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Am Fam Physician. 2001 Jun 1;63(11):2283-2284.
AAP Technical Report on Irradiation of Food
The Committee on Environmental Health of the American Academy of Pediatrics (AAP) has issued a technical report on the irradiation of food. The report discusses irradiation technology, reviews issues of safety and wholesomeness, and gives a historical perspective of the public controversy about food irradiation. The AAP statement appears in the December 2000 issue of Pediatrics.
The AAP committee reports that rates of foodborne illnesses are increasing dramatically in industrialized countries. Irradiation technology can reduce foodborne bacteria in selected foods. During the irradiation process, food is exposed to a controlled source of ionizing radiation to prolong shelf life and reduce food losses, improve microbiologic safety, and/or reduce the use of chemical fumigants and additives.
New food technologies have always been met with resistance. For instance, the development of pasteurization was considered highly suspect, although many of the objections raised about that technology are similar to current arguments about food irradiation. Opponents worry that irradiation might be used to mask spoilage and enable the sale of unsafe foods. However, the chemical and physical changes characteristic of spoiled food cannot be reversed by irradiation.
According to the AAP committee, the scientific consensus on the efficacy and safety of food irradiation is strong. The U.S. Food and Drug Administration has taken a protective stance on the regulation of food irradiation compared with much of the rest of the world, approving only low-dose radiation without toxicologic testing.
Food irradiation cannot be substituted for safe food production, processing and preparation. The AAP committee stresses that irradiated food is safe and nutritious and produces no unusual toxicity as long as best management practices are followed. Irradiation complements established techniques in adding to food safety, increasing shelf life, reducing loss from spoilage and increasing the diversity of foods available to the population. The technology of food irradiation is the most intensely studied of all food processing techniques. In the United States, it is regulated for safety by federal agencies. Because unanticipated consequences are possible, careful monitoring and continuous evaluation of all food processing techniques are prudent.
Measurement of Trends in Childhood Asthma
According to the Centers for Disease Control and Prevention (CDC), asthma is the most common chronic disease of childhood and the prevalence has increased dramatically in this group since 1980. The National Health Interview Survey (NHIS), which is the main source of data on asthma prevalence in the United States, was redesigned in 1997. The CDC has issued a report presenting NHIS data from 1980 to 1998 to examine the effect of the redesign on measuring trends in asthma prevalence overall and among age and racial subgroups of children. The report appears in the October 13, 2000 issue of Morbidity and Mortality Weekly Report.
The NHIS is an ongoing household survey of a representative sample of the U.S. population. Before 1997, one sixth of the sampled households were asked the following question: “During the past 12 months, did anyone in the family have asthma?” After the redesigned survey was introduced in 1997, information about asthma was collected for a randomly selected sample child in every household containing a child. The number of children involved in the survey increased from about 4,500 before 1997 to approximately 14,000 per year after 1997. The redesigned survey also specifically asked if a physician or other health care professional had diagnosed asthma in the child.
The NHIS found that the overall prevalence of asthma in persons up to 17 years of age increased by about 5 percent each year from 1980 through 1995. The childhood prevalence in 1996 was 17 percent lower than that in 1995. Based on the redesigned survey, the rates in 1997 and 1998 were even lower, representing the start of a new trend.
According to the CDC, the NHIS findings indicate that while asthma prevalence estimates for 1997 to 1998 are lower than those before the redesign, estimates after 1997 cannot be compared with previous estimates. Additional data are needed to establish a new trend after 1997. The redesigned survey may have differentially affected the measurement of asthma prevalence in subgroups of children. To promote comparability of surveillance data, the Council of State and Territorial Epidemiologists recommends that a uniform case definition be used by all systems that collect data on self-reported asthma. In addition to the 1997 changes, the 2001 NHIS survey will be modified to adopt a similar case definition by including the question, “Do you still have asthma?”
Rates of Cigarette Smoking in the United States
According to the Centers for Disease Control and Prevention (CDC), one of the national health objectives for the year 2010 is to decrease the rate of cigarette smoking among adults to 12 percent or less. To determine the progress toward meeting this goal, the CDC analyzed self-reported data from the 1998 National Health Interview Survey Sample Adult Core Questionnaire about cigarette smoking among adults in the United States. The findings of this analysis are summarized in a report that was published in the October 6, 2000 issue of Morbidity and Mortality Weekly Report.
The CDC found that in 1998, 24.1 percent of adults were current smokers. The highest rates of smoking were seen in persons 18 to 44 years of age; Alaska Natives and American Indians; adults with nine to 11 years of education; and persons living below the poverty level. These findings suggest that reducing the prevalence of cigarette smoking will require aggressive nationwide public health efforts that address specific subgroups in the population.
To solve the problem of increased smoking among persons 18 to 24 years of age, the CDC recommends that tobacco-use prevention and treatment programs focus on both adolescents and young adults. While many factors contribute to the high rate of smoking among American Indians and Alaska Natives, culturally appropriate prevention and treatment programs should distinguish between the use of manufactured tobacco products and the ceremonial use of tobacco.
According to the CDC, short-term decreases in tobacco-related morbidity and mortality can be accomplished only by helping current smokers to quit. The U.S. Department of Health and Human Services has released guidelines with specific evidence-based recommendations for treatment of tobacco use. Recommendations include individual, group and telephone counseling that offers practical advice about and support for quitting, and support from family and friends. All smokers who are trying to quit should be encouraged to use a medication approved by the U.S. Food and Drug Administration, such as nicotine replacement therapy or a non-nicotine pharmacologic aid.
The CDC stresses that increased attention should be focused on the groups that show no decline in smoking prevalence. Approaches with the widest scope are likely to have the greatest long-term impact on the population.
New Resource Guides on Substance Abuse Issues
The Center for Substance Abuse Prevention (CSAP) of the Substance Abuse and Mental Health Services Administration (SAMHSA) has released six new resource guides on substance abuse issues in specific populations. The guides provide comprehensive listings of reference articles, studies, fact sheets, brochures, findings and Internet sites that can help in SAMHSA's ongoing efforts to support and promote antidrug initiatives.
The new CSAP guides, which briefly describe current substance abuse prevention and treatment materials and findings related to specific topics, are as follows: “Children of Alcoholics”; “Impaired Driving”; “Inhalants”; “Lesbian, Gay, Bisexual and Transgender Populations”; “Middle School and High School Youth”; and “Women.” According to SAMHSA, the guides are intended for use by community leaders and other persons who are concerned about substance abuse problems in their neighborhood.
For free copies of these and other substance abuse resource guides, call CSAP at 800-729-6686 or visit the SAMHSA Web site at http://www.samhsa.gov and click on “Clearinghouses.”
Copyright © 2001 by the American Academy of Family Physicians.
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