 | | | | |  | An antidote to panics based on dodgy statistics and dubious arguments.
Edited by Rob Lyons. |  | | |  |  |
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| | | 11 May 2004 | No fun in the sun
Panic: 'Over a third of parents admit sunburn slip despite warnings.' So declared Cancer Research UK on 9 May 2004, as it published a survey suggesting that, while most parents know that children should be protected from sunburn, many of them do not take the necessary precautions. Also, most parents are unaware how quickly children can start to burn, and 41 per cent think that it is desirable for children to have a tan. According to Cancer Research's press release, 'Children's skin is much more delicate than adults' and research shows that sunburn in childhood can double the risk of getting skin cancer later in life'.
Don't panic: Avoiding sunburn is a good idea for both adults and children, not least because it hurts. But it is doubtful whether avoiding the sun improves life expectancy.
The most common forms of skin cancer (basal-cell or squamous-cell carcinomas) are clearly related to sun exposure. But they are also highly treatable and rarely serious, as the Cancer Research website confirms. The relationship between malignant melanomas, which are far 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.
Claims of parental neglect possibly leading to the early death of their offspring are greatly exaggerated. Melanomas in the young are rare. In the case of malignant melanomas, 88 per cent of deaths in England and Wales in 2002 were in patients over 45. So if there is a link at all, it is unlikely to affect people until later in life.
What is striking is how one panic contradicts another, to the extent that it seems there is no safe course of action. Apparently if our children play in the sun they run the risk of skin cancer or abduction - but apparently if they stay indoors, watching TV or playing computer games, they can look forward to becoming obese victims of heart disease or diabetes. There is even evidence to suggest that some exposure to sunshine may be valuable in helping to counteract cancer.
The fact is that health campaigns, for the most part, have been unsuccessful in changing adult behaviour - though they have succeeded in increasing anxiety levels. So now health campaigners seem to be upping the ante, along the lines of, 'If you tolerate this, your children will be next'. Parents would be best advised to use their own judgement and ignore such scaremongering.
Read: |  | Children 'at risk of skin cancer', | | BBC News, 9 May 2004 | | Don't panic: Getting burned | | Enjoy your moment in the sun, by Mick Hume | | The Times (London), 28 July 2003 | | Vitamin D may have preventive properties against cancer, | | The Scientist, 24 August 2000 |
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| | | 27 April 2004 | New scares over SARS
Panic: Severe acute respiratory syndrome (SARS), a viral chest infection that resulted in 774 deaths worldwide between November 2002 and July 2003, has hit the headlines again, with a new outbreak in China. There have been six new suspected cases of SARS in Beijing, and two cases (one of which has resulted in death) in the eastern province of Anhui. Two of these eight suspected cases are researchers at China's leading virus laboratory, the National Institute of Virology in Beijing, where the SARS virus is being studied. It is thought that this latest outbreak can be traced back to the laboratory, and there are rumours of a safety breach.
One of the laboratory researchers thought to have contracted SARS travelled by train between Beijing and Anhui, prior to being diagnosed with the disease, and it is feared that she exposed many fellow travellers to the virus. Now over 600 residents of Beijing and over 300 residents of Anhui have been quarantined, the National Institute of Virology has been closed, and safety measures have been introduced on public transport. Meanwhile, scientists in Canada and elsewhere have responded to the outbreak by calling for tighter regulation of the study of SARS.
Don't panic: SARS is a relatively contagious disease, that in about 10 percent of cases in the previous outbreak led to death. But the reaction to SARS by authorities around the world continues to be out of proportion to the problem, causing enormous and unnecessary damage to public morale and to the global economy. Discriminate quarantines, and attempts to detect unreported cases of SARS and chains of transmission, are sensible precautions in this instance. But broadening the number of people thought to be at risk from the disease to everyone who might have encountered a laboratory worker on public transport can achieve nothing other than a nationwide panic.
Some of the measures now being taken in China - for example, railway stations and airports being ordered to take the temperature of passengers, in an attempt to detect fever - seem more to be about being seen to be act than dealing with the problem. The number of train journeys that the laboratory worker in question is said to have made between Beijing and Anhui after she became infected, seems to increase depending on which reports you read. The preoccupation with public transport as a conduit for disease, and concerns that China's week-long national holiday at the beginning of May will further increase the risk of infection, demonstrate that the SARS panic has a life of its own beyond the practical matter of addressing eight suspected cases and a death.
Perhaps the saddest thing about this latest episode is that scientific research into SARS has been implicated in the spread of the disease. The most important thing, if SARS is to be dealt with effectively, is not for people to be frightened of it, but to continue with the kind of research that is conducted at the National Institute of Virology.
| | Additional patients in China under investigation for SARS; WHO team travels to Beijing, | | World Health Organisation, 26 April 2004 | | WHO's to blame for the SARS panic?, | | by Rob Lyons | | Summary of probable SARS cases with onset of illness from 1 November 2002 to 31 July 2003, | | World Health Organisation, 21 April 2004 |
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| | | 15 April 2004 | An eggs-aggeration
Panic: 'Danger warning after increase in drug residues found in eggs', reports the Guardian, after a report from the Soil Association revealed high levels of the veterinary antibiotic lasalocid in samples of eggs. One sample contained 3450 parts per billion of the drug, and 12 per cent of eggs sampled contained reportable levels - up from just one per cent in 1999. Although lasalocid is approved for use in chickens intended for meat, it is not approved for use in egg-laying hens. Richard Young of the Soil Association said: 'We believe that eggs contaminated at the high levels found in some samples last year pose real risks to some vulnerable consumers.... [U]ntil this drug is banned, those most at risk should limit the amount of egg eaten.'
Don't panic: There is no direct evidence that lasalocid is harmful to humans, although no proper studies appear to have been carried out. The Soil Association notes in an earlier publication that: 'We have been unable to find a single scientific review of the potential toxic effects for humans of consuming lasalocid residues in food.' However, the European Union (EU) has set an acceptable daily intake (ADI) for laslocid of 0.3 milligrams per day for a 60kg person, based on laboratory testing with rats. The average of the samples taken was 414 parts per billion - or about 0.03 milligrams per egg. So a person would have to eat, on average, 10 of these contaminated eggs every day to breach the EU limit - and only one in eight eggs tested had any reportable levels of lasalocid residues at all. Moreover, the EU safety limit is set at 100 times less, weight-for-weight, than the lowest level found to cause harm in laboratory tests on rats.
Just because a substance like lasalocid is harmful to some mammals, such as horses, does not mean that it is harmful to humans. Penicillin, for example, is lethal to guinea pigs but obviously of enormous benefit to most humans. In truth, to have any likelihood of suffering harm from lasalocid, someone would have to eat so many eggs that they would no doubt expire from excessive wind or cholesterol poisoning from the eggs themselves.
There is little evidence of widespread harm from lasalocid. While more research could be done into its effects on humans, it is inappropriate to launch scare stories like this one without something more than circumstantial evidence of a problem. It would also be better if feed producers didn't accidentally contaminate their products with antibiotics not intended for egg-laying hens. On the other hand, what is clear is that the Soil Association is against intensive agriculture in principle. Digging-up half-baked panics about the food we eat seems to be a rather illegitimate way to make their case.
Read: | | Danger warning after increase in drug residues found in eggs | | Guardian, 14 April 2004 | | Millions of eggs contain drug residues shows new report | | Soil Association, 14 April 2004 | | 2003 and 2004 UK surveillance scheme results and investigations for Great Britain, Appendix 4 (pdf format) | | Veterinary Residues Committee, March 2004 |
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| | | 8 April 2004 | Driving out development
Panic: The World Health Organisation (WHO) used World Health Day, 7 April, to call for greater action on road safety. According to WHO figures, road crashes are the second leading cause of death globally among people aged five to 29 and the third leading cause of death among people aged 30 to 44. Road crashes kill 1.2million people every year and injure as many as 50million. According to Dr Lee Jong-wook, WHO director-general: 'Thousands of people die on the world's roads every day. We are not talking about random events or "accidents". We are talking about road crashes. The risks can be understood and therefore can be prevented.'
Don't panic: There is something disingenuous about WHO's figures; it has selected deaths among young people rather than looking at the overall statistics, which place road accidents as the 11th leading cause of death. In fact, the relative rise in road accidents as a cause of death indicates that many of the previously common causes of death are in decline, even in the developing world. As traffic volumes rise, and deaths from infectious diseases decline, road accidents make up a bigger proportion of deaths in younger age groups than before.
At least road accident deaths represent, to some extent, a trade-off against current and future development. There are many more easily preventable causes of death that have no beneficial spin-off at all. For example, 1.5million under-fives die from diahorreal disease each year, compared to 49,000 deaths from road accidents in the same age group.
Certainly, safety measures can be introduced to reduce road deaths, including better driver training, vehicle maintenance laws and better road layouts and signage - but simply transposing those ideas from the developed world to the developing world would be inappropriate. Just the capacity to get about quickly is an achievement in many countries, and the benefits of such mobility far outweigh the negative consequences. As countries become wealthier more resources can be devoted to improving transport. The alternative seems to be to put development on hold, avoiding the use of motorised vehicles in favour of bicycles and rickshaws - just the kind of attitude that will ensure that developing societies, quite literally, get nowhere fast.
Moreover, there is a limit to what safety measures can achieve in any particular context. To dismiss the notion of an 'accident' - as WHO's Lee Jong-wook did when he said he was talking about road crashes, not 'accidents' (complete with inverted commas) - is to suggest that we can always control all events. We should of course look to improve safety, but it is childishly naïve to think that all misfortunes can be consciously avoided. No matter how many seatbelts and pedestrian crossings there are, there will always be deaths on the roads.
Read: | | World Health Day: Road safety is no accident!, | | World Health Organisation, 7 April 2004 |
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| | | 5 April 2004 | Toxins and breastfeeding
Panic: An American expert has claimed that breastfeeding may expose infants to chemicals linked to cancer. Katherine Tucker from Tufts University in Boston, told ITV's Tonight with Trevor McDonald that tests on eight women had revealed toxins in their breast milk, including dioxins. 'Dioxins have been shown in animals to be related to cancer and in humans there have been suggestions they contribute to cancer. Children exposed to these chemicals may grow more slowly, have learning difficulties and difficulty in development', she said.
Don't panic: It seems that mothers are caught between a rock and a hard place. If they breastfeed, they could be exposing their children to toxins. If they don't breastfeed, they are accused of not giving their children proper nutrition and protection from disease. Experts rushed to defend breastfeeding, lest there be any dilution of the 'breast is best' message.
In truth, neither position is justified. The levels of toxins described by Professor Tucker are tiny, and their links to illness tenuous, even in large quantities. In the quantities found in breast milk they are almost certainly harmless. As one survey put it, 'the search for adverse health effects from dioxin has found no unequivocal epidemiological evidence to link dioxin to human cancers, suppression of immune function, or reproductivity, even among workers exposed to somewhat higher concentrations of dioxin'.
As for breastfeeding: while it does confer certain health benefits, it is far from essential in order to produce a healthy child. The over-zealous campaigns designed to bully new mothers into breastfeeding are enough to drive anybody to the bottle. But the way to counter these scares is not to promote alternative panics around breastmilk - it is to defend mothers' ability to make choices about how best to bring up their children, including deciding what to feed them and how.
Read: | | Chemicals in breast milk, | | Sun, 5 March 2004 | | Dioxin: a toxin for our times, | | by Dr Michael Fitzpatrick | | Who needs Breastfeeding Awareness Week?, | | by Jennie Bristow |
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