U.S. hospitals are ill-prepared to handle emergencies stemming from terrorist attacks and natural disasters, a congressional committee concluded on May 7.

The House Oversight and Government Reform Committee held a two-day hearing into hospitals' lack of emergency surge capacity.

The hearing was specifically related to the Department of Health and Human Services issuing Medicaid regulations that will reduce federal funds to public hospitals.

Committee chairman Rep. Henry Waxman, D-CA, presented results from a committee survey of 34 Level I trauma centers – hospitals equipped with a full range of specialists and equipment available 24/7 – in seven major cities. The survey examined hospital operations on March 25 in order to determine real-time capacity of the trauma centers' emergency rooms and found that none had the capacity to respond to an attack on the scale of the March 11, 2004, commuter train bombings in Madrid that killed 177 and injured more than 2,000.

Some cases were worse than others. For instance, in three of the trauma centers surveyed in Los Angeles, overcrowding would be such an issue that the hospitals would have to turn away new patients. In Washington, D.C., there were no available treatment spaces due to severe overcrowding.

"If a terrorist attack had occurred in Washington, D.C. or Los Angeles on March 25 when we did our survey, the consequences would have been catastrophic," Waxman said in a statement.

The hearings included testimony from doctors and experts in the medical field. "To those of us who work in the front lines of the medical care system, it is irrational to believe that an emergency care system that is already overwhelmed by the day-to-day volume of acutely ill patients would be able to expand its capacity on short notice in response to a terrorist attack or natural disaster," said Roger Lewis, M.D., Ph.D., of Harbor-UCLA Medical Center in Torrance, CA, in a statement.

Homeland Security Secretary Michael Chertoff and Health and Human Services Secretary Mike Leavitt also testified at the hearing. Leavitt said in a statement that his department is "working diligently to improve our nation's emergency preparedness and medical surge capacity, and we have made extensive funding available to hospitals through the states specifically toward this end."

A new government report seeks to curb the number of volunteer firefighter deaths by providing information on various programs and strategies.

"Emerging Health and Safety Issues in the Volunteer Fire Service" (.pdf file) was created by the U.S. Fire Administration and the National Volunteer Fire Council. It highlights the various occupational health and safety issues facing the volunteer firefighter community.

For example, 50 percent of all volunteer firefighter deaths are due to heart attacks – 11 percent more than that of career firefighters, according to the report.

"The volunteer fire service has distinct issues related to health and safety that need to be specifically addressed," NVFC Chairman Philip C. Stittleburg said in a statement. "We lose too many volunteer firefighters in line-of-duty deaths."

The report recommends implementation of a health, wellness and safety initiative for volunteer firefighters that includes:

• Interventions for lowering cholesterol and blood-pressure levels
• Increasing physical activity
• Maintaining a healthy weight
• Benchmarks that include measureable goals and objectives

The Department of Homeland Security has released preliminary results (.pdf file) from a 2007 national exercise that tested terrorism preparedness and response among top officials.

Top Officials 4, also known as TOPOFF 4, was the fourth exercise in a congressionally mandated series and involved more than 23,000 participants from the local, state and federal levels, as well as the private sector. The event – conducted between Oct. 15 and Oct. 29 – focused on prevention, incident management and public information in the lead-up to, and fallout from, a fictional radiological attack.

Among the preliminary findings from the drill, based on observations from participants, were:

• Government departments and agencies lacked "critical information" at times during emergency management.
• Private-sector participants reported difficulty integrating into some of the responses.
• Public information officers had difficulty obtaining information on response activities.

The report listed several recommendations for improvement and corrective actions. DHS said it considered the exercise successful in making improvements from previous exercises, and the report highlighted several strengths observed during the drill.

For anyone dieting, fat may seem like the enemy; but in fact, fat is vital to your health. Certain types of fat contain vitamins and compounds that help regulate blood pressure and heart rate. While too much fat can lead to obesity and heart problems, adequate amounts of the right kinds of fat actually can be beneficial.

The nutrition label heading for fats features subheads listing the types of fats that are in each product. Knowing which fats are good and which are bad can be difficult to determine. The Mayo Clinic in Rochester, MN, offers this clarification:

Saturated fats	Saturated fat can increase LDL and risk of heart attack. It is solid or waxy at room temperature, which causes artery-blocking buildup. This fat is found in animal products such as red meat, poultry and whole milk and also in tropical oils such as palm and coconut.
Trans fat	Beginning in 2006, FDA required trans fats to be listed separately on food labels. Trans fat is created by adding hydrogen to vegetable oil to solidify it, which prevents products from spoiling quickly. Found mostly in prepackaged and fried foods, this fat actually increases your LDL or "bad" cholesterol, while also lowering your HDL or "good" cholesterol. It is important to note that if a product contains less than 0.5 grams of fat, the nutrition label will list "0 grams." So while a product may list "0 grams trans fat," if the ingredient list includes "hydrogenated" or "partially hydrogenated oil," trans fats are present. This is one reason why it is important to be mindful of serving sizes.
Unsaturated fats	These healthy fats help lower your LDL, or "bad" cholesterol, which can clog arteries, leading to heart disease and stroke. Monounsaturated: This type of fat is found in olive oil, avocados and nuts. Polyunsaturated: This fat is found in vegetable oils and soy. Omega-3 fatty acids: A type of polyunsaturated fat, omega-3s are found primarily in seafood and flax. They have been found to decrease the risk of coronary disease and stabilize heart rate and blood pressure.

The Centers for Disease Control and Prevention cautions that any type of fat is high in calories and recommends that adults limit their fat intake to 20-35 percent of their total daily calories. To avoid additional calories, substitute polyunsaturated and monounsaturated fats for saturated fats and trans fats.