Shift work exposures can accelerate metabolic syndrome (MetS) development among the large population of middle-aged males with elevated alanine aminotransferase (ALT). Elevated serum alanine aminotransferase (e-ALT) is a common abnormality of health examinations in middle-aged working populations. It is unavoidable nowadays that a large number of asymptomatic workers with e-ALT may be asked to do rotating shift work on 24 h production lines. In some previous studies, e-ALT and shift work had been independently assessed for their associations with MetS, which is associated with cardiovascular disease, one of the leading causes of death among working populations.

In terms of workplace health management and job arrangements, a five-year follow-up study assessing the association between rotating shift work (RSW) and MetS development was conducted in Taiwan for male workers. In some previous studies, e-ALT and shift work had been independently assessed for their associations with MetS, which is associated with cardiovascular disease, one of the leading causes of death among working populations.

A research article written by Dr. Yu-Cheng Lin et al from Tao-Yuan General Hospital, Taiwan, which has recently been published in World Journal of Gastroenterology, took both risk factors together into consideration, and demonstrated significant findings. In Lin’s study, after a five-year interval, the workers with baseline e-ALT had significantly unfavorable changes in MetS-component abnormalities, and higher rates of MetS development, vs subjects with normal baseline ALT. Particularly, workers who had both baseline e-ALT and long-term RSW exposures had the highest rate of MetS development among four subgroups divided by e-ALT and RSW. Statistically, e-ALT-plus-RSW workers had a significant risk for MetS development.

Lin et al stated that, MetS development among middle-aged males with e-ALT should be carefully monitored. In terms of job arrangements, long-term shift workers with e-ALT deserve special attention for MetS development. They suggested that all workers with e-ALT should be carefully evaluated and managed for MetS. Particularly, MetS risk assessment must be emphasized for male employees with e-ALT facing long-term rotating shift work exposures.

Public health experts agreed that this is an important area of research, given the amount of shift work performed around the globe, particularly when proponents claim that shift working is ‘beneficial’ to the health and safety of those concerned.

Perhaps safety is the last thing on your mind as the holiday season approaches; but spare a few moments to consider these top 12 safety tips to ensure that your festive period, family home time, journeys and activities proceed without mishap, and ensure you, your family and your guests have a merry and cheerful holiday.

1. Make An Emergency Car Kit and Plan for Safe Driving

Preparing to visit relatives or friends over the holiday season? The American Red Cross suggest you make an emergency car kit and include items such as blankets or sleeping bags, jump leads, a fire extinguisher (A-B-C type, 5 lb), compass, road maps, shovel, tyre repair kit, tyre pump, extra clothing, flares, and a tow rope.

And of course, don’t drive off until you and your passengers have buckled their seat belts and children 12 and under are in the back seat. Avoid travelling with sharp or heavy objects in the passenger area of the car; in the event of a sudden stop or crash they turn into dangerous flying missiles. Also, make sure any child seats meet recognized federal or national standards for crash protection.

You should avoid driving in a storm, but if you feel you must, keep your gas tank full and don’t let the fuel line freeze. Let someone know where you are going, which route you are planning to take and when you expect to arrive.

2. Make Delicious Non-Alcoholic Drinks for the Driver

Don’t drink and drive: this doesn’t have to be boring for the driver if you make sure he or she has plenty of delicious non-alcoholic drinks to choose from. Be a thoughtful host and make sure drivers coming to your party have a good choice of non-alcoholic drinks. These are available in good supermarkets, or you can make your own.

Try this non-alcoholic Christmas punch: take 2 cups (half a litre) white grape juice, 2 really ripe mashed bananas, 1 cup each of pineapple and mango juice, 2 cups ginger ale, a litre (a quart) of sparkling water or plain soda, half a cup blueberries, 1 cup raspberries, 1 tin mandarin segments. Mix all together, sweeten to taste (eg with agave syrup or sugar syrup), decorate with chopped mint leaves and cinnamon sticks.

3. Use Layers for Warmth

When it is very cold outside, if you dress in several thin layers rather than rely on one single heavy coat you will stay warmer and avoid hypothermia; plus wear a hat, especially one that covers your ears.

The American Academy of Pediatrics advises that you dress an older baby or young child in one more layer of clothing than an adult would wear in the same conditions. For outdoor activities they suggest children wear thermal long johns, turtlenecks, one or two shirts, pants, sweater, coat, warm socks, boots, gloves or mittens, and a hat.

Hypothermia symptoms include: confusion, dizziness, exhaustion and severe shivering: seek medical attention immediately if you get cold and have these symptoms.

4. Use a Baby Sitter Trained in First Aid

For peace of mind while you enjoy your Christmas party, engage a baby sitter who is trained in first aid. If you have a regular and reliable baby sitter who is not first aid trained encourage them to get training.

Red-Cross certified babysitters learn how to give basic first aid, hold and feed a child properly, monitor safe play, actively engage with the child, take emergency action when needed, and they can also become certified in infant and child CPR (cardiopulmonary resuscitation).

5. Stay Safe in the Kitchen

Keep flammable items such as towels, curtains, cloth potholders away from the stove top. Keep children out of the area where hot food or drinks are being prepared, and use back burners and turn pot handles toward the back of your stove so they are out of reach of little hands.

6. Ensure Your Home is Fire Safe

Winter is a time when household fires occur, so remember to install smoke alarms on every floor of your home, test them every month, and make sure family members know what to do in the event of a fire. Don’t leave portable heaters or fireplaces unattended.

If you are planning to build a new home, consider installing fire sprinklers.

7. Prevent Falls at Home

According to a 2004 report from the Home Safety Council, falls are by far the leading cause of cause of unintentional home injury death and account for over 5 million injuries and nearly 6,000 deaths a year in the US.

Walk through your home and look for potential fall hazards and put them right. For example, have handrails on both sides of stairs and steps, have lots of light at the top and bottom of stairs, tape rugs to the floor or don’t use them, keep the stairs clear of toys and obstacles, use non skid bathroom mats, install grab bars in the tub and shower, and have a non slip mat or non slip strips in your tub and shower.

8. Prevent Poisoning

Poisons are things you breathe, touch, eat or get in your eyes. Know where they are in and outside your home. Keep all poisonous items locked away from children, read the instructions and make sure containers have child proof locks on them. Don’t leave tablets and medication lying around where children can get them, eg open handbags, low lying drawers or bedside tables.

If you burn fuel for cooking or heating, install a carbon monoxide (CO) detector near bedrooms and arrange for a service engineer to check heaters, stoves and fireplaces every year.

Call the emergency services if someone won’t wake up, is having trouble breathing or is having a seizure: call them even if the person seems OK but you think they may have taken poison.

9. Prevent Choking and Suffocation

If an object can pass through a toilet paper tube it can cause a young child to choke. So keep coins, peanuts, grapes, other small round or hard foods, small objects, hard sweets and candy, buttons, pins and jewellery out of the sight and reach of children. Don’t let young children play with balloons unsupervised and make sure no pieces of latex are left lying around from burst balloons: these can be dangerous if swallowed.

Don’t put loose blankets, pillows, comforters or toys in a baby’s crib or cot: they can sometimes cause a baby to stop breathing. Don’t be tempted to hang pictures, quilts, or ribbons on or over the cot or crib, even if they were well intended Christmas gifts.

Don’t leave young children unattended in baths, tubs, near toilets, pools and spas: stay close enough to reach out and touch them.

10. Enjoy Winter Sports Safely

Observe sensible guidelines about safe winter sports. For example don’t let children skate on unapproved surfaces and don’t let them skate alone. Check sleds are free of sharp edges and splinters, make sure slopes are free of obstructions and end with a flat run off away from traffic. Keep young children separated from older children.

Don’t ski or snowboard on your own, and always make sure young children are supervised and wear the appropriate equipment that is safe and of the right size for them. Avoid crowded slopes and skiing in areas with trees and other obstacles. The American Academy of Pediatrics recommends that children should be taught to ski or snowboard by a qualified instructor in a program designed for children and that children under the age 7 should not snowboard at all.

11. Wear Sun Block

It may be hard to believe, but the sun’s rays can burn in winter, especially when they reflect off snow. So make sure you cover exposed skin, particularly on children, with sun block if spending time outside, for instance going for walks or doing winter sports.

12. Help Prevent Spread of Flu

Help prevent spread of flu this winter by practising simple and sensible hygiene. Wash hands with soap and water as often as possible, or use hand sanitizer with at least 60 per cent alcohol. If travelling by plane or other means where there are lots of people, take sanitizing wipes with you and disinfect hard surfaces like the food tray table on the plane, luggage handles, door handles, seat armrests and even your cellphone.

13. Get Trained in First Aid

Learn to save lives, not just during the holidays, but all year round. The Red Cross suggests every household should have at least one member trained in life saving skills and first aid. If you don’t have time to attend a course before the holidays, schedule one for the New Year: it only takes a few hours to become certified in first aid and CPR/AED (Cardiopulmonary Resuscitation and Automated External Defibrillation).

NHS budgets are under pressure from the ever increasing demand for hospital services. Many Primary Care Trusts are reporting significant financial concerns, with cost controls likely to tighten further when public sector spending is reviewed after the 2010 election.

In the meantime a significant proportion of privately insured patients are still being admitted or referred to NHS facilities where they are using precious resources and further increasing pressures on public hospital services.

GPs are sometimes not aware that their patients have private insurance or that they may be willing to pay for a health service. Patients are very much influenced by the GP’s advice of the best place for them to receive care, and in some cases the GP may not be familiar with the processes for booking private patients into an independent sector facility.

Each time a patient is treated outside of the NHS it frees up funds for others who are waiting for services. It is important that all GPs actively seek out information on their patients’ insurance status and understand the treatment options that are available in the community.

Ensuring ease of access for patients with private insurance to private hospitals is an important area for the independent healthcare sector, and something they need to work closely with GPs on. By offering all patients the choice of the independent sector whenever a referral is made, GPs can save public money and ease pressure on NHS waiting times.

To maximise the potential advantages to the NHS in enabling insured patients to access the private sector, independent healthcare group Ramsay Health Care has launched a unique service package for private patients. Premium Care is available to all patients using private medical insurance or funding their own treatment, and aims to set the standard for private healthcare.

Jill Watts, Ramsay’s UK Chief Executive Officer, explains the drive behind the product: “Private patients naturally expect good value for money. We believe that Premium Care will encourage patients who have private medical insurance to ask their doctor for a referral to a Ramsay hospital.”

The Premium Care package focuses on the areas that patients feel are the most important. These include:

- Early access to a private hospital for diagnosis and treatment
- Choice of Consultant, who will deliver the service personally
- Choice of appointment
- Single room with en-suite facilities (where clinically appropriate)
- Premium Care accommodation and menus
- Premium Care gift
- Free car parking, free television and newspaper

“Every patient coming to a Ramsay hospital, whether private or NHS, receives an excellent standard of clinical and customer care, a friendly local service, low infection rates, and waiting times often shorter than the national NHS guidelines,” Jill continues. “But with Premium Care, patients with private medical insurance can go that step further.”

A federal law took effect Saturday that prohibits employer discrimination based on genetic information, the Los Angeles Times reports. The Genetic Information Nondiscrimination Act (Pub.L. 110-233), signed into law in May 2008, also prohibits health insurers from denying coverage or setting rates based on a person’s genetic makeup, such as a predisposition to a disease.
“No one should be denied a job or the right to be treated fairly in the workplace based on fears that he or she may develop some condition in the future,” Stuart Ishimaru, acting chair of the Equal Employment Opportunity Commission, said.

Industry groups oppose the law. The National Federal of Independent Businesses in April filed several concerns with EEOC, which oversees the law. The group said it was concerned about liability for employers who “innocently discover” genetic information and about a lack of an exception for publicly available genetic information accessible online. NFIB also said that there is a “confusing” relationship between the new law and other federal statutes. America’s Health Insurance Plans says the regulations will disrupt wellness programs and disease-management efforts.

As of May, there had been no genetics-related employment discrimination cases brought before federal or state courts, according to the National Human Genome Research Institute (Markman, Los Angeles Times, 11/21).

New York Times Editorial Backs New Law

The new law “removes a significant obstacle to genetic testing, which can help prevent and treat serious illness,” according to a New York Times editorial supporting the new law. The editorial cites anecdotes about workers who have been denied jobs because of genetic factors, including the presence of the BRCA1 gene, which signals a predisposition to breast and ovarian cancer. The new law “is an important step in protecting people who have inherited a predisposition to disease,” the editorial says.

“An added benefit” of the law is that it will help advance scientific research because people might be more willing to undergo genetic testing if they are confident that the results will not be used against them (New York Times, 11/22).

The Wall Street Journal reports that, in a party-line vote Saturday night, “Democratic leaders finally moved their sweeping health bill to the Senate floor, where wheeling and dealing over major unresolved and divisive issues likely will shape the legislation before its next big test.” Some centrists are busy saying they won’t support a bill with a government-run public option in it. They are also divided over abortion. And, “Another growing concern even as the bill progresses is the political heat on Democrats over expanded government spending amid rising unemployment and deficit concerns.” The vote paves the way for three weeks of debate “and perhaps more in January, a struggle that is sure to color the 2010 fight for control of Congress” (Hitt and Adamy, 11/23).

McClatchy Newspapers: “They all voted yes Saturday, saying they were motivated by a desire to let debate proceed, but many Democrats still had qualms.” Major flashpoints in the bill also include budget deficits and affordability. “Despite all these controversies, Democratic leaders said that near-universal coverage legislation, a goal of party leaders since the 1940s, has now proceeded further than ever before” (Lightman, 11/22).

And now, Senate Majority Leader Harry Reid is faced with the task of getting the Democrats to stick together as the bill undergoes changes before a final vote, Roll Call reports. “Reid added that he is mindful that not all Democrats agree on the underlying substance of the bill, including over whether it should include a public insurance option to compete with private insurers. ‘We’ve got some things to work out, but we’re going to get a bill,’ he said.” Reid said moderate Sen. Mary Landrieu, D-La., plans to work with “Sens. Charles Schumer (D-N.Y.) and Tom Carper (D-Del.) on a ‘public option that’s acceptable to all Democrats’” (Pierce, 11/23).

The Christian Science Monitor: “In discussions with Senator Reid, Senator Landrieu won more than $100 million to help her state, still reeling from hurricane Katrina, to help pay for healthcare for the poor. Yet her support remained tepid. … To rally all 60 members of the Democratic caucus for the first key procedural vote on this legislation Saturday was an epic challenge for Reid, who faces his own tough reelection race next year” (Russell Chaddock, 11/22).