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HPRC Fitness Arena: Environment
West Nile. Dengue. Malaria. Chikungunya. No, that’s not a typo. Chikungunya (pronounced “chik-en-gun-ye”), a mosquito-borne virus that primarily occurs in Africa, Asia, and the Indian subcontinent, and Warfighters deployed to these regions have been exposed to this risk for some time, now, however, it is reportedly spreading to Europe and the Americas. Most of the cases in the U.S. involve individuals who have recently traveled abroad, but the Centers for Disease Control and Prevention (CDC) just reported the first locally acquired case, in Florida.
The viral illness is characterized by fever and severe joint pain, but other symptoms include headache, muscle pain, joint swelling, and rash. There is currently no antiviral drug for Chikungunya, and treatment is aimed at relieving symptoms. Most patients will recover fully on their own, although sometimes symptoms persist for several months.
It’s important to know your environment. If you’re being deployed to these regions or even going there on vacation, there are things you can do to protect yourself from mosquito bites and mosquito-borne infections. Wearing long pants, shirts with long sleeves, and insect repellent while outdoors reduces the chance of an insect bite. Other precautions include removing standing water from containers such as flowerpots and buckets and placing screens over open windows and doors.
If you think you could have been infected, you should see your doctor, especially if you have recently traveled to high-risk regions. Visit the Center for Disease Control (CDC) for more information about Chikungunya.
E-cigarettes were introduced to help people stop smoking, but they are becoming a popular alternative to traditional cigarettes. But are they really a healthier substitute, as many companies claim? In short, we don’t yet have a full answer to this important question, and the U.S. Food and Drug Administration (FDA) is on a mission to find out.
On April 25th, FDA released a proposal for new regulations on e-cigarettes—a multibillion-dollar industry that so far has not been highly regulated. In fact, FDA currently lacks the authority to collect vital information about these products. Traditional cigarettes deliver thousands of chemicals, many of which are dangerous, to cigarette smokers and non-smokers around them. By comparison, e-cigarettes deliver substantially fewer chemicals. However, little is known about the potential dangers of the chemicals that e-cigs deliver.
Proposed new rules would allow FDA to collect information about the ingredients in e-cigarettes, as well as their health and behavioral effects. It also suggests that more research is needed to study the long-term health effects of these products.
E-cigarettes are now being marketed with flavors popular among young people. Preliminary studies have found that young people who say they would never use a tobacco product are experimenting with e-cigarettes. The proposed new rules also would require e-cigarette users to be at least 18 years of age to purchase these products.
Although it’s still unclear how the popularity of e-cigarettes will impact public health, but it’s certain that more research will shed some light on their long-term effects.
Inhalation of major air pollutants has been found to decrease lung function and exacerbate symptoms of exercise-induced bronchospasms, including coughing, wheezing, and shortness of breath. In order to meet oxygen demands during light- to moderate-intensity exercise, you take in more air with each breath. And when you breathe through your mouth, you bypass the nose’s natural filtration of large particles and soluble vapors. As your exercise intensity increases, you breathe faster and deeper, which also increases the amount of pollution inhaled and the depth it travels into your respiratory system.
If you live in or near a busy city, you are exposed to even more combustion-related pollutants—such as nitrogen oxides (NOx), carbon monoxide (CO), particulate matter (PM), and ozone—that can inflame your airways and worsen asthmatic responses. Exposure to freshly generated emissions is most common near areas of high vehicular traffic.
While indoor exercise is often a good alternative to limit exposure to outdoor pollutants, some indoor conditions may be just as toxic. Nitrogen dioxide (NO2)—the more toxic NOx—is usually higher in gas-heated homes and indoor areas with poor ventilation. Carbon monoxide poisoning is also more likely to occur indoors. When carbon monoxide is in your system, the blood carries substantially less oxygen, reducing performance and eventually leading to carbon monoxide poisoning. Be sure to choose well-ventilated areas for indoor exercise.
Particulate matter and ozone are two significant pollutants you may be exposed to outdoors. Inhalation of high levels of particulates has been shown to reduce exercise performance as much as 24.4% during short-term, high-intensity cycling. Women may be more vulnerable than men to certain particulates, associated with greater decrements in performance. Ultrafine particle concentrations are highest in freshly generated automobile exhaust, and these small particles can be carried deep into the lungs. However, the further away you are from fresh exhaust, the less concentrated the particulates.
Bad ozone occurs lower in the atmosphere; it is not directly emitted into the air but is created from chemical reactions between NOx, volatile organic compounds (VOCs), heat, and sunlight. Ozone levels also are higher in summer than in winter; and especially in larger, hotter cities, concentrations tend to peak around midday when solar radiation is highest. Exposure to ozone during exercise has been found to increase resting blood pressure, reduce lung function, and decrease exercise capacity.
The risks associated with not exercising at all are far greater than the risks of exercising outdoors; it just takes a little more planning on days and in conditions when pollution is bad. When planning outdoor exercise activities, follow these tips to limit your exposure to pollutants:
- Avoid exercising in areas of heavy traffic, such as along highways and during rush hour.
- During summer, exercise earlier in the morning, when ozone levels and temperatures are not as high.
- Check the domestic or international air-quality ratings to determine if it’s safe to exercise outside. Limit your time outside on Code Red and Code Orange days. Environmental conditions on these days are not healthy, especially for children, the elderly, and people with existing respiratory conditions.
- Exercise indoors when the air quality indicates high ozone and particulate levels.
- Before any demanding physical activity, limit your carbon monoxide exposure by avoiding smoky areas and long car rides in congested traffic.
More than two million new cases of skin cancer are diagnosed each year, and the number is growing. Skin cancer is a major public health issue, and with proper precautions you can decrease your risk considerably. Hopefully this information on sun safety will help you, whether you are a Warfighter or dependent, stay safe during all outdoor activities!
Ultraviolet radiation (UVR) has been identified as the most important risk factor for both melanoma and non-melanoma skin cancer. Exposure to UVR weakens the skin’s elasticity and can result in sagging cheeks, deeper facial wrinkles, skin discoloration, burn, skin aging, photosensitivity, and cancer. Taking steps to safeguard yourself is crucial, especially when participating in outdoor activities or exercising.
Sweating increases the skin’s sensitivity to the sun’s rays, magnifying the risk of sunburn and skin damage. Athletes who practice outdoor sports have been found to be at increased risk for skin cancer. Remember—the weather does not have to be sunny and hot for you to get sun damage. Ultraviolet rays penetrate clouds, exposing you to 80% of the UVR. Even skiers and mountain climbers are at risk for sun exposure and skin cancer because of the stronger UVR at altitude.
Follow these precautions from the Occupational Safety and Health Administration (OSHA) whether training for the PRT, patrolling, road marching, or participating in a summer league softball game:
Avoid burning. Avoid sun tanning. Also, try to avoid sun exposure during midday (11 a.m. to 3 p.m.) when the rays are the strongest.
Seek shade. When possible, especially during midday, seek shade under a tree or tent.
Cover up. Wear protective clothing, including hats, long-sleeved shirts, and pants when going outdoors. Keep in mind protection decreases when clothes are wet.
Use extra caution near water, snow, and sand. Ultraviolet rays can reflect off of these surfaces, which can increase your chance of sun exposure and skin damage.
Apply sunscreen. Use water-resistant sunscreen and apply 15-30 minutes prior to sun exposure to allow for it to absorb. Also, reapply after swimming, sweating, or toweling off. Be sure to take a look at the new FDA regulations regarding sunscreens and their effectiveness.
Wear sunglasses. Protect your eyes when working, driving, participating in sports, taking a walk, or running an errand. Solar ultraviolet B radiation can cause an increased risk of cataracts and cancer of the skin around the eye without proper cover.
It’s always important to remember hydration when engaging in outdoor activities as well! HPRC has useful tips on hydration and the consumption of sports drinks and caffeine during exercise in the heat.
Have you been experiencing symptoms such as sneezing; a runny nose; watery and/or itchy eyes, and fatigue? Colds and allergies both can make you feel miserable and affect your performance, but it can be hard sometimes to tell which is which. The causes of each are distinctly different: Colds are contagious, and they are caused by viruses. But allergies are due to sensitivity to allergens such as seasonal pollen, and they’re not contagious. To prevent colds, hand washing is key, along with hygiene etiquette such as covering your mouth or nose when you cough or sneeze. To avert allergies, on the other hand, try to avoid the allergens that cause your symptoms. Common allergens, especially in the spring, include grass and tree pollen. Year-round allergens include mold, animal dander, and dust mites. It can be a challenge to exercise and enjoy the outdoors if you have allergies, but it’s not impossible. Here are some tips to help you manage your allergies:
- Know and avoid your allergy triggers. If you’re not sure what you might be allergic to, getting tests done by a specialist could help you narrow it down. A doctor might also suggest an antihistamine or inhaler to help prevent flare-ups.
- Check the air quality in your area every day. If the pollen count is high, avoid spending too much time outside, mowing the grass, or exercising outdoors.
- Shower after being outside. This can help reduce symptoms by washing pollen off your, skin, hair, and eyelashes.
- If you must be outside during high pollen/pollutant times, wear a cover (such as a mask or bandana) over your mouth and nose to keep particles out of your airways.
- Rinse out your nose with a saline spray to help wash away allergens after being outside.
Have you heard of Total Force Fitness, but you aren’t sure what it is? It’s a framework for building and maintaining health, readiness, and performance in the Department of Defense. It views health, wellness, and resilience as a holistic concept that recognizes “total fitness” as a “state in which the individual, family and organization can sustain optimal well-being and performance under all conditions”—a connection between mind, body, spirit, and family/social relationships. Total fitness shifts the perspective from treatment to wellness and focuses on prevention and strengths.
The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury created a slide presentation for units and groups on Total Force Fitness: A Brief Overview that describes what TFF is, its core components, and each of its eight “domains” (behavioral, social, physical, environmental, medical and dental, spiritual, nutritional, and psychological). For more in-depth reading, check out the original Military Medicine Supplement that started it all, including a scholarly chapter for each domain.
The word “antibacterial” is all too familiar to 21st-century consumers. Soaps and cleaning products that tout “antibacterial” or “kills germs” in large print seem to be everywhere. So it may surprise you to learn that recent studies suggest the use of antibacterial soaps may not be as beneficial as once thought. Research now shows that overuse of these soaps contributes to antibiotic resistance, which makes bacteria stronger and less responsive to antibiotic treatment—a potentially major problem in combat zones and hospitals. In addition, recent animal studies have shown that triclosan, the most common active ingredient in antibacterial soaps, may alter the way hormones work in the body. While these soaps are sometimes necessary in hospital settings, scientists caution against using them in our everyday lives.
FDA will now require that over-the-counter antibacterial soaps must prove that their benefit to a consumer’s health is greater than the current risk for harm to the user and the environment. Manufacturers of over-the-counter antibacterial soaps will be given until December 16, 2014, to provide this evidence or FDA will ban their products.
The ban will not affect hand sanitizers and soaps used in hospital settings. To learn more about the proposed ban of antibacterial soaps, read the FDA consumer update.
Wanting some holistic strategies to enhance your performance? Check out the “One Shot One Kill (OSOK) Performance Enhancement Program” that shows Warfighters how to set up and manage their own performance-enhancement system. OSOK is designed not only to enhance performance but also to jumpstart Warfighter resilience. It builds on the skills that Warfighters already possess and then teaches new ones as needed.
There are two ways you can use OSOK: as an individual through “OSOK Solo” and as a unit/group through “OSOK-IP Unit.” Both highlight “10 Rules of Engagement” and provide seven core modules: Controlled Response, Mind Tactics, Performance-Based Nutrition, Primal Fitness, Purpose, Code, and Recharge. OSOK also provides self-assessment forms so you can track your progress over time.
For other performance-enhancement programs and information about holistic (total) fitness, check out HPRC’s Total Force Fitness domain.
The U.S. Army’s Asymmetric Warfare Group has been training joint forces in some unusual places—underground venues such as tunnels, caves, and sewers. As battlefields become more urban and enemies move underground, subterranean environments pose unique operational challenges. Although the Army does not currently have an official field manual for underground combat, this new tactical training has developed units’ ability to perform in these environments. Combat training centers are starting to integrate these kinds of complex environments into their facilities, and the Army is urging home-station training to “get creative” and use simple techniques to simulate their own underground environments. Something as simple as training in a dark room with obstacles can simulate underground areas. Israeli Defense Forces have also had success with this type of training. Being able to adapt and perform in challenging environments is a vital part of warrior resilience.
In 2013, the Research Institute of Chicago (RIC) presented the first mind-controlled bionic leg, thanks to support from the U.S. Army Medical Research and Material Command's (USAMRMC) Telemedicine and Advanced Technology Research Center (TATRC). Until now, this technology was only available for prosthetic arms. These brainy bionic legs are still being studied and perfected, but it’s hoped that they will be available in the next few years. This life-changing technology will be able to help the more than 1,600 service members who have returned from Iraq and Afghanistan with amputations. Bionic limbs will make the transition to active duty or civilian life smoother for wounded warriors.
In one case study, a civilian who lost his lower leg in a motorcycle accident underwent a procedure called “Targeted Muscle Re-innervation”. This procedure redirects nerves that originally went to muscles in the amputated limb to still-healthy muscles in the limb above the amputation. As these healthy muscles contract, they generate signals that are detected by sensors within the prosthetic and analyzed by a specially-designed computer chip and program The program rapidly decodes the type of movement the individual is preparing to do, such as bending the knee, and then sends those commands to the leg. This allows the person to walk up and down ramps and stairs and transition between activities without stopping. The user also can move (reposition) the bionic leg just by thinking about it, which is not possible with current motorized prosthetics.
The bionic leg is also showing a decreased rate of falling and quicker response time. Stay tuned for availability of this groundbreaking technology.
[Image Source: RIC/NWU]