School, camp, daycare, and sports physicals: What to do in the time of COVID-19

Summer activities are underway and some schools will be reopening come September. Does your child need a physical exam, or a form from the pediatrician? Here's how to think through the options for fulfilling these requirements. The post School, camp, daycare, and sports physicals: What to do in the time of COVID-19 appeared first on Harvard Health Blog.

School, camp, daycare, and sports physicals: What to do in the time of COVID-19

As some youth sports teams get started again, some summer camps and daycares are opening up, and we begin to think about school (or some form of it) in the fall, many parents are wondering: what do I do about getting that physical form I need for my child?

Understandably, many families do not want to go to the doctor right now. They are worried about going anywhere, and especially worried about going to a medical office, where they are concerned they may end up around sick people.

I want to say up front that most medical facilities are very aware of the risk, and take measures to make sure that patients can safely get the medical care they need. But when it comes to forms for physicals, in some cases families may not need to leave their homes at all — or if they do, they may be able to do it in a limited way.

What questions should parents ask about forms for sports, daycare, or school?

Do I even need a form?

  • In many school districts, forms are not required every year but rather at certain times, such as kindergarten or middle school entry. Parents should check and find out; it may not be an issue at all.
  • Some activities and facilities that the child has attended in the past may be willing to use a previously submitted form. It’s worth asking.
  • Because of the pandemic, there may be some wiggle room or a grace period allowed for forms. Again, parents should check.

Would my child’s last appointment suffice for the form?

  • Very often, what is required is documentation of a check-up within the past one to two years. If your child had a check-up within that time frame, you may be able to just get a form sent to you, no visit needed.

Would a telehealth visit be possible — and accepted?

  • Many practices, mine included, are providing well-child care via telehealth for children who do not need to be seen in person — and providing forms based on those visits. (It’s helpful if you can get your child’s height and weight before the visit.). Parents should call their doctor to find out if this is an option, and also check to be sure a form based on a telehealth visit would be accepted.

Does my child need immunizations or something else that requires an in-person visit?

  • It’s very important that children stay up to date on immunizations. Because of the pandemic, many children are falling behind. This may lead to outbreaks of measles and other vaccine-preventable diseases, many of which could be more dangerous to children than COVID-19.
  • There are some conditions that require in-person monitoring, like anemia or high blood pressure. While many practices are finding remote ways to manage these and other chronic health problems, not everything can be done remotely. Parents should check with their doctor.

If my child needs to go in person, what can be done to keep us safe?

I strongly encourage families to call their doctor’s office to find out what they are doing to minimize risk; they will likely be pleasantly surprised. For instance:

  • In my practice, we have cut down on the number of patients we are seeing, and spread out the appointments so that patients go directly into rooms and don’t wait in a waiting room. We also do lots of screening before and at the visit, everyone wears a mask, and we have made physical changes to our office as well as changes in our routines that make spread of the virus less likely.
  • Sometimes, the visit can be streamlined by having a phone call or virtual visit ahead of time to collect information. Then when the child comes in, it’s for a quick exam and any shots or other in-person care they need, minimizing the time in the office. Parents should see if this is an option.

As a pediatrician, the most important thing to me is that children get the medical care they need. I worry that many children won’t because their families are afraid of COVID-19. Please, call your doctor and talk about what your child needs — and how they can get it safely. Trust me, we are just as invested in your child’s health and safety as you are.

Follow me on Twitter @drClaire

The post School, camp, daycare, and sports physicals: What to do in the time of COVID-19 appeared first on Harvard Health Blog.

Source : Harvard Health More   

What's Your Reaction?

like
0
dislike
0
love
0
funny
0
angry
0
sad
0
wow
0

Next Article

Glyphosate Found in Manuka Honey

Honey, a complex mixture of sugars, amino acids, phenolics and other compounds, has been valued for its medicinal properties since ancient times. Made from flower nectar and produced by bees, honey's medicinal properties vary depending on what type of flowering plant it comes from. One of the most heavily researched and renowned is Manuka honey, which is produced from certain Manuka plants — also known as tea trees — of the Leptospermum species, which are native to New Zealand and Australia.1 Manuka honey is a high-value export in New Zealand, one that prides itself on being a pure, high-quality product. "Our reputation for honey production and export rests on the integrity of our products and the credibility of our systems," wrote New Zealand's Ministry for Prime Industries (MPI).2 Tests by the agency show, however, that even natural Manuka honey is being affected by environmental contaminants — namely the herbicide glyphosate. Glyphosate Detected in New Zealand Manuka Honey Glyphosate is most commonly known as the active ingredient in Roundup herbicide, but it's found in about 90 different products. Overall, glyphosate is the most used herbicide in the world, including in New Zealand.3 New Zealand Food Safety has been testing honey samples for agricultural compounds, including insecticides, fungicides, herbicides and other environmental contaminants for years, but in 2017/2018 and 2018/2019, they tested honey samples for glyphosate residues, some of which turned up positive. In their "National Chemical Residues Programme Report" released January 2020, it's noted that 300 raw extracted archival and retail-packed honey samples were tested for glyphosate residues during 2017/2018, while another 60 retail-packed Manuka honey samples were tested for the herbicide during 2018/2019.4 Out of the 300 samples, 22.3% contained glyphosate residues above the laboratory limit of reporting, with clover or pasture floral types testing positive more often than other varieties. About 1.7% of the unblended or unprocessed (raw extracted) honey samples contained glyphosate residues at levels above the regulatory limit. Among the 2018/2019 retail samples tested, 18.3% contained glyphosate residues, though they were below the regulatory maximum. As for where the glyphosate contamination came from, the report noted:5 "Based on reported honey types, the most likely cause of the residues in honey is attributed to unintended exposure of honeybees to glyphosate from its approved use in agriculture. This causal attribution is in comparable with previous international reports. As a consequence, beekeepers have little practical means of excluding bees from foraging on plants treated with glyphosate. … To do so, would require the beekeeper to place their hives at the centre of 28 square kilometre area where they had assurance from land owners and managers there was no agricultural compound use." Glyphosate Residues Pose 'Possible Trade Risk' New Zealand's health officials maintain that no health risks are posed by the glyphosate residues detected in the honey, but a ministerial briefing document obtained by 1 News labeled the contamination a "possible trade risk … because most countries importing honey from New Zealand have no maximum residue limit (MRL), generally meaning that residues must not be detected at any level."6 Further details revealed in the confidential briefing suggest that a honey producer in New Zealand began investigating glyphosate residues in 2018 after the chemical was revealed in its honey by a retail market overseas. According to 1 News:7 "'Their investigation into the detections found residues present in unprocessed honey at levels above the New Zealand default maximum residue limit,' it reads. 'Their investigation concluded the likely cause of the residues was the use of glyphosate in pasture renovation/renewal.'" New Zealand Food Safety reiterated that the glyphosate-contaminated honey posed no food safety concerns, adding:8 "For context, a 5-year old child who was consuming honey with 0.1 mg/kg of glyphosate residues (the default maximum residue level in New Zealand) would need to eat roughly 230kg of honey every day for the rest of their life to reach the World Health Organization Acceptable Daily Intake for glyphosate." However, critics said that even at low levels, glyphosate residues mean the honey is tainted, and not due to the fault of the beekeepers, but to lax environmental regulations. "If New Zealand wants to be a cheap commodity producer, producing tainted food, then that's New Zealand choice, or we can actually have stronger regulation, which protects our free market," Jodie Bruning of the Soil and Health Association told 1 News.9 Glyphosate Detected in Honey Samples Worldwide Glyphosate has been detected in a variety of honey samples tested worldwide, including that taken directly from 59 beehives on the Hawaiian island of Kauai. Th

Glyphosate Found in Manuka Honey

Honey, a complex mixture of sugars, amino acids, phenolics and other compounds, has been valued for its medicinal properties since ancient times. Made from flower nectar and produced by bees, honey's medicinal properties vary depending on what type of flowering plant it comes from.

One of the most heavily researched and renowned is Manuka honey, which is produced from certain Manuka plants — also known as tea trees — of the Leptospermum species, which are native to New Zealand and Australia.1

Manuka honey is a high-value export in New Zealand, one that prides itself on being a pure, high-quality product. "Our reputation for honey production and export rests on the integrity of our products and the credibility of our systems," wrote New Zealand's Ministry for Prime Industries (MPI).2

Tests by the agency show, however, that even natural Manuka honey is being affected by environmental contaminants — namely the herbicide glyphosate.

Glyphosate Detected in New Zealand Manuka Honey

Glyphosate is most commonly known as the active ingredient in Roundup herbicide, but it's found in about 90 different products. Overall, glyphosate is the most used herbicide in the world, including in New Zealand.3

New Zealand Food Safety has been testing honey samples for agricultural compounds, including insecticides, fungicides, herbicides and other environmental contaminants for years, but in 2017/2018 and 2018/2019, they tested honey samples for glyphosate residues, some of which turned up positive.

In their "National Chemical Residues Programme Report" released January 2020, it's noted that 300 raw extracted archival and retail-packed honey samples were tested for glyphosate residues during 2017/2018, while another 60 retail-packed Manuka honey samples were tested for the herbicide during 2018/2019.4

Out of the 300 samples, 22.3% contained glyphosate residues above the laboratory limit of reporting, with clover or pasture floral types testing positive more often than other varieties. About 1.7% of the unblended or unprocessed (raw extracted) honey samples contained glyphosate residues at levels above the regulatory limit.

Among the 2018/2019 retail samples tested, 18.3% contained glyphosate residues, though they were below the regulatory maximum. As for where the glyphosate contamination came from, the report noted:5

"Based on reported honey types, the most likely cause of the residues in honey is attributed to unintended exposure of honeybees to glyphosate from its approved use in agriculture.

This causal attribution is in comparable with previous international reports. As a consequence, beekeepers have little practical means of excluding bees from foraging on plants treated with glyphosate.

… To do so, would require the beekeeper to place their hives at the centre of 28 square kilometre area where they had assurance from land owners and managers there was no agricultural compound use."

Glyphosate Residues Pose 'Possible Trade Risk'

New Zealand's health officials maintain that no health risks are posed by the glyphosate residues detected in the honey, but a ministerial briefing document obtained by 1 News labeled the contamination a "possible trade risk … because most countries importing honey from New Zealand have no maximum residue limit (MRL), generally meaning that residues must not be detected at any level."6

Further details revealed in the confidential briefing suggest that a honey producer in New Zealand began investigating glyphosate residues in 2018 after the chemical was revealed in its honey by a retail market overseas. According to 1 News:7

"'Their investigation into the detections found residues present in unprocessed honey at levels above the New Zealand default maximum residue limit,' it reads. 'Their investigation concluded the likely cause of the residues was the use of glyphosate in pasture renovation/renewal.'"

New Zealand Food Safety reiterated that the glyphosate-contaminated honey posed no food safety concerns, adding:8

"For context, a 5-year old child who was consuming honey with 0.1 mg/kg of glyphosate residues (the default maximum residue level in New Zealand) would need to eat roughly 230kg of honey every day for the rest of their life to reach the World Health Organization Acceptable Daily Intake for glyphosate."

However, critics said that even at low levels, glyphosate residues mean the honey is tainted, and not due to the fault of the beekeepers, but to lax environmental regulations.

"If New Zealand wants to be a cheap commodity producer, producing tainted food, then that's New Zealand choice, or we can actually have stronger regulation, which protects our free market," Jodie Bruning of the Soil and Health Association told 1 News.9

Glyphosate Detected in Honey Samples Worldwide

Glyphosate has been detected in a variety of honey samples tested worldwide, including that taken directly from 59 beehives on the Hawaiian island of Kauai. There, glyphosate residues were found in 27% of honey samples, at levels as high as 342 parts per billion (ppb).10 Honey was also detected in 33% of honey samples purchased from stores on Kauai.

Not surprisingly, glyphosate occurrence and concentrations were higher in samples taken from the western, predominantly agricultural half of Kauai. Agriculture land use was strongly associated with glyphosate concentrations in honey from hives nearby, as was having extensive golf courses or highways nearby (glyphosate is not only used in agricultural areas, but also on golf courses and roadsides).

In 2014, researchers also found glyphosate in 45.5% of honey samples labeled organic, while the Canadian Food Inspection Agency found glyphosate in 29.7% of 3,188 food samples tested.11 Likewise, the U.S. FDA began a limited testing program for glyphosate in 2016, in which high levels of glyphosate were found in oatmeal products and honey, but the agency did not release the results publicly.

Internal FDA emails obtained by investigative journalist Carey Gillam through Freedom of Information Act (FOIA) requests reveal Roundup has been found in virtually all foods tested, including granola and crackers.12 In 2016, Gillam wrote:13

"All of the samples the FDA tested in a recent examination contained glyphosate residues, and some of the honey showed residue levels double the legally allowed limit in the European Union, according to documents obtained through a Freedom of Information Act request.

… In the records released by the FDA, one internal email describes trouble locating honey that doesn't contain glyphosate: 'It is difficult to find blank honey that does not contain residue. I collect about 10 samples of honey in the market and they all contain glyphosate,' states an FDA researcher."

Glyphosate Is Widespread in the Food Supply

While New Zealand Food Safety suggested a child would have to eat huge amounts of honey daily to even come close to consuming the amount of glyphosate deemed risky by the World Health Organization, this doesn't take into account how ubiquitous this chemical is in the environment.

Honey is unlikely to be a person's only source of exposure, as glyphosate has been detected in a wide variety of commonly consumed foods.

For example, the Environmental Working Group (EWG) commissioned three rounds of glyphosate testing on cereals and other foods sold by Kellogg, General Mills and Quaker, the latest of which took place in 2019 and involved 21 oat-based cereal and snack products.

The chemical was found in all 21 products, with all but four of them coming in higher than EWG's benchmark for lifetime cancer risk in children, which is 160 ppb.14 Glyphosate has also been detected in PediaSure Enteral Formula nutritional drink, which is given to infants and children via feeding tubes,15 to get an idea of just how widespread it is.

It's also found in air, rain, municipal water supplies, soil samples, breast milk, urine, organic plant-based protein supplements and even vaccines, including the pneumococcal, Tdap, hepatitis B (which is injected on the day of birth), influenza and MMR vaccines.16,17

Even Low Levels of Glyphosate Pose a Risk

The International Agency for Research on Cancer (IARC) identified glyphosate as a probable human carcinogen in 2015,18 and in the U.S. about 125,000 claims have been initiated by people who believe exposure to Roundup caused them to develop Non-Hodgkin lymphoma.19

Research published in Frontiers in Genetics also supports glyphosate's cancer link, finding that exposure even in low concentrations (in parts per trillion) may induce cancer in cells when combined with microRNA-182-5p (miR182-5p).20

MicroRNA-182-5p is a gene regulatory molecule found in everyone, and overexpression of the molecule has been linked to cancer. Michael Antoniou of King's College London, who peer reviewed the study, stated, "These observations highlight for the first time a possible biomarker of glyphosate activity at the level of gene expression that could be linked with breast cancer formation."21

Aside from cancer, significant bioaccumulation of glyphosate has been documented in the kidney, an organ with known susceptibility to glyphosate, and glyphosate-induced kidney toxicity has been associated with disturbances in the expression of genes associated with fibrosis, necrosis and mitochondrial membrane dysfunction.22

Further, research published in 2015 found that glyphosate in combination with aluminum synergistically induced pineal gland pathology, which in turn was linked to gut dysbiosis and neurological diseases such as autism, depression, dementia, anxiety disorder and Parkinson's disease.23

Bayer Proposes Roundup Lawsuit Settlement

A number of animal and human diseases have been rising in step with glyphosate usage. This includes conditions such as failure to thrive, congenital heart defects, enlarged right ventricle, liver cancer and, in newborns, lung problems, metabolic disorders and genitourinary disorders.24

The environmental risks are also immense. Speaking to Politico, Jeroen van der Sluijs, a professor of science and ethics at Norway's Bergen University, explained:25

"It [glyphosate] kills a lot of non-target plants and it leads to an agricultural practice where you have monoculture with no wild plants left in the fields … If you remove all the wild plants from the fields then you only have the crop that flowers and that's only a very short period in the year. The rest of the year there's nothing to forage on.

… We find [glyphosate] everywhere in surface waters, it is indeed toxic for all kinds of aquatic organisms, so of special concern are amphibians like frogs and salamanders."

Bayer, which acquired Monsanto, Roundup's original maker, in 2018, has been in settlement talks for months to resolve the litigation but continues to deny that the chemical causes cancer. In June 2020, they reportedly reached a settlement agreement with attorneys representing 75% of the claims initiated, in which they said they will provide $8.8 billion to $9.6 billion to resolve the litigation.26

However, more than 20,000 additional cases have not agreed to Bayer's settlement offer and intend to proceed through the court system.27

Is There a Way to Find Pure Honey?

Beekeepers are, unfortunately, at the mercy of their neighbors' glyphosate usage, as they can't control which plants their bees choose to visit. Some beekeepers, however, are carefully managing where they put their hives to minimize pesticide exposure and keep track of when spraying occurs to help reduce exposures.28

This is an issue not only for honey purity but also for bee health, as glyphosate is known to harm bees. Even organic honey can be contaminated with glyphosate, though there are some organizations that offer glyphosate-free certifications.

The Detox Project is among them. If you see their glyphosate-residue-free certification on Manuka honey, it means the product has no glyphosate residues down to government-recognized limits of detection (usually 0.01 parts per million), and lower levels than the default government Maximum Residue Limits in the European Union and Japan.29

Source : Mercola More   

This site uses cookies. By continuing to browse the site you are agreeing to our use of cookies.