Tag Archives: Healthcare

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The blessing and burden of caregiving

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Beyond the breathless years of raising “typical” children, many of us find ourselves again in caregiving roles.

What do we do when those we love won’t die, grow up or leave and we must care for them? Some of us see caring for another as a burden; others see it as a blessing. Often, it’s both.

The attitude one takes may be culturally influenced.

Living in Tanzania, I found older people there to be universally revered. The idea of putting a parent in a skilled nursing home was foreign to Tanzanians — there aren’t any! Elders are the leaders of the family and the village. In America, my adult son’s Asian and Indian friends share similar sentiments.

On the other hand, I remember a participant’s perspective in the “A Year to Live” group that I facilitated. She was adamant about not wanting to become a burden to her family so was considering some sort of “Death with Dignity” or “Medical Aid in Dying” strategy to assist her at the end of her life.

Her son, a family practice physician, heartfully heard her wishes. He asked her to consider, though, all that they, her children, might learn by being able to care for her during her final days. He felt it would be such an honor and privilege. She had never thought of that and reconsidered her options.

Caregiving is hard work. It can be torturous, tenuous and tender — simultaneously. For any of us, especially providers who do it for a living, coming home and doing it some more can be exhausting and dispiriting; it may seem like a terminal sentence. Caregiving impacts our well-being — in positive ways, too!

Our roles change. A child becomes the parent, a friend becomes the patient. I remember how difficult it was for my mother, while in the hospital years ago, to ask me to help with her hygiene.

And, the same for my best friend to request that I sit with her while she bathed during her final weeks in case she fell again. Both experiences humbled me; I remain grateful to this day to have shared such intimacy.

Whatever your situation, determine first and foremost what is most important to your loved one and then develop a plan of care that reflects their goals — for now and for the future.

For you, the caregiver, I encourage three things:

Take care of yourself.

You must. I read of a woman with 12 children. From 1-3 p.m. daily, she religiously retired to her bedroom to take time for herself.

She wasn’t rich; this mother just knew she must stop to continue consciously caregiving. The family figured out a way to carry on during those two critical hours.

Strive to be clear in your communications.

It helps to start by acknowledging the feelings and needs of all parties.

Ira Byok, M.D., in his classic book, “Dying Well,” summarizes the developmental stages of dying — which are key for communicating closure:

“Please forgive me.”

“I forgive you.”

“Thank you.”

“I love you.”

“Goodbye.”

Rally support!

It may seem easier if you have money to spare; if you’re on a limited budget, though, there are resources to be had — for free. The biggest stretch is often recognizing that you cannot do it alone anymore and reaching out. People and organizations are here to help you.

Ultimately, when all is said and done, our experience as caregivers has the potential to change the way we, ourselves, choose to live and die. We’ve had the good (albeit difficult at times) fortune of a dress rehearsal. Take heed!

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Podcast: The 7 most dangerous words in healthcare

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This podcast originally appeared on NurseKeith.com.

Podcast: Click here to play.

What are the seven most dangerous words in healthcare? In my universe, those seven words are “that’s the way we’ve always done it.”

Highlights and questions from this episode:

  • Where do our habits and beliefs come from?
  • How do we so easily get bogged down in feeling right rather than listening and evaluating?
  • Resistance to change can be like an infectious disease.
  • Who are the people who resist change? They’re the ones who generally aren’t natural intrapreneurs or leaders. They’re more likely to be the people who just do their work and go home, with little investment in their careers or jobs — they’re mostly in it simply for the paycheck. Such individuals may also be fearful of technology, which one would think is a stark difference between generations, but that’s not always the case — resistance can come from any nurse from any generation.
  • What do we resist? New ways of doing things that take us out of our comfort zone; things that go against our natural modus operandi; new tech that feels scary or hard to learn; change for change’s sake and arbitrary change with no evidence base.
  • We may also resist new leadership styles; new policies and procedures; new staff members and colleagues; novice colleagues; residents and interns; and any changes to our workflow and the way we’re used to doing things.
  • What changes around us? Economics; research; technology; medications and treatments; diagnoses; mergers and acquisitions; unions or the lack thereof; staffing practices.
  • I mentioned the Tenet nurse strikes in three states in September 2019.
  • How do we open ourselves and our colleagues to change? Use our critical thinking; assess before reacting; talk about the pros and cons; ignore the naysayers who say no just for the sake of saying no.

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Deadliest, most common cancers get the least attention

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Cancer is one of the top five leading causes of death in the U.S. The American Cancer Society estimates 1.7 million new cases will be diagnosed and more than 600,000 people will die of the disease in 2019.

Americans across the nation are responding to these alarming numbers, but the public and the federal government are focusing their concerns — and donations — on cancers getting the most publicity, not the ones killing the most people.

For example, breast cancer organizations in 2015 received more than $460 million in donations, according to a 2015 study in the Journal of the National Comprehensive Cancer Network. Meanwhile, charities that raise funds for lung cancer, which kills more people in the U.S. than breast cancer, received $92 million that same year.

That’s why it’s important for you to start learning about the deadliest cancers, so you can make a more informed decision when it comes to choosing which cancer organizations you will financially support.

Breast Cancer Tops List of Most Worrisome Cancers

After surveying 1,000 Americans, The Mesothelioma Center at Asbestos.com found the majority of respondents are most concerned about breast cancer. Based on the amount of media attention breast cancer receives every year, it makes sense that Americans are more aware of breast cancer than any other type of cancer.

Breast cancer is one of the most publicized types of cancer; it’s also the second most frequently diagnosed cancer in the U.S., with a total of 271,270 estimated new cases in 2019. This may help explain why it’s one of the most widely known cancers among Americans.

After breast cancer, Americans are most concerned about prostate and colon cancer. Prostate cancer is the second leading cause of cancer death in men, with an estimated 164,690 new cases in 2019. Colon cancer comes is third, and it’s among the most common types of cancers, with an estimated 145,600 yearly cases in 2019.

Lung cancer, the second most common type of cancer, has an estimated 228,150 new cases in 2019, and pancreatic cancer has an estimated 56,770 new cases in 2019.

We also found that gender plays a significant role in which cancers concern Americans most. According to our survey, men are most concerned with prostate cancer, whereas women claimed to be most concerned with breast cancer.

Interestingly, only 15% of men and women claimed they were most concerned about lung cancer.

Americans’ Cancer Concerns Misaligned with Mortality Rates

What types of cancer are the deadliest? According to the American Cancer Society, lung cancer — and lung cancer caused by asbestos — is the number one killer, with 142,670 estimated deaths in 2019 alone, making it three times deadlier than breast cancer. Despite this, only 14% of respondents said they were most concerned about lung cancer.

The second and third deadliest cancers are colorectal cancer and pancreatic cancer, respectively. Breast cancer, which will claim an estimated 42,260 lives in 2019, is the fourth deadliest.

According to these figures, breast cancer, which has a much smaller mortality rate compared to lung or colon cancer, is the one Americans fear and support the most.

Lung Cancer: Deadliest and Least Funded

Which cancer charities and foundations secure the most funding?

It’s difficult to track exactly how much money charities accrue annually from donations and grants because there are so many organizations that raise money for every type of cancer.

For example, Reuters covered a similar survey that analyzed the annual revenue of 119 cancer organizations, totaling $5.98 billion. More than three-quarters of that income went to general cancer charities that don’t focus on a specific type of disease.

To get a broader sense of which cancer organizations rack up the most donations, we researched the most funded charities for each type of cancer according to Charity Navigator, the largest charity evaluator in the U.S. with data on over 1.8 million nonprofits.

According to Charity Navigator, the following charities are the most funded for each type of cancer:

  • Breast Cancer Awareness Foundation: $78,996,006
  • The Prostate Cancer Foundation: $43,283,262
  • The Pancreatic Cancer Action Network: $32,849,702
  • The Colorectal Cancer Alliance: $8,640,005
  • Lung Cancer Research Foundation: $4,633,495

On a federal level, cancers that affect Americans the most have less funding allocated toward research than other types of cancers. For example, lung cancer — the deadliest cancer to date — receives less funding per death than prostate, colon, pancreatic and breast cancer combined.

Based on these figures, the most common types of cancers receive ample funding and media attention, but there are many other cancers that don’t. For example, mesothelioma has approximately 3,000 diagnosed cases per year.

As an asbestos-related cancer, mesothelioma patients have an average life expectancy of 12 to 22 months after diagnosis, yet it receives a lot less funding than other types of cancer.

While it’s great to support any type of cancer, consider contributing to underfunded cancer charities to potentially save a life or help further breakthroughs in treatments and research. If you’re interested in finding a new cancer charity to donate your money, start by researching which types of cancers are the most underfunded.

From there, you can explore the types of initiatives the organizations offer and how much of their annual donations, gifts and grants are allocated for research. You’ll be glad to know your money is being used wisely.

Methodology:
This study consisted of one survey question conducted using Google Surveys. The sample consisted of no less than 1,000 completed responses. Post-stratification weighting has been applied to ensure an accurate and reliable representation of the total population. The survey ran during August 2019.

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Infographic: Is nanotechnology the future of medicine?

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Nanotechnology has been used in medicine since 2001, but it’s now being developed into something bigger. Ingestible capsules containing sensors, cameras, and more are already changing the face of medicine. By 2024, the global market for nanotech will exceed $125 billion.

However, there are some ethical concerns about this futuristic field, and public sentiment is currently mixed regarding nanotech. This infographic outlines the advances in medical nanotechnology as well as where the industry is headed.

Infographic courtesy NowSourcing

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New protocol triples storage time for donated livers

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A three-step approach to the organ preservation process promises to help physicians store donated livers for hours longer than before. To this point, donated livers must be transplanted within nine hours of harvest. A varied protocol means livers may be viable for up to 27 hours.

Researchers at Massachusetts General Hospital and Harvard University experimented with ways to preserve livers longer by avoiding ice nucleation.

In previous studies, rat livers were preserved using a supercooling method that included a modified glucose compound. The combination prevented ice crystals from growing on the livers.

However, when the process was replicated for human livers, it didn’t work. Since human livers are 200 times larger, the risk of heterogenous ice nucleation increased significantly. If ice grows on the organ, it cannot be used as a transplant.

“Delivering viable organs to matching recipients within the window of viability can often be the most challenging aspect of organ transplantation,” said Seila Selimovic, Ph.D., director of National Institute of Biomedical Imaging and Bioengineering’s Engineered Tissues program. “By giving doctors and patients more time, this research could someday affect thousands of patients who are waiting for liver transplants.”

In the most recent study, published in the journal Nature in September 2019, researchers took a three-pronged approach to the problem. The first step was to prevent the storage solution from coming into contact with air.

Exposure to air greatly increases the chance of ice crystal formation. Therefore, the team removed air from the storage solution bag prior to supercooling a liver.

Next, two ingredients were added to the storage solution. Trehalose and glycerol protect and stabilize cell structure while also supporting the preservative properties of the other solution ingredients. Both additives have been used to cryogenically preserve cells in a lab setting but had not been used to preserve organs for transplant.

Finally, the team used machine perfusion to deliver the preservation solution to the liver. In the previous method, the solution is manually flushed through the liver tissue. Since the new solution is thicker, it can damage the cells lining the liver’s blood vessels.

Machine perfusion delivers oxygen and nutrients to tissue capillaries while they’re located outside the body. Researchers slowly lowered the temperature of the liver while increasing the concentration of the solution. This approach allowed the liver tissue to adjust and the solution to distribute more evenly throughout the organ.

“With supercooling, as the volume increases it becomes exponentially more difficult to prevent ice formation at sub-zero temperatures,” said Dr. Reinier de Vries, a research fellow in surgery who worked on the study. “Before, there were a lot of experts who said, ‘well this is amazing in small rats, but it will not work in human organs,’ and now we have successfully scaled it up 200 times from rat to human livers using a combination of technologies.”

A human liver treated in this manner has not been implanted, but this process will not negatively impact the organ.

“This new liver preservation method exemplifies National Institutes of Health’s goal to foster the discovery and translation of innovative ideas,” said Dr. Averell H. Sherker, NIDDK program director for liver diseases. “With further research, organs will be able to travel greater distances and benefit the most critically ill patients requiring liver transplantation.”

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5 ways to improve your pediatric patients’ hospital experience

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As a hospital administrator, you know your pediatric patients have much different emotional and physical needs than their adult counterparts. But even though you think you’re working effectively to address those needs, you may miss the mark.

It’s key to encourage kids and their families to express what they want and need from your staff during a hospital stay — but it’s also key to anticipate what they will make them feel comfortable, too. Use this research-driven advice to ace the task and earn high patient satisfaction marks.

Know what your pediatric patients fear.

A hospital stay is scary for a child, and new research from lead study author Mandie Foster at Edith Cowan University finds that hospitalized kids most want to feel safe and be able to get to sleep at night.

Constant verbal reassurance from your nursing staff is job No. 1, as is making your young charges’ rooms feel as comfortable as possible. Make sure nurses ask kids what feels scary in their room, so it can be removed or changed.

Also, simple things like leaving on a light when a child fears the dark makes a huge difference, as is providing a new stuffed animal as a gift right before bedtime.

Reevaluate night staffing levels.

Research from a team led by Katherine Fullerton and published by the Society for Academic Emergency Medicine found that kids with suspected appendicitis get better daytime care because lower staffing levels often caused these patients to not get a CT scan for diagnostic confirmation at night.

Make certain you have sufficient overnight technician/radiology support to avoid this concern, which parents may quickly voice.

Be a wish-granter.

Researcher Anup Patel from Nationwide Children’s Hospital reports that kids with a progressive, long-term or critical illness who get a wish — anything from a new puppy to a dream family vacation — are 2.5 times more likely to have fewer unplanned hospital admissions and are 1.9 times less likely to visit the ER.

Work with wish-granting organizations to help your regular peds patients feel better emotionally and hopefully avoid readmissions significantly.

Ask your peds parents what they need on a constant and progressive basis.

A Boston Children’s Hospital study found that the most important issues to parents of hospitalized kids were full communication about condition and paying attention to their kids’ pain.

It’s absolutely crucial to assign a medical team member to be a family’s point person, who can take the initiative when it comes to clear, frequent medical updates and check comfort levels on a constant basis.

Be fun.

Kids need distractions and smiles when they’re in the hospital. Stopping in to your peds patients’ rooms with a joke or treat each day is an easy way to make them feel happy when they are experiencing perhaps the most stressful time of their young lives.

Your staff should continually offer positive words, warmth and kindness — those are incredibly valuable tools in terms of satisfaction and a speedy recovery!

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Cafeteria plan benefits: A primer for employers

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As employee benefits continue their upward trend, the need for cafeteria plans is more urgent than ever.

According to a 2019 survey by the Society for Human Resource Management, “employers were more likely to increase offerings in all benefits categories than to decrease offerings.” Further, employers believe that healthcare benefits are the most important to their workforce.

However, healthcare benefits have a long-standing reputation for being expensive. To alleviate the cost burden for employees, in 1978, the U.S. Congress created Section 125 of the Internal Revenue Code. Benefit plans established under Code Section 125 are known as cafeteria — or Section 125 — plans.

How Cafeteria Plans Work

A cafeteria plan enables employees to pay for qualified benefits, such as group health insurance, on a pretax basis.

Paying for benefits with pretax dollars means that the benefits are withheld from the employee’s wages before taxes are taken out — thereby lowering the employee’s and employer’s tax liability. In order to deliver benefits on a pretax basis, the cafeteria plan must meet the conditions of Code Section 125.

Key Legal Requirements

  • The cafeteria plan must maintain a written plan document that includes a description of benefits provided under the plan, eligibility requirements, how elections can be made, employer contribution guidelines, and the plan year.
  • Only common-law employees can participate in the plan on a pretax basis.
  • Elections normally cannot be revoked or modified during the plan year — unless the change is permitted under Internal Revenue Service (IRS) rules, such as a change in marital status.
  • The plan must offer employees a choice between at least one taxable benefit (e.g., cash in the form of wages) and at least one qualified nontaxable benefit.
  • Typically, the plan must pass certain tests — including an eligibility test and a key employee concentration test — to ensure it does not discriminate in favor of highly compensated employees. Small employers, however, can adopt a “simple cafeteria plan,” which is treated as satisfying nondiscrimination rules so long as eligibility, participation, and minimum contribution requirements are met.

Some states have adopted cafeteria plan laws as part of their healthcare reform. So, consult state law for standards that may apply to your business.

Permitted Benefits

Only “qualified benefits” — as defined by law — are allowed in a cafeteria plan. They include:

  • Group health plans
  • Dental and vision plans
  • Group-term life insurance
  • Disability insurance
  • Adoption assistance
  • Dependent care assistance
  • Health savings accounts
  • Health flexible spending accounts
  • Health reimbursement arrangements
  • Accidental death and dismemberment coverage
  • 401(k) deferrals
  • Cash or other taxable benefits

Benefits that cannot be provided through a cafeteria plan include educational assistance and transportation (commuting) benefits.

Tax Advantages and Implications

Most benefits offered under a cafeteria plan are excluded from federal income tax, Social Security tax, Medicare tax, and federal unemployment (FUTA) tax. But there are exceptions:

  • Group-term life insurance coverage over $50,000 is subject to Social Security and Medicare taxes, but not federal income tax withholding or FUTA tax.
  • Adoption assistance benefits and 401(k) deferrals are subject to Social Security tax, Medicare tax, and FUTA tax, but not federal income tax withholding.
  • Some benefits, such as dependent care assistance, have a yearly pretax contribution cap. Anything over the annual limit is taxable.

If a benefit is not taxable, it should be subtracted from the employee’s gross wages before the respective taxes are withheld.

This process lowers the employee’s taxable wages and tax liability plus your share of applicable taxes. If the benefit is taxable, it should be subtracted after taxes are withheld. This process does not reduce taxable wages or tax liability.

Cafeteria plan benefits are often excluded from state and local payroll taxes. But not all states and localities are on-board with this exclusion. For example, in New Jersey, cafeteria plan benefits are generally subject to state income tax.

Check with your state or local taxation agency to determine whether cafeteria plan benefits should be deducted before or after withholding state or local taxes.

Laws Impacting Cafeteria Plans

Along with obeying Code Section 125, a cafeteria plan may need to comply with:

  • The Employee Retirement Income Security Act (ERISA)
  • The Affordable Care Act (ACA)
  • The Consolidated Omnibus Budget Reconciliation Act (COBRA)
  • The Health Insurance Portability and Accountability Act (HIPAA)
  • The Genetic Information Nondiscrimination Act (GINA)
  • Federal and state discrimination laws
  • Federal and state wage and hour laws
  • IRS reporting rules

Conclusion

Cafeteria plans can be quite challenging to design, establish, administer and maintain. They also cost money to set up. But for many employers, these inconveniences are offset by tax savings plus a competitive edge that strengthens talent attraction and retention.

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Soulfully preparing for the end of life

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These past few months I’ve been on a mission. Throwing caution to the wind, I moved out of state temporarily to be near Mom to set her up to “age in place.” Amidst the plethora of preparations, we’ve shared many soulful moments.

What began as an odyssey is ending with an opus. Before launching into all her current and possible future arrangements (financial, legal, transportation, caregiving, home, household help, medical, family, etc.), it was important for us to sit down and talk. Heartfully and honestly talk — as if our lives depended on it. Because, they did.

The “Talk”

We prayed and cried before we spoke, surprising us both. Yet, deep inside we must have known that the outcome of this conversation would determine both our futures.

Mom was adamant, “I am not moving.” It didn’t matter that she would be living on a limited budget with no family available, she was not budging.

We honed in on how she wanted to spend her time — what was of highest value to her. How we would ensure that her priorities were part of her everyday life.

And, we reviewed her desires and details for her death.

Mom, nearing 90 years old, is smart as a whip and totally cognizant. She is fully capable of making her own decisions. So, regardless of my preferences, I was hell-bent on respecting her wishes as we created her plan of care.

Shared Experiences

While it’s been a lot of work for both of us, we’ve shared precious, poignant experiences we never would have had I not shown up.

We’ve enjoyed concerts, old movies and gardens together. I’ve watched Mom come alive, calling her a “perky little puppy” on my most recent birthday. She stood straight up, walked without her cane and wore the cutest shoes with bows on top — for a few hours anyway.

I’ve seen her transfigured: radiant —beatific even — as she received communion at Mass.

When one of my childhood friends came for a visit, Mom became a giggly girl again, laughing over lunch about all our teenage antics.

We’ve relied on each other for moral support during family reunions and ruckuses with our relatives.

There have been teary times, too. Mom reminiscing, doing her life review with me via albums, audio tapes and stories. Leave-taking. Closing gestalts.

Postmortem Message

Mom says it’s important to leave something personal behind, more than memories and mementos. Perhaps a hand-written letter, a recording or a video speaking specifically to your loved ones. Maybe consider an ethical will, meant to pass on your values, your legacy.

Ironically, it’s me who will be doing the leave-taking first. Soon, I’m headed home, returning to my affairs, my life. We both know, only too well, that Mom may not be here when I plan to come back for her birthday in the spring.

We accomplished what we set out to do — she has an opus of a care plan now. Yet, just showing up — being present with my mother — has been the greatest reward of this odyssey.

The “talk,” the shared experiences and listening to Mom’s personal audio postmortem message with her while she is still alive are what my soul will treasure long after she’s gone.

We are put on earth for a little space that we might learn to bear the beams of love.
— William Blake

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Study: ED patients report less rest than hospital inpatients

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A new study published in the Emergency Medicine Journal has confirmed what anyone who’s ever spent time in a hospital emergency department already knows: ED patients don’t rest as well as inpatients.

Researchers surveyed 49 ED patients who were awaiting an inpatient bed and 44 people who had already been admitted to an inpatient unit.

During the survey, patients described noise levels and rated the quality of their sleep using the Richards-Campbell Sleep Questionnaire. That is, patients ranked their sleep quality on a 1-100 scale, with 1 being the worst and 100 the best.

Questions focused on:

  • How lightly or deeply they slept;
  • How easily they fell asleep;
  • How often they awoke during the night;
  • How easily they returned to sleep when they did wake up; and
  • If they thought they had a good or bad night’s sleep.

The research team factored in patient characteristics that could affect sleep such as their age and the acuity of their illness or injury. Even after accounting for these factors, the team found patients in inpatient rooms rated their sleep environment as 65% quieter than patients in the ED.

Patients in the ED also said their sleep was significantly worse across all five aspects of sleep quality. Patients with cognitive impairments, those who were incapacitated or had used alcohol or drugs in the previous 24 hours were excluded.

“Often in my experience, patients react with dread at the idea of spending a night in the noisy ER — bad enough you are unwell, and been told you need to stay in hospital, without then having to stay in the sleepless ER for the night,” said Dr. Richard Prendiville, the lead study author and a researcher at National University of Ireland in Galway.

“Hopefully the finding will show hospitals that ER patients sleep measurably worse, and that this needs to be addressed,” Prendiville was quoted as saying in Reuters Physicians Weekly.

A key difference was the age of patients in the study. Half of those who stayed in the ED were 60 years or older. Patients given inpatient rooms had a median age of 47.

ED patients were also more gravely ill. About three quarters were identified as the most seriously ill and injured patients upon arrival. Slightly less than half of inpatients were considered to be the most seriously ill.

The study wasn’t a perfect experience. First, it wasn’t controlled so it couldn’t prove that staying in the ED or transferring to an inpatient bed directly improved sleep or health. The study also didn’t factor in the effect of pain and the use of painkillers on sleep quality.

Even so, adequate sleep is vital to people who are sick, injured or recovering from a surgery or illness.

“Insufficient sleep causes stress…which increases sleepiness during the day and may limit mobility,” Nanayakkara said. “This will cause loss of function especially in the elderly and can also cause delirium with and negatively impact general wellbeing.”

The study was conducted at the University College Hospital in Galway, Ireland, in October and November 2016.

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Study: Air pollution particulates can even harm unborn children

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It turns out that air pollution is worse on us than we may have previously known, especially for those not yet born. According to the findings of a new study, pollution can be so pervasive that it can penetrate a pregnant woman’s placenta and may threaten the health of a developing fetus.

The study reviewed and analyzed high-resolution images taken of placenta tissue retrieved from 28 women who had given birth at East-Limburg Hospital in Genk, Belgium. Of these, five gave birth prematurely. The remainder carried their babies to term. In either case, placenta tissue was retrieved within 10 minutes after each child’s delivery.

The research team found black carbon particles produced by fossil fuel combustion in the placenta of all the participating mothers. The mothers studied who were living in relatively polluted areas showed much higher levels of carbon particulates in the placenta than those from less polluted areas.

This first-of-its-kind study shows that pollution particles can reach the fetal side of the placenta, said study author Hannelore Bove, a postdoctoral researcher with the Centre for Environmental Sciences and Biomedical Research Institute at Hasselt University in Diepenbeek, Belgium.

Whether those particles harm fetal development is not yet clear, but one might think any outside environmental pollutant entering a woman’s placenta is not a good thing.

The study set out to determine whether pollution was present in the placenta. What’s the takeaway? That the placenta is not entirely protected from the outside world.

“This matches previous findings and proves that more than was previously thought can cross the placenta,” said Bove.

In the 1960s, the so-called thalidomide crisis first showed us this, she said. The sleeping pill drug’s ingredients were in the placenta in pregnant women, triggering birth defects.

Since then, other substances, including alcohol, drugs and now fossil fuel pollution, were found to cross over. “Black carbon particles are thought to be especially toxic since they can absorb toxic compounds like heavy metals and benzene,” said Bove.

These cancer-causing agents can mix with the oxygen and nutrients that feed a developing fetus.

What can be done to avoid pollution? Not much, researchers said.

However, air pollution’s impacts don’t stop there. In a separate, unrelated study by researchers from Monash University in Australia, exposure to toxic air pollutants showed a link to increased cardiovascular and respiratory death rates.

The study, led by Dr. Haidong Kan from Fudan University in China, analyzed air pollution and mortality data collected from 652 cities in 24 countries and found increases in total deaths linked to exposure to inhalable particles and fine particles.

Published in the New England Journal of Medicine, the international study investigated the short-term impacts of air pollution on death, conducted over 30 years.

Associate Professor Yuming Guo from Monash University’s School of Public Health and Preventive Medicine in Australia said there’s no threshold between particulate matter and mortality, but that even low levels of air pollution can increase the risk of death.

“The adverse health effects of short-term exposure to air pollution have been well documented, and known to raise public health concerns of its toxicity and widespread exposure,” Professor Guo said. “The smaller the airborne particles, the more easily they can penetrate deep into the lungs and absorb more toxic components causing death.”

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