Workaholics Are at Higher Risk for Heart Attacks
The Japanese have a word--karoshi--for sudden death caused by cardiovascular disease from working long hours with too little sleep. And now, Japanese researchers have found that overwork and sleep deprivation can double or triple the risk of a heart attack.
Workaholism and sleep deprivation, of course, aren’t unique to Japan. Several studies in the United States, the Netherlands, Denmark and Sweden have shown that death from heart disease is highest among those who work overtime. The Japanese study had a narrower focus: Researchers examined the relationship between working and sleep in men who had survived their first heart attack.
Two hundred and sixty men, ages 40 to 79, who had a heart attack, or myocardial infarctions, were compared with 445 healthy men matched by age and living in similar areas.
All the men were asked questions about their work habits, medical histories and lifestyles. Such health factors as weight, smoking and drinking habits and occupation were taken into account in comparing the men’s heart-attack risk.
Men who worked more than 61 hours a week had twice the risk of a heart attack as those working 40 hours or less per week. Sleeping five hours or less two or more days a week increased the risk of a heart attack by two to three times. Also, men who had been working long hours very recently were more likely to have a heart attack than those who had put in a lot of extra hours less recently in the past year.
In fact, the researchers report, sleep deprivation and lack of rest may trigger a heart attack. . “Working 40 hours a week and sleeping seven hours a night is optimal,” says Dr. Ying Liu, a member of the Fukuoka Heart Study Group that involved more than 20 universities and hospitals in Fukuoka, Japan. When overwork is unavoidable, she advises people to try to take a couple of days off, get more rest and eat more healthfully to offset the risk.
Occupational and Environmental Medicine 59: 447-451
Using Sunscreen Does Not Increase Risk of Melanoma, Researchers Find
Several studies have indicated that when sunscreen use goes up, the risk of melanoma increases. This surprising finding has stumped some experts. Could it be that sunscreen creates a false sense of security and leads us to stay out in the sun longer than we should? Researchers have now taken a closer look at the data from those studies and many others. Their conclusion: Sunscreen can’t be blamed for melanoma.
Dr. Michael Huncharek and colleagues at the Meta-Analysis Research Group in Stevens Point, Wis., pooled data from more than 9,000 people who participated in several melanoma studies between 1966 and 1999. They found that sunscreen use did not increase a person’s chances of developing the deadly skin cancer.
The link between sunscreen and melanoma appears to be due to bias in some of those earlier studies, the researchers said. While some hospital studies found only a marginal increase in melanoma, others found increases ranging from 50% to 400%, says Huncharek, of the Marshfield Clinic Cancer Center in Marshfield, Wis. He says this variation indicates a bias in the study. One reason it happens with hospital-based studies is that they typically include only patients treated at that center. Characteristics of patients seen at one center can be very different from those treated at another.
In contrast, the researchers found that studies using information from tumor registries, which collect data from everyone who has cancer regardless of where they are treated, were more consistent. Until more conclusive data is available, the researchers say that wearing sunscreen as a cancer prevention strategy is a wise practice.
American Journal of Public Health 92 (7): 1173-1177
Study Finds Multiple Therapies Boost the Cancer Survivor Rate
Killing rapidly growing malignant cells is one goal of cancer treatment; preventing them from coming back is another. Some therapies do both, but often two therapies are better than one. Now a long-term European study of men with aggressive prostate cancer shows that combining radiation therapy with a drug that suppresses male hormone is nearly twice as effective as radiation therapy alone.
The new study builds on prior research by the European Organisation for Research and Treatment of Cancer begun in the late 1980s, involving more than 400 prostate cancer patients with disease that had progressed beyond the gland itself but not yet spread to other parts of the body.
Half the men received radiation therapy alone for seven weeks. The other half received the same radiation therapy and monthly injections of the testosterone-reducing drug Zoladex (goserelin) for three years. Preliminary results of the combined therapy were quite impressive, but some scientists thought the benefit might not last. “This long-term study is much more convincing,” says Dr. Judd W. Moul, director of the Center for Prostate Disease Research at Walter Reed Army Medical Center in Rockville, Md..
The latest study found that, after five years, 74% of those treated with radiation and hormone therapies still had no recurrence of prostate cancer, compared to 40% of those who were cancer-free after receiving radiation alone.
Today, most U.S. males have their prostate cancer detected early because of widespread screening. If the cancer has advanced locally upon diagnosis, however, the combination of radiation and hormone therapies is now commonly used, Moul says. Monthly injections are no longer necessary because the hormone-blocking drugs are now available in a longer-acting form that can be administered every three months or longer.
Hormone-blocking drugs, such as Zoladex, cause the brain to stop stimulating testosterone production in the testes, producing a kind of chemical castration. The drug has side effects, such as hot flashes, which get better when use is discontinued. The Lancet 360:103-108
Surgery May Help Children With Sleep Apnea, Behavioral Problems
Some parents of children with sleep apnea have believed that certain behavior and learning difficulties are related to their child’s bedtime problems. Now researchers in New York have found that there is a link. The good news is that the researchers also found that the children’s behavior and quality of life improved after their tonsils and adenoids were removed.
The researchers at Long Island College Hospital studied 64 children with sleep apnea whose enlarged tonsils and adenoids were partially blocking their breathing passages. In some cases, surgery was for chronic tonsillitis alone. These children were included so the researchers had a range of breathing problems to compare.
Using behavioral surveys completed by the parents, the researchers found a high prevalence of behavioral and emotional problems in a quarter of those with the disorder. Three months after the surgery, the children improved significantly, particularly in measures of anxiety, depression and withdrawn behavior and aggressive and destructive behaviors.
Why the apnea caused behavior problems isn’t known, but researchers say disrupted sleep and lack of oxygen must play a role.
Archives of Otolaryngology, Head and Neck Surgery 128: 770-775.
*
Dianne Lange can be reached at dianne lange@cs.com.
