Public health
Antimicrobial soap restrictions?
The Canadian Public Health Association wants health Canada to restrict the availability of antimicrobial soaps in an attempt to slow the increase in the growth of resistant strains of pathogenic barriers. At its annual meeting in June 1999, association delegates passed a resolution urging Health Canada to "restrict the availability of personal and home-cleaning products that contain nonconventional antimicrobial agents to health care settings in general and to make them available elsewhere only by nonpublic access through pharmacists." [CMAJ 1999;161(5):477]
Asthma rates vary across Canada
The International Study of Asthma and Allergies in childhood has provided a standardized questionnaire for determining the prevalence of asthma and allergies. A comparison of rates among 6- and 7-year-old children in two Canadian cities has uncovered some interesting results. The asthma rates in Hamilton and Saskatoon were high but comparable to rates reported in parts of the United Kingdom, Australia, New Zealand and Ireland. The study also found that the prevalence of eczema was slightly higher in Saskatoon than in Hamilton.
The Canadian authors recommend further research into regional variations of prevalence rates for asthma that focus on differences in humidity - identified in some studies as a potential factor for increasing asthma rates -climatic conditions, air quality and exposure to house dust mites, mould and cockroaches. [CMAJ 1999;160(13):1824-8]
Ban on bovine growth hormones
The European ban on bovine growth hormones should continue despite the "small risk" that is may contribute to certain types of cancer in humans, says an expert. Dr. Annie Sasco, acting chief of the World Health Organization's Program for Cancer Control, said: "We have sufficient evidence to say it's better to abstain [from ingesting these hormones]." [CMAJ 1999;161(6):677]
Boat safety
Canada's lakes and rivers should be at least a little safer this summer, thanks to new regulations from the federal Department of Fisheries and Oceans, which oversees the Coast Guard. The first batch of regulations took effect Apr. 1 and several others will be phased in over the next 10 years. In the past decade there have been 6000 accidents and 200 fatalities annually involving boats and other powered watercraft in Canada. [CMA News 1999;9(5):1]
CMA sparks review of food labels
Health Canada is reviewing nutritional information labels on food products, but based on a recommendation passed by CMA General Council two years ago it may not go far enough. Canada's current voluntary food-labelling system consists of a small panel printed on food packaging that lists serving size and nutrients on a per-serving basis. The panel contains a list of core nutrients - specifically energy (calories), protein and fat - and many food manufacturers voluntarily print it. General Council delegates voted that the federal government should require all food manufacturers to provide the nutritional information for their products. The National Institute of Nutrition agreed with the resolution and said that more rigorous requirements for nutrition labelling are needed. [CMA News 1999;9(6):3]
Diabetes rate high among aboriginal women
Two new studies document the high prevalence of gestational diabetes mellitus in aboriginal populations in Canada. In the first, researchers studied data for all births to Cree women in the eastern James Bay region of northern Quebec during a two-year period. Almost all of the women had undergone screening for gestational diabetes after 22 weeks' gestation. The prevalence of gestational diabetes was found to be 12.8% or approximately twice as high as that found among women in the general North American population and the second highest reported in an aboriginal group worldwide. [CMAJ 1999;160(9):1293-7]
In the second study, researchers reviewed the medical charts of almost all Swampy Cree women who gave birth at the Weeneebayko Hospital in Moose Factory, James Bay, Ont. between 1987 and 1995. They found a prevalence of gestational diabetes of 8.5% and, as expected, these women had heavier babies and an increased likelihood of assisted delivery. While gestational diabetes seemed to have little effect on the course of labour, the infants tended to be sicker and the authors recommend that infants of women with gestational diabetes be watched in hospital for 48 hours and not be discharged within the first 24 hours. [CMAJ 1999;160(9):1299-1302]
New virus emerges
A new virus, similar to the recently identified Australian Hendra virus, has emerged. The novel morbillivirus has affected pig farmers in Malaysia and abbatoir workers in Singapore, causing more than 100 deaths. [CMAJ 1999;160(11):1607]
Nunavut's health problems
Nunavut, Canada's new territory in the Eastern Arctic as of Apr. 1, 1999, is home to 25,000 people, of whom 85% are Inuit and 56% are under 25 years of age. The area has some of Canada's highest rates of infant mortality, teenage suicide and chronic disease. This inequity in health status reflects inequity in opportunity. [CMAJ 1999;160(7):1037]
Nursing home quality of care
In a study comparing quality of care in licensed versus unlicensed nursing homes in Quebec, researchers found that while unlicensed homes performed worse in the provision and management of physical care, the overall quality of care was similar in both types of facility. However, they also determined that 25% of the homes, both licensed and unlicensed, provided inadequate care to at least one resident. They caution that reasons for providing inadequate care may vary, and also note that residents who received inadequate care were concentrated in a small number of facilities, which generally had fewer than 40 residents. [CMAJ 1999;160(10):1441-5]
An accompanying editorial argued for the establishment of ongoing testing of the quality of care provided in all nursing homes. [CMAJ 1999;160(10):1463-4]
Nutraceuticals arriving in Canada
Nutraceutical foods, which claim to treat or prevent either symptoms or diseases, are threatening to slip across the border from the US. There, grocery stores stock products such as "Kitchen Prescription Chicken Broth and Noodles with Echinacea" to "support your immune system" and "Chunky Tomato with St. John's Wort" to "give your mood a natural lift." Health Canada is attempting to develop a policy on the new products though legislation is not expected for two years. [CMAJ 1999;161(6):742]
Obesity epidemic
Almost one-third of adult Canadians are at increased risk of disability, disease and premature death because of obesity. A group of researchers estimate that the total direct cost of the epidemic in Canada was more than $1.8 billion in 1997, or 2.4% of total health expenditures in the country that year. They predict future prevention and treatment programs for obesity will have major positive effects on the overall cost of health care. [CMAJ 1999;160(4):483-88]
Another group of researchers examined the evidence on the effectiveness of methods used to prevent and treat obesity and recommend that physicians give priority to preventing obesity in their patients and helping them maintain a stable weight over the long term. [CMAJ 1999;160(4):503-6]
In a study of 12,000 Canadians aged 20-64, about one-third of men and one-quarter of women were found to be obese. Obese subjects were more likely to suffer activity restrictions and a number of chronic diseases including diabetes, hypertension, heart disease and asthma. They were also more likely to consult with physicians and to be prescribed various medications. There is no doubt that the burden of obesity on health and health care resources in Canada is substantial. [CMAJ 1999;160(10):1457-62]
Radiofrequency radiation okay
Health Canada conducted an investigation in Vancouver involving three schools that are close to cellular telephone transmitter stations and two control schools. They found that levels of radiofrequency radiation were far below allowable environmental limits and posed no risk to students or staff. [CMAJ 1999;160(9):1311]
Smog advisories
A trio of smog advisory health messages helped Ontario patients weather the dog days of summer. Developed by the Ontario Medical Association, the one-page advisories were aimed at smog-sensitive people, children and those working or exercising outdoors. In Ontario smog causes respiratory difficulties for about 7% of the population and triggers approximately 1,800 premature deaths annually. [CMAJ 1999;161(3):237]
