Western Occupational & Environmental Medical Association
Leading Occupational & Environmental Medicine

e-Newsletter – December 2010 / January 2011

Welcome to WOEMA’s e-newsletter. After over 50 years, gone is WOEMA’s printed newsletter for this new electronic format. WOEMA is committed to providing on-going communications to members while reducing its carbon footprint by eliminating paper usage. WOEMA members receive the newsletter via email every other month with contents appearing on this website. It includes links to pertinent information. — Peter Swann, MD, FAAFP, Newsletter Editor 


• President’s Message
” WOEMA Finishing 2010 in Fine Shape”
• News You Can Use from the Literature
• Survey: 2011 WOEMA Legislative Priorities
• There’s Still time to Complete the On-Line SCERC Survey

WOEMA Wishes You a Happy New Year!

We hope the year ahead brings you much success, prosperity, and good luck. And we want you to bring that good luck with you when you attend the Western Occupational Health Conference (WOHC) September 8-10, 2011 at the beautiful Bellagio Hotel & Spa in Las Vegas, NV! WOHC offers CME/MOC/QME credit. Special room rates of just $139 per night are available now. Call: 888-987-6667 to reserve your room early. Questions? Contact: WOEMA

President’s Message: WOEMA Finishing 2010 in Fine Shape
by Paul Papanek MD MPH FACOEM

WOEMA finishes the year with an increase in its influence and reach in many areas, including in the halls of state and local governments, among businesses of business, and in the House of Medicine. We now have a stronger voice with a number of California state agencies, including the Cal-OSHA, the Division of Worker’s Compensation, the California Department of Public Health, and CHSWC, and we’ve secured a stronger place at the table within the state Medical Associations in California and Arizona. For this next year, we’re also optimistic about outreach to potential new affiliate members, and I would encourage all of you with non-MD colleagues in the field of Occupational Medicine to encourage them consider joining WOEMA as affiliate members. Our finances remain solid, with a small net gain in our balance sheets, largely because of the recent success of WOHC and because of some deft economizing.

Our educational achievements have been stronger than ever. This has been the first full year of our educational webinars – which have been profitable and highly rated by participants. We remain proud of the fact that WOEMA is the only ACOEM Component certified to grant CME, and we’re poised to gain full accreditation status next year.

In the area of leadership in the field of Occupational Medicine we launched the WOEMA Advisory Council this year, a project to bring former WOEMA leaders into closer touch with our operations and advocacy efforts. We’ve also been successful in advancing WOEMA members into positions of leadership within ACOEM.

So, as WOEMA completes a successful year, I want to assure our terrific members that they’re part of a dynamic and successful organization. I’ve been proud to be WOEMA’s president this year, and I feel fortunate to leave this post with WOEMA stronger than ever.

To list a few noteworthy news items:

1.  Congratulations to the newly elected WOEMA Board members Ellyn McIntosh, MD, MPH who will serve as Second Vice President and new Director Scott Levy, MD, MPH. Completing terms on the WOEMA Board are Steve Schumann, MD and Dennis Pocekay, MD, MPH. To view the current list of WOEMA Board members and Committee chairs, visit the WOEMA website.

2.  WOEMA salutes Walt Newman, MD for his great work in helping to organize the “Vote and VAX” program at Stanford on election day – a volunteer clinic that offered influenza vaccines to voters. The program was a successful and very creative win-win.

3. Dean Baker, MD at the Southern California Education and Research Center, UC Irvine, (“SC-ERC”) requests input from WOEMA membership for SC-ERC’s Needs Assessment Survey on their Continuing Medical Education offerings for the Occupational Health community. Please take a few minutes to complete the online survey, if you have not yet done so, which can be found athttp://www.ph.ucla.edu/erc/ced.php.

4. The Third Edition of the ACOEM Practice Guidelines is now available on the ACOEM website. Newly included are Guidelines for Neck and Shoulder disorders, and treatment guidelines adopted by California and New York.

5. Congratulations to Bob Orford, MD for being named one of the 50 Most Influential People in Workers’ Comp by Workers’ Comp Executive on December 8, 2010. The publication noted Dr. Orford’s leadership in occupational health and safety in the western hemisphere and his impact on bringing evidence-based medicine to CA through ACOEM “making a huge difference for injured workers and payers alike.”

Best Wishes for a bountiful and fulfilling New Year to all of you. I hope you’ll continue to support WOEMA in the upcoming year, and can find even a little more energy to get involved and make it an even greater organization.

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News You Can Use from the Literature
by Constantine J. Gean, MD, MS, MBA, FACOEM

A useful review of the latest journal articles of interest to the field of occupational medicine.

HDL decreased -1.76% (lag 2 days), and -5.58% (moving average of 4 weeks) for each 5°C increase in mean ambient temperature.
 For the same increase in mean ambient temperature, LDL increased by 1.74% (lag 1 day) and 1.87% (lag 2 days). Based on a study cohort consisted of 478 men in the greater Boston (ave age = 74.2 yrs) who visited clinic every 3-5 years (1995 to 2008) resulting in a total of 862 visits. Authors conclude changes in HDL and LDL levels associated with an increase in ambient temperature may be among the underlying mechanisms of temperature-related cardiovascular mortality. Environ Res. 2010 Dec 18. [Epub ahead of print] [Read More]

An FDA Advisory Panel voted 8 to 2 in favor of approving the weight-loss Lap-Band for use in people with BMI (Body Mass Index) of 35 or more (or 30 or more with at least one comorbid condition). The Gastroenterology and Urology Devices Panel of the Medical Devices Advisory Committee determined that the benefits outweigh the risks for less obese patients, based on 12-month data from a 5-year, single-arm, non-randomized trial involving 149 obese individuals. [Read More]

Visits to emergency departments for opioid abuse more than doubled between 2004 and 2008, and admissions to substance-abuse treatment programs increased by 400% between1998 and 2008 deaths from unintentional drug overdoses in the United States are the second leading cause of accidental death, with 27,658 such deaths recorded in 2007. This parallels an 10x increase in the medical use of opioids since 1990, spurred in part by aggressive marketing of OxyContin. Between 1997 and 2002, sales of oxycodone and methadone nearly quadrupled.
NEJM 363;21 nejm.org november 18, 2010 [Read More]

There was a 31% overall rise >in the prevalence of hearing loss in teens over the last decade based on examination of 4,699 participants aged 12 to 19 years (NHANES – 2 periods 1990’s and mid 2000s). The prevalence of any hearing loss increased significantly from 14.9% in 1988-1994 to 19.5% in 2005-2006. Loss was categorized as either unilateral or bilateral for low or high frequency and as slight loss (> 15 to < 25 dB) or mild or greater loss (> or = 25 dB) according to hearing sensitivity in the worse ear. prevalence of any hearing loss increased significantly from 14.9%. JAMA. 2010 Aug 18;304(7):772-8. [Read More]

Aspirin reduced the 20-year incidence risk of colon cancer by 24% (HR = 0.76), and mortality by 35% (HR= 0.65), but not rectal cancer per a metaanalysis of four randomised trials of aspirin versus control involving lower dose (75-300 mg daily). 391 (2.8%) of 14,033 patients had colorectal cancer during a median follow-up of 18.3 years. Allocation to aspirin reduced the 20-year risk of colon cancer – mean duration of scheduled treatment was 6.0 years. Lancet 2010 Nov 20;376(9754):1741-50. Epub 2010 Oct 21. [Read More]

Open-label placebo produced a 32% improvement at 11-days and a 28% improvement at 21-day endpoint in IBS Symptom Severity Scale scores (IBS-SSS) per a two-group, randomized, controlled three week trial, involving 80 IBS patients (70% female) (Rome III with ≥150 on the IBS-SSS). Authors conclude placebos administered without deception may be an effective treatment for IBS. [Read More]

Teens who overuse cell phone texting or social networking web sites have disturbingly higher rates health risk behaviors and hypertexters were twofold more likely to have ever tried alcohol, 43% more likely to be binge drinkers, 32% more likely to be current users of marijuana, and 40% more likely to have tried cigarettes; they were also 2.7-fold more likely to rarely or never wear a bike helmet and 39% more likely to rarely or never wear a seat belt, than kids who texted less. This was based on an anonymous survey completed by 4,257 teens at 20 schools in Ohio. Of the responders, 20% were “hypertexters,” (i.e., self-reported texting an average of 120 or more times per day on school days). APHA Annual meeting. [Read More]

Echinacea is not efficacious for treatment of the common cold illness duration and severity were not statistically significantly different with echinacea compared with placebo per a study of 719 patients, aged 12 to 80 years, with new-onset common cold. Primary outcome was the area under the curve for global severity, with severity assessed twice daily by self-report using the Wisconsin Upper Respiratory Symptom Survey, short version. Secondary outcomes included interleukin-8 levels and neutrophil counts from nasal wash, assessed at intake and 2 days later. Authors conclude these results do not support the ability of echinacea formulation to substantively change the course of the common cold. Annals of Internal Medicine 2010 Dec 21;153(12):769-77 [Read More]

Safety problems associated with opioid treatment for nonmalignant pain in older adults vary with the type of opioid and even the duration of treatment, per a 1996 through 2005 propensity-matched cohort analysis assessing the safety of opioid medications used to treat noncancer pain. At 180 days, cardiovascular risk was significantly elevated for patients taking codeine: RR = 1.62; after 30 days, all-cause mortality was twice as high for patients taking oxycodone or codeine, compared to hydrocodone: RR 2.43 and 2.05, respectively. Arch Intern Med. 2010;170:1979-1986, 1968-1978. [Read More]

In a severe motor vehicle crash, a moderately obese driver faces a 21 percent (OR, 1.21) increased risk of death, while the morbidly obese face a 56 percent (OR, 1.55) increased risk of not surviving, based on fatalities were selected from 155,584 drivers stratified by body mass index included in the 2000-2005 Fatality Analysis Reporting System. Underweight drivers also had increased risk ((OR, 1.11) Am J Emerg Med. 2010 Dec 1. [Epub ahead of print] [Read More]

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Survey: 2011 WOEMA Legislative Priorities

We need your input
. WOEMA’s Legislative Affairs Committee is meeting in January to develop its 2011 legislative priorities and guide our advocacy and lobbying activities in our five member states. To assist us, please rate each of the following 14 policy goals on a scale of 1-5, with 1 being “Very Important” and 5 being “Not Important.” Your evaluation can take into account how effective you think WOEMA could be in making progress toward that goal. That is, feel free to elevate (or reduce) your rating of a goal if you think it is within (or outside) WOEMA’s ability to have impact. Take Survey Now.

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There’s Still time to Complete the On-Line SCERC Survey

It is the interests of WOEMA and its members that the Southern California Education and Research Center receive our comments on their academic programs and Continuing Medical Education offerings. Therefore, we encourage you to take a few minutes to go on-line to complete the survey, if you have not yet done so. Click on the EHS PROFESSIONAL NEEDS ASSESSMENT SURVEY link at the bottom of the Featured Classes box on the left. The survey will close on Friday, December 31 at 5 pm Pacific Time.

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