Early April saw some unusually smoggy days across much of Western Europe, resulting in widespread media attention to air pollution.
(See, for example, here, here and here.) On one day, air quality in some parts of London was worse than in Beijing. Further attention has been drawn to the issue by a number of recent official reports, including one from the World Health Organisation, which has declared that air pollution is now the world’s biggest single environmental threat to health.
As has been noted, media coverage can give a misleading picture of the health risks of air pollution. Coverage tends to focus on short-term peaks, such as those seen recently in Western Europe, but the health risks of air pollution are primarily related to long term exposure, and show no ’safe threshold’ effect. Elevated baseline levels of pollution are thus more of a problem than occasional peaks.
There’s another important aspect of air pollution that often goes unnoticed; small geographical differences can have a marked effect on exposure to air pollution and thus on risk of adverse health effects. For example, living near a busy road appears to substantially increase air pollution-related mortality. A study published last year in the Lancet (press summary here) investigated the effects of very local differences in air quality on mortality by pooling 22 European cohort studies. The investigators found that an increase in average annual fine particulate (PM2.5) exposure of 5 µg/m3 was associated with a 7% increase in the risk of dying from all natural causes. This is approximately the difference between living on a busy urban road and living in a traffic-free area. The finding was robust in the face of correction for various possible confounding factors. Continue reading
‘Re-homing’ is a term coined to describe the adopting out of adopted children. Reuters today published a long story on the practice, describing several cases in which children adopted from overseas by American parents were then put up for adoption again within the States, in one case only a few days after the initial adoption.
The adoptions described in the Reuters piece are problematic for obvious reasons. It appears that lax oversight arrangements in the US, particularly for intra-state adoptions, have allowed couples to adopt out their children with little or no vetting of the new parents, in some cases into abusive families, and often without much consideration of the child’s interests. But might there also be less obvious considerations in play here? Continue reading
Pharmaceutical treatment of attention deficit-hyperactivity disorder (ADHD) is associated with reduced criminality according to a study published yesterday in the New England Journal of Medicine. The study of over 25,000 Swedish adults with the disorder found that men undergoing pharmaceutical treatments had a 51% chance of committing at least one crime in a 4-year period compared to 63% for those not in treatment. The risk of criminality for women with ADHD was 25% for those taking medication, and 31% for those not in treatment. It’s possible, of course, that the reduction in criminality associated with treatment was due not to the treatment itself, but to other factors, such as desire to improve behaviour, which could have both motivated treatment and reduced criminality. However, even when the investigators adjusted for likely confounders, they found that treatment was associated with significantly reduced criminal offending. Thus, their findings are at least suggestive of a causal relationship between medication and reduced crime.
It will be interesting to see how such a relationship, if it can be further supported, will be viewed by the general public and medical profession. Will it be seen as strengthening or weakening the case for ADHD treatment?
One of my clearest childhood memories is of seeing images of the 1989 Hillsborough Disaster on the television news. Ninety-six Liverpool fans died in the crush, with an estimated 766 injured. I lived on the other side of the world, had never been to see a football game, and presumably had little comprehension of what the victims had gone through, yet the images of the crush, and of a few people being hauled to safety from it, made a strong and disturbing impression. Continue reading
Suppose that a despotic political regime is keeping its citizens in cramped and unhygenic labour camps. The survival and and economic productivity of the incarcerated individuals is sustained only through the widespread administration of antibiotics which helps to prevent epidemics. It is difficult for international organisations to do anything about these work camps, but one thing they could do is cut off the supply of antibiotics. This would risk the lives of thousands of inmates in the short term, but can also be expected to put an end to the work-camp system in the longer term, since it would render the camps uneconomic.
Should the international organisations cut-off the supply of antibiotics? It is doubtful whether they should.
But now suppose we replace the work-camps with chicken houses and sow stalls, and the citzens with farm animals. Many farm animals held under cramped and unhygenic conditions are kept alive, and economically productive, only through the widespread administration of antibiotics. Restricting access to these antibiotics would force the agricultural industry to reform these practices. In this case it seems more plausible that antibiotic use should be restricted. At least, this is what Robert S. Lawrence writes in The Atlantic.
Recent news stories have brought to public attention the fact that many Apple products, including iPhones, iPads, and Macs, are produced in part in factories with a record of using child labour, failing to provide safe work conditions, and requiring employees to work long shifts for low wages (see, for example, here, here, here and here). This raises the question: should we all stop buying these products?
Suppose you need a new laptop, or at least, are going to buy one. Leaving aside ethical considerations, you are indifferent between getting a Mac and buying a PC laptop from one of Apple’s competitors. Which should you buy?
To answer this, we need to say something more about the situation at factories run by Apple’s Chinese suppliers. Much of the attention has focused on Foxconn, which assembles the iPad and iPhone. It’s alleged that Foxconn negligence was responsible for a blast which killed two people and injured more than a dozen; that it exposes workers to toxic chemicals without adequate protection; that it requires illegal levels of overtime (often more than double the legal limit of 36 hours per month) for which it frequently does not pay in full; that it deceives potential recruits regarding pay rates; that workers are humiliated by supervisors; that workers often have to stand almost uninterrupted for a 12 hour shift; and that poor work conditions contributed to a spate of suicides at the company’s Shenzen plant in 2010. In addition, Mike Daisey, a New York performer who visited the Foxconn plant in Shenzen, reports that he met children in the age range 12-14 who were working in the plant. They told him that it was not difficult for children of their age to find employment there.
Primaquine is an anti-malarial drug. When taken as a single dose by someone infected with the falciparum malaria parasite, it reduces the risk of transmission to mosquitoes and so to other people. However it confers no direct benefit on the individual who takes the drug. Indeed it poses a net risk, since it has side-effects, including the potential for a severe haemolytic reaction (breakdown of red blood cells) in a certain class of individuals (those with genetic G6PD deficiency). Nevertheless, primaquine is taken as a single dose by millions of people annually.
Cyproterone acetate (CPA) is a testosterone-blocking drug that has been used to ‘chemically castrate’ certain sexual offenders, including paedophiles. It can’t redirect misplaced sexual desires. But it can attenuate them, thereby reducing recidivism. Again, though, it can have serious side effects for the user, including liver damage and possibly depressive mood changes. Still, more than twenty countries allow the use of CPA in sex-offenders, and several US states have authorised the use of a related agent (MPA).
Primaquine and CPA might appear to have little in common. But ethically, there are some interesting parallels. Continue reading
Earlier this month German authorities closed around 4,700 farms following the discovery that pigs and poultry had been given feed contaminated with dioxins, which are thought to be among the most carcinogenic environmental pollutants. Yesterday Russia banned the import of untested pork products produced in Germany after 1 November 2010. This follows earlier import bans on some German food products in Slovakia, China, Belarus and South Korea.
Evidently the North German firm Harles und Jentzsch added a contaminated oil, possibly intended for industrial paper production, to an ingredient for animal feed that was then sold to 25 different feed manufacturers. Tests showed that the oil contained dioxin at 77 times the permitted level. Around 150,000 tons of feed incorporating this oil was reportedly fed to poultry and pigs across Germany, and affected eggs were sold in Germany, The Netherlands and the UK.
Internal tests at the Harles und Jentzsch plant revealed elevated dioxin levels in feed ingredients as early as March last year, suggesting the possibility that the human food supply may have been contaminated for months. And of course, this is nothing new. There were similar dioxin scandals in Ireland and Italy in 2008, Belgium in 1999 and 2006, and Germany in 2003.
How can such practices go unnoticed so often and for so long?
The UK's culture secretary, Jeremy Hunt, has suggested that the state should limit the provision of social security benefits to large, unemployed families. Hunt said last week that
The number of children that you have is a choice and what we're saying is that if people are living on benefits, then they make choices but they also have to have responsibility for those choices . . . It's not going to be the role of the state to finance those choices.
Two quite different arguments might be offered in support of such a move.
by Lachlan de Crespigny, Thomas Douglas, Mark Textor and Julian Savulescu
Regular calls to limit numbers of abortions are a familiar cry. Yet people are outraged if a friend or family member with a serious complication in much wanted pregnancy reluctantly requests an abortion but encounters resistance. Or when a woman faces a criminal court, as will happen to Tegan Leach next month in Queensland.