Nodding off behind the wheel is not the only threat from a lack of sleep. Evidence is growing that people who regularly sleep too little and at the wrong time suffer long-lasting consequences that a nap will not cure: increased risk of diabetes, heart disease and other health problems.

“We have a societal conspiracy for sleep deprivation,” says Russell Sanna of Harvard Medical School’s sleep medicine division, who attended a TEDMED conference last week where scientists called sleep loss one of health care’s big challenges.

Just how unhealthy is it? Consider how sleep may play a role in the nation’s diabetes epidemic.

Studies have long shown that people who sleep fewer than five hours a night have an increased risk of developing Type 2 diabetes, the kind that tends to strike later in life.

Rotating shift work, three or more night shifts a month interspersed with day or evening hours, raises the risk, too, says a recent report from researchers who analyzed years of medical records from the huge Nurses’ Health Study.

Diet and physical activity are big factors in Type 2 diabetes. Certainly it is harder to work out or choose an apple over a doughnut when you’re tired, especially at 3 a.m. when your body’s internal clock knows you should be sleeping.

A study published last week, however, shows sleep plays a more complex role than that. As sleep drops and normal biological rhythms are disrupted, a person’s body physically changes in ways that can help set the stage for diabetes, reports neuroscientist Orfeu Buxton of Boston’s Brigham and Women’s Hospital.

Buxton’s team had 21 healthy volunteers spend almost six weeks living in a laboratory where their diet, physical activity, sleep and even the light was strictly controlled.

The volunteers started out well-rested. But for three of those weeks, they were allowed only about 5{ hours of sleep every 24 hours – at varying times of the day or night, to mimic a bad shift rotation or prolonged jet lag. That knocked out of whack the body’s “circadian rhythm,” a master biological clock that regulates such patterns as when a person becomes sleepy or how body temperature rises and falls.

What happened was startling: Blood sugar levels increased after meals, sometimes to pre-diabetic levels, because the pancreas stopped secreting enough insulin, Buxton reported in the journal Science Translational Medicine.

At the same time, the volunteers’ metabolic rate slowed by 8 percent. The researchers had them on a diet so they did not gain weight, but Buxton says typically, a metabolism drop of that size could mean gaining 10 to 12 pounds over a year.

The results make sense, says Dr. Michael Thorpy, sleep center director at New York’s Montefiore Medical Center and a neurology professor at Albert Einstein College of Medicine.

“If we’re going to spend a third of our day sleeping, there’s got to be a good reason for it,” says Thorpy, who notes that diabetes is far from the only worry.

Up to 70 million Americans are estimated to suffer from chronic problems with sleep, from insomnia to sleep apnea. Impaired sleep has been linked to high blood pressure, heart disease, obesity, depression, memory impairment and a weakened immune system. Still another concern: The World Health Organization has classified night shift work as a probable carcinogen, because too much light at night may hamper a hormone involved both with sleep and suppressing tumor cells.

Don’t people adjust to the night shift if they are on it long enough? Buxton says rotating shifts probably are most worrisome. In his study, the volunteers’ bodies went back to normal after nine nights of sufficient sleep at the right time. No one knows how long it takes before sleep deprivation and an off-kilter biological clock may cause permanent damage.

Montefiore’s Thorpy says natural night owls seem to adapt better to night shifts, but that people never fully adapt if they swing back to daytime schedules on their days off. Also, about 30 percent of regular night workers have trouble sleeping during their off hours or are particularly fatigued, he says, something termed “sift work disorder.”

The consumer message:

-The National Institutes of Health says adults need between seven and nine hours of sleep daily for good health.

-People you work nights, should go straight to bed when they get home, Buxton advises. Avoid too much light along the way. Thorpy says earing yellow- or orange-tinted sunglasses on the drive home can block short-wavelength “blue light” that triggers wakefulness.

-Let natural light help keep the biological sleep clock on schedule, advises Harvard’s sleep-education Web site. For most people, sunlight in the morning is crucial. For the night shift, more bright light in the evening shifts people’s internal clock, Buxton explains.

-For anyone, a sleep-inducing bedroom is one that’s dark, quiet and cool. Avoid caffeine, alcohol and stressful situations near bedtime. Electronics right before bed aren’t advised, either. Going to bed and waking up a the same time every day also helps.

Infections cause about 2 million cancer cases a year, and 80 % of those cases occur in less developed areas of the world, according to the study, which was published online May 8 in The Lancet Oncology. Of the 7.5 million cancer deaths worldwide in 2008, about 1.5 million were due to potentially preventable or treatable infections.

“Infections with certain viruses, bacteria and parasites are one of the biggest and most preventable causes of cancer worldwide,” lead authors Catherine de Martel and Martyn Plummer, from the International Agency for Research on Cancer in Lyon, France, said in a journal news release. “Application of existing public-health methods for infection prevention – such as vaccination, safer injection practice or antimicrobial treatments — could have a substantial effect on future burden of cancer worldwide.”

The researchers examined data on 27 cancers in 184 countries and calculated that about 16 percent of all cancers in 2008 were infection-related. The rate of infection-related cancers was 23 percent in developing countries and 7 percent in developed countries.

Rates of infection-related cancers ranged from 3 percent in Australia and New Zealand to 33 percent in sub-Saharan Africa.

“Many infection-related cancers are preventable, particularly those associated with human papillomavirus (HPV), Helicobacter pylori, and hepatitis B and hepatitis C viruses,” the researchers said.

In 2008, these four main infections together caused 1.9 million cancers, mostly of the stomach, liver and cervix. Cervical cancer accounted for about half of infection-related cancers in women, and liver and gastric cancers accounted for more than 80 percent of infection-related cancers in men.

The study findings “show the potential for preventive and therapeutic programs in less developed countries to significantly reduce the global burden of cancer and the vast disparities across regions and countries,” Goodarz Danaei, of the Harvard School of Public Health in Boston, wrote in an accompanying editorial.

“Since effective and relatively low-cost vaccines for HPV and [hepatitis B] are available, increasing coverage should be a priority for health systems in high-burden countries,” Danaei added.

University of Chicago Medicine researchers surveyed nearly 1,900 heart attack survivors for the study. Among patients who were sexually active before their heart attack, those who received counseling about sex before they were discharged from the hospital were 1.5 times more likely to carry on with their sex lives.

Patients who did not receive medical advice about their sex lives often either unnecessarily delayed their return to sexual activity or refrained from sex altogether.

The study also found that less than half of male patients and about one-third of female patients recalled receiving predischarge instructions on when to return safely to sexual activity.

One year after being discharged from the hospital, only 41% of men and 24% of women said they’d had a discussion with their doctor about sex since their heart attack.

The findings, published in the May 10 issue of the American Journal of Cardiology, show the need for doctors to regard sex as an important part of overall function, even after a life-threatening event such as a heart attack, said study author Dr. Stacy Tessler Lindau, an associate professor of obstetrics and gynecology at the University of Chicago Medicine.

“Doctors need to understand the significant role they play in helping [heart attack] patients avoid needless fear and worry about the risk of relapse or even death with return to sexual activity,” Lindau said in a university news release.

“Receiving instructions prior to hospital discharge about resuming sex was a major predictor of whether patients resumed sexual activity in the year following [heart attack],” Lindau said. “For women, this was the only significant predictor. The discharging cardiologist has detailed knowledge of the patient’s condition, has provided lifesaving care and is best positioned to advise on the safety of engaging in physical activity, including sex.”

If heart attack survivors don’t receive professional advice, they have to make their own, often incorrect, assumptions about the risks associated with sexual activity, Lindau said.

Europe’s environmental watchdog, the European Environment Agency, has warned that products containing endocrine disrupting chemicals should be treated with caution until their true effects are better known. However, it stopped short of recommending a ban of any specific products. A few such chemicals have already been banned, but many are still in widespread use.

Jacqueline McGlade, executive director of the EEA, said: “Scientific research gathered over the last few decades shows us that endocrine disruption is a real problem, with serious effects on wildlife, and possibly people. It would be prudent to take a precautionary approach to many of these chemicals until their effects are more fully understood.”

She singled out for particular scrutiny five classes of chemicals: phthalates, often found in pesticides; bisphenol A and other PCBs, used to make plastics and sometimes, controversially, used to make baby’s feeding bottles; parabens, found increasingly in sunscreen; and the chemicals used in contraceptive pills.

But McGlade said that the real problem was not a single chemical or product, but the fact that we are constantly exposed to so many of them, and the interactions between them in our bodies. “It’s the cocktail effect,” she said. That effect is one of the most difficult to study.

Endocrine disrupting chemicals (EDCs) interfere with the body’s hormone systems, which is why some of the most common are those found in the contraceptive pill. They are increasingly found in a wide range of products, from cosmetics to plastics. For decades, researchers have suspected potential links between the increasingly common chemicals and a range of human illnesses, and numerous studies have been undertaken.

But the EEA study is the first to take a comprehensive review of the evidence gathered over the past 15 years, and it concludes that there is serious cause for concern.

According to the study, EDCs have been found to be connected to a higher incidence of breast cancer, and an earlier onset of puberty, as well as to male fertility problems including lower semen quality.

McGlade told the Guardian that ways of dealing with the chemicals included stricter treatment of sewage, such as installing sand filtration, membrane filtration and using ozone to purify water. But she also insisted the need to look “upstream”, to the manufacture of products, to ensure their use is minimised and as safe as possible.

The EEA noted that several studies also linked exposure to some EDCs with neurodevelopmental disorders such as autism, attention deficit disorder and diminished cognitive function in children. But it concluded that more work would be needed to confirm or disprove this.

Linking EDCs to specific ailments is difficult: although tests on animals have shown clear links between the chemicals and a range of ill effects, this does not translate directly into problems for human health if these chemicals are dispersed in the wider environment.

The EEA said another complicating factor was that if these chemicals were harming the early development of the brain, reproductive, immune and metabolic systems, this could be invisible until several years or even decades after exposure.

The EEA report builds on a landmark study, the 1995 Weybridge report, that recorded serious questions over the chemicals but lacked long-range data in some key areas.

Data submitted in Parliament by the water resources ministry has revealed that groundwater in the pockets of 158 out of the 639 districts has gone saline.

It says in pockets across 267 districts, groundwater contains excess fluoride; in 385 districts, it has nitrates beyond permissible levels; in 53 there is arsenic and a high level of iron is found in 270 districts.

Besides this, aquifers in 63 districts contain heavy metals like lead, chromium and cadmium, the presence of which in any concentration poses a danger, The Times of India reported today.

The record submitted in answer to a question by Congress MP Shruti Chowdhry presents a countrywide map of where groundwater has become unfit for drinking and where contamination levels have breached government safety standards.

Nearly 80 per cent of India’s rural drinking water comes from underground sources. The growing health crisis could be worse in rural India where facilities to even detect chronic health problems arising out of water contamination do not exist.

For instance, drinking fluoride-laden water beyond safe levels can lead to fluorosis which hits teeth and bones.

Arsenic causes problems in the nervous system, reduces IQ level in children and in extreme cases can also cause cancer. Chromium is a known carcinogen. Presence of nitrates in drinking water leads to what is commonly called as blue baby disease which hits infants and can lead to respiratory and digestive system problems, said the English daily.

These chemicals have appeared in the water sources either due to too much water being drawn from deeper and deeper in the ground, or due to industrial and human waste contamination.

Government reports have shown that water withdrawal from underground aquifers is higher than the annual recharge levels in almost 15 per cent of the country’s geographical area.

The number of wells are increasing rapidly and so are the depths to which people are plumbing to bring water out as the sources dry up, it said.

This is because they have not had regular medical check-ups.

“A study has revealed that more than two million people who have high glucose levels in their blood are unaware that they have a problem.

“What is shocking is that these people have not gone for their regular medical check-ups to know of their latest health status,” she said at the opening of the Diabetes Awareness Campaign at SK Kuala Perai in Bagan Dalam recently.

She said diabetes was a “silent disease” and patients would usually only come to know of their condition seven to 10 years later.

The event was jointly organised by the Diabetes Council of Malaysia and drinking water manufacturer ECPI.

More than 30 senior citizens in Bagan Dalam received spectacles while students with excellent results in the UPSR, PMR and SPM examinations received cash rewards and bicycles at the function.

Rosnah said that in 2006, 1.5 million people were diagnosed as diabetic but in 2011, the figure had increased to three million people.

“The number will continue to rise if the people fail to change their eating habits and lifestyles,” she added.

She advised Malaysians to reduce their sugar consumption and to exercise regularly to stay healthy.

Director-general of health Datuk Seri Dr Hasan Abdul Rahman, in a statement, said so far checks conducted on 24 samples of vegetables, including cabbages found no traces of formaldehyde.

He said a risk assessment on formaldehyde exposure conducted on fish found that the risk was low and has no effect on health.

“Excessive amount of formaldehyde on vegetables could cause inflammation of the skin, and respiratory and digestive problems,” he said when commenting on vegetable sellers in China caught spraying cabbages with a formaldehyde solution to keep them fresh in transit recently.

Formaldehyde is a toxic cancer-causing compound often used as a disinfectant and for embalming.

Director-general of Health, Datuk Seri Dr Hasan Abdul Rahman said this happened in the hot spots such as Site B, Sekincan where only one gotong-royong activity during an outbreak period (31 days) was carried out despite the reported 10 cases of dengue.

“The area is till dirty and unkempt due to the lack of such community activities, and monitoring done by the Health Ministry showed a high aedes breeding rate of 1.8 per cent, resulting in residents getting dengue,” he said.

Drug administrative authorities should keep a tight rein on unqualified capsules to make sure that these products are totally destroyed, the State Food and Drug Administration said recently on its website.

Nine companies have been accused of manufacturing drug capsules with industrial gelatin, which contains a greater amount of chromium than edible gelatin and may result in chronic diseases if ingested in excessive amounts, according to a report from China Central Television last April 15.

Local drug authorities should take strict measures to stop pharmacy companies from randomly discarding the tainted capsules, said the administration.

The statement came after several cases of capsules were found to have been dumped in Central China’s Henan province since the scandal broke.

A large number of unidentified empty drug capsules were found discarded in a gutter in the suburban village of Ligang, in Zhengzhou, capital of Henan province, on April 21.

The capsules dyed the sewage water blue and formed a colorful layer stretching for more than 300 meters. The local drug bureau could not confirm whether the water and soil had been contaminated.

Sun Baozhou, the Party chief of Ligang village, said that there is no pharmaceutical company near the village, and the local government is probing the case.

“We are going to check the local residents’ homes one by one to find out whether any illegal capsule-making workshops are being hidden in the villagers’ houses,” Sun said.

In a separate case, about seven packs of green and white capsules were found discarded in a wheat field in Guodian township of Xinzheng city.

Samples have been sent to the pharmacy authority for further checks, said Du Changtao, an official from the publicity department of Zhengzhou.

The Ministry of Public Security announced on Sunday that it had confiscated 77 million tainted capsules in Zhejiang, Jiangxi and Hebei provinces, arrested nine suspects, detained 54 people and sealed 80 manufacturing lines.

Liu Aiguo, an employee of the Hebei Xueyang Glair Gelatin Factory, was detained by police on Saturday evening after allegedly setting fire to the plant on instructions from his superiors in a bid to destroy evidence, said the Ministry of Public Security.

The Ministry of Health on Saturday required hospitals nationwide to stop using contaminated medicine capsules, and said hospitals must sort through their inventories, and remove and seal any suspected contaminated medications.

The administration announced on Monday that it had revoked production licenses of another two gelatin-capsule manufacturers in Zhejiang province for “grave violations of laws and regulations”. The licenses of three pharmacy companies in Zhejiang province were revoked on April 19.

The Beijing Drug Administration has recalled 12,000 packs of tainted capsules as of Monday, and the municipal government has tightened checks on local pharmaceutical manufacturing companies, the administration said on its website.

The Xiuzheng Pharmaceutical Group Company apologized to the public on its website on April 19 after the State Food and Drug Administration listed one of its products for cold treatment as being contaminated with chromium.

The company had halted the manufacturing line of the problematic capsule and withdrawn 199 batches of the listed capsules, said the company’s statement.

More than 4.2 million people in the United States had a permanent pacemaker or defibrillator implanted between 1993 and 2008, and heart-device infections increased 210 percent during that time, according to the study.

“These infections tend to occur in very vulnerable patients who have other medical conditions that may partially contribute to developing an infection,” said study author Dr. Andrew Wang, a cardiologist at Duke University Hospital in Durham, N.C.

Pacemakers help control abnormal heart rhythms. Defibrillators use shocks to help manage life-threatening heart-rhythm abnormalities that can cause sudden cardiac death.

The findings appear in the April 25 issue of the Journal of the American Medical Association.

Heart-device-related infections, which are caused by bacteria, grow more dangerous when they spread to the heart valve or other organs. Treating these infections requires prolonged antibiotic therapy, removal of the device and possibly device reimplantation, but repeat surgeries also can be risky. Hospital charges for this complication are at least $146,000, the authors said.

Researchers set out to determine how common and lethal these infections are, and which heart patients are at greatest risk. Using data from 61 centers in 28 countries, they found that of 2,760 people with an infection of the heart’s lining or valves (endocarditis), an implantable heart device was the cause in 177 cases.

Endocarditis carries an increased risk of death compared to other heart-device-related infections.

Overall, device-related infections were more common in older men, who were about 71 on average. The infection reached the heart valve in 66 people in the study. Other complications included heart failure and persistent blood infections.

Factors such as longer hospital stays and medical procedures unrelated to the implantable device also increase the likelihood of infection. Health-care-associated infection was seen in 81 of the patients with an implantable cardiac device, the study showed.

Device removal sometimes carries more risks than benefits. “It comes down to a decision as to whether the device infection can be cleared without having to remove it,” Wang said. “In general, most experts feel removing the device is necessary.”

Infections are more likely to be fatal when the valve is involved, but those people who have the infected device removed at the time of the initial infection do live longer, the study showed.

Preventing these infections is a challenge, Wang said. Knowing the signs and symptoms can help identify device infections early. There may be skin inflammation if it is an infection of the pacemaker leads or wires. There also are systemic signs of infection, including low-grade fever, weight loss and night sweats. Earlier detection lowers risk of infection spreading to a valve, but some strains of bacteria are stealthier than others, he said.

This risk is “real and sobering,” said Dr. Gregory Crooke, a cardiac surgeon at Maimonides Medical Center in New York City. “It is not insignificant. Catch it as early as possible and intervene as early as possible.”

Hardware removal is preferable to antibiotics, Crooke said.

“Removal of the infected device is simpler than open heart surgery, which is what will be needed if the infection spreads to the valve,” he said.

Crooke said prevention starts when the device is first implanted. Doctors need to take all precautions to make sure it is done in a sterile and hygienic environment.

Dr. Ranjit Suri, director of the Electrophysiology Service and Cardiac Arrhythmia Center at Lenox Hill Hospital in New York City, agreed. “We should do everything in our power to prevent these infections starting with using pristine sterile techniques,” he said.

“We should try and limit our exposure to pathogens in the hospital by prevention techniques, including hand washing and shortening a patient’s stay in the hospital,” Suri said. “The longer they stay in the hospital, the higher their risk of infection.”

If a patient does develop an infection, “there is clearly a survival advantage with removal of the whole system,” Suri added. “Antibiotics themselves won’t sterilize the infection.”