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October 14–November 18, 2019 10 Working Nurse l WorkingNurse.com ON THE QUICK Nursing & Healthcare News The Weight of Lead Study links maternal lead exposure to childhood obesity A new study suggests that maternal exposure to lead can increase children's chances of becoming overweight or obese. The good news is that a common dietary supple- ment may reduce this risk. Lead Connections Once common in everything from pipes and paint to gasoline, lead is highly toxic and can cause a host of health problems, especially in young children. Although the use of lead has declined significantly over the past 40 years, lead exposure remains a major environmental health risk in low-income neighborhoods and for families of color. A recent study — led by Guoying Wang, M.D., Ph.D., and Xiaobin Wang, M.D., MPH, Sc.D., of Johns Hopkins Bloomberg School of Public Health and published October 2 in JAMA Network Open — found that children of mothers with high blood lead levels (over 5.0 µg/dL) were significantly more like- ly to become overweight or obese during childhood, particular- ly if the mother was also overweight or obese. Interestingly, children's own blood lead levels didn't seem to have any significant correlation with childhood weight gain, suggesting that fetal exposure to lead (which is released from the mother's bones during pregnancy and lactation) has a greater impact on weight than exposure in childhood. Folic Acid The study also suggests that mothers may be able to mitigate this increased risk by taking folic acid. In fact, the authors found that for mothers with elevated blood lead levels, main- taining adequate folate levels reduced their children's risk of childhood obesity by more than 40 percent. These results further underscore the importance of taking folic acid during pregnancy. The CDC and U.S. Public Health Service already recommend that women who are or may become pregnant eat a folate-rich diet and take at least 400 mcg of folic acid a day to help reduce the risk of certain birth defects. WN For direct links to the websites cited, find these articles at WorkingNurse.com Defining Burnout Syndrome WHO adds occupational burnout to ICD-11 O ccupational burnout remains a global problem for healthcare workers, but it recently became easier to consistently define. The World Health Organization (WHO) has added burnout to its latest, 11th revi- sion of the International Classification of Diseases (ICD-11). More Than a Bad Day The ICD-11 — the standardized diagnostic tool used by healthcare providers, public health officials, researchers and insurance companies around the world to classify different health conditions — now defines burnout as an occupational syndrome caused by ineffectively managed work- place stress, characterized by three key factors: 1. Feeling exhausted or drained of energy, and 2. Feeling more detached from or negative/cynical about your job, and 3. Experiencing a reduction in "professional efficacy" — i.e., becom- ing less able to effectively perform your professional responsibilities. This new three-point definition, which replaces a less detailed one in the outgo- ing ICD-10, emphasizes that burnout is more complex and more severe than just having a bad day or bad week at work. Any nurse or other healthcare worker may feel drained of energy after a 12-hour shift. Where exhaustion becomes burnout is when chronic stress begins to damage your relationship to your job and your ability to practice. A Workplace Problem Contrary to some early press reports, this new definition does not mean that WHO has classified burnout as a disease. The organization carefully notes that occupa- tional burnout isn't a medical condition. However, Itai Danovitch, M.D., who chairs the Cedars-Sinai Department of Psychiatry and Behavioral Neurosciences, says the ICD-11 definition "should improve recognition of burnout, as well as foster research into causes, consequences, pre- vention and interventions." This is particularly important, Danovitch adds, because burnout isn't just an individ- ual problem. "Burnout is a personal manifestation of a multifaceted workplace problem," he says, requiring solutions that "address fundamen- tal problems in the work environment." WN