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2010 was marked by a recall of eggs, drug warnings and progress on flu vaccines

Tuesday, February 8, 2011; E02

Anationwide recall of eggs in August left many of us wondering about the safety of our food. New restrictions placed on a popular diabetes drug in September raised questions about medication safety. And editorials this past year in major medical journals on the alarming increase in radiation exposure from imaging tests were a wake-up call about the risks posed by the technology. But we did learn from these problems, and not all the news during 2010 was bad. Health-care reform, which started taking effect this past summer, will improve access to treatment and insurance. And public-health officials were ahead of the flu this year, with new and possibly better vaccines. Here are some of the health-related highlights from the past year:

New food protections

The outbreak of salmonella from tainted eggs, which sickened more than 1,900 people, is a small part of the food-safety problem. About 48 million people in the United States get food-borne illnesses each year, 128,000 are hospitalized and 3,000 die.

New regulations offer some hope. In December, the Senate passed the Food Safety Modernization Act, a major overhaul of the laws enforced by the Food and Drug Administration.

Drug warnings

Proton pump inhibitors (PPIs). The FDA warned last spring that these acid-reducing drugs, including esomeprazole (Nexium) and omeprazole (Prilosec and its generic kin) might raise the risk of fractures if taken in high doses or over long periods. Other research suggests that PPIs increase the risk of bacterial infections and interfere with the blood thinner clopidogrel (Plavix).

l Consumer Reports' take: Occasional use of PPIs is probably safe, but they shouldn't be used routinely for normal indigestion.

Rosiglitazone (Avandia). Concerns about the risk of heart attacks and strokes posed by this diabetes drug prompted the FDA to limit its use to the very few people who have not responded to any other diabetes medication.

l Consumer Reports' take: Generic metformin, alone or with glimepiride or glipizide, should be the first choice for most people with Type 2 diabetes. These inexpensive drugs are safe and effective.

Sibutramine (Meridia). In September, a study in the New England Journal of Medicine found that this weight-loss drug was only minimally effective and increased the risk of heart attacks and strokes in people with certain heart problems. In October, the company agreed to remove it from the market.

l Consumer Reports' take: If you still have sibutramine in your medicine cabinet, throw it out.

Simvastatin (Zocor and generic substitutes). The FDA warned that the maximum recommended dose of 80 milligrams of this cholesterol-lowering drug could cause muscle damage.

l Consumer Reports' take: High doses of any statin can cause muscle pain or, in rare cases, a dangerous form of muscle breakdown called rhabdomyolysis. So start with the lowest effective dose, and tell your doctor if you have even mild muscle pain.

Concerns about testing

Medical imaging can be lifesaving, but computed-tomographic (CT) scans and other tests also pose risks. The average radiation dose from medical imaging is estimated to be six times higher now than it was a few decades ago.

During 2010, the FDA issued warnings to the industry and to the public about potentially excessive radiation exposure. Such exposure increases cancer risk, especially in younger people and women.

For example, CT scans of the heart cause one cancer for every 270 40-year-old women who undergo the test, researchers estimate. Yet in a study of CT scans investigating abdominal, hip or pelvic pain, only 9 percent of emergency-room doctors knew that the scans increased cancer risk.

To reduce unnecessary imaging, ask about alternatives and avoid duplicate tests.

Better flu vaccines

Current vaccines protect against the most prevalent flu strains, including last year's H1N1 (swine) strain. The Centers for Disease Control and Prevention now recommends that everyone age 6 months and older get vaccinated annually. That's especially important for people at high risk, such as those 50 and older, people with chronic medical conditions and anyone who lives with or cares for others who are at high risk.

Another change is the availability of Fluzone High-Dose for people 65 and older.

Because immune response diminishes with age, the standard vaccine is less likely to cause enough of a response to provide complete coverage in old people. The new vaccine contains four times the amount of immune-stimulating antigen, so people who get it will produce more flu antibodies.

(c) Copyright 2010. Consumers Union of United States Inc.

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