Risky alcohol-related driving behavior increases at age 21

Underage drinking is a widespread problem and includes risky behaviors like drinking and driving or being a passenger in a car with a driver who is impaired. But a study shows that college-age youths take even more alcohol-related driving risks than underage drinkers. The study found a sharp uptick when students turned 21 years old, the legal age for purchasing alcohol.

Researchers at the University of Maryland School of Public Health recruited 1,253 first-year college students to participate in a four-year study examining drinking behaviors. They found that, among 20-year-olds, 8% drove after drinking any alcohol, 20% drove while intoxicated and 43% rode with an intoxicated driver. At age 21, 63% drove after drinking any alcohol, 25% drove while intoxicated and 49% rode with an intoxicated driver.

Other studies have shown that freshmen in college tend to drink more than upper-classmen. However, risky driving behavior related to alcohol appears to increase with age among college students, perhaps due to reaching the legal drinking age or more access to cars. The study should be considered in the national debate about lowering the legal drinking age to 18, said the lead author of the study, Amelia M. Arria, director of the Center on Young Adult Health and Development at the University of Maryland School of Public Health.

"Our findings call into question the assertions of some advocates who claim that lowering the drinking age to 18 would be a useful strategy for reducing harm associated with alcohol consumption," Arria said in a news release. "The present findings are consistent with numerous prior studies showing that increased availability of alcohol is associated with a greater level of problems, especially underage drinking-and-driving fatal crashes."

The study was published Monday in the journal Alcoholism: Clinical & Experimental Research.

— Shari Roan

Photo: High school students portray the living dead during the 'Every 15 Minutes' program, a staged drunk-driving accident to help illustrate the dangers of drinking and driving, in Roswell, N.M. Credit: Mark Wilson / Roswell Daily Record.

New meaning to the hazards of air travel

Air travel seems to get harder all the time. The latest threat to the traveling public comes in the form of four legs and fur.

According to an editorial published today in the Canadian Medical Assn. Journal, it's time for humans with pet allergies to take back the skies. So many people today are flying with small pets in the airline cabins that people with pet allergies are being put at risk, state the authors of the paper, who represent the journal and the University of Ottawa. About one in 10 people have an allergy to animals.

Service animals are rightfully permitted on planes, the authors said, and are not the issue. But pets can travel in cargo, they argue. Some countries have ruled that people who are allergic to nuts should be spared from exposure to those courtesy peanuts aboard many flights, but there are few rules governing pets in the cabin. According to the paper, one Canadian-based airline has pets on about 25% of its flights.

"The preferences of pet owners should not supersede the well-being of their fellow passengers," the authors wrote. "Pets can be accommodated comfortably and safely in airplane cargo holds, which is where they belong. Airlines must choose to put the needs of their human passengers first, or be forced to do so."

-- Shari Roan

Photo credit: Ray Kachatorian / For The Times

Flight attendants may offer too much slack; same can't be said for Blue Shield

Sometimes, stringent adherence to the rules can be good for one's health. Sometimes, the effects have more negative repercussions. Here are two examples from today's L.A. Times ...

Staff writer Rong-Gong Lin II writes: "Amid concern about H1N1 and seasonal flu, federal health officials issued guidelines late last month on how to handle obviously sick passengers: Flight attendants should ask the person with the cough to wear a mask and move them at least 6 feet from others. In the air, recent travelers report a different reality."

Read more.

On an unrelated topic, columnist David Lazarus begins:

"Amid a national debate on how to make the healthcare system friendlier and more accessible, and as millions of people grapple with the loss of jobs and homes, what does insurance heavyweight Blue Shield of California do? It decides to take a key benefit away."

Read more.

It seems much depends on who follows, and who makes, the rules.

-- Tami Dennis

Where there's swine flu, there's a pitch. Seat protection anyone?

Perhaps on the surface, this product might make some kind of sense to people overly alarmed about the H1N1 outbreak, who don't like to be slowed down by facts and who have $14.99 burning a hole in their pocket. But to everyone else, using the Sure Fit Transit Cover to protect against the flu would have to defy logic.

As the e-mailed pitch goes: "Searching for an option to keep people safe and protected, Sure Fit, the nation’s leading slip cover and accessories provider has created the newest must-have item to ease fears of catching the flu en route with the Transit Cover."

The cover does what it sounds like it does. It slips over the back (just the back) of an airplane or bus seat.

It's up to you to avoid touching the arm rests. And tray table. And bathroom door. And the seat while taking the cover on or off. And the cover itself once you take it off, because presumably you'd want to reuse it... Airborne transmission is a less reliable way to spread the flu, but it might be a good idea to not breathe while you're on the plane too.

Just ignore the fact that not even toilet seat covers do much to protect against the spread of disease. And one is presumably not touching multiple surfaces in a toilet stall. Here's an answer to that much-wondered-about public health question, courtesy NYU Langone Medical Center: True or False: It Is Possible for a Person to Get a Sexually Transmitted Infection from a Public Toilet Seat.

Users don't even have to take those things with them when they leave.

If you really want to know how to reduce the chances of contracting so-called swine flu, or any other flu, here's some advice from the federal Centers for Disease Control and Prevention. Soap and hand sanitizers are featured prominently; seat covers are not.

For more on disease transmission, here's a report from the L.A. Times earlier this year: Cold and flu viruses travel a tricky route, plus a sidebar: Discovering how flu is transmitted may give clue to prevention.

The first story states: "The mere presence of a virus doesn't necessarily mean it is still infectious. But a Swiss study published in Applied and Environmental Microbiology in May showed that influenza virus not only can remain on paper money for up to 17 days, but also that it can be alive and ready to infect."

Separating consumers from their money? Maybe there is something to this seat cover. And if that's what it takes to "ease fears of catching the flu en route," please, go ahead.

-- Tami Dennis

Photo: Don't touch anything. Don't even look at anything.

Credit: Richard Derk / Los Angeles Times

Flight risks

Longer flights and aging passengers mean that a growing number of airline passengers are suffering medical problems en route to business meetings or vacations, according to a review in the Lancet, the British medical journal, published online today.

It's not so much that the stale air, cramped quarters and hacking fellow travelers have gotten worse. In fact, on some of the newer aircraft, such as the gigantic Airbus A380, air circulation and leg room may be improved.

But the jumbo-plus airplanes are capable of flying for 18 to 20 hours at a time. And the risk of deep vein thrombosis -- a blood clot in the legs that can move to the lungs -- begins to rise at four hours and is highest in flights of eight or more hours.  (Staying well-hydrated, walking around the cabin and flexing your calf muscles can help prevent blood clots.)

Additionally, aging passengers with heart, breathing or other problems may be more sensitive to changes in air cabin pressure. And for those who have recently had major surgery, the same change in pressure that causes ears to pop can also --at least anecdotally -- cause wounds to open.

For old and young alike, longer flights mean more opportunities to contract the flu and other bugs circulating in close quarters.

Earlier this month, passengers on flights from Vietnam to Singapore and then Singapore to New Zealand were warned that they may have been exposed to highly infectious measles after an unvaccinated child returned home ill from a visit to Vietnam, which has been experiencing an outbreak.

Reviewers recited a litany of diseases that have been transmitted on commercial flights, including severe acute respiratory syndrome (SARS) and tuberculosis.

Still feel like flying? It's generally safe, the review concluded. But the take away: Make sure you're in good enough health for the flight, and understand the risks.

-- Mary Engel

Photo credit: AP / Charles Rex Arbogast

On a mission? Wear a mask

In the no-good-deeds-go-unpunished category, 20 volunteers from mission groups in Pennsylvania and Virginia who helped renovate a church in El Salvador earlier this year fell ill with a fungal disease called histoplasmosis.

The fungus, Histoplasma capsulatum, is found in soil, especially soil that's been contaminated by bird or bat droppings. If inhaled, it can cause acute respiratory illness.

The outbreak was written up in Thursday's Morbidity and Mortality Weekly Report, published by the national Centers for Disease Control and Prevention.

The 20 volunteers were among 34 people from three mission groups who traveled to Nueva San Salvador, El Salvador, last January and February for a week to replace a church roof, tinker with plumbing and generally spruce up the place. Those whose jobs included digging or sweeping were the most likely to fall ill, probably because they disturbed the soil and caused microscopic fungal spores to become airborne.

Symptoms, which began about 12 days after exposure, included fever, fatigue, headaches and chills. Six of the volunteers were hospitalized. All recovered.

The fungus can be found in soil throughout the world, including the United States, especially around chicken coops and bird roosts. Most people who become infected have only mild symptoms and recover without treatment. Construction workers and farmers, who are most at risk, are advised to wear respirators and to spray water to keep dust down.

Good-deed doers can do the same.

-- Mary Engel

A U.S. Olympic team doctor blogs from Beijing: The guts, the glory, the gastrointestinal problems

Amid all the hoopla that is the Beijing Summer Olympics, it’s understandable that some things are lost in the wake of feats such as acquiring eight gold medals.

Take, for instance, the live-from-the-Beijing Olympics blog being written by Dr. Scott Rodeo (pronounced row-dee-oh, not the fancy row-day-oh), an orthopedic surgeon on the medical team treating U.S. Olympic athletes. He may not have the cachet of Oprah-approved Dr. Mehmet Oz, but Rodeo has great creds — he’s the co-chief of the Sports Medicine and Shoulder Service at the Hospital for Special Surgery in New York City, associate team physician for the New York Giants, and a former competitive swimmer. He’s done the Olympics gig before as the U.S. Olympic team’s physician at the Athens Games in 2004. The hospital’s public relations director suggested he blog via his Blackberry about his experiences as one of several medical personnel at the event, and so he has, starting with the swim team’s training camp in Singapore. Which is great, except the posts are … less than spine-tingling.

"I have continued to treat both gastrointestinal illness as well as sinusitis, upper respiratory conditions, coughs, and sore throats," he writes. "We have also had a few minor injuries in swimmers (finger, elbow) which occurred from a forceful finish."

All righty then.

Frankly, we feel for Rodeo, who must be caught between a rock and a hard place. On one hand, he certainly has no desire to see nasty injuries befall the athletes, most of whom have trained years for this opportunity. On the other hand, flying about 7,000 miles to treat diarrhea must be … a touch of a disappointment.

"There’s enough other stuff going on," he says, chuckling. "The less I see the better, because it means that everybody’s healthy."

A phone conversation (part of which took place en route to an event as Rodeo’s bag, filled with syringes and such, was being checked by security) yielded more info on what Rodeo’s been up to. Although his main focus is on swimmers, he cares for other U.S. and foreign athletes as well, plus a few media people and NBC staffers thrown in for good measure.

As for the athletes, "There may be a number of little things that you treat," he says. "More significant things are small fractures, which can be taped, and if it’s not too serious the athlete may keep competing. Most things are muscle strains — some are acute and demand attention." Those, he adds, are usually treated with ice and anti-inflammatory medications.

Various sports, he explains, yield specific types of injuries. Swimmers, for example, typically suffer overuse injuries such as shoulder strains, caused by repetitive arm movements. They can also suffer acute injuries such as fractures if they smash their hands against the pool wall during a finish. Track athletes can have stress reactions, a chronic bone injury that can be a precursor to a stress fracture.

It’s obvious that Rodeo must be prepared to treat anything, like the aforementioned gastrointestinal issues, which are typical for travelers and can stem from changes in water, food, and environment and can alter the GI tract’s bacterial balance. Nerves, he adds, are probably a factor in some of these cases. He’s been treating most mild cases with anti-diarrheal medications, and more serious ones with antibiotics. The danger here, Rodeo says, is dehydration: "Athletes can lose a lot of fluid, and that can affect performance."

For those hoping Rodeo would name names of who’s been injured and how, don’t hold your breath. The United States Olympic Committee prohibits him from giving out specifics. But a couple of nuggets were extracted: Michael Phelps is a stand-up guy who hasn’t gotten a swelled head from his phenomenal accomplishments. "He’s a good person, normal, he puts his pants on one leg at a time." Or should that be super-duper Speedos? Most athletes at this level, he adds, are pretty savvy about injuries and treatment and don’t act like prima donnas around the docs.

Despite a rigorous work schedule (he’s had little time to sightsee), Rodeo’s perks are getting to attend the competitions (he witnessed Phelps’ win in the 100-meter butterfly), as well as gather useful information to take home.

"You see injuries as they occur, as opposed to people coming in to see me a day later," he says. "So we can see what the best scenario is right away and learn how to get someone back quickly."

The blog has received about 1,000 visitors over seven days of tracking, and has received five comments. He sums up his month away from home this way: "It’s a neat experience on a lot of levels."

-Jeannine Stein

Photo credit: Martin/Presse Sports via US PRESSWIRE.