Embargoed news from Annals of Internal Medicine

1. Oil Spill Clean-up Workers Face Increased Risk for Lower Respiratory Tract Symptoms

In 2002, the oil tanker Prestige spilled more than 67,000 tons of bunker oil, highly contaminating the north-western coast of Spain. More than 300,000 volunteers participated in clean-up activities. Among them, local fishermen were a large and highly-exposed group. Researchers sought to determine respiratory effects and chromosomal damage in clean-up workers two years after exposure. The researchers studied 501 local fisherman who were highly exposed to clean-up and compared their health to that of 177 fisherman who were not exposed. The researchers evaluated changes in lung function, assessed respiratory markers of oxidative stress and airway inflammation in exhaled breath condensate, and assessed chromosomal damage, a biomarker of increased risk of malignancy. The authors found that two years after having participated in oil clean-up efforts, exposed fishermen had increased prevalence rates of respiratory symptoms and biomarkers of pulmonary oxidative stress and growth factor activity, suggesting persistent airway injury. In addition, the workers showed higher levels of structural chromosomal abnormalities in circulating lymphocytes. According to the authors, their findings indicate that even short-term exposure to oil sediments may have detrimental health effects.

2. White House Officials Outline Major Provisions and Physicians Implications of Affordable Care Act*

To Fully Realize Benefits, Physicians Will Need to Embrace Change

The Affordable Care Act will expand access to health care for Americans and clearly influence health care delivery. In this article, key individuals in the White House Office of Health Care Reform assert that physicians, their patients, and the health care system will realize significant benefits once the transformation to the new system is complete. Under the new system, all Americans will have affordable access to care as many of the barriers to health care that existed previously will be removed. In addition, improved information will allow physicians to benefit from electronic medical records and a patient-centered medical home model. Patients will benefit through greater access to information about physician, hospital, drug, and device quality and safety data. A reader survey regarding this article will appear online at www.annals.org.

*Note: This article was featured in a previous tip sheet for early release online. The online publication date has been rescheduled for August 24.

Provided by American College of Physicians