Movie Sets are Dangerous to Ears!

First it was Maggie Q, and now I learn that there are other celebrities with hearing loss due to movie set loud noise exposure.

Leonard Nimoy (Spock of Star Trek fame) suffers from right ear tinnitus due to hearing damage from a special effects explosion during filming of Star Trek episode "Arena".

Similarly, Steve Martin suffers from tinnitus due to hearing damage sustained during filming of a pistol-shooting scene for "¡Three Amigos!" in 1986.

Here is a full list of celebrities with hearing problems.

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Kids Exposed to Fido or Fluffy in the First Year of Life Decreases Risk of Becoming Allergic to Them

There have been a number of studies in the past investigating whether it is healthy for a baby to be around pets and whether such exposure increases or decreases risk of becoming allergic to them later in life.

In a recent study (published online June 2011), the researchers found that among males, those with an indoor dog during the first year of life had half the risk of becoming allergic to dogs at age 18 compared with those who did not have an indoor dog in the first year of life regardless whether born by C-section or vaginally. Also, teens with an indoor cat in the first year of life also had a decreased risk of becoming allergic to cats. Neither cumulative exposure nor exposure at any other particular age was associated with either outcome. So it appears that the FIRST year of life is key to whether a child develops pet allergies or not.

Although in this study, cat and dog ownership appears to be beneficial in kids, prior studies have suggested that for at least cats, it increases risk of overall allergies in children by 13 times! Dog exposure, however, reduces overall allergy by 4 times.

Reference:
Lifetime dog and cat exposure and dog- and cat-specific sensitization at age 18 years. Clinical & Experimental Allergy Volume 41, Issue 7, pages 979–986, July 2011

Genetic and environmental risk factors for childhood eczema development and allergic sensitization in the CCAAPS cohort. J Invest Dermatol. 2010 Feb;130(2):430-7. Epub 2009 Sep 17

Opposing Effects of Cat and Dog Ownership and Allergic Sensitization on Eczema in an Atopic Birth Cohort. J Pediatr. 2011 Feb;158(2):265-71.e1-5.

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Avoidable Pediatric Radiation Exposure

Children and teens often get diagnostic tests that expose them to radiation, increasing the risk of cancer later in life. Over just a 3 year span, 42.5% of kids got some form of ionizing radiation from a diagnostic medical procedure whether it be a chest x-ray, CT scan, dental scan, etc. Click here to calculate the cumulative risk of cancer with each type of test.

It also estimated that 1/3 of CT scans are unnecessary and that by limiting CT scans to when it is truly needed would reduce the number of cancers by 43%.

From an ENT standpoint, common diagnostic tests that expose patients to radiation include CT scans of the head, facial x-rays, and neck x-rays.

Why would kids get such scans done?

CT scans are often performed to evaluate for sinusitis as well as to figure out what is causing chronic headaches. Neck x-rays are often done to evaluate for adenoid hypertrophy while facial x-rays are done after facial trauma to look for a nasal fracture.

It is my personal bias to avoid such diagnostics tests if at all possible, ESPECIALLY because there are alternative options.

Nasal endoscopy can be performed to evaluate for sinusitis as well as adenoid hypertrophy thereby making unnecessary the need for neck x-rays as well as CT scans. X-rays to evaluate sinusitis is NEVER indicated as it is wrong 50% of the time (click here for more info on this).

Nasal fractures are easily appreciated on exam thereby making unnecessary facial x-rays. In cases of trauma, an x-ray can be considered from a purely medico-legal documentation standpoint, but is not really necessary from a medical standpoint. Read more here why.

Read a story about this in Reuters and in the LA Times.

References:
The Use of Computed Tomography in Pediatrics and the Associated Radiation Exposure and Estimated Cancer Risk. JAMA Pediatr. 2013;():1-8. doi:10.1001/jamapediatrics.2013.311.

Computed Tomography — An Increasing Source of Radiation Exposure. N Engl J Med 2007; 357:2277-2284November 29, 2007DOI: 10.1056/NEJMra072149

Children, computed tomography radiation dose, and the As Low As Reasonably Achievable (ALARA) concept. Pediatrics. 2003 Oct;112(4):971-2.

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