend in silliness? Now we’re onto something, and the real benefit is in the laughs we had along the way.
Because those worst moments? Are probably when we need it the most, so it’s good to get some practice in!
Want more ways to find the funny and make it a life habit?
We reviewed a good book recently:
The Humor Habit: Rewire Your Brain To Stress Less, Laugh More, And Achieve More’er – by Paul Osincup
Stay silly!
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What is silicosis and what does research say about it?
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Silicosis is a progressive, debilitating and sometimes fatal lung disease caused by breathing silica dust from cutting, drilling, chipping or grinding materials such as granite, sandstone, slate or artificial stone. The dust gets trapped in the lung tissue, causing inflammation, scarring and permanent damage.
Silicosis is a job-related lung disease and has no cure. The disease mostly affects workers in construction, stone countertop fabrication, mining, and even those who sandblast and stonewash denim jeans to create a ‘worn out’ look.
Silica is one of the most common minerals in nature. About 59% of the Earth’s crust is made of silica, found in quartz, granite, sandstone, slate and sand. Historically, people at the highest risk for the disease have worked in natural environments — mining, digging tunnels or doing quarry work. The disease was first documented by the Greek physician Hippocrates, who in 430 B.C. described breathing disorders in metal diggers.
But in recent decades there’s been renewed attention to the disease due to its more rapid progression and severity among younger workers. Research has shown that the culprit is artificial stone mostly used for countertops for kitchens and bathrooms, which has a very high silica content.
The new generation of coal miners is also at an increased risk of silicosis, in addition to black lung, because layers of coal have become thinner, forcing them to dig deeper into rock, as explained in a joint investigation by the Pittsburgh Post-Gazette and the Medill Investigative Lab at Northwestern University published on Dec. 4. CBS Sunday Morning also had a report on the same issue among West Virginia coal miners, aired as part of its Dec. 10 episode.
Silicosis in modern industries
Artificial, or engineered, stone used for countertops, also known as “quartz,” is formed from finely crushed rocks mixed with resin. Quartz is a natural mineral, but man-made products like many quartz countertops consist of not just quartz, but also resin, colors and other materials that are used to style and strengthen them.
The silica content of artificial stone is about 90%, compared with the 3% silica content of natural marble and 30% silica content in granite stones, according to the authors of a 2019 systematic review published in the International Journal of Environmental Research and Public Health.
The first reported case of silicosis associated with working with artificial stone was from Italy in 2010, according to a 2020 study published in Allergy. Since then, more studies have documented the growing number of cases among artificial stone workers, many of whom are from marginalized populations, such as immigrants.
A July 2023 study published in JAMA Internal Medicine found that in California, the disease mainly occurred among young Latino immigrant men. The disease was severe in most men by the time they sought care.
An August 2022 study, published in Occupational & Environmental Medicine, analyzing the Global Silicosis Registry, with workers in Israel, Spain, Australia and the U.S., found “a substantial emerging population of workers worldwide with severe and irreversible silica-associated diseases,” due to exposure from silica dust from engineered stone.
Other modern occupations such as denim sandblasting, work on dental prostheses, manufacturing of electrical cables and working on jewelry and semi-precious stones also put workers at risk of silicosis.
In the wake of modern-day silicosis cases, researchers have called for larger studies to better understand the disease and the discovery of effective treatments.
In the U.S. about 2.3 million workers are exposed to silica dust on the job, according to the American Lung Association. Other estimates show approximately 10 million workers in India, 3.2 million in the European Union and 2 million in Brazil work with material containing silica.
However, “the reporting system for occupational injuries and illnesses in the United States fails to capture many cases, leading to a poor understanding of silicosis incidence and prevalence,” writes Ryan F. Hoy, who has published extensively on the topic, in a June 2022 article in Respirology.
A 2015 study in the Morbidity & Mortality Weekly Report found the annual number of silicosis deaths declined from 185 people in 1999 to 111 in 2013, but the decline appeared to have leveled off between 2010 and 2013, the authors write. Another 2015 study in MMWR, examining silicosis deaths between 2001 and 2010, found the death rate from silicosis was significantly higher among Black people compared with whites and other races. Men also have a significantly higher death rate from silicosis than women.
The 2019 Global Burden of Disease Study estimates that more than 12,900 people worldwide die from silicosis each year.
Silicosis has no cure, but it’s preventable when workers have access to proper respiratory protection and are educated on safe practices set by regulatory bodies such as the U.S. National Institute for Occupational Safety and Health. The European Network on Silica also has guidelines on handling and using materials containing silica. A March 2023 study published in Environmental Science and Pollution Research International finds that “education, training, and marketing strategies improve respirator use, while training and education motivate workers to use dust control measures.”
Silicosis symptoms and treatment
Symptoms of silicosis include cough, fatigue, shortness of breath and chest pain. There’s no specific test for silicosis. The first signs may show in an abnormal chest X-ray and a slowly developing cough, according to the American Lung Association.
Silicosis symptoms don’t appear right away in most cases, usually taking several years to develop working with silica dust. However, studies indicate that symptoms of silicosis due to exposure to artificial stone appear quicker than exposure to natural silica sources, potentially due to the higher concentration of silica in artificial stone.
There are three types of silicosis: acute (most commonly caused by working with artificial stone), accelerated and chronic, depending on the level of exposure to silica dust, according to the Centers for Disease Control and Prevention, which explains the severity of each type on its website.
Complications from silicosis can include tuberculosis, lung cancer, chronic bronchitis, kidney disease and autoimmune disorders. In some cases, silicosis can cause severe scarring of the lung tissue, leading to a condition called progressive massive fibrosis, or PMF. Some patients may require a lung transplant.
Lung damage from silicosis is irreversible, so treatment of silicosis is aimed at slowing down the disease and relieving its symptoms.
In 1995, the World Health Organization called for the elimination of silicosis by 2030, but research studies and news stories show it remains a threat to many workers.
Below, we have gathered several studies on the topic to help journalists bolster their reporting with academic research.
Research roundup
Artificial Stone Associated Silicosis: A Systematic Review
Veruscka Leso, et al. International Journal of Environmental Research and Public Health, February 2019.This systematic review aims to verify the association between exposure to silica dust in artificial stone and the development of silicosis.
Researchers narrowed down their selection from 75 papers to seven studies that met their inclusion criteria. The seven studies were from Australia, Israel and Spain. Most of the studies are observational and impede a definite association between exposure to silica while working with artificial stone and developing silicosis, the authors note.
However, “the unusually high incidence of the disease that was reported over short periods of investigations, and the comparable occupational histories of affected workers, all being involved in the manufacture and manipulation of engineered stones, may indicate a cause-effect relationship of this type.”
The review of studies reveals a lack of basic preventive measures such as lack of access to disposable masks; lack of information and training on the dangers of silica dust; and lack of periodic medical examinations, including a chest X-ray, among workers. There was limited environmental monitoring of dust levels at the workplace. Also, there was no dust suppression system, such as the use of water when polishing the stones, or effective ventilation. Machinery and tools weren’t properly set up and didn’t undergo routine checks, the authors write.
The authors recommend environmental monitoring for assessing silica levels in the workplace and verifying the effectiveness of personal protections. They also recommend the health surveillance of workers exposed to silica dust.
“Stakeholders, manufacturers, occupational risk prevention services, insurance companies for occupational accidents and diseases, business owners, occupational health physicians, general practitioners, and also employees should be engaged, not only in designing/planning processes and operational working environments, but also in assessing the global applicability of proactive preventive and protective measures to identify and control crystalline silica exposure, especially in new and unexpected exposure scenarios, the full extent of which cannot yet be accurately predicted,” they write.
Silica-Related Diseases in the Modern World
Ryan F. Hoy and Daniel C. Chambers. Allergy, November 2020.The study is a review of the mineralogy of silica, epidemiology, clinical and radiological features of the various forms of silicosis and other diseases associated with exposure to silica.
The primary factor associated with the development of silicosis is the intensity and duration of cumulative exposure to silica dust. Most countries regulate silica dust occupational exposure limits, generally in the range of 0.05 mg/m3 to 0.1 mg/m3, although the risk of dust exposure to workers still remains high at those levels.
The study provides a list of activities that could expose workers to silica dust. They include abrasive blasting of sand and sandstone; cement and brick manufacturing; mixing, glazing or sculpting of china, ceramic and pottery; construction involving bricklaying, concrete cutting, paving and demolition; sandblasting denim jeans; working with and polishing dental materials; mining and related milling; handling raw material during paint manufacturing; road and highway construction and repair; soap and cosmetic production; blasting and drilling tunnels; and waste incineration.
“Despite the large number of workers in the construction sector, there have been few studies of [silica dust] exposure in this industry,” the authors note.
Other than silicosis, conditions associated with silica exposure include sarcoidosis, an inflammatory disease that commonly affects the lungs and lymph nodes, autoimmune disease, lung cancer and pulmonary infections.
“Recent outbreaks of silica-associated disease highlight the need for constant vigilance to identify and control new and well-established sources of silica exposure. While there are currently no effective treatments for silicosis, it is a completely preventable lung disease,” the authors write.
A Systematic Review of the Effectiveness of Dust Control Measures Adopted to Reduce Workplace Exposure
Frederick Anlimah, Vinod Gopaldasani, Catherine MacPhail and Brian Davies. Environmental Science and Pollution Research International, March 2023.This study provides an overview of various interventions and their effectiveness in preventing exposure to silica dust based on a review of 133 studies from 16 countries, including the U.S., Canada, China, India, Taiwan and Australia, and published between 2010 and 2020.
These dust control measures range from simple work practices such as the use of respirators to more sophisticated technologies, such as water and air curtains and foam technology, the authors note.
The review finds increasing research interest in dust reduction, mainly in China. But overall, regulatory influence remains inadequate in preventing miners’ exposure to silica dust.
“Results from the review suggest that adopted interventions increase knowledge, awareness, and attitudes about respirator usage and generate positive perceptions about respirator usage while reducing misconceptions,” the authors write. “Interventions can increase the use, proper use, and frequency of use of respirators and the adoption readiness for dust controls but may not provide sustained motivation in workers for the continual use of dust controls or [personal protective equipment.]”
Notes from the Field: Surveillance of Silicosis Using Electronic Case Reporting — California, December 2022–July 2023
Jennifer Flattery, et al. Morbidity and Mortality Weekly Report, November 2023.This study examines the use of electronic case reporting to identify silicosis cases in California. Electronic case reporting, or eCR, is the automated, real-time exchange of case report information between electronic health records at health facilities at state and local public health agencies in the U.S. It is a joint effort between the Association of Public Health Laboratories, the Council of State and Territorial Epidemiologists, and the CDC. Currently, 208 health conditions can be reported using eCR. All 50 states and other U.S.-affiliated jurisdictions are connected to eCR. Once a public health agency receives a case report, it reaches out to the patient for contact tracing or other actions.
From October 2022 to July 2023, the California Department of Public Health received initial silicosis case reports for 41 individuals. A review of medical records confirmed 19 cases and 16 probable cases. Six of the 41 cases were considered unlikely to be silicosis after a review of medical records.
Notably, engineered stone countertop fabrication was a significant source of exposure, especially among Hispanic and Latino workers.
At least seven of the 19 confirmed cases were associated with the fabrication of engineered stone — quartz — countertops. The 19 patients’ ages ranged from 33 to 51 and all were Hispanic or Latino. One patient died and two had both lungs replaced. One was evaluated for a lung transplant.
The median age of the 35 patients with probable or confirmed silicosis was 65, ranging from 33 to 89 years, and 91% were men.
“It is important that health care providers routinely ask patients about their work as an important determinant of health,” the authors write. “Being aware of the risks associated with work exposures, as well as the regulations, medical monitoring, and prevention strategies that address those risks can help guide patient care.”
Additional research
Understanding the Pathogenesis of Engineered Stone-Associated Silicosis: The Effect of Particle Chemistry on the Lung Cell Response
Chandnee Ramkissoon, et al. Respirology, December 2023.Silicosis, Tuberculosis and Silica Exposure Among Artisanal and Small-Scale Miners: A Systematic Review and Modelling Paper
Patrick Howlett, et al. PLOS Global Public Health, September 2023.Silicosis Among Immigrant Engineered Stone (Quartz) Countertop Fabrication Workers in California
Jane C. Fazio, et al. JAMA Internal Medicine, July 2023.Silicosis and Tuberculosis: A Systematic Review and Meta-Analysis
P. Jamshidi, et al. Pulmonology, June 2023.From Basic Research to Clinical Practice: Considerations for Treatment Drugs for Silicosis
Rou Li, Huimin Kang and Shi Chen. International Journal of Molecular Science, May 2023.Silicosis After Short-Term Exposure
J. Nowak-Pasternak, A. Lipińska-Ojrzanowska and B. Świątkowska. Occupational Medicine, January 2023.Occupational Silica Exposure and Dose-Response for Related Disorders—Silicosis, Pulmonary TB, AIDs and Renal Diseases: Results of a 15-Year Israeli Surveillance
Rachel Raanan, et al. International Journal of Environmental Research and Public Health, November 2022.Demographic, Exposure and Clinical Characteristics in a Multinational Registry of Engineered Stone Workers with Silicosis
Jeremy Tang Hua, et al. Occupational & Environmental Medicine, August 2022.Current Global Perspectives on Silicosis — Convergence of Old and Newly Emergent Hazards
Ryan F. Hoy, et al. Respirology, March 2022.The Association Between Silica Exposure, Silicosis and Tuberculosis: A systematic Review and Metal-Analysis
Rodney Ehrlich, Paula Akugizibwe, Nandi Siegfried and David Rees. BMC Public Health, May 2021.Silicosis, Progressive Massive Fibrosis and Silico-Tuberculosis Among Workers with Occupational Exposure to Silica Dusts in Sandstone Mines of Rajasthan State
Subroto Nandi, Sarang Dhatrak, Kamalesh Sarkar. Journal of Family Medicine and Primary Care, February 2021.Artificial Stone Silicosis: Rapid Progression Following Exposure Cessation
Antonio León-Jiménez, et al. Chest, September 2020.Silica-Associated Lung Disease: An Old-World Exposure in Modern Industries
Hayley Barnes, Nicole S.L. Goh, Tracy L. Leong and Ryan Hoy. Respirology, September 2019.Australia Reports on Audit of Silicosis for Stonecutters
Tony Kirby. The Lancet, March 2019.Artificial Stone-Associated Silicosis: A Rapidly Emerging Occupational Lung Disease
Ryan F. Hoy, et al. Occupational & Environmental Medicine, December 2017.This article first appeared on The Journalist’s Resource and is republished here under a Creative Commons license.
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The Five Key Traits Of Healthy Aging
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The Five Keys Of Aging Healthily
Image courtesy of Peter Prato. This is Dr. Daniel Levitin. He’s a neuroscientist, and his research focuses on aging, the brain, health, productivity, and creativity. Also music, and he himself is an accomplished musician also, but we’re not going to be focusing on that today.
We’re going to be looking at the traits that, according to science, promote healthy longevity in old age. In other words, the things that increase our healthspan, from the perspective of a cognitive scientist.
What does he say we should do?
Dr. Levitin offers us what he calls the “COACH” traits:
- Curiosity
- Openness
- Associations
- Conscientiousness
- Healthy practices
By “associations”, he means relationships. However, that would have made the acronym “CORCH”, and decisions had to be made.
Curiosity
Leonardo da Vinci had a list of seven traits he considered most important.
We’ll not go into those today (he is not our featured expert of the day!), but we will say that he agreed with Dr. Levitin on what goes at the top of the list: curiosity.
- Without curiosity, we will tend not to learn things, and learning things is key to keeping good cognitive function in old age
- Without curiosity, we will tend not to form hypotheses about how/why things are the way they are, so we will not exercise imagination, creativity, problem-solving, and other key functions of our brain
- Without curiosity, we will tend not to seek out new experiences, and consequently, our stimuli will be limited—and thus, so will our brains
Openness
Being curious about taking up ballroom dancing will do little for you, if you are not also open to actually trying it. But, openness is not just a tag-on to curiosity; it deserves its spot in its own right too.
Sometimes, ideas and opportunities come to us unbidden, and we have to be able to be open to those too. This doesn’t mean being naïve, but it does mean having at least a position of open-minded skepticism.
Basically, Dr. Levitin is asking us to be the opposite of the pejorative stereotype of “an old person stuck in their ways”.
Associations
People are complex, and so they bring complexities to our lives. Hopefully, positively stimulating ones. Without them to challenge us (again, hopefully in a positive way), we can get very stuck in a narrow field of experience.
And of course, having at least a few good friends has numerous benefits to health. There’s been a lot of research on this; 5 appears to be optimal.
- More than that, and the depth tends to tail off, and/or stresses ensue from juggling too many relationships
- Fewer than that, and we might be only a calendar clash away from loneliness
Friends provide social stimulation and mutual support; they’re good for our mental health and even our physiological immunity (counterintuitively, by means of shared germs).
And, a strong secure romantic relationship is something that has been found time and again to extend healthy life.
Note: by popular statistics, this benefit is conferred upon men partnered with women, men partnered with men, women partnered with women, but not women partnered with men.
There may be a causative factor that’s beyond the scope of this article which is about cognitive science, not feminism, but there could also be a mathematical explanation for this apparent odd-one-out:
Since women tend to live longer than men (who are also often older than their female partners), women who live the longest are often not in a relationship—precisely because they are widows. So these long-lived widows will tend to skew the stats, through no fault of their husbands.
On the flipside of this, for a woman to predecease her (statistically older and shorter-lived) husband will often require that she die quite early (perhaps due to accident or illness unrelated to age), which will again skew the stats to “women married to men die younger”, without anything nefarious going on.
Conscientiousness
People who score highly in the character trait “conscientiousness” will tend to live longer. The impact is so great, that a child’s scores will tend to dictate who dies in their 60s or their 80s, for example.
What does conscientiousness mean? It’s a broad character trait that’s scored in psychometric tests, so it can be things that have a direct impact on health, such as brushing one’s teeth, or things that are merely correlated, such as checking one’s work for typos (this writer does her best!).
In short, if you are the sort of person who attends to the paperwork for your taxes on time, you are probably also the sort of person who remembers to get your flu vaccination and cancer screening.
Healthy practices
This means “the usual things”, such as:
- Healthy diet (Mediterranean Diet consistently scores up top)
- Good exercise (especially the tendency to keep moving in general)
- Good sleep (7–9 hours, no compromises)
- Not drinking (or at least only very moderate consumption, but the only safe amount is zero)
- Not smoking (just don’t; there is no wiggle room on this one)
Want to learn more?
You can check out his book, which we reviewed all so recently, and you can also enjoy this video, in which he talks about matters concerning healthy aging from a neuroscientist’s perspective, ranging from heart health and neurodegeneration, to the myth of failing memory, to music and lifespan and more:
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