 | | | | |  | An antidote to panics based on dodgy statistics and dubious arguments. |  | | |  |  |
|
| | Pool panic
Panic: 'Asthma rise is linked to kids' wee in swim pools', proclaims the Sun, quoting research by Belgian scientists. 226 children were tested for the presence of proteins linked to lung problems. Those children who regularly swam in indoor pools had a higher level of such proteins. Moreover, the researchers looked at a previous study of 1881 children and found that regular pool attendance was associated with higher levels of asthma.
Don't panic: Even the researchers do not think that their study is in any way conclusive. All that they suggest is that this is a new theory to explain the increasing prevalence of asthma, and that bigger studies should be done. There may well be an association between pool use and asthma, but it could be the opposite way around: asthma sufferers get taken to the pool because it is a form of exercise they seem to react less badly to.
Explaining the rising asthma statistics is unlikely to be that easy. Previous explanations suggested include: increasing traffic fumes reacting with sunlight, obesity, wall-to-wall carpets, margarine, stress, genes, passive smoking, bacteria, viruses, dust mites, central heating, furniture, pollen, pets, poor domestic hygiene, excessive domestic hygiene...the list goes on. It could even be that part of the problem is a redefinition of other conditions as asthma in recent years. Giving general advice about how to avoid asthma seems pretty much impossible.
Parents will understandably feel confused. They get told not to let their kids play outside for fear of being kidnapped by marauding paedophiles or getting run over by a speeding motorist. Now, if they take them to the pool for some safe, well-monitored exercise, they could, apparently, get asthma. And if the kids stay in their bedrooms, spending hours on their PlayStations and watching TV, they will supposedly end up obese with greater risk of diabetes and heart disease.
The Sun quotes mum-of-two Cathryn Allen on why she will continue to take her kids swimming. 'I wouldn't pay it much attention. If you took everything to heart you would never do anything with your kids.' A much healthier attitude.
Read: |  | Asthma rise 'link' to pool chemicals, | | BBC News, 28 May 2003 |
| |
| | Passive smoking
Panic: The British Medical Journal (BMJ) has been criticised for publishing a study showing that the health risk of passive smoking is exaggerated. The study has been criticised for its allegedly unreliable data, and on the grounds that tobacco industry funding may have skewed its findings. Anti-smoking group ASH argues that the study 'could be very damaging as it will be used by industry lobbyists to argue against laws to ban smoking in public places'. Perhaps more surprisingly, the American Cancer Society (whose research provided most of the data used in the study) and the British Medical Association (which publishes the BMJ) have also criticised the study.
Don't panic: Unreliable data is a common feature of research into passive smoking. As the authors of the BMJ study say, in the research conducted to date 'epidemiological data' has 'not been collected in a standardised way', and 'relative risks have been inappropriately combined'.
This new study analyses and adds to data from a previous study, which over a 40-year period examined 35,561 people in California who had never smoked, but who had a spouse who did. According to its authors, the new study has the advantage of 'long-established value as a prospective epidemiological study, large size, extensive baseline data on smoking and potential confounders, extensive follow-up data, and excellent long term follow-up'.
This doesn't make the new study the last word on passive smoking, but it is a valuable contribution to the debate. For all the attacks on the study, in fact it presents its findings in a sometimes excessively even-handed way: it acknowledges the possibility of some risk to health posed by passive smoking, and the BMJ printed an accompanying apologetic editorial which claimed that the study's authors 'may overemphasise the negative nature of their findings'.
Yet none of this was enough to placate the report's critics - because the passive smoking issue is a moral, not a medial, discussion. If the message 'Smoking can damage your health' doesn't stop people from lighting up, the message that smoking harms others is a powerful guilt-trip - whatever the facts about second-hand smoke. The reaction to this study shows that now, even research into the facts is seen as morally dubious. Unless, one can only assume, the research supports the anti-smoking cause.
Read: | | Environmental tobacco smoke and tobacco related mortality in a prospective study of Californians, 1960-98, | | by James Enstrom and Geoffrey Kabat, British Medical Journal, 17 May 2003 |
| |
| | SARS scare runs on
Panic: Severe Acute Respiratory Syndrome (SARS) is the 'killer bug' that has now affected 7628 people in 27 countries. Of these, 587 have died. There is no cure or vaccine for the disease, which appears to spread by close contact with an infected person. Many of the early victims were hospital workers, and many cases require ventilation to survive: both of which factors put a strain on health services. Death rates from the disease seem to be rising, leading to suggestions that a more virulent form of the disease may have developed. People have been advised not to visit Hong Kong, mainland China or Toronto, Canada. Sales of face masks have risen in many of the countries affected.
Don't panic: The number of reported cases remains a tiny fraction of the populations of the countries affected. Even in Hong Kong, the most disproportionately affected area, the 1698 reported cases represent just 0.025 percent of the people living there. As a comparison, in the year 2000 there were 7578 cases of tuberculosis in Hong Kong. About 10 percent of deaths in Hong Kong annually are from previously known forms of pneumonia. So while SARS in Hong Kong is a significant new strain on health services, it not out of proportion to other, existing infections.
There is even less reason for general alarm elsewhere in the world. Eighty-nine percent of all cases have been in mainland China and Hong Kong, and many cases in other countries have been among travellers who contracted the disease while in China and Hong Kong. There is panic over the apparent rise in the number of cases: but these are cumulative figures, not new cases. Of the 7628 cases reported, 3397 patients have already recovered. The daily number of new cases in Hong Kong is now in single figures, and the rate of spread in mainland China has fallen sharply, too.
The death rate does not appear to have risen. Rather, the rising figure is largely a result of the way it was being calculated. More recent figures, calculated on a different basis, suggest a higher death rate than previously thought but largely due to high mortality among people over 60 years old.
What is clear is that SARS is a powerful demonstration of the ability of medical services to respond to novel disease. The World Health Organisation (WHO) is now convinced that the virus responsible has been identified, as have the likely modes of transmission. Treatment methods have been adapted to minimise the risk to hospital staff. While there is no cure, a reasonably successful form of care has been devised. The death rate appears to be quite low, although there is variation between countries. All this for a disease that was only identified as something new and important in February 2003.
The SARS panic, rather than the disease itself, seems to be the biggest problem. Reduction in trade and tourism may badly effect many economies. Travellers face quarantine procedures at airports, as do many private school children returning from the worst affected areas. Governments have taken draconian steps to deal with anyone who refuses to cooperate with containment measures. While the health risk of SARS appears largely under control, the consequences of the panic could run and run.
Read: | | Pandemic of precaution, | | by Stuart Derbyshire | | Severe Acute Respiratory Syndrome, | | World Health Organisation | | Reported new cases by date [Excel document] |
| |
| | Sexual health
Panic: 'It is no exaggeration that we now face a public health crisis in relation to sexual health', concludes Professor Michael Adler in an editorial for the BMJ Journal Sexually Transmitted Infections. The article notes that the UK government has completely failed to meet the targets for sexual health set in the Health of the Nation report in 1992, and that things have only got worse since the Blair administration came into office in 1997.
Between 1997 and 2001, rates of infection have gone up for gonorrhoea (78 percent), chlamydia (73 percent), genital warts (six percent), genital herpes (13 percent), and syphilis (374 percent). 2001 also brought the largest single-year reporting of new HIV infection in the UK, with 4419 cases diagnosed. The rate of pregnancy in women under 16 is almost double the target set in 1992.
Don't panic: These figures should be treated with caution. Diagnoses of sexually transmitted infections (STIs) may have gone up for a number of reasons other than increased sexual promiscuity - not least, because of greater awareness of these diseases. For example, 10 years ago, young people could have been forgiven for thinking that chlamydia was a character in a Shakespeare play, but it would be difficult to avoid discussion of it now. Adler notes that attendance at clinics has doubled: surely leading to a rise in diagnosis of STIs.
Moreover, some of the percentage rises mask quite small absolute rises. The figure for syphilis seems alarming, but there were only 697 cases in 2001. HIV remains a disease predominantly of homosexual men and heterosexuals who contracted the disease in Africa: 79 percent of new infections among heterosexuals were acquired abroard. That is not to belittle the problem for those groups, but indicates that there is little in the figures that is new or which suggests a problem for the population as a whole. As for underage pregnancies, the current rate of conceptions is 8.3 per 1000 - exactly the same as it was in 1992.
This is not an indication of a massive threat to public health, but rather shows the nonsensical character of the government's attempts to set and meet targets for 'sexual health'. Adler, however, complains that 'sexual health is not an NHS or political priority'. Heaven forbid it should be one. Sex should be a private matter to do with procreation and pleasure, not a public matter of health and disease.
Read: | | Sexually Transmitted Infections, | | April 2003 | | Expert warns of sex disease crisis, | | BBC News, 15 April 2003 |
| |
| | Passive smoking
Panic: A new report suggests that 12,000 people in the UK die each year as a result of breathing second-hand tobacco smoke (SHS) (1). The report, produced for Action on Smoking and Health (ASH) and the TUC, further notes that among the UK's 53,000 bar workers, '17 percent will die from passive smoking during their working lifetime'. It is suggested that there are about 900 deaths among office workers and 146 deaths among manufacturing workers due to SHS. The conclusion is that there must be a ban on smoking in all workplaces, as improved ventilation could never be adequate to make workplaces completely safe.
Don't panic: Even by the standards of the passive smoking debate, this report is alarmist. The link between second-hand smoke and ill-health has always been controversial. Even in cases where a link has been made, the figures suggested have always been lower. For example, the British Medical Association (BMA) produced a report in November 2002 that suggested a death toll of around 1000 in the UK each year. It is remarkable that the new report has produced a figure 12 times greater.
While a link between SHS and a slightly increased level of illness seems plausible on the surface, no link has ever been proven. Even where studies have found an increased risk of cancer, the increase has been too small to be practically significant. ASH's website suggests the risk of lung cancer for non-smokers is about 10 cases per 100,000 people (1 in 10,000) (2). An ASH factsheet from July 2002 suggests that 'Non-smokers who are exposed to passive smoking in the home, have a 25 percent increased risk of heart disease and lung cancer' (3). In other words, 12.5 cases per 100,000 population (1 in 8,000).
Moreover, studies that show no link are often not published. When these were taken into account by researchers at the University of Warwick, the relative increase in risk fell to about 15 percent (4). An effect this small would usually be dismissed as potentially the product of other kinds of research bias. For this reason, researchers are usually advised to treat with extreme scepticism increases in risk of less than 100 percent.
For anti-smoking campaigners, the passive smoking debate is a perfect stick to beat smokers with. It suggests that, even if a smoker doesn't care about their own health, he should be more careful as regards the health of others. The argument seems to have been very successful, as recent proposals for outright bans on public smoking in New York and Norway suggest. But is it really the place of the authorities to micro-manage our lives through dubious morality dressed up as science?
| | (1) A killer on the loose [.pdf, 600KB], | | ASH | | (2) Factsheet no.5: smoking and respiratory disease, | | ASH, July 2001 | | (3) Factsheet no. 8: passive smoking, | | ASH, July 2002 | | (4) Passive smoking risk 'overstated', | | BBC News, 11 February 2000 | | Read: | | Passive smoke gets in their eyes, | | by Brendan O'Neill |
| |
| | Anthraxiety
Panic: A new study published in the Proceedings of the National Academy of Sciences warns that unless the US authorities become better equipped to deal with anthrax attacks, then one kilo of spores unleashed on a major city will kill 123,000 people - even if every victim of the disease receives medical treatment. The study advises people to stockpile antibiotics in their homes, on the grounds that distributing antibiotics after an attack would be too inefficient.
In the UK, this coming Sunday will see a mock chemical attack staged at London Underground's Bank station, as a means of preparing firefighters, ambulance teams and the police for the real thing. Volunteers will play the role of victims, and mass evacuation and decontamination will be rehearsed. Meanwhile in Leeds, a museum has launched a new exhibition dedicated to anthrax, involving schoolchildren having to vote on whether or not immunisation against the disease is a good idea.
Don't panic: Anthrax is an ineffective biological weapon, especially when used against large populations. It is difficult for anthrax to be transmitted from one human being to another, and the most common form of anthrax (affecting the skin) is easily identifiable and treatable - it is only the rarer forms of anthrax (affecting the gut and lungs) that are difficult to identify and treat.
Panic around anthrax has grown since anthrax spores were sent in mail and discovered in offices in the USA, in the months following the terrorist attacks of 11 September 2001. These anthrax spores resulted in approximately two dozen people being infected, of whom five died. But successful biological terrorism remains an incredibly rare occurence - the most notable recorded example, prior to the 2001 anthrax case, is the spread of salmonella by a religious sect in Oregon in 1984. This infected approximately 700 people, but killed none. The impact of the anthrax panic after 11 September, by contrast, was considerable. Instead of worrying about anthrax attacks, the authorities might do better to consider the consequences of their own irrational scaremongering.
Read: | | Anthraxiety | | by Dr Michael Fitzpatrick | | Simulating leadership | | by Jennie Bristow | | Anthrax response plans inadequate, study warns, | | Washington Post, 18 March 2003 | | Exhibition charts history of anthrax experiments | | Guardian, 12 March 2003 |
| |
| | Text message injury
Panic: Text message injury has hit the headlines again. Andrew Chadwick, director of the British Repetitive Strain Injury Association, who first coined the term 'text message injury', has warned of the 'tingling, burning, pins and needles or a long, dull pain' that afflict texters.
The British Chiropractic Association (BCA) claims that 'text messaging rapidly, over a long period of time, could cause repetitive strain which may cause both short- and long-term injuries'. The BCA has issued a series of exercises that texters should do to avoid injury, and has called for mobile phones to come with bigger buttons, prompting fears of a return of the brick-sized mobiles of the 1980s.
Don't panic: Repetitive strain injury, where repetitive action and awkward posture affect the muscles, tendons and nerves, is a problem that some people suffer from. But there is no reason to think that when such injury is caused by text messaging, it needs its own scary category. The 'Nintenditis' scare of the early 1990s, where we were told that children playing Nintendo games consoles could suffer injury to their thumbs, was equally unwarranted.
It is telling that the BCA's 'Too much text can be bad for you' press release has statistics that show an increase in mobile phone use, but nothing that indicates the scale of the text message injury problem. Instead, it simply warns that 'too much text messaging could lead to injuries in later life'. Any number of things could conceivably lead to problems 'in later life' - that's hardly sufficient grounds for a panic.
Read: | | Texting your way to TMI | | by Ray Crowley | | Too much text could be bad for you warns British Chiropractic Association (.pdf 13.4 KB) | | British Chiropractic Association, 10 March 2003 | | Txters warned about damaging their health | | Children's BBC, 10 March 2003 | | Do you practise safe text? | | Evening Standard, 10 March 2003 |
| |
|
|
|
| |
|
|
What is spiked?
spiked is an online publication with the modest ambition of making history as well as reporting it. spiked stands for liberty, enlightenment, experimentation and excellence.
Read on...
|
| |
|
|
