Summer Health Tips

Summer Health for BT

by Dr. Zach, 2019

 

1. Being outside and active is healthy
2. Skin Protection
3. Heat Illness
4. Insect Bites
5. Hymenoptera Stings
6. Animal bites
7. See #1

 

Also — bbq safety — careful of metal bristles, wear a helmet when cycling, and water safety

 

Skin protection –

Sun exposure is the greatest cause of skin damage with time (aka photoaging), caused by uv radiation

Sun exposure is the greatest cause of skin cancer

 

Skin cancer:

Squamous cell cancer (16%)

Basal cell cancer (80%)

Malignant melanoma (4% but >75% of skin cancer deaths)

 

ABCDE rule for skin cancer, esp melanoma

Asymmetry

B — Irregular borders

Colour – blue black, multiple colours

Diameter – greater than 6mm (pencil eraser)

Evolution – changes

 

Highest UV between 10am and 4pm

Shade, hat, clothing, esp with UV protection factor (more tightly woven)

 

Typical car, home, and office windows block most UVB rays but a smaller portion of UVA rays

 

Sunscreen – get broad spectrum upf (uv protection factor) (UVA and UVB).  spf reflects uvb protection. Use 30+ — spf 30 means 30 times longer before you start to burn

Uva skin aging wrinkling some skin cancer

Uvb main cause of sunburn and cancer

Both lead to skin aging eye damage (cataracts mainly) skin cancer

 

Reapply sunscreen every 2 hours and after swimming (some are water resistant)

 

UVB does induce production of vitamin D s.  Can get it via diet or supplements. And even with sunscreen you will produce vitamin D.

Foods with vitamin D:  Fatty fish, like tuna, mackerel, and salmon.

• Foods fortified with vitamin D, like some dairy products, orange juice, soy milk, and cereals.
• Beef liver.
• Cheese.
• Egg yolks.

Sunscreen prevents sunburn by blocking UVB light. Theoretically, that means sunscreen use lowers vitamin D levels. But as a practical matter, very few people put on enough sunscreen to block all UVB light, or they use sunscreen irregularly, so sunscreen’s effects on vitamin D might not be that important.

 

Sunglasses should block 99% to 100% of UVA and UVB rays (which cause cataracts, pterygium, and cancer)

 

Avoid tanning beds — >90% UVA, rest UVB.  exposure to tanning bed in youth increases risk of melanoma by 75%

 

If you “need” a tan use a cream (stains the skin)

 

Heat

 

Risk factors for heat illness – young and old, chronic medical conditions, certain medications

When high humidity sweat will not evaporate, so less able to cool.  Other conditions predisposing are obesity, fever, heart disease, mental illness, poor circulation, sunburn, alcohol.

 

Heat syncope (passing out from low blood pressure from relative dehydration), heat cramps from loss of fluids and electrolytes, heat exhaustion (weakness, lightheadedness, fatigue)

 

Heatstroke – life-threatening emergency that can damage almost every organ (brain, gi tract, liver disease, kidney damage).  Treated with cooling, fluids

 

Dress lightly, limit physical exertion, air conditioning, fluids — bring water drink regularly.  Avoid alcohol, stay in the shade. Keep urine clear

 

Insect bites – most are not harmful though some people are allergic.  Some spiders can cause quite severe local reactions.

 

Mosquitos can carry serious diseases – west nile virus (aka WNV, which is here in Quebec, and Montreal), dengue, ebola, chikungunya.

 

WNV- 1 in 2-300 people infected with WNV get sick.  Only in summer. Symptoms – vomiting myalgias sore throat fever chills (the concern is that some get encephalitis)

Avoid mosquito bites – DEET repellent, don’t leave sitting water.  Consider netting. Peak biting times are dawn and dusk/early evening.

 

Tick bites – deer tick can carry Lyme disease.  3 stages (rash, flulike, headache arthritis). Tx with antibiotics.  Prevention with long-sleeves, light clothing, DEET-containing repellent, keep grass trim, check pets for ticks.

 

Hymenoptera (ants, bees, wasps, spider – a type of insect) stings – In most people they cause pain and local swelling.  Some people have anaphylactic allergies which is life threatening.

Noisy activity, bright colours, perfumes, may incite stings

Remove stinger or tick from skin

 

Animal bites – dogs cats rodents (rat mouse hamster squirrel gerbil) primates farm animals humans

Dog bites – 5-10% infection (12-30% in hand)

Cat bites – 30-50% infection

Rodents – low risk of infection

Primates (chimps, apes, monkeys, humans) – high risk of infection.  Human bites to hand 25-50% infect

 

Rabies – virus, from bites more than scratches.  Fatal if not treated.

Headache runny nose fever sore throat muscle aches upset stomach back pain spasms

High risk animals for rabies — fox raccoon skunk bat coyote

Post-exposure prophylaxis