JAMA news releases are made available to the public after 3 pm US Central time on the first 4 Tuesdays of each month. The Archives Journals news releases are made available to the public after 3 pm Central time on Mondays. We also provide a list of previous news releases.
THIS WEEK'S CONTENT
JAMA NEWS RELEASES
(Embargoed for Release: 3:00 p.m. CT, Tuesday, October 10, 2006)
JAMA NEWS RELEASES
PSORIASIS ASSOCIATED WITH INCREASED RISK FOR HEART ATTACK
SMOKING BAN ASSOCIATED WITH RAPID IMPROVEMENT IN HEALTH OF BAR WORKERS
STATES THAT EASILY GRANT IMMUNIZATION EXEMPTIONS HAVE HIGHER INCIDENCE OF WHOOPING COUGH
JAMA REPORT (VIDEO SCRIPT)
VIDEO: Windows Media | Quicktime
WORKPLACE SMOKING BAN IMPROVED BAR WORKERS’ HEALTH IN AS LITTLE AS ONE MONTH
INFORMATION CONTAINED IN THESE NEWS RELEASES IS PROTECTED BY COPYRIGHT. JOURNAL ATTRIBUTION IS REQUIRED.
TV Note: This week's JAMA Report video is on the improvement in health for bar workers following a smoking ban. The report will be fed Tuesday, October 10, from 9:00 - 9:30 a.m. ET and 2:00 - 2:30 p.m. ET, on Intelsat America 6 (formerly Telstar 6), Transponder 11 (C-Band), Downlink Freq: 3920 MHz Vertical, Audio: 6.20/6.80. For more information, call 312/464-JAMA.
Save the Date: JAMA will present new research from its theme issue on men’s health at a media briefing on Tuesday, November 14, at the Millennium Broadway Hotel in New York. Program and registration information will be provided in a future email.
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Embargoed for Release: 3:00 p.m. CT, Tuesday, October 10, 2006
Media Advisory: To contact Joel M. Gelfand, M.D., M.S.C.E., call Kate Olderman at 215-349-8369.
PSORIASIS ASSOCIATED WITH INCREASED RISK FOR HEART ATTACK
CHICAGO—Adults with psoriasis, especially younger patients with severe psoriasis, appear to be at increased risk for a heart attack, according to a study in the October 11 issue of JAMA.
Psoriasis is a common, chronic disease that affects about 2 percent to 3 percent of the adult population. It is associated with markers of systemic inflammation, such as increased C-reactive protein levels, which have been linked to the development of atherosclerosis and myocardial infarction (MI; heart attack), according to background information in the article. Several hospital-based studies have indicated that psoriasis is associated with a higher prevalence of cardiovascular diseases, including heart attack, but these studies did not control for major cardiovascular risk factors.
Joel M. Gelfand, M.D., M.S.C.E., and colleagues from the University of Pennsylvania, Philadelphia, conducted a perspective population-based cohort study to determine the risk of heart attack in patients with psoriasis when controlling for major cardiovascular risk factors. The study, which included a total of 556,995 control patients, and patients with mild (n = 127,139) and severe psoriasis (n = 3,837), compared outcomes among patients with and without a diagnosis of psoriasis. The patients, living in the United Kingdom, were 20 to 90 years of age. Adjustments were made for hypertension, diabetes, history of heart attack, hyperlipidemia (an excess of fats or lipids in the blood), age, sex, smoking, and body mass index. Up to five controls without psoriasis were randomly selected from the same practices and start dates as the patients with psoriasis.
The researchers found that the incidence of heart attack was higher in patients with severe psoriasis (5.13 MIs per 1,000 person-years) and mild psoriasis (4.04 MIs per 1,000 person-years) compared with control patients (3.58 MIs per 1,000 person-years), with patients who were younger and had severe psoriasis having the highest rate. For example, a 30-year-old patient with mild psoriasis had a 29 percent greater risk of having a heart attack than a patient without psoriasis; a 30-year-old patient with severe psoriasis had about three times the risk. A 60-year-old patient with severe psoriasis had a 36 percent increased risk for heart attack.
“The magnitude of association between severe psoriasis and MI in those patients younger than 50 years is similar to the magnitude of association for other major cardiac risk factors,” the authors write.
“Our findings are novel and therefore it is important that additional studies be performed to confirm these results and determine their therapeutic implications. In particular, it is important to determine the impact of clinical markers of psoriasis activity, such as body surface area, as well as biomarkers of systemic inflammation (e.g., C-reactive protein) on the risk of MI in patients with psoriasis. In the meantime, as part of good medical care, patients with psoriasis should be encouraged to aggressively address their modifiable cardiovascular risk factors,” the researchers conclude.
(JAMA. 2006;296:1735-1741. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For More Information: Contact the JAMA/Archives Media Relations Department at 312/464-JAMA (5262) or email: mediarelations{at}jama-archives.org.
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Embargoed for Release: 3:00 p.m. CT, Tuesday, October 10, 2006
Media Advisory: To contact Daniel Menzies, M.B.Ch.B., email: d.menzies{at}dundee.ac.uk.. To contact editorial author Mark D. Eisner, M.D., M.P.H., call Janet Basu at 415-502-4608.
SMOKING BAN ASSOCIATED WITH RAPID IMPROVEMENT IN HEALTH OF BAR WORKERS
CHICAGO—Bar workers in Scotland showed significant improvements in respiratory symptoms and lung function within 2 months following a ban on smoking in confined public places, according to a study in the October 11 issue of JAMA.
Exposure to secondhand tobacco smoke is a major worldwide public health issue, according to background information in the article. The effects on individuals has been difficult to measure, but a number of studies have established an increased risk of coronary artery disease, cerebrovascular disease and lung cancer, and the 2006 report by the U.S. surgeon general highlighted the causal relationship between secondhand smoke and premature death. In addition, for patients with preexisting respiratory conditions such as asthma, secondhand smoke leads to poorer disease control and more frequent hospital admission.
As the harmful effects of secondhand smoke become more widely appreciated, a number of countries have attempted to limit the health risks to the population at large by prohibiting smoking in public. On March 26, 2006, Scotland introduced a legislative ban on smoking in enclosed public places. One group of people most likely to benefit from this legislation is bar workers, who are exposed to high levels of secondhand smoke as part of their occupation.
Daniel Menzies, M.B.Ch.B., and colleagues from Ninewells Hospital and Medical School, Dundee, Scotland examined the effect of the recently introduced smoke-free legislation on bar workers’ health in Scotland. The study, conducted in Tayside, Scotland from Feb. - June 2006, initially included 105 nonasthmatic and asthmatic nonsmoking bar workers, of whom 77 completed the study. The participants were evaluated for respiratory symptoms (wheeze, shortness of breath, cough, and phlegm) and sensory symptoms (red or irritated eyes, painful throat and nasal itch, runny nose, and sneeze), and also had pulmonary tests and blood tests performed before the ban and at 1 month and 2 months after the ban went into effect.
The researchers found that a total of 79.2 percent (n = 61) of the bar workers experienced respiratory or sensory symptoms before the introduction of the smoke-free policy, whereas 1 month afterward, 53.2 percent (n = 41) reported these symptoms, a decline of 26 percent. At 2 months after introduction of the smoke-free policy, this improvement was maintained, with 46.8 percent of participants reporting any symptom (a decrease of 32.4 percent from baseline). There were also improvements on certain measurements of lung function and reductions in serum cotinine (metabolized nicotine) levels. Asthmatic bar workers also had less airway inflammation and an increase in quality of life scores.
(JAMA. 2006;296:1742-1748. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
EDITORIAL: BANNING SMOKING IN PUBLIC PLACES—TIME TO CLEAR THE AIR
In an accompanying editorial, Mark D. Eisner, M.D., M.P.H., of the University of California, San Francisco, comments on the erroneous arguments made against banning smoking in certain places.
“Three common arguments are advanced against mandating smoke-free bars, restaurants, and other hospitality businesses. Each is fallacious. First, laws to prevent smoking in bars will not be effective. Four years after the California ban on smoking in bars, adherence with the law was high: 99 percent of bars in restaurants and 76 percent of freestanding bars were smoke-free. Near perfect adherence has been reported in Boston, Ireland, and New Zealand. Second, the general public will not accept smoke-free bars and restaurants. In fact, a series of international studies shows that most people do support smoke-free bars and restaurants. Moreover, public opinion becomes increasingly positive following smoke-free legislation. Third, smoke-free laws will cause bars and restaurants to lose money. Using sales tax and other objective financial data, studies now conclusively demonstrate that bars, restaurants, and hotels do not lose revenue after becoming smoke-free. In fact, some of these studies actually show a growth in income. In sum, smoke-free legislation is effective, accepted by the public, and has no negative economic impact.”
“Mandating smoke-free workplaces will decrease secondhand smoke exposure and will improve respiratory health, prevent chronic disease, and extend life span. Important salutary health effects occur in as little as 1 month after cessation of secondhand smoke exposure. The comprehensive body of research documenting the serious adverse health effects of passive smoking provides a powerful rationale for prohibiting smoking in all public places. The time has come to clear the air,” Dr. Eisner writes.
(JAMA. 2006;296:1778-1779. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Financial disclosures – none reported.
For More Information: Contact the JAMA/Archives Media Relations Department at 312/464-JAMA (5262) or email: mediarelations{at}jama-archives.org.
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Embargoed for Release: 3:00 p.m. CT, Tuesday, October 10, 2006
Media Advisory: To contact corresponding author Daniel A. Salmon, Ph.D., M.P.H., call Tom Fortner at 352-273-5814.
STATES THAT EASILY GRANT IMMUNIZATION EXEMPTIONS HAVE HIGHER INCIDENCE OF WHOOPING COUGH
CHICAGO—States that have personal belief exemptions for school immunization requirements, and exemptions that are easily obtained, have higher rates of new cases of pertussis (whooping cough) than states in which obtaining immunization exemptions is more difficult, according to a study in the October 11 issue of JAMA.
State-mandated school immunization requirements have played a major role in achieving and maintaining low rates of vaccine-preventable diseases in the United States. All states and the District of Columbia require children entering school to provide documentation that they have met the state vaccine requirements, according to background information in the article. As of March 2006, all states permitted medical exemptions to school and daycare immunization requirements; 48 states allowed religious exemptions; and 19 states had a provision for personal belief exemptions, such as religious, philosophical, and any other unspecified nonmedical exemption.
States that make exemptions widely available to parents, either by offering a personal belief exemption or making the exemption option easy to obtain, may have higher rates of exemptions or may experience substantial increases in exemption rates. Increasing exemption rates can increase individual and community risk to vaccine-preventable diseases, the authors write. The role of exemption policies may be especially important for pertussis, which remains present in certain areas of the United States and has been increasing in incidence during the past decade.
Saad B. Omer, M.B.B.S., M.P.H., of the Johns Hopkins Bloomberg School of Public Health, Baltimore, and colleagues conducted a study to determine if the rates of nonmedical exemptions differ and have been increasing in states that offer only religious vs. personal belief exemptions, and if the incidence of pertussis is associated with policies of granting personal belief exemptions and ease of obtaining exemptions. The researchers analyzed state-level rates of nonmedical exemptions at school entry from 1991 through 2004 and data for incidence of pertussis from 1986 through 2004 for individuals age 18 years or younger.
From 2001 through 2004, states that permitted personal belief exemptions had higher nonmedical exemption rates than states that offered only religious exemptions, and states that easily granted exemptions had higher nonmedical exemption rates in 2002 through 2003 compared with states with medium and difficult exemption processes. The average exemption rate increased an average of 6 percent per year from 1991 to 2004 among states that offered personal belief exemptions. In states that easily granted exemptions, the rate increased 5 percent per year from 1991 to 2004. No statistically significant change was seen in states that offered only religious exemptions or that had medium and difficult exemption processes. However, the researchers also found that easier granting of exemptions was associated with a 53 percent increased incidence of pertussis, and the availability of personal belief exemptions was associated with a 48 percent increased incidence.
“States must balance parental autonomy with the tremendous public health benefit of vaccines when considering the types of exemptions allowed and how policies are implemented. An approach similar to the model applied to conscientious objectors to [military] conscription, which focuses on the sincerity of the applicants’ beliefs and includes administrative controls, may provide a reasonable middle ground. Our findings support the need for effective administrative controls over granting nonmedical exemptions. Moreover, state-level policies on nonmedical exemptions and documentation of immunization status should be viewed as part of the efforts to control or eliminate vaccine-preventable diseases,” the authors conclude.
(JAMA. 2006;296:1757-1763. Available pre-embargo to the media at www.jamamedia.org)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
For More Information: Contact the JAMA/Archives Media Relations Department at 312/464-JAMA (5262) or email: mediarelations{at}jama-archives.org.
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JAMA REPORTS
VIDEO: Windows Media | Quicktime
WORKPLACE SMOKING BAN IMPROVED BAR WORKERS’ HEALTH IN AS LITTLE AS ONE MONTH
VIDEO:
B-ROLL
Bridget pouring beer
Exterior of Bar
Cigarette being put out in ashtray
Pan from Bridget to beer taps
AUDIO:
BRIDGET MCCARTHY HAS TENDED BAR IN THIS SAN FRANCISCO PUB FOR FOURTEEN YEARS. WHEN CALIFORNIA BANNED SMOKING IN BARS EIGHT YEARS AGO, SHE QUICKLY SAW A DIFFERENCE IN HER HEALTH.
VIDEO:
SOT/FULL
@ :10
Super: Bridget McCarthy
Bartender
Runs :12
AUDIO:
“It used to be you’d get home at night and you’d be coughing, you felt like you smoked a pack of cigarettes and you smelled and your eyes burned, and since the ban that doesn’t happen anymore.”
VIDEO:
B-ROLL
Bite runs through “improved”
GFX/JAMA COVER
Person smoking in bar
Bartender making drinks
Hand holding cigarette next to pack and ashtray on bar
Person smoking
AUDIO:
SHE SAYS HER HEALTH HAS IMPROVED, AND A NEW STUDY IN JAMA, THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, BACKS UP HER CLAIM. THE STUDY MEASURED BAR WORKERS’ LUNG HEALTH IN SCOTLAND BEFORE AND AFTER A WORKPLACE SMOKING BAN WENT INTO EFFECT THERE. THE RESEARCHERS MEASURED SENSORY AND RESPIRATORY SYMPTOMS.
VIDEO:
SOT/FULL
@ :39
Super: Mark Eisner, M.D., M.P.H.
University of California, San Francisco
Runs :12
AUDIO:
“The sensory symptoms are eye, nose and throat irritation and the respiratory symptoms are cough, wheezing and shortness of breath, and both improved markedly within one to two months after the smoking ban went into effect.”
VIDEO:
B-ROLL
Dr. Eisner looking at images of lungs on light board
Exterior UCSF medical center
Bartender talking to customers in smoky bar
C/U hand holding lit cigarette
Bartending pouring drink
AUDIO:
DR. MARK EISNER, AN EXPERT ON WORKPLACE HEALTH AT UNIVERSITY OF CALIFORNIA IN SAN FRANCISCO, SAYS THE SCOTTISH RESEARCHERS ALSO MEASURED LUNG FUNCTION IN BAR WORKERS, AND SAW QUICK AND DRAMATIC IMPROVEMENT THERE AS WELL. AND ASTHMATIC BAR WORKERS HAD LESS AIRWAY INFLAMMATION.
VIDEO:
SOT/FULL
Mark Eisner, M.D., M.P.H.
University of California, San Francisco
Runs :13
AUDIO:
“In the medical community it’s actually been controversial whether second-hand-smoke makes asthma worse in adults, and this is the first study to really show that creation of smoke-free workplaces led to dramatic improvement.”
VIDEO:
SOT/FULL
Bridget McCarthy
Bartender
Runs :08
AUDIO:
“I am living proof of it. I actually have asthma and my need for inhalers went down exponentially after the ban.”
VIDEO:
B-ROLL
Dr. Eisner at his computer
C/U hand flicking cigarette ashes in ashtray on bar
AUDIO:
DR. EISNER WROTE AN EDITORIAL WHICH ALSO APPEARS IN JAMA, IN WHICH HE CALLS FOR BANNING SMOKING IN WORKPLACES EVERYWHERE.
VIDEO:
SOT/FULL
Mark Eisner, M.D., M.P.H.
University of California, San Francisco
Runs :08
AUDIO:
“I think it is straightforward, that laws that prohibit smoking in the workplace lead to improvement in breathing over a very short time period.”
VIDEO:
B-ROLL
Person smoking in bar
Wide shot of bar/patrons
Bridget talking to customers
AUDIO:
AUDIO: HE ALSO SAYS THAT STUDIES SHOW BANNING SMOKING DOES NOT HURT BUSINESS, AND IN FACT, MAY IMPROVE IT. BRIDGET SAYS BUSINESS IS BOOMING AT HER SMOKE-FREE BAR, AND SHE’S BREATHING EASY. THIS IS MAVIS PRALL WITH THE JAMA REPORT.
