Indonesian government ‘defeated by cigarette industry’

Tobacco companies have largely ignored the deadline for displaying graphic warnings on all cigarette packs sold in Indonesia. The setback is a blow to Indonesia’s anti-smoking campaign and its efforts to lower the smoking rate, currently the highest for male smokers in the world.

Despite being told a year and a half ago, many tobacco companies have not heeded the requirements to cover at least 40 percent of packaging with graphic warnings. The deadline for complying was Tuesday 24th June and campaigners say most companies didn’t make changes.

The National Commission for Child Protection said it found little sign of change in brands being sold in Jakarta and 11 other cities across the country. “This clearly indicates that the cigarette industry has defied Indonesian law,” said commission chair Arist Merdeka Sirait. “The government has been defeated by the cigarette industry.”

Only around 12 percent of the 3,300 tobacco brands owned by 672 companies nationwide have registered the photos they plan to use on their packaging, according to the Food and Drug Monitoring Agency. Manufacturers were given a choice of five images last June.

Health Minister Nafsiah Mboi said companies who missed the deadline will be issued with a warning and continued failure to comply could result in a fine of up to $42,000, and five years in prison.

Indonesia’s largest cigarette supplier, Philip Morris-owned Sampoerna, said it had issued packets with the new warnings on Monday, but needed time to clear its existing stock.

“We believe the government will implement the regulation consistently and fairly, so as to realize a climate of healthy competition among cigarette manufacturers, as well as providing clear information about the impact of smoking on health,” Sampoerna spokesman Tommy Hersyaputera said.

Tobacco controls are particularly contentious in Indonesia, one of the world’s largest producers of cigarettes and a growing market for the industry. Tobacco farmers often hold protests when restrictions are proposed. Indonesia is also one of the few countries which hasn’t joined a World Health Organisation tobacco treaty.

Advertising also runs rife in ways not seen in western countries for years. Billboards, LED displays, and television ads all push cigarettes on Indonesia’s 240 million people. A national survey found 67 percent of males aged of 15 smoke – the highest rate in the world – and 35 percent of the total population regularly smoke, surpassed on only by Russia

Travelers warned to get measles vaccine and A-line Wedding Dresses

treavel-healthAfter the recent measles outbreak in the USA, travelers going abroad this summer are advised to get vaccinated before they travel. There have been a record-number of measles cases in the United States this year, many resulting from unvaccinated travelers visiting places such as Southeast Asia, and Africa and returning home infected with the disease, reports

So far this year, there have been a confirmed 334 measles cases, the highest figure in more than two decades. ‘Homegrown’ measles cases – those originating the US – were eliminated in 2000, and the recent spike is due to unvaccinated travelers visiting areas which have an active measles outbreak.

“This is not the kind of record we want to break, but should be a wake-up call for travelers and for parents to make sure vaccination records are up to date,” said Anne Schuchat, director of the CDC’s National Center for Immunizations and Respiratory Diseases.

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Before the measles vaccine became available in 1963, the virus infected about 500,000 Americans each year, causing 500 deaths and 48,000 hospitalizations. Measles is still common in many parts of the world, including countries in Europe, Africa, Asia, and the Pacific. The CDC said 22 of the cases seen the US this year had been brought back from the Philippines, where a large outbreak began in October 2013.

Measles is best prevented by the MMR vaccine, which, when administered correctly, protects patients from measles, mumps and rubella. Ninety percent of cases in the US this year have been among people who have not had the vaccination or are of unknown vaccination status, according to the CDC. Many people who don’t have the vaccine do so due to religious, personal, or philosophical reasons, reports USA Today.

“Measles is a highly contagious respiratory disease that’s best prevented with an MMR vaccine,” said Dr. Mark Sannes, chair of infectious disease for the Park Nicollet Travel Clinic. He also noted polio is on the rise in other countries, and 10 places are currently experiencing outbreaks.

Other common disease travelers should consider vaccinations for are hepatitis A and B, typhoid, yellow fever, and rabies. While there is no vaccine at present, malaria is another ongoing risk for visitors to many tropical and subtropical regions. You should ideally see your doctor four to six weeks before you travel for advice on which vaccines you may require. Even if you leave it late, Sannes notes, last-minute appointments should still be available.

Though measles remains officially “eliminated” in the USA – because there have been no sustained homegrown outbreaks in recent years – “this is a reminder that we cannot let our guard down,” Schuchat said.

Lack of exercise greatest health threat for Australian women

Physical inactivity is the biggest threat to Australian women’s health, posing more of a risk than smoking, obesity, or high blood pressure, reports this week. The research, carried out by the University of Queensland, shows women over 30 who don’t exercise are at the reports

In women aged 22-27, smoking was, as expected, the most serious risk factor but after the age of 30 the risk begins to drop off, with lack of exercise becoming the biggest cause of heart problems. The Australian Longitudinal Study on Women’s Health, published in the British Journal of Sports Medicine, tracks the health of more than 32,000 Australia women.

Researchers warned the dangers of an inactive lifestyle were being underestimated, and deserved to be a much higher public health priority. The risks associated with smoking, being overweight and high blood pressure are well known, the dangers of physical inactivity are being under-publicized.

University of Queensland research professor Wendy Brown said the research showed women needed to move more.

“Continuing efforts to encourage people to stop smoking are warranted, but much more emphasis should be placed on physical inactivity,” she said.

“If all over-30s followed recommended daily exercise guidelines – 150 minutes of at least moderate intensity physical activity – the lives of more than 2,600 middle-aged and older women could be saved each year in Australia alone.’’

The study is one of the first in developed countries to look at how lack of exercise affects women specifically. Last month the UK government warned the country has become less physically active than at “any time in human history”, reported the Independent. The report called for more funds to be allocated for footpath and cycle track building, as well as an independent body dedicated to improve physical fitness.

In Australia more companies are introducing wellness and health promotion plans into their employee benefits package, reflecting a global trend. reports the Queenslanders Credit Union has introduced initiatives such as free lunchtime yoga classes and fresh fruit provision to keep employees healthy.

Study co-author Dr Toby Pavey said the low levels of physical inactivity in women over 30 could be due to women starting their families later in life. The demands of small children were now falling later.

Working through lunch and staying late ‘damaging employees’ health

Poor work habits like not taking a break, staying late or eating lunch at the desk are damaging the nation’s health, the Chartered Society of Physiotherapy (CSP) has warned reports Health Insurance Daily

Apoll of 2,000 employees, released for the CSP’s annual Workout at Work Day, found that 21% worked through their lunch every day.

Of those who do manage to take a break, 48% said they ate at their desk.

In addition, only 19% leave their workplace to go outside for a break and only 3% go to the gym, meaning most miss out on any kind of physical activity during the day.

Some 42% said they often had to cancel evening exercise plans because of work, while 32% said they started earlier or finished later than their contracted hours every day.

The CSP said employers should find ways to support staff to be more physically active during the working day in order to reduce their risk of developing musculoskeletal problems like back and neck pain and more serious illnesses such as cancer, heart disease and stroke.

Only 30% of workers said their employer provided any kind of exercise opportunities, such as a subsidised gym membership, a lunchtime running club, or an after work fitness class.

Prof Karen Middleton, chief executive of the CSP, said: “Full-time workers spend a significant bulk of their week at work, or travelling to and from it. Finding ways to build in time to do at least 30 minutes of moderate intensity physical activity, five times a week, can be a challenge.”

by Emily Perryman

Polio spread is an “international health emergency”

For only the second time in the its history, the World Health Organisation is calling for a global effort to contain polio outbreaks in Asia, the Middle East and Africa. In a statement this week the Organisation said the spread of the poliovirus constitutes an international health emergency.

“If unchecked, this situation could result in failure to eradicate globally one of the world’s most serious vaccine preventable diseases. It was the unanimous view of the committee that the conditions for a public health emergency of international concern have been met,” WHO said in a statement.

Polio is endemic in three countries, Nigeria, Pakistan, and Afghanistan, while it has been effectively eradicated elsewhere through vaccination programmes started in 1988. However, it is now spreading across borders due to military conflicts, and the breakdown of immunisation schemes.

WHO lists Afghanistan, Equatorial Guinea, Ethiopia, Iraq, Israel, Nigeria, and Somalia as countries at risk of exporting polio in 2014. For people travelling abroad from infected countries, WHO recommends carrying a vaccination certificate to prevent problems as other countries try to limit their risk.

In 2013 WHO recorded 417 cases of polio worldwide. For 2014, 68 cases had already been recorded by 30 April. At the end of last year 60 percent of polio cases were the result of international spread of wild poliovirus, with evidence pointing to adult travellers being the cause of this spread.

In the first half of 2014, known as the low-transmission season, polio has already been spread across international borders notably – Pakistan to Afghanistan, Cameroon to Equatorial Guinea and Syria to Iraq. WHO is calling for a greater international effort to combat these outbreaks and prevent new ones as the start of high-transmission season begins in May/June writes

The polio virus typically affects children under five and can cause paralysis and death. It is usually spread via contaminated water, and around 95 percent of cases are asymptomatic, allowing the virus to spread among a community undetected. One in 200 infections leads to irreversible paralysis and five to ten percent of patients die when their respiratory muscles become immobilised. While there is no cure for polio, infection can be prevented by taking the vaccination.

90% Wikipedia medical articles contain errors, say researchers

Trust your doctor, not the Internet, is the message from scientists this week, as a study finds 9 out of 10 Wikipedia medical entries contain errors. Scientists in the U.S. compared Wikipedia entries for health related issues such as heart disease, lung cancer, depression and diabetes with peer-reviewed research. They found most articles contain “many errors”.

The concept of Wikipedia allows people to create edit, and delete entries, which increases the likelihood of mistakes. Wikimedia UK, the British arm of Wikipedia, said it was “crucial” that people with health concerns spoke to their GP first. Though the articles can be altered by anybody, there are volunteers from the medical profession who check pages for inaccuracies, reports

Wikipedia is the sixth most popular website for research said the authors of the study, published in the Journal of the American Osteopathic Association. Researchers found up to 70% of medical students and 47% of physicians use the tool.

The researchers wrote, “Physicians and medical students who currently use Wikipedia as a medical reference should be discouraged from doing so because of the potential for errors.”

The study looked at articles for the 10 most costly conditions in America, including asthma, back problems and osteoarthritis. The articles were printed and analysed on 25 April 2012 and the researchers found 90% made statements which contradicted the latest medical research.

Errors found included an entry which stated to correctly diagnose high blood pressure three high readings needed to be taken over time. This is incorrect and could lead to a dangerous delay in treatment said doctors. Another entry claimed antidepressants were not beneficial for children, but according to the researchers, this is incorrect and could prevent parents from allowing their children to be treated with medication if necessary.

Lead author Robert Hasty of Campbell University said, while many of the mistakes were relatively minor, some “could have clinical implications”. He urged fellow doctors to get involved in editing Wikipedia entries to improve their accuracy.

“Wikipedia is not about truth but about verifiability”

Reported by the BBC, James Heilman president at Wiki Project Med Foundation said he disagreed with the findings, “The conclusions of Hasty’s paper are not supported by the data he provides.

“One example he raises of a so called ‘error’ is Wikipedia’s recommendation around the diagnosis of blood pressure. We stated that three measurements are usually required.

“So does the National Institute for Health and Care Excellence in the UK which was our reference. Wikipedia is not about truth but about verifiability.”

ALC Health Director Chairs 8th Asia Health Insurance Conference, Singapore

AWAALC Health director Andrew Apps will be jetting off this month to chair the Health Insurance Asia Conference in Singapore (17-20 June)

After Japan, China has the second highest number of high net worth (HNW) individuals in Southeast Asia, with Forbes magazine naming 162 Chinese nationals breaking the billion dollar mark in its Forbes Billionaries 2014 list. Affluence is causing yet more population migration which is placing pressure on the medical services.

Cities with the worst air pollutioncity air quality

Air PollutionThe levels of air pollution in many of the world’s cities fail to meet the World Health Organisation’s safe guidelines, according to the urban air quality database. Air pollution which exceeds recommended guidelines puts people at risk of respiratory disease and other health problems.

According to the report, issued this week, only 12 percent of people living in the cities which measure air pollution are breathing air which meets the quality guidelines. About half of the urban population being monitored by WHO is exposed to urban air pollution which exceeds the recommended levels by at least 2.5 times.

WHO’s urban air quality database covers 1,600 cities across 91 countries – 500 more cities than the previous database (2011), revealing that more cities worldwide are monitoring outdoor air quality, reflecting growing recognition of air pollution’s health risks.

In cities where there is sufficient data to compare pollution levels today with those from previous years the situation is getting worse. WHO attributes this to many factors, but highlights fossil fuel use, dependence on private transport, insufficient energy use in buildings, and the use of biomass for cooking and heating.

The countries with the highest annual mean levels of PM2.5 (fine particles with a diameter of less than 2.5 micrometres) are Pakistan, Qatar, Afghanistan, Bangladesh, and Iran. However, half the 20 cities in the world with the highest PM2.5 levels are found in India. Delhi has the highest levels, 153 micrograms per cubic metre (ug/m3), in the world. This is six times the WHO “safe” level of 25 ug/m3.

Surprisingly, no Chinese cities ranked in the top 20 worst cities. Beijing, often in the news for its bad air quality, reported 56 ug/m3 and Chinese politicians have this year declared a “war upon pollution” write

In April 2014 WHO estimated that outdoor pollution was responsible for the deaths of some 3.7 million people under the age of 60 in 2012. The Organisation also highlighted outdoor and indoor air pollution as one of the biggest combined health risks worldwide.

The report notes that individual cities can take local action to improve air quality and thus go against regional trends. And good air quality can go hand in hand with economic development, as indicated by some major cities in Latin America which meet, or approach, the WHO air quality guidelines.