Global & Disaster Medicine

Archive for September, 2019

USA: 18 cases of silicosis, including 2 deaths, occurring in four states among mainly Hispanic stone fabrication workers who worked principally with engineered stone materials.

Rose C, Heinzerling A, Patel K, et al. Severe Silicosis in Engineered Stone Fabrication Workers — California, Colorado, Texas, and Washington, 2017–2019. MMWR Morb Mortal Wkly Rep 2019;68:813–818. DOI: icon


“Silicosis is an incurable occupational lung disease caused by inhaling particles of respirable crystalline silica. These particles trigger inflammation and fibrosis in the lungs, leading to progressive, irreversible, and potentially disabling disease. Silica exposure is also associated with increased risk for lung infection (notably, tuberculosis), lung cancer, emphysema, autoimmune diseases, and kidney disease (1). Because quartz, a type of crystalline silica, is commonly found in stone, workers who cut, polish, or grind stone materials can be exposed to silica dust…..”

The figure shows a visual abstract about silicosis in stone fabrication workers and offers information on how employers can protect their workers.

9/27/1854: Heavy fog causes two ships, the Arctic and Vesta, to collide, killing 322 people off the coast of Newfoundland


“……On September 20, the Arctic left Liverpool, England, for North America. Seven days later, just off of the Newfoundland coast, it came into a heavy fog. Unfortunately, the ship’s captain, James Luce, did not take the usual safety measures for dealing with fog—he did not slow the Arctic, he did not sound the ship’s horn and he did not add extra watchmen……”


Will Fosravuconazole – an anti-fungal drug developed by Eisai Pharmaceuticals in Japan – be more effective treatment than Itraconazole in the treatment of fungal mycetoma?

Daily Telegraph

“….Fungal mycetoma – dubbed a “silent killer” – is an infection that burrows into the limbs of its victims, causing massive swelling and peppering patients with lesions and sores. It can lead to disability, limb amputation or – in extreme cases – death.

The current treatment regime is brutal and long – patients take four tablets a day for up to three years but side effects include vomiting and even liver failure. …..”

Countries shown in dark green indicate those in which cases of mycetoma have been reported in the medical literature. The mycetoma belt region is shaded in gray

Countries shown in dark green indicate those in which cases of mycetoma have been reported in the medical literature. The mycetoma belt region is shaded in light green.

Source:  WHO


Pakistan: Condoms? Huh? Embarassed?

Jakarta Post


“…..Birth control shots are the most popular form of contraception, while condoms, used by only 3.23 percent, stand in third place from the bottom after tubal ligation and vasectomy….The BKKBN’s undersecretary for population control, Wendy Hartanto, said the low condom usage was caused by the cultural barriers, as many men think contraception is the responsibility of women……”


Identifying the root causes of poorly maintained WASH infrastructure, and understanding the deeply embedded socio-cultural values around menstrual hygiene management that need to be addressed in order to provide truly supportive school environments for menstruating girls.

Journal of Adolescence

Volume 76, October 2019, Pages 152-161
Journal of Adolescence

“How can we leave the traditions of our Baab Daada” socio-cultural structures and values driving menstrual hygiene management challenges in schools in Pakistan


“……Three key themes emerged from our data: (1) a poorly maintained, girls-unfriendly School WASH infrastructure was a result of gender-insensitive design, a cultural devaluation of toilet cleaners and inadequate governing practices; (2) the design of WASH facilities did not align with traditionally-determined modes of disposal of rag-pads, the most common used absorbents; (3) traditional menstrual management practices situate girls in an ‘alternate space’ characterised by withdrawal from many daily routines. These three socio-culturally determined practices interacted in a complex manner, often leading to interrupted class engagement and attendance……”

A 5.6 magnitude earthquake rocked several cities in northern Pakistan and parts of the Kashmir region under its control, leaving at least 22 people dead and more than 700 wounded


DYFI intensity map

Estimated Fatalities

Estimated Fatalities Histogram
Orange alert for shaking-related fatalities and economic losses. Significant casualties and damage are likely and the disaster is potentially widespread. Past orange alerts have required a regional or national level response.

Estimated Economic Losses

Estimated Economic Losses Histogram
Estimated economic losses are less than 1% of GDP of Pakistan.

Special Report on the Ocean and Cryosphere in a Changing Climate


NYT:  “……Earth’s oceans are under severe strain from climate change, a major new United Nations report warns, threatening everything from the ability to harvest seafood to the well-being of hundreds of millions of people living along the coasts.

Rising temperatures are contributing to a drop in fish populations in many regions, and oxygen levels in the ocean are declining while acidity levels are on the rise, posing risks to important marine ecosystems, according to the report issued Wednesday by the Intergovernmental Panel on Climate Change, a group of scientists convened by the United Nations to guide world leaders in policymaking.

In addition, warmer ocean waters, when combined with rising sea levels, threaten to fuel ever more powerful tropical cyclones and floods, the report said, further imperiling coastal regions and worsening a phenomenon that is already contributing to storms like Hurricane Harvey, which devastated Houston two years ago……”


9/25/1978: A Pacific Southwest Airlines jet collides in mid-air with a small Cessna over San Diego, killing 153 people


“…….The planes nose-dived straight into San Diego’s North Park neighborhood, destroying 22 homes and killing seven people on the ground. All 144 people on the 727 were killed, as well as both of the Cessna’s pilots……..”

Quack pharmacists around the world are fueling future superbug pandemics

Bureau of Investigative Journalism

“……Despite recent attempts by the Cambodian government to crack down on illegal pharmacies, these sellers fly under the radar. Most do not have any qualifications that would allow them to prescribe the cocktail of drugs they give patients, the researchers from the London School of Hygiene and Tropical Medicine and the University of Health Sciences found.

The invisible sellers had many misconceptions about antibiotics and dispensed them incorrectly, researchers said. Most openly admitted they sold them in response to patients’ demands, rather than medical need, leading to overprescription. They believed that antibiotics were necessary for colds and diarrhoea, and sold short courses of the drugs. They also sold antibiotics designed for humans to people wanting to give them to their cattle, chickens and dogs.

One seller said she learned about medicines during the Khmer Rouge regime and incorrectly believed antibiotics should be smeared into wounds. She said: “We break them into small pieces and pour them on wounds on our legs.”

This kind of misuse speeds up the creation of drug resistant bacteria, or superbugs, which are predicted to kill 10 million people by 2050 if no action is taken…..”

Safe Surgery & WASH

WASH in Healthcare Facilities

“…..Yet the state of hundreds of thousands of healthcare facilities in low- and middle- income countries is deplorable. Take into account that this data includes developed countries. Worldwide, 1/4 lack basic water services and 1/5 lack adequate sanitation services, leaving 2 billion people without access to safe, affordable surgical care.The WHO/UNICEF Joint Monitoring Programme for Water Supply, Sanitation and Hygiene, report—the first-ever effort to collect baseline water and sanitation data in healthcare facilities around the world, released last April—evaluated over 560,000 facilities in 125 countries.….”


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