What You Should Have Been Told About The Menopause Beforehand

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What You Should Have Been Told About Menopause Beforehand

Dr. Jen Gunter provides important information on menopause.

This is Dr. Jen Gunter. She’s a gynecologist, specializing in chronic pain and vulvovaginal disorders. She’s also a woman on a mission to demystify things that popular culture, especially in the US, would rather not talk about.

When was the last time you remember the menopause being referenced in a movie or TV show? If you can think of one at all, was it just played for laughs?

And of course, the human body can be funny, so that’s not necessarily the problem, but it sure would be nice if that weren’t all that there is!

So, what does Dr. Gunter want us to know?

It’s a time of changes, not an end

The name “menopause” is misleading. It’s not a “pause”, and those menses aren’t coming back.

And yet, to call it a “menostop” would be differently misleading, because there’s a lot more going on than a simple cessation of menstruation.

Estrogen levels will drop a lot, testosterone levels may rise slightly, mood and sleep and appetite and sex drive will probably be affected (progesterone can improve all these things!) and not to mention but we’re going to mention: vaginal atrophy, which is very normal and very treatable with a topical estrogen cream. Untreated menopause can also bring a whole lot of increased health risks (for example, heart disease, osteoporosis, and, counterintuitively given the lower estrogen levels, breast cancer).

However, with a little awareness and appropriate management, all these things can usually be navigated with minimal adverse health outcomes.

Dr Gunter, for this reason, refers to it interchangeably as “the menopausal transition”. She describes it as being less like a cliff edge we fall off, and more like a bridge we cross.

Bridges can be dangerous to cross! But they can also get us safely where we’re going.

Ok, so how do we manage those things?

Dr. Gunter is a big fan of evidence-based medicine, so we’ll not be seeing any yonic crystals or jade eggs. Or “goop”.

See also: Meet Goop’s Number One Enemy

For most people, she recommends Menopausal Hormone Therapy (MHT), which falls under the more general category of Hormone Replacement Therapy (HRT).

This is the most well-evidenced, science-based way to avoid most of the risks associated with menopause.

Nevertheless, there are scare-stories out there, ranging from painful recommencement of bleeding, to (once again) increased risk of breast cancer. However, most of these are either misunderstandings, or unrelated to menopause and MHT, and are rather signs of other problems that should not be ignored.

To get a good grounding in this, you might want to read her Hormone Therapy Guide, freely available as a standalone section on her website. This series of posts is dedicated to hormone therapy. It starts with some basics and builds on that knowledge with each post:

Dr. Gunter’s Guide To The Hormone Menoverse

What about natural therapies?

There are some non-hormonal things that work, but these are mostly things that:

  • give a statistically significant reduction in symptoms
  • give the same statistically significant reduction in symptoms as placebo

As Dr. Gunter puts it:

❝While most of the studies of prescription medications for hot flashes have an appropriate placebo arm, this is rarely the case with so-called alternative therapies.

In fact, the studies here are almost always low quality, so it’s often not possible to conclude much.

Many reviews that look at these studies often end with a line that goes something like, “Randomized trials with a placebo arm, a low risk of bias, and adequate sample sizes are urgently needed.”

You should interpret this kind of conclusion as the polite way of saying, “We need studies that aren’t BS to say something constructive.”❞

~ Gunter, 2023

However, if it works, it works, whatever its mechanism. It’s just good, when making medical decisions, to do so with the full facts!

For that matter, even Dr. Gunter acknowledges that while MHT can be lifechanging (in a positive way) for many, it’s not for everyone:

Informed Decisions: When Menopause Hormone Therapy Isn’t Recommended

Want to know more?

Dr. Gunter also has an assortment of books available, including The Menopause Manifesto (which we’ve reviewed previously), and some others that we haven’t, such as “Blood” and “The Vagina Bible”.

Enjoy!

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  • Watermelon vs Grapes – Which is Healthier?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our Verdict

    When comparing watermelon to grapes, we picked the watermelon.

    Why?

    It was close! And certainly both are very healthy.

    Both fruits are (like most fruits) good sources of water, fiber, vitamins, and minerals. Any sugar content (of which grapes are slightly higher) is offset by their fiber content and polyphenols.

    See: Which Sugars Are Healthier, And Which Are Just The Same?

    While both are good sources of vitamins A and C, watermelon has about 10x as much vitamin A, and about 6x as much vitamin C (give or take individual plants, how they were grown, etc, but the overall balance is clearly in watermelon’s favor).

    When it comes to antioxidants, both fruits are good, but again watermelon is the more potent source. Grapes famously contain resveratrol, and they also contain quercetin, albeit you’d have to eat quite a lot of grapes to get a large portion.

    Now, having to eat a lot of grapes might not sound like a terrible fate (who else finds that the grapes are gone by the time the groceries are put away?), but we are comparing the fruits here, and on a list of “100 best foods for quercetin”, for example, grapes took 99th place.

    Watermelon’s main antioxidant meanwhile is lycopene, and watermelon is one of the best sources of lycopene in existence (better even than tomatoes).

    We’ll have to do a main feature about lycopene sometime soon, so watch this space

    Take care!

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  • It Didn’t Start with You – by Mark Wolynn

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    There is a trend in psychology to “blame the parents” for “childhood trauma” that can result in problems later in life. Sometimes fairly, sometimes not. This book’s mostly not about that.

    It does touch on our own childhood trauma, if applicable. But mostly, it’s about epigenetic trauma inheritance. In other words, not just trauma that’s passed on in terms of “the cycle of abuse”, but trauma that’s passed on in terms of “this generation experienced trauma x, developed trauma response y, encoded it epigenetically, and passed it on to their offspring”.

    So, how does one heal from a trauma one never directly experienced, and just inherited the response to it? That’s what most of this book is about, after establishing how epigenetic trauma inheritance works.

    The author, a therapist, provides practical advice for how to do the things that can be done to rewrite the epigenetic code we inherited. Better late than never!

    Bottom line: it is well-established that trauma is inheritable. But unlike one’s eye color or the ability to smell asparagus metabolites in urine, we can rewrite epigenetic things, to a degree. This book explains how.

    Click here to check out It Didn’t Start With You, and put things to rest!

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  • Ice Cream vs Fruit Sorbet – Which is Healthier?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our Verdict

    When comparing ice cream to fruit sorbet, we picked the ice cream.

    Why?

    Well, neither are great!

    But the deciding factor is simple: ice cream has more nutrients to go with its sugar.

    While “fruit is good” is a very reliable truism in and of itself, sorbet tends to be made with fruit juice (or at best, purée, which for these purposes is more or less the same) and sugar. The small vitamin content is nowhere near enough to make up for this. The fiber having been removed by juicing or puréeing, the fruit juice with added sugar is basically shooting glucose and fructose into your veins while doing little else.

    Fruit juice (even freshly-pressed) is nowhere near in the same league of healthiness as actual fruit!

    See also: Which Sugars Are Healthier, And Which Are Just The Same?

    Ice cream, meanwhile, is also not exactly a health food. But it has at least some minerals worth speaking of (mostly: calcium, potassium, phosphorus), and some fat that a) can be used b) helps slightly slow the absorption of the sugars.

    In short: please do not consider either of these things to be a health food. But if you’re going to choose one or the other (and are not lactose-intolerant), then ice cream has some small positives to go with its negatives.

    Take care!

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Related Posts

  • Dr. Greger’s Daily Dozen
  • Revealed: The Soviet Secret Recipe For Success That The CIA Admits Put The US To Shame

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Today’s edition of 10almonds brings you a blast from the past with a modern twist: an ancient Russian peasant food that became a Soviet staple, and today, is almost unknown in the West.

    Before we get to that, let’s take a sneaky look at this declassified CIA memorandum from near the end of the Cold War:

    (Click here to see a bigger version)

    The take-away here is:

    • Americans were eating 2–3 times more meat than Soviets
    • Soviets were eating nearly double the amount of grain products and potatoes

    …and both of these statistics meant that nutritionally speaking, the Soviets were doing better.

    Americans also consumed more sugar and fats, which again, wasn’t the best dietary option.

    But was the American diet tastier? Depends on whom you ask.

    Which brings us to a literal recipe we’re going to be sharing with you today:

    It’s not well-known in the West, but in Russia, it’s a famous national comfort food, a bastion of health and nutrition, and it rose to popularity because it was not only cheap and nutritious, but also, you could eat it for days without getting sick of it. And it could be easily frozen for reheating later without losing any of its appeal—it’d still be just as good.

    In Russia there are sayings about it:

    Щи да каша — пища наша (Shchi da kasha — pishcha nasha)

    Shchi and buckwheat are what we eat

    Top tip: buckwheat makes an excellent (and naturally sweet) alternative to porridge oats if prepared the same way!

    Где щи, там и нас ищи (Gdye shchi, tam i nas ishchi)

    Where there’s shchi, us you’ll see

    Голь голью, а луковка во щах есть (Gol’ gol’yu, a lukovka vo shchakh yest’)

    I’m stark naked, but there’s shchi with onions

    There’s a very strong sentiment in Russia that really, all you need is shchi (shchi, shchi… shchi is all you need )

    But what, you may ask, is shchi?

    Our culinary cultural ambassador Nastja is here to offer her tried-and-tested recipe for…

    …Russian cabbage soup (yes, really—bear with us now, and you can thank us later)

    There are a lot of recipes for shchi (see for yourself what the Russian version of Lifehacker recommends), and we’ll be offering our favorite…

    Nastja’s Nutritious and Delicious Homemade Shchi

    Hi, Nastja here! I’m going to share with you my shchi recipe that is:

    • Cheap
    • So tasty
    • Super nutritious*
    • Vegan
    • Gluten Free

    You will also need:

    • A cabbage (I use sweetheart, but any white cabbage will do)
    • 1 cup (250g) red lentils (other kinds of lentils will work too)
    • ½ lb or so (250–300g) tomatoes (I use baby plum tomatoes, but any kind will do)
    • ½ lb or so (250–300g) mushrooms (the edible kind)
    • An onion (I use a brown onion; any kind will do)
    • Salt, pepper, rosemary, thyme, parsley, cumin
    • Marmite or similar yeast extract (do you hate it? Me too. Trust me, it’ll be fine, you’ll love it. Omit if you’re a coward.)
    • A little oil for sautéing (I use sunflower, but canola is fine, as is soy oil. Do not use olive oil or coconut oil, because the taste is too strong and the flashpoint too low)

    First, what the French call mise-en-place, the prep work:

    1. Chop the cabbage into small strips, ⅛–¼ inch x 1 inch is a good guideline, but you can’t really go wrong unless you go to extremes
    2. Chop the tomatoes. If you’re using baby plum tomatoes (or cherry tomatoes), cut them in half. If using larger tomatoes, cut them into eighths (halve them, halve the halves, then halve the quarters)
    3. Chop the mushrooms. If using button mushrooms, half them. If using larger mushrooms, quarter them.
    4. Chop the onion finely.
    5. Gather the following kitchenware: A big pan (stock pot or similar), a sauté pan (a big wok or frying pan will do), a small frying pan (here a wok will not do), and a saucepan (a rice cook will also do)

    Now, for actual cooking:

    1. Cook the red lentils until soft (I use a rice cooker, but a saucepan is fine) and set aside
    2. Sauté the cabbage, put it in the big pot (not yet on the heat!)
    3. Fry the mushrooms, put them in the big pot (still not yet on the heat!)

    When you’ve done this a few times and/or if you’re feeling confident, you can do the above simultaneously to save time

    1. Blend the lentils into the water you cooked them in, and then add to the big pot.
    2. Turn the heat on low, and if necessary, add more water to make it into a rich soup
    3. Add the seasonings to taste, except the parsley. Go easy on the cumin, be generous with the rosemary and thyme, let your heart guide you with the salt and pepper.
    4. When it comes to the yeast extract: add about one teaspoon and stir it into the pot. Even if you don’t like Marmite, it barely changes the flavour (makes it slightly richer) and adds a healthy dose of vitamin B12.

    We did not forget the tomatoes and the onion:

    1. Caramelize the onion (keep an eye on the big pot) and set it aside
    2. Fry the tomatoes and add them to the big pot

    Last but definitely not least:

    1. Serve!
    2. The caramelized onion is a garnish, so put a little on top of each bowl of shchi
    3. The parsley is also a garnish, just add a little

    Any shchi you don’t eat today will keep in the fridge for several days, or in the freezer for much longer.

    *That nutritious goodness I talked about? Check it out:

    • Lentils are high in protein and iron
    • Cabbage is high in vitamin C and calcium
    • Mushrooms are high in magnesium
    • Tomatoes are good against inflammation
    • Black pepper has a host of health benefits
    • Yeast extract contains vitamin B12

    Let us know how it went! We love to receive emails from our subscribers!

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  • Science of Stretch – by Dr. Leada Malek

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    This book is part of a “Science of…” series, of which we’ve reviewed some others before (Yoga | HIIT | Pilates), and needless to say, we like them.

    You may be wondering: is this just that thing where a brand releases the same content under multiple names to get more sales, and no, it’s not (long-time 10almonds readers will know: if it were, we’d say so!).

    While flexibility and mobility are indeed key benefits in yoga and Pilates, they looked into the science of what was going on in yoga asanas and Pilates exercises, stretchy or otherwise, so the stretching element was not nearly so deep as in this book.

    In this one, Dr. Malek takes us on a wonderful tour of (relevant) human anatomy and physiology, far deeper than most pop-science books go into when it comes to stretching, so that the reader can really understand every aspect of what’s going on in there.

    This is important, because it means busting a lot of myths (instead of busting tendons and ligaments and things), understanding why certain things work and (critically!) why certain things don’t, how certain stretching practices will sabotage our progress, things like that.

    It’s also beautifully clearly illustrated! The cover art is a fair representation of the illustrations inside.

    Bottom line: if you want to get serious about stretching, this is a top-tier book and you won’t regret it.

    Click here to check out Science of Stretching, and learn what you can do and how!

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  • What is silicosis and what does research say about it?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    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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