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This post is co-written by Mary Kostenblatt BSN, RN, Graduate Student, MS Community and Public Health Nursing, Hunter-Bellevue School of Nursing, CUNY and CHMP Senior Fellow, Peggy Rafferty DNP RN MPH, Associate Professor New York City College of Technology CUNY

Mary Kostenblatt BSN, RN advocate for her children & all children on the planet.

Mary Kostenblatt BSN, RN advocate for her children & all children on the planet.

The history of the reform movement that led to the removal of lead from gasoline and paint is highlighted in the recently released book Lead Wars The Politics of Science and the Fate of America’s Children by Gerald Markowitz and David Rosner. The authors, public health historians, describe the social, political economic, legal and ethical issues surrounding the 100 year old history of lead poisoning in the United States.

Lead poisoning, although greatly decreased, remains a problem in these modern, post-lead paint times. The dust has largely settled on the debate about the toxicity of lead. Lead is recognized as a potent toxin that causes behavioral and learning disabilities, IQ loss, and in severe cases, convulsions, coma and death.

Newer studies link elevated lead levels to criminality in later life.  In one of the major public health victories of the century, after lead’s removal from gasoline and paint, children’s average lead levels fell 95% and children’s IQ increased by between 4 and 5 points.   In the last six decades, the cutoff point for lead poisoning has been decreasing but the only truly safe level for lead in children is zero.  The majority of the quarter million children with elevated lead levels in the United States live in poverty.

NYC banned the use of  lead-based paint in 1960 which was followed slowly by the federal government legislation in 1978. A group that is working hard to keep NYC’s children safe from the dangers of lead is the NYC Lead Poisoning Prevention Program 

NYS law requires children to be tested at 1 and 2 years of age and Department of Health promotes such testing by outreach and education to families and medical providers.   A blood test is taken to measure levels of lead. The results direct action – if they are 5-9 mcg/dL, families are encouraged to follow up.  If blood lead level is 15 mcg/dL or greater,  the Department of Health (DOH) goes in and tests the site where the child lives or other places the child spends a significant amount of time.

When the DOH does go in for any inspection, they also look at other risk factors as well, like roaches, rodents, mold or other environmental risks.   Discovering less common sources of  lead (candy, jewelry etc) requires much detective work by NYC Lead Poisoning Prevention Program.

Philip J. Landrigan, MD, M.Sc., Director of Mount Sinai Children’s Environmental Health Center, created much of the science that first demonstrated the toxicity of lead in children and provided the scientific evidence-base for political reform.

The Mount Sinai Children’s Environmental Health Center is part of a national network of Pediatric Environmental Health Specialty Units (PEHSU).  The Mount Sinai team serves Federal Region II which includes New York, New Jersey, Puerto Rico and the U.S.  Virgin Islands. Members of the interdisciplinary team include physicians, fellows, medical students, a social worker, industrial hygienists and epidemiologists.

The mission of the PEHSU team is to “provide clinical consultation and education to families, health care professionals, public health officials, and community organizations that have concerns regarding children’s environmental health.”   The team investigates problems associated with a broad spectrum of exposures.  Today Mount Sinai’s PEHSU team continues this innovative work on new frontiers with endocrine disruptors and other toxic substances.

The Center recently released a report, New York’s Children and the Environment that includes a comprehensive strategy to develop a network of Centers of Excellence in Children’s Environmental Health throughout NYS. The proposed Centers would provide “expert diagnosis and treatment for New York children who are suffering from diseases of environmental origin.”

Legislation to provide public funding for the establishment of these Centers was introduced in the New York State legislature under Bill  A07885.

Let your representative know where you stand on this public health initiative. You can contact your NYS Senator  here  and your NYS Assembly member here.

As a society, we need to prioritize keeping our children safe from toxins.

 

This post is co-written by Mary Kostenblatt

This guest post is by Lynn Robinson, an RN and a student at the Hunter–Bellevue School of Nursing. In 2012 Lynn took a course in narrative writing for nursing students at Hunter taught by CHMP senior fellows Joy Jacobson and Jim Stubenrauch.

It’s almost midnight, five hours into my 12-hour nursing shift, but the lobby’s still buzzing with excitement. I’m greeted by whiffs of strong coffee every time I pass the nurse’s station. The little old lady in the room by the nurse’s station is complaining that her temporary roommate won’t turn down the volume of the television, while the young, strapping lad in the room at the end of the hall is limping across the floor pleading for more pain medication. I feel the pressure building up behind my eyes. I take a minute to run to the bathroom to wash the sleep off of my face. Just a few hours more and the unsightly dark circles will begin to form around my eyes. Ah, burning the midnight oil on the night shift!

Lynn Robinson

Lynn Robinson

Nursing is a 24-hour-a-day business—the availability of round-the-clock health care is a hallmark of our modern society. Some nurses take on the lengthy 12-hour day shifts, while others opt to work late evenings and nights when most people are watching Modern Family or Once Upon A Time in Wonderland just before their bedtime. Working the night shift has been found to be associated with an increased risk of a number of health complications including sleep disorders, obesity, heart disease, hypertension, diabetes, reproduction irregularities, infections, as well as familial and social life disturbances. Lengthy shifts, in general, have been found to cause similar problems. Take a look here at this literature review from the National Institute of Occupational Safety and Health, which examines research reports that studied the links between long working hours and performance, employee health, and safety complications.

Nurses are no strangers to stressful shift-work schedules. The job postings for nursing jobs advertise the attractive differential in pay for taking a night-shift position. Sure the night shift pays more, but can you put a price on your health? Studies have linked obesity in nurses to job stress and long work hours. Check this study out here, which found that 55% of nurses are overweight or obese. Obesity in nurses is getting much-needed attention. Take a look at a press release about this study from the University of Maryland.

I’ve found the night shift to be particularly challenging. Sleep is a big factor in our health. Some nights I imagine leading a call-and-response chant with my coworkers.

What do we want? Sleep!
When do we want it? All the time! Basically.

Our bodies prefer to be active during the day and to rest at night. Being awake at night interrupts our circadian rhythm, or body clock. Our body clock sits inside our brains, running the show—it’s responsible for our sleep-wake cycles, temperature, metabolism, hormones, and reproductive system. Tick-tock!

With enough sleep, my body is a well-oiled machine. But when’s the last time I got eight hours of uninterrupted sleep? Maybe a year and 10 pounds ago, before I started working the night shift. Nobody really respects daytime sleepers. Your kids more than likely won’t. Neither will the heavy-duty truck horns, the UPS deliveryman, or the 15 errands on your to-do list.

Unhealthy habits are also to blame.

Quick question! What time’s lunch time when you’re on the night shift? Maybe 2 am. Some may argue 4 am. But, where’s the kitchen staff that serves all those healthy food options to the day-shift clan? They were already gone by the time my belly grumbled for “lunch.” Sure enough, there was also no time for home-cooked meals, so I opted for delivery. A chicken-and-steak burrito, served on a fresh 12-inch tortilla, with rice, beans, lettuce, ripe tomatoes, and cheese, minus any remnants of guacamole, became “the usual.” Potato chips or candy bars were also popular choices from the vending machines that lined the hallway outside the cafeteria. As you could imagine, finding time for much exercise also became more difficult.

It’s surprising to me that anyone is still willing to work the night shift. But I think there’s hope. Employers need to get involved in addressing these health issues. Making schedules that allow nurses to get enough rest needs to become a top priority. They can also put wellness programs in place to help encourage healthier lifestyles. I’m talking about offering on-site gyms, or discounts and reimbursement for off-site health club fees, or weight management programs. How about addressing that cafeteria? During the day, healthy selections of food and drinks are available for employees. Night-shift workers aren’t always this lucky. Putting healthier options in the vending machines may be a good start. No more candy bars, potato chips, and sweet drinks. Maybe nuts, low-fat pretzels, baked chips, diet sodas, and water might be better choices!

A lesson in irony? I lost sleep to finish this blog post. I’m not worried about that just yet, since America likes her nurses like nurses like their coffee—strong.

This guest post is by Lynn Robinson,

Barbara Glickstein is the co-director of the Center for Health, Media & Policy and has been reporting on human trafficking for the past 6 years.

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“There is no such things as a child prostitute”

This was just one of the straightforward facts made by Minh Dang to reporters (including this reporter) attending the McCormick Institute on Reporting on Sex Trafficking: A Local Problem with Global Dimensions this past October.

The institute was sponsored by the Robert R. McCormick Foundation and The Irina Project (TIP) at the University of North Carolina School of Journalism and Mass Communication. 194a5dcaf266bf618514162a0dbfa1b2_bigger

The Irina Project (TIP), co-directed by  Dr. Barbara Friedman and Dr. Anne Johnston, monitors media representations of sex trafficking and advocates for the responsible and accurate reporting of sex trafficking.

Drs. Friedman and Johnston presented their research looking at 5 years of international and national media coverage on sex trafficking. Their research identified patterns framing the issue including the use of language. They found that the label prostitute or hooker was most frequently used by reporters to describe the persons involved.

Under federal law, children cannot consent to being a prostitute and a child does not need to be moved across international or even state borders to be considered a victim of commercial sexual exploitation. In the United States, a minor is defined as someone under the age of 18.

A recent headline in the Washington Post, “D.C. police search home of officer in investigation of prostitution ring” reports locating a 16 year old female who was reported missing in his apartment. The article states, “The teenager told police that the officer took nude photos of her and arranged for her to have sex for money, the court papers say.”

Kudos to these reporters for using plain language – this girl was found here and here’s what she was experiencing.

Journalists struggle with reporting on sex trafficking and how to better frame the stories.  There was significant time dedicated to addressing the lack of reliable data on the issue and how to work with that limitation.

But that’s not all.

In several sessions we heard directly from women survivors on what it was like being interviewed by journalists – not all good. One suggested that we “stay in our lane” and “to be human”.

Here’s one critical take-away – we must all confront our own assumptions about sex trafficking.

The reporters in attendance made a promise – we’d never use the words child prostitute in a story on sex trafficking.

Because there is no such thing as a child prostitute.

Barbara Glickstein is the co-director of the