 | | | | |  | An antidote to panics based on dodgy statistics and dubious arguments.
Edited by Rob Lyons. |  | | |  |  |
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| | | 31 March 2004 | Getting burned
Panic: 'Young face skin cancer "timebomb"', reports BBC News. The UK Department of Health (DoH) and Cancer Research UK have launched the second year of their SunSmart campaign with the news that 70 per cent of 16- to 24-year-olds surveyed still aim to get a suntan on holiday. Cases of melanoma are rising in the UK, from 5,626 in 1995 to 6,967 in 2000. Cancer Research says: 'Experts fear that while young people are constantly warned about the dangers of holiday binge drinking and unprotected sex, not enough is being done to alert them to the dangers of irresponsible behaviour in the sun.' This comes on top of calls in recent weeks to ban under-16s from using sunbeds, and to ban sunbeds from local authority leisure centres.
Don't panic: The most common forms of skin cancer (basal-cell or squamous-cell carcinomas) are definitely related to sun exposure. But they are also highly treatable and rarely serious, as Cancer Research's website confirms. The relationship between malignant melanomas, which are much more serious, and sunlight is less clear. For example, melanomas tend to appear on areas of the body that are less likely to be exposed to the sun. Rates for melanoma in Japan are comparable to those in the UK, even though there is no tradition of sunbathing in Japan.
The explanation offered for this apparent contradiction is that cancers can be caused by one-off incidents of sunburn on holiday, when parts of the body get rare exposure to the sun. Can the occasional bit of sunburn really cause cancer, or is this a case of trying to fit the facts to a shaky theory? While the British obsession with turning lobster-pink in Mediterranean resorts may lead to nasty sunburn (and the collective bafflement of the locals), it seems unlikely to cause cancer.
Professor Jonathan Rees, head of the dermatology department at Edinburgh University, believes 'there is little hard evidence to support these public health campaigns in the UK'. What such campaigns do provide is an opportunity to regulate the behaviour of young people through public health messages. There is little or no immediate threat, hence the use of the word 'timebomb'. Rather like Hell, or the non-appearance of gifts from Santa, it is a threat set in the distant future to enforce good behaviour in the present. In the case of malignant melanomas, 88 per cent of deaths in England and Wales in 2002 were in patients over the age of 45.
To suggest that young people aren't being told that sunbathing is dangerous is remarkable; the sun-and-skin-cancer link has been widely popularised in the UK in recent years. But even if awareness of the 'dangers' is low, surely the fact that warnings about binge drinking and unsafe sex are routinely ignored suggests that such campaigns are pointless?
Read: |  | Young face skin cancer 'timebomb', | | BBC News, 31 March 2004 | | Enjoy your moment in the sun, by Mick Hume, | | The Times (London), 28 July 2003 |
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| | | 24 March 2004 | Hospital 'superbug'
Panic: A new report has warned that infection rates for the 'superbug' methicillin-resistant Staphylococcus aureus (MRSA) are sky-rocketing among children in the UK - since 1990, infection rates have increased by 19 times. While MRSA is normally harmless, in a minority of patients it can lead to a condition called bacteriaemia - which can cause food poisoning, and may be fatal for vulnerable patients. Earlier figures suggested a 15-fold increase in fatal cases among adults during a similar period.
Don't panic: This is a classic case of highlighting relative rather than absolute increases in risk. In 1990, there were four cases of MRSA in children; in 2001, there were 77. Many of these cases are premature babies who are already weak, and taking antibiotics to ward off other potential infections. It would be best if such figures were used by health authorities to quietly monitor the situation, and act to reduce infection rates where possible. The figures don't warrant banner headlines.
Even among adults, MRSA is not particularly common. The worst affected hospital in the country, the North Middlesex, has an infection rate of 0.3 cases per 1000 'bed days' - meaning that for each day a patient spends in hospital, they have a roughly one-in-3000 chance of contracting the disease.
There is no doubt that National Health Service (NHS) hospitals have their problems. As one consultant-turned-patient noted in the Guardian in 2003, overworked staff often don't wash their hands or clean equipment between patients, and ward cleaning standards are appalling. Patients have every right to expect hospitals to be especially clean, yet they are frequently filthy. The hospitals with the lowest MRSA figures have rates little more than one-tenth those of the worst, suggesting that management practices and hygiene standards have a significant part to play.
It is telling that MRSA is flagged up as a 'superbug'. Whether it is SARS, avian flu, Ebola or MRSA, today's society is always looking out for the next superbug - infections that are either particularly contagious, nasty or difficult to treat. The chances of actually being struck down by any of these diseases remains slim. The fuss about superbugs says more about the fearful and vulnerable mindset of the twenty-first century, than it does about the powers of Staphylococcus aureus and co.
| | 'I was gobsmacked by the filth', | | Guardian, 21 January 2003 | | 'Superbug' crackdown is launched, | | BBC News, 5 December 2003 | | MRSA superbug hits more children, | | BBC News, 22 March 2003 |
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| | | 17 March 2004 | Binge drinking
Panic: A new report by the UK Cabinet Office suggests that action is needed to stop the tide of alcohol abuse in the UK. According to the report, between 15,000 and 22,000 deaths, up to 150,000 hospital admissions, and 1.2million incidents of violence are linked to alcohol each year. The overall cost of drinking is £20billion per year. The report suggests increased use of police powers to curb problem behaviour in city centres, which may include bars contributing towards policing costs, and better identification of problem drinkers by health services. Ministers have suggested that a shift towards a continental 'cafe culture' is required.
Don't panic: An interim Cabinet Office report from September 2003 notes that, while drinking levels have been rising since 1945, they are still substantially below consumption levels in 1900. Per capita consumption in the UK is still lower than that in Ireland, France and Germany. According to the report, in fact, most of the population drinks less than the abstemious levels recommended by the Department of Health, and 4.7million Brits are teetotal. An increase in consumption in recent years has been largely due to an increase in wine consumption - so much for the cafe culture.
Binge drinking is defined as drinking twice the recommended daily allowance in one sitting. For men, this means roughly four pints of ordinary-strength beer or one bottle of wine. For women, it means three pints or two-thirds of a bottle of wine. While drinking to excess frequently is certainly a bad idea, these definitions of binge drinking lump together ordinary social drinking with alcoholism.
What is most striking is the moralistic tone of the discussion, and the contempt for any hint of risky or reckless behaviour among the young, particularly young women. But incapable of laying down a moral standard about alcohol, the government hides behind health campaigns and junk science. The vast majority of young drinkers will suffer no more than a bad hangover and the occasional embarrassing moment.
Read: | | Binge drinking culture confronted | | BBC News, 15 March 2004 | | Alcohol misuse: interim Cabinet Office report | | Prime Minister's Strategy Unit, September 2003 | | Alcohol harm reduction strategy for England | | Prime Minister's Strategy Unit, March 2004 |
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| | | 5 March 2004 | The fat of the brand
Panic: An alliance of consumer groups has called on the UK government to ban advertising of junk food directed at children. While culture secretary Tessa Jowell seems to be opposed to legislation, she accepts that advertisers must do more to promote healthy foods. In the USA, an expert panel from the American Psychological Association reported in February 2004 that children under eight years of age are unable to view advertising critically, with the result that they beg for, and eat, more foods rich in fats, salt and sugar. The UK Food Standards Agency has described childhood obesity as a 'ticking timebomb', claiming that life expectancies may fall if nothing is done about it.
Don't panic: Tessa Jowell's reluctance to legislate may be for a practical, rather than a principled, reason: it is almost impossible to define what junk food is.
Is junk food high fat? In that case, ban adverts for butter and margarine (and foie gras, for that matter). Is it high sugar foods that should concern us? Orange juice has more calories per 100ml than non-diet Coca-Cola. Should we worry about salt? Breakfast cereals are often saltier than crisps - Kellogg's cornflakes contain more sodium per 100g (1.0g) than Walker's ready salted crisps (0.6g).
The obsession with diet is misplaced. Children have a tradition of eating rubbish, given half a chance, but in the past they had plenty of opportunity to burn off those excess calories. Now, with school sports reduced and chances to play freely curtailed by fears of stranger danger, kids are becoming much more sedentary. Moreover, evidence for a relationship between childhood puppy fat and adult obesity remains fairly weak. Obese children are still rare, and their risk of becoming obese adults is around 30 per cent.
Children may be easily influenced by advertising, but they have little or no money of their own. The real message of the call to ban adverts is that parents are too weak or stupid to say no to their kids' demands.
Read: | | Jowell cold on junk food ad ban, | | BBC News, 3 March 2004 | | Why be paranoid about puppy fat?, | | by Mick Hume |
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| | | 27 February 2004 | A pinch of salt
Panic: British food manufacturers and supermarkets have agreed to reduce the salt content in many of their products, in response to government pressure. High salt intake has been linked to high blood pressure, which in turn has been linked to coronary heart disease and strokes. Health officials argue that adults should consume no more than six grams of salt per day - and many convenience meals contain more than half a day's recommended intake in a single serving.
Don't panic: The link between salt intake and blood pressure is more controversial than government advice suggests. A recent report in the British Medical Journal concluded: 'Intensive interventions, unsuited to primary care or population prevention programmes, provide only small reductions in blood pressure and sodium excretion, and effects on deaths and cardiovascular events are unclear. Advice to reduce sodium intake may help people on antihypertensive drugs to stop their medication while maintaining good blood pressure control.'
In short, if you've already got high blood pressure, reducing salt intake might help your hypertension. However, to achieve even these small effects would require large drops in salt intake.
It is easy to forget that salt is crucial to our existence. David Blaine could survive for 44 days without food - but not without salt. Excess salt is not a problem for healthy adults. If we have consumed too much, our kidneys remove it from our blood. If salt is such a big problem, how can it have played a central role in the flavouring and preservation of food for thousands of years?
The kind of reductions proposed by the food industry will almost certainly have no effect at all - except to make our food taste a little more boring, and reinforce the myth that what we eat is slowly killing us.
Read: | | Manufacturers in last-minute deal to cut salt in food , | | Daily Telegraph, 27 February 2004 | | Systematic review of long term effects of advice to reduce dietary salt in adults, , | | British Medical Journal, 21 September 2002 [pdf, 320KB] |
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