Researchers studying the microbiology of water systems at 45 sites in seven different states across the U.S. found unusually high levels of bacteria in showerheads—almost 100 times more than any other place in the home. Although bacteria levels were high in all showerheads, some sample sites in the New York City and Denver areas had large amounts of Mycobacterium avium, a relative of the bacteria that causes tuberculosis and leprosy.

“If you’re getting a face full of water when you first turn your shower on, that means you are probably getting a particularly high load of Mycobacterium avium,” says study author Norman Pace, professor of biology at the University of Colorado.

Mycobacteria are found in soil, water, and decaying matter. Certain Mycobacteria, such as Mycobactrium avium, can cause digestive, lymphatic, and pulmonary infections. In the shower, these bacteria are delivered as aerosols. Particles are small enough to get into the lungs, and when inhaled or swallowed, can lead to a host of pulmonary problems.

The study, part of a bigger study that began as a class project, used DNA barcode testing to extract rRNA (bacterial DNA) from different parts of the shower and showerhead. Researchers sampled water flowing from the showerhead and obtained swab samples from the inside of the showerhead. Finally, samples were collected from water flowing out of the pipe after the showerhead was removed.

Homes with well water systems did not have Mycobacteria in their showerheads, a factor authors believe may be due to Mycobacteria’s chlorine resistance. Although they suggest that bathing may be safer, researchers assure that it’s not dangerous to shower.

“We did see some organisms that might be of concern if you have immune issues (such as) cystic fibrosis, AIDS, recent organ transplant, substance abuse, or are pregnant or otherwise immune compromised,” the authors wrote.

Click for more information on pulmonary disease.

Scientists report today in the New England Journal of Medicine that people who live in areas with high levels of ozone, a main constituent of smog, face a significantly higher risk of death from lung diseases than those living in areas with lower ozone concentrations. The study found the risk of dying from respiratory diseases to be 30 percent higher in metropolitan areas with the highest average smog levels.

The new study is the first to examine the long-term health impact of ozone exposure in metropolitan areas throughout the nation. Several studies have examined the effects of particulates, the small (less than 2.5 microns) particles present in soot, and found that exposure to these particles elevates the risk of heart and lung disease, but no previous study has examined the effects of long-term ozone exposure independent of particulates.

In the present study, researchers analyzed data on nearly half a million people who were living in 96 metropolitan areas of the U.S. between 1982 and 2000. They subtracted out the effects due to particulate pollution and found that while ozone does not increase the risk of cardiovascular disease like particulates do, ozone does severely impact respiratory health: the higher the ozone level in a particular city, the more likely its residents were to die of lung disease. For every increase of 10 parts-per-billion in ozone levels, the risk of respiratory death rose 4%. Even the city with the lowest ozone level, San Francisco, had an associated 14 percent increase in risk compared to no ozone exposure at all. The researchers controlled for individual risk factors, such as age, smoking status, body mass, and diet, and also for regional differences.

The present Environmental Protection Agency (EPA) air quality standards are based on short-term peaks in ozone exposure which occur during the spring and summer and can exacerbate existing respiratory conditions such as asthma and allergies. The present study links elevated risk of respiratory death to long-term cumulative effects of ozone exposure. The researchers note that their results suggest that environmental agencies should pay more attention to the health risks associated with long-term elevations in ozone levels. The EPA will be reviewing its ozone standard in the coming year.

Ground ozone (O₃), a reactive form of oxygen, is formed when sunlight reacts with nitrogen dioxide (NO₂), mostly from tailpipe and factory emissions) and oxygen (O₂) in the air. Its levels tend to be highest in the warmer months, in places with more overall sun exposure, and in cities with greater nitrogen dioxide emissions from cars and factories.

You can find out about current ozone levels in your area by visiting the government website http://airnow.gov/ . Want to learn more about respiratory diseases? Join the Healia Community for Lung Diseases. For more about allergies, read the Healia Health Guide to Outdoor Allergies or the Healia Health Guide on Allergies ; for more on asthma, see the Healia Health Guide to Asthma.

_{Photo: Dr. Keats, Flickr, Creative Commons}

Deaths due to cigarette smoking have declined since the 1960s thanks to a parallel decline in smoking rates. When the Surgeon General first reported that smoking may be hazardous to your health in 1964, about 42 percent of American adults smoked. The most recent data available show that this rate has now dropped below twenty percent (19.8%) for the first time on record. The Centers for Disease Control and Prevention’s Smoking-Attributable Mortality, Morbidity, and Economic Costs report shows that overall death rates from smoking declined in all but one state (Oklahoma) between 1996-1999 and 2000-2004. Below is a list of the states with the lowest rates of smoking-related deaths, followed in parentheses by the smoking-attributable death rate per 100,000 residents and the percent change in that death rate between 1996-1999 and 2000-2004.

The top 10 states with the lowest rates of smoking-related deaths for 2000-2004 are:

1. Utah (138.3 deaths per 100,000 residents, -11.0% change)
2. Hawaii (167.6, -28.0%)
3. Minnesota (215.1, -14.4%)
4. North Dakota (225.6, -10.9%)
5. New Mexico (234, -21.1%)
6. California (235, -37.8%)
7. Nebraska (235.8, -25.9%)
8. Idaho (237.4, -21.5%)
9. Colorado (237.6, -24.3%)
10. Connecticut (238.3, -18.4%)

To find out more about lung diseases related to smoking, visit the Healia Health Community for Lung Diseases. Find help and support to quit smoking at the Healia Health Community for Smoking.

_{Source: Adhikari B et al "State-specific smoking-attributable mortality and years of potential life lost-United States 2000-2004" MMWR 2009; 58:29-33. http://www.cdc.gov/MMWR/preview/mmwrhtml/mm5802a2.htm}

Photo: Paraflyer, Flickr, Creative Commons

The State of the Air report is an annual publication of the American Lung Association (ALA) that ranks cities and counties based on their levels of air pollution. The following is a list of the cleanest cities for air pollution from that report, based on the annual PM2.5 concentration, a measure of the yearly concentration of particles in the air that are less than 2.5 micrometers in size (PM2.5), which are thought to be the most harmful to human health. The ALA used the Environmental Protection Agency’s database to obtain the data, calculated the concentration of a pollutant, and ranked cities based on the EPA’s determination of the number of days that violated the national ambient air quality standard for annual PM2.5 of 15 µg/m³. The list below represents the cities with the best annual PM2.5 measures over the years 2004-2006 followed in parentheses by the total population that inhabits each area. Note that mostly small and medium-sized cities make the list.

The top 10 cities with the cleanest air in the U.S. are:

1. Cheyenne, WY (85,384)
2. Santa Fe-Espanola, NM (183,356)
3. Honolulu, HI (909,863)
4. Great Falls, MT (79,385)
5. Farmington, NM 126,473
6. Tucson, AZ (946,362)
7. Bismarck, ND (101,138)
8. Flagstaff, AZ 124,953
9. Anchorage, AK (359,180)
10. Salinas, CA (410,206)

To find out more about diseases caused by air pollution, join the Healia Health Community for Lung Diseases or the Healia Health Community for Heart Diseases.

Related blog posts: Study Finds Cleaner Air Lengthens American Lives by Nearly Five Months

        The Top 10 Most Polluted Cities in America

_{Source: American Lung Association, State of the Air 2008, Table 2. http://www.stateoftheair.org/2008/key-findings/SOTA08_Table2.pdf}

Smoking rates—and smoking-related deaths—have declined pretty steadily in the United States since a 1964 Surgeon General’s report that suggested smoking may be hazardous to your health. At that time, around 42 percent of American adults smoked. The latest data from the Centers for Disease Control and Prevention (CDC) show that for the first time on record, the smoking rate among U.S. adults has dropped below twenty percent (19.8%). In the CDC's Smoking-Attributable Mortality, Morbidity, and Economic Costs report, the agency reports that overall deaths rates from smoking declined in all but one state between 1996-1999 and 2000-2004. However, the smoking death rate actually increased for women in several states, and many states still have relatively high rates of smoking-related deaths. Below is a list of the states with the highest rates, followed in parenthesis by the smoking-attributable death rate per 100,000 residents and the percent change in that death rate between 1996-1999 and 2000-2004.

The top 10 states with the highest rates of smoking-related deaths for 2000-2004 are:

1. Kentucky (370.6 deaths per 100,000 residents, -13.3% change)
2. West Virginia (344.3, -21.5%)
3. Nevada (343.7, -44.4%)
4. Mississippi (333.6, -9.4%)
5. Oklahoma (332.1 +26.9%)
6. Tennessee (325, -12.4%)
7. Arkansas (323.7, -9.8%)
8. Alabama (317.5 -5.9%)
9. Indiana (308.9, -14.4%)
10. Missouri (307.8, -27.3%)

To find out more about lung diseases related to smoking, visit the Healia Health Community for Lung Diseases. Find help and support to quit smoking at the Healia Health Community for Smoking.

_{Source: Adhikari B et al "State-specific smoking-attributable mortality and years of potential life lost-United States 2000-2004" MMWR 2009; 58:29-33. http://www.cdc.gov/MMWR/preview/mmwrhtml/mm5802a2.htm}

_{Photo: Saudi..., Flickr, Creative Commons}

The American Lung Association (ALA) recently released its annual State of the Air report for 2008, which ranks cities and counties based on their levels of air pollution. The following is a list of the worst cities for air pollution based on the 24-hour PM2.5 concentration. This measure is the maximum daily value of the concentration of particles in the air that are less than 2.5 micrometers in size (PM2.5), which are thought to be the most harmful to human health. The ALA used the Environmental Protection Agency’s database to obtain the data and ranked cities based on the number of days that the 24-hour PM2.5 was rated in the categories unhealthy for sensitive groups, unhealthy, very unhealthy, or hazardous. The list below represents the cities (and surrounding areas) with the worst 24-hour PM2.5 measures over the years 2004-2006 followed in parentheses by the total population that inhabits each area. Note that cities both small and large make the list.

The top 10 most polluted cities in the U.S. are:

1. Pittsburgh-New Castle, PA (2,462,571)
2. Los Angeles-Long Beach-Riverside, CA (17,775,984)
3. Fresno-Madera, CA (1,038,101)
4. Bakersfield, CA (780,117)
5. Birmingham-Hoover-Cullman, AL (1,180,206)
6. Logan, UT-ID (111,156)
7. Salt Lake City-Ogden-Clearfield, UT (1,632,814)
8. Sacramento-Arden-Arcade-Yuba City, CA-NV (2,373,596)
9. Detroit-Warren-Flint, MI (5,410,014)
10. Washington-Baltimore-Northern Virginia, DC-MD-VA (8,211,213)

To find out more about diseases caused by air pollution, join the Healia Health Community for Lung Diseases or the Healia Health Community for Heart Diseases.

Related blog post: Study Finds Cleaner Air Lengthens American Lives by Nearly Five Months

_{Source: American Lung Association, State of the Air 2008, Table 2. http://www.stateoftheair.org/2008/key-findings/SOTA08_Table2.pdf}

_{Photo: saeru, Flickr, Creative Commons}

A study published today in the New England Journal of Medicine shows that cleaner air is responsible for lengthening the lives of the average American by nearly five months. The researchers report that improvements made in air quality over the past two decades have added 21 weeks to the life expectancy of the average American. It’s the first study to clearly demonstrate that reducing air pollution leads to longer lives.

Overall, the average life expectancy of Americans has risen 2.72 years since the early 1980s, in part because of reduced smoking rates and improved socioeconomic conditions. But the researchers found that 15 percent of that increase in longevity, about 21 weeks, is attributable to reductions in air pollution. Other studied indicate that this increase in longevity is likely due to declines in heart and lung diseases that are associated with air pollution.

The study looked at data on particulate pollution levels and life expectancies from 51 metropolitan areas across the nation during the 1980s and 1990s. On average, particulate levels fell from 21 micrograms per cubic meter of air to 14 micrograms per cubic meter in the cities studied, while the life expectancy increased by nearly three years.

What’s more, the communities that saw larger decreases in particulate levels also showed greater increases in life expectancy. In fact, the researchers found a reliable relationship between the two factors: for every reduction of 10 micrograms per cubic meter of particulate pollution in a city, its residents' average life expectancy increased by more than seven months. Thus, in Pittsburgh and Buffalo where the decrease was close to 14 micrograms per cubic meter, the life expectancy increased by nearly 10 months.

In 1970, the U.S. instituted the Clean Air Act, which gave the federal government power to institute national standards for air pollution. The law led to the development of catalytic converters on vehicles and new standards for factory emissions. While all of this came at great cost, researchers say that findings such as those released today make it all worthwhile.

Even better news is that data from the Environmental Protection Agency show that particulate levels have dropped another 11 percent nationally since 2001, the final year of data that was included in the study.

For more information on lung diseases related to air pollution, join the Healia Health Community for Lung Diseases. To find out more about heart disease, consult the Healia Health Guide on Heart Disease.

_{Photp: pfala, Flickr, Creative Commons}

The number one New Year’s resolution in America is to quit smoking and stay quit for the long term. Unfortunately, many people end up making this resolution year after year without success. The following are tips from the Centers for Disease Control and Prevention that can help you quit smoking successfully and for the long term. If you take them to heart, next year you may be resolving to clean out the garage or give more to charity – and you will be a lot healthier doing it.

1. Set a quit date. Many smokers say they would like to quit smoking, but never seem to get around to doing it. There always seems to be some impending stressful situation that makes people put it off. The best way to quit is to set a concrete date and stick to it.


2. Write down why you want to quit. For example, many people quit to improve their health, protect their family from secondhand smoke, increase their activity level, or to take more control over their life. Write down ALL the reasons that apply to you so you will have a list to consult during times when you are craving a cigarette. Motivation is critical to quitting successfully: the people most likely to quit for good are smokers who survive a heart attack.


3. Know that quitting is hard. Nicotine is a highly addictive drug and stopping its use can lead to symptoms of withdrawal that include irritability and intense cravings. No matter how you choose to quit, it will be hard, but if you prepare yourself for this fact, you will be more able to deal with the symptoms of withdrawal that can occur. Give yourself a month to get over these feelings. Take quitting one day at a time, even one minute at a time—whatever you need to succeed.


4. Avoid triggers. Researchers are finding that a lot of the issues people have with addiction involve behavioral aspects: what you do, where you go, who you are with. For example, say you go outside with co-workers every day at noon to smoke. If you are trying to quit, it is best to avoid such situations that may trigger you to smoke, even though you may not want to miss out on the experience. Do not let people smoke in your home. Avoid going to places you used to go to smoke such as bars, at least until you have gone a month or so without smoking. You should also get rid of all cigarettes and ashtrays in your home, car, and at work. Avoid alcohol, especially excessive amounts as this can be a major smoking trigger.


5. Don’t “cut down.” Smoking any number or kind of cigarettes can hurt your health. Attempting to smoke fewer cigarettes without quitting completely rarely results in permanent changes; eventually, you will return to and exceed the amount you used to smoke. Smoking “light” or "low tar" is also ineffective because you will just smoke more cigarettes or puff harder, longer, and more often on each cigarette. The only safe choice is to quit completely.


6. Be in the right half. Half of all adult smokers have quit: that means you can do it too. There are millions of people alive today who have learned to face life without a cigarette. For staying healthy, quitting smoking is the best step you can take.


7. Seek support if you need it. Many groups offer support in the form of written materials, programs, and advice to help smokers quit for good. There are also support groups composed of people who are trying to quit and social networks such as the Healia Health Community for Quitting Smoking where you can find tips and share stories. Ask family, friends, and people you work with for their support while you quit.


8. Take medicine. Especially if you have tried to quit and failed several times in the past, you should consider taking medication to help you quit. Talk to your doctor, nurse, or other health care worker about the available medicines. You can buy nicotine gum, the nicotine patch, or the nicotine lozenge at a drug store. Prescription medications include nicotine nasal spray, nicotine inhalers, and the pills Bupropion SR (Zyban) and Varenicline (Chantix). Most health insurance will pay for these medicines, but even if you have to pay for them yourself, the savings you will gain by not buying cigarettes will more than offset the cost.


9. Stay quit. After you quit, don't smoke – not even one puff every now and then. Don't use other types of tobacco such as snuff or chewing tobacco either. If you do "slip up" and smoke, don't give up. This is a common mistake that people make, thinking that have one cigarette or one pack means they have failed and then they slip right back into their old ways. Instead, continue on with your attempt to quit. Many people find it easier to quit once they have relapsed and gotten past it.


10. Keep a positive attitude. You can do it!

For help quitting, call 1-800-QUIT NOW (784-8669) to be connected to the free quitline in your State. To connect with others making the journey to better health, join the Healia Health Community for Quitting Smoking.


_{Sources: CDC Quit Tips,Feb 2008. http://www.cdc.gov/tobacco/quit_smoking/how_to_quit/quit_tips/index.htm; Help for Smokers and Other Tobacco Users. Consumer Guide, May 2008. U.S. Public Health Service. Agency for Healthcare Research and Quality. http://www.ahrq.gov/consumer/tobacco/helpsmokers.htm.}

_{Photo: Qfamily, Flickr, Creative Commons}

Each year the Centers for Disease Control and Prevention (CDC) lists the most common causes of death in the United States. The CDC collects data from death records around the country and publishes the results in the National Vital Statistics Report. The latest data available are from 2006. One of the key results to come from this data was that the national life expectancy in 2006 increased to the highest it’s ever been: 78.1 years. In addition, 11 of the top 15 causes of death for the previous year decreased in frequency. Death rates per 100,000 persons are listed in parentheses.

The top 15 causes of death in the U.S. for 2006 are:

1. Heart disease (210.2)
2. Cancer (malignant neoplasms; 187.1)
3. Stroke (cerebrovascular disease; 45.8)
4. Lung diseases (chronic lower respiratory disease; 41.6)
5. Accidents (39.3)
6. Alzheimer’s disease (24.4)
7. Diabetes (24.2)
8. Influenza and pneumonia (18.8)
9. Kidney disease (nephritis, nephrotic syndrome, and nephrosis; 15.0)
10. Blood poisoning (septicemia, 11.4)
11. Suicide (10.7)
12. Liver disease (9.1)
13. High blood pressure (hypertension and hypertensive renal disease; 8.0)
14. Parkinson’s disease (6.6)
15. Assault (6.0)

Use the Healia Health Search Engine to find out more information about the above diseases. Also see our Healia Health Guide on Heart Disease and the Healia Health Guide on Alzheimer's Disease.

_{Source: CDC, National VitalStatistics Reports Vol. 56, No. 16. http://www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_16.pdf
Photo: aussiegall, Flickr, Creative Commons}

On December 31^st, 2008, asthma inhalers are set to go “green” – in more ways than one. Rescue inhalers containing fast-acting medications such as albuterol that are used to ease symptoms of an asthma attack will no longer use chlorofluorocarbons (CFCs) as a propellant. Instead, by year's end, all albuterol inhalers must be powered by the more eco-friendly chemical hydrofluoroalkane (HFA).

While these green inhalers use propellant that is gentler on the ozone layer, they also cost a lot more, even though the medicine they contain is identical to older, CFC-powered inhalers: $30 to $60 for green inhalers compared to as little as $5 or $10 for the older CFC inhalers. What’s more, HFA inhalers must be used differently than the older CFC versions. Patients report that the medicine feels and tastes different, despite claims that the two types of inhalers work equally well.

While most of the nation’s 20 million asthma patients have already made the switch, about 20% of albuterol prescriptions were still being filled with the old CFC inhalers in mid-November. When these asthma sufferers go to refill their rescue inhaler prescriptions after the end of the year, they will find that not only does it cost a lot more, it also works differently. Pharmacists may not even notice the switch since the medication contained within is the same. This can leave patients on their own to figure out how to use the new inhalers.

Rescue inhalers containing albuterol are for quick relief of wheezing, not for daily asthma management. Patients also need daily medication to control their asthma and prevent flare-ups. If you are using your albuterol inhaler more than a few times a month, your asthma is not well-controlled. Talk to your doctor about adjusting your daily asthma control medications.

Recent research suggests only one in five children has their asthma under good control and no one knows how many adults have uncontrolled asthma. Find out more about asthma control by taking the Healia Asthma Quiz or by reading our guide, the Healia Health Guide on Uncontrolled Asthma.

Quick tips about the new HFC inhalers:

• Expect a softer puff instead of the older version's cold blast of air in the back of the throat.
• The new inhalers clog more often because HFA makes the drug stickier. Clean the hole weekly, following the specific instructions for each brand.
• Never get the whole device wet.

If you have asthma and have not been properly instructed on how to use the new HFA inhalers, make an appointment with your doctor or ask your pharmacist to show you how to use them. To find out more about asthma, see the Healia Health Guide on Asthma or join the Healia Health Community for Asthma.

_{Photo: spcummings, Flickr, Creative Commons}