GENEVA – More than 1 billion young people risk damaging their hearing through excessive use of smartphones and other audio devices, the U.N. warned Tuesday, proposing new safety standards for safe volume levels.
In a bid to safeguard hearing, the World Health Organization and International Telecommunications Union issued a non-binding international standard for the manufacture and use of audio devices.
Young people are particularly prone to risky listening habits.
Around half of those between the ages of 12 and 35, or 1.1 billion people, are at risk due to “prolonged and excessive exposure to loud sounds, including music they listen to through personal audio devices,” the UN health agency said.
WHO chief Tedros Adhanom Ghebreyesus pointed out that the world already has “the technological know-how to prevent hearing loss.”
“It should not be the case that so many young people continue to damage their hearing while listening to music,” he said in the statement.
Young people, he said, “must understand that once they lose their hearing, it won’t come back.”
Currently, about 5 percent of the global population, or some 466 million people, including 34 million children, suffer from disabling hearing loss.
WHO said it remained unclear how many of them had damaged their hearing through dangerous use of audio devices.
It insisted though that the new standard developed with ITU would go a long way to “safeguard these young consumers as they go about doing something they enjoy.”
WHO considers a volume above 85 decibels for eight hours or 100 decibels for 15 minutes as unsafe.
The Safe listening devices and systems standard calls for a “sound allowance” software to be included in all audio devices, to track the volume level and duration of a user’s exposure to sound, and to evaluate the risk posed to their hearing.
This system could alert a user if they have dangerous listening habits.
WHO is also calling for parental as well as automatic volume controls on audio devices to prevent dangerous use.
While some smartphones and other audio devices already offer some of these features, the U.N. would like to see a uniform standard used to help protect against disabling hearing loss.
“Think of it like driving on a highway, but without a speedometer in your car or a speed limit,” Shelly Chadha of the WHO told reporters in Geneva.
“What we’ve proposed is that your smartphones come fitted with a speedometer, with a measurement system which tells you how much sound you’re getting and tells you if you are going over the limit.”
It’s not just your heart health you’ll improve when you manage your blood pressure. A national study found that optimizing blood pressure targets could help your memory too.
While people’s blood pressure (BP) fluctuates all the time, the ideal BP target is 120 over 80. The first number (systolic BP) indicates the pressure against your artery walls when the heart beats. The second number (diastolic BP) indicates the pressure against your artery walls when your heart is resting between beats.
Over the years, medical guidelines have suggested managing systolic pressure to different targets, from under 140 to under 130, with recent guidelines suggesting management to under 130.
Doctors typically give more attention to the first number because it’s the major risk for cardiovascular disease — especially as we age.
What the study examined
SPRINT (the Systolic Blood Pressure Intervention Trial), a study of the heart health of more than 9,000 people ages 50+ sponsored by the National Institutes of Health, recently did a subanalysis called the SPRINT MIND trial. It looked at the brain health of a smaller group of almost 700 patients whose blood pressure was managed to 120 (or less) versus a group managed to 140.
These patients received brain scans at the beginning of the trial and again four years later. Researchers found that those who managed their BP to 120 lowered their chances of developing white matter in the brain by a third. (Less white matter means less chance of developing cognitive impairment.)
The SPRINT MIND trial’s take-aways: “We regularly see patients with memory problems and grapple with mysteries that continue to surround the development of Alzheimer’s disease and other forms of age-related cognitive impairment,” says geriatrician Ronan Factora, MD. “So we’re naturally excited to see large, randomized trials like the SPRINT study where the findings can have a dramatic impact on patients’ health. These results give older patients who have high blood pressure, but are otherwise healthy, a strong incentive to work toward the less than 120 blood pressure target.”
But the SPRINT MIND findings are far from a one-size-fits-all prescription, Dr. Factora cautions.
But the study excluded patients who had diabetes, kidney disease and a number of other conditions. That means that it didn’t take into account many real-life scenarios related to managing high blood pressure.
“Especially for older patients, we have to be careful that their blood pressure isn’t so low that it leads to a fall and a broken bone,” Dr. Factora says. We must make sure the SPRINT MIND guidelines are appropriate for each patient we see, taking into account that person’s medical conditions, medications and ultimate medical goals.
That said, if hypertension is the only significant medical problem you’re dealing with, Dr. Factora recommends working with the help of your physician toward the less than 120 blood pressure target.
One hamburger a week is as much red meat people should eat to do what’s best for their health and the planet, according to a report seeking to overhaul the world’s diet.
Eggs should also be limited to fewer than about four a week.
Dairy foods should be about a serving a day, or less.
The report from a panel of nutrition, agriculture and environmental experts recommends a plant-based diet, based on previously published studies that have linked red meat to increased risk of health problems.
NEW YORK (AP) — A hamburger a week, but no more — that’s about as much red meat people should eat to do what’s best for their health and the planet, according to a report seeking to overhaul the world’s diet.
Eggs should be limited to fewer than about four a week, the report says. Dairy foods should be about a serving a day, or less.
The report from a panel of nutrition, agriculture and environmental experts recommends a plant-based diet, based on previously published studies that have linked red meat to increased risk of health problems. It also comes amid recent studies of how eating habits affect the environment. Producing red meat takes up land and feed to raise cattle, which also emit the greenhouse gas methane.
John Ioannidis, chair of disease prevention at Stanford University, said he welcomed the growing attention to how diets affect the environment, but that the report’s recommendations do not reflect the level of scientific uncertainties around nutrition and health.
“The evidence is not as strong as it seems to be,” Ioannidis said.
Got beef? Anna_Pustynnikova/Shutterstock
The report was organized by EAT, a Stockholm-based nonprofit seeking to improve the food system, and published Wednesday by the medical journal Lancet. The panel of experts who wrote it says a “Great Food Transformation” is urgently needed by 2050, and that the optimal diet they outline is flexible enough to accommodate food cultures around the world.
Overall, the diet encourages whole grains, beans, fruits and most vegetables, and says to limit added sugars, refined grains such as white rice and starches like potatoes and cassava. It says red meat consumption on average needs to be slashed by half globally, though the necessary changes vary by region and reductions would need to be more dramatic in richer countries like the United States.
Convincing people to limit meat, cheese and eggs won’t be easy, however, particularly in places where those foods are a notable part of culture.
In Sao Paulo, Brazil, systems analyst Cleberson Bernardes said as he was leaving a barbecue restaurant that limiting himself to just one serving of red meat a week would be “ridiculous.” In Berlin, Germany, craftsman Erik Langguth said there are better ways to reduce greenhouse gas emissions, and dismissed the suggestion that the world needs to cut back on meat.
“If it hasn’t got meat, it’s not a proper meal,” said Langguth, who is from a region known for its bratwurst sausages.
AP Photo/Charlie Litchfield
Before even factoring in the environmental implications, the report sought to sketch out what the healthiest diet for people would look like, said Walter Willett, one of its authors and a nutrition researcher at Harvard University. While eggs are no longer thought to increase risk of heart disease, Willett said the report recommends limiting them because studies indicate a breakfast of whole grains, nuts and fruit would be healthier.
He said everybody doesn’t need to become a vegan, and that many are already limiting how much meat they eat.
“Think of it like lobster — something that I really like, but have a few times a year,” Willett said.
Advice to limit red meat is not new, and is tied to its saturated fat content, which is also found in cheese, milk, nuts and packaged foods with coconut and palm kernel oils. The report notes most evidence on diet and health is from Europe and the United States. In Asian countries, a large analysis found eating poultry and red meat (mostly pork) was associated with improved lifespans. That might be in part because people might eat smaller amounts of meat in those countries, the report says.
Ioannidis of Stanford noted nutrition research is often based on observational links between diet and health, and that some past associations have not been validated. Dietary cholesterol, for example, is no longer believed to be strongly linked to blood cholesterol.
The meat and dairy industries also dispute the report’s recommendations, saying their products deliver important nutrients and can be part of healthy diets.
Andrew Mente, a nutrition epidemiology researcher at McMaster University, urged caution before making widespread dietary recommendations, which he said could have unintended consequences.
Still, the EAT-Lancet report’s authors say the overall body of evidence strongly supports reducing red meat for optimal health and shifting toward plant-based diets. They note the recommendations are compatible with the U.S. dietary guidelines, which say to limit saturated fat to 10 percent of calories.
While people in some poorer counties may benefit from getting more of the nutrients in meat and dairy products, the report says they shouldn’t follow the path of richer countries in how much of those foods they eat in coming years.
Though estimates vary, a report by the United Nations said livestock is responsible for about 15 percent of the world’s gas emissions that warm the climate.
Robbie Andrew, a senior researcher at CICERO Center for International Climate Research in Norway, said farming practices that make animals grow faster and bigger may help limit emissions. But he said cows and other ruminant animals nevertheless produce a lot of methane, a powerful greenhouse gas.
“It’s very difficult to get down these natural emissions that are part of their biology,” Andrew said.
The environmental benefits of giving up red meat depend on what people eat in its place. Chicken and pork produce far fewer emissions than beef, Andrew said, adding that plants in general have among the smallest carbon footprints.
Brent Loken, an author of the EAT-Lancet report, said the report lays out the parameters of an optimal diet, but acknowledged the challenge in figuring out how to work with policy makers, food companies and others in tailoring and implementing it in different regions.
AP reporters Frank Jordans in Berlin and Stan Lehman in Sao Paulo, Brazil, contributed to this article.
The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.
The world is facing multiple health challenges. These range from outbreaks of vaccine-preventable diseases like measles and diphtheria, increasing reports of drug-resistant pathogens, growing rates of obesity and physical inactivity to the health impacts of environmental pollution and climate change and multiple humanitarian crises.
To address these and other threats, 2019 sees the start of the World Health Organization’s new 5-year strategic plan – the 13th General Programme of Work. This plan focuses on a triple billion target: ensuring 1 billion more people benefit from access to universal health coverage, 1 billion more people are protected from health emergencies and 1 billion more people enjoy better health and well-being. Reaching this goal will require addressing the threats to health from a variety of angles.
Here are 10 of the many issues that will demand attention from WHO and health partners in 2019.
Air pollution and climate change
Nine out of ten people breathe polluted airevery day. In 2019, air pollution is considered by WHO as the greatest environmental risk to health. Microscopic pollutants in the air can penetrate respiratory and circulatory systems, damaging the lungs, heart and brain, killing 7 million people prematurely every year from diseases such as cancer, stroke, heart and lung disease. Around 90% of these deaths are in low- and middle-income countries, with high volumes of emissions from industry, transport and agriculture, as well as dirty cookstoves and fuels in homes.
The primary cause of air pollution (burning fossil fuels) is also a major contributor to climate change, which impacts people’s health in different ways. Between 2030 and 2050, climate change is expected to cause 250 000 additional deaths per year, from malnutrition, malaria, diarrhoea and heat stress.
In October 2018, WHO held its first ever Global Conference on Air Pollution and Health in Geneva. Countries and organizations made more than 70 commitments to improve air quality. This year, the United Nations Climate Summit in September will aim to strengthen climate action and ambition worldwide. Even if all the commitments made by countries for the Paris Agreement are achieved, the world is still on a course to warm by more than 3°C this century.
Noncommunicable diseases, such as diabetes, cancer and heart disease, are collectively responsible for over 70% of all deaths worldwide, or 41 million people. This includes 15 million people dying prematurely, aged between 30 and 69.
Over 85% of these premature deaths are in low- and middle-income countries. The rise of these diseases has been driven by five major risk factors: tobacco use, physical inactivity, the harmful use of alcohol, unhealthy diets and air pollution. These risk factors also exacerbate mental health issues, that may originate from an early age: half of all mental illness begins by the age of 14, but most cases go undetected and untreated – suicide is the second leading cause of death among 15-19 year-olds.
Among many things, this year WHO will work with governments to help them meet the global target of reducing physical inactivity by 15% by 2030 – through such actions as implementing the ACTIVE policy toolkit to help get more people being active every day.
Global influenza pandemic
The world will face another influenza pandemic – the only thing we don’t know is when it will hit and how severe it will be. Global defences are only as effective as the weakest link in any country’s health emergency preparedness and response system.
WHO is constantly monitoring the circulation of influenza viruses to detect potential pandemic strains: 153 institutions in 114 countries are involved in global surveillance and response.
Every year, WHO recommends which strains should be included in the flu vaccine to protect people from seasonal flu. In the event that a new flu strain develops pandemic potential, WHO has set up a unique partnership with all the major players to ensure effective and equitable access to diagnostics, vaccines and antivirals (treatments), especially in developing countries.
Fragile and vulnerable settings
More than 1.6 billion people (22% of the global population) live in places where protracted crises (through a combination of challenges such as drought, famine, conflict, and population displacement) and weak health services leave them without access to basic care.
Fragile settings exist in almost all regions of the world, and these are where half of the key targets in the sustainable development goals, including on child and maternal health, remains unmet.
WHO will continue to work in these countries to strengthen health systems so that they are better prepared to detect and respond to outbreaks, as well as able to deliver high quality health services, including immunization.
The development of antibiotics, antivirals and antimalarials are some of modern medicine’s greatest successes. Now, time with these drugs is running out. Antimicrobial resistance – the ability of bacteria, parasites, viruses and fungi to resist these medicines – threatens to send us back to a time when we were unable to easily treat infections such as pneumonia, tuberculosis, gonorrhoea, and salmonellosis. The inability to prevent infections could seriously compromise surgery and procedures such as chemotherapy.
Resistance to tuberculosis drugs is a formidable obstacle to fighting a disease that causes around 10 million people to fall ill, and 1.6 million to die, every year. In 2017, around 600 000 cases of tuberculosis were resistant to rifampicin – the most effective first-line drug – and 82% of these people had multidrug-resistant tuberculosis.
Drug resistance is driven by the overuse of antimicrobials in people, but also in animals, especially those used for food production, as well as in the environment. WHO is working with these sectors to implement a global action plan to tackle antimicrobial resistance by increasing awareness and knowledge, reducing infection, and encouraging prudent use of antimicrobials.
Ebola and other high-threat pathogens
In 2018, the Democratic Republic of the Congo saw two separate Ebola outbreaks, both of which spread to cities of more than 1 million people. One of the affected provinces is also in an active conflict zone.
This shows that the context in which an epidemic of a high-threat pathogen like Ebola erupts is critical – what happened in rural outbreaks in the past doesn’t always apply to densely populated urban areas or conflict-affected areas.
At a conference on Preparedness for Public Health Emergencies held last December, participants from the public health, animal health, transport and tourism sectors focussed on the growing challenges of tackling outbreaks and health emergencies in urban areas. They called for WHO and partners to designate 2019 as a “Year of action on preparedness for health emergencies”.
WHO’s R&D Blueprint identifies diseases and pathogens that have potential to cause a public health emergency but lack effective treatments and vaccines. This watchlist for priority research and development includes Ebola, several other haemorrhagic fevers, Zika, Nipah, Middle East respiratory syndrome coronavirus (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS) and disease X, which represents the need to prepare for an unknown pathogen that could cause a serious epidemic.
Weak primary health care
Primary health care is usually the first point of contact people have with their health care system, and ideally should provide comprehensive, affordable, community-based care throughout life.
Primary health care can meet the majority of a person’s health needs of the course of their life. Health systems with strong primary health care are needed to achieve universal health coverage.
Yet many countries do not have adequate primary health care facilities. This neglect may be a lack of resources in low- or middle-income countries, but possibly also a focus in the past few decades on single disease programmes. In October 2018, WHO co-hosted a major global conference in Astana, Kazakhstan at which all countries committed to renew the commitment to primary health care made in the Alma-Ata declaration in 1978.
In 2019, WHO will work with partners to revitalize and strengthen primary health care in countries, and follow up on specific commitments made by in the Astana Declaration.
Vaccine hesitancy – the reluctance or refusal to vaccinate despite the availability of vaccines – threatens to reverse progress made in tackling vaccine-preventable diseases. Vaccination is one of the most cost-effective ways of avoiding disease – it currently prevents 2-3 million deaths a year, and a further 1.5 million could be avoided if global coverage of vaccinations improved.
Measles, for example, has seen a 30% increase in cases globally. The reasons for this rise are complex, and not all of these cases are due to vaccine hesitancy. However, some countries that were close to eliminating the disease have seen a resurgence.
The reasons why people choose not to vaccinate are complex; a vaccines advisory group to WHO identified complacency, inconvenience in accessing vaccines, and lack of confidence are key reasons underlying hesitancy. Health workers, especially those in communities, remain the most trusted advisor and influencer of vaccination decisions, and they must be supported to provide trusted, credible information on vaccines.
In 2019, WHO will ramp up work to eliminate cervical cancer worldwide by increasing coverage of the HPV vaccine, among other interventions. 2019 may also be the year when transmission of wild poliovirus is stopped in Afghanistan and Pakistan. Last year, less than 30 cases were reported in both countries. WHO and partners are committed to supporting these countries to vaccinate every last child to eradicate this crippling disease for good.
Dengue, a mosquito-borne disease that causes flu-like symptoms and can be lethal and kill up to 20% of those with severe dengue, has been a growing threat for decades.
A high number of cases occur in the rainy seasons of countries such as Bangladesh and India. Now, its season in these countries is lengthening significantly (in 2018, Bangladesh saw the highest number of deaths in almost two decades), and the disease is spreading to less tropical and more temperate countries such as Nepal, that have not traditionally seen the disease.
An estimated 40% of the world is at risk of dengue fever, and there are around 390 million infections a year. WHO’s Dengue control strategy aims to reduce deaths by 50% by 2020.
The progress made against HIV has been enormous in terms of getting people tested, providing them with antiretrovirals (22 million are on treatment), and providing access to preventive measures such as a pre-exposure prophylaxis (PrEP, which is when people at risk of HIV take antiretrovirals to prevent infection).
However, the epidemic continues to rage with nearly a million people every year dying of HIV/AIDS. Since the beginning of the epidemic, more than 70 million people have acquired the infection, and about 35 million people have died. Today, around 37 million worldwide live with HIV. Reaching people like sex workers, people in prison, men who have sex with men, or transgender people is hugely challenging. Often these groups are excluded from health services. A group increasingly affected by HIV are young girls and women (aged 15–24), who are particularly at high risk and account for 1 in 4 HIV infections in sub-Saharan Africa despite being only 10% of the population.
This year, WHO will work with countries to support the introduction of self-testing so that more people living with HIV know their status and can receive treatment (or preventive measures in the case of a negative test result). One activity will be to act on new guidance announced In December 2018, by WHO and the International Labour Organization to support companies and organizations to offer HIV self-tests in the workplace.