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A history of second hand smoke exposure: are we asking the right questions?

 A history of second hand smoke exposure:
are we asking the right questions?

CranePaperMardi A. Crane-Godreau* and Peter Payne

The 2006 Surgeon General’s Report, “Health Consequences of Involuntary Exposure to Tobacco Smoke” (Surgeon General, 2006) documents the health implications of exposure to SHS, including firm evidence that SHS contributes to coronary and lung disease, lung can- cer, premature death in adults, slow lung development, SIDS, asthma, and ear infections in children, as well as suggestive evidence that implicate SHS in COPD, asthma, breast cancer, and nasal sinus cancer in adults, and leukemia, lymphoma, and brain tumors in children. The report indicates that there is no risk-free level of SHS. Despite evidence that SHS is a risk factor for disease, most healthcare orga- nizations and many physicians fail to ask patients about their history of SHS exposure. The implications of that failure are considerable because knowledge of a patient’s history of SHS exposure enables providers to make better-informed decisions about what to include in each patient’s examination and lab tests, and how to conduct longterm monitoring, as well as alerting the patient to the need for measures to help them avoid further smoke exposure.

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Hip Fracture

Your Bones!

Your Bones!

Beautiful bones, our structure, our frame. But those beautiful bones may be at risk of breaking if you are one of us who flew during the years when cigarette smoke was a near constant factor in aircraft cabins.

Osteoporosis (porous bones) leads to an increase risk of bone fractures. Beyond smoke exposure, individuals with a small frame (exacerbated by those horrid weight checks) may have an added risk of osteoporotic bone fractures.

Both lifestyle and medical options can help to maintain bone mass and indeed to rebuild those very necessary bones. For current and former flight attendants, here are tips that may help in keeping your bones strong.

  • Talk to your health care provider about bone health. Make sure to discuss your occupational exposure to cigarette smoke and low body weight.
  • Get a dexa-scan at least every two years.
  • Vitamin D, actually a hormone, plays a crucial role in protecting and rebuilding bone. The Endocrine Society’s spokesperson, Dr. Michael Holick reported new guidelines for Vitamin D intake including that, a “tolerable upper limit of Vitamin D intake for everyone over 8 years of age is 4000 I.U.” Check your Vitamin D levels annually, best in winter. The Endocrine Society recommends that a healthy individual should maintain a level between 30 and 60 ng/mL. www.medscape.com article
    http://jcem.endojournals.org
  •  Mineral intake is crucial in staving off bone fractures. Calcium, magnesium and zinc are ALL required for healthy bones (1). Vitamin K may also play a key role. Supplements with balanced levels of these and other key vitamins and minerals are available at most stores that sell vitamins. http://www.jacn.org/content/19/6/715.long#sec-12
  • The ratio of fatty acids in your diets seems to matter. Relative to Omega -6 fatty acids, an increased intake of Omega 3 fatty acids (the good fats found in cold water-fish: salmon, mackerel, anchovies, sardines and herring) is associated with bone protection. Both Omega-3 & -6 can be found in other foods including in some cheeses like feta, especially from grass fed goats! http://www.umm.edu/altmed/articles/omega-3-000316.htm
  • Weight bearing and resistance exercise are crucial in maintaining or regaining bone mass. Proficiency and practice of Tai Chi or QiGong reduce stress and are reportedly protective against bone loss. Exercise in general, and Tai Chi and QiGong in particular, are associated with increased strength and balance and are protective against falls.
    http://www.ncbi.nlm.nih.gov/pubmed/17080541
    http://www.ncbi.nlm.nih.gov/pubmed/21378497
  • Be moderate in consumption of caffeine, salt and alcoholic beverages. High consumption is associated with weaker bones.
  •  Stay attentive to the state of your bones. Bone fractures are not just a matter of pain and inconvenience. They can be debilitating.

Osteoporosis is not inevitable. Take care of those beautiful bones!

Safe travels.
By Mardi Crane-Godreau, Ph.D.
Mardi Crane-Godreau was a Pan Am Flight Attendant from 1967 to 1985. She is now a faculty member at Dartmouth Medical School.