Filtered and bottled water consumption could increase tooth decay risk

Little did I know that filtering my family's tap water might put our teeth at risk.

Two years ago, when I was pregnant and reporting on how the federal government was unwilling to regulate the rocket-fuel component perchlorate in drinking water, my husband and I decided to install a reverse osmosis filter in our kitchen tap. Since D.C. tap water has come under fire for its high levels of everything from lead to hexavalent chromium, it seemed like a sensible move.

But during a recent visit to the dentist, my hygenist remarked she had started noticing a rise in tooth decay among children who drank only filtered or bottled water, presumably because they were not drinking fluoridated water. And it suddenly occured to me: Neither was my 20-month-old son, with his 17 teeth.

As Americans' consumption of bottled water has risen - it has doubled over the past decade - it is reducing the daily exposure Americans get to the mineral that helps prevent tooth decay. And while researchers have yet to do a comprehensive study of what impact this is having, especially on children, many dentists and pediatricians believe the issue deserves serious examination.

"I think it would be good to look at," said Howard Pollick, a clinical professor in the Department of Preventive and Restorative Dental Sciences at the University of California at San Francisco and a spokesman for the American Dental Association.

Prodded by studies showing that fluoride significantly reduced tooth decay, U.S. municipalities began adding it to public drinking water systems in the 1940s. Today, about 65 percent of Americans get fluoridated tap water, including 95 percent of people in Virginia, 99 percent in Maryland and 100 percent in the District.

While a vocal minority of Americans remain skeptical, the ADA and most other health authorities remain convinced that fluoridation benefits the general population.

District dentist Pierre Palian, who treats my family, told me that after utilities started fluoridating public water supplies, "the cavities rate was cut in half. The only thing they could attribute it to was fluoridating the water."

The Centers for Disease Control and Prevention identifies fluoridation of public drinking water as one of the top 10 public health achievements of the 20th century, noting that studies show it reduces cavitities in adolescents by between 8 and 37 percent, and among adults by 20 to 40 percent.

But when it comes to getting greater precision, researchers are faced with the problem that most people in the United States don't take their children to the dentist before age 3, and most drink water from a mix of sources. As a result, it's difficult to measure the impact of fluoride on children's teeth.

China tobacco profits undermine anti-smoking push

BEIJING -- China's addiction to huge revenues from its state-owned tobacco monopoly is hindering anti-smoking measures, potentially costing millions of lives in the country with the world's largest number of smokers, experts warned Thursday.

The health and other costs of smoking already exceed the tobacco industry's economic contributions by at least $9 billion, said a report prepared by a group of prominent Chinese public health experts and economists.

If trends continue, by 2030 an estimated 3.5 million Chinese will die from smoking each year - three times the current level, it said, citing China's failure to take basic measures such as passing a national law to ban smoking in indoor public places and raising the price of cigarettes.

The analysis underscores increasing concerns that the government is jeopardizing the country's economic potential by refusing to take serious action to combat a widespread problem that escalates medical costs and hurts productivity.

Political will is lacking because China's leaders often consider only the short-term benefits, according to Teh-wei Hu, a health economics professor at the University of California, Berkeley, who has advised the government to raise cigarette prices.

"When I talk to leaders in high-level positions, they say, 'Well, I know and people know that smoking is harmful, but I won't be popular if I raise the prices," Hu said.

The report, titled "Tobacco Control and China's Future," pointed to a conflict of interest in the system. China's State Tobacco Monopoly Administration, which sets tobacco policy and enforces rules, is the same federal agency that controls the China National Tobacco Corp. - the world's largest cigarette maker. The report criticized the administration for promoting tobacco production and sales and hampering efforts to strengthen tobacco control.
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"This is the first 'critical' report of China's efforts on tobacco control from within China itself," said Judith Mackay, a World Lung Foundation senior policy adviser who reviewed the report and wrote a preface. "This speaks volumes of the strengthening of the health groups in China in countering the powerful Chinese national tobacco monopoly."

Curbing tobacco use, which is linked to the deaths of at least 1 million people in China every year, is one of the greatest health challenges the country faces. Nearly 30 percent of adults in China smoke, making up about 300 million people - a number roughly equal to the entire U.S. population. The report said that while China's overall smoking rate has not seen any significant change over the last decade, tobacco-linked deaths have risen rapidly.

"While the (tobacco) industry remains a 'major taxpayer' today, it causes enormous social costs and overall poses a loss rather than a benefit to China," the report said.

The State Tobacco Monopoly Administration could not immediately be reached for comment. The tobacco industry's position has usually been that measures to curb smoking would reduce revenue to the government and put tobacco farmers out of work.

The report was timed for release days ahead of a Sunday deadline that China will fail to meet - to ban smoking at public indoor venues under a global anti-tobacco treaty backed by the World Health Organization.

Smoking is so entrenched in Chinese society that cigarette cartons are commonly exchanged as gifts. A study shows almost half of all male doctors smoke, and tobacco companies are even allowed to sponsor schools. In many parts of China, people will light up in hospitals, offices and even elevators.

However, last year, authorities did instruct kindergartens and elementary, secondary and vocational schools to ban smoking on school grounds and bar teachers from lighting up in front of students.

Nearly 60 experts were involved in writing or reviewing Thursday's report, including its chief authors, Dr. Yang Gonghuan, deputy director of the official Chinese Center for Disease Control and Prevention, and Professor Hu Angang of Tsinghua University, one of China's best-known economists and a key policy adviser.

Consumer Reports Insights: Health clubs harbor hidden dangers

Joining a health club can make it easier and more fun to exercise. But gyms can also present safety problems. Bacteria in poorly maintained pools can spread disease. Antibiotic-resistant staph infections can be picked up in crowded locker rooms and from heavily used exercise equipment. You can be injured or even suffer an exercise-related heart problem. Here's how to minimize those risks.

Skin infections

Staph infections, including those caused by methicillin-resistant Staphylococcus aureus (MRSA) bacteria, can spread through shared gym equipment, mats and towels. Infections tend to occur near a cut or scrape, and on certain body parts (the armpits, buttocks, groin and neck). They start off looking like a large pimple but can swell, become painful and produce pus. If they spread to your bloodstream, they can be life-threatening. Many clear up on their own, but seek medical attention if a fever develops or if the area becomes enlarged, red, tender or warm.

Prevention: Use the alcohol spray or wipes that most gyms provide to wipe off equipment before and after use. Place a clean towel over mats used for doing sit-ups, stretching or yoga. Don't share towels with others. Wash your hands frequently with soap and water, or use an alcohol-based sanitizer. Shower after working out. If you have a cut or scrape, keep it covered with a clean adhesive bandage and don't use hot tubs or whirlpools.

Dirty pools

Poorly maintained swimming pools are common, allowing bacteria and viruses to cause outbreaks of gastrointestinal illness. Inspections at 3,666 health clubs in 13 states found serious lapses requiring the immediate closing of 10 percent of the pools, according to a May report by the Centers for Disease Control and Prevention. Improperly maintained circulation and filtering systems and skimpy disinfection were among the most common problems.
Prevention: To protect others, shower with soap before swimming and wash your hands after using the toilet or changing a baby's diaper. Don't use the pool if the water has a strong chemical smell or appears cloudy. Pool water should have little odor and be clear enough that you can easily see the bottom. Ask employees about chlorine and pH levels, which should be checked at least twice a day, and the pool's latest inspection score. Or use do-it-yourself test strips, available at home-improvement stores. Chlorine should be 1 to 3 parts per million (4 to 6 ppm for hot tubs), and pH should be 7.2 to 7.8.

Strained muscles

Weight-room injuries requiring medical attention have increased by 50 percent since 1990, with the largest increase among people age 45 and older.

Prevention: Warm up with a few minutes of jogging, calisthenics, or light and easy lifts. Use resistance machines or elastic bands rather than free weights. Keep the weight or resistance level light enough that you can do 15 repetitions. Do them slowly, taking about two seconds to lift and four seconds to lower. You should be able to stop the weight at any point in the movement. Don't hold your breath; that can cause fainting or a spike in blood pressure. Exhale during the lifting or pushing phase; inhale when lowering.

Heart attacks

Exercise gradually builds protection against heart disease. But if you're not in good shape, a vigorous workout can temporarily increase the risk of heart attack, especially if you're ill. A 2009 study found that a recent episode of fatigue or flu was associated with an increase in exercise-related cardiac events.

Prevention: Talk with your doctor before starting to work out if you have heart disease or multiple cardiac risk factors, or if you're middle-aged or older and have been sedentary. If you have a cold or the flu or feel fatigued, take a break from exercising or scale back workouts. Make sure your club has at least one automatic external defibrillator, which can save your life if you suffer cardiac arrest. Staff members should be trained in its use and in cardiopulmonary resuscitation. Consider learning CPR, too, so you can help others during emergencies.

Eye injuries

Americans suffer more than 40,000 eye injuries a year during recreational activities. Racquetball, squash, and tennis are leading causes of sports-related eye injuries among people ages 25 to 65. Nearly all could be prevented if people wore adequate eye protection.

Prevention: People engaged in high-risk activities should wear protective eyewear with 3-millimeter polycarbonate lenses and an impact-resistant sports frame meeting the ASTM F803-01 standard. If you regularly wear glasses, you should get prescription sports glasses that meet those criteria.
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