NASHVILLE, Tenn. - Here's a study that could give you a real headache: Three Tennessee cities top a list of migraine "hot spots," according to a report by Sperling's Best Places.

For this survey, the demographic research firm analyzed the number of migraine-related drug prescriptions, people's hours worked, commute time, environmental factors and diets.

Dr. Jan Brandes, a neurology professor at Vanderbilt University, said Tennessee's weather is another factor.

"One of the issues that may play a role has to do with barometric pressure shift," she said. "So, we have four seasons here, and any time there's a fluctuation in barometric pressure, that - for many migraineurs - can trigger an attack."

Knoxville, Nashville, and the Tri-Cities made the top 10 on a list that includes 110 cities.

Brandes said people can reduce their incidence of migraines by reducing alcohol and caffeine intake, and also to be aware of certain foods that, for some people, can be "triggers" for headaches.

The study estimated that 18 percent of women and 6-percent of men suffer from migraines, which are most frequent in people ages 25 to 55. For those who are diagnosed with migraines, Brandes said, it's important not to overuse medications that may relieve their symptoms.

"We know that Tennessee's very high on prescription medication use," she said. "We know that if you take a short-acting medication more than two or three days a week, that can promote daily headache."

She added that migraines often are misdiagnosed as sinus headaches, so experts recommend getting a specific diagnosis to ensure the proper medication is being used.

The report is online at bestplaces.net.


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CO2 pipelines are on the increase in the United States, and like all pipelines, they come with risks. Preparing for those risks is a major focus of the Community Benefits Agreement between Nebraska-based Bold Alliance and Tallgrass Energy Solutions.

Tallgrass plans to modify an existing gas pipeline that crosses Nebraska to transport CO2.

Bold Alliance Director Jane Kleeb said her organization stands with communities facing energy infrastructure projects, to help ensure they have what they need and that the company is giving back. She pointed to Satartia, Mississippi's 2020 experience with a massive CO2 pipeline leak as evidence of the importance of first-responder training.

"We have real money in here," she said, "$400,000 initially, and then an additional $200,000 for training and $100,000 for an emergency response system that first responders will get, to equip their mostly-volunteer firefighters."

Not only did the Mississippi first responders lack the training for a CO2 disaster, Kleeb said, but some were unaware the pipeline even existed.

Tallgrass has said it will conduct yearly training for first responders in the 10-county area, and send yearly notices to all landowners along the route. Kleeb said she expects the firefighter training to begin within the next few months.

CO2 is colorless, odorless and displaces oxygen, making it potentially deadly. It can disable internal-combustion engines on vehicles needed for evacuation. Although CO2 pipelines cover more than 5,000 miles in the United States and continue to be built, Kleeb said federal regulations aren't yet in place.

"For folks listening, you may be, like, 'What do you mean they don't have regulations in place?' And that's what we've been saying for the last few years: We need regulations in place," she said. "No pipeline will go into operation in our state until those regulations are finished, and Tallgrass then knows the type of safety valves and other things they have to put in place to be in compliance."

This month, a pipeline rupture in Sulphur, Louisiana, leaked more than 2,600 barrels of CO2 and took two hours to control.

Another provision in the Community Benefits Agreement is annual royalty payments, which Kleeb calls a "significant win" for Nebraska landowners.

"Landowners are now going to be getting 10 cents per metric ton that is sequestered of the carbon," she said. "So, that could be up to $1 million every year that will go back to landowners in the path of this pipeline."

Kleeb said no pipeline companies in the Midwest currently pay landowners a royalty for use of their land.


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April has been "Invasive Plant Pest and Disease Awareness Month," but the pests don't know that. The U.S. Department of Agriculture says it's the best time of year for Pennsylvanians to spot invasive species before they can do more damage.

Invasive pests cost the United States about $40 billion a year in damages to trees, plants and crops.

Kathryn Bronsky, the USDA's national policy manager for plant protection and quarantine programs, said hungry pests include not only invasive insects but diseases they carry, which people can unknowingly spread.

"Some examples of what to be on the lookout for are Asian longhorn beetle and spongy moths, and other pests that harm trees and natural resources," she said. "And fruit flies, citrus greening, spotted lanternfly and lots of others that can damage crops and agriculture here in the U.S."

Bronsky said spotted lanternfly eggs have not hatched yet, so she urges people to be on the lookout for their egg masses, which resemble small mud smears. She recommends scraping them into plastic bags with sanitizer, or squashing them directly. Either approach will help diminish the invasive spotted lanternfly population.

Invasive pests attack different types of trees, Bronsky said. The tree of heaven is their preferred host, but a wide range of fruit, ornamental and woody trees also are at risk. Bronsky added that climate change and certain weather conditions can magnify the impact of invasive pests.

"We know climate change can increase the level of plant pest infestation and disease infection," she said. "It also allows these pests to produce more generations each year, and extends the suitable habitat for these plant pests so they can spread to new areas that we didn't know they could previously exist."

She added that it's important to note that such items as firewood can carry pests, from spotted lanternflies to spongy moths, that can then be spread through the movement of firewood. She suggests people avoid this by purchasing only heat-treated certified firewood.

People can report sightings to the USDA online at hungrypests.com.

A new study raised red flags about respiratory health in Pennsylvania, particularly for those living near oil and gas activity.

The study by GeoHealth said nationwide, oil and gas venting and flaring exacerbate asthma in 73,000 children, including nearly 12,000 in Pennsylvania.

Jackson Zeiler, public health analyst for the Environmental Health Project, said energy developers do flaring and venting on a regular basis to remove excess gas. He explained the study looked at the potential health risks associated with the practice.

"There's adverse birth outcomes, there's cancer outcomes," Zeiler pointed out. "Volatile Organic Compounds are a big part of these emissions, which have a whole host of health effects, including respiratory health issues, different neurological effects like headaches and dizziness for people who are working in those facilities, and people who live really close by."

Zeiler noted flaring also contributes to an increased risk of hospitalizations, emergency room visits, worsening asthma and even premature death. But the energy industry said flaring is needed to minimize pressure at well sites, for testing and other reasons.

The study used satellite images and gas-imaging techniques to visualize emissions. Zeiler added companies are required to report their emissions to regulatory authorities and the data is compiled into a National Emissions Inventory through various sensors.

"They looked at the National Emissions Inventory numbers and compared it to the actual imaging that they looked at," Zeiler emphasized. "They found that the imaging saw way more emissions than was accounted for in the National Emissions Inventory. They're able to conclude that companies are underreporting, essentially, what they're flaring and what they're emitting."

He suggested Pennsylvanians could work with lawmakers on stricter reporting guidelines and transparency requirements for oil and gas operators. He also recommended advocating for greater setback distances between well sites and residential areas to minimize exposure.


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