SHARYL ATTKISSON: Today on HealthWeek... Toxins in our waterways. They've killed millions of fish, and now they're making some people seriously ill. What can be done to keep us safe? It's different. It's daring. And it may also be dangerous to your health.

IRA PAPEL, MD, JOHNS HOPKINS SCHOOL OF MEDICINE: "They are performing invasive procedures on the human body, and we have no idea under what kind of conditions these are being done."

SHARYL ATTKISSON: A look at the downside of body piercing. And come along on a tour of a house that's designed with your health in mind.

Hello. I'm Sharyl Attkisson. Welcome to HealthWeek.

PFIESTERIA
Today we begin with a story about a new threat lurking in our coastal waterways, a threat that's concerning everyone from boaters to people who eat seafood. Our "Behind the Headlines" segment looks at toxic microbes in the water. They're becoming such a big problem that federal health experts held a special meeting in Atlanta this week to chart a battle plan. One organism that's recently surfaced has affected fish and even some people, who are coming down with skin sores and serious memory problems.

HealthWeek's Bettina Gregory reports.

BETTINA GREGORY: This dawn finds Ray Maddox and Tommy East crabbing at the mouth of Maryland's Pokomoke River because the river itself is closed. A microorganism known as Pfiesteria killed thousands of fish this summer -- but a year ago, Ray and Tommy knew something was wrong.

RAY MADDOX: What we first started seeing on the catfish looked just like somebody had taken a pair of skinning pliers or something and pulled some of the skin off. It was raw and bleeding.

BETTINA GREGORY: Then these men, who have fished these waters their whole lives without any problem, got sick.

RAY MADDOX: I had a fever for about three weeks of and on. It seemed like every night when you'd lay down it would go up to about 103. And during the night it would break.

BETTINA GREGORY: Tommy was hospitalized with double pneumonia. His lungs are fine now, but he still suffers from short term memory loss.

TOMMY EAST: I can be working on something and right in the middle of doing it and knowing what I am doing, and then I stop and then I'm wondering what I'm doing. I mean I've never been like that before.

BETTINA GREGORY: Memory loss seems to be the common link among those complaining of illness after exposure to Pfiesteria -- according to the doctor who's investigating the outbreak.

J. GLENN MORRIS, MD, UNIVERSITY OF MARYLAND MEDICAL CENTER: We saw 13 patients. We did comprehensive neurocognitive testing on 11 of those patients and indeed we were able to show that there was a very clear, almost isolated, defect in terms of their memory abilities and their learning abilities.

BETTINA GREGORY: Even researchers studying Pfiesteria have been affected. Howard Glasgow is the director of the laboratory where Pfiesteria was first identified ten years ago. Glasgow got lesions -- just like fish - from a splash of water containing Pfiesteria.

HOWARD GLASGOW, NORTH CAROLINA STATE UNIVERSITY: And those lesions can develop almost instantaneously. It's just like an acid burning your skin.

BETTINA GREGORY: Glasgow and his colleagues treat Pfiesteria with great respect -- wearing protective gear and respirators. They work in a special lab to avoid exposure to the fumes given off by this tiny microorganism. Before their precautions were perfected, five months of exposure to Pfiesteria fumes from these tanks caused Glasgow to suffer.

HOWARD GLASGOW: Complete loss of ability to read, inability to do math, inability to communicate orally and understand conversations -- fortunately all that came back over a period of time -- but I did end up having to take lessons to learn to read again.

BETTINA GREGORY: The problem appears to be spreading. Once word came that Pfiesteria had been discovered in Virginia waters, the Congress stepped in and voted 7 million dollars for research. But some scientists say they already think they know what's causing the toxic outbreak.

DONALD BOESCH, PhD, UNIV OF MD CENTER FOR ENVIRONMENTAL SCIENCES: We add nutrients to soil to grow plants and there's run-off, there's loss of those nutrients from fertilizers into the surface waters. In addition, of course, if we have dense aggregations of be it chickens or hogs, they produce wastes which are rich in these nutrients and they are therefore lost to the surface waters. There is scientific information that would suggest that nutrients can indeed be a problem in causing these organisms to grow.

BETTINA GREGORY: The first known toxic outbreak of Pfiesteria occurred on the Neuse River in North Carolina six years ago. It killed one billion fish. Now it's been found all over the Eastern Seaboard.

Scientists have learned Pfiesteria has dozens of different forms -- benign and toxic.

HOWARD GLASGOW: In its most toxic form, it is generally the shape of a basketball with a whip-like flagellum that it uses to propel itself through the water.

BETTINA GREGORY: What makes Pfiesteria toxic, no one yet knows. But it is just one of many poisonous microorganisms assaulting coastal waters nationwide. For example: billions of single-celled organisms form so-called red tides that kill manatees off Florida's beaches, decimating these sea mammals. Other microorganisms form brown tides that have killed shellfish and birds from the Gulf Coast of Texas to Long Island, New York. And from Maine to the West Coast, people have gotten severe illness from eating shellfish poisoned by microorganisms.

DONALD BOESCH, PhD: They produce toxins and seem to be on the rise in many parts of the world. So this is a sort of signal, a global signal of some change that's underway.

BETTINA GREGORY: So far, no one is known to have gotten sick from eating fish affected by Pfiesteria. But experts aren't sure how big an impact this and similar microorganisms will ultimately have on human health. Scientists agree this will not be an easy problem to solve.

HOWARD GLASGOW: As we begin to look at it even more closely from a national standpoint, we're probably going to see an increased incidence of Pfiesteria and Pfiesteria-like species and fish mortalities associated with that.

BETTINA GREGORY: Something that will affect all of us, especially the watermen whose survival depends on the health of the fish they catch.

SHARYL ATTKISSON: Among those tackling the Pfiesteria problem at the national level is the Environmental Protection Agency. Joining us now to discuss this issue further is EPA Administrator Carol Browner.

This has not affected, as we've heard, a huge number of people yet, but the prospects seem pretty frightening. How big of a problem do you think it is?

CAROL M. BROWNER, EPA ADMINISTRATOR: Well, I think it's a wake-up call. It tells us that while we've made tremendous progress in cleaning up the pollution in rivers and lakes across the country, the job is not done. There are emerging threats, and we need to be vigilant in our efforts to protect our water resources.

SHARYL ATTKISSON: How safe is seafood? Do we know that there is no threat posed by the seafood that we get at restaurants that may come from areas that are contaminated?

CAROL M. BROWNER: Well, first of all, healthy fish are safe to eat. The fish you get in a grocery store, the fish you get in a restaurant, it's come through a commercial process. It's been tested. It's been observed, and I think you can feel great confidence in the safety of those fish and seafood products.

SHARYL ATTKISSON: How about recreational activities? Because we heard in the story that we just saw that one researcher who was splashed with Pfiesteria got lesions on this skin. Is it safe to go in the water as far as we know?

CAROL M. BROWNER: Well, in the case of Maryland, they have now closed portions of some of their rivers. Obviously if the river is closed, people should not be recreating there. Where rivers are open, people should feel very confident that those waters are safe, they're being tested, and they can enjoy an outdoor activity.

SHARYL ATTKISSON: Pfiesteria isn't the only toxic microbe that's in the water, as we heard. How big of a problem nationwide is this? You mentioned that it was growing, but is this something that's going to be a serious, serious problem in the coming years?

CAROL M. BROWNER: Well, based on what we've seen, what the scientists tell us, there is a growing number of these microorganisms. You mentioned earlier red tide, brown tide, the Pfiesteria outbreak. Again, it is a call to all of us that we have to remain vigilant in our efforts to protect our water resources. These are resources that become our drinking water. They give us the fish we like to eat and they are places we like to recreate. We need to protect them.

SHARYL ATTKISSON: Is this considered something that's being handled on a state-by-state basis, or is there something specific the EPA, as a national agency, can and is doing?

CAROL M. BROWNER: Well, we're working very closely with the states where these issues have arisen. We've provided research dollars. We come in on an emergency basis. It's going to take all of us, federal, state, local government, citizens, fishermen, working together to prevent the pollution that causes these kinds of problems.

SHARYL ATTKISSON: State livelihoods depend in some cases on the industries that may be affected by problems like this. If you're talking about human and animal waste runoff being a cause, does the Federal Government have ultimate authority to step in if it's not working at the state level?

CAROL M. BROWNER: Yes. We have authority, and we are using that authority to look at all of the sources of increased nutrients in our water supplies. It may be coming from air pollution, runoff, both urban and rural runoff, looking at all of those sources of nutrients and how best to reduce the nutrient levels that may be contributing to these problems.

SHARYL ATTKISSON: EPA administrator, Carol Browner, thank you for the information.

CAROL M. BROWNER: Thank you.

HEALTHFUL HINTS

DR. NANCY SNYDERMAN: Hello, I'm Dr. Nancy Snyderman with this week's Healthful Hint.

Your mother probably told you to always wash fresh fruits and vegetables before taking a bite. But did she tell you the right way to wash them? Although it's smart to wash dishes in hot, soapy water, there's no need to use soap on your fruits and veggies, even if the soap is sold specifically for washing produce. Besides leaving a bad taste on items like berries and mushrooms, soap residue may upset your stomach. And forget about hot-water soaks. A stream of cool, running water is usually the best way to shake those germs loose. For tough dirt or getting rid of that waxy covering on things like apples and cucumbers, try a vegetable brush and a little elbow grease. The humble vegetable peeler can also come in handy, especially when you pare the skin off things like cucumbers, carrots or other produce. You could also remove bacteria and pesticide residues. Finally, never assume that those bags of cut-up lettuce and other vegetables have been washed. Even if they have, it can't hurt to give them another rinse under your watchful eye. With Healthful Hints, I'm Dr. Nancy Snyderman.

BLOOD PRESSURE

SHARYL ATTKISSON: If a doctor tells you that you have high blood pressure, it can mean you have to make major changes. You might have to lose weight, change your diet or even take medicine that can have unpleasant side effects. But what if the doctor is wrong and you really don't have high blood pressure? A new study indicates that may happen more often than you think. HealthWeek's Robert Davis has details.

ROBERT DAVIS, PhD: It's quick, easy, and painless. But for some people, getting their blood pressure taken at the doctor's office can, well, send their blood pressure sky-high.

THOMAS PICKERING, MD, NEW YORK HOSPITAL - CORNELL MEDICAL CENTER: "It's very difficult for the doctor to tell if the blood pressure is genuinely high all the time or if it's just high for that period while the patient's making the visit. And for this reason, we think it is extremely helpful for the doctor to get readings taken outside the physician's office."

ROBERT DAVIS, PhD: That's often accomplished through so-called ambulatory monitoring, in which a portable device automatically records blood pressure over a 24-hour period, while the person goes about normal activities. The monitor stores the readings, which the doctor can then analyze.

THOMAS PICKERING, MD: "This display shows the complete blood pressure recording for 24 hours. And probably when the patient goes back from work, it goes down in the evening, and then when the patient goes to sleep, it's quite low. And then when they get up again the following morning, it increases."

ROBERT DAVIS, PhD: Jeanette Lorde's blood pressure was measured this way.

JEANETTE LORDE: "It was really no problem. I was able to do my work. I drove home. I prepared dinner. I went to sleep. And the only problem I had was not being able to have my shower."

ROBERT DAVIS, PhD: Now a Belgian study, in the current Journal of the American Medical Association, finds this test may help some people avoid blood pressure medication: 26% of patients who got ambulatory monitoring were able to go off medicine, compared with only 7% whose blood pressure was measured just in the doctor's office.

THOMAS PICKERING, MD: "I think it has potentially quite major implications because it could mean that about 20 percent of people who are on treatment for their high blood pressure in fact probably don't need it. They just need to have their blood pressure monitored."

ROBERT DAVIS, PhD: So why isn't ambulatory monitoring used for everyone with high blood pressure? Well, for one thing it's expensive, $150, and insurance generally doesn't cover it. Plus it requires several extra trips to the doctor to have the device put on and removed. So, as an alternative, some doctors recommend home test kits like these.

THOMAS PICKERING, MD: The home readings are a very useful supplement to the office readings, particularly when the doctor is starting the patient on treatment. And many of my patients monitor their pressure, and I find it much easier to see how well the treatment is working.

ROBERT DAVIS, PhD: That's what Jeanette does, and as a result, she now has her blood pressure under control.

SHARYL ATTKISSON: If your doctor thinks that home testing might be a good option for you, you need to go shopping for a home blood pressure monitor. Pharmacist Dan Albrant has some tips on how to find the right one.

DAN ALBRANT, PharmD, AMERICAN PHARMACEUTICAL ASSOC: There's a number of different outlets for home blood pressure monitoring kits. The easiest and most successful is probably the local pharmacy. But also the home shopping networks and even the internet now can offer direct mailings from companies for home blood pressure monitoring devices.

The one that we recommend is an automated device that goes on the bicep without use of a stethoscope and then it inflates and deflates automatically and gives a reading for the blood pressure. I think people can find a decent monitor that's reliable for right around $50 cost. They can pay a lot more but they won't get any better service or better outcome from the monitoring device. One of the things people can do to make sure once they've purchased a monitoring device that it's accurate and reliable is take it in the first time to the physician's office. Have the physician or the nurse check their blood pressure both with the office monitor and then with their own monitor and make sure that they correspond very closely.

SHARYL ATTKISSON: For more information on home blood pressure monitoring, or any other HealthWeek story, you can call our toll-free number shown at the end of the program.

HEALTH NOTE
Until age 55, blood pressure is generally lower in women than in men. After that, it's about the same.

BODY PIERCING
Many parents wouldn't bat an eye if their teenage daughter wanted to get her ears pierced. But what if she wanted to go a bit a bit further, maybe pierce her eyebrows or her nose? While you may worry about what it will do to her looks, perhaps an even bigger concern ought to be the impact on her health.

HealthWeek's Andrew Holtz has more from Portland, Oregon.

ANDREW HOLTZ: It's spreading, all around the ears, to lips and eyebrows... even tongues... and far beyond.

And body piercing isn't just kids' stuff anymore.

BODY PIERCER: "Have you thought about where on your nose you want it?"

JEAN WAYNE: "Uh, I think right there."

BODY PIERCER: "Usually right in that crevice is a really good spot.

ANDREW HOLTZ: Jean Wayne got the urge after seeing women with pierced noses in Nepal.

JEAN WAYNE: I think it's beautiful, and I want to do it, and I guess I want to be different. I'll be the only 50-year-old with her nose pierced, in my county.

ANDREW HOLTZ: But what health risks may come with a visit to a body piercer?

DR. IRA PAPEL: "You have two on this side."

PATIENT: "I have two on that side."

DR. IRA PAPEL: "And only one gives you trouble?"

PATIENT: "Only the one."

ANDREW HOLTZ: Plastic surgeon, Ira Papel, says he already sees enough problems from common ear piercings, including scars called keloids that can grow out of control.

The spread of piercing concerns him.

IRA PAPEL, MD, JOHNS HOPKINS SCHOOL OF MEDICINE: They are performing invasive procedures on the human body, and we have no idea under what kind of conditions these are being done.

PAT GLAZIER, FAMILY NURSE PRACTITIONER: "Did the ache extend beyond your breasts, or was it more all-over body aches, or was it just primarily at the site?"

ANDREW HOLTZ: Tina Brinton had her nipples pierced to mark her 21st birthday. It's a gift she had to return.

TINA BRINTON: I cleaned them every day, I'd clean them twice a day sometimes, I even started like every so often using antibiotic ointment, and they would just continually get infected.

ANDREW HOLTZ: She healed. Once the rings were removed.

College nurse Pat Glazier sees infected piercings every school year.

PAT GLAZIER, FAMILY NURSE PRACTITIONER: Most of the time, if they are treated with, if they need antibiotic therapy, it does the trick, and you just teach them how to take care of it.

ANDREW HOLTZ: But if the tools used by body piercers are not sterile, the consequences can be far more serious.

Here in Oregon, concern about the possible spread of diseases, including hepatitis-B or AIDS, prompted the state to become the first in the nation to regulate piercers. Now, shops need licenses, and state inspectors can make surprise visits.

INSPECTOR: "I would like to see your client records, I'm talking about completed client records."

BODY PIERCER: "I keep the tray liners are right here for that."

INSPECTOR: "Okay."

LARRY PECK, OREGON HEALTH DIVISION: The main things we're looking for are of course the safety and the sanitation part of it and disinfection.

ANDREW HOLTZ: The Oregon regulations include: patient recordkeeping to help track any problems; A ban against the piercing of minors, unless a parent is present, and standards for equipment and sanitation.

Some piercers here supported and even helped write the rules.

AHNA EDWARDS, PROFESSIONAL PIERCER: We basically maintain the same regulations and the same criteria as a dental office; we have to do the same kind of sterilization, the same kind of protection for us and the client.

ANDREW HOLTZ: All piercers must be registered, and some shops, including this one, require employees to go through apprenticeships. But there are no state training requirements, and so no guarantees of a piercer's experience.

BODY PIERCER: "There you go. All done."

PATIENT: "Thank you."

ANDREW HOLTZ: Most states, unlike Oregon, don't regulate the growing number of piercings. So some doctors worry there could be a growing number of problems that no one is keeping track of.

IRA PAPEL, MD: We don't know exactly what type of people are doing these procedures. We don't know how many they are doing. We don't even know what parts of the body predominantly they are doing this on.

ANDREW HOLTZ: But Josh Tagliere has a vital tip for people with freshly pierced nipples.

JOSH TAGLIERE: The problem that occurred after that was the seatbelt, of driving, it was completely rubbing right against it, so I had to wear it, like, in the improper position to make it comfortable to drive.

SHARYL ATTKISSON: That's not how we celebrated birthdays when I was a kid. No matter what body part you're getting pierced, even if it's just your ears, you can play a big role in preventing complications. Here's some advice on how to care for new piercings: Always wash your hands before touching your piercing; clean your piercing two to three times a day with a disinfectant solution, like Bactine, that contains the chemical benzalkonium chloride; during the cleaning, remember to rotate the jewelry back and forth so the solution reaches the inside of the piercing; avoid using perfumes, lotions, and other cosmetics near your piercing. All of those can cause extreme irritation. And here's one other thing you might not have thought of: If you've just gotten your ears pierced and you're using the phone, place a clean tissue between your ear and the receiver to reduce the risk of infection.

ASK THE DOCTOR
BOY: "I have heard recently on the news that low cholesterol can be unhealthy for you. Does that mean that we should all go out and eat a steak?"

DR. BRUCE DAN: Not so fast. There are a few things to consider before you reach for the steak sauce.

You may have heard about studies linking low cholesterol levels with cancer. But most researchers, after carefully analyzing the data, now believe cancer caused the low cholesterol levels and not the other way around. Studies have also found a slightly higher risk of a bleeding stroke among people with very low cholesterol. But that applies to only a tiny percentage of people. For the vast majority of us, a much bigger concern is high cholesterol. Doctors know that a high cholesterol count is strongly associated with heart disease, the number one killer in the United States. And don't think you're immune because you're young. Cholesterol build-ups have been found in the arteries of teenagers. If you typically eat a healthful, low-fat diet, one steak won't kill you. But remember, moderation is the key. It's not eating an occasional steak but a steady diet of fatty foods that can send your cholesterol level sky-high. With "Ask the Doctor," I'm Dr. Bruce Dan.

HEALTHY HOME

SHARYL ATTKISSON: When you're shopping for a home, the "wish list" seems to stretch on forever. Nice neighborhood. Big kitchen. Stone fireplace. Maybe even good air quality? For more and more people, it's becoming important that "home sweet home" also be "home healthy home." With that in mind, the American Lung Association of Virginia recently teamed up with a power company and a local contractor to build a special kind of model home. HealthWeek's Jim Slade walks us through.

JIM SLADE: This may look like an ordinary house, but in reality, it's quite different. Like all energy efficient buildings, it's sealed up tight. But new technologies and products have been added that keep its inside air as clean as a whistle. And that's one big reason Gary and Renae Thompson decided to buy it:

GARY THOMPSON: We liked the idea that it has air recirculated and it is filtered and fresh air comes into the house.

RENAE THOMPSON: We get a lot of colds, and knowing that the air is clean and that some of that bacteria is being killed is a real plus for us.

JIM SLADE: The Thompson's home is a disparate collection of new products pulled together by Virginia builder Dick Collier.

RICHARD COLLIER, R.E. COLLIER BUILDERS: Well, it was a challenge at first. It really just took a lot of time and research before we started the house because, actually, the products are available; however, it is a matter of locating and finding them.

JIM SLADE: Interior paint is a special formula.

RICHARD COLLIER: It is a paint that has been developed for the healthy house in that the paint does not give off any volatile organic chemicals.

JIM SLADE: Rugs are recycled nylon with no chemical effect from the adhesives.

"Wow, this is a beautiful kitchen. Are you here to tell me this is healthy too besides what good cooking we're going to see here?"

RICHARD COLLIER: "Oh, absolutely, absolutely."

JIM SLADE: There is no particle board in the counters or cabinets to release fumes, and tile on the floor is chemical free. But the real secret to improving air quality is two machines in the basement: the first circulates air in and out of the house ...

SLATOR TURNER, ENERTEC CORP: The other integral part is the Hepa shield air filtration system and that's a high performance. It keeps about 99.7% of all the particulate matter out of the air.

JIM SLADE: But for it to do that, the house, including all of its ductwork, has to be sealed as tight as a drum. Does it work?

Kathy and Howard Burnette just moved into their healthy house because Kathy has asthma.

HOWARD BURNETTE: We're planning on being in this house until we go to the graveyard, so we wanted to have a very efficient home and then also one that would deal with her asthma.

KATHY BURNETTE: The air just seems lighter and easier to breathe.

JIM SLADE: Bottom line -- how much more does is cost to build?

RICHARD COLLIER: It runs about 1.5% of the cost of the house to achieve the indoor air quality and probably another 1.5% to get the high efficiency.

JIM SLADE: Or, in this case, an extra $4500.

RICHARD COLLIER: However, the silver lining is that the cost of doing this is actually paid back over three to four years with the energy savings on the house.

JIM SLADE: Gary and Renae Thompson think it's worth it. They can't wait to give it a try.

SHARYL ATTKISSON: Well, if you can't move into a brand-new house, the American Lung Association says one of the best things you can do is improve the ventilation in your home. Open windows whenever possible, leave doors between rooms open for better air circulation, and install exhaust fans in the bathrooms to remove moisture and fumes from hairspray and cleaning products.

That's all for this week. Remember you can visit us throughout the week at our site on the World Wide Web. To reach the HealthWeek home page, go to PBS ONLINE at the Internet address on your screen. That address is www.pbs.org. Next time on HealthWeek, we'll look at the often-secret problem of urinary incontinence and tell you why it's no longer necessary for women to suffer in silence. We'll also give you the lowdown on a new "high-tech" treatment for cellulite and introduce you to a guy whom medical students consider the "perfect patient." Until then, I'm Sharyl Attkisson. Be well!

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