Age-related macular degeneration (AMD) has long been the leading cause of severe vision loss in Canadians. As age is one of the predominant risk factors for developing this condition, all Canadians over 50 years of age are strongly encouraged to learn more about the warning signs, as well as having an understanding of what this condition entails.

AMD gradually takes away central vision by the slow degeneration of the macula (a small area located in the very centre of the retina). Due to the slow and painless progress of this condition, AMD can remain undetected until it reaches the more advanced stage; routine eye exams however can detect it in its earlier stages. Therefore it is highly recommended that all people over 50 have their eyes regularly examined. In rare cases AMD can progress incredibly fast, i.e. weeks and/or months, resulting in permanent central vision blindness. It is imperative that AMD be caught as quickly as possible as earlier treatment usually results in less vision loss.

AMD is characterized by either 'dry' or 'wet'. Dry AMD occurs first; all people who have wet AMD have had the dry form of the condition. For 85-90% of people however, AMD will stay at the dry level and not progress to the advanced wet AMD. Dry AMD happens when light sensitive cells in the macula begin to break down; this causes gradual blurring of the central vision. As it progresses some individuals may see a blurry spot in the center of their vision. This loss of central vision increases as less of the macula can function. This can happen to either one eye or both; it is possible that both eyes may be affected at different times as well. For those who have AMD in one eye there is an increased likelihood that AMD will develop in the other eye. It is also possible to have AMD in both eyes and have the eyes progress to wet AMD at different interval.

A common early sign of dry AMD is drusen, which are yellow deposits located under the retina. Scientists are uncertain about the connection between drusen and AMD; what is known is that an increase in size and/or number of drusen raises the likelihood of developing into advanced dry AMD or wet AMD. Drusen alone does not cause vision loss, and many people can have a few small drusen in their eyes and not progress into AMD. However, people who have drusen should be regularly tested by their eye care professional in order to monitor this condition.

Wet AMD (also known as advanced AMD), occurs when abnormal blood vessels start to grow under the macula. These blood vessels are usually quite fragile and often leak blood and fluids, which raise the macula from its normal location at the back of the eye. This damage occurs rapidly, resulting in a greater loss of central vision. Wet AMD tends to be quite unpredictable and can appear very suddenly. There is no set schedule of when dry AMD changes into wet AMD; one of the early symptoms of wet AMD is the appearance of straight lines that are suddenly wavy. This, as well as any other vision change, should be reported immediately to your eye care professional as a comprehensive dilated eye exam is necessary.

There is currently no known cure for either dry or wet AMD. However, there are different treatments, depending on which type of AMD you have that can halt the progress of the condition. People who have the dry form of AMD can slow the progression and/or reduce vision loss by using specific high dose ocular vitamin therapy. As well, lifestyle changes such as quitting smoking and/or and improved diet can have a positive impact on reducing the chance/speed of progression of the disease. As well, vision should be monitored on a regular basis in order to track the progression.

Currently effective treatment is not available for all forms of wet AMD. Research is progressing, but at this date only 3 treatments for wet AMD have been approved by Health Canada. Although these treatments will not cure the condition, they can be very effective in halting the progression of wet AMD. They are:

Laser Photocoagulation (LPC): This method uses a high energy beam of light (laser) to destroy the fragile, leaky blood vessels. However, this method poses a risk of damaging surrounding healthy tissue as well as some vision. As well, there is a high risk of developing new blood vessels after this treatment; repeated treatments are usually necessary. Laser surgery is only used to treat a very small percentage of people who have wet AMD; it is usually most effective on those whose leaky blood vessels have developed away from the fovea (central part of the macula).

Photodynamic Therapy: This method involves injecting the drug verteporfin into an arm, which then travels throughout the body. This drug will 'stick' to the surface of new blood vessels; when a light is shined on the eye for 90 seconds the light will activate the drug, destroying the new blood vessels. It does not destroy the surrounding healthy tissues, but those who are being treated with this method must avoid any bright lights (indoor and outdoor) for five days after the treatment. It is a painless course of treatment that can be done in a doctor's office and usually takes 20 minutes. This treatment may need to be repeated as the results are often temporary.

Injections: This is the latest method to treat wet AMD and involves injecting drugs directly into the affected eye. Also known as anti-VEGF therapy, the injections work by blocking the growth of new abnormal blood vessels that tend to grow at an abnormally high level in eyes with wet AMD. Injections may need to be done as often as monthly. Successful injection treatments can help slow down vision loss; in some cases it can also improve vision. Injections may need to be done as often as on a monthly basis depending on the rate that the wet AMD is progressing. It is done in a doctor's office; the eye is numbed before injection and afterwards the eye will be monitored.

Research shows that AMD occurs more in people of white origin than those of African American descent. As well, women appear to be at greater risk for this disease than men. Having a family history of AMD can also increase the odds of having the condition. However, there are lifestyle choices that can either lessen the risk, and/or slow down AMD. Smoking has been linked to the increased risk of AMD; obesity has also been linked to the progression of early and intermediate stages of AMD to advanced AMD. Eating a healthy diet of fish and leafy green vegetables can reduce your risk of developing AMD; it is also important to maintain a healthy weight, exercise and maintain a normal blood pressure.

More information can be found about Age-related macular degeneration at AMD Canada, as well as the Canadian National Institute for the Blind.

So far, 15 Canadian deaths have been linked to the listeria outbreak that has now spread throughout most of Canada. Nine deaths in Ontario, one in Alberta and one in British Columbia have been attributed to listeria, either as a contributing factor or the direct cause. 4 deaths in Ontario as well as one death in Quebec and another in Saskatchewan are currently being investigated to determine whether listeria was a contributing factor. As well, the number of listeriosis cases has now reached 33, from the original 17 that had been diagnosed. Another 25 illnesses are being investigated as well to determine whether listeriosis was the cause, as well as 6 more deaths.

The outbreak has been definitively linked to a north Toronto plant of Maple Leaf Foods Inc. The plant has since been closed for mass sterilization. Maple Leaf Foods has recalled almost all products that were produced at this plant; so far over 20 different meat products totaling over 500 000 kilograms, have been recalled. Supermarket chains Loblaw Co. and Sobeys Inc. have recalled close to 50 ready-to-eat sandwiches and other deli products that contain meat that could be contaminated as it originated from the affected Toronto plant. This is due to the uncertainty of what lines have been contaminated in the food plant. Currently, the only meat products that have tested positive for listeria were manufactured in July, but all products that were manufactured from June 2 and forward are being recalled as a preventative measure. King Bean Wholesalers is also recalling 4 different varieties of roast beef sandwiches from stores that are located throughout British Columbia.

Maple Leaf Foods Inc. has taken full responsibility for the listeria outbreak. They have released television commercials as well as full page newspaper ads apologizing to the Canadian public and vowing to do to everything in their power to rectify the situation. The spokesperson for Maple Leaf has stated that the company is in no way is blaming Canada's current food inspection laws and guidelines. Health Canada and the Canadian Food Inspection Agency are supervising and monitoring the food recall at the Toronto plant.  Maple Leaf Foods and the Canadian Food Inspection Agency have set up toll-free phone lines that consumers can call with any questions or concerns. These phone numbers are 1-800-568-5801 and 1-800-442-2342.

Public health officials are warning that the current amount of Canadians that have become ill, or may become ill, from listeriosis will likely increase. Every illness and/or death must be investigated in order to determine whether or not the strain of listeria that has been linked to the tainted meat is actually responsible. They are currently locating and interviewing people in order to establish whether they have been ill with listeria, and to determine the likely source of the contaminated food.

To see the list of all recalled products visit the CFIA website. Remember that there is the possibility of more products that will be recalled. Although this outbreak was initially thought to be in Ontario, other provinces are reporting cases that may be linked to Maple Leaf products. Check with your local health agency to see whether or not these products may have been sold in your region. You may want to check every few days in order to be aware of any new recalls.

The Health Minister of Canada has announced that Canada will be increasing protection for Canadians who suffer from food allergies. This will be done through new labeling requirements for food allergens, gluten sources and added sulphites contained in prepackaged foods. Health Canada has also announced that they will also launch several studies related to allergies, including a large national study of food allergy prevalence. They will also conduct 2 studies on the dietary habits and coping skills of people who have celiac disease and are on a gluten-free diet.

Currently, the Food and Drug Regulations requires that ingredients of food products be declared on the labels of most prepackaged foods; however components of certain ingredients are exempted from this declaration. The Canadian Food Inspection Agency does have the ability to recall foods that are currently exempted from the labeling requirements if a health risk is identified; however the tougher labeling regulations will provide manufacturers with clear rules establishing procedures to be followed in a consistent and systematic fashion, thereby reducing the number of food recalls and/or preventable allergic reactions. The improved regulations would require that manufacturers now declare all food allergens, gluten sources as well as added sulphites on prepackaged food labels. The new regulations would detail exactly how these are to be listed on the food labels.

Some Canadians may be unaware between the differences of food allergies and intolerances. You are not necessarily allergic to a particular type of food just because it does not agree well with you. Although certain foods may make you sick, food allergies are much more serious and can be fatal if untreated quickly.

• Food intolerance: is a food sensitivity that does not involve the immune system. Unlike food allergies, or chemical sensitivities, where a small amount of food can cause a reaction, it usually requires a more normal portion of food to produce symptoms of food intolerance. Although these are commonly mistaken for a food allergy, intolerance is more likely to originate in the gastrointestinal system and caused by an inability to digest and/or absorb certain foods, or food components. One of the most common forms of food intolerance is lactose intolerance. This occurs in people who lack an enzyme called lactase, which is needed by the body to digest lactose (a sugar in milk). Symptoms of lactose intolerance may include abdominal pain, bloating, flatulence and/or diarrhea.
• Chemical sensitivities: This occurs when a person experiences an adverse reaction to chemicals that naturally occur in, or are added to foods. This may be the caffeine found in coffee, tyramine in aged cheeses, and flavor enhancer MSG.
• Celiac disease: This is an inherited intolerance to gluten. The main sources of gluten are cereal grains; the only current treatment for celiac disease is a strict diet that is completely gluten free.
• Food allergies: are sensitivities caused by a reaction of the immune system to specific proteins in a food. Currently, it is estimated that food allergies affect as many as 6% of young children and 3-4% of adults. In allergic individuals, a food protein is mistakenly identified as harmful by the immune system. The first time the body is exposed to such a protein the immune system responds by creating antibodies called immunoglobulin E (IgE). When the individual is exposed again to the same food protein, Ige antibodies and chemicals such as histamine are then released. Histamine is a powerful chemical that causes a reaction in the respiratory system, gastrointestinal track, skin and/or cardiovascular system.

It is also a wise choice to carefully read all labels of prepackaged foods that you are buying. Make sure you also understand what the labels mean, and what the ingredients are. Some people can become confused with the long, confusing names of products; some research of your own will give you a better understanding of what you are buying, as well as what the nutrition value of that product is.

Summer can be an ideal time to take part and/or all of your accrued vacation days from work, especially for those who wish to have a family holiday. Taking time off from your work environment is essential in order to maintain mental and physical health. This time is also valuable in terms of maintaining your relationships with your family and friends. Not taking time off from work often leads to higher levels of stress, which negatively impact health. For those who already have health issues such as cardiovascular problems, acute stress can be quite dangerous.

A study which started in 1948 had women filling out questionnaires over a 20 year period that tracked their vacation time, as well as health status. Back then the study showed that women who took a vacation only once every 6 years were almost 8 times more likely to develop health issues such as coronary disease and/or heart attacks than those women who took a minimum of 2 vacations a year. The published study in 1992 also factored in health issues such as obesity, diabetes, smoking and the amount of income; once again those at a higher risk level were those that did not take regular vacation time.

Another study was conducted in 2000 which studied 12,000 men who were considered high risk for coronary disease over a 9 year period. The results showed that those men who did not take a yearly vacation had a 21% higher risk of death from all causes and 32% more likely to have a fatal heart attack.

A study has shown that 23% of Canadians have canceled and/or postponed their vacation plans due to their obligations at work. Canadians also "give back" an average of 3 days of their vacation time that though they are entitled to, do not take due to work. This is in part due to the fact that most Canadians are conditioned to value employment productivity sometimes more than their work-life balance. To maintain work-life balance, it's also important not only to take your vacation days, but to take them properly. 42% of Canadians seem to use all their time at once, taking a 2-3 week vacation from work, while the rest seem use their days here and there. Taking 2 weeks off seems to be the ideal amount of time; it allows the body and mind the chance to properly unwind and become rejuvenated. However, breaking up your vacation time into a series of long weekends does not seem to give you enough

Every company will have their own policies regarding when to submit your vacation days in order to get them approved. This does require sometimes making plans a few (or more) months in advance. You will need to be proactive as your vacation time approaches, in order to let all the other staff know exactly when you are leaving, and for how long. If someone is temporarily filling in for you, you should make sure they are aware of what their responsibilities will be, and what realistically you expect them to accomplish. Due to this advance planning, you may find that when your vacation finally comes, you are swamped with work, i.e. in the middle of a project. This may require you to be in contact with your office while you are on vacation. If this is happening to you, designate with your office a certain time of day that you will be available to them. Try and deal with your work within that window of time, so you can actually relax and enjoy your vacation the rest of the time. Make sure that all people involved are aware of this schedule, as well as that your cell phone/blackberry/laptop etc will be turned off until the next appointed time.

Remember that by not taking time off you are reducing your productivity as well as optimum health status. Whether jetting out of the country, or simply staying home, all Canadians need to take time to unwind and relax in order to be at their peak performance for work.

With summer here bringing the hot weather, air quality can be a big concern for Canadians, especially depending on where you live. Even for those who do not have respiratory problems, smog can be quite harmful and pose a health risk. For those with existing breathing problems, smog can be very dangerous.

Originally, the word smog was a definition of the mixture of smoke and fog. However, today smog defines the harmful mixture of gases and particles and is considered air pollution. Although it is usually visible as haze, it can also be invisible, due to particles that are too tiny to be visible. Weather factors such as humidity, as well as the type of pollutants determine what type of smog you experience on that certain day.

Many air pollutants combine to make smog. These pollutants are usually:

• Ground-level ozone: Ozone that is found high in the atmosphere is known as "good ozone"; it helps protects us from the sun's rays. However, ground level ozone is harmful to human health when it is inhaled. It can exacerbate respiratory problems for those who already have asthma, COPDS and other lung diseases, as well as those who suffer from cardiovascular diseases. Ground-level ozone forms when nitrogen oxide and volatile organic compounds from vehicle exhaust, factory emissions, etc. react with sunlight.
• Fine Particulate Matter (PM): A broad term for particles of liquids and/or solids that are air pollutants. PM 2.5 is matter that is very small but that can be breathed deeply into a person's lungs and remain there. It also stays in the air longer and travels further than other large particles. It is usually a result of vehicle exhaust, wood burning, paved and/or unpaved roads, construction, industry and forest fires. This tends to be the matter that makes people cough and/or sneeze as well as irritate the lungs, eyes, and/or throat. This also exacerbates breathing problems for those who already have respiratory disorders, and can actually cause heart attacks in those who have existing heart diseases.
• Sulphur Dioxide: A colorless gas that usually smells like burnt matches; this is a main ingredient in acid rain. When this combines with Volatile Organic Chemicals (VOC) and sunlight it creates ground-level ozone. The main causes for this gas are burning fossil fuels, industry mills, volcanoes and hot springs, and diesel vehicles. Exposure to sulphur dioxide can actually cause lung disease. It also irritates the nose and throat and causes breathing problems, as well lowering the lung's natural defense system. For those with cardiovascular and/or respiratory problems, exposure can make these worse.
• Nitrogen Oxides: This is caused by the same things that cause sulphur dioxide. Exposure can lower the body's resistance to lung infections as well as cause shortness of breath and irritation of the upper airways.
• Total Reduced Sulphur Compounds (TRS): A mixture of gases that usually smells like rotten eggs. This is common around areas that contain steel, pulp and/or paper mills, refineries and sewage treatment plants. Exposure usually results in headaches and/or nausea.
• Carbon Monoxide (CO): Odorless, tasteless, colorless gas that is poisonous at high levels. This is usually caused by burning fossil fuels in vehicles, the production of metals as well as emissions from heaters. At low levels, it can cause headaches, dizziness, lack of breath as well as slower reflexes and perception. High level exposure can result in unconsciousness, seizures, coma and respiratory failure that can result in death.
• Volatile Organic Compounds (VOC): These are gases in the vapors of gasoline, solvents as well as oil-based paints. They react with nitrogen oxides when it is sunny and/or warm and cause ground level ozone. The most common causes for VOCs are burning gasoline, the production of oil/gas products, wood burning and the evaporation of liquid fuels and solvents. Exposure can cause irritation to the eyes, nose and/or throat, headaches, nausea, loss of coordination and can also worsen lung and heart conditions.
• Polycyclic Aromatic Hydrocarbons (PAH): This is caused by the incomplete burning of carbon materials, i.e. wood, oil, garbage, coal, etc. Over 10,000 compounds make up this group of pollutants, which are responsible for lung irritation as well as skin rashes. Some PAHs have been found to cause cancer in laboratory animals when they are inhaled, ingested, and/or come into contact with skin. The major sources of PAHs are furnaces, exhaust from vehicles, cigarette smoke, wood burning, and fuel producing plants.

It is estimated that smog causes 5900 early deaths in Canada per year. The majority of these early deaths occur in Canadian major cities. While smog is harmful to everyone's health, those who are at high risk are:

• People already suffering from lung disease, i.e. asthma, emphysema and/or chronic bronchitis
• Children and teenagers as their lungs are still developing and they tend to be more active outdoors. Their smaller size also means that they are breathing in more pollutants per pound of body weight which leads to a higher absorption rate.
• Seniors
• Anyone who does vigorous outdoor activities during high smog days, especially those that work outside (construction workers, etc)

Although April – September is usually considered "smog season", it can and often does occur all year round. Ground level ozone generally is more prevalent in the warmer months, while fine particulate matter occurs during the winter. Everyone should be aware of how air quality affects their breathing, especially those listed above. Pay attention to air quality advisories, and try to avoid being outside during times when smog is prevalent.

For those who are sensitive to smog, or suffer from pre-existing heart and/or lung problems, try to stay inside in an air-conditioned environment. Air conditioning can help make breathing easier during the hot summer months, especially in hot and humid weather. If you can’t avoid being outside, make sure to avoid exerting yourself physically. Try to stay in shady areas, as well as roads and streets with heavy traffic. Drink plenty of water, and rest often. Exercise indoors, such as a gym or your home. Going outdoors in the morning instead of the afternoon is also advisable; the pollution levels are usually lower during this time period. If you have asthma, never leave home without your inhaler; chances of having an asthma attack are much higher when the air quality is poor.

Smog can have a negative affect on your health for up to a day after being exposed. If you experience problems breathing, make sure to contact your physician as soon as possible. For severe asthma attacks or other serious difficulties breathing, go to your nearest emergency room.