Summer Health for BT
by Dr. Zach, 2019
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
Squamous cell cancer (16%)
Basal cell cancer (80%)
Malignant melanoma (4% but >75% of skin cancer deaths)
ABCDE rule for skin cancer, esp melanoma
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.
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)
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