VOLUME 3
Ask the Doctor…
Heat Stress: Better Safe Than Sorry…2
yourself every week, limiting television time and exercising for about ISSUE 3 an hour each day. The best diet is not a diet l but a way of life that lets you "eat to live," as you enjoy healthy food, exercise, and optimal health.
AUGUST 2011
What Do Julia Roberts and Chipping Paint have in Common?… 3
Mosquitoes Attract Hollywood Royalty.
Sean Penn gets a lesson in mosquito morphology and more…3
Bugbytes
A publication of Navy Environmental and Preventive Medicine Unit 2
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elcome to this edition of Bug Bytes. Our summer issue deals with the hot button topics of the season as our country is racked by scorching heat waves and stifling humidity. Add to the mix the discovery of a new “superbug” and new research on a known disease vector in Haiti, and we have ourselves a very busy summer. Inevitably awareness of a problem is the key to finding a solution.
Helping You Promote Public Health
Additionally since our last edition, CDR Wagner has turned over the charge of NEPMU 2. We wish him continued success in his future endeavors. As the new OIC, I envision that the dedicated group of professionals at NEPMU 2 will continue to serve the Navy and Marine Corps operational forces with excellence and enthusiasm. A.F. Vaughn CDR MC USN OIC NEPMU-2 VANUATU -- LT Humphrey, NEPMU 2 physician
The Heat is On! Know Your Flag Conditions. LT Timothy Webb
In 1956, the Marine Corps developed the heat flag system to help reduce heat injuries of recruits who were going through boot camp on Parris Island. Since then, this system of color-coded flags has been adopted by the Navy and in some locations the current flag conditions are posted on the internet to inform personnel of the current heat index and what measures they should take to protect themselves from heat related illness. There are five different heat stress conditions that combine the temperature and the relative humidity together as the Wet Bulb Temperature (WBT) which is then used to determine the flag level. The different flag levels are used to warn you to take caution as WBT goes up. The higher it gets, the more exercise should be curtailed to protect personnel. A detailed explanation of the flag conditions can be found at http://www.med.navy.mil/sites/nhjax/Weather/Pages/FlagSystem.aspx.
with a Pacific Partnership advance coordination team, treats a laceration to a young boy's hand. Black Flag is the most serious level. If you are not acclimated to the heat, then you should go inside and minimize the amount of energy you exert outside during black flag conditions. However, even if the flag conditions are not that high outside, the work environment you are in may require you to take more caution when working or exercising. Personnel in places on ships such as the galley and the engine room that operate at a higher flag level should take extra precautions during high heat conditions, especially those who are new to the climate. To view the current flag condition for Norfolk, visit the NEPMU 2 Heat Stress Condition page.
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Did you know?
- Scientists have found a strain of gonorrhea in Japan that is resistant to all recommended antibiotics and this can potentially become a global public health threat. - The World Health Organization estimates there are at least 340 million new cases of curable sexually transmitted infections -including syphilis, gonorrhea, chlamydia and trichomoniasis -every year among people aged 15 to 49. - The "superbug" strain of gonorrhea is called, H041 and it is resistant to all cephalosporin-class antibiotics . - Cephalosporin compounds were first isolated from cultures of Cephalosporium acremonium from a sewer in Sardinia in 1948 by Italian scientist Giuseppe Brotzu. - An egg needs a temperature of 158°F to become firm. In order to cook, proteins in the egg must denature (modify), then coagulate, and that won’t happen until the temperature rises enough to start and maintain the process. - A person can suffer from dehydration and heatstroke while swimming or scuba diving.
Breathing Easier at Home
LTJG Roy Quinn
Everyone thinks about protecting themselves from harmful things while at work, but often we forget that things we do at home can be just as dangerous. One area in particular that gets ignored is the health of our lungs. There are a variety of things that can cause problems with your lungs, many of which can be controlled. When working with hazardous material on the job we wear respirators – but how many people wear them at home? Answer: very few. Here are a few good reasons why you should wear a respirator the next time you start that at home project. Painting in an enclosed space such as a bedroom or bathroom can give you that painter’s high, but did you also know that it can cause damage to your lungs and nasal cavity? If done often enough one can become sensitized to paint and it can cause an allergic reaction. Paints often contain chemicals that can affect your central nervous system which can cause loss of balance, dizziness, and in rare cases blackouts. How do you protect against this? Simple – wear a respirator anytime you paint (and this includes varnishing) in an enclosed space or even a large space that has little or inadequate ventilation. For most projects around the house, the main concern is dust and other small particles (wood working byproducts) that can get in the lungs and cause problems. For this type of project, you would want to select a respirator that has a particle filter or a HEPA filter. For projects that include painting, you should purchase a respirator that has organic vapor filters. If you plan on doing both, consider getting a combination cartridge (organic vapor and HEPA filter).
Use a NIOSH approved respirator that fits properly.
Most home improvement stores carry several models of respirators. The key thing to look for in any respirator is certification. You should purchase a respirator that indicates that is it a NIOSH approved respirator. Another key factor is fit. Make sure when you purchase a respirator that it fits your face well and that there is no air leaking in around the edges. If you are painting and you have your respirator on, you shouldn’t smell the paint, if you do, you need to either adjust the respirator to fit more snugly or get a smaller size. You only have one set of lungs so make sure you are taking the necessary precautions to protect yourself so you can finish all the home improvement projects that you start with minimal interruption. It is up to you to protect your health at home and wear the proper PPE just like you would in the line of duty.
Doctor’s Orders: Heat Stress: Better Safe Than Sorry LT Mark Humphrey, MD, MPH
Courses available at NEPMU2: Click here to for full class schedule Food Safety Managers (B-322-2101):
29-30 Aug, 26-27 Sept 2011 Lab Identification of Malaria (B-322-2210):
28 Sep 2011 Shipboard Pest Management (B-322-1075):
13 Sep 2011 For further info contact Jeff Bolden: (NEPMU2NorfolkEducationandTraining@med.navy.mil)
Structure of cephalosporins
Newsletter Editors LT Chris Coetzer LT Matthew Montgomery
Recently, extreme heat alerts have been ringing across the country, impacting ourselves, our shipmates, and our families. Recognizing the signs and symptoms of heat-related illnesses is the first step toward prevention and keeping injury to a minimum. While many take the heat into consideration when exercising, it is also important to consider it in our workplaces. Many shipboard spaces contain high heat and humidity environments, including engineering spaces, galleys, sculleries, laundries, and weather decks. Sustained high temperatures can lead to heat stress conditions, which can decrease morale, impair mental alertness, and lower work performance. This increases the risk of accidents, which ultimately compromises a ship’s readiness. Severe heat stress can lead to heat cramps, heat exhaustion or heatstroke. Factors that contribute to heat stress include physical fitness, activity levels, type of clothing, medications, heat, and humidity. Avoid heat injury by taking in fluids regularly. Learn to spot the early warning signs of heat stress and seek out medical attention when these symptoms persist or increase in severity.
Signs and Symptoms of Potentially LifeThreatening Heat-Related Illnesses Heat cramps Elevated body temperature Thirst Muscle cramps Sweating Tachycardia Heat exhaustion Same as heat cramps, plus: Nausea/vomiting, Headache, Malaise/myalgias, Hypotension, Lightheadedness/syncope, Oliguria, Uncoordination, Confusion, Irritability Heatstroke Same as heat exhaustion, plus: Anhydrosis (no sweat production), Delirium, Seizure, Coma, Renal failure, Hepatocellular necrosis, Hyperventilation, Pulmonary edema, Arrhythmia, Shock, Rhabdomyolysis (breakdown of muscle tissue), Disseminated Intravascular Coagulation (DIC ) Reference: Wexler RK. Evaluation and treatment of heat-related illnesses. Am Fam Physician. 2002 Jun 1;65(11):2307-14.
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What do Julia Roberts and Chipping Paint have in Common? Richard Cimprich Julia Roberts in the movie, “Erin Brockovitch” brought attention to the hazards of improper hexavalent chromium handling. Chromium Cr (III) or Cr 3+ is element number 24 on the Period Table of Elements. It is normally found in nature as chromite ore with a positive charge of (+3). GET YOUR ANSWERS HERE EMAIL NEPMU-2 click on the links below Fleet/FMF -Entomology -Environmental Health
This means Cr (III) is hungry for 3 negatively charged electrons to balance its charge and become neutral. Hexavalent Chromium Cr (VI) or Cr 6+ is also element number 24 on the Periodic Table of Elements, but has been processed to have a positive charge of (+6). This gives Cr (VI) the ability to neutralize 6 negatively charged electrons. This allows Cr (VI) to be an excellent corrosion control chemical since free roaming negatively charged electrons cause corrosion. Unfortunately, when Hexavalent Chromium comes into contact with human tissue it causes burns, contact dermatitis, and in sufficient quantities causes DNA damage, which in turn can lead to cancer.
-Industrial Health -Health Promotion
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Training
Threat 3311Assessment M Maarrcchh 22001100 EPM Senior Enlisted Leader
RESOURCE LINKS NMCPHC (NEHC) Navy and Marine Corps Public Health Center Instructions Navy Medicine Publications PrevMed Topic Page NMCPHC (NEHC) supported page of Preventive Medicine topics and resources CHPPM U.S. Army Center for Health Promotion and Preventive Medicine WHO Fact Sheets World Health Organization publications and fact sheets AFPMB Armed Forces Pest Management Board online Bug Bytes Archive Back issues of the NEPMU 2 newsletter available online
Hexavalent Chromium can be found in paints, pigments, stainless steel welding fumes, metal flame spraying, concrete dust, chrome plating, and contaminated water sources. An Industrial Hygienist (IH) will monitor activities that may expose workers to Cr (VI) by sampling the air around a worker, taking samples of paint chips, and using a swipe method for surface dust. The samples are sent back to the Consolidated Industrial Hygiene Laboratory for analysis. If an activity is found to have potential exposure to Cr (VI) the IH will recommend the proper PPE and also monitor the activity every six months if it is an ongoing operation. It is critical that any space be surveyed by an IH prior to beginning work so that all dangerous exposures can be avoided.
Mosquitoes Attract Hollywood Royalty
LT Matthew Montgomery
Mosquito borne disease is a major threat in Haiti; this is especially relevant considering the amount of U.S. military involvement that has taken place in the country throughout the years. I recently had the fortune of working with the University of Florida’s Emerging Pathogens Institute to secure a GEIS grant to establish a mosquito research lab near the town of Gressier (20 miles west of Port Au Prince). As of July the lab is complete and ready to support our research goals. Our current studies focus primarily on Aedes mosquito in the area outside Gressier. Aedes mosquitoes are the vectors of Dengue fever throughout the world and our hope is that by better understanding what species serve as Dengue vectors in Haiti we can better tailor mosquito control to target those species most involved in transmission. Currently, the lab is surveying the Aedes species that feed on humans in Gressier. This means analyzing blood found within field caught mosquitoes and conducting human biting surveys, where we essentially offer ourselves up as mosquito bait and see what species bite. In June our lab was paid a visit by LtGen. P. K. Keen, Deputy Commander of U.S. Southern Command, and actor and humanitarian Sean Penn. Both of these VIPs sought to better understand the role of our laboratory and how it will come to benefit the people of Haiti. They also took the time to receive a brief lesson in mosquito identification. While our research is progressing, I still haven’t heard back from Mr. Penn regarding my idea for a Navy entomology movie starring your humble author.
Sean Penn gets a Mosquito ID Class from our visiting NEPMU 2 entomologist.
What can our Industrial Hygiene Officers do for you?
Next Issue
21Oct 2011
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Evaluate NAVOSH Programs and makes recommendations for improvements. Perform noise surveys for equipment, spaces or personnel. Perform ventilation surveys for industrial systems and storage spaces
Contact us: Phone (757) 953-6600 DSN 377 Fax (757) 953-7212 1285 West D St, Norfolk, VA 23511-3394 Website: http://www.med.navy.mil/sites/nmcp/clinics/nepmu2/Pages/default.aspx
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