News in brief - Feb. 23, 2004

Premature birth rate on the rise - HT linked to breast cancer recurrence - HHS to establish quitline network - Overnight noise levels at hospitals as loud as jackhammers

Premature birth rate on the rise

The March of Dimes expressed alarm this month after a report issued by the Centers for Disease Control and Prevention noted a 14% increase in premature births since 1990 and a 29% increase since 1981. Much of the jump was related to the growing number of multiple births, although the preterm rate for single births also rose 7%.

"Premature birth is now the most common, serious and costly infant health problem facing our nation," said Jennifer L. Howse, PhD, president of the organization.

The report, "Births: Final Data for 2002," published in December 2003, found that the increase was mainly for infants born between 32 and 36 weeks of gestation. The rate for infants born before 32 weeks has not changed. Mothers younger than 15 and older than 45 were most likely to give birth early, as were African-Americans.

HT linked to breast cancer recurrence

A Swedish study looking at the impact of hormone therapy on breast cancer survivors has been suspended early because researchers noticed an increase in recurrence for the disease, according to a research letter published in The Lancet this month.

The HABITS trial, "Hormonal replacement therapy after breast cancer diagnosis -- is it safe?" was intended to be a five-year trial but was ended in September 2003 after only two years because 26 out of 174 women receiving HT had a breast cancer recurrence. This number is compared to seven out of 171 in the control group who had a recurrence.

Subgroup analysis according to receptor status, tamoxifen treatment and use of HT before the study began did not result in statistical significance for any of these factors, although there was some indication that those with hormone receptor-positive cancers may have been at higher risk. Researchers cautioned, however, that the numbers were too small to draw conclusions on that matter.

Researchers intend to continue following the subjects for the full five years even though the trial has officially been stopped.

HHS to establish quitline network

A national network of smoking cessation "quitlines" is being established by the Dept. of Health and Human Services featuring a new toll-free telephone number -- not yet designated -- to provide a single access point to state quitlines. Thirty-eight states currently provide information, advice, support and referrals to smokers trying to kick their habits.

These states will receive increased federal funding to enhance their services, according to a Feb. 3 HHS announcement.

States that do not have quitlines will receive grants to establish them. In the meantime, counselors from the National Cancer Institute Cancer Information Service will provide assistance to individuals in those states.

About three out of four U.S. smokers say they want to quit, but fewer than 5% of smokers who quit for at least a day are able to stay tobacco-free for three to 12 months, said HHS. Success rates increase dramatically when smokers use evidence-based treatments such as physician advice, FDA-approved medications or telephone counseling.

Overnight noise levels at hospitals as loud as jackhammers

Patients in need of rest to recuperate from surgery should perhaps be provided with earplugs for their hospital stays, according to Mayo Clinic research, which was published in the February issue of the American Journal of Nursing.

Researchers measured the decibel levels in empty patient hospital rooms from 10 p.m. to 7 a.m. and also spent a night in the hospital. Conditions in the rooms mimicked those typically experienced by a thoracic surgery patient.

"We wanted to experience the patient's perspective, so we became patients for one night," said Cheryl Cmiel, RN, the lead author on the paper. "We got an earful."

Peak noise levels were measure at 113 decibels, roughly the equivalent to the noise of a chainsaw or a jackhammer. Those noises came at the time of the morning shift change, around 7 a.m., although the 11 p.m. shift change was also noisy.

Among the suggested changes to address noise levels: change the staff reporting site at shift changes to an enclosed room rather than the nurses station; place foam rubber padding in the chart holders outside patient rooms and in the pneumatic tube document-delivery system; replace roll-type paper towel dispensers with silent folded-towel dispensers; routinely close the doors to patients' rooms and use flashlights, not the overhead lights, when entering rooms.