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Tag: Lung disease

  • Use of smoke-emitting firecrackers renews air pollution debate in India’s capital ahead of Diwali

    Use of smoke-emitting firecrackers renews air pollution debate in India’s capital ahead of Diwali

    NEW DELHI (AP) — As India gears up for Diwali, the Hindu festival of lights, people are divided over whether they should celebrate by setting off firecrackers, which worsen the country’s chronic air pollution.

    Diwali, which will be celebrated Thursday, is marked by socializing and exchanging gifts with family and friends. Many Indians light earthen oil lamps or candles. But every year the festivities are tinged with worries over air pollution, as smoke-emitting firecrackers cause toxic smog that can takes days to clear.

    The capital, New Delhi, which is among India’s worst cities for air quality, is particularly impacted by the problem and is usually shrouded in toxic gray smog a day after Diwali. Authorities there and in some other states have banned the use and sale of firecrackers since 2017, asking people to opt for more sustainable options like environmentally friendly firecrackers and light shows, but the rule is often flouted. Firecrackers can be easily bought from roadside stalls and stores.

    Some residents in New Delhi say the ban doesn’t make much difference, while others see it as a necessary measure to fight pollution.

    Vegetable vendor Renu, who only uses one name, loves celebrating Diwali in the city. Every year her kids set off firecrackers at night. She tells them to be careful but not to refrain from using them.

    “Diwali is a day of celebration and happiness for us which comes only once a year, and I feel the ban should not be there,” she said.

    Others are against it.

    Unlike most kids, Ruhaani Mandal, 13, doesn’t light firecrackers. She acknowledges it is fun, but says it is hazardous for people and animals.

    “I have seen firsthand the struggle of my father, who has lost his sense of smell due to pollution, and I see how his health worsens after Diwali celebrations,” she said.

    New Delhi and several northern Indian cities typically see extremely high levels of air pollution between October and January each year, disrupting businesses and shutting schools and offices. Authorities close construction sites, restrict diesel-run vehicles and deploy water sprinklers and anti-smog guns to control the haze and smog that envelopes the skyline.

    This year, thick, toxic smog has already started to engulf New Delhi. On Wednesday, authorities reported an AQI of over 300, which is categorized as “very poor.”

    Several studies have estimated that more than a million Indians die each year from air pollution-related diseases. A high level of tiny particulate matter can lodge deep into the lungs and cause major health problems, including chronic respiratory diseases.

    New Delhi’s woes aren’t only due to firecrackers. Vehicular emissions, farm fires in neighboring states and dust from construction are the primary causes of the capital’s air pollution woes. But health experts say the smoke emitted from firecrackers can be more hazardous.

    “The smoke that is produced by firecrackers contains heavy metals like sulphur, lead and toxic gases like carbon monoxide and fumes of heavy metals that are dangerous to our respiratory system,” said Arun Kumar Sharma, a community medicine professor at New Delhi’s University College of Medical Sciences.

    Meanwhile, authorities in New Delhi have largely failed to enforce a strict ban on the use of firecrackers to avoid offending millions of Hindus across the country, for whom Diwali is one of the biggest festivals. To sidestep the ban, many sellers offer firecrackers online, some with the convenience of home delivery.

    Shopkeeper Gyaanchand Goyal said the ban on firecrackers has disadvantaged sellers like him and affected their biggest source of income during the festive season.

    “The government enforces a restriction on firecrackers solely to demonstrate their commitment to the environment. Other than that, I don’t think there are any other consequences of this ban,” he said.

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  • Wildfires are growing under climate change, and their smoke threatens farmworkers, study says

    Wildfires are growing under climate change, and their smoke threatens farmworkers, study says

    LOS ANGELES — As wildfires scorched swaths of land in the wine country of Sonoma County in 2020, sending ash flying and choking the air with smoke, Maria Salinas harvested grapes.

    Her saliva turned black from inhaling the toxins, until one day she had so much trouble breathing she was rushed to the emergency room. When she felt better, she went right back to work as the fires raged on.

    “What forces us to work is necessity,” Salinas said. “We always expose ourselves to danger out of necessity, whether by fire or disaster, when the weather changes, when it’s hot or cold.”

    As climate change increases the frequency and intensity of wildfires around the world, a new study shows that farmworkers are paying a heavy price by being exposed to high levels of air pollution. And in Sonoma County, the focus of the work, researchers found that a program aimed at determining when it was safe to work during wildfires did not adequately protect farmworkers.

    They recommended a series of steps to safeguard the workers’ health, including air quality monitors at work sites, stricter requirements for employers, emergency plans and trainings in various languages, post-exposure health screenings and hazard pay.

    Farmworkers are “experiencing first and hardest what the rest of us are just starting to understand,” Max Bell Alper, executive director of the labor coalition North Bay Jobs with Justice, said Wednesday during a webinar devoted to the research, published in July in the journal GeoHealth. “And I think in many ways that’s analogous to what’s happening all over the country. What we are experiencing in California is now happening everywhere.”

    Farmworkers face immense pressure to work in dangerous conditions. Many are poor and don’t get paid unless they work. Others who are in the country illegally are more vulnerable because of limited English proficiency, lack of benefits, discrimination and exploitation. These realities make it harder for them to advocate for better working conditions and basic rights.

    Researchers examined data from the 2020 Glass and LNU Lightning Complex fires in northern California’s Sonoma County, a region famous for its wine. During those blazes, many farmworkers kept working, often in evacuation zones deemed unsafe for the general population. Because smoke and ash can contaminate grapes, growers were under increasing pressure to get workers into fields.

    The researchers looked at air quality data from a single AirNow monitor, operated by the Environmental Protection Agency and used to alert the public to unsafe levels, and 359 monitors from PurpleAir, which offers sensors that people can install in their homes or businesses.

    From July 31 to Nov. 6, 2020, the AirNow sensor recorded 21 days of air pollution the EPA considers unhealthy for sensitive groups and 13 days of poor air quality unhealthy for everyone. The PurpleAir monitors found 27 days of air the EPA deems unhealthy for sensitive groups and 16 days of air toxic to everyone.

    And on several occasions, the smoke was worse at night. That’s an important detail because some employers asked farmworkers to work at night due in part to cooler temperatures and less concentrated smoke, said Michael Méndez, one of the researchers and an assistant professor at University of California-Irvine.

    “Hundreds of farmworkers were exposed to the toxic air quality of wildfire smoke, and that could have detrimental impact to their health,” he said. “There wasn’t any post-exposure monitoring of these farmworkers.”

    The researchers also examined the county’s Agricultural Pass program, which allows farmworkers and others in agriculture into mandatory evacuation areas to conduct essential activities like water or harvest crops. They found that the approval process lacked clear standards or established protocols, and that requirements of the application were little enforced. In some cases, for example, applications did not include the number of workers in worksites and didn’t have detailed worksite locations.

    Irva Hertz-Picciotto, a professor of public health sciences at the University of California-Davis who was not part of the study, said symptoms of inhaling wildfire smoke — eye irritation, coughing, sneezing and difficulty breathing — can start within just a few minutes of exposure to smoke with fine particulate matter.

    Exposure to those tiny particles, which can go deep into the lungs and bloodstream, has been shown to increase the risk of numerous health conditions such as heart and lung disease, asthma and low birth weight. Its effects are compounded when extreme heat is also present. Another recent study found that inhaling tiny particulates from wildfire smoke can increase the risk of dementia.

    Anayeli Guzmán, who like Salinas worked to harvest grapes during the Sonoma County fires, remembers feeling fatigue and burning in her eyes and throat from the smoke and ash. But she never went to the doctor for a post-exposure health check up.

    “We don’t have that option,” Guzmán, who has no health coverage, said in an interview. “If I go get a checkup, I’d lose a day of work or would be left to pay a medical bill.”

    In the webinar, Guzman said it was “sad that vineyard owners are only worried about the grapes” that may be tainted by smoke, and not about how smoke affects workers.

    A farmworker health survey report released in 2021 by the University of California-Merced and the National Agricultural Workers Survey found that fewer than 1 in 5 farmworkers have employer-based health coverage.

    Hertz-Picciotto said farmworkers are essential workers because the nation’s food supply depends on them.

    “From a moral point of view and a health point of view, it’s really reprehensible that the situation has gotten bad and things have not been put in place to protect farmworkers, and this paper should be really important in trying to bring that to light with real recommendations,” she said.

    ___

    The Associated Press receives support from the Walton Family Foundation for coverage of water and environmental policy. The AP is solely responsible for all content. For all of AP’s environmental coverage, visit https://apnews.com/hub/climate-and-environment.

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  • Virginia heart transplant recipient creates ‘Heartbeat Foundation’ to support others – WTOP News

    Virginia heart transplant recipient creates ‘Heartbeat Foundation’ to support others – WTOP News

    Renee Gibbs, founder and CEO of The Heart Beat Foundation, helps support pre- and post-transplant patients nationwide.

    This is part of WTOP’s continuing coverage of people making a difference in our community, reported by Stephanie Gaines-Bryant. Read more of that coverage.

    CLICK IMAGE TO ENLARGE: Renee Gibbs, founder and CEO of The Heartbeat Foundation. (Courtesy Renee Gibbs)

    After receiving two lungs and a heart, a Front Royal, Virginia, native said she realized why she was diagnosed with lung disease in 2018: “It happened so that I could help other people.”

    Before becoming ill, Renee Gibbs had a successful real estate career. Now she is the founder and CEO of The Heartbeat Foundation, which helps support pre- and post-transplant patients nationwide.

    “This disease and this transplant has made me realize what my purpose is in life,” she told WTOP.

    Gibbs had the surgery in January of 2019, receiving two lungs and a heart. She was living in Maryland in May of 2018 when she was diagnosed with interstitial lung disease. Gibbs was hospitalized in 2018 after her lung capacity significantly decreased.

    She says her two lungs and heart came from a 54-year-old woman, the same age as Gibbs, transported from Duke University.

    On Oct. 31, 2018, after Gibbs moved to Alabama with her husband and two sons, she was hospitalized for five months.

    Between that day and March 29, 2019, the day she was released from the hospital, Gibbs said she valued the support of family and friends.

    “They gave me everything I needed,” she told WTOP. “They were there for me every day. They had a prayer chain going for me.”

    Gibbs said support also came from a Facebook group she joined for pre- and post-op transplant recipients, where she found similarities between what she and others experienced while hospitalized.

    The wife and mother of two sons said family members made sure she got her hair done, had manicures and even brought her special foods.

    Meanwhile, many of the patients around her going through a similar experience didn’t have that type of support.

    Without support, Gibbs said, your request for a transplant can be denied. She said doctors weigh many factors when it comes to receiving a transplant, including your emotional well-being and “if you’re being supported.”

    Although the transplant was a success, the recovery was the difficult part. It took three years before Gibbs said she looked and felt like herself again.

    “I literally cried every day for six months to a year,” she said, adding that her husband was relentless in his support.

    When she noticed how many people on the transplant list had been approved for transplants but didn’t have support, she moved to start her foundation. The organization formally started in April of 2023, helping counsel patients, providing emotional support and things like manicures and hair care to help with their self-esteem.

    More information is available at TheHeartbeatFoundation.com.

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    © 2024 WTOP. All Rights Reserved. This website is not intended for users located within the European Economic Area.

    Stephanie Gaines-Bryant

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  • Bird flu, weather and inflation conspire to keep egg prices near historic highs for Easter

    Bird flu, weather and inflation conspire to keep egg prices near historic highs for Easter

    Egg prices are at near-historic highs in many parts of the world as the spring holidays approach, reflecting a market scrambled by disease, high demand and growing costs for farmers.

    It’s the second year in a row consumers have faced sticker shock ahead of Easter and Passover, both occasions in which eggs play prominent roles.

    While global prices are lower than they were at this time last year, they remain elevated, said Nan-Dirk Mulder, a senior global specialist with Dutch financial firm RaboBank’s RaboResearch Food and Agribusiness division. Mulder doesn’t expect them to return to 2021 levels.

    In the United States, the average price of a dozen eggs was $2.99 in February, down from $4.21 last year, according to government data. Still, that’s significantly more than the $1.59 cents per dozen consumers were paying in February 2021.

    In Europe, egg prices are 10% to 15% lower than last year but still about double what they were in 2021, Mulder said.

    One major culprit is avian flu. Outbreaks of the deadly respiratory disease were reported in Europe, Africa and Asia in 2020 and spread to North America in 2021. In 2022 alone, more than 131 million poultry worldwide died or were culled on affected farms, according to the World Health Organization.

    Outbreaks are continuing. In December, the U.S. confirmed cases in 45 commercial flocks and 33 backyard flocks, affecting 11.4 million birds, according to the U.S. Department of Agriculture.

    In South Africa, egg prices soared after 40% of laying hens were killed late last year due to the respiratory disease, Mulder said. A tray of six eggs cost 25.48 South African rand ($1.34) last month, up 21% from February 2023.

    Even when avian flu dissipates, it can take a long time for the egg market to settle. It takes a farm three to six months to replenish a flock, so during that time, egg supplies are lower and prices rise, said Emily Metz, president of the American Egg Board, a marketing organization.

    If farms restock with too many chickens, it can drive prices down. That’s what happened in the U.S. last summer when egg prices plunged to $2 per dozen.

    “It’s supply and demand searching out. You have to have a profitable price,” David Anderson, a professor and extension economist for livestock and food marketing at Texas A&M University, said.

    And profits can be hard for farmers to come by during periods of inflation. Chicken feed represents up to 70% of a farmer’s costs, and feed prices doubled between 2020 and 2022, Mulder said. Weather, COVID-related disruptions and the war in Ukraine – which drove up the price of wheat and other crops — were all contributors.

    In Nigeria, the cost of a crate of eggs has doubled since the beginning of the year due to weakened currency, the removal of fuel subsidies and high costs for farmers.

    Teslimat Abimbola, who runs a poultry farm in the southern city of Ibadan, said 25 kilograms of feed that cost 2,500 Nigerian naira ($1.78) in 2020 now costs 13,000 naira ($9.23). Abimbola has lost some customers as a result of price increases.

    “Many farms have been forced to shut down due to the high costs of rearing chickens,” Abimbola said.

    The government of Lagos State, Nigeria’s biggest economic center, has implemented a subsidy program to help consumers deal with the increased costs of eggs.

    Elsewhere, government regulations play a part in lifting egg prices. Multiple states, including California and Massachusetts, have passed cage bans for egg-laying hens since 2018; this year, bans are set to take effect in Washington, Oregon and Michigan.

    Converting to cage-free facilities is a big investment for farmers, and consumers may not always realize that’s a factor in the higher prices they see at the grocery store, Metz said. She anticipates such conversion costs will eventually fall as more farms make the changeover.

    Price peaks are inevitably followed by price drops, and egg prices will eventually settle into more normal patterns. In the short term, the holiday demand that picks up every Easter will ease heading into summer, Anderson said. Meanwhile, improving biosecurity measures should help blunt the impact of avian flu, he said.

    Lyncoya Ilion, who teaches cooking classes and runs a catering business called Catered by Coya in Brown Deer, Wisconsin, says she’s noticed egg prices inching back up over the last two to three months but hopes she won’t have to pass her costs onto clients.

    “I haven’t had to increase prices yet because I’m anticipating that the egg prices will decrease again soon,” Ilion said.

    That’s a good bet. In the U.S., egg prices are expected to decrease around 2.8% this year, according to the U.S. Department of Agriculture. That won’t put them back to pre-COVID levels, but it should give some relief.

    “People really love eggs, and they notice when that price fluctuates,” Metz said. “Our farmers wish it wasn’t such a sharp up and down as well. It makes everything challenging.”

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    AP Business Reporter Taiwo Adebayo contributed from Lagos, Nigeria.

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  • Pope Francis skips Palm Sunday homily at start of busy Holy Week

    Pope Francis skips Palm Sunday homily at start of busy Holy Week

    ROME — ROME (AP) — Pope Francis decided at the last minute to skip his homily during Palm Sunday Mass in St. Peter’s Square, avoiding a strenuous speech at the start of a busy Holy Week that will test his increasingly frail health.

    Hobbled by bad knees and persistent respiratory problems, Francis also didn’t participate in the procession of cardinals around the obelisk in the piazza at the start of the Mass. Instead, the 87-year-old pontiff blessed the palm fronds and olive branches carried by the faithful from the altar.

    Francis had been expected to deliver a homily halfway through the service and a prepared text had been distributed to journalists. But when an aide presented Francis with his glasses to begin reading, the pope made clear he wouldn’t deliver the remarks, leaving the crowd waiting in silence.

    Vatican officials didn’t immediately explain why. The Vatican press office later said the homily was replaced by “a moment of silence and prayer.”

    Francis though did pronounce prayers throughout the service and offered a long appeal for peace at the end of the Mass. He said he was praying for the families of those killed in what he called an “inhuman” attack at a suburban Moscow concert hall and also asked for prayers for “the martyred Ukraine” and people of Gaza.

    Vatican officials estimated some 60,000 people attended the Mass, held under a sunny, breezy spring sky. Francis spent several minutes greeting them from the popemobile, making several loops around the piazza at the end of the service.

    Palm Sunday kicks off a busy week for Francis leading up to Easter Sunday when the faithful commemorate the resurrection of Christ. On Thursday, Francis is due to travel to a Rome women’s prison for the traditional washing of the feet ritual. On Friday he is scheduled to preside over the torchlit Way of the Cross procession at Rome’s Colosseum re-enacting Christ’s crucifixion.

    The following day marks the Easter Vigil, during which Francis presides over a solemn nighttime service in the basilica, followed by Easter Sunday Mass in St. Peter’s Square and his noontime blessing from the loggia above.

    The Holy Week schedule is challenging for popes even under the best of circumstances. But that is especially true this year for Francis, who has been battling on and off all winter what he and the Vatican have described as a case of the flu, bronchitis or a cold. For the last several weeks he has occasionally asked an aide to read aloud his speeches and catechism lessons to spare him the effort.

    On Sunday, there was no substitute called in, and the homily was skipped. Vatican officials said the prepared text was to be considered as never having existed. Usually, the pope doesn’t deliver a homily at Easter, but he traditionally offers reflections on Palm Sunday.

    Even when he isn’t sick, Francis often speaks in a whisper and seems to run out of breath easily. He had part of one lung removed when he was a young man because of a respiratory infection.

    At this time last year, he was hospitalized for three days with an acute case of bronchitis, but then rallied to get through Holy Week. He has been hospitalized two other times during his pontificate for abdominal surgery, including one 10-day stay in 2021 to remove a part of his large intestine.

    At the end of the Mass, Francis offered a long prayer for peace for all those suffering from war, and for the Lord to comfort the victims of the “vile terrorist attack” in Moscow.

    “May he convert the hearts of those who protect, organize and carry out these inhuman acts that offend God, who commanded us not to kill,” Francis said.

    Without citing Moscow, Francis also asked the faithful not to forget Ukraine’s suffering. He noted many Ukrainians are now without electricity as a result of “intense attacks on infrastructure, which not only bring death and suffering, but also the risk of a humanitarian catastrophe of even bigger dimensions.”

    “Please don’t forget the martyred Ukraine,” he said. “And let us also think of Gaza, which is suffering so much, and so many other places of war.”

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  • Insurer delays and denials hamper patients seeking at-home breathing machines

    Insurer delays and denials hamper patients seeking at-home breathing machines

    Lou Gehrig’s disease took away Grace Armant’s ability to speak, but the 84-year-old still has plenty to say about her insurance.

    UnitedHealthcare has rejected several requests from her doctors for coverage of a machine Armant needs to breathe as she deals with the fatal illness.

    “They are no good,” Armant said, typing slowly into a device that speaks for her. “I can’t do without the machine.”

    Doctors around the country say UnitedHealthcare and other insurers have made it harder to get coverage for certain home ventilators that patients like Armant need as their lungs fail. They say patients often must struggle first with less effective — and cheaper — devices before some insurers will pay. In other cases, insurers balk at paying for a second machine needed when patients transfer from their bed to a wheelchair.

    Temple University doctoral student Jaggar DeMarco waited more than three years to get his.

    “Breathing is not a luxury,” he said. “It’s really the bare minimum, and that’s what we’re asking for.”

    Some physicians believe insurers are making it harder on patients because more of the devices are being prescribed. Spending by the federal government’s Medicare program on the ventilators jumped from about $3 million to nearly $269 million between 2009 and 2017, according to the U.S. Department of Health and Human Services Office of Inspector General.

    Insurers say they do cover the machines, but that coverage can depend on several factors.

    These “noninvasive” ventilators help patients breathe around the clock by forcing air into the lungs, often through a mask. They are called noninvasive because they don’t require trachea surgery to open the airway, like ones used in hospitals.

    The machines have battery backups so they can keep working when the power goes out. They also are more powerful than other devices meant to be used mainly at night for conditions like sleep apnea. At around $1,200 a month, they can be three times as expensive as those devices.

    These ventilators can help prolong the life of someone with Lou Gehrig’s disease, also known as amyotrophic lateral sclerosis, doctors say.

    But insurance rejections have picked up for those patients and people dealing with advanced cases of chronic obstructive pulmonary disease, said Chuck Coolidge, chief strategy officer for VieMed, which provides respiratory equipment for patients in 46 states.

    That includes both initial approvals and reauthorizations, he said.

    “In early 2023, it was almost like a switch flipped,” he said.

    UnitedHealthcare spokeswoman Heather Soule said her company covers the machines and re-evaluates requests if it gets new information. Coverage can depend on the patient’s condition, terms of their health plan or guidelines from the federal government’s Medicare program.

    Those guidelines give insurers room to reject many ventilator requests, even those for seriously ill patients, said Dr. John Hansen-Flaschen, a pulmonary medicine expert with the University of Pennsylvania.

    Government-funded Medicare Advantage plans run by UnitedHealthcare now deny nearly all initial requests for the ventilators, said Dr. Cathy Lomen-Hoerth, a neurologist with the University of California San Francisco.

    In West Virginia, Dale Harper says it took several months and a personal plea before UnitedHealthcare would cover a ventilator for his 25-year-old son, Jacob, who has a rare and aggressive form of ALS.

    After appeals from Jacob’s doctor failed, Harper called a number on his insurance card and asked for a supervisor.

    “I said, ‘I can feed him, I can help him go to the bathroom, I can move him from one place to the other,’” the Winfield, West Virginia, resident recalled. “The only thing I cannot do is breathe for him … and he can’t breathe.”

    Harper said ventilator coverage was approved within an hour of that call early last year.

    Doctors caring for Armant, who lives outside New Orleans, say they usually get decent ventilator coverage.

    “No one thought there would be a problem,” said Deidre Devier, an LSU Health experimental psychologist who specializes in cognitive disorders.

    They first sought coverage in May, 2022, and Devier said Armant has only had it for around three months near the end of that year. She said a medical device company has been providing Armant’s ventilator for free while her case was appealed. But those appeals have ended.

    Armant’s daughter said she’s considering starting hospice care, which would allow for ventilator coverage but prevent her mom from seeing her regular doctors. She’s also looking online for a refurbished machine.

    “She doesn’t have $20,000″ to buy the machine, Terrellyn Armant said.

    Representatives of both patients with UnitedHealthcare coverage gave the insurer written permission to discuss their cases, but Soule declined to comment on the record.

    Coverage complications aren’t limited to UnitedHealthcare. DeMarco, the Temple student, said Aetna denied a request for a second breathing machine, and then several appeals. Eventually, his father’s employer essentially overruled the insurer and allowed coverage.

    Doctors recommend a second ventilator for people who use wheelchairs during the day. That avoids mistakes in adjusting the machine’s settings when moving someone from their bed.

    “I’m constantly angry that my life and what I can do with (it) is sometimes determined by insurance companies and bureaucracy,” said the 30-year-old DeMarco, who has chronic respiratory failure.

    An Aetna representative said the company could not comment on individual cases. But he added that Aetna does cover second ventilators in certain circumstances. Aetna’s policy bulletin says they are medically necessary for people who need an additional ventilator for their wheelchair during the day.

    Ventilator coverage problems started picking up after technology improvements made the devices easier to use, according to Dr. Lisa Wolfe, a professor at Northwestern’s Feinberg School of Medicine. That led to a rise in use for patients with conditions that are not immediately life-threatening.

    She said she thinks insurers are reacting to that expanded use.

    ALS patients without ventilator access have limited options. They can use a device that’s covered but doesn’t work as well. They may get ventilator coverage by entering hospice care or having a tracheostomy.

    They also might wind up bouncing in and out of hospitals, said Hansen-Flaschen, the Penn physician.

    “Or they die prematurely, and it’s a wretched death because they can’t breathe,” he said.

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    The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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  • Is Our Life Expectancy Extended by Intermittent Fasting?  | NutritionFacts.org

    Is Our Life Expectancy Extended by Intermittent Fasting?  | NutritionFacts.org


    Alternate-day modified fasting is put to the test for lifespan extension. 

    Is it true that alternate-day calorie restriction prolongs life? Doctors have anecdotally attributed improvements in a variety of disease states to alternate-day fasting, including asthma; seasonal allergies; autoimmune diseases, such as rheumatoid arthritis and osteoarthritis; infectious diseases, such as toenail fungus, periodontal disease, and viral upper respiratory tract infections; neurological conditions, such as Tourette’s syndrome and Meniere’s disease; atrial fibrillation; and menopause-related hot flashes. The actual effect on chronic disease, however, remains unclear, as I discuss in my video Does Intermittent Fasting Increase Human Life Expectancy?
     
    Alternate-day fasting has been put to the test for asthma in overweight adults, and researchers found that asthma-related symptoms and control significantly improved, as did the patients’ quality of life, including objective measurements of lung function and inflammation. As you can see in the graphs below and at 0:56 in my video, there were significant improvements in peak airflow, mood, and energy. Their weight also improved—about a 19-pound drop in eight weeks—so it’s hard to tease out the effects specific to the fasting beyond the benefits we might expect from weight loss by any means. 

    For the most remarkable study on alternate-day fasting, you have to go back more than a half-century. Though the 2017 cholesterol findings were the most concerning data I could find on alternate-day fasting, the most enticing was published in Spain in 1956. The title of the study translates as “The Hunger Diet on Alternate Days in the Nutrition of the Aged.” Inspired by the data being published on life extension with caloric restriction on lab rats, researchers split 120 residents of a nursing home in Madrid into two groups. Sixty residents continued to eat their regular diet, and the other half were put on an alternate-day modified fast. On the odd days of the month, they ate a regular 2,300-calorie diet; on the even days, they were given only a pound of fresh fruits and a liter of milk, estimated to add up to about 900 calories. This continued for three years. So, what happened? 
     
    As you can see below and at 2:16 in my video, throughout the study, 13 participants died in the control group, compared to only 6 in the intermittent fasting group, but those numbers were too small to be statistically significant. 

    What was highly significant, though, was the number of days spent hospitalized: Residents in the control group spent a total of 219 days in the infirmary, whereas the alternate-day fasting group only chalked up 123 days, as you can see below and at 2:38 in my video


    This is held up as solid evidence that alternate-day fasting may improve one’s healthspan and potentially even one’s lifespan, but a few caveats must be considered. It’s not clear how the residents were allocated to their respective groups. If, instead of being randomized, healthier individuals were inadvertently placed in the intermittent fasting group, that could skew the results in their favor. As well, it appears the director of the study was also in charge of medical decisions at the nursing home. In that role, he could have unconsciously been biased toward hospitalizing more folks in the control group. Given the progress that has been made in regulating human experimentation, it’s hard to imagine such a trial being run today, so we may never know if such impressive findings can be replicated. 

    Well, that was interesting! I had never even heard of that study until I started digging into the topic.  

    Check out my fasting series and popular videos on the subject here.  

    For more on longevity, see related videos below.





    Michael Greger M.D. FACLM

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  • Airstrikes hit camps in central Gaza as Biden administration approves new weapons sales to Israel

    Airstrikes hit camps in central Gaza as Biden administration approves new weapons sales to Israel

    DEIR AL-BALAH, Gaza Strip — Israeli warplanes struck two urban refugee camps in central Gaza on Saturday, as the Biden administration approved a new emergency weapons sale to Israel despite persistent international cease-fire calls over mounting civilian deaths, hunger and mass displacement in the enclave.

    Israel says it is determined to pursue its unprecedented air and ground offensive until it has dismantled Hamas, a goal viewed by some as unattainable because of the militant group’s deep roots in Palestinian society. The United States has shielded Israel diplomatically and has continued to supply weapons.

    Israel argues that ending the war now would mean victory for Hamas, a stance shared by the Biden administration which at the same time urged Israel to do more to avoid harm to Palestinian civilians.

    The war, triggered by the deadly Oct. 7 Hamas attack on southern Israel, has displaced some 85% of the Gaza Strip’s 2.3 million residents, sending swells of people seeking shelter in Israeli-designated safe areas that the military has nevertheless also bombed. That has left Palestinians with a harrowing sense that nowhere is safe in the tiny enclave.

    Residents in the urban refugee camps of Nuseirat and Bureij, two recent hot spots of combat, reported Israeli airstrikes overnight and into Saturday.

    Nuseirat resident Mustafa Abu Wawee said a strike hit the home of one of his relatives, killing two people.

    “The (Israeli) occupation is doing everything to force people to leave,” he said over the phone while searching along with others for four people missing under the rubble. “They want to break our spirit and will but they will fail. We are here to stay.”

    A second strike late Friday in Nuseirat targeted the home of a journalist for Al-Quds TV, a channel linked to the group Islamic Jihad whose militants also participated in the Oct. 7 attack. The channel said the journalist, Jaber Abu Hadros and six members of his family were killed.

    Bureij resident Rami Abu Mosab said sounds of gunfire echoed across the camp overnight, followed by heavy airstrikes Saturday.

    With Israeli forces pushing deeper into Khan Younis and the camps of central Gaza, tens of thousands of Palestinians streamed into the already crowded city of Rafah at the southernmost end of Gaza in recent days.

    Drone footage showed a vast camp of thousands of tents and makeshift shacks set up on what had been empty land on Rafah’s western outskirts next to U.N. warehouses. People arrived in Rafah in trucks, in carts and on foot. Those who did not find space in the already overwhelmed shelters put up tents on roadsides slick with mud from winter rains.

    The State Department said Friday that Secretary of State Antony Blinken told Congress he approved a $147.5 million sale for equipment, including fuses, charges and primers, that is needed for 155 mm shells Israel bought previously.

    It marked the second time this month that the Biden administration is bypassing Congress to approve an emergency weapons sale to Israel.

    The department cited the “urgency of Israel’s defensive needs” as a reason for the approval, and argued that “it is vital to U.S. national interests to ensure Israel is able to defend itself against the threats it faces.”

    The emergency determination means the purchase will bypass the congressional review requirement for foreign military sales. Such determinations are rare, but not unprecedented, when administrations see an urgent need for weapons to be delivered without waiting for lawmakers’ approval.

    Blinken made a similar decision on Dec. 9 to approve the sale to Israel of nearly 14,000 rounds of tank ammunition worth more than $106 million.

    Both moves have come as President Joe Biden’s request for a nearly $106 billion aid package for Ukraine, Israel and other national security needs remains stalled in Congress, caught up in a debate over U.S. immigration policy and border security. Some Democratic lawmakers have spoken of making the proposed $14.3 billion in American assistance to its Mideast ally contingent on concrete steps by Israeli Prime Minister Benjamin Netanyahu’s government to reduce civilian casualties in Gaza during the war with Hamas.

    More than a week after a U.N. Security Council resolution called for the unhindered delivery of aid at scale across besieged Gaza, conditions have only worsened, U.N. agencies warned.

    Aid officials said the aid entering Gaza remains woefully inadequate. Distributing goods is hampered by long delays at two border crossings, ongoing fighting, Israeli airstrikes, repeated cuts in internet and phone services and a breakdown of law and order that makes it difficult to secure aid convoys, they said.

    Nearly the entire population is fully dependent on outside humanitarian aid, said Philippe Lazzarini, head of UNRWA, the U.N. agency for Palestinian refugees. A quarter of the population is starving because too few trucks enter with food, medicine, fuel and other supplies — sometimes fewer than 100 trucks a day, according to U.N. daily reports.

    U.N. monitors said operations at the Israeli-run Kerem Shalom crossing halted for four days this week because of security incidents, such as a drone strike and the seizing of aid by desperate Gaza residents.

    They said the crossing reopened Friday, and that a total of 81 aid trucks entered Gaza through Kerem Shalom and the Rafah crossing on the Egyptian border — a fraction of the typical prewar volume of 500 trucks a day.

    Meanwhile, the World Health Organization warned that the spread of disease is accelerating, particularly in southern Gaza, where hundreds of thousands have crammed into an ever-shrinking area to flee airstrikes and advancing Israeli ground forces. The agency reported more cases of upper respiratory infections, diarrhea, lice, scabies, chickenpox, skin rashes and meningitis.

    The war has already killed over 21,500 Palestinians, most of them women and children, according to the Health Ministry in the Hamas-ruled territory. Its count does not distinguish between civilians and combatants. Israel holds Hamas responsible for civilian deaths and injuries, saying the militants embed themselves within civilian infrastructure.

    Israeli officials, meanwhile, have vowed to bring back more than 100 hostages still held by the militants after their Oct. 7 attack on southern Israel that triggered the war. The assault killed some 1,200 people, mostly civilians.

    The military says 168 of its soldiers have been killed since the ground offensive began.

    ___

    Magdy reported from Cairo.

    ___

    Find more of AP’s coverage at https://apnews.com/hub/israel-hamas-war

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  • Pope says he's 'much better' after bout of bronchitis

    Pope says he's 'much better' after bout of bronchitis

    ROME — Pope Francis said Wednesday he was feeling “much better” after a two-week bout of bronchitis but again asked an aide to read his remarks.

    Francis, who had part of one lung removed as a young man, told his weekly general audience that he still gets tired if he speaks too much.

    Francis, who turns 87 on Dec. 17, came down with the flu on Nov. 25 and was forced to cancel a planned trip to Dubai to participate in the U.N. climate conference. He later revealed he had been diagnosed with an acute case of infectious bronchitis that made breathing difficult.

    It was the second time this year he has had a serious case of bronchitis; in spring he was hospitalized for three days to receive intravenous antibiotics.

    Francis walked onto the stage of the Vatican audience hall with his cane Wednesday and smiled broadly at the cheering crowd. He appeared in good spirits and received several prelates who came to speak to him individually at the end of the audience.

    Explaining why he would ask his aide to read his remarks, he said: “I’m much better, but I get tired if I speak too much.”

    Francis then made a brief appeal asking for prayers for all those who are suffering from war, including people in Ukraine, Israel and Gaza.

    “War is always a defeat,” he said. “No one wins, everyone loses. The only ones who win are the weapons makers.”

    To spare him from temperature changes that might aggravate his condition, Francis has delivered his weekly Sunday blessing for the past two weekends from the Vatican chapel rather than the open window of his studio overlooking St. Peter’s Square.

    Nevertheless, the Vatican has confirmed Francis would participate in his annual visit to pray before a statue of the Virgin Mary at Rome’s Piazza di Spagna on Friday to mark an important Catholic feast day and officially kick off the Christmas season in Rome.

    The Vatican said Francis is also planning to add on a visit that day, the Immaculate Conception, to Rome’s St. Mary Major basilica to pray before one of his favorite icons of Mary.

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  • Pope says he's doing better but skips his window appearance facing St. Peter's Square

    Pope says he's doing better but skips his window appearance facing St. Peter's Square

    VATICAN CITY — For a second Sunday, an ailing Pope Francis skipped his popular window appearance to the public in St. Peter’s Square, but in televised remarks said he’s doing better even though his voice wouldn’t let him read all his comments aloud.

    As he did a week earlier, Francis delivered very brief remarks from the chapel of the Vatican hotel where he lives and where he is recovering from what he has said is infectious bronchitis. Thousands of people in the square followed his words from giant screens set up outdoors.

    Francis, whose 87th birthday is later this month, also said he is following from afar the workings of the U.N. climate conference in Dubai. The pontiff was due to go to the COP28 conference on Friday to address the gathering.

    During his first chapel appearance on Nov. 26, he insisted he would make the trip despite his illness. He instead canceled it following his doctors’ orders and stayed at the Vatican, where he has received antibiotics intravenously.

    “Dear brothers and sisters, good day. Also today, I won’t be able to read everything. I’m getting better, but the voice still isn’t” enough to read everything, Francis said. He then passed the microphone to a priest who read prepared remarks, including about the end of the truce in the Israeli-Hamas war.

    “It’s painful that the truce has been broken,” Francis said in the remarks read by the priest. ”That means death, destruction and misery,” the pontiff said. He called for the release of the remaining hostages who were seized from Israel in the Hamas’ Oct. 7 attack, and lamented the lack of basic necessities of life in Gaza after Israel launched its war against Hamas.

    On Thursday, Francis told an audience of health care workers that he was advised against making the Dec. 1-3 trip to the United Arab Emirates because “it’s very hot there, and you go from heat to air conditioning,” Of his current illness, Francis told that audience: “Thank God it wasn’t pneumonia. It’s a very acute, infectious bronchitis.”

    Previously the Vatican had said Francis was suffering from a lung inflammation and the flu. Francis had a previous case of acute bronchitis in the spring, when he was hospitalized for three days so he could receive intravenous antibiotics.

    Francis said that “even from a distance, I am following with great attention the work of COP28 in Dubai. I am close” to the conference. He said he was renewing his appeal so that “climate change is answered by concrete political change.”

    In his Sunday remarks about climate change, Francis urged the end of what he called “bottlenecks” caused by nationalism, and “patterns of the past.” He added: “let’s embrace a common vision, committing all of us and now, without delay, to a necessary global ecological conversion.”

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  • Coal power, traffic, waste burning a toxic smog cocktail in Indonesia’s Jakarta

    Coal power, traffic, waste burning a toxic smog cocktail in Indonesia’s Jakarta

    JAKARTA, Indonesia — Against the backdrop of smokestacks from a nearby coal power plant, the sky above Edy Suryana’s village stays grey for months at a time, while ashes and the stench of smoke hang in the air.

    Suryana has spent more than three decades living in the shadow of the power plant in northern Java, just 60 miles from Jakarta, Indonesia’s most populous city. She and other villagers have watched as their loved ones suffered from coughing fits, itchy skin and other health problems that many believe are partly because of the ever-present smog.

    Pollution is causing a rise in respiratory illnesses and deaths in northern Java, including Jakarta, experts say. Smog in the metropolis of 11.2 million people comes from a combination of the coal-fired plants, vehicle and motorcycle exhaust, trash burning and industries, and many in the city are demanding that the government take action.

    Emissions from coal-fired power plants contribute to greenhouse gases that rise into the atmosphere and help heat the planet, a key focus of the United Nations climate conference, or COP28, which begins next week in Dubai.

    Countries like Indonesia are struggling to balance rising demand to power industrialization with the need to cut carbon emissions and protect public health.

    In 2010 Suryana watched as his sister-in-law died from lung problems. In 2019, the dirty air seemed to worsen his daughter’s bout of tuberculosis.

    “We’ve clearly suffered an impact,” he told The Associated Press.

    Data gathered by IQAir, a Swiss air technology company, regularly ranks Jakarta as one of the most polluted cities in the world. Blue skies are a rare sight and the air often smells like petrol or heavy smoke. Normally healthy residents complain of itchy eyes and sore throats on days when pollution levels soar past levels considered safe by the World Health Organization and Indonesian government.

    Air pollution potentially contributed to more than 10,000 deaths and 5,000 hospitalizations in Jakarta in 2019, according to research conducted by Vital Strategies, a global health public health nongovernmental organization that is headquartered in New York.

    Pollution levels get and stay so high that it’s not safe for people to do outdoor activities without risking short and long-term damage to their health, said Ginanjar Syuhada, a health analyst at Vital Strategies.

    But not everyone is able to stay inside.

    Misnar, a street vendor who spends his days working outdoors — and like many Indonesians only uses one name — went to the hospital on September and spent days in a special air chamber to treat his pneumonia, which was worsened by routinely working outdoors in the polluted air, said Misnar’s eldest daughter, Siti Nurzanah.

    His doctor recommended that Misnar stay home after he left the hospital. But he makes his living selling items on the street. So his only option is to rely on face masks to help filter the dirty air he breathes.

    “I want my father to stay at home. My father is old, 63, the air is bad with his health condition,” Nurzanah said.

    Acute respiratory infections and pneumonia cases have been increasing, according to a spokesperson from Indonesia’s Ministry of Health, who also recognized that Jakarta’s air pollution has exceeded WHO safe limits.

    Data from the Jakarta Health Agency show that the number of residents treated for pneumonia from January to August was more than double the same period the year before, at 9,192 cases.

    The number of patients visiting Jakarta’s Persahabatan Hospital, a national respiratory referral hospital, with acute respiratory infections and pneumonia from January to August likewise doubled.

    The heavy smog takes a toll on the economy.

    “If we calculate it in terms of economic value, it could potentially cause economic losses, from a health perspective, of around 40 trillion rupiah (more than $25.2 billion) a year,” said Syuhada, the health analyst.

    “It’s working age people who suffer symptoms of prolonged coughs and colds,” Feni Fitriani Taufik, a pulmonologist at Persahabatan Hospital told The Associated Press. “They used to have it for only three to five days. Now, after two or three weeks the cough still lingers.”

    Solving the pollution issue is complicated.

    Emissions from burning coal, which is highly polluting but relatively cheap, contribute up to a third of Indonesia’s air pollution according to Siti Nurbaya, Indonesia’s Environmental and Forestry Minster. The country has pledged to cut emissions in coming decades, but it still provides most of Indonesia’s energy needs.

    Millions of vehicles and motorcycles spew emissions as workers commute to and within the city. The Indonesian government has called on residents to use public transportation and has given regulation and financial incentives to residents who want to shift from using gas or diesel-fueled vehicles to electric vehicles.

    Public transport remains limited and electric vehicle uptake has been slow: Transportation Minister Budi Karya Sumadi at a national seminar in September said that there were 26,100 electric vehicles and 79,700 electric motorbikes currently operating in Indonesia in 2022— less than one percent of the over 17.2 million registered cars and 125.2 million motorbikes in Indonesia.

    The government is pushing to have more than 530,000 electric vehicles on the road in Indonesia by 2030.

    To make a real dent in the pollution, the government also needs to tighten regulations for emissions from factories and industries in and near Jakarta, according to research from Vital Strategies.

    “They should. Because industry is contributing 30% to 40% of the air pollution in Jakarta, in addition to emissions from transportation,” Syuhada said.

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  • China says a surge in respiratory illnesses caused by flu and other known pathogens

    China says a surge in respiratory illnesses caused by flu and other known pathogens

    BEIJING — A surge in respiratory illnesses across China that has drawn the attention of the World Health Organization is caused by the flu and other known pathogens and not by a novel virus, the country’s health ministry said Sunday.

    Recent clusters of respiratory infections are caused by an overlap of common viruses such as the influenza virus, rhinoviruses, the respiratory syncytial virus, or RSV, the adenovirus as well as bacteria such as mycoplasma pneumoniae, which is a common culprit for respiratory tract infections, a National Health Commission spokesperson said.

    The ministry called on local authorities to open more fever clinics and promote vaccinations among children and the elderly as the country grapples with a wave of respiratory illnesses in its first full winter since the removal of COVID-19 restrictions.

    “Efforts should be made to increase the opening of relevant clinics and treatment areas, extend service hours and increase the supply of medicines,” said ministry spokesman Mi Feng.

    He advised people to wear masks and called on local authorities to focus on preventing the spread of illnesses in crowded places such as schools and nursing homes.

    The WHO earlier this week formally requested that China provide information about a potentially worrying spike in respiratory illnesses and clusters of pneumonia in children, as mentioned by several media reports and a global infectious disease monitoring service.

    The emergence of new flu strains or other viruses capable of triggering pandemics typically starts with undiagnosed clusters of respiratory illness. Both SARS and COVID-19 were first reported as unusual types of pneumonia.

    Chinese authorities earlier this month blamed the increase in respiratory diseases on the lifting of COVID-19 lockdown restrictions. Other countries also saw a jump in respiratory diseases such as RSV when pandemic restrictions ended.

    The WHO said Chinese health officials on Thursday provided the data it requested during a teleconference. Those showed an increase in hospital admissions of children due to diseases including bacterial infection, RSV, influenza and common cold viruses since October.

    Chinese officials maintained the spike in patients had not overloaded the country’s hospitals, according to the WHO.

    It is rare for the U.N. health agency to publicly ask for more detailed information from countries, as such requests are typically made internally. WHO said it requested further data from China via an international legal mechanism.

    According to internal accounts in China, the outbreaks have swamped some hospitals in northern China, including in Beijing, and health authorities have asked the public to take children with less severe symptoms to clinics and other facilities.

    WHO said that there was too little information at the moment to properly assess the risk of these reported cases of respiratory illness in children.

    Both Chinese authorities and WHO have been accused of a lack of transparency in their initial reports on the COVID-19 pandemic, which started in the central Chinese city of Wuhan in December 2019.

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  • WHO asks China for more information about rise in illnesses and pneumonia clusters

    WHO asks China for more information about rise in illnesses and pneumonia clusters

    GENEVA — The World Health Organization says it has made an official request to China for information about a potentially worrying spike in respiratory illnesses and clusters of pneumonia in children.

    The U.N. health agency cited unspecified media reports and a global infectious disease monitoring service as reporting clusters of undiagnosed pneumonia in children in northern China. In a statement late Wednesday, WHO said it was unclear whether those were linked to a rise in respiratory infections reported by Chinese authorities.

    Outside scientists said the situation warranted close monitoring, but were not convinced that the recent spike in respiratory illnesses in China signaled the start of a new global outbreak.

    The emergence of new flu strains or other viruses capable of triggering pandemics typically starts with undiagnosed clusters of respiratory illness. Both SARS and COVID-19 were first reported as unusual types of pneumonia.

    WHO noted that authorities at China’s National Health Commission on Nov. 13 reported an increase in respiratory diseases, which they said was due to the lifting of COVID-19 lockdown restrictions. Other countries also saw a jump in respiratory diseases such as respiratory syncytial virus, or RSV, when pandemic restrictions ended.

    WHO said media reports about a week later reported clusters of undiagnosed pneumonia in children in northern China.

    “It is unclear if these are associated with the overall increase in respiratory infections previously reported by Chinese authorities, or separate events,” WHO said, adding that it had requested more details from China about currently circulating viruses and any increased burden on hospitals, via an international legal mechanism.

    Dr. David Heymann of the London School of Hygiene and Tropical Medicine said there was a likely background of seasonal respiratory infections.

    “The challenge is to discern the outbreaks and determine the cause,” Heymann said in a statement, adding that genetic sequencing and isolating cases would be critical. He led WHO’s response to the 2002-2003 SARS outbreak.

    Francois Balloux of University College London said the current wave of disease in China was likely due to respiratory illnesses like flu, RSV or a bacterial infection.

    He said China was probably experiencing a significant wave of childhood infections since this was the first winter since lockdown restrictions were lifted, which likely reduced children’s immunity to common bugs.

    “Unless new evidence emerges, there is no reason to suspect the emergence of a novel pathogen,” Balloux said.

    WHO said that northern China has reported a jump in influenza-like illnesses since mid-October compared to the previous three years. It is rare for the U.N. health agency to publicly ask for more detailed information from countries, as such requests are typically made internally.

    The outbreaks have swamped some hospitals in northern China, including in Beijing, and health authorities have asked the public to take children with less severe symptoms to clinics and other facilities.

    The average number of patients in the internal medicine department at Beijing Children’s Hospital topped 7,000 per day, exceeding the hospital’s capacity, state-owned China National Radio said in an online article earlier this week.

    China’s National Health Commission, in a written Q&A posted online by the official Xinhua News Agency, suggested Thursday that children with mild symptoms “first visit primary healthcare institutions or pediatrics departments of general hospitals” because large hospitals are crowded and have long waiting times.

    The health commission said it has been paying close attention to the high incidence of infectious diseases among children and is “guiding local authorities to enhance coordinated scheduling and implement a tiered diagnosis and treatment system.”

    After SARS broke out in southern China in 2002, Beijing officials told doctors to hide patients, with some being driven around in ambulances while WHO scientists were visiting the country. That prompted WHO to threaten to close its office in China.

    Nearly two decades later, China stalled on sharing critical details about the coronavirus with the U.N. health agency after the new virus emerged in late 2019. WHO publicly applauded China’s commitment to stopping the virus — weeks before it started causing explosive epidemics worldwide.

    “While WHO seeks this additional information, we recommend that people in China follow measures to reduce the risk of respiratory illness,” the agency said, advising people to get vaccinated, isolate if they are feeling ill, wear masks if necessary and get medical care as needed.

    ___

    Cheng reported from London. AP researcher Wanqing Chen in Beijing contributed to this report.

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  • Daughter of ex-Thai leader Thaksin says he is fatigued, as criticism grows of his hospitalization

    Daughter of ex-Thai leader Thaksin says he is fatigued, as criticism grows of his hospitalization

    BANGKOK — Former Thai Prime Minister Thaksin Shinawatra is suffering from stress and fatigue but is in good spirits, his daughter said Tuesday as criticism grew of his transfer to a hospital just hours after he began serving an eight-year prison sentence.

    Thaksin, who was ousted in a 2006 military coup, returned to Thailand last week after 15 years of self-imposed exile and was immediately sent to prison over several criminal convictions he has decried as politically motivated.

    Corrections officials said Thaksin, 74, was considered vulnerable due to his age, chronic heart and lung conditions, high blood pressure and back problems. Thaksin, a former police lieutenant colonel, is being treated in a private room at the Police General Hospital, where the director said he was in serious condition with heart and lung problems.

    “My dad was happy to see me, very happy. He’s stressed and tired but he is in good spirits,” Paetongtarn Shinawatra told reporters at the headquarters of populist Pheu Thai party, of which she is a key member. Pheu Thai is the latest in a string of parties affiliated with Thaksin that were founded after he was removed from power and his party dissolved.

    Paetongtarn said after visiting her father in the hospital that he had suffered complications after contracting the coronavirus in 2020 and that she is most worried about his heart condition.

    Hours after Thaksin’s return to Thailand, a Pheu Thai candidate, Srettha Thavisin, won enough votes in Parliament to become prime minister, ending more than three months of uncertainty after national elections.

    To achieve a majority, the party formed a coalition with pro-military parties linked to a coup that removed a Pheu Thai government led by Thaksin’s sister, Yingluck Shinawatra, from power in 2014. It also excluded the progressive Move Forward Party, which won the most votes in the elections, from the coalition.

    It is widely believed that the divisive former leader returned out of hope that a friendly government would reduce his sentence, and that he may have made a deal with authorities, although Thaksin has said his decision had nothing to do with the Pheu Thai party’s bid for power. The outgoing government said Thaksin can request a royal pardon like any other prisoner.

    Paetongtarn said her father will decide when to request a pardon.

    There is growing criticism that Thaksin has received special treatment compared to other inmates, including not having to get a prison-style haircut. His swift transfer to the hospital has prompted calls for proof that he is genuinely sick. A conservative-aligned group of activists went to the hospital last week demanding that it release information about his condition and treatment.

    Asked about the controversy, Paetongtarn replied only that she was worried about him being sick. She said the duration of his stay is up to the medical staff.

    ___

    Associated Press video journalist Jerry Harmer contributed to this report.

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  • Death toll rises to 27 as Dominican firefighters find more bodies in this week’s explosion

    Death toll rises to 27 as Dominican firefighters find more bodies in this week’s explosion

    SANTO DOMINGO, Dominican Republic — The death toll from this week’s powerful explosion in the Dominican Republic rose to 27 on Wednesday as firefighters continued efforts to extinguish the persistent fire set off by the blast, the national emergency director said.

    Juan Manuel Méndez, director of the Center of Emergency Operations, also said there were no longer any people believed missing. Earlier, authorities cited 10 missing but said that would change as forensic officials identified bodies found by search teams.

    Firefighters still have not been able to fully put out the fires in a building where the explosion occurred Monday at a bakery in the city of San Cristobal, which lies just west of the capital of Santo Domingo.

    Anguished friends and family have been pacing outside hospitals and morgues in anger and frustration, saying no one has been providing them information.

    Meanwhile, authorities are probing what might have caused the explosion, vowing to crack down on any business that might not have been following regulations.

    Ito Bisonó, minister of industry and commerce, told reporters that officials already have determined there were no tanks of any type in the area, adding that he is waiting on authorities to investigate what happened.

    “It was of great magnitude,” he said of the explosion.

    Bisonó spoke inside a cathedral in San Cristobal that held a service Wednesday for those who died, with mourners dressed largely in white filling the building to standing room only.

    Méndez, said at a news conference late Tuesday that if an unidentified factory was operating illegally as some residents have alleged, the investigation would shed light on that.

    “If there is some type of culpability or not, the investigation will determine that,” he said. “We will take legal action.”

    At least 59 people were injured in the blast, which occurred in a bustling commercial area in the city’s center and destroyed four buildings and damaged nine others. More than 30 people remain hospitalized with conditions including fractures, burns and respiratory problems. Two firefighters also were treated for smoke inhalation.

    More than 30 ambulances and some 500 personnel including rescuers and officials responded to the incident.

    Toxic smoke still hovered over the explosion site, with health officials urging people to wear face masks.

    San Cristobal, the birthplace of dictator Rafael Trujillo, was the site of another explosion nearly 23 years ago. An arms depot exploded in October 2000, killing at least two people and injured more than two dozen others, forcing authorities to evacuate thousands.

    ___

    Associated Press reporter Dánica Coto reported from San Juan, Puerto Rico.

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  • Searching for the missing on Maui, some wait in agony to make contact. And then the phone rings

    Searching for the missing on Maui, some wait in agony to make contact. And then the phone rings

    WAILUKU, Hawaii — Leshia Wright heard the crackle of the fast-moving inferno closing in on her home in Lahaina and decided it was time to evacuate.

    The 66-year-old grabbed her medication for a pulmonary disease and her passport and fled the subdivision in the historic Hawaii oceanside community just minutes before flames engulfed the neighborhood. Hours later, she called family members and told them she slept in her car.

    Then her phone went dead.

    The next 40 hours were agony for her daughter in New York and sister in Arizona. But early Friday morning, Wright called back and told them she was OK.

    “I’m obviously relieved beyond words that my mother is alive,” said Alexandra Wright, who added that her mother finally was able to charge her phone after reaching a friend’s undamaged house on a quarter-tank of gas.

    The firestorm that killed dozens of people and leveled this historic town launched hundreds of people on a desperate search for their loved ones — many from thousands of miles away — and some are still searching. But amid the tragedy, glimmers of joy and relief broke through for the lucky ones as their mothers, brothers and fathers made it to safety and finally got in touch again.

    Kathleen Llewellyn also worked the phones from thousands of miles away in Bardstown, Kentucky, to find her 71-year-old brother, Jim Caslin, who had lived in Lahaina for 45 years. Her many calls went straight to voicemail.

    “He’s homeless; he lives in a van; he’s got leukemia; he’s got mobility issues and asthma and pulmonary issues,” she said.

    Waiting and calling and waiting more, Llewellyn grew uneasy. Anxiety took hold and then turned to resignation as Llewellyn, a semi-retired attorney, tried to distract herself with work and weeding her garden.

    She recalled thinking, “If this is his end, this is his end. I hope not. But there’s nothing I could do about it.”

    Then her phone rang.

    “I’m fine,” Caslin said. “I’m fine.”

    Caslin told his sister he spent two days escaping the inferno with a friend in a journey that included bumper-to-bumper traffic, road closures, downed trees and power lines and a punctured tire. The pair nervously watched the gas needle drop before a gas station appeared and they pulled into the long line.

    “I am a pretty controlled person, but I did have a good cry,” Llewellyn said.

    Sherrie Esquivel was frantic to find her father, a retired mail carrier in Lahaina, but there was little she could do from her home in Dunn, North Carolina.

    She put her 74-year-old father’s name on a missing person’s list with her phone number and waited.

    “As the days were going on, I’m like, ‘There’s no way that he survived because … how have we not heard from him?’” she said. “I felt so helpless.”

    Early Friday morning, she got a call from her father’s neighbor, who had tracked Thom Leonard down. He was safe at a shelter, but lost everything in the fire, the friend told her.

    It wasn’t until Esquivel read an Associated Press article that she learned exactly how her father survived the fire. He was interviewed Thursday at a shelter on Maui.

    Leonard tried but couldn’t leave Lahaina in his Jeep, so he scrambled to the ocean and hid behind the seawall for hours, dodging hot ash and cinders blowing everywhere.

    “When I heard that, I thought of him when he was in Vietnam, and I thought, ‘Oh, gosh, his PTSD must have kicked in and his survival instincts,’” she said.

    Firefighters eventually escorted Leonard and others out of the burning city.

    Esquivel assumes it’s the same seawall across the street from his home where they took family photos at sunset in January.

    She hoped to speak to her father, whom she described as a “hippie” who refuses to buy a cellphone.

    When they talk, the first words out of her mouth will be: “I love you, but I’m angry that you didn’t get a cellphone,’” Esquivel said.

    Interviewed Friday at the same shelter, Leonard also began to tear up when he heard what his daughter wanted to tell him. “I’m quivering,” he said, adding he loves her too.

    He said he had a flip phone, but didn’t know how to use it.

    ___

    Thiessen reported from Anchorage, Alaska, and Komenda from Tacoma, Washington.

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  • Coal miners plead with feds for stronger enforcement during emotional hearing on black lung rule

    Coal miners plead with feds for stronger enforcement during emotional hearing on black lung rule

    BEAVER, W.Va. — Laboring to breathe, West Virginia coal miner Terry Lilly told federal regulators Thursday he is appreciative the U.S. government is finally considering a proposal to limit the poisonous rock dust causing a severe resurgence of black lung.

    But Lilly said the rule — a half-century in the making — will mean nothing if there aren’t strict enforcement mechanisms in place to ensure companies comply.

    “Cheating the samples is what we need to stop. If we can stop this, we can save some lives,” said Lilly, asking officials to excuse him as a took a pause to catch his breath. He’s now limited to 40% lung capacity, he said.

    Lilly was one of the dozens of miners and advocates who came to the historic coal-mining county in West Virginia’s southern coalfields to discuss a proposed rule from the federal Mine Safety and Health Administration that would cut the current limit for silica dust exposure in half.

    During an emotional, hours-long hearing — the second of three before public comment on the proposal ends next month — miners spoke about their fear of retaliation for speaking up about unsafe dust levels and being asked by companies to help falsify samples. They said the government needs more inspectors to spend more time in the mines making sure existing rules are followed. Otherwise, new regulation won’t make a meaningful difference, they said.

    “When I speak about this, people look at me like I’m stupid,” Lilly, who said miners don’t always feel like the federal government takes their concerns seriously. “I’ve got 30 years of experience. I know the tricks and how they operate.”

    President of the National Black Lung Association Gary Hairston, who lives in neighboring Fayette County, said that too often, miners have to choose between their safety and their livelihood.

    “We can fix this when we start making the coal mining companies responsible for what they’re doing,” said Hairston, becoming emotional speaking into the microphone wearing a “black lung kills shirt. “I wish the coal miner – us – that we would come forward – but we’re scared. In a non-union mine, you ain’t got representation. We know they’ll get rid of us.”

    Silicosis, commonly referred to as black lung, is an occupational pneumoconiosis caused by the inhalation of crystalline silica dust present in minerals like sandstone. The problem has only grown in recent years as miners dig through more layers of rock to get to less accessible coal, generating deadly silica dust in the process. Silica dust is 20 times more toxic than coal dust and causes severe forms of black lung disease even after a few years of exposure.

    An estimated one in five tenured miners in Central Appalachia has black lung disease; one in 20 has the most disabling form of black lung.

    The proposed federal rule, published in the Federal Register last month, cuts the permissible exposure limit for silica dust from 100 to 50 micrograms per cubic meter of air for an 8-hour shift in coal, metal and nonmetal mines such as sand and gravel.

    The proposal is in line with exposure levels imposed by the Occupational Safety and Health Administration on construction and other non-mining industries. And it’s the standard The Centers for Disease Control was recommending as far back as 1974.

    Old wounds over mine safety run deep in West Virginia’s southern coalfields, where thousands of miners 100 years ago marched to unionize in the Battle of Blair Mountain, the largest armed uprising in the United States since the Civil War.

    In the 1940s and 1950s, roughly half of West Virginia workers were employed in heavy industries like coal, steel and glass, and the majority of those workers belonged to a union. By 2022, however, only 10% of West Virginia workers were represented by unions, according to the U.S. Department of Labor.

    Hairston said that with the waning of union representation, miners have lost advocates they could rely on ensure regulations are being enforced.

    Attorney Sam Petsonk, who has represented coal miners who were diagnosed with black lung after companies violated safety violations, said a silica rule is long overdue. But he is concerned that the rule requires no routine sampling and contains no specific monetary penalties for exceeding silica dust limits.

    The rule also allows miners to work in higher-than-allowable levels of dust on a temporary basis if they wear respirators and companies are working on bringing exposure down to safer levels. Petsonk said respirators are ineffective while performing heavy labor in hot, confined spaces, and that inspectors are not present enough to ensure they don’t become a permanent solution.

    The National Mining Association has said it would like to see respiratory protection equipment be used as a method of compliance with the rule.

    The organization, which represents operators, said in a statement last month that ventilation controls, strict adherence to mine ventilation control plans, increased operator and miner safety awareness, and a 2014 rule regulating coal dust have “all contributed to exponentially lower dust levels inside the mine.”

    Mine, Safety and Health Administration Deputy Secretary Patricia Silvey said if inspectors see evidence of overexposure, operators will have to take immediate “corrective action,” which could mean implementing engineering controls. The government makes a record of the infraction and ensures retesting to make sure the action is working, she said.

    Willie Dodson, Central Appalachian field coordinator for advocacy group Appalachian Voices, said the nation has a current epidemic of black lung now that is “built in part on the current enforcement mechanisms and deficiencies.”

    “If MSHA gets this wrong, we will look back on this process as its own sort of tragedy — a moment when we came close to doing right by coal miners, but ultimately failed them,” he said.

    United Mine Workers of America Director of Occupational Health and Safety Josh Roberts asked regulators to look at the proposed rule and ask this: “Does this section open the door for cheating or gaming the system?”

    “Everybody wants the rule to be the best that it can be this go-round because you might not get another bite at the apple for a long time,” he said.

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  • Closure of 3 Southern California power plants likely to be postponed, state energy officials decide

    Closure of 3 Southern California power plants likely to be postponed, state energy officials decide

    SACRAMENTO, Calif. — Temperatures in many California cities are cooling down this week, but a debate is simmering on how to generate enough electricity to power the state through extreme weather events while transitioning away from a reliance on fossil fuels.

    The California Energy Commission voted Wednesday to extend the life of three gas power plants along the state’s southern coast through 2026, postponing a shutoff deadline previously set for the end of this year. The vote would keep the decades-old facilities — Ormond Beach Generating Station, AES Alamitos and AES Huntington Beach — open so they can run during emergencies.

    The state is at a greater risk of blackouts during major events when many Californians simultaneously crank up their air conditioning, such as a blistering heat wave.

    “We need to move faster in incorporating renewable energy. We need to move faster at incorporating battery storage. We need to build out chargers faster,” commissioner Patricia Monahan said. “We’re working with all the energy institutions to do that, but we are not there yet.”

    The plan, put together by the state’s Department of Water Resources, still needs final approval from the State Water Resources Control Board, which may vote on the issue next week. Democratic Gov. Gavin Newsom signed legislation last year creating an energy reserve the state could use as a last resort if there is likely to be an energy shortage. The law allowed the Department of Water Resources to fund or secure power sources in those instances.

    The commission acknowledged it was a difficult decision. Environmentalists say the state needs to transition to more short- and long-term solutions that will help it move away from fossil fuels and to rely more on renewable energy sources like solar and wind. They’re also concerned about the health impacts associated with pollution from gas plants.

    Few people spoke in support of keeping the plants open during about three hours of public comment.

    Neither GenOn, the company running the Ormond Beach plant, nor AES, which runs the Alamitos and Huntington Beach plants, responded to email requests for comment on the vote.

    At Wednesday’s meeting, activists said residents cannot be sure the state will not decide to again extend the life of these plants in another three years. Siva Gunda, the commission’s vice-chair, said the state should better prepare a strategy for ending operations of the plants by 2026.

    The three plants were originally set to shut down in 2020 under state regulations aimed at power plants that suck up ocean water to cool down their equipment. Many similar power plants have already shut down to comply with those rules.

    The Ormond Beach plant is located in a largely Latino, low-income part of Oxnard, a city about 54 miles (87 kilometers) west of Los Angeles, next to agricultural fields that border homes. Oxnard residents who testified at the meeting said they are concerned about respiratory illnesses associated with pollution from gas facilities, as well as odors and noises coming from the plant.

    “We are tired of fighting for our human right to breathe clean air,” said Oxnard resident and activist Sofi Magallon.

    Newsom said earlier this year that the state would have enough water in its reservoirs from intense periods of snow and rain this past winter to revive hydroelectric plants, which reduces the chances of electricity outages during heat waves.

    Emissions from the three plants dramatically increased during a record-breaking September heat wave, according to a report released by Regenerate California, a coalition of environmental groups. That included pollution from carbon and smog-forming nitrogen oxides. The report also cites data from the state showing that several gas plants didn’t generate as much electricity as expected during the heat wave.

    “They’re not providing the energy that we’re relying on them for. They’re overpromising and underdelivering,” said Ari Eisenstadt, an energy equity manager with the California Environmental Justice Alliance. “That makes them a pretty bad investment.”

    California has made strides in recent years to move toward renewables. In 2021, more than 37% of the state’s electricity came from renewable sources, up nearly 3% from the previous year, according to the Energy Commission. The state has set out to remove as many carbon emissions from the atmosphere as it emits by 2045.

    But environmentalists still want California to speed up its transition toward renewables like solar and wind. In the meantime, the state should spend “much more ambitiously” to fund programs incentivizing people to reduce their energy use, so resources are not strained during extreme heat, said Teresa Cheng, a campaigner with Sierra Club.

    That includes a statewide program to pay people to conserve energy during peak electricity times.

    During last September’s heat wave, Newsom issued something called a Flex Alert, which asked Californians to use less energy during the evenings in part by setting their thermostats to 78 degrees Fahrenheit (26 degrees Celsius) or higher. The result was a dramatic reduction in reliance on the grid, Cheng said.

    Cheng said the state keeps depending on being able to use gas plants as a crutch.

    “As long as we have these gas plants online, we never really have to invest in clean energy solutions,” Cheng said.

    ___

    Sophie Austin is a corps member for the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues. Follow Austin on Twitter: @sophieadanna.

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  • After decades of delays and broken promises, coal miners hail rule to slow rise of black lung

    After decades of delays and broken promises, coal miners hail rule to slow rise of black lung

    CHARLESTON, W.Va. — A half-century ago, the nation’s top health experts urged the federal agency in charge of mine safety to adopt strict rules protecting miners from poisonous rock dust.

    The inaction since — fueled by denials and lobbying from coal and other industries — has contributed to the premature deaths of thousands of miners from pneumoconiosis, more commonly known as “black lung.” The problem has only grown in recent years as miners dig through more layers of rock to get to less accessible coal, generating deadly silica dust in the process.

    One former regulator called the lack of protection from silica-related illnesses “stunning” and one of the most “catastrophic” occupational health failures in U.S. history.

    Now the federal Mine Safety and Health Administration has proposed a rule that would cut the current limit for silica exposure in half — a major victory for safety advocates. But there is skepticism and concern about the government following through after years of broken promises and delays.

    James Bounds, a retired coal miner from Oak Hill, West Virginia, said nothing can be done to reverse the debilitating illness he was diagnosed with at 37 in 1984. But he doesn’t want others to suffer the same fate.

    “It’s not going to help me — I’m through mining,” said Bounds, 75, who now uses supplemental oxygen to breathe. “But we don’t want these young kids breathing like we do.”

    The rule, published in the Federal Register this month, cuts the permissible exposure limit for silica dust from 100 to 50 micrograms per cubic meter of air for an 8-hour shift in coal, metal and nonmetal mines such as sand and gravel.

    The proposal is in line with exposure levels imposed by the Occupational Safety and Health Administration on construction and other non-mining industries. And it’s the standard The Centers for Disease Control was recommending as far back as 1974.

    Silicosis is an occupational pneumoconiosis caused by the inhalation of crystalline silica dust present in minerals like sandstone. The U.S. Department of Labor began studying silica and its impact on workers’ health in the 1930s, but the focus on stopping exposure in the workplace largely bypassed coal miners.

    Instead, regulations centered on coal dust, a separate hazard created by crushing or pulverizing coal rock that also contributes to black lung.

    In the decades since, silica dust has become a major problem as Appalachian miners cut through layers of sandstone to reach less accessible coal seams in mountaintop mines where coal closer to the surface has long been tapped. Silica dust is 20 times more toxic than coal dust and causes severe forms of black lung disease even after a few years of exposure.

    An estimated one in five tenured miners in Central Appalachia has black lung disease; one in 20 has the most disabling form of black lung.

    Miners are also being diagnosed at younger ages — some in their 30s and others with the advanced kind in their 40s. “That’s just nuts,” said Dr. Carl Werntz, a West Virginia physician who conducts black lung examinations and described cases as “skyrocketing.”

    United Mine Workers of America President Cecil Roberts said there’s no reason a 35-year-old miner should be diagnosed with a disease “that’s going to cost him his life.”

    “Nobody should be dying because of a job they have,” Roberts said.

    MSHA’s existing silica standards were developed in the 1970s, around the time of the U.S. Coal Mine Health and Safety Act of 1969 and the Federal Mine Safety and Health Act of 1977.

    West Virginia University law professor Pat McGinley, who was part of a state team investigating the 2010 Upper Big Branch mining disaster that killed 29 miners, called the resurgence of black lung “unparalleled” when it comes to occupational health failures. In the Upper Big Branch mine, 71% of the 24 miners who received autopsies were found to have black lung.

    “I can’t think of any occupation where there has been such devastation that’s been ignored” by corporations and the government, he said. “It’s stunning.”

    The new rule is supported by Democratic Sens. Joe Manchin of West Virginia, Sherrod Brown of Ohio, Bob Casey and John Fetterman of Pennsylvania, and Mark Warner and Tim Kaine of Virginia, who pushed for the change and released a joint statement saying protecting miners from “dangerous levels of silica cannot wait.”

    MSHA will be collecting comments on the proposal through Aug. 28, with three hearings scheduled in Arlington, Virginia, Beckley, West Virginia, and Denver.

    One issue expected to come up: the use of respiratory protection equipment.

    The National Mining Association, which represents mine operators, wants workers to be permitted to use respirators as a method of compliance with the rule.

    “These are recognized industrial hygiene practices utilized by″ federal regulators in other industries, “but not in mining,″ spokesman Conor Bernstein said, adding that better ventilation controls, safety awareness and regulations on coal dust have all contributed to ”exponentially lower dust levels” inside U.S. mines in recent years.

    The mine workers’ union and others, however, say respirators are ineffective while performing heavy labor in hot, confined spaces common in mines. The proposed rule allows for the use of respirators on a temporary basis while operators are implementing engineering controls. But advocates say inspectors aren’t present often enough to ensure they don’t become a permanent solution.

    “The history of miner safety and health enforcement teaches us that exceptions become the rule,” said Sam Petsonk, a West Virginia attorney who represented miners who were diagnosed with black lung after operators knowingly violated regulations.

    The proposed rule also includes a provision that allows companies to self-report silica levels. Federal inspectors conduct spot checks to ensure accuracy, but mine operators still have leeway to manipulate reporting data, said Willie Dodson, Central Appalachian field coordinator for Appalachian Voices, an advocacy group.

    “Ideally, MSHA inspectors would take samples day after day after day in a given mine to determine compliance,″ he said.

    A coal dust examiner who worked for a Kentucky mining company was sentenced to six months in prison last month for falsifying dust samples and lying to federal officials.

    In rural Nickelsville, Virginia, near the Tennessee border, Vonda Robinson says miners and their families are owed more accountability from the federal government and mine operators. Her husband John was diagnosed with black lung about a decade ago at 47. Now, his doctors say he will need a lung transplant.

    Vonda Robinson said her husband doesn’t know what to say when his 5-year-old granddaughter asks why he can’t run and play with her, why even walking down the end of the driveway leaves him physically spent.

    “He’ll tell her ‘Honey, papaw can’t do that,’ ” she said.

    During his 28 years mining, John Robinson would come home with his face covered with dust. But she tried not to worry. Everyone in the community mined coal.

    “He was one of those that wanted to go in the mines to give his family the American dream — the nice house, vehicles, put our kids through college,” she said. “And this is what he got.”

    ___

    Daly reported from Washington.

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  • Canada wildfires are leading to air-quality alerts in US. Here’s how to stay safe

    Canada wildfires are leading to air-quality alerts in US. Here’s how to stay safe

    Canada is dealing with a series of intense wildfires that have spread from the western provinces to Quebec, with hundreds of forest fires burning. The smoke has traveled into the United States, resulting in a number of air quality alerts issued since May.

    On Tuesday, the U.S. Environmental Protection Agency issued a poor air quality alert for New England, a day after parts of Illinois, Wisconsin and Minnesota received a similar advisory. Last week, U.S. officials as far south as Maryland, Baltimore, Virginia and Pennsylvania reported being impacted by the wildfires.

    Here’s a summary of what’s being evaluated and some suggested precautions:

    WHAT’S HAPPENING?

    Smoke from Canada’s wildfires has been moving into the United States since last month. The most recent fires near Quebec have been burning for at least several days.

    The EPA said hazy skies, reduced visibility and the odor of burning wood are likely, and that the smoke will linger for a few days in New England.

    “It’s not unusual for us to get fire smoke in our area. It’s very typical in terms of northwest Canada,” said Darren Austin, a meteorologist and senior air quality specialist with the Rhode Island Department of Environmental Management. But the smoke usually has been aloft and doesn’t affect people’s health, he said.

    The Quebec-area fires are big and relatively close, about 500 to 600 miles (roughly 800 to 970 kilometers) away from Rhode Island. And they followed wildfires in Nova Scotia, which resulted in a short-lived air quality alert on May 30, Austin said.

    WHAT’S THE BIGGEST CONCERN?

    Air quality alerts are triggered by a number of factors, including the detection of fine-particle pollution — known as “PM 2.5” — which can irritate the lungs.

    “We have defenses in our upper airway to trap larger particles and prevent them from getting down into the lungs. These are sort of the right size to get past those defenses,” said Dr. David Hill, a pulmonologist in Waterbury, Connecticut, and a member of the American Lung Association’s National Board of Directors. “When those particles get down into the respiratory space, they cause the body to have an inflammatory reaction to them.”

    Trent Ford, the state climatologist in Illinois, said the atmospheric conditions in the upper Midwest creating dry, warm weather made it possible for small particulates to travel hundreds of miles from the Canadian wildfires and linger for days.

    “It’s a good example of how complex the climate system is but also how connected it is,” Ford said.

    WHO SHOULD BE CAREFUL?

    Exposure to elevated fine particle pollution levels can affect the lungs and heart.

    The air quality alerts caution “sensitive groups,” a big category that includes children, older adults, and people with lung diseases, such as asthma and chronic obstructive pulmonary disease.

    Kids, who often are encouraged to go out and play, “are more susceptible to smoke for a number of reasons,” said Laura Kate Bender, the lung association’s National Assistant Vice President, healthy air. “Their lungs are still developing, they breathe in more air per unit of body weight.”

    WHAT CAN YOU DO FOR NOW?

    It’s a good time to put off that yard work and outdoor exercise. If you go out, consider wearing an N95 mask to reduce your exposure to pollutants.

    Stay inside, keeping your doors, windows and fireplaces shut. It’s recommended that you run the air conditioning on a recirculation setting.

    “If you have filters on your home HVAC system, you should make sure they’re up to date and high quality,” Hill said. “Some people, particularly those with underlying lung disease, or heart disease, should consider investing in in air purifiers for their homes.”

    ____

    Associated Press reporter Katie Foody in Chicago contributed to this story.

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