ACSH Dispatches Round-Up: Oprah, Spice, Tanorexics, and More

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ACSH/Staff, Oprah/Cranks, Meat/Breasts, HRT/Lungs, Sun/Skin, Spice/Island

by Elizabeth Wade

ACSH welcomes two new staffers

We'd like to extend a warm welcome to the two newest members of the ACSH team: art director Anthony Manzo and research intern Curtis Porter. Curtis will be taking over as writer of Morning Dispatch this week, as I prepare to leave to start my Fulbright scholarship in Mexico.

Could watching Oprah be dangerous for your health?

ACSH staffers were impressed by an article in Newsweek criticizing Oprah for allowing junk science to be espoused on her popular television show. "When she invites guests like Jenny McCarthy on to talk about the supposed vaccine-autism link, Oprah doesn't provide any balance," says ACSH's Dr. Elizabeth Whelan. "She even dismisses questions from the audience and doctors who doubt her guest's point of view."

Weston Kosova and Pat Wingert, the writers of the Newsweek article, eloquently sum up the problem by saying Oprah "has the power to summon the most learned authorities on any subject; who would refuse her? Instead, all too often Oprah winds up putting herself and her trusting audience in the hands of celebrity authors and pop-science artists pitching wonder cures and miracle treatments that are questionable or flat-out wrong, and sometimes dangerous."

In addition to Jenny McCarthy (who is now a semi-regular guest on Oprah's show), the article also discusses appearances by actress Suzanne Somers, who takes sixty supplements a day and swears by an intense regimen of "bio-identical" hormones, and Dr. Christiane Northrup, a Dartmouth-educated ob-gyn who emphasizes the "unseen connections between the soul and the body" and who advised women to forgo the HPV vaccine Gardasil in favor of a "healthier diet" to "boost your immune system" during one of her appearances on the show. (In case you think she sounds sensible, she also believes in using Tarot cards to diagnose illness -- and sells her own special deck on her website.) "While we at ACSH know that this stuff is junk science, there are millions of people out there who watch Oprah's show every day and seem to believe what she says," says ACSH's Dr. Gilbert Ross.

Dr. Whelan adds, "Whether you are a loyal fan of the show or not, this is a good, candid article about how misinformation is presented on Oprah." For more on a similar topic, check out ACSH's publication Celebrities vs. Science.

Meat intake not linked to breast cancer -- again

ACSH Advisor and Albert Einstein College of Medicine professor Dr. Geoffrey Kabat found no link between meat consumption and breast cancer in a recent study. "Dr. Kabat and his colleagues investigated not only total meat consumption but also how different kinds of meat were cooked," ACSH's Dr. Ruth Kava explains. "They found no link to breast cancer from any of the categories, which doesn't surprise me at all."

Could HRT be linked to lung cancer?

A new analysis of data from the 2002 Women's Health Initiative (WHI) federal study suggests that taking hormone replacement therapy (HRT) may increase a woman's risk of dying of lung cancer, but ACSH staffers aren't convinced. "First of all, there were very few cases of lung cancer," Dr. Kava says.

Dr. Ross adds, "The initial study's claims about the dangers of HRT have been largely discredited because the authors crunched the numbers to align with their agenda. That said, doctors shouldn't put women on HRT indefinitely because there are possible adverse effects with prolonged use." When used in low doses and for a short amount of time, HRT can greatly relieve menopausal symptoms with minimal adverse side effects. HRT is also effective at preventing and treating osteoporosis, or thinning of the bones.

"Tanorexics" ignore the dangers of sun exposure

Despite the dangers of sun exposure, many people -- especially women -- are still devoted to tanning, whether in the sunshine or in tanning beds. One woman summed up the appeal on sunbathing this way: "Tan fat looks better than white fat." Dr. Kava notes, "People go to a tanning salon before they go on vacation somewhere sunny in order to get a little bit of 'protection' for their skin -- tans do offer an SPF of about 8. But then they spend extra time on the beach because they think they are protected."

Having darker skin also provides some protection against the sun; the darkest skin tones offer an SPF of about 13. But as a CNN article points out, people of any skin color can develop skin cancer linked to sun exposure. For information about sunscreen and tips for a safe summer, read ACSH's Health and Safety Tips for Your Summer Vacation.

Deserted islands: The new smoking cessation tool

We at ACSH are well aware of the dangers of smoking, but we've never heard of someone going to such great lengths to quit: British smoker Geoff Spice plans to spend a month on a deserted island in hopes of kicking the habit. "It just shows how addictive cigarettes are that he would be so desperate," Dr. Whelan remarks.

Dr. Ross adds, "He's apparently tried all the currently approved cessation methods, such as the nicotine patch and gum. He didn't, however, try smokeless tobacco because not many people know that it can be effective when used as a form of harm reduction and as an aid to quitting."

May 29, 2009

Flu Vaccine, Jacobson on Freiden, Stroke, and Pregnancy Weight

by Elizabeth Wade

Research on swine flu vaccine proceeds, while some myths are dispelled

Even though the World Health Organization (WHO) is holding off on any decision about the swine flu vaccine, the immunization could be ready as early as October. "They are making test doses now, and then the vaccine will probably go through clinical trials," explains ACSH's Dr. Gilbert Ross. Scientists are also considering adding an adjuvant to the swine flu vaccine, which would serve as an immune system booster to make the shot more effective.

Many myths are still associated with swine flu, and Good Morning America took steps to dispel a few of them this morning. The show clarified that swine flu is not proven to be more benign than seasonal influenza, you cannot catch the disease from eating or handling pork products, last year's flu shot does not offer protection against the new strain, and the WHO's pandemic alert levels are not associated with virulence (although that may be changing).

Jacobson defends Frieden in WSJ

ACSH staffers weren't surprised to see a letter by CSPI's Michael Jacobson in the Wall Street Journal defending the nanny state public health philosophy of NYC Health Commissioner and recently appointed CDC head Dr. Thomas Frieden. The letter encompasses many major nutritional myths, including banning trans fats, reducing sodium in processed foods, and taxing soda and alcohol. While Jacobson looks forward to these policies taking hold across the country, ACSH dreads the day they become national standards.

Some patients have more time for treatment after a stroke

A new study suggests that the drug tPA can benefit some stroke victims up to four and a half hours after the event. tPA, which must be administered in the emergency department intravenously, dissolves the clot-blocking blood flow to the brain, reducing the number of brain cells that die as the result of a stroke. But the drug carries a risk of uncontrolled bleeding in the brain, so patients who are over eighty, are taking anticoagulants such as coumadin, or have a history of stroke or diabetes must still receive tPA treatment within three hours after a stroke in order for the benefit to outweigh the risk. Of course, sooner is always better when it comes to treatment for a stroke, so getting to a hospital as soon as possible is imperative.

Pregnancy weight gain guidelines broken down by BMI

The Institute of Medicine has issued new guidelines for how much weight obese, overweight, normal-weight, and underweight women should aim to gain during pregnancy. "There have been guidelines about pregnancy weight gain based on BMI since the 1980s, but it's important that women know about them -- especially as obesity rates in the U.S. continue to climb," says ACSH's Dr. Ruth Kava.

The most important piece of advice doctors have on this subject, though, is to aim to be at a healthy weight before beginning a pregnancy. Obesity among pregnant women is associated with pregnancy-related high blood pressure and diabetes, as well as an increased risk of C-section or premature birth. For more information, read the "Obstetrics and Gynecology" chapter of ACSH's publication Obesity and Its Health Effects.

May 28, 2009

Flu, Cosmetics, Acetaminophen, Quit Rates, and Stupid Food

By Elizabeth Wade

Could swine flu return in the fall?

Even though swine flu is no longer dominating the news cycle, the possibility remains that another outbreak, of a more virulent form of the virus, could occur in the fall. Another concern is that the H1N1 bug could mutate to become resistant to Tamiflu, as last year's seasonal flu was. But ACSH's Dr. Gilbert Ross reminds us, "There are lots of potentially scary scenarios, but there is no evidence this flu is going to take any of these paths."

The World Health Organization (WHO) seems to agree with Dr. Ross's assessment, as it has decided not to issue any guidelines for vaccine production until more monitoring is done. The virus's path in the southern hemisphere (which is currently experiencing its fall-winter flu season) is being studied especially closely, as it could be a harbinger of what will happen here during the fall. Meanwhile, the FDA is warning against buying fraudulent swine flu products, especially the "cures" and "treatments" advertised all over the Internet.

Who's afraid of "toxic" cosmetics?

ACSH staffers are disappointed by an article in the New York Times style section about the possible "dangers" of trace amounts of lead in lipstick. "The article does try to provide a balanced perspective, but it is reprehensible to lend any legitimacy to this story," says ACSH's Dr. Elizabeth Whelan.

Dr. Ross adds, "The bottom line is, does the use of cosmetics of any type cause changes in your body's lead levels? Nothing of any significance, I can assure you." For more on this issue, read ACSH's publication Health Claims Against Cosmetics: How Do They Look in the Light?

FDA calls for stronger warning about acetaminophen

The FDA is recommending stronger warning labels for products containing the painkiller acetaminophen, which in high doses can cause liver damage. Acetaminophen is found in Tylenol and many other over-the-counter drugs, so when consumers combine different medications they may be inadvertently ingesting a dangerously high dose of acetaminophen. Drinking alcohol in combination with acetaminophen is particularly dangerous.

"Acetaminophen overdose is one of the more common causes of acute liver disease and liver failure," Dr. Ross says. "Since people are inadvertently injuring themselves, making the warning label stronger is perhaps a good idea, if it was worded carefully to avoid unnecessarily scaring people away from correctly using helpful products."

Smoking cessation programs continue to disappoint

A new study suggests that computer-based smoking cessation programs may increase a smoker's chance of quitting. But what the researchers and reporters don't emphasize is how low the quit rate remains -- only 9.9% of those who were using the computer program managed to quit for a year, compared to 5.7% who weren't using the program.

"Anti-tobacco zealots will talk about what a remarkable intervention this is, how is doubles the cessation rate -- but they never grab the bull by the horns and point out how low quit rates are to begin with," Dr. Ross says. "The smoking cessation programs we have now do not work, and we should try other methods -- including switching addicted smokers to reduced-risk products like smokeless tobacco."

Does fast food lower test scores?

Fast food is now being blamed for lowering students' test scores, but ACSH staffers are skeptical. "It's a cross-sectional study, which allows them to make the inflammatory statement that eating fast food three or more times a week is associated with lower test scores," says ACSH's Dr. Ruth Kava.

"But they weren't even monitoring the children's diets over time." Dr. Whelan says, "Since fast food is 'bad,' it can be blamed for every problem -- and no one questions these studies' legitimacy."

May 27, 2009

ACSH Advisor to Ag Dept? Plus Vacccines, Football, Babies, Bags

by Elizabeth Wade

Seat at the table goes to Sarah Lovinger

We'd like to offer a seat at the ACSH breakfast table to Sarah Lovinger, the executive director of the Chicago chapter of Physicians for Social Responsibility, for her passionate defense of vaccines on HuffingtonPost. "She writes that parents should listen to scientists and doctors, not celebrities like Jenny McCarthy, when it comes to making decisions about their children's health," says ACSH's Jeff Stier. "Coming from a leader of an activist group, this is pretty impressive."

ACSH advisor up for food safety post

ACSH is proud that our advisor Dr. Michael Doyle is the frontrunner for the top food safety job at the Agriculture Department, but we are stunned by the criticism being lobbed at him. As Roll Call reports (full article is subscription only), some allege that Dr. Doyle is "too cozy with the meat industry" -- and others have even criticized him for being an ACSH Advisor! "I wish them luck trying to find a nominee who is both a good microbiologist and who hasn't been tapped to work with the food industry on certain projects," says ACSH's Dr. Ruth Kava.

Dr. Doyle himself explains, "The primary reason I work with food companies is that's who makes most of the food that we eat. And if we're going to make a major impact on [food safety] you have to work with the companies. That's why I work with the industry and often why CDC comes to me -- because I have that relationship that will get the industry engaged."

The anonymous critique of Dr. Doyle's relationship with ACSH hinges on an assessment that ACSH is "vehemently anti-regulatory." But as Stier told Roll Call, "My organization represents consumers around the country. These groups who think, 'if you disagree with us, then you're in the pocket of industry' -- I find that a very offensive allegation...to suggest that someone's paying us to lie. The very thing that makes us credible is that we have so many wonderful scientists, like Dr. Doyle, advising us." We are proud to count Dr. Doyle among our advisors and hope he is given the opportunity to bring sound science to the top food safety post.

Children at risk -- but from what?

The attack on baby products continues with a press release issued by the so-called Campaign for Safe Cosmetics (a spin-off of the Environmental Working Group) urging Johnson & Johnson to "remove toxic ingredients from its popular baby products." "It's so incredibly irresponsible to scare parents with inflammatory statements like this when we are talking about trace levels of chemicals," says ACSH's Dr. Elizabeth Whelan.

ACSH's Dr. Gilbert Ross agrees. "Parents should resent this cynical manipulation of their desire to protect their children." We hope these anti-chemical scares don't distract parents from real dangers to their children. For example, 80% of childhood drownings occur in residential pools. For more on staying safe for summer, read ACSH's Health and Safety Tips for Your Summer Vacation. And don't forget to check out our Riskometer to put risks in perspective.

Many football players at risk for hypertension

An interesting study indicates that professional football players are much more likely than the general population to have high blood pressure. Linemen run the most risk because they are often obese, with many reaching weights of well over 300 pounds. "I think disaster is looming for many of these players," Dr. Kava says. "While their hearts may be healthy now because of all the exercise they get, it is going to be hard for them to lose all the excess weight after they stop playing." For a comprehensive review of the many health risks associated with obesity, read ACSH's publication Obesity and Its Health Effects.

Sound science meets political correctness

Jeff spotted some sound science finally making it onto Consumer Union's Consumerist blog, but he finds it ironic that it is in defense of reusable bags. "They jumped to reusable bags' defense when a poorly designed small study found some to harbor bacteria," he says. "It appears that consumer groups have suddenly figured out how to criticize junk studies, but they use these cognitive abilities selectively." For a related issue, read Jeff's HuffingtonPost article about mercury in compact fluorescent light bulbs.

May 26, 2009

Food Taxes, Sunscreen Simplification, Tobacco Candy, and Castration

by Elizabeth Wade

Taxing unhealthy foods will not improve public health

ACSH's Dr. Ruth Kava had a letter in the Cleveland Plain Dealer arguing against imposing punitive taxes on certain "unhealthy" foods. In particular, she takes on the notion that cigarettes and "bad foods" can be treated -- and taxed -- the same way. She writes, "No one has to smoke cigarettes, but everyone must eat and drink. While raising taxes on cigarettes decreases their use, similarly raising the price of a few specific foods or beverages deemed 'unhealthy' doesn't mean people will automatically choose a healthier diet."

Dr. Kava continues, "Obesity is a real health risk, but we should be promoting healthier lifestyles (including physical education classes in schools) and educating people about how to make healthier nutritional choices (including the reduced-calorie foods modern technology has produced)." For more ideas on how to combat the obesity epidemic, read ACSH's reports Obesity and Food Technology and Obesity and New Pharmaceutical Approaches.

FDA tries to end confusion over sunscreen

The FDA is finalizing new federal label changes for sunscreens in an attempt to clarify how much sun protection these products offer. "This is really good news," Dr. Kava says.

Dr. Whelan agrees. "It could be a big step toward clearing up a lot of the confusion about sunscreen."

The label changes will require companies to provide information on how much protection their products offer against both UVA and UVB rays. Currently, SPF applies only to UVB rays, which cause sunburns, but UVA rays also contribute to skin cancer and sun-related skin aging.

Furthermore, the terms "sunblock," "waterproof," "sweat-proof," and "all-day protection" will be barred from sunscreen labels. As the FDA's Rita Chappelle explains, "No product can completely block out the rays from the sun and no product is completely waterproof. And labels will have to advise consumers to limit their time in the sun, wear protective clothing, and reapply sunscreen at a minimum of every two hours, especially after swimming or perspiring."

Sunscreen label reform couldn't come at a better time, as a warm and sunny Memorial Day signaled the beginning of summer here in New York. Be sure to read ACSH's Health and Safety Tips for Your Summer Vacation before you hit the beach -- and don't forget the sunscreen!

Smokeless tobacco vilified as "tobacco candy"

ACSH staffers are extremely disappointed that Senators Jeff Merkley (D-Ore.) and Sherrod Brown (D-Ohio) have proposed an amendment to the FDA tobacco bill that would make it even harder for addicted smokers to switch to less harmful smokeless tobacco alternatives. They believe smokeless tobacco products are aimed at children and have even labeled them "tobacco candy" -- but in reality, smokeless tobacco can be an effective harm reduction tool that helps smokers kick the habit.

"These senators seems to think that it is a bad thing that smokeless tobacco packs a potent nicotine punch, when in reality it is precisely that nicotine punch that helps addicted smokers quit cigarettes," ACSH's Dr. Gilbert Ross says. "If they had done any research, they would know that the dangers of using smokeless tobacco are 1/100 or less of the dangers of smoking cigarettes. The bottom line is that this amendment makes the horrible FDA tobacco bill even worse."

Junk science quacks tout castration drug as a "cure" for autism

The topic of autism carries with it many emotions, from the sadness and surprise of a diagnosis to the desperation many feel for a "cure." Dr. Mark Geier and his son Dr. David Geier have been taking advantage of these feelings for years as part of the anti-vaccine crusade. But as ACSH Advisor Dr. Marvin J. Schissel pointed out to us, their ideas have recently turned even more sinister, as they are now touting the chemical castration drug Lupron as a "treatment" for young autistic boys -- and they are selling it around the country, despite the complete lack of evidence that this bizarre treatment is effective.

The drug drastically reduces levels of testosterone, and some parents report daily injections have decreased their autistic children's aggression and uncontrollable behavior. But not only is the drug painful to administer, it can disrupt a child's development by interfering with puberty and may even damage the heart and bones. Most importantly, Lupron's use as an autism treatment is not backed by any valid science.

Dr. Whelan says, "Parents of autistic children are vulnerable to any snake oil claim that's out there because there's no sanctioned cure or treatment for autism. It's awful that some people are taking advantage of vulnerable and desperate parents and their unsuspecting children."

Parents are vulnerable to fears of autism even if their children don't have the disease, as the continuing hysteria over the debunked vaccine-autism link makes clear. As more parents opt out of vaccinating their children against life threatening diseases, more children contract these dangerous illnesses, especially in communities where the non-vaccination rate is high. A new study confirms the danger of declining vaccination rates, as it found that children who are not vaccinated against pertussis (commonly known as whooping cough) are twenty-three times more likely to get the disease.

May 21, 2009

Panicky Flu Reactions, Bad Tobacco Bill

By Elizabeth Wade

What do toxicologists really think of chemicals?

A survey of members of the Society of Toxicology reveals both good and bad news. Bad news first: 26% believe that cosmetics pose a significant health risk, 33% believe food additives pose a significant health risk, and 55% believe pesticides pose a significant health risk. But now for the good news: only 6% believe that exposure to a harmful chemical is unacceptable at absolutely any level, just 10% believe organic or "natural" products are inherently safer, and 69% say chemicals do not need to be regulated according to the precautionary principle.

"Toxicologists see all kinds of problems during experiments on laboratory animals, but they don't often see the broad picture of public health," Dr. Whelan says. ACSH staffers are glad that some toxicologists are moving in the right direction -- on a few issues, at least.

Stier adds, only partially tongue in cheek, "In an informal survey of the scientists affiliated with ACSH, 0% believe that cosmetics pose a significant health risk (they wrote our report Health Claims Against Cosmetics: How Do They Look in the Light?), and less than 1% believe food additives pose a significant health risk (our scientists have practically memorized our Holiday Dinner Menu)."

All kidding aside, ACSH gives voice to rational common-sense scientists who don't allow ideology to interfere with their work. And only YOU give voice to ACSH. We need your support now more than ever. Please make a generous contribution today!

Swine flu panic heats up again, despite some good news

In order to prepare for the production and distribution of a swine flu vaccine in the fall, health officials are planning to move up the timeline for the seasonal flu shot. Since most of the seasonal vaccine has already been produced, it could be distributed earlier than the usual September start date. Doing so would allow for a second round of swine flu shots before flu season starts in earnest. "They are really moving toward making available a series of vaccines -- one seasonal shot and at least one swine flu shot," says ACSH's Dr. Elizabeth Whelan.

ACSH's Dr. Gilbert Ross notes, "The media attention on swine flu is raising awareness of the importance and availability of flu vaccines. I believe that this fall we'll see more people taking advantage of the seasonal shot, not to mention any new swine flu shot."

Still, much of the media attention on the swine flu outbreak has done more harm than good. Worried by the city's over twenty school closings, some New York City parents are taking their healthy children to emergency rooms to have them tested for the virus, while others are keeping their children out of schools that are still open and have shown no signs of an outbreak -- thereby skewing the absence rate and frightening more parents into believing there is a problem. As NYC Health Commissioner (and soon-to-be CDC director) Dr. Thomas Frieden said, "What we've seen...is a lot of concern but very few sick kids."

The World Health Organization (WHO) finally appears to understand the importance of minimizing this type of panic about the swine flu epidemic by fully explaining its actions in a consumer-friendly manner. When discussing the possibility of raising the pandemic alert to the highest level, 6, WHO director Dr. Margaret Chan addressed concerns that the general public doesn't understand that the alert levels pertain to spread of the virus rather than severity of cases, saying, "I am hearing from all of you your concern about the disconnect...We cannot leave the world's people confused."

One of the most frightening aspects of the new swine flu strain is that it has been hitting mostly young adults, a pattern familiar from the severe flu pandemic of 1918. But some scientists have come up with a new way to explain this phenomenon: It's possible that many adults over fifty have immunity to the new strain because of their exposure to related H1N1 viruses before 1957. After that year, the seasonal flu strains tended to be other types of viruses, leaving younger people with no residual immunity to the latest H1N1 swine flu strain.

Dr. Ross emphasizes, "The most important thing to remember about swine flu is that the mortality rate is still under 1%. It's likely that many cases have gone undocumented or unconfirmed, but health officials are careful to take note of the deaths. In fact, if there are more cases than we currently estimate but still no more deaths, the mortality rate is even lower."

FDA tobacco bill passes Senate committee

The Senate health committee has passed the bill that would give the FDA regulatory power over tobacco products. "This latest development is no surprise," says ACSH's Jeff Stier. "The bill passed a hurdle, but not a very high hurdle. Now the question becomes whether Senate leadership will give the bill the necessary time to come to a vote, since the Senators from North Carolina have threatened to filibuster. It's possible that the bill won't come to the floor until September, giving advocates of public health, as opposed to political correctness, more time to pick off a few more votes."

ACSH is very much opposed to the bill in its current form. "While giving the FDA control over tobacco sounds like a great idea, it's a terrible bill for public health," Dr. Ross explains. "It won't actually hurt the tobacco industry because detailing the list of chemicals in the carcinogenic soup of cigarette smoke won't hurt cigarette companies' bottom line. It proposes to eliminate flavors, but it leaves lucrative menthol cigarettes alone. Plus, it will block harm reduction efforts while giving cigarettes the FDA seal of approval for years to come."

May 20, 2009

Cartoon Science, Flu Evolution, Astronaut Ice Cream

By Elizabeth Wade

Seat at the table to Jorge Cham

We'd like to offer a seat at the ACSH breakfast table to cartoonist Jorge Cham for his insightful comic "The Science News Cycle." It illustrates the often unwarranted and alarmist leaps made between a scientific discovery ("A is correlated with B, given C, assuming D, and under E conditions") and its appearance as a health scare on local news ("What you don't know about 'A' can kill you! More at 11...").

"This is really what we face," says ACSH's Jeff Stier. Unlike many media outlets and health organizations, ACSH is careful to approach health scares with a scientific perspective, and we aim to teach others how to do the same -- just take a look at our publication Distinguishing Association from Causation: A Backgrounder for Journalists.

The evolution of swine flu

Much has been said of a possible second wave of swine flu in the fall and winter, but doctors and health officials must also keep an eye out for mutations or recombinations of the virus that make it more dangerous or increase its resistance to drugs such as Tamiflu. The current seasonal influenza (which continues to circulate at a surprisingly high rate this far into spring) is also an H1N1 strain and has proved resistant to Tamiflu. Scientists worry that because the related viruses are circulating at the same time, they could undergo a reassortment, or an exchange of genetic material, that would make swine flu resistant to Tamiflu as well.

Influenza viruses often evolve and mutate, which is why each year's seasonal strain is unique. But, ACSH's Dr. Gilbert Ross cautions, "This discussion about the hypothetical evolution of the new swine flu strain is still highly speculative." As of now, the swine flu virus responds to Tamiflu.

Short of a vaccine, how can we protect ourselves from catching swine flu? Despite the constant refrain that hand-washing, social distancing, and covering your mouth when you sneeze or cough is the best protection against the virus, some people may still turn to masks.

"I doubt normal surgical masks are efficacious at all because not only do people rarely get them fitted properly, you break down the protective barrier just by breathing," says ACSH's Dr. Elizabeth Whelan. As ACSH Trustee Dr. D.A. Henderson told us, "Simple breathing gradually clogs the pores of the mask and the air simply enters around the mask. In brief, you are breathing ambient air -- but it is less complicated to simply breathe it in without the mask!"

Properly fitted respirator masks are the only ones that will filter viruses out of inhaled air, but simple surgical masks can be helpful in preventing an infected person from spreading the virus. "It is a good idea to hand out masks to people who come to emergency rooms with flu-like symptoms in order to protect others, including the doctors and nurses," says ACSH's Dr. Ruth Kava. No ACSH staffers have observed anyone using a mask on the subways or buses in New York City -- yet.

Most cases of swine flu in the U.S. have been mild, but scientists are investigating what underlying health conditions may contribute to severe flu cases. Scientists suspect that obese people may be more vulnerable to complications of the swine flu, but so far the data pointing to obesity as an underlying risk factor for developing a severe case of swine flu have had sample sizes that are too small to reach any definitive conclusions.

What astronaut ice cream can teach us about food safety

ACSH staffers are pleased to see a group of scientists from the University of Florida standing up for using the most modern methods to guarantee food safety. They say that research into such topics as biofilms and genetics has been helping to ensure the safety of astronauts' food for years, and that the food industry should be investigating the same questions and adopting similar techniques. "It's an important point, but I'm disappointed that they didn't mention food irradiation," Dr. Kava says. "After all, the technology is right there and ready to go."

May 19, 2009

School Closings, E-Cigarettes, Facial Injuries, and Over-Protected Kids

By Elizabeth Wade

Will school closures keep kids safe from swine flu?

One of the most troubling aspects of the current swine flu epidemic is the virus's tendency to affect young adults. While the seasonal flu primarily affects the elderly and the very young, a disproportionate number of the estimated 100,000 U.S. swine flu cases have been among children, teenagers, and young adults. Hundreds of schools in Texas have been closed at various points over the past month, and sixteen schools in New York City are currently closed in an attempt to stop the virus's spread. But the question remains, will closing schools work?

"Influenza has a five- to seven-day incubation period in which you are communicable but you're not sick," notes ACSH's Dr. Gilbert Ross. "If officials really wanted to stop the spread of influenza among young people, they would close schools prophylactically before any students got sick. But even that might not work, because teenagers will go to the mall or find other ways to see each other outside of school."

While many questions about swine flu remain, one thing that's clear is that the virus is not going away anytime soon. "Earlier this month, swine flu was the topic du jour, but shortly thereafter, people started treating it like it was last week's news," says ACSH's Dr. Elizabeth Whelan. "But the virus is now in forty-eight out of fifty U.S. states and many other countries around the world. The fact that it is hitting high schools, not nursing homes, is reminiscent of dangerous flu pandemics in the past, including that of 1918. Of course, the severity of the infection does not seem to be nearly that high, as of now."

E-cigarettes: Friend or foe?

The debate over e-cigarettes is raging, while a Senate committee begins deliberation today on a bill giving FDA authority to regulate tobacco. But ACSH staffers believe that the innovative nicotine delivery device should be viewed as a harm reduction and smoking cessation tool, not simply a replacement for cigarettes when smoking is inconvenient or prohibited.

"Opponents of the e-cigarette are right in pointing out that there have been no clinical trials of the product, and we don't know how effective it is at helping people quit smoking," Dr. Ross says. "We can't make an authoritative statement, but we suspect that e-cigarettes could have a beneficial effect. It is almost certain that they would be much less dangerous than cigarettes."

William T. Godshall, ACSH ally and executive director of Smokefree Pennsylvania, agrees that e-cigarettes should be embraced as a possible harm reduction tool. "These e-cigarettes are at least 99.9% less deadly than cigarettes," he says. "Let's worry about the products that are actually killing people."

While regulators are mired in debates over harm reduction products such as the e-cigarette and smokeless tobacco, the evidence about the dangers of smoking continues to pile up. Today, we learn that women who smoke are more prone to lung damage than male smokers. "We've known for years that women are more vulnerable to the dangers of cigarettes in terms of developing lung cancer," Dr. Whelan says. This new study indicates that the same trend may be present when it comes to developing chronic obstructive pulmonary disease (COPD) as well.

Saving face: Rate of facial injuries in car accidents drops

The number of facial injuries sustained in car accidents continues to fall, thanks to improved car design. "People often don't realize how much progress has been made in terms of car safety," Dr. Whelan states. "Seatbelts are very much a part of it, but the overall design of cars has improved to make them safer as well."

Such improvements should not be viewed as license to drive without a seatbelt, however. Wearing a seatbelt greatly reduces the likelihood of suffering a facial fracture during an injury, for example. "Also, it is important to know that airbags don't protect you unless you're wearing a seatbelt," Dr. Whelan reminds us. "If you don't have a seatbelt on, you will just slide right under the air bag."

Are we going too far in "protecting" our children?

ACSH staffers were intrigued by a segment on ABC News examining the "kid safety craze." As ACSH's Jeff Stier says, "There is a multi-million-dollar industry aimed at protecting kids." But protecting them from what? Protective items now popular include helmets for toddlers, knee pads for crawling children, and sanitary gloves for children who have a hard time staying clean.

"The question is, at what point is it going too far?" Stier continues. "I think we reached that point with the Consumer Product Safety Improvement Act, which requires children's products to contain ridiculously low levels of lead and phthalates -- and puts a huge burden on small businesses to make this happen."

May 18, 2009

Friedenesque, Flu Death, Inhaler Asymmetry, Prop 65 (and Fox)

By Elizabeth Wade

Dr. Frieden's replacement eerily similar to Dr. Frieden

ACSH's Jeff Stier is quoted in the New York Times article about the appointment of NYC Health Commissioner Dr. Thomas Frieden as director of the Centers for Disease Control. "He plays the politics game better than he does good science," Stier said, referring in particular to Dr. Frieden's propensity to overstate the dangers of secondhand smoke and trans fats.

Stier adds, "When we surveyed ACSH donors about what we need to do better, you told us we need to get our message out to a broader audience -- including to that of 'non-friendly' media. Well, here we are in the New York Times! We are listening to you."

While ACSH staffers were initially glad that Dr. Frieden and his nanny state tendencies would be leaving New York, his replacement is poised to repeat Frieden's mistakes. Mayor Bloomberg plans to appoint to the post Dr. Thomas A. Farley, a professor at Tulane School of Public Health and Tropical Medicine who advocates such ideas as workplace bans on snack foods in cubicles to encourage healthy behavior. "Dr. Frieden and Dr. Farley are like clones," remarks ACSH's Dr. Elizabeth Whelan. "Now we'll have one in [CDC HQ in] Atlanta and one in New York!"

New York suffers first swine flu death

Mitchell Wiener, the assistant principal at the Queens middle school I.S. 238 (one of the eleven schools in the city that are currently closed due to swine flu outbreaks), died from swine flu on Sunday evening at Flushing Hospital Medical Center, making him the first swine flu death in New York City and the sixth in the U.S. The virus has now spread to Asia, with 120 cases reported in Japan, which makes it likely the World Health Organzation (WHO) will raise its pandemic alert level to six.

"People are going to get quite hysterical when the WHO raises the alert level to six because it is the highest 'alert,' but you must understand that these levels are not about severity," Dr. Whelan explains. "The 'pan' in 'pandemic' indicates that a disease is found all over the world, which is now the case with swine flu. WHO's level six does not mean that the disease has become more dangerous, just that it has spread to more places."

The CDC is also currently reporting a surprisingly high number of cases of non-H1N1 influenza, an unexpected occurrence after the end of the annual flu season. About half of the people who are now testing positive for the flu appear to have seasonal influenza, not the new swine flu strain. "Perhaps more people are getting medical attention when they get any kind of flu because of all the news about swine flu," Stier says. But medical officials doubt that such an increase in reporting can account for all the new seasonal flu cases.

Dr. Whelan says, "After the first week of constant swine flu news, we got swine flu-ed out and were told it was basically over. But the virus is proving to be very infectious from person-to-person and is moving quickly around the world. Swine flu is not going away anytime soon."

Dr. Ross adds, "The statistics, such as they are, do not point towards an especially severe type of flu. The death rate appears to be well under 1%, similar to the annual flu epidemics, and far less than the estimated rate from the pandemic of 1918. But if swine flu does spread, the number of deaths will become substantial, even with modern medicines unavailable during prior pandemics."

Inhaler switch provokes ire

Nearly six months after all U.S. asthma patients were required to switch from CFC inhalers to more environmentally sound HFA inhalers, some people are reporting problems with the new devices. HFA inhalers have a distinct taste, a weaker feeling spray, and require patients to take slow, deep breathes. But as Megan McArdle writes on her Atlantic blog:

[S]aying that the inhalers are just the same except that they require perfect technique is saying that the inhalers are not just the same. In the real world, it's hard to get perfect technique. So substituting an inhaler that requires really very extensive maintenance...is the kind of thing that only a non-asthmatic would think was a good trade. Again, if this has to be done to save the ozone layer, fine. But I don't see that it did; I see that we did something stupid and costly to sick people for no good reason.

ACSH's Dr. Gilbert Ross agrees, "CFC and HFA inhalers may appear to the be 'the same' when testing them in the lab, but it's a different story when you put them out in the real world. Experimental studies do not necessarily apply to the experiences of individual patients." For more on asthma and the inhaler switch, check out ACSH's publication Asthma: Causes, Diagnosis, and Treatment.

Prop 65 set to expand

It appears that many more chemicals will soon be added to the list of "carcinogens" governed by California's Proposition 65, which mandates that chemicals that can, even hypothetically, cause cancer or harm the reproductive system be kept out of drinking water and be listed on warning labels. But, as ACSH has explained, the law does not protect public health because its list of "dangerous chemicals" is based on high-dose animal studies. "Prop 65 is simply a drain on the economy of California that does no good to anyone except for litigation lawyers," Dr. Ross says.

Dr. Whelan wonders, "Is there anyone in the whole state who will step up and say this whole thing is absurd?"

ACSH is critical of the federal Consumer Product Safety and Information Act (CPSIA) for the same reasons: It restricts lead and phthalate levels in children's products to unnecessarily low levels, thereby hurting small businesses while doing nothing to protect public health. For more on this topic, watch Jeff's recent appearance on the Fox Business Channel's show Money for Breakfast: Weekend.