The Health Wrap: Air pollution public health crisis; dialysis distress; STI spike makes headlines

Megan Howe
Friday, November 17, 2017

Climate emergency, The Health Wrap, Indigenous health, Non communicable diseases, Sexual health, Infectious diseases, Global health matters, Global health, Rural and remote health, Public health and population health, Air pollution

This fortnight’s Health Wrap, compiled by Sax Institute Publications Manager Megan Howe, takes a look at how the media covered three of the top public health stories that have been making headlines over the past fortnight.

Enjoy this new format of the wrap and don’t forget to tweet us @SaxInstitute if you have any feedback on the changes to The Health Wrap, or ideas you’d like to share.

An air pollution public health crisis

The world media’s attention has turned to New Delhi, India, this fortnight after the thick smog yet again blanketing the city was declared a public health crisis by the Indian Medical Association.

The New York Times reported that the smog had reached levels nearly 30 times higher than the World Health Organisation considers safe, or the equivalent of smoking more than two packs of cigarettes a day. It explained the main cause of the pollution was the annual burning of crop stubble by farmers in nearby states who are too poor to clear their fields for replanting by less polluting means.

The latest crisis comes after a special series on pollution in The Lancet estimated that India topped the list of countries with the most pollution-related deaths in 2015, with 2.5 million deaths linked to air, water and other types of pollution, as detailed by Times of India.

An analysis by ABC’s South Asia correspondent James Bennett gave a taste of what it’s like for residents in the city. He wrote:

“The concentration of poisonous particles is so intense that ingesting it, even through a mask, blurs the line between taste and smell. Eyes water. Throats rasp.”

Bennett looked at the issue of why China’s pollution levels are falling, while India’s have continued to rise, suggesting that public outrage over the situation in India is often “seasonal”, and is “quickly diluted by a myriad of rival interests”.

BBC News quoted Delhi chief minister Arvind Kejriwal, who warned that the pollution had turned the city into a “gas chamber” and outlined how four major hospitals in the city have jointly begun the first investigation of its kind into links between changes in air quality and the worsening of respiratory problems in patients.

Writing in Hindustan Times, Nitish Dogra, an associate professor at IIHMR Delhi and convenor of the Centre for Climate Change and Environmental Health, said it was critical to prioritise options in the local context, particularly since resources were always limited. Measures that needed to be considered included curtailing the use of solid fuel in households, replacing crop burning with measures that are affordable and can benefit small farmers, and tackling pollution from industry and brick kilns. He wrote:

“It is crucial to understand the adverse implication of air pollution on human health. Priorities for pollution abatement often do not take into account its long-term health impact. Air pollution also makes children prone to obesity and cognition deficits. It can adversely affect pregnant women too, resulting in low birth weight and premature births which are already high and a leading cause of high infant mortality in India.”

Meanwhile, The Daily Mail reported on a US study which found air pollution was associated with osteoporosis, fractures and increased risk of an early death, adding to known risks of cardiovascular and respiratory disease, cancer and impaired cognition.

The Indian air pollution crisis is also a timely reminder of the impact of environmental issues on health, as Croakey reports on COP23 — the 23rd session of the Conference of the Parties to the UN Convention on Climate Change (UNFCCC) taking place at the headquarters of the UNFCCC Secretariat in Bonn, Germany. Also check these Croakey reports: COP23: Working on a “rulebook” for the Paris Agreement; and Postcard from COP23: exchanging ideas to avoid climate catastrophe.

Dialysis distress

A new Menzies School of Health Research report has put kidney dialysis in the media spotlight, with renal patients and carers from across northern and central Australia highlighting the need for more holistic care and services to be made available closer to home.

Aboriginal and Torres Strait Islander people with chronic kidney disease were having to travel hundreds of kilometres for treatment and some were homeless because of a shortage of accommodation, National Indigenous Times reported.

Report lead author Dr Jaquelyne Hughes said current health care systems missed the mark in helping Indigenous people feel connected to their country, communities and culture while they received treatment. She said:

“We heard, overwhelmingly, of how people felt lonely, distressed and isolated following relocation to access treatment. Some patients reported homelessness and desperation because of this disconnect. They are not rejecting the desire to live well; they are rejecting the only model of care available to them.”

The Age and AAP reported that many sick people are forced to travel up to 1,000 kilometres to Cairns and Townsville to receive dialysis, and ABC News said it was not known how many Indigenous patients decided against having life-saving dialysis treatment due to the distress caused by travelling long distances from home.

Speculation over STI spike

Australia’s sexual health was also making news this fortnight, with much speculation around a 63 per cent spike in the number of Australians diagnosed with gonorrhoea in the past five years. As reported by The Sydney Morning Herald, the University of NSW’s Kirby Institute annual surveillance report on STIs and blood-borne viruses found that diagnoses of gonorrhoea and syphilis were rising while the number of people diagnosed annually with HIV has remained stable.

ABC News reported that the highest rates were in people aged 15–24, but the greatest increase has been in the 25–40 age bracket. However, the reasons behind the rise remained a mystery. Rebecca Guy from the Kirby Institute commented that it was not due to more testing and there was no data to suggest that fewer people were using condoms or more people were having casual sex due to dating apps.

The Guardian blamed the spike on “urban heterosexuals”, and similarly Buzzfeed said, “Straight people living in major cities can’t stop giving each other gonorrhoea”. A story by AAP, published by The Age and The Australian, suggested that “kissing kids” could be to blame for the rise in cases, as experts are now investigating whether gonorrhoea can be transmitted through kissing and more young Australians have oral sex.

While Associate Professor of Medicine at ANU Dr Sanjaya Senanayake said the kissing theory was yet to be proven, Professor of Sexual Health at the Kirby Institute Basil Donovan suggested there was a “very real” chance that kissing has become an issue for the spread of the sexually transmitted infection (STI).

“There’s some evidence coming out of Melbourne that’s certainly pointing that way; I’d like to see it replicated but I wouldn’t call it undeniable,”he said.

Meanwhile, Gay Star News highlighted a different aspect of the report, a rise of HIV and STIs in Australia’s Indigenous population, and in the Daily Mail, Sydney GP Dr Brad McKay urged young people to heed the message about condom use, although he acknowledged gonorrhoea could still spread even with vigilant condom use.

For a snapshot on the latest data on the state of STIs and blood-borne viruses in Australia, it’s worth a look at this article in The Conversation, and this ABC News explainer gives a rundown on the symptoms and dangers and treatments for common STIs.