Inside Duke Medicine

Faculty offer hot tips for a fun, healthy summer

With summery weather finally here, everyone is looking forward to some outdoor fun. But warm weather also can pose some health hazards worth keeping in mind. Here’s some DUHS employee-friendly advice from Duke Medicine experts on how to enjoy the season and stay healthy at the same time.

BEFORE YOU TAKE THE PLUNGE…
Swimming is a great way to beat the heat and stay active during warmer months, but all pools aren’t created equal. Harmful parasites and bacteria may be swimming right alongside you if pools aren’t properly maintained.

Still, that doesn’t mean you have to skip the dip, says Coleen Cunningham, M.D., Duke's division chief of pediatric infectious diseases. She suggests keeping a few things in mind before you take the plunge:

• Take a close look. Water should be clear enough to see through at least 10 feet. Foamy or bubbly water could be a sign of excessive organic matter such as pollen or bacteria.
• Keep your mouth closed.
• Be watchful of kids in diapers. Parents should change diapers frequently, as far from the pool as possible, and wash hands immediately after.
• Wash your hands and shower before entering the pool.
• If you want to be really vigilant, invest in a $10 home-pool testing kit that measures the water’s pH level to make sure it’s in a safe range.

YOU ARE WHAT YOU GRILL
Nothing says summertime more than hot dogs, bacon cheeseburgers and juicy sausage and pepper subs. But new research says eating one daily serving of just one of these processed meats can increase your risk of heart disease by a whopping 42 percent and your diabetes risk by 19 percent.

“Your best defense may simply be to avoid processed meats as much as possible,” says Pao-Hwa Lin, Ph.D., a nutritionist at Duke's Sarah W. Stedman Nutrition and Metabolism Center.

Lin also suggests moderating your daily intake of unprocessed red meats like steak and burgers, too. Too much red meat already has been associated with high blood pressure, cancer and other health problems. Instead, fill in your menu with lean meats like chicken, fish, and lots of grilled vegetables.

SPF: HOW HIGH SHOULD YOU GO?
Today’s sunscreens tout Sun Protection Factors (SPFs) as high as 100 in their quest to block those ultraviolet B rays that cause sunburn.

But is an SPF rating of 100 twice as good as a 50? Not necessarily, says Kelly Nelson, M.D., a dermatologist at Duke. “SPF is a measure of the time it takes an individual to burn in the sun if they were not wearing sunscreen. Higher SPFs block slightly more UVB rays, but none offers 100 percent protection.”

Regardless of which sunscreen product and SPF you choose, Nelson recommends:

• Remembering that there’s no such thing as a “safe tan.” A tan is a visual sign that your skin has had damage to its DNA.
• Making sunscreen part of your daily morning routine. Use SPF 15 or 30 on your face, ears, neck, upper chest and upper arms every day. Even the sun exposure you see from walking to work and to your mailbox adds up over time.
• Applying at least an SPF 30 liberally to all sun-exposed areas when you know you’ll be outdoors. Don’t skimp. Full body application should require two fluid ounces, the volume of a shot glass. If used properly, a typical tube of sunscreen should not last long.
• Applying an SPF 75 too thinly makes it, in effect, an SPF 30. That’s when higher SPF sunscreens become helpful. Even with lighter-than-ideal application, the skin still sees some SPF protection.

DRINK UP BEFORE HEADING OUT
Hot weather puts high demands on the human body, so it’s important to hydrate properly – and that means starting before you exercise.

Also take care not to drink too much water. That can lead to a condition called hyponatremia, in which sodium levels drop too low.

David Berkoff, M.D., a Duke sports medicine specialist, recommends building up your outdoor exercise intensity over 10 days to two weeks to help your body grow accustomed to the heat.

“We typically recommend drinking eight ounces of water or a sport drink about every 20 minutes,” he says. If you’re exercising longer than 40 minutes, choose a sport drink. The sugar and salt it contains helps increase the amount of fluid that your body retains.

“Weigh yourself before and after a workout and drink eight ounces of fluid for every pound lost,” Berkoff says.

THE EYES HAVE IT
Children are particularly vulnerable to harmful ultraviolet A and B damage related to sun exposure, says Jill Bryant, an optometrist with the Duke Eye Center. 

“Kids spend more time in the sun, and the lenses of their young eyes are more transparent than adults, which puts them at higher risk for retinal damage,” Bryant says.

Longterm exposure to UV rays and solar radiation can be cumulative, and has been linked to cataracts, macular degeneration and other eye health issues. To minimize the risk of long-term damage in your kids, encourage them to wear sunglasses that block 99 to 100 percent of both UVA and UVB radiation.

Sunglasses that don't offer that protection can actually make things worse by dilating the pupils and allowing more harmful rays in. Wraparound sunglasses are ideal because they protect the skin immediately surrounding a child's eyes.

Be sure to look for sunglasses made of scratch-free impact-resistant polycarbonates because they offer superior impact resistance. Read the label carefully. Labels should say the sunglasses absorb 99-100% of both UV-A and UV-B not just “block harmful UV” without indicating an amount. If your child refuses to wear sunglasses, use wide-brimmed hats or caps.

NOW HEAR THIS!
Some sounds of summer can damage your hearing more than you might think. Attending a rock concert, watching fireworks, lying on the beach listening to your iPod, or even mowing your lawn can put you at risk for permanent long-term hearing loss. “Any event that registered around 80 decibels or higher can damage your hearing,” says David Kaylie, M.D., a Duke otolaryngologist.

“The sound of a dial tone is 80dB, so people shouldn’t turn up their iPods louder than that. Most people can gauge it pretty closely,” Kaylie says. 

To reduce risk, wear hearing protection. IPod users should choose ear buds that fit inside the ear to block out outside noise. Good ear buds come with different-size ear pieces so you can get the right fit. “That’s important,” Kaylie says. “Kids often turn their iPods up to drown out background noise, but if the ear buds fit well, the outside noise will be attenuated and they won't need to turn it up so loud.”