Messages from State Health Officer Dr. Scott Harris
- Encourage Heart Health During February, American Heart Month
- Keep Toy Safety in Mind This Holiday Season
- Chronic Obstructive Pulmonary Disease (COPD): Smoking is Usually the Cause and Quitting Helps
- Lead Poisoning Causes Significant Damage to Children; Be Aware and Prevent Exposure
- Do Not Ignore the Symptoms of Sepsis
- Vaccines Are Very Safe; Adults Need Them Too
February is American Heart Month, an observance to increase our focus on cardiovascular disease (CVD), the leading cause of death in the United States and Alabama. CVD includes diseases that affect the heart or blood vessels, including heart disease, hypertension (high blood pressure), and stroke.
Consider these facts:
- More than 1 in 3 U.S. adults have at least one type of CVD.
- In 2018, the death rate from heart disease in Alabama was 275.6 per 100,000 population.
- There were 13,473 deaths attributed to heart disease in Alabama in 2018.
Even though some risk factors such as family history cannot be changed, the good news is that other risk factors can be modified and controlled, which include the following:
- High blood pressure
- High blood cholesterol
- Overweight and obesity
- Marijuana use
- Sedentary lifestyle
- Excessive alcohol consumption
- Inadequate fruit and vegetable consumption
The Alabama Department of Public Health (ADPH) offers several programs that educate the public about reducing risk factors for heart health. For example, the department’s Cardiovascular Health Program works to increase self-monitoring of blood pressure and the awareness/management of hypertension and high blood cholesterol. ADPH has established and monitors 53 public blood pressure self-monitoring sites in 30 counties around the state. The sites include senior centers, public libraries, barber shops, recreation centers, independent pharmacies, and other public locations. Last year about 2,000 individuals measured their blood pressure more than 6,000 times at one or more of the ADPH sites.
The ADPH Alabama Diabetes Control Program focuses on clinical and community linkages to better support chronic disease management and prevention. Approximately 50 accredited/recognized Diabetes Self-Management Education and Support main sites and 21 Diabetes Prevention Program sites are available in Alabama. ADPH has offered facilitator trainings, a marketing workshop for program partners, and developed community health teams to support diabetes initiatives.
The Nutrition and Physical Activity Division implements nutrition and physical activity interventions, and promotes policy and environmental initiatives to increase the number of Alabamians who maintain a healthy weight, eat balanced meals, and are physically active. Dietary strategies, for example, include decreasing salt intake, reading labels, and increasing access to healthier foods.
In addition, the department’s Tobacco Prevention and Control Program helps tobacco users quit, prevents youth and young adults from starting tobacco use, and protects people from exposure to secondhand smoke. ADPH encourages Alabama’s smokers to start a healthier, tobacco- and vape-free life with the help of the Alabama Tobacco Quitline. Alabama residents can call 1-800-QUIT-NOW (1-800-784-8669) or visit quitnowalabama.com for free help.
Scott Harris, M.D.
State Health Officer
Make this holiday season a joyful one by keeping safety in mind when shopping for children’s toys and overseeing their use. While the majority of toys are safe, toys can become dangerous if misused or if they fall into the hands of kids who are too young to play with them. The U.S. Consumer Product Safety Commission (CPSC) reports there were an estimated 240,000 toy-related injuries treated in U.S. hospital emergency departments, and the commission received 7 reports of toy-related deaths in 2016.
CPSC summarizes its toy safety recommendations succinctly as follows: Play safe, keep safe, put away safe. When selecting toys, safety experts stress the need to choose age-appropriate toys to reduce the risk of potential hazards and remind caregivers, including grandparents, of play-related safety concerns.
Listed below are some tips to prevent toy-related injuries:
- Before shopping for toys, consider the child's age, interest, and skill level. Read instructions and warning labels and follow the age and safety information provided.
- Carefully read and follow instructions for the assembly and use of toys.
- Make sure the toy is sturdy and that no small parts (such as eyes, noses, buttons, or other parts) can break off the toy.
- Keep toys with small parts away from children under age 3 to prevent choking. Small, rounded, and oval objects (like balls and marbles) can easily fit into a child’s mouth. Government regulations specify that toys for children under age 3 cannot have parts less than 1.25 inches in diameter and 2.25 inches long. Choking and aspiration of toy parts are leading causes of toy-related fatalities.
- Always remove and discard all packaging before giving a present to a baby or small child.
- Separate and store toys by age levels. Teach children to put toys away after playing. Safe storage prevents falls and other injuries.
- If a toy box has a hinged lid, be sure it has lid support that holds the lid open at any angle to which the lid is opened. Make sure bins or other toy storage containers have no hinges that could catch little fingers. Toy boxes should have rounded or padded edges.
- Do not leave products with accessible batteries within reach of children. A child can swallow a button battery and suffer dangerous chemical burns in as little as 2 hours.
- Be aware that high-powered magnets are a safety risk to children. Injuries are serious if magnets are swallowed.
- Check old and new toys regularly for damages such as sharp edges or small parts.
- Make repairs immediately or throw away damaged toys.
- For all children under 8, avoid toys that have sharp edges and points.
- Keep un-inflated balloons and broken balloon pieces away from children.
- Include a CPSC-certified helmet if giving a bicycle, skateboard, scooter, or any other riding equipment.
Some suggestions for suitable toys for children by age:
- 0 to 1: Newborns to 1-year-olds explore with their hands, mouths, and eyes, and enjoy toys they can touch or squeeze. Crib gyms, floor activity centers, activity quilts, squeaky toys, soft dolls, or stuffed animals
- 1 to 3: One- to 3-year olds climb, jump, walk, throw, and play rough-and-tumble games. Soft blocks, large blocks, push and pull toys, pounding and shaping toys, books
- 3 to 5: Three- to 5-year-olds like to experiment with imaginary situations and have toys that are close companions. Non-toxic art supplies, pretend toys (such as play money, telephones), teddy bears or dolls, outdoor toys such as tricycles with approved helmets
- 5 to 9: Five- to 9-year-olds like to be challenged with complex games that teach specific skills and concepts. Arts and crafts kits, puppets, jump ropes, non-toxic art supplies, miniature dolls, and action figures
- 9 to 14: Nine- to 14-year-olds develop lifelong skills, hobbies, and enjoy team sports. Electronic games, board games, sports equipment, model kits, musical instruments
Safety Education Resources
Toy manufacturers must design and manufacture their products to meet regulations to prevent hazardous products from being sold. If a product causes a safety risk to children, however, a recall can be issued. Check the CPSC website for the latest information about toy recalls and please call the hotline number toll free at 800-638-CPSC (800-638-2772) to report a toy you believe is unsafe. Visit www.cpsc.gov to search toys under the recall list.
For more information, go to https://www.cpsc.gov/safety-education/safety-guides/toys#alerts.
Scott Harris, M.D.
State Health Officer
Commercial advertisements have helped familiarize the public with COPD, a term which refers to a group of diseases that cause airflow blockage and breathing-related problems. COPD includes emphysema; chronic bronchitis; and in some cases, asthma. November is National COPD Awareness Month, a time to learn about COPD symptoms and prevention.
The Centers for Disease Control and Prevention describes COPD as a condition in which less air flows through the airways—the tubes that carry air in and out of the lungs. In the early stages of COPD, there may be no symptoms, or only mild symptoms, such as:
- A nagging cough (often called “smoker’s cough”)
- Shortness of breath, especially with physical activity
- Wheezing (a whistling sound when breathing)
- Tightness in the chest
As the disease gets worse, symptoms may include:
- Having trouble catching your breath or talking
- Blue or gray lips and/or fingernails (a sign of low oxygen levels in the blood)
- Trouble with mental alertness
- A very fast heartbeat
- Swelling in the feet and ankles
- Weight loss
Most often, COPD is caused by smoking. Smoking accounts for as many as 8 out of 10 COPD-related deaths. However, as many as 1 out of 4 Americans with COPD never smoked cigarettes. Smoking during the childhood and teenage years can slow the way lungs grow and develop. This can increase the risk of developing COPD in adulthood.
How severe COPD symptoms become depend on the amount of damage to the lungs. If a person keeps smoking, the damage will worsen faster than if he or she stops smoking. Among 15 million U.S. adults with COPD, more than one-third (39 percent) continue to smoke.
The best way to prevent COPD is to never start smoking. Smokers should quit and avoid secondhand smoke. For those ready to quit, help is available at no charge. Alabama residents may call the Alabama Tobacco Quitline toll free at 1-800-QUIT-NOW (1-800-784-8669) or visit quitnowalabama.com. The Quitline provides free individualized coaching to help tobacco users quit. The Quitline also offers up to 8 weeks of free nicotine patches to those medically eligible and enrolled in the program. Services from the Quitline are available 7 days a week from 6 a.m. to midnight.
Even though there is no cure for COPD, lifestyle changes and treatments can help make breathing easier, allow for more activity, and slow the progress of disease.
Scott Harris, M.D.
State Health Officer
The Centers for Disease Control and Prevention estimates that nearly a quarter of a million children living in the United States have blood lead levels high enough to cause significant damage to their health. If high blood lead levels are not detected early, children can suffer from damage to the brain and nervous system and develop behavior and learning problems, slowed growth, hearing issues, and aggressive behavior patterns.
The Alabama Department of Public Health (ADPH) encourages parents to learn more about childhood lead poisoning prevention, especially during the week of October 20 through October 26, 2019, National Lead Poisoning Prevention Week.
According to the Environmental Protection Agency (EPA), lead is particularly dangerous to children because their growing bodies absorb more lead than adults, and their brains and nervous systems are more sensitive to the damaging effects of lead. Babies and young children are more likely to be exposed to lead because they often put their hands and other objects that can have lead from dust or soil on them into their mouths. Children may also be exposed to lead by eating and drinking food or water containing lead or from dishes or glasses that contain lead, inhaling lead dust from lead-based paint or lead-contaminated soil, or from playing with toys with lead paint.
In addition to eating and drinking food or water containing lead or using dishes or glasses that contain lead, the EPA warns that adults may also breathe lead dust by spending time in areas where lead-based paint is deteriorating, and during renovation or repair work that disturbs painted surfaces in older homes and buildings. Working in a job or engaging in hobbies where lead is used, such as making stained glass, can increase exposure as can certain folk remedies containing lead. A pregnant woman’s exposure to lead from these sources is of particular concern because it can result in exposure to her developing baby.
Fortunately, several services are made available to the families of children diagnosed with elevated blood lead levels in Alabama. The Alabama Childhood Lead Poisoning Prevention Program is the product of the collaborative efforts of the ADPH bureaus of Family Health Services and Environmental Services, the Centers for Disease Control and Prevention, and the Alabama Medicaid Agency. Its mission is to help every child in Alabama develop to his or her maximum potential and promote a healthy lifestyle and environment which will prevent further lead exposure. The program provides public outreach and education, case investigation, and case management services to help prevent further lead exposure in Alabama's children.
Simple steps like keeping your home clean and well-maintained will go a long way in preventing lead exposure. The EPA recommends the following steps to reduce the chances of exposure to lead in your home:
- Inspect and maintain all painted surfaces to prevent paint deterioration.
- Address water damage quickly and completely.
- Keep your home clean and dust-free.
- Clean around painted areas where friction can generate dust, such as doors, windows, and drawers. Wipe these areas with a wet sponge or rag to remove paint chips or dust.
- Use only cold water to prepare food and drinks.
- Flush water outlets used for drinking or food preparation.
- Clean debris out of outlet screens or faucet aerators on a regular basis.
- Wash children's hands, bottles, pacifiers, and toys often.
- Teach children to wipe and remove their shoes and wash hands after playing outdoors.
- Ensure that your family members eat well-balanced meals. Children with healthy low-fat diets high in calcium and iron absorb less lead.
- If you are having home renovation, repairs, or painting done, make sure your contractors are Lead-Safe Certified, and make sure they follow lead-safe work practices.
Scott Harris, M.D.
State Health Officer
Sepsis is a matter of life and death, and early detection can save lives. September is Sepsis Awareness Month, a time to learn about the risks and symptoms of sepsis. According to the Sepsis Alliance, more than one-third of adults in the United States have never heard of sepsis. Yet sepsis is the leading cause of death in U.S. hospitals, and 19 percent of people hospitalized with sepsis need to be re-hospitalized within 30 days.
Sepsis is the body’s overwhelming and life-threatening response to infection, which can lead to tissue damage, organ failure, and death. While sepsis strikes the sick, the well, and people of all ages, some groups are more likely to be affected. These include infants, adults age 65 or older, people with weakened immune systems, and those with chronic medical conditions such as diabetes, lung disease, cancer, and kidney disease.
The risk of sepsis can be reduced by preventing or quickly identifying and managing infections. This includes practicing good hygiene, staying current with vaccinations, and seeking treatment when infections are suspected. The most frequently identified germs that cause infections which can develop into sepsis include Staphylococcus aureus (staph), Escherichia coli ( E. coli), and some types of Streptococcus.
Symptoms can include a combination of any of the following:
- Confusion or disorientation
- Shortness of breath
- High heart rate
- Fever, shivering, or feeling very cold
- Extreme pain or discomfort
- Clammy or sweaty skin
Doctors diagnose sepsis using physical findings such as:
- Low blood pressure
- Increased heart rate
- Difficulty breathing
Doctors also perform laboratory tests that check for signs of infection or organ damage.
Many individuals fully recover from sepsis, while others may have long-lasting effects, such as amputations or organ dysfunction like kidney failure. Other after-effects of sepsis are less obvious, such as memory loss, anxiety, or depression.
Sepsis is a medical emergency that requires urgent attention and rapid treatment for survival. If you have an infection that is not getting better or is worsening, see your medical professional immediately, call 911, or go to a hospital with an advocate and express your concern about sepsis.
Sepsis cannot always be prevented, but by knowing the sepsis risk factors and symptoms, you can help reduce your chances of developing sepsis. Sepsis can be treated, and lives can be saved by using existing and proven protocols.
To find out more, please visit cdc.gov/sepsis.
Scott Harris, M.D.
State Health Officer
Vaccines have greatly reduced or eliminated many infectious diseases that once routinely killed or harmed infants, children, and adults. The Centers for Disease Control and Prevention (CDC) cautions us that the viruses and bacteria that cause these diseases still exist and you can still get these diseases if you are not vaccinated. During August, National Immunization Awareness Month, the Alabama Department of Public Health (ADPH), reminds people of all ages how important immunizations are for adults, as well as children.
Every year thousands of adults become seriously ill and are hospitalized because of diseases that vaccines can help prevent. Many adults even die from these diseases. By getting vaccinated, you can help protect yourself from much of this unnecessary suffering.
Even if you received the vaccines you needed as a child, the protection from some vaccines can diminish. As we get older, our immune systems tend to weaken over time, putting us at higher risk for certain diseases. You may also be at risk for other diseases due to your job, lifestyle, travel, or health conditions. CDC and ADPH have information to help you learn what vaccines you may need based on different risk factors. Talk with your healthcare provider about the vaccines you should safely receive based on your health or other conditions.
Vaccines are tested and monitored. Vaccines go through years of testing before the Food and Drug Administration (FDA) licenses them for use. Both the CDC and the FDA continue to track the safety of all licensed vaccines. Any vaccine side effects are usually mild and go away in a few days. The most common side effects include soreness, redness, or swelling where the shot was given. Severe side effects are very rare. CDC notes the benefits of vaccines for adults:
Vaccines can lower your chance of getting certain diseases.
Vaccines work with your body’s natural defenses to help you safely develop immunity to disease. This lowers your chances of getting certain diseases and suffering from their complications. For instance:
- Hepatitis B vaccine lowers your risk of liver cancer.
- HPV vaccine lowers your risk of cervical, oral, anal, penile, throat, and head cancers.
- Flu vaccine lowers your risk of flu-related heart attacks or other flu-related complications from existing health conditions like diabetes and chronic lung disease.
Vaccines lower your chance of spreading disease.
- Some people in your family or community may not be able to get certain vaccines due to their age or health condition. They rely on you to help prevent the spread of disease.
- Infants, older adults, and people with weakened immune systems (like those undergoing cancer treatment) are especially vulnerable to infectious disease. For example, newborn babies are too young to be vaccinated against whooping cough. Unfortunately, whooping cough can be very dangerous or even deadly for them. Pregnant women should get the Tdap vaccine during every pregnancy to help protect their babies from whooping cough. Anyone who is around babies should be up to date with their whooping cough vaccine.
Another reason to be vaccinated is that adults with multiple responsibilities and busy lives cannot afford to get sick. Vaccines can help you stay healthy, so you do not miss work and will give you more time for other pursuits.
Make an appointment with your healthcare provider today to have the best possible protection against a number of serious diseases. If you do not have a provider currently, please to go ADPH’s Adult Immunization Provider website, alabamapublichealth.gov/immunization/adult-immunization-providers.html, to locate someone locally who can determine if you need to be vaccinated. In addition, ADPH’s Immunization Division website contains a wealth of immunization resources for children and adults, including recommended vaccines for back to school and links to the recommended vaccines for 2019. Go to alabamapublichealth.gov/immunization for additional information.
Scott Harris, M.D.
State Health Officer
Page last updated: February 28, 2020