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To arrest rising health-care costs, a growing number of U.S. employers are expanding workplace "wellness" initiatives. Providing workers with tools and incentives to improve their health, the thinking goes, will reduce medical-care costs and boost worker productivity.
Experts say it's a trend that bodes well for employees who are motivated to lose weight, quit smoking, manage a chronic condition or just stay fit.
"Pretty clearly, employers have realized that if they're going to manage benefit costs and manage work loss, they need to get at the underlying health drivers of that -- employee health -- and get at the root causes of health-care utilization and health-care expenditures," said Bruce Kelley, practice leader for data services in the Minneapolis office of Watson Wyatt Worldwide, a human resources consulting firm.
According to Kelley, employers have been investing much more heavily in wellness services in the last few years. "I've been consulting in this area for 20 years," he noted, "and I've never seen as much activity among employers as I've seen just in the last few years."
Wellness is a broad term that describes the panoply of health-management services that companies offer, from onsite fitness centers and smoking-cessation classes to health-risk appraisals and disease-management programs.
Survey data show that more large employers are offering programs to improve employee health and productivity. Seventy-five percent offered a "health promotion" program in 2005 or 2006, up from 56 percent in 2003, according to survey results released last December by Watson Wyatt and the National Business Group on Health.
Nearly three out of four employers (72 percent) are sponsoring health-risk appraisals to measure individual employees' health risks and behaviors. And 40 percent are engaging "personal health coaches," health professionals who can help, say, an employee with diabetes manage their diet, exercise and drug regimens.
At the same time, corporate America and public health leaders are grappling to understand which particular interventions or combinations of programs and incentives yield the greatest return on investment.
"There has not been a tremendous amount of high quality research in this area," said Doug Evans, director of the Center for Health Promotion Research at RTI International, a nonprofit research institute based in Research Triangle Park, N.C.
But there are a number of efforts under way to learn what works. The U.S. Centers for Disease Control and Prevention, for one, is sponsoring a series of studies to evaluate worksite efforts to prevent and control obesity.
In one study, published in the September/October 2005 issue of the American Journal of Health Promotion, CDC and RTI researchers found that obesity boosts employers' costs, including medical expenditures and absenteeism, by $460 to $2,500 per obese employee per year. They estimated that the cost of obesity at a firm with 1,000 employees is about $285,000 per year.
In March, the National Business Group on Health issued 10 recommendations for promoting prevention in the workplace. Overall, it concluded that without the support of top-level management, companies cannot convey "the importance to employees of caring for themselves."
Some employers are using incentives to get workers on the wellness bandwagon. You might qualify for a lower health insurance premium, say, if you stop smoking, or you could earn a $25 gift certificate for completing a health-risk appraisal.
The use of incentives will continue, Evans predicted. However, he believes employers must do a better job of promoting the benefits of health, much like anti-tobacco advocates did by portraying a non-smoking lifestyle as cool, hip and fun.
"Maybe that kind of technique can be effective in obesity," he offered. "Can you make it cool to be healthy weight and not to be fat?"
Arkansas Gov. Mike Huckabee, chairman of the National Governors Association, is encouraging all Americans to live healthy lifestyles through a national campaign, Healthy America: Wellness Where We Live, Work and Learn.
By Karen Pallerito, HealthDay News, October 5, 2006
An antibiotic-resistant acne germ can spread among family members, Swedish researchers find.
The germ is Propionibacterium acnes. Skin colonized by P. acnes tends to erupt into the blotches and pustules of acne. Since the 1960s, doctors have fought P. acnes with antibiotics. The bug fought back. It's now common to find P. acnes strains resistant to several common antibiotics.
Doctors hoped that the only people carrying the drug-resistant acne bugs would be patients on long-term antibiotic therapy. That isn't the case, find Carl Eric Nord, MD, PhD, and colleagues at Karolinska Institute in Stockholm, Sweden.
Nord and colleagues took skin samples from 10 acne patients, all on antibiotic therapy, and from two close family contacts of each patient. Twelve healthy, acne-free volunteers -- who were not taking antibiotics and did not have family members with acne -- served as a comparison group.
Nord and colleagues found that nearly half of the family members carried drug-resistant acne bacteria on their skin. Genetic analysis showed that these family members carried the same strain of P. acnes as the acne patient among them.
The good news is that the family members fought off the drug-resistant germs -- but only after the acne patient in their family stopped using antibiotics.
On the other hand, you apparently can't avoid drug-resistant acne germs by avoiding people with acne. A third of the healthy comparison group also carried drug-resistant P. acnes on their skin.
Nord reported the findings at last week's 46th Interscience Conference on Antimicrobial Agents and Chemotherapy, held Sept. 27-30 in San Francisco.
SOURCES: 46th Interscience Conference on Antimicrobial Agents and Chemotherapy, San Francisco, Sept. 27-30, 2006.
By Daniel DeNoon, WebMD, October 2, 2006
By Judi Bailey
Learn more about identifying this disorder and helping clients who demonstrate its symptoms.
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Fair-skinned people who yearn for a suntan -- even though they know it's hopeless and unhealthy -- may one day have cause for celebration.
Harvard scientists have discovered new information about how the skin tans or -- in the case of fair-skinned people -- stubbornly refuses to tan due to a genetic defect. Using a skin treatment, they have turned pale skin dark, while also protecting it from ultraviolet-induced.
"Darkening a person's skin may mimic the protective benefit seen in people who otherwise make a large amount of pigment," says researcher David E. Fisher, MD, PhD, director of the Melanoma Program at Dana Farber Cancer Institute in Boston. And that could translate into a reduction in the toll of the potentially deadly skin cancer melanoma, expected to be diagnosed this year in 62,000 people in the U.S. and to result in 8,000 deaths, according to American Cancer Society projections.
The study appears in the Sept. 21 edition of the journal Nature. Fisher cautions that the study was done only in animals. Using a topical cream instead of the sun's rays, Fisher's team was able to switch on the tanning mechanism in the skin cells of fair-skinned mice, turning them into olive-skinned animals. "This has not been demonstrated in people and there is a lot that needs to be proven before it's ready for even a first attempt in clinical subjects," Fisher says.
Even so, the study was called intriguing by Meenhard Herlyn, DVM, PhD, a tumor biologist at The Wistar Institute, a research center on the campus of the University of Pennsylvania. "What he clearly has shown is ... you can induce a pigmentation, tanning, and the purpose is that people who are very susceptible to skin cancer, including melanoma, can be protected."
By Kathleen Doheny, WebMD, September 20, 2006
Rates of eczema and hay fever in the United Kingdom appear to have stabilized, after charting a steady rise over recent decades.
However, the study also found that rates of systemic allergic reactions -- including the severe condition known as anaphylaxis -- have surged in the past 20 years.
The researchers analyzed data gathered from numerous sources: national surveys, primary care doctors, prescription and hospital admission records, and death records.
Over the past three decades, diagnoses of allergic rhinitis and eczema in children have tripled, but there appears to have been a recent decrease in the prevalence of symptoms. Hospital admissions for eczema have stabilized since 1995, the researchers found, while admissions for allergic rhinitis have decreased to about 40 percent of their 1990 levels.
Between 1971 and 1991, the number of consultations with family doctors about hay fever increased by 260 percent and by 150 percent for eczema. However, these rates have stabilized in the past 10 years, the study said.
Hospital admissions for anaphylaxis have soared by 700 percent, for food allergy by 500 percent, and for the skin allergy urticaria by 100 percent.
Prescriptions for all types of allergies have increased since 1991.
The researchers said that some of the trends could be related to changes in medical practice and care but could also be explained by changes in the sources of allergic disease.
The study was published in the current issue of Thorax.
HealthDay News, September 7, 2006
The FDA is seeking to ban over-the-counter sales of skin bleaching drug products.
The FDA cites the possible risk ofand skin discoloration from hydroquinone typically found in these products.
However, those cancer studies were done on rats, not people.
"The actual risk to humans from use of hydroquinone has yet to be fully determined," the FDA states in its proposal, published in the U.S. government's Federal Register.
The type of skin discoloration noted by the FDA is called exogenous ochronosis, a darkening of the skin. The FDA cites research linking the condition to hydroquinone use.
The FDA isn't proposing a ban on prescription skin bleaching drug products. But all such products would need to submit a new drug application for the FDA's review.
Not all skin lighteners contain hydroquinone. The FDA knows of 200 products containing hydroquinone in strengths from 0.4% to 5%, about two-thirds of which "appear to be marketed as OTC [over-the-counter] drugs," says the FDA.
The FDA is taking comments on its proposal until Dec. 27.
WebMD spoke with dermatologist Susan Taylor, MD, of Society Hill Dermatology in Philadelphia, and the Skin of Color Center in New York about the FDA's proposal.
"I feel that hydroquinones are safe and effective treatment for pigmentary disorders," Taylor says. "I feel comfortable recommending that my patients continue to use hydroquinones if they have a pigmentary disorder."
"I think the evidence is quite weak with the link between hydroquinones and cancer," Taylor tells WebMD.
"Data on rats and mice cannot necessarily be extrapolated to human data," she says.
"In Africa, people have used hyrdoquinones for long periods of time ... meaning years, 10, 20, 30, years ... and at high concentrations," Taylor says. "We've not seen a proliferation of various types of cancers reported from that population.
Exogenous ochronosis is rare in the U.S., Taylor notes.
"If you look at the case reports, it's probably less than 200," Taylor says. "So it's really not a significant problem here in the United States."
Millions of Users
Taylor points out that "many patients have disorders that are truly disfiguring and devastating. And these conditions can be improved significantly with hydroquinone products."
"It's important therapy and it's used by millions and millions of people," Taylor says.
She says hydroquinone products are primarily used to lighten dark areas of the skin due to conditions including injury,, , and sun damage.
"So there are real problems and this is a real solution," Taylor says. She adds that filing new drug applications can cost millions of dollars.
"My concern is that we could lose prescription products that we have," Taylor says. "That would have major consequences, I think."
"It's safe, effective; it's the gold standard, and I think our patients would benefit from continued use for these problems. I think those three points sum it up for me," Taylor says.
SOURCES: U.S. Government Printing Office, Federal Register, Aug. 29, 2006; vol 71: pp 51146-51155. Susan Taylor, MD, Society Hill Dermatology, Philadelphia, Skin of Color Center, New York.
By Miranda Hitti, WebMD, August 30, 2006
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Unless it's continuously reapplied, sunscreen can actually attack the skin and leave it vulnerable to ultraviolet (UV) radiation, concludes a University of California, Riverside study.
The researchers found that, over time, molecules in sunscreen that block UV radiation can penetrate into the skin and leave the outer layer susceptible to UV, CBC News reported.
The study appears in an upcoming issue of the journal Free Radical Biology & Medicine.
"Sunscreens do an excellent job protecting against sunburn when used correctly," Kerry Hanson, a research scientist in the university's department of chemistry, said in a prepared statement.
"This means using a sunscreen with a high sun protection factor and applying it uniformly on the skin. Our data show, however, that if coverage at the skin surface is low, the UV filters in sunscreens that have penetrated into the epidermis can potentially do more harm than good," he said.
HealthNews Day, 8/29/06