Health
An Invisible Medical Shortage: Oxygen
At the height of the Covid-19 pandemic, millions of people in poor nations died literally gasping for breath, even in hospitals. What they lacked was medical oxygen, which is in short supply in much of the world.
On Monday, a panel of experts published a comprehensive report on the shortage. Each year, the report noted, more than 370 million people worldwide need oxygen as part of their medical care, but fewer than 1 in 3 receive it, jeopardizing the health and lives of those who do not. Access to safe and affordable medical oxygen is especially limited in low- and middle-income nations.
“The need is very urgent,” said Dr. Hamish Graham, a pediatrician and a lead author of the report. “We know that there’s more epidemics coming, and there’ll be another pandemic, probably like Covid, within the next 15 to 20 years.”
The report, published in The Lancet Global Health, comes just weeks after the Trump administration froze foreign aid programs, including some that could improve access to oxygen.
Boosting the availability of medical oxygen would require an investment of about $6.8 billion, the report noted. “Within the current climate, that’s obviously going to become a bit more of a challenge,” said Carina King, an infectious disease epidemiologist at the Karolinska Institute and a lead author of the report.
Still, she said, governments and funding organizations should prioritize medical oxygen because of its importance across health care. People of all ages may need oxygen for pneumonia and other respiratory conditions, for severe infections including malaria and sepsis, for surgeries and for chronic lung conditions.
“We’re not pitting oxygen against other priorities, but rather that it should be embedded within all of those programs and within those priorities,” Dr. King said. “It’s completely fundamental to a functioning health system.”
Medical oxygen has been used for more than 100 years, often for treating patients with pneumonia. But it was added to the World Health Organization’s Essential Medicines List only in 2017.
Early in the Covid-19 pandemic, Every Breath Counts, a coalition of more than 50 organizations, pushed for increased access to medical oxygen. By the end of 2022, an emergency task force had mobilized more than $1 billion worth of medical oxygen equipment and supplies to more than 100 countries.
One country that has made substantial investment in improving oxygen access is Nigeria, which had taken steps in that direction even before Covid.
Nigeria has set up about 20 cost-effective plants for generating oxygen on-site for hospitals, and is exploring liquid oxygen plants that can supply large swaths of urban areas, said Dr. Muhammad Ali Pate, the country’s minister of health and social welfare.
Many hospitals do not have systems that can deliver oxygen reliably, “so that is sort of a design and a legacy issue that we have to deal with,” he said. “There’s more that needs to be done.”
Modifying hospital systems to deliver oxygen can pose engineering and market issues, and delivering oxygen requires infrastructure that can transport heavy oxygen tanks for long distances.
Even once oxygen supply is assured, the equipment to deliver the oxygen directly to patients must be routinely maintained and cleaned, and spare parts may take months to be delivered. Health care workers must be trained to use the equipment effectively.
“We’ve seen so much investment in equipment, but very little investment in how to operationalize that equipment sustainably,” Dr. King said.
Health care facilities also require pulse oximeters to screen and monitor blood oxygen levels during treatment. But in low- and middle-income countries, pulse oximetry is used in fewer than 1 in 5 patients in general hospitals, and it’s almost never used at primary health care facilities, according to the report.
The panel included testimonials from patients, families and health care workers who have struggled with the oxygen shortage. In Sierra Leone, before the Covid-19 pandemic, only one public hospital in the entire country had a functioning oxygen plant, resulting in thousands of avoidable deaths. In Pakistan, a man with a chronic lung condition said that he stayed indoors and avoided stairs to prevent his lungs from rupturing under the strain. He had to borrow money from friends and family to pay the $18,000 cost of treatment at home.
In Ethiopia, a doctor was forced to take oxygen away from one patient to treat another who was more desperately ill. “It was very heartbreaking trying to decide who lives and who dies,” he said.
Health
Common nighttime noise exposure may trigger heart problems, study suggests
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Living near heavy traffic could negatively impact your heart health.
A European study, published in the journal Environmental Research, found that exposure to nighttime road traffic noise is linked to changes in the blood, leading to worsened cholesterol and cardiovascular risks.
The researchers considered data from the U.K. Biobank, Rotterdam Study, and Northern Finland Birth Cohort 1966, including more than 272,000 adults over the age of 30, according to a press release.
Nighttime road noise exposure was estimated at all participants’ homes based on national noise maps. Researchers also took blood samples to measure the participants’ metabolic biomarkers for disease, then mapped the link between nightly noise levels and existence of biomarkers.
Exposure to loud noise was associated with increased concentrations of cholesterol-related biomarkers. (iStock)
The study found that people exposed to louder noise at night — especially sounds above 55 decibels — showed changes in 48 different substances in their blood. Twenty of these associations “remained robust” throughout all cohorts.
Exposure to loud noise was associated with increased concentrations of cholesterol-related biomarkers, especially LDL “bad” cholesterol, IDL (intermediate-density lipoprotein) and unsaturated fatty acids.
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As noise levels increased, starting at around 50 decibels, cholesterol markers rose steadily, the release stated.
The authors concluded that this study “provides evidence that nighttime road traffic noise exposure from 50 dB upward is associated with alterations in blood cholesterol and lipid profiles in adults.”
Researchers noted a link between traffic noise and cardiometabolic disease. (iStock)
Study co-author Yiyan He, doctoral researcher at the University of Oulu in Finland, noted that in this type of research, small effect sizes are expected, and environmental exposures such as traffic noise are “typically modest.”
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“Despite this, we observed statistically robust and consistent associations across many biomarkers, especially those related to LDL and IDL lipoproteins,” she told Fox News Digital.
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“We also identified a clear exposure-response pattern starting at around 50 dB, suggesting that metabolic changes become more evident as noise levels increase.”
This aligns with public health guidance, as the World Health Organization recommends lower nighttime noise limits at around 40 to 45 dB, Yiyan He added.
“This finding may clarify the association between traffic noise and cardiometabolic diseases,” the researchers wrote. (iStock)
“The 55 dB level is often used as an interim benchmark associated with substantial noise annoyance and sleep disturbance,” she said. “In our study, we observed associations not only at 55 dB, but also indications of effects emerging at around 50 dB.”
The strength and consistency of the cholesterol-related associations were surprising, as these changes are usually “subtle.”
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“Instead, we found consistent associations across multiple large European cohorts, which strengthens confidence that the findings may reflect real biological patterns,” Yiyan He went on. “We were also interested to see that effects were minimal below ~50 dB, suggesting a possible threshold-like pattern.”
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The researcher noted that these findings were consistent across genders, education levels and obesity status.
The study was restricted to White Europeans, which posed a limitation. There was also a lack of information on the fasting status in the UK Biobank.
Changes in cholesterol levels were more severe than researchers expected. (iStock)
“Fasting can influence levels of certain metabolites, particularly fatty acids,” Yiyan He said. “However, based on UK Biobank documentation, fewer than 10% of participants were fasting for at least eight hours, and our main findings focused on cholesterol-related biomarkers, which are generally less sensitive to short-term fasting.”
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The researchers also lacked information on bedroom location, indoor noise exposure and time spent at home.
“These factors may introduce non-differential exposure misclassification,” Yiyan He said. “Additionally, noise exposure estimates were based on participants’ temporary residential addresses at the time of blood sampling, without considering the duration of residence.”
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“Many of these limitations would tend to bias results toward the null, so the consistent associations we observed remain noteworthy.”
Experts recommend taking measures to limit traffic noise at night. (iStock)
Based on this latest research, Yiyan He noted that nighttime noise is a “health-relevant exposure,” not just “an annoyance.”
“Our findings suggest that nighttime traffic noise may subtly but consistently affect metabolic health,” she said. “While the changes in cholesterol and lipid levels for any one individual are small, traffic noise affects a very large number of people, which means the potential public health impact could be substantial.”
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The researcher recommends taking measures like improving sound insulation, using noise-reducing strategies and placing bedrooms on the quieter side of the home when possible.
“Because sleep is a key pathway linking noise to health, protecting the nighttime sleep environment is especially important,” she added.
Health
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