Wide Variation Seen in ‘Dense’ Breast Diagnoses

By Amy Norton
HealthDay Reporter

MONDAY, July 18, 2016 (HealthDay News) — A woman’s odds of being told she has “dense” breasts may depend on which radiologist reads her mammogram, a new study finds.

The study, which involved centers in four U.S. states, found that radiologists varied widely in how often they defined mammography patients’ breasts as dense. Higher breast density is a risk factor for breast cancer, experts note.

The range went from 6 percent of patients to nearly 85 percent, the researchers reported.

The findings could have implications for the so-called breast density notification laws that have been passed in about half of U.S. states.

Under the laws, mammography results must inform women whether their breasts appeared dense on the X-ray. Dense breasts have little fat and a lot of fibrous or glandular tissue, which makes it harder to see tumors. They are also a risk factor for developing breast cancer, the researchers explained in background notes.

The idea is to make those women aware that mammography may be less accurate for them. But the laws are controversial, said Brian Sprague, the lead researcher on the new study.

In many states, the notifications tell women to discuss “supplemental” screening options with their doctors. Those other options may include breast ultrasound, MRI or digital breast tomosynthesis.

“But there’s no consensus in the medical community on what should be done,” said Sprague, an assistant professor of surgery at the University of Vermont in Burlington.

“We don’t have enough evidence on the benefits and harms of alternative screening options for these women,” he said.

Now his team’s findings highlight another issue: Defining breast density is, to a degree, subjective.

According to Dr. Stamatia Destounis, a radiologist at Elizabeth Wende Breast Care in Rochester, N.Y., “We’ve been aware for a long time that there is subjectivity in interpreting mammographic density.”

When a woman’s breasts are either largely fat tissue or very dense, it’s an easy call, said Destounis, who is also a clinical professor at the University of Rochester Medical Center.

But things get trickier when a woman has dense tissue scattered throughout the breast, noted Destounis, who was not involved with the study.

“We don’t all see the same thing,” Destounis said. Plus, she noted, other factors can affect a radiologist’s view of breast density — including the equipment used and how much compression there was on the breasts during the test.

But if the subjectivity has been acknowledged by radiologists, others may not be aware of it — including legislators passing the notification laws, Sprague pointed out.

“Breast density measurement is taking on a clinical importance that it hasn’t had before,” Sprague said. “And our findings suggest it would be somewhat hazardous to rely on these measurements alone to guide decision-making.”

The new study results are based on nearly 217,000 screening mammograms done at 30 facilities between 2011 and 2013. A total of 83 radiologists interpreted the X-rays.

Overall, 37 percent of the mammogram results cited dense breasts. But doctors varied widely in how often they made that call. And among women who had two consecutive mammograms read by different radiologists, 17 percent had a different density rating on the two tests, the findings showed.

Breast density typically declines with age, Sprague said. It’s also affected by weight, and can vary according to race or ethnicity.

But those factors did not explain why some radiologists gave a “dense” rating far more often, or far less often, than others, the study found.

According to Destounis, more centers are using computer models to interpret breast density in mammograms. That, she said, may allow a more objective rating.

For now, Sprague said doctors may want to be cautious about suggesting any supplemental screening based only on a breast density measurement.

It’s important to consider the whole picture, Sprague stressed, including whether a woman has any other risk factors for breast cancer, such as a strong family history.

“Breast density is just one piece of information,” he said. “It carries some importance, but it’s also a rough measure that comes with some subjectivity.”

Notification laws have gained steam since 2009, when Connecticut became the first state to enact one, according to the Radiological Society of North America. There is no federal legislation, but a bill introduced last year is under consideration.

The study findings were published online July 18 in Annals of Internal Medicine.

More information

The American Cancer Society has more on breast density and mammograms.

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Get Outside, Get Moving to Prevent ‘Gamer’s Thumb’

MONDAY, July 18, 2016 (HealthDay News) — “Gamer’s thumb” — a repetitive stress injury — can strike anyone who spends a lot of time playing video games. But taking breaks can be just what the doctor ordered, a new study suggests.

“Forcefully pounding a game controller or computer mouse for hours can cause inflammation of the tendons of the hand, as well as neck and back pain,” orthopedic hand surgeon Dr. Dori Cage said in a news release from the American Academy of Orthopaedic Surgeons.

“Parents can identify signs of gamer’s thumb if a child complains about pain or locking and clicking in [their] thumb. To help reduce the risk of kids having this condition, limit their daily gaming to two hours or less,” Cage suggested.

Gamer’s thumb is technically known as De Quervain’s tendinosis. It’s an inflammation of the tendons connecting the wrist to the thumb.

Video game fans can develop the problem when they use their thumbs rapidly and repeatedly.

To prevent injury to the thumb and other parts of the body from electronic game play, the academy offers this advice:

• Take a break from gaming. If you find it hard to stop playing, use software that will alert you when it’s time to do something else.
• Stretch your thumb during breaks. Try holding your hand out in front of you with your palm facing you, and gently bend the tip of your thumb down toward the base of your index finger. Hold for 30 to 60 seconds and repeat 10 times. Or put your palm on a table and lift your thumb up. Hold for 10 seconds, then lower your thumb. Do this 10 times.
• Watch your posture. Slouching could cause back, neck and arm pain.
• Get exercise, especially in the upper body and core, to lower the risk of back problems and reduce hand and arm strain. Running, biking and swimming can help. Aim to get 35 to 60 minutes of exercise a day.
• Don’t play video games if doing so causes pain.

More information

For more about De Quervain’s tendinosis, visit the American Academy of Orthopaedic Surgeons.

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Latest Zika Puzzle: How U.S. Patient Infected Caregiver

MONDAY, July 18, 2016 (HealthDay News) — The mysterious Zika virus continues to surprise health scientists. On Monday, U.S. health officials said they were trying to determine how a now-deceased elderly Utah man who had Zika managed to infect a family caregiver.

Zika is normally spread by mosquitoes and can also be transmitted sexually. But health officials said neither appears to have played a role in this case. For one thing, the disease-spreading mosquitoes aren’t usually found at the altitudes where the unidentified man lived in northern Utah.

“The new case in Utah is a surprise, showing that we still have more to learn about Zika,” said Dr. Erin Staples, a medical epidemiologist with the U.S. Centers for Disease Control and Prevention working in Utah.

Dr. Satish Pillai, incident manager for CDC Zika Response, said, “Utah health officials confirmed today a new case of Zika. This person is associated with the family of the patient who died in late June. Based on what we know now, that person [who has since recovered] had not traveled to an area with Zika and has not had sex with someone infected with Zika or a returning traveler.

“In addition, there is no evidence at this time that mosquitoes that are commonly the way Zika is spread are presently in Utah,” Pillai added.

Staples said the infected caregiver recovered quickly. And local Utah authorities said the public shouldn’t fear general Zika transmission.

The deceased patient had traveled to an area outside the country where Zika is circulating and apparently caught the virus there. Lab tests showed he had extremely high amounts of the virus in his blood — 100,000 times higher than that seen in other Zika samples, according to a CDC news release.

Prior to his death, the man had Zika symptoms — including rash, fever and pink eye — but it’s not known if the virus led to his death.

The caregiver also suffered Zika-like symptoms, officials said. Information about both patients is being withheld for reasons of medical privacy.

Typically, the Zika virus doesn’t cause serious illness. Only about 20 percent of patients notice symptoms.

But Zika can cause serious birth defects if a woman becomes infected while pregnant. Thousands of babies have been born in Brazil with abnormally small heads and brains, a condition called microcephaly. Brazil is the epicenter of the Zika epidemic. The virus has also been linked to a rare paralyzing condition called Guillain-Barre syndrome.

As of July 13, roughly 1,300 Zika cases had been reported in the continental United States and Hawaii, including eight in Utah. But none was caused by local mosquitoes, the CDC said. Most of the infected people had visited countries where Zika is endemic.

However, 14 patients had not traveled to Zika zones but had sex with someone who had, the CDC said.

The CDC advises pregnant women not to travel to an area where active Zika transmission is ongoing, and to use insect repellent if they are in those areas. Partners of pregnant women are also advised to use a condom to guard against sexual transmission during pregnancy.

More information

The U.S. Centers for Disease Control and Prevention provides more information on mosquito-borne diseases.

This Q&A will tell you what you need to know about Zika.

To see the CDC list of sites where Zika virus is active and may pose a threat to pregnant women, click here.

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Obese Teens Take Weight-Loss Surgery in Stride

MONDAY, July 18, 2016 (HealthDay News) — Severely obese teens who have weight-loss surgery may be able to walk faster and with less pain afterwards, new research suggests.

For the study, a team led by Justin Ryder, an assistant professor of pediatrics at the University of Minnesota Medical School, analyzed how weight-loss surgery affected obese teens’ ability to walk up to two years after their procedure.

The study involved 242 significantly obese teens who were 19 years old or younger and had weight-loss surgery between 2007 and 2012 at five U.S. bariatric surgery centers.

Gastric bypass (where a portion of the stomach is rerouted) was performed on 161 of the teens. The rest had either gastrectomy (removal of part of the stomach) or LAGB (laparoscopic adjustable gastric band), a procedure in which a band is placed around a portion of the stomach to make it smaller.

The researchers timed the teens as they walked roughly a quarter-mile before their surgery. They repeated the walking test six months, one year and two years after their weight-loss procedure.

Before and after each test, the researchers measured the teens’ heart rates. The young people reported how much pain they felt while walking.

Just six months after surgery, the teens were able to walk faster and with less pain. Before surgery, they did the walk in 6.3 minutes, on average. Six months later, their average time dropped to 5.8 minutes. Their pre-walk resting heart rate also improved over that period from an average of 84 beats per minute to 74 beats per minute. Their post-walk heart rate dropped from an average of 128 beats per minute to 113 beats per minute, according to the study.

These improvements were also seen at one year and two years after surgery, the study published online July 18 in JAMA Pediatrics showed.

The study did not include a comparison group of teens who didn’t have weight-loss surgery. Researchers said more study is needed to determine if the benefits of weight-loss surgery continue long-term and lead to additional health improvements.

More information

The U.S. The National Institute of Diabetes and Digestive and Kidney Diseases has more on weight-loss surgery.

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Can Comedy Kill?

MONDAY, July 18, 2016 (HealthDay News) — Watch out Kevin Hart, Amy Schumer and Louis C.K. A new study finds standup comics seem to die at an earlier age than actors.

“The results point to a need for awareness of health and well-being concerns in the entertainment industry, and in elite comedians in particular,” said the study’s lead researcher, Simon Stewart, from the Mary MacKillop Institute of Health Research at Australian Catholic University.

Ongoing stress, risky behaviors and irregular schedules associated with standup comedy were cited as reasons why telling jokes may not always be a laughing matter.

The study involved 200 standup comedians, 114 comedic actors and 184 dramatic actors who were highly rated in ability and popularity by a crowd-ranking website.

Looking at those who had passed away in each group, the researchers found the standup comics died at a younger age — about 67 years on average compared to almost 69 among the comedic actors and nearly 71 among dramatic actors.

Once date of birth and life expectancy were taken into account, the researchers found that of the 36 standup comics who had died, 39 percent passed away prematurely, compared to about 20 percent of the 56 dramatic actors who had died.

The study found only an association between being a standup comedian and risk of an earlier death; it did not prove cause-and-effect.

Still, the researchers pointed out standup comics accounted for four out of nine drug-related deaths, and a higher rate of suicides than the other performers.

Moreover, the highest ranked standup comedians tended to have shorter lifespans than their less popular peers — a trend that was reversed among dramatic and comedic actors, the study found.

“Indeed, the data confirmed an adverse relationship between comedic ability and longevity, with elite standup comedians more highly rated by the public more likely to die prematurely,” Stewart said in a university news release.

Oscar-winning actors, on the other hand, enjoy a 3.9-year life expectancy advantage, he added.

Stewart said comics tend to have higher rates of bipolar disorder than actors or non-comedians. Also, the profession often forces people to endure years of little job security, low pay and high stress before they attain success.

And instead of working on a controlled and highly supervised film set, comics are often working in nightclubs and bars where they are more likely to drink, smoke and engage in risky sexual behavior, Stewart said.

Combined with extensive travel and irregular work schedules, these behaviors could negatively affect comics’ sleeping, eating and exercise habits. This, in turn, could lead to chronic health issues, such as high blood pressure, high blood sugar, obesity and heart disease, the study suggested.

The findings were published recently in the International Journal of Cardiology.

More information

The U.S. Centers for Disease Control and Prevention provides more on the leading causes of death in the United States.

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Monthly Vaginal Ring May Help Protect Against HIV

MONDAY, July 18, 2016 (HealthDay News) — When used regularly, a medicated monthly vaginal ring may be an effective way for women in sub-Saharan Africa to protect themselves from HIV infection, according to new research.

The flexible ring contains the antiretroviral drug dapivirine. The ring, developed by the nonprofit International Partnership for Microbicides (IPM), is placed high inside the vagina where it steadily releases the medication over the course of the month. Women insert the ring and remove it on their own.

A Phase 3 trial, known as the ASPIRE study, involved more than 2,600 African women between the ages of 18 and 45.

Researchers divided the women from Malawi, South Africa, Uganda and Zimbabwe into two groups. One group was assigned to use the dapivirine ring and the other group to use a placebo ring that contained no medication.

Between August 2012 and June 2015, 27 percent fewer women in the dapivirine ring group were infected with HIV than in the placebo group, the study’s authors found.

The researchers determined how consistently the women used the ring by testing levels of dapivirine in their blood every three months. They also tested how much drug remained on 12,000 rings the women used.

The researchers classified the women based on how regularly they used the ring, ranging from non-use to almost perfect use. They found that women who appeared to use the ring most regularly from month to month could cut their HIV risk by more than 50 percent and in some cases, by 75 percent or more.

“Adherence to HIV prevention strategies is not always perfect, and we knew that not all women used the ring consistently, so we developed an analysis to explore the degree of HIV protection that was associated with more consistent use. Across all analyses we saw high adherence was associated with significantly better HIV protection,” the study’s principal investigator, Elizabeth Brown, said in a news release from the Microbicide Trials Network (MTN). Brown is a research professor at the Fred Hutchinson Cancer Research Center and the University of Washington in Seattle.

The researchers said more studies are needed to confirm their findings, which were published online July 18 in the New England Journal of Medicine. The findings were also expected to be presented Tuesday at an international AIDS conference in Durban, South Africa.

A new study, known as the HOPE trial, will explore why the ring may work well for some women but not others. Women represent nearly 60 percent of adults with HIV in sub-Saharan Africa, the researchers reported. They noted that unprotected heterosexual sex is fueling the epidemic.

“The timing of these results could not be more perfect,” said Dr. Jared Baeten, protocol chairman of the ASPIRE study and leader of the HOPE study. Baeten is vice chairman of the Department of Global Health at the University of Washington.

“The goal of HOPE is to offer women a product shown to be safe and able to provide some protection against HIV. When we were conducting ASPIRE, we did not know whether the ring would be effective. Knowing the results of ASPIRE, it will be a totally new conversation with women in HOPE,” Baeten said.

More information

The U.S. Centers for Disease Control and Prevention provides more information on HIV prevention.

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Neti Pot Beats Steam for Sinus Congestion Relief

By Don Rauf
HealthDay Reporter

MONDAY, July 18, 2016 (HealthDay News) — Inhaling steam probably won’t open your chronically clogged sinuses. But nasal irrigation may bring some relief, a new study finds.

“People with chronic and recurrent sinusitis have poor quality of life, similar to having a major chronic disease,” said lead study author Dr. Paul Little, professor of primary care research at the University of Southampton in England.

“It is very nice to be able to provide something really simple that empowers people to manage this problem, helps them with their symptoms, reduces the need to take over-the-counter medications, and makes them less likely to want to see the doctor in future attacks,” he said.

More than 29 million American adults were diagnosed with sinusitis in 2014, according to the U.S. Centers for Disease Control and Prevention. Sinusitis is an inflammation of the nasal cavities often caused by a virus, allergy, bacteria, fungus, or possibly an autoimmune reaction.

For those with chronic sinusitis, doctors often recommend steam inhalation or nasal irrigation — rinsing the sinuses with a saline (salt-based) solution.

To evaluate the effectiveness of these two common treatments, Little and his team followed 871 patients in England who had a history of chronic or recurrent sinusitis. Participants were assigned one of four treatments: daily nasal irrigation with saline plus use of an instructional video; daily steam inhalation; a combination of both; or their usual treatment. Usual care was at the discretion of the patient’s physician and could include the use of antibiotic medications.

Participants in the nasal irrigation group were given a neti pot, a vessel designed to rinse mucus and debris from the nasal cavities. (Typically, they look like little teapots with long spouts.) These individuals were asked to irrigate their nose daily with about 5 ounces of saline solution in each nostril. The solution was made of 1 teaspoon salt and a half teaspoon of baking soda combined in 1 pint of water.

The steam treatment group was asked to inhale steam for five minutes every day. They were directed to place a towel over their head and stand over a bowl of recently boiled water.

The scientists measured results using the Rhinosinusitis Disability Index, a questionnaire used to evaluate nasal congestion and related problems, such as throat pain and headaches.

At three months and six months, the researchers found that patients who used nasal irrigation reported improvement. Those using steam inhalation said headaches had eased, but they appeared to have no congestion relief.

The results aren’t surprising, one doctor said.

“Nasal irrigation is foundational in sinus care,” said Dr. Len Horovitz, an internist at Lenox Hill Hospital in New York City. “Saline solution can be easily mixed and utilized with a neti pot or other irrigation device. Simple saline mists only moisturize, and steam can cause swelling of membranes. Heat provokes swelling, so that can be harmful.”

The study authors also noted that fewer participants in the nasal irrigation group (compared to no-irrigation patients) took over-the-counter medications, had headaches, or intended to consult a doctor in future episodes.

Little added that people suffering from sinusitis often get repeated courses of antibiotics, which may not help much and may contribute to the development of antibiotic resistance.

“It’s well worthwhile not taking antibiotics unless absolutely necessary because they make it more likely that you will then carry antibiotic-resistant bacteria,” said Little. “They [antibiotics] have side effects and can also affect the ability of the body to fight infections.”

Although the U.S. Food and Drug Administration has said that rinsing nasal passages with neti pots is generally safe, the agency has expressed some concerns about the risk of infection tied to the improper use of these devices.

To avoid an infection caused by contaminated tap water, the CDC advises using filtered, boiled or distilled water. The CDC also recommends rinsing irrigation devices after each use with safe water, and letting them air dry completely.

The study was published July 18 in CMAJ.

More information

The U.S. Food and Drug Administration answers some questions about rinsing your sinuses.

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Poverty Takes Bigger Toll on a Man’s Health If He’s Black: Study

MONDAY, July 18, 2016 (HealthDay News) — While being poor raises the odds of dying early for American black males, it doesn’t seem to have the same impact for white males, a new study suggests.

One expert who’s long researched health disparities wasn’t surprised by the finding.

“The fact that poverty in African Americans can be considered a life-threatening ‘disease’ emphasizes the urgent need for society to increase their health care access opportunities,” said Dr. Liron Sinvani. She is an investigator at the Feinstein Institute for Medical Research in Manhasset, N.Y.

Sinvani was not involved in the new study, which was led by Dr. Alan Zonderman of the U.S. National Institute on Aging.

In its research, Zonderman’s team tracked data on more than 3,700 black and white men and women aged 30 to 64. All of the participants were involved in a major national study on “healthy aging,” conducted between 2004 and 2013.

The investigators found that the risk of dying during the study period was more than twice as high for black men living at low incomes — at or below 125 percent of the federal poverty level — compared to black men living above the poverty level.

However, this income-linked difference was much less significant for white men, the researchers found. Among white males, those living below the poverty line had roughly the same risk of dying over the study period as those living above that income level.

Why would race make a difference in the relationship between income and life span? Zonderman’s group speculated that having less education, lower income and poorer job prospects might all play a role in this racial disparity.

For her part, Sinvani called the impact that race and poverty has on black men’s health “a critical issue, not only for health care providers but also for our society.”

The study was published online July 18 in JAMA Internal Medicine.

More information

The U.S. Centers for Disease Control and Prevention has more about health disparities and inequalities.

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Concussion Study Shows Player-to-Player Hits Most Damaging

By Randy Dotinga
HealthDay Reporter

MONDAY, July 18, 2016 (HealthDay News) — As officials at all levels of American football continue to debate how to prevent concussions, a new study using data from devices inside the helmets of high school players confirms that hits with other players are especially damaging.

“Impacts to the head that resulted from contact with another player were of higher magnitude than contact with other surfaces, such as the ground,” said study author Julianne Schmidt, an assistant professor of kinesiology at the University of Georgia.

“We also found that running a long distance before colliding with an opponent resulted in higher-magnitude head impacts compared to running a short distance,” she said.

The researchers suggest that officials consider ways to reduce collisions between players that put the head in danger, especially those involving players who have run longer distances.

“We know that even young kids in elementary school who play football sustain impacts of significant force and do have concussions,” said Dr. John Kuluz, director of Traumatic Brain Injury and Neuro-Rehab at Nicklaus Children’s Hospital in Miami. “But we do not know the long-term consequences of hits to the head in children.”

Concussions can cause headache, dizziness, loss of consciousness and other symptoms. The wide majority of concussion sufferers appear to recover within a couple weeks, but some continue to have symptoms.

Research has linked concussions in adults to Parkinson’s disease decades later. And thousands of retired National Football League players successfully sued the league, charging that it didn’t do enough to protect them from the long-term neurological effects of hits to the head. Such effects include a progressive brain disease known as chronic traumatic encephalopathy (CTE), mood disorders and memory problems.

In the new study, researchers outfitted 32 high school football players with devices that monitored the movement of their heads upon impact. The researchers analyzed video and other information from almost 4,000 impacts during a 13-game season.

The researchers found that several kinds of hits resulted in a larger magnitude of impact: those with other players; during the second quarter; in the first of a two-part impact, and when players traveled a longer distance prior to the collision.

The researchers also linked three-point stances (when players line up with one hand touching the ground) to higher-magnitude impacts when they were combined with players traveling a longer distance. And they found a higher risk in impacts linked to two-point stances (with no hand contact with the ground).

Why do starting positions at the line of scrimmage matter?

“Starting with your trunk down in a position similar to a track start gives you more momentum going into a collision,” Schmidt explained. “When you allow that momentum to build over a long running distance, it seems to result in higher-magnitude head impacts.”

So, should two-point or three-point stances be banned?

“High school football players that start in a three-point stance do not typically run a long distance before collision, but some position types like tight ends and defensive ends might be more likely to combine the two,” Schmidt said.

“Eliminating the three-point stance all together might not be the answer either,” she added. “The three-point stance alone doesn’t result in higher-magnitude head impacts. In fact, we found that overall head impacts that resulted following a three-point stance were less severe than a two-point stance.”

Brain injury specialist Kuluz said the study appears valid.

So what should be done?

“Schools should emphasize proper tackling technique by teaching proper head and body position,” Schmidt said. “Keeping the head up and avoiding head contact with another player may reduce the magnitude of head impacts sustained while playing football or prevent the head impact all together.”

Schmidt also suggested using rules or coaches to reduce collisions that occur after players run a long distance.

The study was published online July 18 in the journal Pediatrics.

More information

For more about concussions, visit the American Association of Neurological Surgeons.

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Does Living Near a Fracking Site Make Asthma Worse?

By Steven Reinberg
HealthDay Reporter

MONDAY, July 18, 2016 (HealthDay News) — Living near fracking sites may make asthma worse for many of those who suffer from the respiratory condition, a new study suggests.

Fracking is a controversial process in which water, sand and chemicals are pumped deep into the ground at high pressure to extract hard-to-reach pockets of natural gas.

“The unconventional natural gas development process [fracking] has numerous environmental impacts that could affect health,” said lead researcher Dr. Brian Schwartz. He is a professor of environmental health sciences, epidemiology and medicine at Johns Hopkins Bloomberg School of Public Health in Baltimore.

The list of impacts includes noise, vibration, strong odors, air pollution, water pollution, soil pollution, heavy truck traffic, conversion of rural areas to industrial ones and stress, he said.

Many of these can also affect asthma symptoms, Schwartz added. For example, asthma is known to be worsened by air pollution, odors and stress, all of which increase in areas with fracking, he said.

“I cannot say which impact may be causing asthma exacerbation. But, I can say there are multiple biologically plausible ways this could happen. Our two primary hypotheses are air pollution and stress,” he added.

Schwartz said it’s difficult to give advice on what exposures to avoid, since it’s not known which of these is the most important one.

Also, the study didn’t prove that fracking exposure causes asthma to worsen, just that there seems to be an association.

“Advice for how to minimize sleep disruption versus stress versus air pollution versus noise versus odors are all different,” Schwartz said. “So, I think all we can do is to advise asthma patients in these areas is to be very vigilant about worsening of symptoms and have early discussions with their doctors.”

One energy industry representative said there were flaws in the study.

“The authors focus in on a condition that can arise for numerous reasons, admit that they aren’t actually able to show causation from oil and gas development, and even point out that cases that resulted in hospitalizations were of patients who were older, current smokers and obese,” said Nicole Jacobs. She is Pennsylvania director for Energy In Depth, an energy industry lobbying group.

“Yet, they blame fracking anyway. Considering that one of the authors is on the board of an anti-oil and gas organization [Schwartz is a fellow at the Post Carbon Institute], this methodology should be called into question,” she said.

For the study, Schwartz and his colleagues used electronic health records to collect data on more than 35,000 patients treated at Pennsylvania’s Geisinger Clinic from 2005 through 2012.

The researchers looked at asthma exacerbations at four stages of natural gas production: preparing the site; drilling: stimulating the gas through fracking; and production. The investigators also calculated the distance of patients’ homes from the wells.

Between 2005 and 2013, more than 6,000 natural gas wells were drilled at nearly 3,000 fracking sites, gas was stimulated in nearly 5,000 wells and gas production began at close to 4,000 wells, according to the report.

During that time, nearly 21,000 patients got new prescriptions for asthma medication for mild asthma, nearly 2,000 were seen in the emergency room for moderate asthma, and nearly 5,000 were hospitalized with severe asthma, the researchers found.

Patients with asthma living in areas with the highest activity of gas drilling and production had a higher risk of mild, moderate and severe asthma exacerbations, compared with those living in areas of lowest fracking activity, Schwartz’s team found.

The report was published online July 18 in the journal JAMA Internal Medicine.

“This study doesn’t prove that oil and gas extraction causes asthma, but it hints at it,” said Rob Jackson, a professor in the School of Earth, Energy and Environmental Sciences at Stanford University.

“We need immediate cause-and-effect studies to figure out what’s happening,” Jackson said. “The frequency of asthma appears to jump for people living near producing oil and gas wells. That’s where I’d look first.”

More information

For more on asthma, visit the U.S. National Heart, Lung, and Blood Institute.

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