Flu Risk Higher for Workers in Certain Industries

Clickbank Products Flu Risk Higher for Workers in Certain Industries



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Reasons for Increased Workplace Risk Not Entirely Clear

By Matt McMillen
WebMD Health News

Reviewed by Louise Chang, MD

March 22, 2012 -- Although having a job offers some protection against the flu, a new report from the CDC shows that workers in some industries appear more flu-prone than workers in other industries.

"[T]his information is needed for recognizing and responding to increased risks for infection among key occupational groups (e.g., health care workers, school teachers, retail and food service workers, and others with substantial exposure to the general public)," the authors write.

In the wake of the 2009 H1N1 pandemic, researchers with the CDC's Emerging Infections Program (EIP) and the National Institute for Occupational Safety and Health (NIOSH) collected data from 3,365 adults whose flu had sent them to the hospital. Although hospitalizations for flu are not the norm, the report states, the authors' aim was to provide "some clues about specific groups of workers that might be most commonly affected by severe influenza."

Health care workers top the list. They account for more than 16% of all hospitalizations. Retail workers, at slightly above 12%, are not far behind. Accommodation and food service workers and educators each make up between 9% and 10% of the total number of those hospitalized.

Rather than simply look at the total number of hospitalized employees in each industry, the researchers also wanted to know which industries had the highest proportion of employees whose flu was severe enough to require a hospital stay.

They found that those in the transportation and warehousing industries -- airline workers, postal employees, and bus drivers, for example -- were more than 1.5 times more likely to be admitted to a hospital for flu than the average worker.

Nearly as likely were travel agents, janitors, secretaries, and other employees in the administrative and support services and waste management and remediation services. Health care workers followed close behind.

Educators, surprisingly, were no more likely to be hospitalized than the average worker.

The authors say that it is hard to determine why some industries are more at risk than others, though they do offer some potential explanations.

"Overrepresentation of an industry sector in the EIP data set may be related to demographic and underlying health characteristics of the sector's work force that put them at increased risk for acquiring influenza and for being hospitalized with influenza," the authors write, "but it may also partially reflect occupational risk factors for influenza (e.g., exposure to ill members of the public)."

For example, more workers in the accommodation and food services smoked than in any other industry. They were also among those with the lowest incomes and the least likely to have a regular doctor. Educators, meanwhile, may be less likely to require a hospital stay because of their comparatively higher salaries and better access to health care.

But such factors can't account for all the hospitalizations, the authors conclude.

"[M]ore research is needed to understand the reasons for the increased incidence of severe influenza among specific groups of workers," they write. "Concurrently, any interventions that focus on these groups of workers should be evaluated for effectiveness and efficiency."

SOURCES: Luckhaupt, S. Emerging Infectious Diseases, March 2012. News release, CDC.

©2012 WebMD, LLC. All Rights Reserved.

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FDA Mulls Expanding Patients' Access to Certain Drugs

Clickbank Products FDA Mulls Expanding Patients' Access to Certain Drugs



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By Amanda Gardner
HealthDay Reporter

THURSDAY, March 22 (HealthDay News) -- Americans troubled by a range of ailments might someday more easily obtain medications that are now only available by prescription.

On Thursday and Friday, experts at the U.S. Food and Drug Administration (FDA) are holding hearings on whether to expand the availability of certain prescription drugs by giving them "conditional" over-the-counter, or OTC, status.

The details of the new plan are sketchy, but certain drugs used to treat such conditions as high blood pressure, high cholesterol, diabetes, asthma and migraine may no longer require a prescription.

Dispensing of these drugs would vary on a case-by-case basis and would include "conditions of safe use," possibly to be determined by the consumer with the help of a pharmacist.

"There are a lot of unanswered questions right now but we're advocating that the pharmacist would be involved with the patient as they . . . determine if the product is right for them," explained pharmacist Ronna Hauser, vice president of policy and regulatory affairs at the National Community Pharmacists Association. "The information would be relayed back to a physician if necessary."

According to Brian Gallagher, senior vice president of government affairs at the American Pharmacists Association, many of the discussions that have taken place with the FDA on the issue so far have involved emergency medications, such as asthma inhalers.

For example, he said, "if someone had already had an inhaler [prescribed] and they had it confiscated at the airport, they could go in, talk to their pharmacist who has access to medical records and get a refill on their inhaler," he said.

Farther down the road, the plan might give pharmacists the ability to screen a person who has already been diagnosed with high blood pressure by their doctor and restart them on medication if needed.

"The pharmacist could urge them to go see a physician before they get into a really bad situation," Gallagher added.

The idea behind the plan is to get millions of untreated or undertreated Americans back into the health care system, experts said.

The move is being driven partly by computer technology, such as the touch-screen kiosks found in pharmacies that help patients self-diagnose common diseases, an idea that has raised inevitable concerns about patient safety.

But the kiosks, said Gallagher, would be less for self-diagnosing than for making decisions in conjunction with a pharmacist in the drug store.

"It might say 'You need to see a doctor right away' rather than 'I've made a diagnosis. Here's some medication,'" Gallagher said.

In particular, concerns about drug interactions, specifically interactions that would lessen the effectiveness of certain cancer drugs, have been voiced.

Without knowing details of the new initiative, Diane Pinakiewicz, president of the National Patient Safety Foundation, said the intent of making it easier for patients to obtain certain types of medications for certain types of conditions is "reasonable."

"Patients today are better informed and want to play a more active role and that's what we're trying to encourage patients to do," she said. "Patient engagement is a key piece of patient care."

But coordination of care with a physician is still critical, she added.

Dr. Sandra Adamson Fryhofer, chair-elect of the American Medical Association's Council on Science and Public Health, testified at the hearing Thursday and expressed concern about the potential lack of physician involvement.

"A patient's confidence in their physician and the prescriber's emphasis on the need to take the medicine as prescribed is one of the most motivating influences in promoting medication adherence," she explained in a statement. "For a program to be successful on this front, it must be delivered by a trusted source, be personalized to the patient's situation, reinforce medical need and expected outcomes, segment and target at-risk populations and reinforce and reward initiation and maintenance of treatment," Fryhofer added.

"We also have concerns about patients taking certain drugs without physician involvement, especially for patients with chronic disease," she continued.

"While the increased availability of certain prescription-based antidotes, such as Epi-Pens [which administer adrenaline for severe allergic reaction], appear to have few if any safety concerns, the FDA has not offered evidence that patients with hypertension [high blood pressure], hyperlipidemia [high cholesterol], asthma or migraine headaches can self-diagnose and manage these serious chronic medical conditions safely on their own," Fryhofer stated.

Copyright © 2012 HealthDay. All rights reserved. SOURCES: Brian Gallagher, R.Ph., J.D., senior vice president, government affairs, American Pharmacists Association; Ronna Hauser, Pharm.D., vice president of policy and regulatory affairs, National Community Pharmacists Association; Diane Pinakiewicz, president, National Patient Safety Foundation; statement of Sandra Adamson Fryhofer, M.D., chair-elect, Council on Science and Public Health, American Medical Association

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New Drug Bests Standard Treatment for Certain Strokes

Clickbank Products New Drug Bests Standard Treatment for Certain Strokes



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By Serena Gordon
HealthDay Reporter

WEDNESDAY, March 21 (HealthDay News) -- A new medication called tenecteplase may be more effective at treating strokes caused by clots in large blood vessels in the brain than the current standard therapy, Australian researchers report.

"This study compares a newer thrombolytic medicine [tenecteplase] to the standard thrombolytic medicine [alteplase] in the treatment of patients with acute ischemic stroke," explained study author Dr. Mark Parsons, an associate professor at the University of Newcastle School of Medicine and Public Health and a senior staff specialist in neurology at John Hunter Hospital, in Newcastle.

Thrombolytic drugs are essentially clot-busters. The researchers found that tenecteplase was better at restoring blood flow to the brain after a stroke than alteplase. In addition, fewer people treated with a higher dose of tenecteplase had a serious disability at 90 days after their stroke compared to those on alteplase.

Results of the study are published in the March 22 issue of the New England Journal of Medicine. Funding for the study came from the Australian National Health and Medical Research Council.

Acute ischemic strokes occur when a clot blocks blood supply to the brain. Both tenecteplase and alteplase are from a class of medications known as a tissue plasminogen activator (tPA). When given within three hours of the first stroke symptoms, intravenous tPA can open up the blocked blood vessel in the brain and prevent further brain damage.

Recovery after receiving one of these medications can be fast and dramatic, though this isn't always the case. And, excessive bleeding is a significant risk factor associated with these medications.

The current study included 75 people treated within six hours after an acute ischemic stroke. All received advanced computed tomography (CT) imaging to ensure that there wasn't any stroke-induced brain damage yet, and the researchers also looked for people who were having strokes in a large blood vessel.

Parsons said the researchers used the advanced CT screening to "identify stroke patients with the greatest potential to benefit from thrombolytic treatment."

The patients were randomly assigned to receive either a standard dose of alteplase, or one of two different doses of tenecteplase (0.1 milligrams (mg) per kilogram (kg) of body weight or 0.25 mg per kg). A kilogram is about 2.2 pounds. All received the medication less than six hours after the onset of symptoms, according to the study.

Blood flow of both tenecteplase groups was restored more effectively than for the alteplase patients. People in the tenecteplase groups also showed greater clinical improvements than those on alteplase after 24 hours.

The higher dose of tenecteplase appeared to be more effective. After 90 days, 72 percent of those treated with the higher dose of tenecteplase were free of serious disability compared to just 40 percent of those on alteplase.

There were no significant differences in excessive bleeding in the brain or other serious adverse events, according to the study.

"The perfect clot-busting drug would open up the blockage without causing any hemorrhage. Short of that, the goal is to find a drug that works at least as well, if not better, and that's as safe," said Dr. Keith Siller, director of the Comprehensive Stroke Center at NYU Langone Medical Center in New York City.

"They showed that under ideal circumstances, this drug works well. It still remains to be seen if other types of strokes will be helped as much," said Siller.

Hemorrhagic strokes, which occur when a blood vessel in the brain bursts, are less common than ischemic strokes.

Parsons said he and his colleagues hope to broaden the study population in their next study. They said the current findings warrant moving on to a study comparing the drugs' performance within a shorter window for treatment.

Siller said that while researchers are trying to refine the type of clot-busting drug that might work best, the message to the public remains clear: If you have any symptoms of stroke, get to the hospital as soon as possible.

"All of these treatments require patients to come to the hospital as soon as possible," noted Siller, who added that treatments currently need to be administered within three hours after the onset of symptoms.

Copyright © 2012 HealthDay. All rights reserved. SOURCES: Mark Parsons, M.D., senior staff specialist, neurology, John Hunter Hospital, and associate professor, University of Newcastle School of Medicine and Public Health, Newcastle, Australia; Keith Siller, M.D., director, Comprehensive Stroke Care Center, NYU Langone Medical Center, and assistant professor, neurology and psychiatry, NYU School of Medicine, New York City; March 22, 2012, New England Journal of Medicine

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