Bike lanes and paths make biking easier and safer.

“My life is too busy!”

“I just don’t have time!”

Ever heard these reasons for not exercising regularly—or have you even said them yourself? Many of us live busy lives with multiple responsibilities at work, home, school, and elsewhere. But would improving your health or saving your life be reason enough to figure out some way to add exercise to your life?

Regular physical activity can prevent many of the leading causes of death and disability, but too few people exercise regularly. Walking and biking are good ways to add regular exercise to your life. But you may still wonder how you can find time. What if I told you that you can incorporate physical activity into your life as part of your daily routine? How about walking or biking to work or to run errands?

If walking or biking as part of a daily commute is possible for many, then why are more people not doing it? The answer is clear: along many city routes, biking is not only difficult, but also dangerous. Motor vehicle fatalities are a leading cause of death, but per mile traveled, bicyclists are at even higher risk for injuries and fatalities than drivers.

Even for short trips, many people feel that concern for personal safety outweighs the health benefits of bicycling to work and other places. But well-designed infrastructure such as bike lanes and paths can relieve that concern and remove the barrier to bicycling as a regular means of transportation and daily exercise.

As a public health physician, I am committed to exercising. Other than bicycling, my choices for exercise are running or going to the gym, but these require an investment of time on a regular basis. Yes, it takes me 10 minutes longer to bike to work rather than driving, but I can get exercise and travel at the same time. Yes, the risk of injury is real. But biking to work is a great way to squeeze in regular exercise among job, volunteer, and family commitments.

Biking can also be about economics. That was my primary reason for riding in medical school when I was spending a fortune on tuition. I started riding my bike regularly rather than take on the financial burden of a car. I continued this practice through residency and my state-based public health training. Both of my primary work sites were on a major bike path and parking a car was expensive, so riding made even more sense.

Arthur Wendel and his son biking together.

My biking habit in Atlanta, my current home, is more challenging. While there are certainly some great places for recreational riding and the promise of better infrastructure in the future, my 5-mile commute to work is not the best environment for riding. Through trial-and-error, I have adjusted routes and times of travel to avoid hazards; yet many are unavoidable.

Despite the risks, I still enjoy riding, especially at this time of year when everything is blooming. My favorite part of the commute is starting the morning off riding with my son through our neighborhood to his school. I’m grateful for our time together and the opportunity for him to get some physical activity to help him concentrate better during the day.

I’ll be biking to work for Bike to Work Week on May 13-17. I encourage anyone with a reasonable commute to dust off that bike stashed in a garage or storage space and give it a shot. If it seems too dangerous, go for a ride in your neighborhood, or, at a minimum, think about what it would take to make a bicycle commute realistic for you—even if it is to the local coffee shop. Check out your local bicycling coalition Web sites; they may have route maps and tips for a safer commute.

My hope is that my son will grow up in a world that increasingly recognizes the important relationship between safety and physical activity, and creates environments where he can go for a walk or ride a bicycle to places without fear of injury. Participating in Bike to Work week is one small step to help increase this recognition.

New York, N.Y., September 17, 2001 -- FEMA Urban Search and Rescue teams work to clear rubble and search for survivors at the World Trade Center. Photo by Andrea Booher/ FEMA News Photo

On September 11, 2001, people around the world watched as the two towers of the New York City World Trade Center (WTC) fell to the ground. Dense clouds of smoke and dust rose into the air. While the streets filled with people escaping the burning buildings, emergency responders charged into the darkness with little thought for their own safety.

In the following days, police, firefighters, and emergency medical technicians (EMTs) continued to search for survivors. Construction and sanitation workers joined them to clean up the six-story pile of debris that burned for more than 3 months.

Because the attack was unexpected, many rescue and recovery workers had no time to find respiratory protective equipment (RPE) needed to keep them from inhaling dust and smoke. RPE can range from dust masks to respirators that cover the face and help people breathe. Even in the months following the disaster, many workers did not protect themselves from toxic substances coming from the debris pile.

Dr. Antao and his colleagues wanted to see if using dust masks and respirators protected rescue and recovery workers from breathing problems, and, if so, how effectively. They used the World Trade Center Health Registry to study the health of these 9/11 workers.

Firefighter wearing respirator

Their study, published in the American Journal of Industrial Medicine, was the first to look at the use and fit of respiratory protective devices for workers on the WTC debris pile. The study shows that during the first day of response, half of the workers wore no respiratory protection at all, and about a third wore only disposable masks. Beginning in 2002, however, half of responders wore protective respirators most of the time.

In general, survey results showed that workers who used respirators had a lower chance of developing breathing problems and disease, and that workers who were trained were the most likely to use them. The study also showed that surgical or nuisance dust masks gave workers almost no protection at all.

The study has meaning beyond the WTC disaster. It advises all local, state, and national emergency programs to keep a supply of respirators on hand and to train responders to fit, use, and care for them. It also recommends that emergency managers require workers to use them in all disaster responses.

Antao says, “Being ready to protect the health of the emergency responders who risk their lives safeguarding the health and safety of others is an essential part of preparedness. Using well-fitted respirators is one of the best ways to do this.”

For more detailed information, please see the ATSDR feature Respirators Protect Health in WTC Emergency Response.

You can also view the study at http://onlinelibrary.wiley.com/doi/10.1002/ajim.21009/full

Work in NCEH’s Tobacco Laboratory Helps Reduce Exposure to Secondhand Smoke

If you saw a cloud of smoke that you knew contained more than 4,000 chemical components, of which at least 250 caused cancer, then you’d run for cover and seek cleaner air. This is the case each time you’re near someone who smokes a cigarette, cigar, or pipe.

Exposure to secondhand smoke causes 3,400 deaths a year due to lung cancer. The toxic cloud also has immediate effects on your cardiovascular system and can cause heart attack and stroke.

At NCEH, we have a tobacco laboratory where research focuses on five areas:

• tobacco product design and content
• tobacco smoke and other emissions
• tobacco product use
• tobacco markers in the body
• future tobacco research

Lanqing Wang, a research chemist in NCEH’s Tobacco Laboratory, says researchers in the laboratory measure the toxic and addictive substances in tobacco products, smoke, smokers, and nonsmokers. Wang explains that workers in the laboratory examine the inside and outside of a cigarette. In the laboratory, cigarettes are inserted in smoking machines. Workers use the machines to collect data on the particulate matter and gases the cigarette releases.

Secondhand smoke comes from two sources. It includes the smoke that is released when the tobacco product is burned and the smoke that a smoker exhales.

When a nonsmoker comes in contact with secondhand smoke, the negative health effects are about the same as for the smoker. The nonsmoker’s body breaks down the chemicals in the smoke. One of the byproducts produced during the process is cotinine.

Back in the early 1990s, NCEH’s Tobacco Laboratory developed a method for measuring levels of cotinine in a person’s bloodstream. The measurement was used as an indicator of the risks for a smoker and a nonsmoker who is exposed to secondhand smoke. “Our laboratory is probably the only one of its kind that can measure toxic substances from different sources, such as the blood, urine, and saliva,” Wang says.

NCEH Tobacco Laboratory data showed 88% of nonsmokers in the United States were exposed to secondhand smoke and, therefore, its negative health effects. State and local governments used these data to argue for outlawing smoking in public buildings. In some cities, legislation has been expanded to ban smoking in parks, restaurants, and other public places.

CDC data have shown a decrease in cotinine levels in nonsmokers.

• During 1988 to 1991, data showed that 87.9% of nonsmokers had measurable levels of cotinine in their bodies.
• From 1999 to 2000, the figure dropped to 52.5%.
• From 2007 to 2008, an estimated 40.1% of nonsmokers had cotinine in their bodies.
• From 2009 to 2010, CDC data showed this figure dropped to 30.1%.

Wang credits the decrease in secondhand smoke exposure to legislation that bans smoking in public places and the workplace and to the decrease in adult and children smoking rates. “Our work provides scientific evidence that policies are working,” Wang says.

Although the number of persons exposed to secondhand smoke has decreased over more than 20 years, secondhand smoke remains a major public health treat.

“The reason it’s a big problem is because it has such a big impact on public health,” Wang says.

For more information about secondhand smoke, visit CDC – Secondhand Smoke – Smoking & Tobacco Use, and find out more about NCEH’s Tobacco Laboratory at their website.

Resources

How Tobacco Smoke Causes Disease

Secondhand Smoke Facts

Tobacco Laboratory

April 22 marks the 43nd anniversary of Earth Day, which reminds us of our personal and collective responsibility to preserve and protect our environment. At CDC’s National Center for Environmental Health (NCEH) and the Agency for Toxic Substances and Disease Registry (ATSDR), we begin our celebration of Earth Day by observing National Environmental Education Week during the week leading up to it.

For many the word “environment” means the natural world—mountains, forests, rivers, oceans, animals, and the air around us. To others, the environment brings to mind “tree huggers,” the green movement, and “reduce—reuse—recycle.” These are logical connections and are all, indeed, part of what we mean when we use the term.

But the environment is really everything in the world surrounding us—from conditions affecting our basic physical needs (like healthy air, water and food) to conditions affecting our needs for safe communities and for personal satisfaction (such as needs for relationships, resources, and fulfillment).

Recent research has shown that many people continue to believe that “public health” refers to government health programs for financially vulnerable people. In fact, public health is about protecting populations—families, communities, cities, states, nations and tribes—from threats to their health, safety, and well-being.

Environmental public health professionals at CDC’s National Center for Environmental Health (NCEH) and the Agency for Toxic Substances and Disease Registry (ATSDR) focus on protecting groups of people from everyday threats to their health and safety that result from elements in their environments.

When you think about it, all of our needs can be affected by the same environmental threat. For example, natural disasters, such as tornadoes or hurricanes, can endanger our physical health by affecting the safety of food, water, and shelter. Beyond threatening our physical health, disasters can also affect the health and safety of our communities by disabling community services or making access to medical care more difficult. And disasters can affect our mental and emotional health by creating family stress and eliminating any sense of control.

NCEH and ATSDR work to minimize environmental threats and ensure that physical, mental, and emotional health is protected in all environments. By doing this, we reduce costs for medical care and lost work time, protect the health of populations both in the U.S. and abroad, and save lives.

April 7 is United Nations World Health Day, marking the anniversary of the founding of the World Health Organization (WHO) in 1948. CDC works in close partnership with WHO and its regional offices, other UN agencies (like UNICEF) as well as other international health agencies to help people throughout the world live healthier, safer, longer lives.

In honor of World Health Day, read some of our previous blog posts about NCEH’s international work:

• Indo-US Joint Working Group
• Global Alliance for Clean Cookstoves
• Aflatoxin in Kenya—Finding Our Way through the Maize
• International Disease Detectives Discover Cause of Disease in Ethiopia
• Environmental Health Training in Emergency Response (EHTER)

Spring is the time of year when many things change—including the weather. Sunny days may be followed by a week of stormy weather. Sometimes extreme weather changes can occur within the same day.

Thunderstorms cause most of the severe spring weather. Whenever warm, moist air collides with cool, dry air, thunderstorms can occur, bringing with them lightning, tornadoes and flooding.

Because spring weather is so unpredictable, you may be unprepared when severe weather hits—particularly if you live in a region that does not often experience thunderstorms, tornadoes or flooding.

When severe weather hits unexpectedly, the risk of injury and death increases. So planning ahead makes sense. Prepare for storms, floods, and tornadoes as if you know in advance they are coming, because in the spring, they very likely will.

Advance planning for thunderstorms, lightning, tornadoes and floods requires specific safety precautions. Still, you can follow many of the same steps for all extreme weather events. You should have on hand:

• A battery-operated flashlight and NOAA Weather Radio and extra batteries
• An emergency evacuation plan and shelter in place plan for every type of severe weather emergency and every location
• A list of telephone numbers and other personal and home information
• A first aid kit and personal hygiene items
• A 3–5 day supply of bottled water and nonperishable food
• Blankets or sleeping bags
• An emergency kit in your car

Why not take the surprise factor out of severe weather and prepare yourself, your family, and your home? You may not have to deal with extreme weather events this spring, but if thunderstorms, tornadoes and floods do occur, you’ll be ready for them.

See also Prepare for Unpredictable Spring Weather.

Spring water

Can you remember a time when you were so thirsty you would have done almost anything for a glass of cool, refreshing water? Now imagine that the only water available to you is full of bacteria or chemicals that can make you sick. People across the globe face this dilemma daily. The world’s water supply is not unlimited and is not always safe.

Even in the United States, clean water is not always assured. Improper chemical disposal, naturally occurring substances such as arsenic, pesticides, animal and human wastes, improper water treatment, extreme weather events, and aging water distribution systems can contaminate our drinking water supply.

NCEH/ATSDR’s water programs help protect people from environmental water hazards as well as diseases caused by contaminated water.

Environmental Health Water Programs, Part 1

Tracking Program

• Community Water

The U.S. Environmental Protection Agency (EPA) requires community water systems to provide drinking water that meets safety standards established under the Safe Drinking Water Act. To verify that water systems meet these standards, states must collect and submit water quality data to EPA.

The Environmental Public Health Tracking Program provides funds to tracking programs in 23 states and one city to send water quality data to CDC, including summary data for arsenic, nitrates, and disinfection by-products. This data is available on the Tracking Network.

• Well Water

Although many states regulate private household wells, most have limited rules. Individual well owners are responsible for the safety of water drawn from their wells. The U.S. Geological Survey (USGS) monitors U.S. groundwater supplies in a national network of observation wells.

The Tracking Network uses USGS data to provide information about the levels of 11 contaminants in well water, such as arsenic, atrazine, benzene, manganese, radon, and uranium.

Laboratory Biomonitoring of Chemicals in Water and Other Biological Sources

Biomonitoring measures environmental chemicals in people’s blood, urine, or other body tissues. It determines which chemicals—and how much of them—get into people after they have been exposed. The Environmental Health Laboratory uses the health information and specimens gathered by the National Health and Nutrition Evaluation Survey (NHANES) to determine the exposure of the U.S. population to chemicals found in water and other biological sources. Biomonitoring helps health officials make timely and appropriate health decisions by providing better information on human exposure. (See CDC’s National Report on Human Exposure to Environmental Chemicals.)

Health Studies Clean Water for Health Programs

The goal of the Clean Water for Health (CWH) programs is to prevent human exposure to water contaminants. Listed below are examples of their work.

Countryside well

• The Private Well Initiative

An estimated 45 million Americans are not protected by the Safe Drinking Water Act because they get their water from unregulated drinking water sources, such as private wells, local springs, livestock water tanks, or rainwater cisterns. Sixty percent of these households are rural, and 35% have incomes less than $35,000 per year. The Private Well Initiative has funded 7 states to locate data about unregulated drinking water sources and use it to identify communities or regions at risk for harmful exposures in their water.

• Navajo Water Study

Approximately 25% of households on the Navajo Nation must haul drinking water from outside sources that are often untreated. Even households connected to public systems may still choose to haul water from untreated sources.

CWH studied contaminants in 199 untreated livestock wells and springs used for drinking water in Navajo communities. Results showed widespread bacterial contamination and identified 5 high risk communities where water arsenic and uranium were concentrated. The exposures were below levels known to cause health effects, but were at higher levels than national averages.

CWH and the Navajo Nation EPA and Division of Health followed up with education on the risks of using these water sources.

• Native Alaska Village Water Study

Though some rural Alaskan villages are connected to regulated community water, many villages still rely on water hauled from unregulated sources. CWH, the Alaska Native Tribal Health Consortium, and village supervisors surveyed 300 households in five villages, collecting household water samples and testing them for chemicals, bacteria, and viruses. ANTHC staff reported the results to each household and presented safe water community education.

• Floodwater Testing

After rainfall caused severe flooding in Tennessee and Kentucky in 2010, CWH staff collected floodwater samples and follow-up samples in the summer. In both states, the floodwater was heavily contaminated with total coliforms, E. coli, Enterococcus, and Salmonella, all of which cause gastrointestinal illness. CWH also found contamination in some private wells in Tennessee and elevated iron and manganese levels in Kentucky water samples.

Read Part 2 of Environmental Health Water Programs next week!

Can exercise be convenient?

Getting into the habit of exercising can be a challenge. But this year I promised myself I would become more active and get more exercise. We all know that physical activity helps us live longer by reducing our risk from leading killers like stroke, diabetes, cardiovascular disease, and some types of cancer. And now, as the weather gets warmer, I can begin to exercise outdoors. The easiest activities I can do are walking and biking —these activities are free and don’t require access to a gym.

Making walking or biking part of my daily routine—visiting a neighbor, commuting to work, or running errands—is a convenient way to incorporate exercise into my life. Unfortunately, I face many barriers that discourage my good intentions.

Why is walking and biking so difficult?

High on my list of barriers are route distance and choice. Often I find myself within a few hundred feet of my destination, but due to street connectivity, I would have to walk over a mile to get there. So my transportation choice is often based on how much time I have. If my destination requires more than 15 minutes walking or biking, like most people, I am more likely to drive.

Other factors that I consider are how safe I’d feel walking or biking. Speeding cars, dangerous crosswalks, poorly maintained properties, ugly streets, isolation, lack of shade, or the threat of crime can make me decide to drive.

If you live or work in areas without sidewalks or where crosswalks are over a mile apart, you might improve your cardiovascular health by walking and biking, but you could also be risking injury. These factors obviously lower the overall health benefit of walking and bicycling, but communities can take action to reduce hazards and improve safety for pedestrians and bicyclists.

How can communities make it easier for people to walk and bike?

Some communities are already taking measures to provide safe and convenient routes for their citizens to walk, bike or take public transit.

Of course, the best way to make walking and biking easier for residents is planning before building. Developers and city planners can study people’s possible destinations before they decide where to put the entrances to new neighborhoods.

But what about all of those established communities that are unsafe? How can we improve them?

Ways to Increase Walking and Biking in Your Neighborhood

Here are 9 actions cities and towns can take to increase opportunities for residents to walk and bike safely:

• Lower speed limits and implement traffic calming strategies.
• Repair existing sidewalks.
• Add sidewalks wide enough to walk with friends.
• Separate sidewalks from vehicle traffic.
• Create dedicated bike lanes that are separated from auto traffic.
• Create buffers between bike lanes and auto traffic.
• Make sure crosswalks are appropriately located, well-marked, and lit.
• Add pedestrian-operated traffic lights that give all ages and abilities enough time to cross the street.
• Plant canopy trees that shade sidewalks on warmer days.

You can help make your neighborhood easier and safer to walk and bike by gathering support, petitioning your local government, and attending local planning and transportation meetings. Let your voice be heard for safety and health in your community.

Check out our Health Community Design Checklist for other ways you can make your community a safer, healthier place to live.

To learn more about CDC’s Healthy Community Design Initiative, visit Designing and Building Health Places.

CDC study shows notable decrease in the levels of trans-fatty acids in the blood.

To reduce your intake of trans fatty acids, choose foods with either no trans fats or the lowest amounts of trans fats.

As the old saying goes, you are what you eat. The problem is that sometimes the things we eat can increase the levels of trans-fatty acids we have in our bloodstreams. Trans-fatty acids can increase a person’s “bad” cholesterol levels, or LDL. Researchers indicate higher LDL, or “bad” cholesterol can lead to cardiovascular disease.

The Centers for Disease Control and Prevention (CDC) has developed and used a new method to measure the levels of trans-fatty acids in our blood. Dr. Hubert Vesper, a research chemist in CDC’s National Center for Environmental Health (NCEH), led the development of the new method.

Vesper published results from a study using the new method in the Journal of the American Medical Association in February 2012. In the study, Vesper and his team found a 58% drop from 2000 to 2009 in the trans-fatty acids levels in the blood levels of participants

“It’s the first study of its kind,” Vesper says. Vesper says he and his team measured four types of trans-fatty acids: elaidic acids, vaccenic acids, linoelaidic acids and palmitelaidic acids. He says the results indicate progress that’s been made in recent years to educate the public on the health risks of trans fats.

The new method to measure trans-fatty acids was used in the JAMA-published study of the blood samples of fasting white adults who participated in CDC’s 2000 and 2009 National Health and Nutrition Examination Survey (NHANES).

Vesper says that state health departments have taken steps to reduce the amount of trans fats in foods and to distribute information on the health risks. These increased efforts coincide with the U.S. Food and Drug Administration’s 2003 mandate that requires food and dietary supplement manufacturers to list the amount of trans-fatty acids that are in their products on the nutrition information labels.

“The decrease in trans-fatty acids in the blood could be related to the ongoing efforts to educate the public about trans fats,” Vesper says.

Vesper says more trans-fatty acid studies using the new method are coming with participants from other population segments, including ethnic groups, young children, and adolescents.

According to FDA, trans fat is a specific type of fat that is formed when liquid oils are turned into solid fats, such as shortening or stick margarine. During this process—called hydrogenation—manufacturers add hydrogen to vegetable oil to increase the shelf life and flavor stability of foods. The result of the process is trans fat.

Trans fat can be found in many of the same foods as saturated fat. These can include crackers, cookies, cakes, frozen pies, and other baked goods, snack foods (such as microwave popcorn), frozen pizza, fast food, vegetable shortenings, and stick margarines, coffee creamer, refrigerated dough products (such as biscuits and cinnamon rolls), and ready-to-use frostings.

To Learn More

• Trans fat information on CDC’s website
• FDA fact sheet about trans fat

“It’s ok to have MCADD! You can do whatever you want!” says five-year-old Karina Martinez, happily.

Background

People with medium chain acyl-CoA dehydrogenase deficiency (MCADD) cannot burn fat for energy. Our bodies rely on fat for energy when we don’t eat for a while, such as when we miss a meal, or when we sleep. MCADD symptoms range from low blood sugar to coma or even sudden death. But early detection and treatment can save lives.

Success Story

Karina is just one example of a life saved by newborn screening. Because her MCADD was detected during the critical early stage, today she is a healthy little girl. Her favorite activity is dancing, especially ballet, which includes a role in Cinderella next year. When asked if she has to do anything special because of her condition, she simply says “Eat healthy a bunch of times.” She has had only one extended hospital stay.

With help from her mother, Tara Vicencio, Karina has really taken charge of her MCADD, even at her young age. Tara put together a binder of information for Karina’s pre-kindergarten teachers. Karina carries snacks with her, and the teachers know to let her eat when she says she needs her “fuel.” Karina tells her friends that she has MCADD, but that she is “fine and ok,” and that they should “eat healthy, too.”

Spreading the Word

Tara wants all parents to know that newborn screening “saves lives. It’s so important because without it we would have never known” about Karina’s condition. Tara now talks about newborn screening with friends who are expecting. “It’s really great,” she says, “to know that somebody is looking out for you.”

More Info

• http://www.cdc.gov/labstandards/nsqap.html
• http://www.cdc.gov/newbornscreening/
• http://www.cdc.gov/genomics/about/reports/2003/chap05.htm