So What If It’s Winter – Get Out and Play!

As winter descends with its shorter days, frigid temperatures, ice and snow, the harsher weather conditions shouldn’t be seen as a deterrent to going outdoors. If anything, the winter landscape is beautiful and inviting . . .  as long as you dress properly and take cold-weather precautions to keep you healthy and safe.

Preventing hypothermia is a major concern for those who work or recreate outdoors in the winter months. Hypothermia is caused by prolonged exposures to very cold temperatures. When exposed, your body begins to lose heat faster than it’s produced. Lengthy exposures will eventually use up your body’s stored energy, which leads to lower body temperature.

Body temperature that is too low affects the brain, making us unable to think clearly or move well. This makes hypothermia especially dangerous, because a person may not know that it’s happening and won’t be able to do anything about it.

While hypothermia is most likely at very cold temperatures, it can occur even at cool temperatures (above 40°F) if a person becomes chilled from rain, sweat, or submersion in cold water. Victims of hypothermia are often older adults with inadequate food, clothing, or heating; babies sleeping in cold bedrooms; people who remain outdoors for prolonged periods, such as the homeless, hikers, hunters, skiers and snowmobilers; and people who drink alcohol or use illicit drugs.

Warning signs of hypothermia include shivering and exhaustion; confusion and fumbling hands; memory loss; slurred speech; and drowsiness. If you notice any of these signs, take the person’s temperature. If it is below 95° F, the situation is an emergency—get medical attention immediately.

If medical care is not available, begin warming the person, as follows:

  • Get the victim into a warm room or shelter.
  • If the victim has on any wet clothing, remove it.
  • Warm the center of the body first, including his or her chest, neck, head and groin, using an electric blanket, if available. You can also use skin-to-skin contact under loose, dry layers of blankets, clothing, towels, or sheets.
  • Warm beverages can help increase body temperature, but do not give alcoholic beverages.
  • After body temperature has increased, keep the person dry and wrapped in a warm blanket, including the head and neck.
  • Get medical attention as soon as possible.

A person with severe hypothermia may be unconscious and may not seem to have a pulse or to be breathing. In this case, handle the victim gently, and get emergency assistance immediately. Even if the victim appears dead, CPR should be provided. CPR should continue while the victim is being warmed, until the victim responds, or medical aid becomes available. In some cases, hypothermia victims who appear to be dead can be successfully resuscitated.

Dress for the weather

No matter your choice of outdoor activity, take appropriate measures to protect yourself. That includes dressing for the weather, making sure you’re properly hydrated, wearing sunscreen, knowing your limitations, and always respecting Mother Nature.

Dressing in layers and wearing the right types of materials are critical for keeping yourself warm in the cold weather. But when planning your outdoor wardrobe, moisture management is also an important consideration. To keep the body warm during high-energy activities, clothing should transport moisture away from the skin to the outer surface of the fabric where it can evaporate.

Cotton is a poor choice for insulation, because it absorbs moisture and loses any insulating value when it gets wet. Instead, moisture-wicking synthetics, which move moisture away from the skin and stay light, are the best choice for active winter sports like skiing, snowboarding, hiking or climbing. Not only do synthetic fabrics wick moisture away from the skin, they dry quickly and help keep you warm in the process.

Your next layer should be a lightweight stretchy insulator, such as a breathable fleece sweater or vest. The final part of your cold-weather wear should be a lightweight and versatile shell jacket. Fabrics like three-layer Gore-Tex and Windstopper allow companies to create shells that are ultra lightweight while remaining waterproof, windproof, and breathable. For aerobic activities, a shell’s ventilating features are particularly important. Look for underarm zippers, venting pockets, and back flaps.

Always bring a hat and gloves, regardless of the weather or your activity level. Proper foot protection is critical, as well — you should be wearing insulated and water-proof shoes or boots, and synthetic socks that won’t absorb sweat. As with the rest of your clothing, synthetic materials work best for protecting you against the extremes. Look for fleece hats made with Windstopper fabric, gloves and mittens layered with Gore-Tex and fleece, and socks made of synthetic, moisture-wicking materials.

Finally, bring an abundance of water or sports drinks when you recreate outdoors, and try to avoid caffeine or alcohol — both actually dry you out, instead of hydrating, and alcohol lowers your body temperature. Also, make sure you have a cell phone, that somebody knows where you are, and when you’ll be returning. And remember to wear sunscreen — the sun’s ultraviolet rays remain potent, even in the winter, and hydrating your skin with a UV-protective moisturizer will help protect you from wind and other elements.

Getting outdoors in the winter months should be part of your healthy-living planning. Exercising or working outdoors, or simply enjoying the winter beauty will help keep you well, emotionally and physically.


Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Reducing Year-end Burnout

The end of each year, as well as the accompanying holidays, bring a multitude of gifts. While the holidays represent joy, gratitude and happiness for many people, they also are punctuated by a wide spectrum of emotional reactions including nostalgia, guilt, loneliness and, for many, sadness. These can become overwhelming and lead to depression, anxiety or illness.

The culmination of our business and calendar years increases pressure on us as we rush around trying to multitask, wrap up projects and budgets, deal with personal and family needs and prepare ourselves for the coming year. If money challenges are wearing on us, this time of year exacerbates financial woes, adding to stress and guilt. And if we’re alone, or missing people in our lives who have passed, moved away or otherwise departed, those feelings can come home to roost as the holidays rapidly approach.

It’s also a time of overindulgence, especially when it comes to eating and drinking. These activities, as wonderful as they are in moderation, may contribute to an unhealthy sense of self, which typically results in more unhealthy practices. Statistics for how much weight Americans tend to gain during this end-of-the-year smorgasbord vary from one pound to 10, but it’s undoubtedly a tough time for anyone trying to eat healthfully.

But it’s more than just overeating; exercise substantially reduces, as well. According to the National Center for Health Statistics, most Americans (approximately 60 percent) do not engage in vigorous, leisure-time physical activity. Add in the time demands of the holidays and the urge to stay inside because of the weather, and you have a recipe for even more inactivity.

What we need is our own way to help reduce stress and disorganization, improve our focus, and slow down enough – in a short, manageable period – to regain our emotional and physical footing without losing traction or productivity. Some people hit the gym, run or take a walk; others go out to eat, read, nap, pray or call a friend. Many also find that the pursuit of mindfulness – the ability to slow ourselves down, focus and truly be present in the moment – can be enhanced through meditation or other relaxation activities.

Taking charge

Many factors combine to increase the urge to overeat or feel stressed during this season. Holiday feasting, as well as stress, exhaustion and wintry weather can dampen the best of workout intentions. To make this holiday season a healthier one, it’s important to be conscious of what we’re eating, and to manage our stress and emotions.

  • Practice awareness.  It’s important to be conscious of what we eat and how much. Allow yourself some special treats at the holidays but consider moderate servings. When there’s a lot of food available, try an appetizer-sized helping of each dish instead of a full serving. Don’t deprive yourself, but be aware of content and calories. When possible, avoid foods rich in fats, salt, sugar, and preservatives. Remember, we don’t have to indulge every minute. We can allow some treats for those special days, and then get back into our healthy routines the next day.
  • Manage stress and emotions.  For some people it’s an abundance of friends and family coming out of the woodwork that has them down. In contrast, you may be alone, not have your family or friends nearby, and feel isolated. The holidays are very nostalgic, but for every good memory there also may be memories of family members and friends now deceased or living far away, and traditions no longer possible. Spending time with difficult family members, grieving the loss of a loved one, feeling pressure to give gifts when finances are tight, and loneliness can leave people feeling sad, angry, or even depressed. And these feelings are aggravated by the shorter, colder days and reduced sunlight.
  • Outreach and consistency are good. It’s always beneficial to try and continue our normal routines to help feel like we’re still in control. We can consciously try to not over-eat and make time for exercise and rest. Additionally, personal outreach, especially socializing and connecting with old friends and associates, is important for our emotional health. We humans are social creatures, and while digital outreach is valuable and sometimes our easiest option, the Internet tends to act as a buffer between us and real intimacy.
  • Dealing with the holiday blues. Though depression as the holidays near is common, there is a difference between the holiday blues, which are often temporary and go away once the season ends, and more serious conditions. Seasonal Affective Disorder (SAD) is a psychological state that literally changes your biology and can cause or add to depression. Depressed individuals tend to feel helpless and hopeless about changing their situation. If the holiday blues seem to linger or become more intense, seek help from a mental health professional.
  • Do your personal planning. This is the perfect time to assess what you did or didn’t accomplish in your personal health and wellness efforts, and to plan action for the coming year. Set simple goals, and commit to action. That choice is yours, and can involve joining a gym or fitness center, changing your eating habits, participating in organized athletic events, swimming, learning to meditate, reading more, or getting involved through volunteering or charity work. Telling a friend about your goals or enlisting someone to be a partner increases your chance of success, and is more fun.

This season certainly isn’t a time to be punishing yourself. No matter if you forget to follow the above advice, your healthy habits slip a little, or you do end up eating that extra pumpkin pie, cookies or cheesecake – this is a time to recognize how far you’ve come this year, to celebrate what you’ve achieved and to show your body and yourself the love and respect you deserve.


Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Take Care of Your Skin

As soon as the thermostat falls and the heat goes on, many of us suffer from dry itchy skin, especially on our faces, hands and feet. The dry, cold air exacerbates skin conditions like eczema, saps moisture and critical natural oils, and can leave our skin feeling parched, raw, flaky and irritated. Cold-weather elements affect us regardless of the type of heating we use at home or at work, but there are several steps we can take to mitigate the damage and to help keep our skin healthier.

Using moisturizers is a sure bet, but with so many choices and marketing pitches, it’s hard to know what’s best for your own skin. The moisturizer you use in the warmer months may not be as effective in the winter, so as the weather changes, you should adapt your skin regimen, as well. Find an ointment that’s oil-based, rather than water-based, since the oil creates a protective barrier on the skin that retains more moisture than a cream or lotion.

Seeing a specialist is recommended, as well. A dermatologist can analyze your skin type, diagnose maladies, screen for skin cancer and other illnesses and provide professional advice on steps you can be taking and the types of products best suited for your body chemistry and situation. Remaining properly hydrated throughout the winter months is critical for your skin and overall health, and wearing sunscreen when outdoors is essential.

Here are several additional tips for helping maintain healthy skin in the colder, drier months:

  • Apply moisturizers. Content, not cost, should drive this decision. Higher-priced products are charging you for packaging and marketing as well as content. How your skin responds should be the deciding factor. Switch to oil-based products in the colder months, but be aware that not oil-based moisturizers are appropriate for your face. Choose “non-clogging” oils like avocado, mineral, primrose or almond oil. Shea oil or butter can clog facial pores. Also look for lotions containing “humectants,” a class of substances (including glycerin, sorbitol, and alpha-hydroxyl acids) that attract moisture to your skin.

Also, if your facial skin is uncomfortably dry, avoid using harsh peels, masks, and alcohol-based toners or astringents, all of which can strip vital oil from our skin. Instead, find a cleansing milk or mild foaming cleanser, a toner with no alcohol, and masks that are “deeply hydrating,” rather than clay-based, which tends to draw moisture out of the face, and apply them less often.

  • Use sunscreen. Even in the winter months, the sun’s ultra violet rays can penetrate and damage our skin. Use a broad-spectrum sunscreen on exposed face and hands about half an hour before going outdoors and remember to reapply it if you’re outside for a long period playing, walking or working.
  • Wear gloves. It’s hard to keep our hands warm in the cold, dry weather because the skin on our hands is thinner and has fewer oil glands.  To avoid itching and cracking, wear gloves when outdoors. Cotton and wool are preferable to synthetics; if you have sensitive skin, wear a thin cotton glove under your regular gloves for added protection.
  • Avoid wet gloves and socks. There’s nothing as uncomfortable as having wet hands and feet. That moisture trapped against your skin also causes dryness and irritation. Wear cotton near your skin whenever possible, or invest in “wicking” materials which help keep your skin dry. Also use latex or rubber gloves if your hands are in the water often, such as when washing dishes, doing laundry or at work.
  • Invest in a dehumidifier. Whether you’re heating your home with oil, electricity, gas or wood, dry air is bad for our skin. Humidifiers add moisture to the air, which helps our skin and our lungs. Place units in different locations in the house, and in your bedroom.
  • Remember your feet. Don’t forget that our feet dry out in the cooler months, along with our faces and hands. Use lotions that contain petroleum jelly or glycerin instead of water-based lotions. And use exfoliates to get the dead skin off periodically; that helps any moisturizers you use to sink in faster and deeper.
  • Avoid really hot baths or showers. As great as hot water feels on our tired bones, the intense heat of a hot shower or bath actually breaks down the lipid barriers in the skin, which can lead to a loss of moisture. A lukewarm bath with oatmeal orbaking soda can help relieve skin that is so dry it has become itchy.

If you practice these common-sense skin-care steps, your body will thank you. Remember to check in with a dermatologist or skin-care specialist to ensure you’re doing the right things for your specific needs, and enjoy all the winter has to offer!


 

Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

A Shot in the Arm Beats Days in Bed

Influenza (the flu) is a contagious respiratory illness caused by viruses that infect the nose, throat, and lungs. It can cause mild to severe symptoms, and can lead to hospitalization and death. Every year in the United States, millions of people are sickened, hundreds of thousands are hospitalized and thousands die from the flu.

Anyone, no matter how healthy you are, can get the flu, and serious problems related to the flu can happen at any age. Unfortunately, some people are at a higher risk of developing serious flu-related complications if they get sick. This includes people 65 years and older, people of any age with certain chronic medical conditions (such as diabetes, asthma, or heart disease), pregnant women, and young children.

The best way to prevent the flu is by getting a flu vaccine each year. The Centers for Disease Control and Prevention (CDC) recommends that everyone six months of age and older get a flu vaccine annually. Flu vaccination can reduce flu illnesses, doctors’ visits, and missed work and school, as well as prevent flu-related hospitalizations.

The body’s immune response from vaccination declines over time, so an annual vaccine is needed for optimal protection. Also, flu viruses are constantly changing, so the formulation of the flu vaccine is reviewed each year and sometimes updated to keep up with changing flu viruses. For the best protection, everyone six months and older should get vaccinated annually.

“Flu season” in the United States can begin as early as October and last as late as May. When more people get vaccinated against the flu, less flu can spread through their community.

How vaccines work

Flu vaccines cause antibodies to develop in the body about two weeks after vaccination. These antibodies provide protection against infection with the viruses that are in the vaccine. The seasonal flu vaccine protects against the influenza viruses that research indicates will be most common during the upcoming season. Traditional flu vaccines (called “trivalent” vaccines) are made to protect against three flu viruses; an influenza A (H1N1) virus; an influenza A (H3N2) virus; and an influenza B virus. There also are flu vaccines made to protect against four flu viruses (called “quadrivalent” vaccines). These vaccines protect against the same viruses as the trivalent vaccine and an additional B virus.

The CDC recommends use of injectable influenza vaccines (including inactivated influenza vaccines and recombinant influenza vaccines).  A nasal mist is typically available, as well, but last year, the CDC advised against using it and favored immunizations. One exception of note is that standard-dose trivalent shots are manufactured using virus grown in eggs. If you are allergic to eggs, there exists an alternative made using a different base grown in cell culture.

Flu vaccination has been associated with lower rates of some cardiac (heart) events among people with heart disease, especially among those who experienced a cardiac event in the past year. Flu vaccination also has been associated with reduced hospitalizations among people with diabetes (79%) and chronic lung disease (52%). And flu vaccination helps protect women during and after pregnancy. Getting vaccinated against the flu can also protect a baby from flu after birth. (A mother can pass antibodies onto the developing baby during pregnancy.) Flu vaccination also may make your flu illness milder if you do get sick.

Contrary to myth, a flu vaccine cannot cause flu illness. Flu vaccines that are administered with a needle are currently made in two ways: the vaccine is made either with flu vaccine viruses that have been ‘inactivated’ and are therefore not infectious, or with no flu vaccine viruses at all (which is the case for recombinant influenza vaccine). The nasal spray flu vaccine does contain live viruses. However, the viruses are attenuated (weakened), and therefore cannot cause flu illness.

Side effects from a flu vaccination are mild and short-lasting, especially when compared to symptoms of the flu. Side effects may include soreness, redness or swelling where the shot was given, a low-grade fever, or aches, but it’s all short term.

Get vaccinated now

You should get a flu vaccine before flu begins spreading in your community, so make plans to get vaccinated early in fall. CDC recommends that people get a flu vaccine by the end of October, if possible. Getting vaccinated later, however, can still be beneficial and vaccination is offered throughout the flu season, even into January or later. Children who need two doses of vaccine to be protected should start the vaccination process sooner, because the two doses must be given at least four weeks apart.

There are many options for obtaining your vaccination, ranging from your regular physician to walk-in clinics, college health centers and even local drug stores and supermarket pharmacies.  Many larger employers will sponsor flu clinics so people don’t have to leave work to obtain their shot.  If you have questions about which vaccine is best for you, talk to your doctor or other health care professional.

Preventing pneumonia and shingles

Another important consideration as we head into the autumn months is to get vaccinated against pneumococcal infections. Pneumococcal disease is common in young children, but older adults are at greatest risk of serious pneumococcal infections and even death. The CDC recommends vaccination with the pneumococcal conjugate vaccine for all babies and children younger than two years old, all adults 65 years or older, and people two years through 64 years old who are at increased risk for pneumococcal disease due to certain medical conditions.

Shingles is the reactivation of a viral infection in the nerves to the skin that causes pain, burning, or a tingling sensation, along with an itch and blisters in the skin supplied by the affected nerve.  It is caused by the varicella zoster virus, or VZV — the same virus that causes chickenpox.  When the itchy red spots of childhood chickenpox disappear, the virus remains in a dormant state in our nerve cells, able to strike again. This second eruption of the chickenpox virus is called shingles or herpes-zoster.  Shingles is not caused by the same virus that causes genital herpes, a sexually transmitted disease.

Shingles occurs when an unknown trigger causes the virus to become activated.  It afflicts approximately one million Americans annually, and children are vulnerable, too. However, about half of all cases occur in men and women 60 years old or older. People who develop shingles typically have only one episode in their lifetime, though it can strike a person a second or even third time. Since most of us had chickenpox as children, we’re at risk, even if the case was so mild that it may have passed unnoticed.

In the original exposure to VZV (chickenpox), some of the virus particles settle into nerve cells where they remain for many years in an inactive, hidden form. When the VZV reactivates, it spreads down the long nerve fibers that extend from the sensory cell bodies to the skin. As the virus multiplies, a telltale rash erupts. With shingles, the nervous system is more deeply involved than it was during the bout with chickenpox, and the symptoms are often more complex and severe.

Several antiviral medicines are available to treat shingles. These medicines will help shorten the length and severity of the illness. But to be effective, they must be started as soon as possible after the rash appears. But the only way to reduce the risk of developing shingles and the long-term pain from post-herpetic neuralgia (PHN) – a condition that can afflict people after they’ve recovered from shingles – is to get vaccinated. Shingles vaccine (Zostavax®) reduces the risk of developing shingles and the long-term pain that can sometimes afflict those who have had shingles. The CDC recommends that people aged 60 years and older get one dose of shingles vaccine.


 

Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

It’s That Other Sneezing, Coughing, Itchy Eye Time of Year

As the days get shorter and the temperature drops, we’re already seeing color in the trees and bushes.  Autumn is almost upon us, and while we may be mesmerized by what’s to come – including the vibrant colors, crunching of leaves underfoot and seasonal squash and vegetables — there are a few side effects of fall we might not love, such as allergic reactions to ragweed, respiratory illnesses and the 2017/2018 flu season.

If you’re already sniffling and sneezing, the symptoms may be familiar, but the causes – and diagnosis – may not be as clear. Many respiratory ailments start with sneezing, running eyes and noses, and then may progress to sore throats, coughs, chest pain and fever. Understanding the differences, deciding on treatment options, and when to seek medical attention are important, especially if the patient is young, elderly or suffers from other chronic illnesses.

Beware pneumonia and bronchitis

Pneumonia is a condition of the lungs where the air sac (alveoli) become filled with fluid or pus. The pus in the lungs can be the result of a bacterial or viral infection, which leaves the infected person with a cough containing phlegm.

People with weaker immune systems, such as young children below the age of five and elderly people above the age of 65 are most likely to be affected by the infection. If left unchecked it can be fatal. If bacterial, it can be treated effectively with antibiotics.

Bronchitis is a respiratory condition where the bronchial tubes and trachea are inflamed. These are the airways that carry air to the lungs. With bronchitis, the airways are constantly irritated, inducing a cough, and the mucus that comes up with the cough is responsible for spreading the infection. The infection that causes bronchitis is usually caused by the same viruses that spread the common cold and flu.

The primary difference between pneumonia and bronchitis is that while the air sacs in the lungs are infected in pneumonia, it is the airways of the lungs that are affected in bronchitis. Both are respiratory disorders which affect the effective functioning of the lungs, which make it difficult to breathe properly.

But sneezing, coughing and related symptoms aren’t always a sign of a serious illness. Oftentimes, it’s more likely to be seasonal allergies which, though more prevalent in the spring, cause a fair share of autumn suffering, as well.

What causes hay fever in the fall?

Many plant varieties can cause hay fever, but the 17 varieties of ragweed that grow in North America pose the biggest threat. Three out of four people who are allergic to pollen are allergic to ragweed.

A hardy annual, ragweed thrives just about anywhere turf grasses and other perennials haven’t taken root — along roads and riverbanks, in vacant lots, and certainly in your yard or neighborhood. Over the course of a single year, one ragweed plant can produce one billion grains of pollen, which float wherever the breeze carries them, and often are unwelcome visitors in your home, car and workplace.

For hay-fever sufferers, inhaling these tiny particles triggers a cascade of biochemical reactions resulting in the release of histamine, a protein that causes sneezing, congestion, fatigue, coughing, and post-nasal drip; itchy eyes, nose, and throat; dark circles under the eyes; and asthma attacks.

Here are six simple strategies for reducing the severity of hay fever attacks:

  • Make Your Home as pollen-free as possible: During ragweed season, keep your windows shut and the air conditioner on (and do the same while in your car). Running the air conditioner will also help remove moisture from the air, which helps prevent the growth of mold, which also aggravates hay fever symptoms. HEPA air filters can be helpful, especially if your home is carpeted.
  • Wear a Mask: A surgical-style facemask isn’t going to completely protect you from pollen, but it can cut exposure substantially, especially when gardening, mowing the lawn, walking and Look for a facemask with an “N95” rating from the National Institute for Occupational Safety and Health (NIOSH). You should be able to pick one up at a drugstore or home-supply store.
  • Wash your hands and face: Whenever you come in from outside, wash your face and hands. If you’ve been exposed to outdoor air for quite a while, shower and change into fresh clothes. And if you have pets that go outdoors, regular brushing and bathing will help reduce the amount of pollen in their fur.
  • Beware of certain foods that aggravate allergies: Some foods, such as bananas, melons and chamomile contain proteins similar to the ones in ragweed.
  • Beware of pollen counts where you live and work. On days when the pollen count is especially high, stay indoors as possible, or take over-the-counter or prescription medicines before you go out.

If these pollen-avoidance strategies fail to bring relief, consider non-prescription antihistamines. If you’re bothered by congestion as well as sneezing and a runny, itchy nose, adding a decongestant may help. There are also antihistamine/decongestant combinations available. For severe or persistent symptoms, a steroid nasal spray may also be helpful. If you have any medical conditions or questions about what to take, talk to your doctor or pharmacist about your options, including generics which cost less and generally work just as well.

Finally, tenderness or pressure in the nasal passages and headaches might be an indication of a sinus infection, which may require antibiotics. And with flu season rapidly approaching, it’s time to schedule your flu shot, which is easily available through your physician’s office, at walk-in clinics, chain drugstores and even in many supermarket pharmacies.


 

Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

 

Flu Shot Protocols for Employers

The cost of getting sick taxes employers and employees alike. Chronic illness and injuries—though not always anticipated—can be managed, but it’s hard to limit exposure to viruses and bacteria. However, there are steps we can take to mitigate the chances that we and our fellow workers will come down with and share certain contagious illnesses, especially in the workplace.

High on the list of contagions that can be controlled is influenza, or the flu. Every year, millions of Americans contract the flu, losing three to five days of work or more, requiring visits to physicians or walk-in clinics, and for many, a stay in the hospital. It’s also life threatening for seniors, small children and adults with compromised immune or respiratory systems. The annual medical costs run in the billions, as do the costs of lost productivity.

With easy, convenient, and affordable access to safe immunizations for preventing the flu, employers across the country, especially in the healthcare industry, are taking a more proactive stance toward ensuring employee compliance. Some companies are shooting for 100%compliance, launching educational campaigns, team competitions, rallies, and incentive options such as discounts and premiums. Others are taking a carrot and stick approach, linking employer contribution incentives to medical savings accounts. Others are just wielding the stick, insisting that employees receive a flu vaccination as a condition of employment, with exceptions for those who have legitimate religious concerns or allergies to the vaccination.

Recognizing the central role businesses and employers play in protecting the health and safety of their employees, the Centers for Disease Control and Prevention (CDC) and the Occupational Safety and Health Administration (OSHA) have produced materials intended to guide employers in their planning and preparedness for seasonal and pandemic influenza. The guidance is intended to help employers take actions to decrease influenza spread, maintain business continuity, and secure critical infrastructure. OSHA recommends that employers prioritize vaccination because it is a long-term and effective intervention that reduces reliance on employee behavioral changes such as hand hygiene and respiratory etiquette.

As far back as February of 2010, the Advisory Committee for Immunization Practices (ACIP) released their provisional recommendation that all people six months of age or older receive an annual influenza vaccination, unless contraindicated. The CDC also recommends that employers encourage employees to seek vaccination against both seasonal and pandemic influenza, offer influenza vaccination opportunities at their worksite or consider allowing employees time off from work to seek vaccination.

Despite the potential benefits of vaccination, self-reports within the National Health Interview Survey suggest that vaccine coverage among healthy adults 18 to 49 years is only approximately 20%. Offering vaccination in the workplace could increase coverage by making vaccination more convenient, and reducing or eliminating the associated cost may further improve influenza vaccine participation.

Studies have shown that individuals who received influenza vaccine at work cited convenience as an important factor in the decision to be vaccinated. Following physicians’ offices, workplaces are the most common location to receive an influenza vaccination, with one-third of 18- to 49-year-old vaccine recipients and one-fifth of 50 to 64-year-old vaccine recipients receiving the vaccine at work. The addition of workplace education programs can provide information and alleviate employees’ concerns and misinformation about influenza vaccination.

Compliance and the law

More and more healthcare employers are requiring that all employees get the influenza vaccine in order to help protect patients and coworkers during flu season. This trend has resulted in questions pertaining to the legality of such policies, as well as how to properly implement a mandatory influenza vaccination policy for employees. Employers may adopt mandatory flu shot policies which are drafted and implemented in a legally compliant manner.

As a condition of employment, an employer may require that all employees receive a flu shot. However, an employer’s compulsory flu shot policy must provide for exemptions in order to comply with various laws regulating the employer/employee relationship. For example, if an employee with a physical or mental disability refuses a flu shot, the employer may have to make a reasonable accommodation in order to comply with the federal Americans with Disabilities Act (ADA). A reasonable accommodation could take the form of exempting the employee from the requirement and instead requiring a different protective measure, such as wearing a surgical mask. Similarly, if an employee objects due to a sincerely held religious belief, the employer may also have to provide a reasonable accommodation, unless doing so would impose an undue hardship on the employer.

If an employee refuses to comply with the employer’s policy and/or any reasonable alternative protective measures required by the employer if an exemption is granted, an at-will employer may pursue disciplinary action which could include termination. Employers should consult knowledgeable legal counsel before making employment-based decisions.

Employers wishing to require flu shots should adopt a written flu shot policy so that all employees have reasonable advance notice that receiving an annual influenza vaccination is a condition of employment. The policy should set an annual compliance deadline based on the anticipated start of the flu season and outline consequences for noncompliance. For instance, the policy may list the steps triggered by noncompliance, such as a written warning, suspension, and termination if the noncompliance is not addressed within a certain time frame. The policy should also specify what written documentation the employee must furnish the employer to prove that the employee was vaccinated.

An Employer’s Policy Should Include Exemptions

An employer’s influenza vaccination policy should provide a process for employees to request an exemption from the employer. Additionally, the policy should notify employees that if the employer grants an exemption, employees are required to comply, as a condition of employment, with reasonable alternative protective measures specified by the employer.
Exemptions should be allowed for reasons such as

  • A sincerely held religious belief or creed;
  • A qualifying physical or mental disability;
  • A prior severe allergic reaction to the flu shot;
  • A history of Guillain-Barré Syndrome; or
  • Some other relevant medical reason.

Ultimately, educating employees about the benefits and importance of the flu shot may help maximize employee participation. Just like frequent hand washing, the flu shot is an important protective measure for employees and their families. The Centers for Disease Control and Prevention (CDC), the Advisory Committee on Immunization Practices (ACIP), and the Healthcare Infection Control Practices Advisory Committee (HICPAC) recommend that all U.S. health care workers get vaccinated annually against influenza. The CDC has a variety of resources related to influenza vaccination  that may be helpful to employers and employees, especially those in the healthcare field.


Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Eat Well and Be Safe This Summer

It’s July, and the temperature and your dinner are sizzling! Americans love to barbecue, especially in the summer. It’s the season for burgers, dogs, barbecued chicken, and ribs, corn on the cob and every type of salad and dessert known to man.

If you’re a barbeque and picnic lover, the last thing in the world you want to hear is another warning about the perils of charcoal- or grill-cooked food.  But there’s a reason for these warnings, and there are a variety of safety tips, compromises, healthier alternatives and choices you can make to ensure good summer eating and improved nutritional wellness.

There’s a science to cooking outdoors. Heterocyclic amines (HCAs) and polycyclic aromatic hydrocarbons (PAHs) are chemicals formed when meat, including beef, pork, fish, and poultry is cooked using high-temperature methods, such as pan frying or grilling directly over an open flame. The formation of HCAs and PAHs is influenced by the type of meat, the cooking time, the cooking temperature, and the cooking method.

HCAs are formed when amino acids (the building blocks of proteins), sugars, and creatine (a substance found in muscle) react at high temperatures. PAHs are formed when fat and juices from meat grilled directly over an open fire drip onto the fire, causing flames. These flames contain PAHs that then adhere to the surface of the meat. PAHs can also be formed during other food preparation processes, such as smoking of meats.

Exposure to high levels of HCAs and PAHs have been shown to cause cancer in animals. Currently, no Federal guidelines address consumption levels of HCAs and PAHs formed in meat. HCA and PAH formation can be reduced by avoiding direct exposure of meat to an open flame or a hot metal surface, reducing the cooking time, and using a microwave oven or standard oven to partially cook meat before exposing it to high temperatures.

HCAs are not found in significant amounts in foods other than meat cooked at high temperatures. PAHs can be found in other charred foods, as well as in cigarette smoke and car exhaust fumes.

We can reduce our exposure to these potentially damaging chemicals through several cooking methods:

  • When possible, avoid direct exposure of meat to an open flame or a hot metal surface and avoid prolonged cooking times (especially at high temperatures).
  • Use a microwave or standard oven to pre-cook meat prior to exposure to high temperatures. This can substantially reduce HCA formation by reducing the time that meat must be in contact with high heat to finish cooking.
  • Continuously turn meat over on a high heat source to reduce HCA formation, compared with just leaving the meat on the heat source without flipping it often.
  • Remove charred portions of meat, such as the skin from chicken, and refrain from using gravy made from meat drippings, which also contain HCA and PAH.
  • Consider steaming fish and vegetables in foil, rather than grilling over an open flame.

Proper refrigeration and cooling prevents deadly contaminants

Keeping perishables properly refrigerated and stored helps limit opportunities for bacteria to form, but it’s only one of several steps you should be taking regularly to limit exposure, protect your food, and protect yourself, your family and guests from getting sick.

The Center for Disease Control (CDC) says that one in six Americans gets sick from eating contaminated food, and there are at least a thousand reported outbreaks of potentially deadly Salmonella and E. coli infections annually. Overall, the CDC estimates that between 6 million and 33 million are affected by food-borne illnesses each year, resulting in at least 9,000 fatalities. The reason the numbers vary so much is that many cases are never reported as food-borne. Salmonella infections cause more hospitalizations and deaths than any other type of germ found in food, and $365 million in direct medical costs annually.

Follow these tips to reduce the risk of food poisoning at home:

  1. Wash your hands thoroughly with soap and hot water and dry them before handling food and after handling raw foods (meat, fish, eggs and vegetables), after touching the garbage pail, going to the toilet, blowing your nose, or touching animals (including pets).
  2. Wash worktops before and after preparing food, particularly after they’ve been touched by raw meat, including poultry, raw eggs, fish and vegetables. You don’t have to use anti-bacterial sprays. Hot soapy water is fine.
  3. Wash dishcloths and dish or hand towels regularly and let them dry before you use them again. Dirty, damp cloths are the perfect place for bacteria to breed.
  4. Use separate chopping boards for raw food and for ready-to-eat food. Raw foods can contain harmful bacteria that can spread very easily to anything they touch, including other foods, worktops, chopping boards and knives. Less porous materials, like glass, are less likely to become contaminated than wood or plastic.
  5. It’s especially important to keep raw meat away from ready-to-eat foods such as salad, fruit and bread. This is because these foods won’t be cooked before you eat them, so any bacteria that get on to the foods won’t be killed.
  6. Always cover raw meat and store it on the bottom shelf of the refrigerator where it can’t touch other foods or drip on to them.
  7. Cook food thoroughly and check that it’s piping hot all the way through. Make sure poultry, pork, burgers, sausages and kebabs are cooked until steaming hot, with no pink meat inside. Learn to use a meat thermometer to verify cooking temperature.
  8. Keep your fridge temperature below 41 degrees Fahrenheit (5 Celsius), and your freezer temperature below 32 degrees Fahrenheit, preferably closer to zero. By keeping food cold, you stop germs that cause food poisoning from growing.
  9. If you have cooked food that you’re not going to eat straight away, cool it as quickly as possible (within 90 minutes) and store it in the fridge or freezer. Use any leftovers from the fridge within two days.
  10. Don’t eat food that’s past its “use by” date label. These are based on scientific tests that show how quickly harmful germs can develop in packaged food.

Finally, it’s important to keep many kinds of food cool to prevent germs from multiplying. Make sure you keep salads, dips, milk- or dairy-based products, sandwiches, and cooked meats cool. Don’t leave food out of the fridge for more than a couple of hours, and don’t leave food in the sun. Food poisoning and contamination are serious threats to your health all-year round, but simple attention to these details can help ensure healthier and happier eating.

Summer is a blast, and summer eating doesn’t have to be harmful if you eat everything in moderation and try to avoid those foods and preparation processes that are less healthy. Eat more seasonal fresh fruit and vegetables when at picnics, out, or at home. Avoid high-fat desserts high in sugar, or processed foods loaded with sodium, fat, and preservatives. You can eat healthfully AND enjoy delicious food in the summer . . . it just takes some compromise and planning.


 

Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Bug off!

The good news is that with all the rain we’ve had this spring in Connecticut, our reservoirs and water tables are almost back to normal and we’re not likely to experience water shortages this summer. The bad news is that all the rain also is producing a bumper crop of mosquitos, gnats, ticks and other flying and crawling creatures.  The more aggressive species will bug us to distraction, and their bites or stings can cause allergic reactions, discomfort, itchy side effects or illness.

Unless you plan to spend the summer indoors, you’re likely to come in contact with some of these annoying pests. You can improve your odds of not getting bitten by wearing protective clothing, headgear and socks, using insect repellants and citronella products, minimizing use of cologne and perfume when planning outdoor activities, avoiding swampy areas, and moving the party indoors during the height of bite time. You also can spray clothes with repellent containing permethrin, and use a repellant like DEET on your skin.

Of great concern is the possibility of contracting Lyme disease caused by the bacterium Borrelia burgdorferi. It is transmitted to humans through the bite of infected blacklegged ticks, which are common to Connecticut. Typical symptoms include fever, headache, fatigue, and a characteristic skin rash called erythema migrans. If left untreated, infection can spread to joints, the heart, and the nervous system. Lyme disease is diagnosed based on symptoms, physical findings (such as a rash), and the possibility of exposure to infected ticks. Most cases of Lyme disease can be treated successfully with a few weeks of antibiotics. Steps to prevent Lyme disease include using insect repellent, removing ticks promptly, applying pesticides, and reducing tick habitat. The ticks that transmit Lyme disease can occasionally transmit other tick-borne diseases as well.

Certain types of mosquitos carry diseases such as West Nile Virus (WNV), which has been present in Connecticut since 1999 in mosquitoes, horses, wild birds and people. Most people who are infected with WNV have no symptoms or may experience mild illness such as a fever and headache before fully recovering. In some individuals, particularly persons over 50 years of age, West Nile virus can cause serious illness, including encephalitis (inflammation of the brain) or meningitis (inflammation of the membranes covering the brain and spinal cord). Symptoms range from a slight fever, headache, rash, swollen lymph nodes and nausea to the rapid onset of a severe headache, high fever, stiff neck, disorientation, muscle weakness, and coma. West Nile virus infection can lead to death in three percent to 15 percent of persons with severe forms of the illness.

Health professionals also are keeping a vigilant watch for the Zika virus, which is spread mostly by the bite of an infected Aedes species mosquito, which bite during the day and night.

Zika can be passed from a pregnant woman to her fetus, and infection during pregnancy can cause certain birth defects. There is no vaccine or medicine for Zika, and while local mosquito-borne Zika virus transmission has been reported primarily in tropical climates like Florida, Connecticut experienced a few dozen cases in 2016.

Protecting against ticks and mosquitoes

While it is a good idea to take preventive measures against ticks and mosquitoes year-round, be extra vigilant in warmer months (April through September) when ticks are most active. In summer, when out hiking, biking, camping, and spending time in and around grass and woods, there are several steps you can take to limit bites from ticks, mosquitoes and other disease-bearing insects:

  • Avoid direct contact with ticks and mosquitoes as possible. If you can, avoid wooded and bushy areas with high grass and leaf litter. When hiking, picnicking or walking, try to remain in the center of trails.
  • Use repellents that contain 20 percent or more DEET (N, N-diethyl-m-toluamide) on the exposed skin for protection that lasts up to several hours. Always follow product instructions. Parents should apply this product to their children, avoiding hands, eyes, and mouth.
  • Use products that contain permethrin on clothing. Treat clothing and gear, such as boots, pants, socks and tents. It remains protective through several washings. Pre-treated clothing is available and remains protective for up to 70 washings.
  • If you’re using other repellents, go to the Environmental Protection Agency (EPA) website for safety information.

Ticks embedded in your skin can be gross, but painless. The best bet is to keep them at bay. But if they do find you, here are tips for dealing with them easily and effectively:

  • Bathe or shower as soon as possible after coming indoors (preferably within two hours) to wash off and more easily find ticks that are crawling on you.
  • Conduct a full-body tick check using a hand-held or full-length mirror to view all parts of your body upon return from tick-infested areas. Parents should check their children for ticks under the arms, in and around the ears, inside the belly button, behind the knees, between the legs, around the waist, and especially in their hair.
  • Examine gear and pets. Ticks can ride into the home on clothing and pets, then attach to a person later, so carefully examine pets, coats, and day packs. Tumble clothes in a dryer on high heat for an hour to kill remaining ticks.
  • Consult your doctor or a nurse (or internet sources) to determine the best method for removing the tick; it’s important to remove the entire tick, or it can leave parts embedded in your skin.

Should you or a family member develop a bulls-eye-type red rash near the bite site, or exhibit other side effects such as a fever, lethargy or extreme exhaustion, consult your doctor. You may need to be tested for Lyme disease.

If you know you have an allergy to one or more biting insects, you should always carry an epi-pen or other backup medication in case you’re stung or bitten, and seek immediate medical attention. For the rest of us, most bites or stings leave a mark and cause some swelling and irritation. Ice or a cool compress applied directly to the site can bring relief, as can topical salves, ointments or sprays sold over the counter. If the area around the bite continues to expand or becomes blistery and weepy, you have to get checked for a possible infection.

If you’re not aware of allergies but react dramatically, experiencing symptoms such as dizziness, nausea, vomiting, trouble breathing or extensive swelling, it’s important to get to a hospital, urgent care center or physician immediately, or to call for emergency medical assistance as quickly as possible.

Last but not least, there are biting spiders in Connecticut. Most spiders in New England are relatively harmless as long as you’re not allergic to their bite. One of the common venomous spiders in this region is the Brown Recluse. You can identify this spider by the violin-shaped marking on its back. The bite produces a mild stinging, followed by local redness and intense pain within eight hours. A fluid-filled blister forms at the site and then sloughs off to leave a deep, enlarging ulcer. Reactions from a Brown Recluse spider bite vary from a mild fever and rash to nausea and listlessness. On rare occasions death results, more often in children.

If bitten by a spider, try and identify the type of spider that bit you. Clean the site of the spider bite well with soap and water. Apply a cool compress over the spider bite location. If the bite is on an extremity, elevate it. Aspirin or acetaminophen (Tylenol, others) and antihistamines may be used to relieve minor signs and symptoms in adults. Use caution when giving aspirin to children or teenagers. Talk to your doctor if you have concerns.


 

Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

The Message Doesn’t Get Old, but Our Skin Does

We love the sun, especially after a dreary winter and rainy spring. Whether working or playing outdoors, attending parties and picnics, enjoying trips to the beach, or just hanging on the deck or in the yard, we soak up those rays, get our vitamin D, and savor our 2017 tans. But this year, as the perennial warnings about sun exposure and the dangers of Ultraviolet (UV) rays hit the air waves, take note: Skin cancer is the most common form of cancer in the United States, and you can help minimize exposure and prevent its onset by taking simple precautions.

Unprotected exposure to UV radiation is the most preventable risk factor for skin cancer. In fact, UV radiation from the sun and tanning beds is classified as a human carcinogen by the U.S. Department of Health and Human Services and the World Health Organization. Each year, more new cases of skin cancer are diagnosed in the U.S. than new cases of breast, prostate, lung, and colon cancer combined. One in five Americans will develop skin cancer in their lifetime, and one American dies from skin cancer every hour.

Chronic exposure to the sun suppresses our natural immune system and also causes premature aging, which over time can make the skin become thick, wrinkled and leathery. Since it occurs gradually, often manifesting itself many years after the majority of a person’s sun exposure, premature aging is often regarded as an unavoidable, normal part of growing older. However, up to 90% of the visible skin changes commonly attributed to aging are caused by the sun. With proper protection from UV radiation, many forms of skin cancer and most premature aging of the skin can be avoided.

Properly protecting ourselves from UV exposure

The best way to lower our risk of skin cancer is to protect our skin from the sun and ultraviolet light. Using sunscreen and avoiding the sun helps reduce the chance of many aging skin changes, including some skin cancers. However, it is important not to rely too much on sunscreen alone. You should also not use sunscreen as an excuse to increase the amount of time you spend in the sun. Even with the use of sunscreen, people should not stay out too long during peak sunlight hours; UV rays can still penetrate our clothes and skin and do harm.

When possible, avoid sun exposure during the peak hours of 10:00 am to 4:00 pm, when UV rays are the strongest. Clouds and haze do not protect you from the sun, so use sun protection even on cloudy days.

Use sunscreens that block out both UVA and UVB radiation. Products that contain either zinc oxide or titanium oxide offer the best protection. Less expensive products that have the same ingredients work as well as expensive ones. Older children and adults (even those with darker skin) benefit from using SPFs (sun protection factor) of 15 and over. Many experts recommend that most people use SPF 30 or higher on the face and 15 or higher on the body, and people who burn easily or have risk factors for skin cancer should use SPF 50+.

Here’s how to use sunscreen to ensure the best possible protection from the sun’s damaging UV rays:

  • Adults and children should wear sunscreen every day, even if they go outdoors for only a short time.
  • Apply 30 minutes before going outdoors for best results. This allows time for the sunscreen to be absorbed.
  • Remember to use sunscreen during the winter when snow and sun are both present.
  • Reapply at least every two hours while you are out in the sunlight.
  • Reapply after swimming or sweating. Waterproof formulas last for about 40 minutes in the water, and water-resistant formulas last half as long.
  • Adults and children should wear hats with wide brims to shield from the sun’s rays.
  • Wear protective clothing. Look for loose-fitting, unbleached, tightly woven fabrics. The tighter the weave, the more protective the garment.
  • Avoid sun lamps, tanning beds, and tanning salons.
  • Buy clothing and swimwear that block out UV rays. This clothing is rated using SPF (as used with sunscreen) or a system called the ultraviolet protection factor (UPF) index.
  • Avoid surfaces that reflect light, such as water, sand, concrete, snow, and white-painted areas.
  • Beware that at higher altitudes we burn more quickly.

The sun’s rays are important to our health, in moderation, but we get more than enough just by being outdoors for normal activities like going to work and to school, and when puttering in the yard or walking the dog. Taking simple, painless steps to help protect ourselves and our children now can make a huge difference later in life.


 

Be sure to check out the CBIA Healthy Connections wellness program at your company’s next renewal. It’s free as part of your participation in CBIA Health Connections!

Oral Cancers Are Largely Preventable

Oral health is not only important to our appearance and sense of well-being, but also to our overall health. Cavities and gum disease may contribute to many serious conditions, such as diabetes and respiratory disease, and untreated cavities can be painful and lead to serious infections. Poor oral health has been linked to sleeping problems, as well as behavioral and developmental problems in children. It also can affect our ability to chew and digest food properly.

But there’s a more insidious nature to poor oral health. While genetics can play a role, lifestyle and poor choices are major contributors to a cancer that kills approximately 10,000 Americans annually. In fact, the American Cancer Society’s latest estimates for 2017 forecast that approximately 50,000 people will get oral cavity or oropharyngeal cancer this year.

April is National Oral Cancer Awareness Month. Oropharyngeal cancer is a disease in which malignant (cancer) cells form in the tissues of the oropharynx. The oropharynx is the middle part of the pharynx (throat) behind the mouth. It includes the back one-third of the tongue, soft palate, side and back walls of the throat, and our tonsils. The rest are found in the lips, the minor salivary glands (which often occur in the roof of the mouth), and other sites.

These cancers are more than twice as common in men as in women. The average age of most people diagnosed with these cancers is 62, but they can occur in young people. They are rare in children, but a little more than one-quarter occur in patients younger than 55.

Smoking is a major risk factor for oral and dental disease, including oral cancer. Tobacco smoke (including the smoking of cigars and pipes) is very harmful to gum tissues and other tissues in your mouth. Toxins in smoke can cause oral cancer and also damage the bone around your teeth, a major cause of tooth loss. In fact, smoking and tobacco products that are chewed or held in the mouth are one of the biggest risk factors for gum disease and perhaps the biggest risk factor for oral cancer.

Oral tobacco products (snuff or chewing tobacco) are linked with cancers of the cheek, gums, and inner surface of the lips. Using oral tobacco products for a long time poses an especially high risk. These products also cause gum disease, destruction of the bone sockets around teeth, and tooth loss.

The most common risk factors for oropharyngeal cancer include the following:

  • Being infected with human papillomavirus (HPV) — the number of oropharyngeal cancers linked to HPV infection is increasing annually
  • A history of smoking a pack or more a day for greater than 10 years
  • The use of chewing tobacco, snuff, and other “smokeless” tobacco products
  • Heavy alcohol use
  • A diet low in fruits and vegetables
  • Drinking maté, a stimulant drink common in South America
  • Chewing betel quid, a stimulant commonly used in parts of Asia

Sometimes oropharyngeal cancer does not cause early signs or symptoms, but common signs include a lump in the neck and a sore throat. These and other signs and symptoms may be caused by oropharyngeal cancer or by other conditions. Check with your doctor if you have any of the following:

  • A sore throat that does not go away
  • Trouble swallowing
  • Trouble opening the mouth fully
  • Trouble moving the tongue
  • Weight loss for no known reason
  • Ear pain
  • A lump in the back of the mouth, throat, or neck
  • A change in voice
  • Coughing up blood.

When patients newly diagnosed with oral and oropharyngeal cancers are carefully examined, a small portion will have another cancer in a nearby area such as the larynx (voice box), the esophagus (the tube that carries food from the throat to the stomach), or the lung. Some who are cured of oral or oropharyngeal cancer will develop another cancer later in the lung, mouth, throat, or other nearby areas. For this reason, people with oral and oropharyngeal cancer will need to have follow-up exams for the rest of their lives. They also need to avoid using tobacco and alcohol, which increase the risk for these second cancers.

The good news is that the death rate for these cancers generally has been decreasing over the last 30 years. That’s primarily attributable to better health education, outreach from national organizations like the American Cancer Society, and changing patterns in the use of tobacco and alcohol. But oral cancer from human papillomavirus (HPV) is increasing significantly, and risk factors for youth who indulge in smoking or the use of smokeless tobacco also is on the rise. Another questionable practice is the use of “vapes” or electric cigarettes, but research on the long-term effects of these devices is still in its infancy.