Newsletter Issues 4

7/27/2019 Newsletter Issues 4

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AirpollutionandCancer

HikeforHealth:AnExperienceofanElixirian

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2 I Richa Bajimaya Memorial Foundation Newsletter

AIR POLLUTION ANDCANCER: WHAT DO WEKNOW ABOUT IT?

Air pollution in the past

Since the beginning of the industrial

revolution, effects of toxic compounds

released by the factories of Europe

and U.S.A. became evident to most

of the population living in industrial

areas. The use of coal as a source of

energy contributed to high emissions of

substances causing pulmonary diseases

to workers and inhabitants. Over the

centuries, industrial plants were gradually

located outside urban areas, hence

reducing their impact on the population.

Since the second half of the last century,

important improvements in the processes

and in the treatment of emissions have

been achieved, with consequent positive

effects on the population. However,

the contemporary development of new

industrial activities, the increase of roadtraffic, and the introduction of new

products in agriculture and in buildings

did not enhance the healthiness of urban

areas.

Hidden sources ofcarcinogenic air pollutants

The environmental legislation of

many countries has tried to face this

situation and impose more and morestringent regulations to limit the level

of pollution in urban areas. But, some

Marco Schiavon,

PhD researcher at University of Trento, Italy

[email protected]

local situations are still a matter of

concern, especially because of the large

number of emission sources and since a

wide and deep control of air pollution

is difficult to be achieved. Nowadays,

some activities, which have never

drawn the attention on their potential

impact in terms of effects on the human

health, are worth special consideration

because of their hidden dangerousness.For instance, road traffic is a known

source of air pollution, but maybe

only few people are aware of the fact

that fuel filling stations are even more

important sources of carcinogenic

compounds. Some recent scientific

studies focused on the level of pollution

found near fuel filling stations and

demonstrated that some pollutants

exceed the limits by 10 times. Benzene

and ethylbenzene are two of the most

toxic compounds released by the pumpsof fuel filling stations. Moreover, these

two compounds can induce cancer in

people that are exposed for years to

these pollutants.

There are also some practices whose

carcinogenic potential has rarely been

taken into consideration. Such practices

are usually depicted as sustainable

in developed countries and ofen used

as the main source of energy in many

developing countries. This is the case of

wood burning, which is an underrated

source of particles and carcinogenic

compounds, such as benzene and

dioxins. The later is known as one of the

most important cancer promoter. People

are exposed to the emissions from

wood burning both outside and inside

their houses, especially if stoves and

fireplaces are open. In many developing

countries, peat and manure are

frequently used instead of wood; in this

case, the emissions of toxic compounds

are even higher.

The problem of asbestos, a building

material widely used in the past, emerged

in the United Kingdom more than 80

years ago, when studies demonstrated

the link between the inhalation of this

material and lung cancer. Unfortunately,

even though its production is now

forbidden, this material is still in use in

building and its remediation requires

hard work and a large amount of money.

Thus, asbestos is still an actual problemin many contexts, both in developing and

developed countries.

Air pollution: not only amater of inhalatio n

Air pollution is a ubiquitous problem and

should not be seen as a mere urban issue.

Indeed, air pollutants are ofen intended

as toxic compounds we can inhale by

breathing polluted air, but inhalation

is not the only pathway of exposure to

these compounds. Several substances,once emited into the atmosphere, tend

to aggregate into particles and deposit

to soil, grass, leaves and cultivations

of vegetables and fruit. Afer reaching

these targets, such pollutants can be

adsorbed into the tissues of vegetables,

cereals and fruit and can be ingested by

the humans through the diet. Moreover,

when depositing in to soil, grass or

leaves, these compounds can be ingested

by grazing animals. The transport chain

would probably stop at this stage if somecompounds were not able to persist in

the environment and in the fat tissues of

animals. These substances are known as

Persistent Organic Pollutants (POPs) and

dioxins represent the most important sub-

group. As POPs, dioxins are lipophilic

compounds. This means that dioxins

tend to be accumulated in the fat tissues

of animals and some vegetables, cereals

and fruit. The intake of dioxins through

the ingestion of contaminated meat, fish,

eggs, vegetables, fruit, cereals and dairy

products is estimated to represent about

90% of our total daily dioxin intake,

the remaining 10% entering the human

body via inhalation or by ingestion of

contaminated soil. This last pathway of

exposure is very important for children,

since playing in open spaces, playgrounds

and gardens can favour the accidental

ingestion of small amounts of soil.

Different activities contribute most to the

emission of dioxins into the atmosphere.

The incineration of municipal waste hasbecome mater of concern in the public

opinion. However, due to the known

impacts of incineration plants, more

and more stringent emission limits have

been established by the environmental

legislations in the course of time, so

that, in some countries, other dioxin

sources became more important than

incinerators in terms of dioxin emissions.

Unfortunately, in several cases, these

sources have not drawn the needed

at

ention yet, with adverse consequenceson the contamination of the food chain. In

this framework, the metal industry plays


3/8

Richa Bajimaya Memorial Foundation Newsletter I 3

an important role. Steel making plants,

especially, nowadays release about 4

times the amount of dioxins generated

by waste incinerators. In light of this fact,

particular atention should be paid when

deciding the location of these activities,

because the proximity of cultivated lands

and pastures can seriously affect the

introduction of POPs into the food chain

and, thus, into the human body.

Weak points of theenvironmental legislations

In spite of the extreme importance of

preserving our health from the exposure

to carcinogenic compounds, some

incongruities are still present in the

environmental legislations. According

to several studies on the health effects

of carcinogenic air pollutants, the

Environmental Protection Agency ofthe United States (U.S. EPA) developed

a valuable methodology to estimate the

cancer risk associated to the exposure

to different concentrations of an ample

selection of carcinogenic compounds.

By reviewing the limit values for

some pollutants established by the

environmental legislations, it emerges

that an exposure to concentrations even

lower than the limit values would not

always guarantee an acceptable cancer

risk. Furthermore, the conventional

methodology used by the environmentalagencies to monitor the air quality is

mainly based on fixed and sparse air

quality stations, which are not able to

highlight possible local situations of high

pollution levels.

Conclusions

Additional efforts should be made by

the governments, both to adopt different

methods to monitor the air quality

(for instance, smaller and portableinstruments) and to improve the emission

and concentration limits for carcinogenic

pollutants. Consequently, this last aspect

requires more efforts by the industrial

companies to invest money in the

adoption of cleaner technologies and

appropriate techniques for the removal of

air pollutants.

Investing money in prevention means

saving much more money to fix the

damage caused. And when the possible

damage is cancer, every effort towards

preventing this should be done.

Hike for Health: An

Experience of an ElixirianSandesh Acharya, 8C Ideal Model School, Jhamshikhel Lalitpur

Before sharing my experience, I want to thank Richa Bajimaya Memorial Foundation

for organizing such a wonderful hiking in a very peaceful and beautiful forest. Iam also very thankful for all the knowledge that we received about the various

historical places we visited.

I was not very

excited in the

beginning as

the journey on

the bus to the

hiking point

was not good. I

was very much

scared too. But,as we reached

the hiking

point, I started

feeling good.

The whole place

was just very

fantastic, as the

fresh air was

blowing and all the insects in the place were making their own kind of sounds. We

made wonderful visits to different places like the batle fort of Prithivi Narayan

Shah, the graveyard of warrior Kalu Padey, the place where Necon Air once crashed,

and others. We discovered many things like a big leaf insect, molting of bees etc. The

whole place was very exciting but dangerous too. Not in the other sense but becauseof the leeches. The whole environment became terrifying for some time. Everyone

started running here and there as they were atacked by leeches. I got very lucky as

I didnt suffer any leech bites.

We also played different games and it was the most fun time. We had to use logic

to solve the puzzle pieces that we were given. We had to make leter T using

different pieces of paper. Our team won that game as we worked hard to make that

happen. There was another game that required us to make the tallest tower. Sadly,

we couldnt make the tallest but we were awarded with the most creative group for

making the creative tower.

We could not have gained all this knowledge if Richa Bajimaya Memorial Foundationhad not organized this program.

The whole place was just

very fantastic, as the fresh

air was blowing and all

the insects in the placewere making their own

kind of sounds.


4/8


Hike for Health- Ramkot Adventure

42 students from Ideal Model School participated in a program-Hike for Health-Ramkot Adventure. The program was organized by Richa

Thapa, former AIG of Armed Police Force and Founder of Aastha Nepal briefed about the surrounding historically important places. Studeteam building games. It was a great mix of fun, knowledge and health.

Biotechnology Fair: Disseminated information on cancer at the fair organized by Biotechnology Society of Nepal.


5/8


ndation along with Aastha Nepal. Mr. Ravi Raj

were also involved in diff

erent leadership and

25th March Celebrating Foundation Day

Elixir Club Orientation and Leadership Training

25 students from 5 Elixir schools and their Elixir coordinator atended the program-

Elixir club orientation workshop and leadership training. The workshop included

sessions on introduction to elixir club and Richa foundation, introduction of cancer

and leadership session. It also included group work and discussion sessions with

students and coordinators about the function of elixir club. The resource persons for

the program were Dr. Poojan Shrestha, Mr. Sanjeev Dahal, Ms. Sajani Manandhar,

Er. Prabesh Maharjan and Er. Jeewan Shrestha. Ms. Abina Subba, Ms. Pema Shrepa(trainees), Mr. Prasant Niroula (past president-OPS Elixir club) and Ms. Deepa Shrestha

(Life time member, RBMF).


6/8


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d'vsf] SofG;/ / ckgfpg' kg{] ;fjwfgLxDr. Prenit Pokhrel, MDS, Manipal, Observership- Dept of OMFS (oral and maxillofacial surgery), RIGS Hospital Copenhagen


7/8


Breast cancer is the most common cancerin the world today among females withan estimated 1.38 million new cases everyyear. In Nepal, breast cancer is the secondmost common cancer among femalesafer cervical cancer. However, somestudies have reported that breast cancer

is in an ever-increasing trend in Nepaland has been forecasted to rise further.Therefore, multidisciplinary approacheshave been adopted for the treatment ofbreast cancer patients. With the advent ofnew technology and innovative medicalapproaches, the chances of survival arealso improving. But, surviving the fightagainst cancer is not that simple as wethink. The diagnosis of cancer in itself andthe aggressive treatment have an impacton patient's physical, psychological,social and financial aspects; thus,eventually affect the patient's quality of

life. As Robert Kaplan said, The measureof health must be able to encompassnot only differences in length of life butdifferences in the quality of that life. So,the question arises, Prolonging life, is itenough?"

To know about the quality of life ofbreast cancer patients in Nepal, a surveywas done among breast cancer patientsundergoing treatment in National cancer

centers of Nepal (Bharatupur CancerHospital and Bhaktapur Cancer Hospital).One hundred breast cancer patientsundergoing any form of treatment(surgery, chemotherapy or radiotherapy)were interviewed.

Patients age ranged from 22-76 years. Itshows that every woman is at risk to getbreast cancer at any period in their lifetime. Furthermore, it also found that themajority of the patients were married(82%), uneducated (66%), involved inagriculture (66%), with family monthlyincome 10,000 (43%), and no familyhistory of any type of cancer (83%).

The study assessed the quality of life inmany dimensions: global health status/QoL, physical function (their ability toperform strenuous activities/walking/

eating/dressing/washing themselvesetc.), role function (their ability ofperform their everyday activities/theirhobbies), emotional function (perceivingtension, worry, irritability and feelingof depression), cognitive function(concentrating and remembering things),social function (ability to take care oftheir family and to participate in socialactivities), body image function (theirlevel of satisfaction with their body'simage afer surgery), sexual function(ability to involve in sexual activities),sexual enjoyment (ability of enjoy sexual

activities) and future perspective (concernabout their health in future).

It was found that most of them hadproblems in emotional and socialfunctions. Women expressed moreconcern for their family and children.Many of the women even said that, ifanything would happen to them, thenthey are sure that their husband willmarry another woman hence, theywere found to have more apprehensiontowards their children's future.

Financial difficulty has also beenarticulated as being perceived by 84%of the patients. In a country like Nepal,

many people cannot afford the cost ofcancer care.

Sexual function and sexual enjoymentfunction have been the worst performeddimensions of all. Perhaps, Nepalesewomen do not feel comfortable to talkfreely about their sexual life so it couldhave been seen as they poorly performed.

They were found to be more worriedabout their health in future, probablydue to the lack of knowledge that if thedisease is in an early stage and has beentreated properly, there is a cent percentchance of complete cure.

When interviewed about the perceivedsocial support, many of them reportedperceiving poor social support (52%)while just one quarter of them reportedperceiving good social support. Moreover,it was also found that those women whoreported perceiving poor social supporthave poor quality of life.

Conclusion:The global health status/quality of life ofthe breast cancer patients is comparableto the international studies. However,outcome of this study demands necessityof an efficient preventive programsall around the country, nationwidehealth education program about theprognosis (future health) of the breastcancer treatment, and proper strategyto improve the social support when theyare undergoing treatment. In addition,advocacy for the treatment support to thecancer patients is a must. Governmentshould come up with a concrete plan tofinancially support cancer patients suchas initiating health insurance programs,allocating more budgets to health, and/orproviding financial support to patients,just as how they are doing for kidneypatients.

Prolonging life, is it enough?

Sajani ManandharGeneral Secretary, RBMF

Table 1: General Characteristics of the

breast cancer patients (n=100)

General Characteristics Percent

Age

20,000 15

Family History of Cancer

Present 17

Absent 83

Variables Good%

Avg.%

Poor%

Global HealthStatus/QOL

48 32 20

Physical 77 21 2

Role 78 22 0

Emotional 38 38 24

Cognitive 56 27 17

Social 35 46 19

FinancialDifficulties

9 7 84

Body Image 50 28 22

Sexual 3.0 18.0 79.0

SexualEnjoyment

19 23 58

FuturePerspective

38 33 29

Table 2: Level of Quality of Life Perceived

by Breast Cancer Patients (n=100)


8/8


OCTOBER: BREAST CANCER AWARENESS MONTH

Breast cancer awareness month, marked

every October, is a health campaign

organized by major breast cancer charity

organizations all over the world to

increase awareness and raise funds for

breast cancer research and to support

those aff

ected by breast cancer. It wasfounded in 1985 as a partnership between

the American Cancer Society and the

pharmaceutical division of Imperial

Chemical Industries (now part of

AstraZeneca, producer of several anti-

breast cancer drugs).

Pink Ribbon Campaign of Richa

Foundation

"Aware and Support"- Awarethose who are at risk and support

those who already had it.

Dr. Deepak S. Shrestha

President ,RBMF

Mrs. Jolly Shrestha

Elixir Cub Supervisor, IMS

Message:

Mrs. Sushma Maharjan Lilly

Pink Ribbon Advocate-Richa Bajimaya

Memorial Foundation

I was 32 years old when I discovered

a lump in my right breast. I took anappointment with an oncologist. I did

a biopsy test and they suspected that it

was a cancer lump. I did a mammogram

and the second time biopsy test

confirmed it was a cancer lump. I then

did a mastectomy and six rounds of

chemotherapy. In my family, there was no

history of breast cancer. Now I am cancer

free - I have finally won the batle against

cancer afer a nine-month long treatment.

As the president of Sangkalpa(The

Pledge), I work with children with

cancer and their parents and staff at

Kanti Children Hospital. With the help

of my husband, we have been doing pink

soccer/football games with a inter school

competition in October in the US. With

this program, we are going to make all

aware about breast cancer.

Since 2011, I have participated in

American Cancer Society Making

Strides against Breast Cancer walk every

October as a cancer survivor. MakingStrides against Breast Cancer events

are held as an inspiring opportunity for

the community to honor breast cancer

survivors, raise awareness to reduce

breast cancer risk, and to raise money for

American Cancer Society to do research

on breast cancer and help for women who

need mammograms.

Afer suffering from cancer, I know the

value of life now. I have dedicated my life

to doing good work. Thank you for Richa

Bajimaya Foundation for honoring me

as a Pink Ribbon Advocate. It gives me

the opportunity to share my story with

diff

erent school students and teachers tobe aware about their health. I encourage

everyone to exam your breast regularly.

Tell your family and friends to just do it. It

might save your life. Dont be shy to go to

the hospital. Your health is in your hands.

We need you. Support your family and

friends.

Ms. Sajani Manandhar

Pink Ribbon Campaign Moderator- RBMF

Mrs. Blessie G. DhakalCEO and President, Womens Federation

for World Peace Nepal

It is very important that we take care

of ourselves and our loved ones.

Breast Cancer is the commonest

cancer in females, and like many

cancers, it can be cured if caught

early. One of the main reasons for

late diagnosis is that women try tohide their condition for various social

or personal reasons. It's not an issue

to hide or fear. It's an issue to be

aware of and deal with. Let us all be

aware and play our role. - "United

Against Cancer"

Every woman is at risk of getting

breast cancer. There are some

modifiable causes of it - we can

prevent it by having the right body

weight, involving ourselves in physical

exercise, breast feeding infants,

abstaining from tobacco and alcohol,

and by reducing our exposure to

hormones. Let's play our part to stay

breast cancer free.

In context to Nepal, people come from

diverse background. People are still

unaware about information on Breast

Cancer. According to W.H.O. report

2011, Nepal ranks 142 in the world

health ranking. It is said that after

40, not even 1% of the women go for

mammography. The notion here is that

Nepali women still inhibit to share their

problem. Therefore, to avoid cancer

risk, lets come out from the cocooned

shell and idolize ourselves and bringtransformation in our society through

early detection.

We have been organizing a breast

cancer awareness event annually for

the past two years. We believe that it

is indeed a wakeup call for all women

to be aware of this silent disease. All

women should stand together to help

one another to diagnose it early and

cure it.

Chabahil, Kathmandu, Nepal Tel/Fax +977-01-4484691i h f d ti i f @ i h f d ti P O B N 23112

Newsletter Issues 4

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Transcript of Newsletter Issues 4