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Environmental Toxins and Cardiovascular Disease
Published in Stephen T. Sinatra, Mark C. Houston, Nutritional and Integrative Strategies in Cardiovascular Medicine, 2022
All should be aware of the need for careful control of core body temperature in pregnant women. While some simply recommend against pregnant women using sauna, hot tubs, heavy exercise, etc. (i.e., anything that raises body temperature), careful research has shown that the teratogenic effects don’t start until her core body temperature exceeds 39°C.36 This helps explain why pregnant women in Finland who sauna regularly have the lowest rates of anencephaly in the world, while women who sauna infrequently suffer elevated risk for neural tube disorders.37
Prenatal Care
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
Gabriele Saccone, Kerri Sendek
In general, working is not associated with poor pregnancy outcome. Some workplace exposures, such as toxic chemicals, radiation (>5 rad), heavy repeated lifting, prolonged (>8 hours) standing, excessive (>80/week) work hours, and high fatigue score, may be associated with pregnancy complications, but there is insufficient evidence on the effect of avoidance of these risks (see also Chap. 17). There are insufficient safety data for paint, solvents, hair dyes, fumes, anesthetic drugs, etc., with no absolute evidence of harm. Hot tubs, saunas, etc., should avoid temperatures >102°F to avoid risk of dehydration, especially in the first trimester.
Investigative Duties on Scene
Published in Kevin L. Erskine, Erica J. Armstrong, Water-Related Death Investigation, 2021
Hot tubs also have much hotter water than an ordinary bathtub. Hot water is a necessary part of a hot tub to help relieve stress and sore muscles. Various methods to heat the water include electric, natural gas, and sometimes even firewood. If the water temperature is not monitored properly and is allowed to exceed 110°F, the heat can cause sleepiness, which in turn may contribute to drowning. Raising the body temperature to higher levels can also cause heat stroke, heart attack, skin burns, and in extreme cases, brain damage. The hot temperature can have adverse effects on people with preexisting high blood pressure or heart conditions.
A consistent skin care regimen leads to objective and subjective improvements in dry human skin: investigator-blinded randomized clinical trial
Published in Journal of Dermatological Treatment, 2022
Sooyoung Kim, Baochau K. Ly, Judy H. Ha, Kathryn A. Carson, Stacy Hawkins, Sewon Kang, Anna L. Chien
Healthy volunteers aged 18 years and older who had moderate to severe dry skin were enrolled. Participants had to have clinically dry skin, corresponding to a score of at least 2 (moderate dryness) on the Visual Dryness Score (VDS) determined by a dermatologist on at least one of four extremities for inclusion at baseline. Participants who had been treated with systemic retinoids or steroids within the past month, treated with topical steroids or topical retinoids or other topical drugs within 2 weeks, used an investigational drug in the prior 30 days, and women who self-reported that they were pregnant or nursing were excluded. Participants who had systemic diseases (liver/biliary, renal, heart, infectious, malignant disease) or skin diseases (atopic dermatitis, psoriasis, ezema, urticaria) which might affect their involvement in the study were excluded. Participants were asked to refrain from swimming or hot tub use and limited to no more than two showers per day during the study.
A multidisciplinary approach to the management of nontuberculous mycobacterial lung disease: a clinical perspective
Published in Expert Review of Respiratory Medicine, 2021
Environmental exposure to NTM (mainly via soil and water sources) increases the risk for NTM infection in susceptible patients. Improper maintenance and underchlorination of indoor swimming pools and hot tubs, as well as poor hygiene prior to their use, contributes to an increased risk of NTM exposure from such facilities [28]. Municipal and domestic water systems and household showerheads are also common sources of NTM exposure [47,48]. The extent to which these sources contribute to the risk of NTM re-infection is still unknown; however, regular cleaning, frequently replacing showerheads, or installing point-of-use showerhead filters may reduce patients’ risk of NTM re-infection [1,49]. Such practical considerations to reduce risk should be considered, if applicable, and incorporated into the comprehensive patient education [1] sessions as outlined in Figure 3.
Infection prevention and control in cystic fibrosis: a systematic review of interventions
Published in Expert Review of Respiratory Medicine, 2019
Nicola J Rowbotham, Sally C Palser, Sherie J Smith, Alan R Smyth
Many CF pathogens, including PA, NTM, and BCC are found in soil and water. They may also contaminate similar environments in the home. PA has been found in the home environment, commonly in sinks and drains [8,9]. However, in only 9 out of 50 patients with acute PA infection was an identical strain isolated in both the patient and their home environment [9]. Outside the home, swimming pools [10] and paddling pools [11] may be contaminated with PA, though regular use of a swimming pool has been found to reduce the risk of PA acquisition in CF and use of hot tubs had no effect [12]. Living in a location with warmer temperatures, greater humidity, and increased rainfall also increases the risk of acquisition of PA, whilst living further from the equator reduces the risk [13]. Geography also plays a part in NTM infection. In the US, the prevalence of NTM in CF patients is greatest in states in the West or the South East of the country and prevalence increases with increasing humidity [14]. In the US [1], NTM infection in people with CF is mainly Mycobacterium avium complex whereas, in the UK [2], M. abscessus complex predominates. For BCC there is no phenotypic correlation between clinical and soil isolates [15], though a study of clinical and agricultural B. cenocepacia samples found strains from onion rhizospheres that were identical on multilocus sequence typing (MLST) to the PHDC clinical strain [16].