Radon Levels in Your Home

Do you have a basement? Do you know what Radon Zone you live in?

	Zone 1 counties have a predicted average indoor radon screening level greater than 4 pCi/L (pico curies per liter) (red zones)	Highest Potential
	Zone 2 counties have a predicted average indoor radon screening level between 2 and 4 pCi/L (orange zones)	Moderate Potential
	Zone 3 counties have a predicted average indoor radon screening level less than 2 pCi/L (yellow zones)	Low Potential

Unless you're a homeowner, you may not be thinking about Radon. However, I've recently done some research on this topic for personal reasons (I'll let you guess), and here are some interesting findings:

• Radon is the second leading cause of lung cancer.
  
• According to the EPA, "Radon levels less than 4 pCi/L still pose a risk, and in many cases may be reduced." (see the chart below)
  
• The EPA recommends building new homes with radon-resistant features in high radon potential (Zone 1) areas.
  
• Even at levels of 2, there is an increased risk of cancer and the EPA suggests that you should "Consider fixing between 2 and 4 pCi/L" (see the chart below)

For a Radon Zone map, click here

The chart below is from this EPA Radon site:

Radon Risk If You Smoke

Radon Level	If 1,000 people who smoked were exposed to this level over a lifetime*...	The risk of cancer from radon exposure compares to**...	WHAT TO DO: Stop smoking and...
20 pCi/L	About 260 people could get lung cancer	250 times the risk of drowning	Fix your home
10 pCi/L	About 150 people could get lung cancer	200 times the risk of dying in a home fire	Fix your home
8 pCi/L	About 120 people could get lung cancer	30 times the risk of dying in a fall	Fix your home
4 pCi/L	About 62 people could get lung cancer	5 times the risk of dying in a car crash	Fix your home
2 pCi/L	About 32 people could get lung cancer	6 times the risk of dying from poison	Consider fixing between 2 and 4 pCi/L
1.3 pCi/L	About 20 people could get lung cancer	(Average indoor radon level)	(Reducing radon levels below 2 pCi/L is difficult.)
0.4 pCi/L	About 3 people could get lung cancer	(Average outdoor radon level)
Note: If you are a former smoker, your risk may be lower. * Lifetime risk of lung cancer deaths from EPA Assessment of Risks from Radon in Homes (EPA 402-R-03-003). ** Comparison data calculated using the Centers for Disease Control and Prevention's 1999-2001 National Center for Injury Prevention and Control Reports.

Radon Risk If You've Never Smoked

Radon Level	If 1,000 people who never smoked were exposed to this level over a lifetime*...	The risk of cancer from radon exposure compares to**...	WHAT TO DO:
20 pCi/L	About 36 people could get lung cancer	35 times the risk of drowning	Fix your home
10 pCi/L	About 18 people could get lung cancer	20 times the risk of dying in a home fire	Fix your home
8 pCi/L	About 15 people could get lung cancer	4 times the risk of dying in a fall	Fix your home
4 pCi/L	About 7 people could get lung cancer	The risk of dying in a car crash	Fix your home
2 pCi/L	About 4 person could get lung cancer	The risk of dying from poison	Consider fixing between 2 and 4 pCi/L
1.3 pCi/L	About 2 people could get lung cancer	(Average indoor radon level)	(Reducing radon levels below 2 pCi/L is difficult.)
0.4 pCi/L		(Average outdoor radon level)
Note: If you are a former smoker, your risk may be higher. * Lifetime risk of lung cancer deaths from EPA Assessment of Risks from Radon in Homes (EPA 402-R-03-003). ** Comparison data calculated using the Centers for Disease Control and Prevention's 1999-2001 National Center for Injury Prevention and Control Reports.

So what's the bottom line? Radon causes cancer and you should do what you can to avoid exposure to it. Should the EPA lower the limit from 4 to something less? That depends on whether that would be a "cost-effective" public health decision for the government. How much are you willing to pay to mitigate your risk?

Received Vol 35 of the PEJ

What's the PEJ? It's the Physician Executive Journal of Medical Management and it's published by the American College of Physician Executives (ACPE). I hope to read this over the weekend (and I'll be sharing my opinions on this site or on my other site: http://www.nonclinicaljobs.com

Schools in NYC Closing Because of Swine Flu

Just when you thought that all the buzz about swine flu was disappearing: 3 NYC schools are closing because of H1N1. CNN has the story. Even though the H1N1 virus isn't considered to be more serious than the regular flu, these schools have made a public health decision. Here's a snippet from a news release: "the H1N1 virus appears to spread more extensively, at least in schools..."

AMA on Ethics and CME

The CME (Continuing Medical Education) industry has gone through some significant changes over the last several years. Have you been keeping up with all the changes?

The American Medical Association (AMA) Council on Ethical and Judicial Affairs (CEJA) recently released a report titled, "Financial Relationships with Industry in Continuing Medical Education." This report outlines the ethics of industry supported education - according to the Council on Ethical and Judicial Affairs (CEJA).

Please note that advisory report will be up for consideration at the AMA's upcoming annual House of Delegates meeting. This report is not necessarily the AMA's take/perspective/position on ethics and CME.

Here's the bottom line from the CEJA report:

• It is ethically preferable to accept funding only from non-commercial supporters (this would probably mean that doctors would have to pay for their CME credits).
• It is ethically permissible to accept funding from commercial supporters (such as pharmaceutical companies, biotech, medical device, etc.). This generally leads to free CME.
  

The world of medicine is constantly changing and physicians need every opportunity to keep up with the latest clinical development. If they have to pay for CME, will they be less inclined to learn? Does the abundant supply of free CME cause physicians to practice evidence-based medicine? How does free CME impact patient outcomes?

Need Health Insurance?

CNN has a nice article that outlines some practical tips to help you get health insurance if you have a pre-existing medical condition. In a nutshell, they are:

1. Become a group of one.
2. If you've been laid off, get COBRA.
3. When you lose your employer-related insurance, apply for new insurance within 63 days.
4. Find out whether your state has a high-risk pool.
5. See whether your professional organization offers group insurance.

I encourage you to read the article because it goes into more depth explaining each of these points. Finally, if you're unemployed and you take medications made by Pfizer, remember: Pfizer Offers Free Drugs to Unemployed, Uninsured

It's a Tree-Climbing Robot!

This may seem a bit off-topic, but you'll see me tying this into medicine and technology. This photo on the right is of a tree-climbing robot developed by engineers at the University of Pennsylvania. RiSE is a four-legged robot that can both scamper along the ground and rapidly climb a tree or a pole. RiSE V3 was designed and built at Boston Dynamics (they make the four-legged military robot BigDog).

So how is this robotic technology relevant to medicine and technology? It's relevant because robotic technology has been used to help disabled people walk (ReWalk Exoskeleton). As engineers develop more sophisticated robots, this type of technology may translate over to the healthcare field and help people who are physically disabled. Image source: Technology Review.

HP Battery Recall

Take a look at this if you have an HP or Compaq laptop/notebook PC: HP Recalling 70,000 Laptop Batteries

Pfizer Offers Free Drugs to Unemployed, Uninsured

These are tough economic times and we need better patient assistance programs. Pfizer is coming out with a program to help people who have lost their jobs and health insurance. If you lost your jobs since Jan. 1 and you've been taking a Pfizer drug for three months or more, then probably qualify. These individuals will have access to free prescription Pfizer medications (including common drugs like Lipitor which is used to lower cholesterol and Viagra for the treatment of erectile dysfunction) for up to a year.

• Starting today, patients can call a toll-free number, 866-706-2400, to sign up.
• Starting July 1, patients can also apply through the Web site

So, do you know anyone who could take advantage of this program?

MIT Research: Monitoring Cancer Tumor Growth

MIT students are having so much fun with research these days. Nanotechnology has taken biomedical research to an entirely new level. In many ways, this research reminds me of my days at MIT when I was involved in some biomedical cancer research. I was working on biopsy needles that involved hyperthermia treatment, but this story is about an implantable device that continuously monitors how a malignant tumor responds to treatment. Researchers at MIT engineered a tiny cylindrical, 5-millimeter implant that contains magnetic nanoparticles coated with antibodies. Can you do that?

Lead author of the research paper (published in Biosensors & Bioelectronics) is Karen Daniel, a recent MIT PhD recipient. Other authors are recent PhD recipients Grace Kim (not related - as far as I know) and Christophoros Vassiliou; Marilyn Galindo, research affiliate in the Harvard-MIT Division of Health Sciences and Technology; Alexander Guimares, a radiologist at Massachusetts General Hospital; Ralph Weissleder, a professor of radiology at Harvard Medical School; Al Charest, visiting assistant professor of biology at MIT; and David H. Koch Institute for Integrative Cancer Research Professor Robert Langer.

The research was funded by the National Cancer Institute Centers of Cancer Nanotechnology Excellence and the National Science Foundation. Image source: MIT news site.

Cheerios and the FDA

My kids love Cheerios. I also love Cheerios. I have no stocks or ownership in General Mills. Now, the FDA is giving General Mills a hard time because its claim that Cheerios is "clinically proven to help lower cholesterol" makes the cereal a drug under federal law. The FDA warning letter can be viewed here.

So what do you think will happen? Will we see Cheerios turn into an over-the-counter drug? Or, will we see changes in the box, label, and television commercials?

7 Hospitalized Due to Filthy Office Fridge?

Can you believe this story on ABC News? 7 Hospitalized From Filthy Office Fridge

Here's a snippet: "An office worker cleaning a fridge full of rotten food created a smell so noxious that it sent seven co-workers to the hospital and made many others ill."

The office was an AT&T building in downtown San Jose, California. The funny part of this story is that the person cleaning the fridge couldn't smell because she had allergies, so she was fine. The rest of the office was evacuated and a hazmat team was called in.

Have You Caught the Buzz About the Next iPhone?

If so, take a look at this post: Next iPhone

Living and Dying in an Iron Lung

What's an iron lung? Take a look at the picture. It's obviously not something you transplant into your body. According to the NY Times, Martha Mason lived in this "iron lung" for over 60 years and recently died at the age of 71. She was parlayed from polio and her life depended on this machine.

Mason had quite a life and even wrote a book while living in this life-saving contraption. She also appeared on several documentaries. Advances in Medical technology have significantly improved the quality of life for people who are unable to breathe independently. Image source: NY Times

Chicago is Banning BPA Baby Bottles

According to this story on MSNBC, Chicago is the first U.S. city to ban baby bottles and sippy cups that are made with plastic that contain BPA. What exactly is BPA? Well, BPA, or bisphenol A, is used to harden plastic. Is it toxic? The FDA has indicated that they are still researching the answer to that question. Here's the latest snippet from the FDA:

"Based on our ongoing review, we believe there is a large body of evidence that indicates that FDA-regulated products containing BPA currently on the market are safe and that exposure levels to BPA from food contact materials, including for infants and children, are below those that may cause health effects. However, we will continue to consider new research and information as they become available."

Image source: Babble.com

For Healthcare Business Women

Do you consider yourself a healthcare business woman? If you do, then this may be of interest: HBA Leadership Conference 2009

Do We Need More Doctors?

According to this commentary on CNN, the answer seems to be "no." Well, perhaps we should explore this a bit further. This story is written by Clayton Christensen, Dr. Jason Hwang (there's another common Asian name), and Vineeta Vijayaraghavan. Here's a bit of background:

• Clayton M. Christensen is the Robert and Jane Cizik Professor of Business Administration at Harvard Business School, co-founder of Innosight Institute, and the best-selling author of six books.
• Jason Hwang, M.D., M.B.A. is co-founder and executive director of healthcare at Innosight Institute.
• Vineeta Vijayaraghavan, M.B.A. is a Research Fellow at Innosight Institute.
  
• Innosight Institute is a non-profit think tank whose mission is to apply Harvard Business School Professor Clayton Christensen’s theories of disruptive innovation to develop and promote solutions to the most vexing problems in the social sector.
  

One point they make is this: "There is a shortage of health care services being provided, but many of them are not best offered by a doctor."

I agree with that statement. However, I also personally believe that we also have a shortage of physicians, especially when we look at rural and other types of underserved areas of this country. If you live in a major metropolitan area, then you won't have any problems finding a doctor (you may have a challenge finding one who takes your insurance, but that's another story). The authors acknowledge the fact that health care is unevenly distributed around the nation, but then they point out that "Studies of geographical disparities of care have demonstrated that more physicians will likely lead to greater intensity of care -- but not better health outcomes." So where does that lead us? What about all the incentive programs that try to drive physicians to these underserved areas? Are those failing?

The authors also argue that we need to embrace more eHealth solutions. I also agree with this point. Technology is making it easier for patients to receive some basic health services

So what's the solution? The authors propose this: "what the country really needs are policies that pave the way to more avenues of care, which is well within the government's control."

Do You Use a Tablet PC?

How many doctors use a tablet PC? Among those, how many use them like a laptop vs. a tablet? Want to see my opinion? How Many Doctors Use a Tablet PC Like a Tablet?

Advances in Medical Technology

Do you think we'll ever see the types of major advances in medical technology that are depicted in science fiction movies? Right now, the buzz around Star Trek is quite strong. When I went to see the movie, people from a local fan club were displaying some movie props. It was fun to play with some of the medical tricorders. If you don't know what a tricorder is, you may want to look at this post: Star Trek and Medical Computers

Who's going to develop the first medical tricorder? I'm willing to bet that it will be someone at MIT.

Fascinating Jim.

The ACLU Sues Over Patents on Cancer Genes

CNN: "Patents on two human genes linked to breast and ovarian cancers are being challenged in court by the American Civil Liberties Union (ACLU), which argues that patenting pure genes is unconstitutional and hinders research for a cancer cure." According to the ACLU, "Myriad's patents give it exclusive right to perform diagnostic tests on the genes -- forcing other researchers to request permission from the company before they can take a look at BRCA1 and BRCA2."

What do you think about this?

Scientists are identifying more cancer genes all the time. We already know that several forms of breast and ovarian cancers are linked to specific genes (like BRCA1 and BRCA2) that can be detected through special genetic tests. Oncologists and geneticists often struggle with the ethical dilemmas that frequently complicate genetic testing. Image source: CNN

FDA Recall: Face Paint Made in China

I hate to sound like I'm giving China such a hard time about their manufacturing standards. I've been to China several times and I even have some very good friends who are living there.

Well, the FDA has issued another consumer product recall. This time, it's on water-based face paints. Symptoms associated with these face paints included: rashes, itchiness, burning sensation, and swelling where the face paints were applied.

Fun Express, Inc. recalls children’s face paint associated with adverse events. Fun Express Inc., is a wholly-owned subsidiary of Oriental Trading Co.

Health Data Hacked at UC Berkeley

This doesn't sound good. Data security breaches are occurring all over the country (see: Hacked: Medical Data on 8 Million Virginia Residents)

Hackers (or maybe there's just one hacker) have compromised personal health information on over 160,000 individuals at the University of California Berkeley. The hackers attacked restricted computer databases in the campus' health service center and probably gained access to personally identifiable information used for billing, such as Social Security numbers, and non-treatment medical information such as immunization history, UHS medical record numbers, dates of visits or names of providers seen. Image source: Health IT News

Would You Buy Tamiflu or Relenza Online?

Do you live by the Boy Scout motto: "Be Prepared"?

Do you feel prepared against the swine flu? I'm not suggesting that you should buy Tamiflu or Relenza on the Internet. Perhaps the thought has crossed your mind. Would you buy any of these drugs from eBay if it were allowed? (eBay has strict rules and you won't find drugs on eBay unless someone has found a way to bypass these rules). Recently, we've seen so many stories about counterfeit drugs. This will only get worse if the demand for these types of antiviral therapies continues to rise among the public and if our ability to screen for counterfeit medications simply doesn't keep up.

Today is Fibromyalgia Awareness Day

Today (May 12) is Fibromyalgia Awareness Day. The The National Fibromyalgia Association’s theme for the 2009 National Fibromyalgia Awareness Day campaign is “Fibromyalgia Affects Everyone." Do you know anyone with fibromyalgia?

Regenerate Cartilage?

If you scrape your knee, your skin grows back. If you damage cartilage, does it grow back? Not usually. Thanks to some advances in nanotechnology, it may be possible to regenerate cartilage. In this image on the right, mesenchymal stem cells are grown on a scaffold of nanofibers. Biomedical researchers are constantly looking at ways to utilize nanotechnology to advance healthcare. The end result in this case may lead to new cartilage that can get transplanted into those areas of wear-and-tear and/or injury. Image source: Technology Review

A Sad Story on CNN

CNN has a tragic story of a U.S. soldier who killed his fellow comrades in Iraq. With all that violence and mental trauma, this person was suffering and was receiving therapy at a stress-relief clinic treatment center. I'm not sure anyone can ever receive enough counseling and therapy for going through actual combat. My heart goes out to the grieving families.

Golf, Exercise, and Health

I love to golf. If you walk while you golf, it's great exercise. Even if you're only playing nine holes, you can still get some great exercise if you walk instead of ride. If you're not a great golfer, then you may get extra exercise as you chase your ball through the woods. If you drive around in a golf cart, then you're really missing out on achieving your 10,000 steps a day. I try to walk whenever I can to achieve as many steps each day. Now that the weather is warming up, it's time to get my golf clubs out so that I can enjoy a break. I think it's time to look into some Golf Vacations!

I love to golf along the beach. Nothing beats the cool breeze, the ocean, and a great game of golf. One of my favorite spots is Myrtle Beach. It's been a while since I've been there, but I love the fact that it isn't too crowded. Arnold Palmer created some incredible courses out there. The scenery is so pleasant that you actually enjoy walking through the golf courses. Why ride if you can walk? A few years ago, I had a bad case of golfer's elbow (medial epicondylitis). Then, I developed tennis elbow (lateral epicondylitis)! I think it's time for a relaxing vacation. Sometimes you may find some great deals on some Golf Packages. Make sure to send me a tweet on Twitter if you find one!

Women and Mental Illness

What role does gender play in the diagnosis, course and treatment of mental illness? Are women more prone to mental illness? The U.S. Department of Health and Human Services' Office on Women's Health (OWH) has a report called "Action Steps for Improving Women's Mental Health." According to that report, women are twice as likely to suffer from major depression; three times as likely to attempt suicide; and they experience anxiety disorders two to three times more often than men. Why? What makes women so different from men?

CNN has a story about this interesting topic and highlights the personal stories of a few individuals. As technology improves brain imaging abilities and we gain a better understanding of how hormones affect our mood and cognition, are we as healthcare professionals moving in the right direction when it comes to the management of mental conditions?

Annoying Phone Calls

We all get annoying phone calls. There's no way to escape them. Is there any way to Trace That Phone Number? However, you may be interested to know that there are services that can help you remove some of these calls. One way is to ask your phone provider to block that specific number. I had to do that a few weeks ago because I continued to get calls from a 1-800 number that would call me in the middle of the night. Each time I would go to answer the call, the caller would hang up. It was essentially an automated prank call (or crank call if you prefer).

Trace That Number is one service where you can enter a phone number and get a fair amount of useful information. I've used this service several times and it's helped me identify mysterious callers. I've also used Google and other search engines to look up strange phone numbers, but often you end up reading about complaints against that same number. It doesn't always yield useful information. So, the next time you have to perform a Free Phone Lookup, give this service a try.

Now Part of the HCP Live Network

You may have noticed that this blog is now a part of the HCP Live Healthcare Professionals Network. You'll be hearing more about this over the next several weeks as things unfold. I'm very excited to be a part of this network (which includes bloggers like KevinMD). In the meanwhile, I invite you to explore my other blogs that are now a part of this network:

• Medicine and Technology
• Non-Clinical Medical Jobs, Careers, and Opportunities
• Medical Smartphones
• Mobile Health Computing

Top Content Last Week

Top content for the last week:

1. Double Hand Transplant!

2. Autism and the Amygdala

3. Jobs for Physicians with No Residency Experience

4. Face Transplant Photos

5. Non-Clinical Careers and Opportunities for Physicians

6. Face Transplant and Microsurgery

7. Hacked: Medical Data on 8 Million Virginia Residents

8. What if Some Medical Myths Were True?

Top Search Engine Keywords Last Week

Over the last week, here are the top search engine keywords that people typed to reach this site:

1. medicine and technology
2. blackberry storm medical
3. joe kim blog
4. technology in medicine
5. free emr
6. technology and medicine

I'm not surprised to see that people are still looking into free EMR solutions and medical software for the BlackBerry Storm.

BlackBerry Thumb to PDA Nail

• Look at my thumbs doc! I thought technology was supposed to improve health, not cause new medical problems! I've already had BlackBerry thumb because of Twitter. I think I'm going to sue RIM and Twitter because now, I'm getting PDA Nail!

Sound ridiculous? Well, BlackBerry thumb is a type of repetitive motion injury that is becoming more prevalent among working professionals who Twitter, I mean who use their BlackBerry for corporate e-mail. People who use their mobile smartphones for hours each day are even developing dystrophic nail changes that some clinical experts are calling PDA nail. The Am J Clin Dermatol. 2009;10(3):193-6. has a case study (two cases actually) titled, "The 'PDA Nail': Traumatic Nail Dystrophy in Habitual Users of Personal Digital Assistants."

Here's a snippet: "We describe two cases of traumatic thumb nail dystrophy associated with using a PDA keyboard for several hours per day... In conclusion, biomechanical stress resulting from overuse of PDAs may result in various types of nail dystrophy. We suggest the general term 'PDA nails' for these nail abnormalities."

So, what do your thumbs look like? Are your nails turning dystrophic? Image Source: Access Emergency Medicine I

National Women's Health Week

National Women's Health Week!

• National Women's Checkup Day will be Monday, May 11, 2009.
  
• The eight-week Woman Challenge, an online physical activity program, starts May 10, 2009.

National Women's Health Week is a weeklong health observance coordinated by the U.S. Department of Health and Human Services' Office on Women's Health (OWH). The theme this year is "It's Your Time" and the focus is on taking simple steps that will lead to improved health. These steps are:

• Getting at least 2 ½ hours of moderate physical activity, 1 hour and 15 minutes of vigorous physical activity, or a combination of both each week
• Eating a nutritious diet.
• Visiting a health care professional for regular checkups and preventive screenings.
• Avoiding risky behaviors, like smoking and not wearing a seatbelt.
• Paying attention to mental health, including getting enough sleep and managing stress

Job Loss Linked to Health Problems?

Do you know anyone who has recently lost a job? CNN has a story about how the risks of hypertension, heart disease, and arthritis are higher in those who lose their job.

As someone trained in public health, I often wonder whether we're talking about association or causation. In other words, does job loss cause these conditions? Probably not. However, the association is an interesting one and it may point to some issues that revolve around healthcare disparities. These findings were recently published in the journal Demography by Kate Strully, assistant professor of sociology at the State University of New York at Albany. Demography is the statistical study of all populations. What an interesting name for a journal. I'll have to keep my eye out for this edition. Image source: CNN.

Healthcare Reform

CNN is reporting that Obama has won support for healthcare reform. Do we actually have a choice? Healthcare really needs to undergo some serious changes, so what are we to do? Let's see what he will announce tomorrow.

May is Lyme Disease Awareness Month

This month is Lyme Disease awareness month. What do you know about Lyme Disease? Do you live in an area where ticks cause diseases? I do, and I've lived in several different states where ticks cause medical diseases (like Lyme Disease, ehrlichiosis, and Rocky Mountain Spotted Fever). When we're talking about ticks, it's important to differentiate between diseases caused by Borrelia vs. Rickettsia. You don't have to be an infectious disease expert to know the difference between these.

Lyme disease is caued by a bug (well, not literally a bug) called Borrelia burgdorferi. Everyone probably knows that you get Lyme through a tick bite, so as camping season approaches, it becomes important to check yourself for ticks.

Tickborne rickettsial diseases (TBRD) include other diseases like: 1) Rocky Mountain spotted fever (RMSF), 2) ehrlichiosis, 3) anaplasmosis, and 4) emerging diseases such as Rickettsia parkeri infection. The CDC has a great site that summarizes these common diseases.

Happy Mother's Day!

Happy Mother's Day to all you moms out there! I hope that you'll really enjoy this day and have a chance to relax.