Latest / Morning Medical with Dr. Chow / Youth Suicide Rates, Seine River Water Quality, and Olympic Athlete Performance Factors

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Youth Suicide Rates, Seine River Water Quality, and Olympic Athlete Performance Factors · Morning Medical with Dr. Chow

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Good morning, everyone, and welcome to another episode of Morning Medical with Dr.
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Chow.
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I'm your host, Dr.
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Chi-Ming Chow, and today we're diving into some critical and concerning findings regarding
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youth mental health and suicide rates.
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Let's get started.
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Two new cross-sectional studies have revealed a significant increase in suicide rates among
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preteens in the United States.
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Even more troubling is the fact that more than half of the adolescents who died by suicide did
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not have a prior documented mental health diagnosis.
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These findings shed light on some very alarming trends.
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The first study, led by Dr.
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Donna A.
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Ruch of Nationwide Children's Hospital in Columbus, Ohio, found that among preteens aged
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eight to twelve years, suicide rates increased by 8.2 percent annually from 2008 to 2022.
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This upward trend follows a period of decline up until 2007.
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The overall suicide rate during this time period was 5.71 per one million, a significant
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increase over the rate from 2001 to 2007, which was 3.34 per one million.
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The researchers reported an incidence rate ratio of 1.71, according to their publication
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in JAMA Network Open.
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Dr.
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Ruch emphasized the need for widespread and universal suicide risk screening starting at
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earlier ages as a preventative measure.
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The increasing trend is concerning, particularly as it disproportionately affects
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several minority groups.
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For instance, female preteens saw a disproportionate increase in suicide rates
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compared to male preteens, with an incidence rate ratio of 3.32 versus 1.35.
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Black preteens had the highest overall suicide rates for both time periods: 4.94 per one
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million in 2001 to 2007, and 8.50 per one million in 2008 to 2022.
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In a second study, researchers examined suicide among youths aged ten to twenty-four years and
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found that only 40.4 percent had a documented mental health diagnosis.
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Even more alarming, 46.8 percent of these youths died by firearms.
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Dr.
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Sofia Chaudhary of Emory University School of Medicine in Atlanta and her co-authors reported
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these findings, also in JAMA Network Open.
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This study highlighted that minority youth were less likely to have a mental health diagnosis
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compared to white youth, particularly those who identified as American Indian or Alaska Native,
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Asian, Native Hawaiian, or other Pacific Islander, and Black.
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Girls were more likely to have a mental health diagnosis than boys.
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Dr.
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Chaudhary pointed out the critical need for improved detection and connection to mental
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health services, especially for at-risk adolescents.
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She stressed the importance of universal lethal means counseling in both healthcare and
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community settings.
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Social inequities could be contributing to racial and ethnic disparities, so communities
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could help ensure equitable access to mental health services by increasing culturally
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sensitive services and diversity in the mental health workforce.
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In an invited commentary for Dr.
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Chaudhary's study, Dr.
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Lisa M.
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Horowitz of the National Institute of Mental Health, who was also a co-author on Dr.
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Ruch's study, noted that identifying mental disorders and suicide risk early is a rare
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exception in the United States.
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She emphasized that intervention in childhood could reduce mental health concerns and suicide
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risk across the lifespan.
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Dr.
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Horowitz also supported universal suicide risk screening, a measure backed by the American
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Academy of Pediatrics.
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Dr.
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Ruch and her colleagues collected data on 2,241 preteens who died by suicide from January 2001
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through December 2022, using the Web-based Injury Statistics Query and Reporting System.
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The majority were male and white, but significant increases were observed among all
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subgroups, with the greatest increases in girls, American Indian or Alaska Native, Asian,
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or Pacific Islander preteens, Hispanic preteens, and firearm suicides.
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For their part, Dr.
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Chaudhary and her team collected data on 40,618 youths who died by suicide from January 2010
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through December 2021, using the National Violent Death Reporting System Restricted
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Access Database.
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This data was gathered from death certificates, coroner and medical examiner records, and law
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enforcement reports.
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They found that mental health diagnoses were less likely among Hispanic youths compared to
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non-Hispanic youths, and among youths aged ten to fourteen years compared to those aged twenty
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to twenty-four years.
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Both studies had key limitations.
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For Dr.
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Ruch's study, some suicides may have been misclassified as other causes of death, and the
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lack of more specific racial and ethnic categorization may have limited the accuracy of
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suicide statistics.
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For Dr.
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Chaudhary's study, the National Violent Death Reporting System database was not a nationally
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representative sample, and the use of source records and family member accounts to determine
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mental health diagnoses may mean some prior diagnoses were unknown or underreported.
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These findings underscore a critical need for early intervention, improved mental health
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services, and community-level support to address these alarming trends in youth suicide.
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It's a call to action for all of us, from healthcare providers to community leaders, to
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ensure that our young people receive the support and care they need.
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With some Olympic events postponed, the water quality of the Seine River is raising concerns,
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particularly after heavy rains.
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The romantic image of the Seine River often overshadows the reality beneath its surface,
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but recent weather conditions have brought these issues to light.
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Organizers canceled the practice run for the triathlon on both Sunday and Monday due to
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concerns over the water quality affected by the heavy rains.
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According to multiple reports, the rains negatively impacted the river's water quality,
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leading to the postponement of the men's triathlon, which was initially scheduled for
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Tuesday.
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Despite some improvement in water quality levels, the World Triathlon stated that
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readings at certain points of the swim course were still above acceptable levels.
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This decision underscores the ongoing challenges in maintaining water quality in the
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Seine, especially during periods of heavy rainfall.
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Experts from University of Florida Health, which is part of the United States Olympic and
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Paralympic Medical Network, have weighed in on how the Seine River's water quality could
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affect athletes' health.
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Dr.
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Kartikeya Cherabuddi, a professor of infectious diseases and global medicine at the University
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of Florida, emphasized the importance of taking precautions and being aware of potential
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symptoms to manage them early.
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For the past century, swimming in the Seine River has been illegal due to poor water
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quality, except for rare competitions.
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Dr.
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Nicole Iovine, chief epidemiologist and chief quality officer at University of Florida
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Health, mentioned that Paris has invested significant effort into cleaning up the Seine.
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She explained that in many old cities like Paris, sewage and storm runoff travel through
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the same pipes to water treatment plants.
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Heavy rains can overwhelm these systems, leading to excess water, and sometimes
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untreated sewage, ending up in the river.
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To prepare for the Olympics, Paris spent 1.5 billion dollars on infrastructure improvements,
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including an underground storage basin called the Austerlitz Basin, a renovated sewer system,
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and upgraded treatment plants.
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These enhancements aim to collect excess rainwater to prevent wastewater from flowing
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into the Seine.
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However, heavy rains can still pose a challenge to these systems.
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About a week before the Olympic Games, Paris Mayor Anne Hidalgo took a highly publicized
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swim in the Seine to demonstrate that the water was safe for the triathlon and marathon events.
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However, subsequent testing revealed that in some areas, levels of E.
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coli bacteria were above Europe’s maximum safety limit of 900 colony-forming units per
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100 milliliters.
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Experts pointed out that one person swimming in the river does not prove its safety.
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Dr.
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Iovine noted that the risk of aspirating river water is much higher during highly exertional
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activities like a competitive race, compared to a leisurely swim.
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The largest public water company in France, Eau de Paris, reported that the Seine's water
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quality reached the compliance thresholds of the European directive at all four monitored
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points during the week of July 17.
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Nonetheless, daily water testing during the Olympics is necessary to ensure the events can
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proceed safely.
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The tests primarily screen for certain types of bacteria called total coliforms, which are
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generally harmless but can indicate the presence of harmful pathogens if found in large
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quantities.
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High levels of coliforms can signify excessive fecal matter, which poses health risks.
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E.
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coli, a group of bacteria found in the intestinal tract, can cause illness if harmful
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types are ingested.
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Symptoms include watery or bloody diarrhea, severe stomach cramps, and vomiting, sometimes
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accompanied by fever.
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Other bacteria associated with sewage, such as Enterococcus, Salmonella, and Campylobacter,
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can cause similar infections.
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Dr.
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Iovine expressed concern that high levels of harmful bacteria could put athletes at risk for
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gastrointestinal illnesses.
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Skin and eye infections are also possible if individuals have small cuts or abrasions before
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entering the water.
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Parasites like Giardia, amoebas, and Cryptosporidium, along with viruses such as
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norovirus, hepatitis A, and hepatitis E, may also be present in contaminated water.
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Symptoms of these infections are typically stomach-related but can also include fevers,
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headaches, and respiratory or urinary issues.
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Dr.
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Cherabuddi noted that symptoms might start within one to two days but could also appear a
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week or two later.
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Harmful pathogens carried by rodents can also enter the river through rainwater overflow.
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Rodent urine can contain bacteria called Leptospires, which cause leptospirosis, a
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bacterial disease.
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Symptoms include nausea, vomiting, body aches, red eyes, fever, and headache.
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Although young and healthy athletes are expected to recover from these infections,
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being sick could impact their ability to compete.
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The concerns over the Seine River's water quality highlight the complexities of hosting
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outdoor water events in urban environments.
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It's a reminder of the importance of vigilant water quality monitoring and the need for
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robust infrastructure to handle the challenges posed by unpredictable weather conditions.
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In the quest to understand the pinnacle of human athletic performance, researchers at the
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University of Waterloo have delved into decades of Olympic data, uncovering a surprising trend
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among the world’s top track and field athletes.
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The study, published in the July 2024 issue of the Royal Statistical Society’s Significance
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Journal, found the median peak age for Olympic track and field athletes was around 27,
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regardless of gender.
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“We found that most athletes are participating in the Olympics at around the age of 27, and
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coincidentally, the peak age of these athletes when they reached their prime, whether or not
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it happens at the Olympics, is also 27,” said David Awosoga, the study's lead author and a
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data scientist student at the University of Waterloo.
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“So a peak of an athlete is their best performance and the age at which they achieve
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it,” he told Global News.
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Track and field in the Olympics encompasses a variety of athletic events including sprints,
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long-distance running, hurdles, relays, and various jumping and throwing events.
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According to the study, after years of rigorous training, track and field athletes may peak
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around the age of 27, only to see their performance levels gradually decline afterward.
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This may be because of the physical toll elite athletes face, explained Dr.
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Paddy McCluskey, the team physician for Athletics Canada.
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Although exercising and playing sports are healthy, elite athletes like Olympians may face
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long-term injuries due to the demands of high-level competition, McCluskey said.
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“The demands of being an elite athlete are not as good for you long-term.
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Elite athletes are more likely to push through pain or injuries that others might not,” he
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added.
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Since the Olympics occur every four years, the study’s authors pointed out that the
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opportunity to time your athletic debut is limited.
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They sought to determine the optimal age for reaching this peak before the injuries catch
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up.
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To find the prime age, the researchers analyzed annual career performance data for every track
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and field athlete who competed in an individual event at the Olympics from the 1996 Games in
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Atlanta to the Tokyo 2020 Olympics.
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They looked at five factors: gender, nationality, event type, the length of time the
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athlete had been training at an elite level, and whether it was an Olympic year.
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When they crunched the numbers, the researchers discovered that the average age of
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participation for both genders over the past three decades was pretty consistent — a little
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under 27 years old.
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“The lone notable exception to this trend was Tokyo 2020, where the mean age of 27.6 years
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old is readily explained by the year’s delay to the Games due to the COVID-19 pandemic,” the
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study said.
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After the age of 27, there is only a 44 percent probability that an athlete’s peak is still
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ahead of them, and this number drops every subsequent year, the study found.
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“We found that most athletes, over 70 percent of Olympic track and field athletes, only
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attend one Olympic Games historically,” Awosoga said.
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“And so that window is looking like less than four years on average for an athlete in general
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to make an Olympic Games.
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The prime is this time interval of how long the best performances in your life are achievable.
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The peak is the age when you get your single best performance in your event discipline.”
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Looking back, some big Canadian names hold true to the trend.
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Donovan Bailey was 28 when he set a personal best and won gold in the 100-meter race at the
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Olympics in Atlanta.
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Brianne Theisen-Eaton was 26 when she peaked in the heptathlon competition at the annual
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Hypo-Meeting in 2015.
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And Andre De Grasse was also 26 when he got his bronze and personal best in the 100-meter race
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in Tokyo.
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To understand why 27 stands out as the median age for peak performance among Olympic track
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and field athletes, Awosoga said he can only speculate on the underlying reasons.
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“Genetics could play a role, how much the country invests into the training regimes, the
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types of living conditions, and quality of life could play a role.
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Also, the event category that an athlete is in also plays a role,” he said.
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For example, the researchers examined how the event category could predict an athlete’s peak
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age.
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They found that some event categories, such as road racing, were much easier to predict, with
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a clear trend of athletes peaking later in life.
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However, jumps and throws were much more difficult to predict.
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“We speculate that for throws in particular, the peak age of a thrower is hardest to predict
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because they had the longest careers on average out of any event discipline.
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And so there’s a lot more variability there,” he said.
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Despite the median age being 27, the study notes there are outliers to these findings.
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One example is Kim Collins, a track and field sprinter and five-time Olympian.
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In 2003, he became the World Champion in the 100-meter race at the age of 26.
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Remarkably, in 2016, he achieved another personal best at the age of 40.
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“Collins was the first one that we saw as, ‘wow, that’s an athlete who had a peak nearly
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12 years after it’s predicted.
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So that was really, really cool to see’,” Awosoga said.
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The age differences can also be seen with Canadian athletes currently at the Paris
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Olympics, McCluskey said.
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“On our team, we have got athletes that are under 20, and athletes that are over 40.
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There are a few athletes that are on their fourth Olympic team, and there are 30 athletes
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or so that are on their first Olympic team.
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So we have got a big range of experience and new athletes here,” he said.
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“Twenty-seven is in the middle, but it is a range.
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People’s performance trajectory is really individual and hard to predict.”
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That brings us to the end of this episode.
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Thank you for joining me on Morning Medical with Dr.
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Chow.
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We covered some crucial topics today, from alarming trends in youth mental health to the
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challenges of maintaining water quality for the Olympics, and finally, the peak age of track
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and field athletes.
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I hope you found this information valuable and insightful.
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Until next time, stay healthy and informed.
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I'm Dr.
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Chi-Ming Chow, signing off.