November 16, 2007: No Industry Experts Allowed -- They May Eat iPods
-- Quote to Note: "So the immediate takeaway is, don't eat your iPhone or your earbuds?" --CNN American Morning co-anchor John Roberts, about reports that iPods contain phthalates and bromides.
-- News broke yesterday that Target caved in to activists, taking certain children's products off its shelves because they contain polyvinyl chloride plastic, commonly referred to as PVC or vinyl. While such tiny quantities of these "toxins" will not actually cause harm to children, ACSH staffers said they are astounded how quickly Target acquiesced to scare tactics.
And Target is not the only company to do so. Toys 'R' Us and Wal-Mart also have taken PVC consumer products like toys, lunchboxes, and baby bibs out of their aisles.
As ACSH's Dr. Ruth Kava said, removing these safe products is completely ludicrous. "There are so many necessary uses for these chemicals," Dr. Kava said. For instance, tubing for dialysis. Are dialysis patients now going to boycott this essential treatment for fear an unproven "toxin" may cause harm? Both Dr. Kava and ACSH's Dr. Elizabeth Whelan theorize that this is fallout from the more legitimate scare about lead paint in toys imported from China. Problem is, there's a huge difference between lead and PVC. What are these companies going to use to replace the PVC? They'll use a different chemical that, most likely, in a few years, will also be proven to "cause" cancer. And then what? Sooner or later, these companies will run out of chemicals, and consumers will no longer have the product they need.
We wonder if before Target hastily stripped its store of PVC-containing products it consulted scientists about the actual harm level. We're willing to bet the answer is no.
-- Target isn't the only company as of late caving into scare tactics -- so is Apple. Lately, environmentalists have been on Apple's back. Now, it seems they've won. After reports surfaced that the cord connecting the earbuds to the iPod contains phthalates and bromides, Apple pledged to end the use of bromides by the end of 2008.
"Really?" ACSH staffers wondered aloud. We have a different solution in mind for Apple. In California, the absurd Proposition 65 mandates that any product containing chemicals with the potential (as gauged by super-high-dose rodent tests) to cause cancer or reproductive harm must bear a warning label. Since Prop 65 is a "right to know" law, we suggest Apple provide everyone purchasing its products with this knowledge -- why not slap on a big warning label saying that eating your iPod may cause cancer? Indeed, maybe California could move toward labeling everything sold in the state as a cancer-causing agent. That would put things in proper perspective.
-- Dr. Whelan said a recent publication by Boston University School of Public Health and University of Massachusetts Lowell concerned her. The publication, "Environmental and Occupational Causes of Cancer," went against everything that is supposedly basic knowledge in public health -- it managed to attribute every cancer to an environmental exposure. Besides contradicting what Dr. Whelan calls the Epidemiologist's Bible, Cancer Epidemiology and Prevention (edited by Drs. David Schottenfeld and Joseph Fraumeni), the publication also made some implausible claims. One such claim was that secondhand smoke exposure increases the risk of breast cancer (how is that possible, ACSH staffers wondered, as even active smoking doesn't increase risk of breast cancer?). As Dr. Kava said, when reviewing certain reports, people should pay attention to plausibility. The report is nothing but a quest to study phantom health risks.
-- Finally, the witch-hunt continues in public health. The FDA announced new rules that will require outside experts who serve on panels to disclose any financial ties to the industry under review, including past stock holdings. Dr. Whelan said she's been asked many times to serve on similar types of committees, all of which require you to fill out an inch-thick packet about your financial history. The process of searching through old records is complicated and time-consuming -- no one is going to want to go through this, Dr. Whelan said. Once again, ACSH is very concerned that this effort to purge all scientists who have ever worked with industry from federal panels is going to lead to a very small pool of candidates -- ones who have not distinguished themselves to the point where industry would call upon them for advise.
November 19, 2007: Vaccines, Drugs, and Calories for All!
"If companies can sell their drugs only at cost -- and cannot recoup more than the approximate $800 million it costs to bring a drug to market -- companies will stop making new drugs, just as they have in other countries with price controls." --Dr. Elizabeth Whelan, in a 2005 National Review Online article about drug importation.
-- The biggest public health story of the weekend came straight from the mouth of presidential hopeful John McCain. His proposal of drug reimportation from Canada and other foreign countries is shocking, ACSH's Dr. Elizabeth Whelan said. McCain is a smart man, ACSH staffers agreed, and he has a smart staff, but such a statement is playing to people's anxiety about drug prices.
No one will deny that drug prices are significantly lower in Canada. But that is because Canada, like other countries, has drug price controls -- its government mandates that companies like Pfizer sell its drugs at lower prices, below market value. So what's the problem with legalizing importation of these drugs back into the United States?
For one, there's the safety issue -- without regulation, there is no way to ensure that these drugs coming from other countries (often falsely labeled "Canadian") aren't harmful. But the more important issue is the risk to innovation that drug price controls pose for the pharmaceutical industry. Pharmaceutical companies rely on their drug profits to fund research and development of new drugs -- if drug prices were reduced to price-control levels, drug innovation could come to a halt.
But this is part of the debate no one realizes -- partially, Dr. Whelan says, because drug companies do not explain this to consumers. Then, someone like John McCain makes statements like this. An even more dangerous consequence of McCain's statement, ACSH's Dr. Gil Ross said, is that it implies that legalizing these cheaper drugs would "solve" the healthcare crisis. That is completely false. Someone needs to stand up and teach the public the actual cost of legalized drug importation.
-- In Prince George's County, MD, officials are taking a strong stance against parents who are refusing to vaccinate their children. Parents in the county are being issued arrest warrants unless their children get vaccinated. (The intermediary step is that if not vaccinated, children cannot go to school, and parents can be arrested if their children are not attending school.) When parents went to court to face their arrest warrants, they were given the option of free vaccinations for their children. Still they resisted.
The tragedy here, Dr. Whelan said, is the pervasive misinformation about the life-saving effect of childhood vaccines. ACSH's Dr. Ruth Kava said that while there has always been some resistance to vaccinations on religious grounds, such as that from Jehovah's Witnesses, she believes the recent increase in resistance is made possible by the Internet. There are so many fear-inducing websites making false claims, such as that vaccinations cause autism.
The real story here, Dr. Ross insisted, is about the safety of the community. Parents may assert their right not to have their child vaccinated, but it's important to point out that a few children not getting the vaccine puts everyone at risk -- that's why states have the right to step in and mandate vaccinations.
In 1905, that very issue came before the U.S. Supreme Court in the case Jacobson v. Commonwealth of Massachusetts. The court ruled that the state could require individuals to be vaccinated for the common good. Compulsory vaccination has greatly reduced rates of infectious diseases in the United States. As Dr. Ross said: "It's a civic duty, it's good for the kid, and there's no downside risk."
-- Finally, the recent segment on CBS about underestimating calories brought up the hot topic of caloric labeling in restaurants. A CBS correspondent went around a mall asking shoppers how many calories they believed they were consuming in certain meals. One man at a Subway estimated his foot-long sandwich with mayo, chips, and juice only contained 300 calories. In truth, the meal had a whopping 1,390. If he had known about the additional calories in his meal, the man said he didn't think he'd have gotten it.
Once again, CBS discussed proposed new legislation that would require most chain restaurants in New York City to post caloric contents. Almost all of these restaurants provide nutritional information on their websites already, and chains like McDonald's advertise the caloric values of menu items on wrappers, tray liners, and pamphlets in the restaurant. If, like McDonald's, a restaurant is already posting the information in numerous places, we think further requiring it to post the calories on the overhead menu is an absurd overreach. Yes, if nutritional information is solely on the Internet, ACSH staffers understand that many people will not bother looking. But mandating huge signs listing caloric contents on every wall of a restaurant is not the most effective way to battle obesity.
November 20, 2007: Text Messages and Bacteria, Spreading
-- Quote to Note: "There are obviously times when telemedicine is inappropriate. Texting someone to tell them they have cancer is one of them." --Jonathan Linkous, executive director of the American Telemedicine Association, regarding new text-messaging health services.
-- The upcoming Thanksgiving weekend will provide students and teachers with a much-anticipated vacation, briefly freeing them from the fear of the "superbug" spreading in their schools. Public health officials are still working to think up better ways to prevent the spread of infections like MRSA. An editorial in today's New York Times called for an end to the overuse of antibiotics in both medicine and agriculture and for the pharmaceutical industry to get on the stick and start developing new antibiotics. Of course, the Times has no concerns about how its policies on regulating the pharmaceutical industry (and on drug importation, and on suing drug makers every time someone suffers a side effect from an FDA-approved drug) would impact the decade-long, billion-dollar investment new treatments such as antibiotics require. It's not quite as easy as snapping your fingers (or writing an editorial) and poof! -- a safe, powerful new drug appears.
-- Also noteworthy is that, while schools and locker rooms are getting a lot of flack for spreading staph infections, the vast majority of serious infections, about 85%, were linked to exposure in health care institutions.
ACSH's Dr. Elizabeth Whelan met yesterday with ACSH Trustee and founder of the Committee to Reduce Infection Deaths (RID) Dr. Betsy McCaughey. Dr. Whelan, who is on RID's board of directors, said McCaughey mentioned a source of infection often overlooked in doctors' offices and hospitals -- the blood pressure cuff. McCaughey is encouraging a more widespread use of removable cuffs.
While ACSH staffers agreed that we'd never considered the cuffs a risk factor in the spread of infectious diseases, ACSH's Dr. Gil Ross explained that staph bugs don't care what surface they're on -- from sweaty towels in a locker room to hospital gowns to blood pressure cuffs. All of the above items can transmit the disease.
But there is good news in changing sanitary levels in hospitals and doctors' offices. A few years ago, physicians and hospitals were resistant to change, but now they seem more open to it, Dr. Whelan said. Even the Centers for Disease Control, which were resistant as well to tracking infections and screening new patients for infection, have changed their tune. Here at ACSH we're optimistic that even slight changes, such as the aforementioned removable cuffs on blood pressure monitors, can make a difference.
-- There were other "calls to change" in today's news that we're not so eager to embrace, though. Michael Jacobson, who we can always count on to overstate risk, is in the news proclaiming an epidemic of sodium overconsumption. According to Jacobson, it's an "emergency," and we must lower the level of sodium in the food industry pronto.
Here at ACSH, we recognize the risk of ingesting too much sodium. As Dr. Ross pointed out, we have about 50 million people in this country whose blood pressure is too high, and only one-quarter of those are being adequately diagnosed and treated. Many of them are doing nothing. But while there is a problem, Jacobson is overstating how many lives can be "saved" by taking sodium out of foods.
According to Dr. Ross, it's similar to the portion-size debate. People like Jacobson don't trust the public to make decisions for themselves. Still, it looks like his scare tactics may work -- the article says that he's gotten the food industry to sit down and have a closed-door discussion about lowering sodium content.
-- The usual news stories on text-messaging describe high cell phone bills or allegations about Britney Spears texting while driving her car. But today, the _Wall Street Journal_ took a different approach -- analyzing text-messaging and your health.
According to the Journal, there's a new trend that allows cell phone users to get different health alerts via text-messaging. Don't want to forget your pills? You can receive a reminder text. Have a (potentially) embarrassing health question that's easier to type out than discuss on the phone? One service allows you to use your phone to ask things like "What to do if the condom breaks." Wait a few minutes, and the response will give you advice and directions to a local health clinic. ACSH staffers believe this is a great new, innovative way to use technology. Problem is, elderly pill-takers who could benefit the most from reminder texts don't use texting, nor do many even have cell phones. Also, as the article noted, text-messaging can be used to convey silly distractions -- such as rumors and worries about PCBs in fish.
November 21, 2007: Thankful for Stem Cells, Wi-Fi, and Less So Deirdre Imus
"None of this feels like it should be one versus the other. That's the politicization of science." --Representative Diana DeGette, on the new discovery of how to turn human skin cells into embryonic stem cells.
-- By far the biggest health story today is how two separate labs discovered a way to turn human skin cells into embryonic stem cells, without having to make or destroy an embryo. ACSH staffers are always thrilled by scientific innovations, and this one is no different. Still, our interest waned when we saw the coverage of this exciting news.
People, mostly politicians, are gloating about the discovery -- claiming "credit" for the breakthrough. The ridiculous statements overshadow the actual science. One of President Bush's domestic policy advisors, for instance, went so far as to say he doesn't think there's "any doubt" that Bush's limits on stem cell research encouraged this discovery.
ACSH's Dr. Elizabeth Whelan said that to her the crux of the story is that scientists don't need ova anymore, and that we can, essentially, have stem cells on demand. (As ACSH's Todd Seavey said, "Ova are a lot harder to come by than skin cells.") The politicization of science shifts this focus, though. Besides the Quote to Note above, we also loved what Pennsylvania Sen. Arlen Specter had to say on the issue: "I really don't think anybody ought to take credit in light of the six-year delay we've had. My own view is that science ought to be unfettered and that every possible alternative ought to be explored."
ACSH staffers do realize politics will be politics, and we can only hope that if this technology proceeds, the overlay of ethics and religion regarding this issue will gradually whither away. But in the meantime, ACSH's Dr. Gil Ross said, we should continue to advance in all directions at the same time. Even if this new technology works, some aspects of research might still work better with embryonic cells. "I don't think skin cells are going to be as pluripotent as embryonic stem cells," Dr. Ross said. "Science is the process by which we will find out."
-- Yesterday, our own Jeff Stier appeared on the Vicki McKenna radio show, talking about the latest crazy health claim -- that Wi-Fi and cell phones cause autism. This "link" was met with groans and eye rolls at today's table, but we did find ourselves a little concerned. How in the world did something as preposterous as this get on the top of the news?
-- C may no longer be for Cookie, but rather for Caution -- as in "Caution: Not appropriate for young children." Most of us grew up watching Sesame Street and/or showed it to our children. Yesterday, we learned that, according to new warnings, old episodes are OK for adult viewing but may send the "wrong message" to children. As last Sunday's New York Times magazine summarized: "Cookie Monster was on a fast track to diabetes. Oscar's depression was untreated. Prozacky Elmo didn't exist."
Reactions from around the table were the same: Why?! "It makes my hair stand on end," Dr. Ross said. "There is no reason to revise history," Dr. Whelan added. In our politically-correct world, a warning label on the first season of Sesame Street may take the cake for the most absurd safety measure. And, as with other ill-advised bans, does anyone actually believe this will help prevent obesity?
-- If banning Cookie Monster raised our blood pressure, ACSH staffers were even more incensed when we read articles about how heart disease is killing more women under the age of forty-five -- but saw that the reports completely ignored one (essential!) point: the women who had heart disease were almost all smokers. It's not the first time smoking has been ignored as the primary cause of heart disease in women -- in the 90s, when analyzing how health hazards were covered in women's magazines, ACSH learned that at least one (Self magazine) actually suggested that women get a pet to lower their blood pressure and cholesterol but did not also suggest quitting smoking. This more recent report focuses on an important problem -- heart disease in young women -- but fails to reference the most important causal link.
-- In the latest issue of the Journal of the American Medical Association, researchers at Stanford University Medical School evaluated data on the effects of pedometer use on activity levels and found that pedometer users tend to walk more and lose more weight. ACSH staffers said they find this fairly intuitive -- by wearing pedometers, people are in a sense declaring a goal: to walk more. As pedometer-wearer Dr. Whelan said, when you are wearing a pedometer, you go out of your way to make sure you walk those 10,000 steps you say you're going to walk.
-- We may be warned about overeating during the Thanksgiving holiday weekend, but here's one food, oddly, that we're being told not to worry about: Hellmann's mayonnaise. That is, if you believe its advertisements.
ACSH staffers are appalled to see Hellmann's promoting itself as a "health" food. Eating Hellmann's, its website proclaims, is "wholesome." Yes, it may have omega-3 fatty acids (and of course it's trans-fat-free!), but it's also 100% fat. The advertising gimmick of claiming that it's "healthy" is outrageous. "It really just shows you the extent to which food companies will go to confuse people," Dr. Whelan said.
-- Finally, ACSH staffers addressed Deirdre Imus's Huffington Post blog on how children are "overmedicated" and "overvaccinated." Although we fear we've used the term "outrageous" too often already this morning, we'll go ahead and say it again -- her claims that children are getting too many "unnecessary" booster shots that contain "heavy metals and viruses" are outrageous. She questions the CDC and the Institute for Vaccine Safety's findings that there are "no biological effects" from trace amounts of mercury. She goes so far as to ask where the "hard data" is that shows giving vaccines where immunity already exists is not harmful. (We are confused by this question, too).
Here at ACSH, we must admit we're a little scared when we see how much attention people like Imus get in the media. They scare everyone by talking about the "danger" of vaccines but are never held accountable. Imus should realize that by scaring parents with hysterical attacks on vaccines, she is causing kids to be at risk of illness and death from preventable infections.
-- We wish everyone a very healthy and happy Thanksgiving. As a closing note, we'd like to include a few public health tips for all of you preparing a Thanksgiving feast for your families:
Never defrost a turkey outside of a refrigerator, Dr. Whelan warns. One way to defrost it is in cold water. Also, make sure to cook stuffing in a separate pan, as it can brew bacteria inside a turkey. And, as always, watch for cross-contamination between raw meat and produce on your knives and countertops.
Corrie Driebusch is an ACSH research intern. Receive these dispatches each workday in your e-mail by becoming an ACSH donor -- donate here, send a tax-deductible donation to the Broadway address at the bottom of this site, or call (212-362-7044 x225) or e-mail DriebuschC[at]acsh.org.