In place of the regular article by the Environmental Health Committee, I have asked my friend and colleague, Dr Nelson Ames, to write about his experiences in Thailand during the disastrous tsunami of 26 December 2004. His story is a vivid reminder that environmental catastrophes can happen anywhere at any time. Will we be ready if one happens here?
—W.G. Meekison, MD
Chair, Environmental Health Committee
Exposure to air pollutants is an important public health problem in British Columbia. Conservative estimates place the premature death toll from air pollution in BC at approximately 140 to 400 deaths per year, with 700 to 2000 hospital admissions and 900 to 2700 emergency rooms visits caused annually by air pollution.[1]
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When considering a treatment plan for a pregnant or breastfeeding woman with a psychiatric disorder, the risks to the mother and the fetus or newborn from both the illness and the treatments must be assessed. Medications that should not be used during pregnancy are listed in Table 1. If possible, psychotropic medications in general should be avoided during the first 12 weeks of pregnancy, as this is the time of the most active organ development in the fetus.
Read More Despite the high prevalence and negative consequences associated with depression and anxiety disorders during pregnancy, information to guide women and their physicians about treatment options is limited. Current treatments include psychotherapy (see “Nonpharmacological treatments during pregnancy and lactation,” elsewhere in this issue) and pharmacotherapy.
Read More When managing pregnant and postpartum women with mild or moderate symptoms of psychiatric disorders, clinicians should consider using nonpharmacological treatments first. When managing women with severe symptoms, clinicians should consider some of these same nonpharmacological treatments in addition to the psychotropic medications (see articles elsewhere in this issue) that are usually needed.
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