Entry: SCIENCE AND NEWS Tuesday, December 21, 2004



Lung lobby lambastes smoking stars

Aykroyd under fire over on-screen prop

Sunday, December 19th, 2004

By Chris Cobb

OTTAWA -- The American Lung Association is shining a critical spotlight on Hollywood stars in a high-pressure effort to get them to butt out on screen. And one of the first targets on the association's new anti-smoking website launched this week is Canada's own Oscar winner Dan Aykroyd, who has incurred the wrath of clean-lung advocates for puffing on a pipe towards the end of Christmas with the Kranks.

The association rates movies with icons of lungs -- black for heavy depictions of smoking and pink when none of the characters smoke. Aykroyd's neighbourly Kranks movie gets a light grey rating.

In other reviews of the week's top 10 movies and DVDs, SceneSmoking.org also has harsh words for Andy Garcia and his cigar-chomping Ocean's Twelve character Terry Benedict.

"There won't be an Ocean's Thirteen if some of the thieves and Benedict don't quit their cigar habits," notes one of the 50 young people the association has hired in the Sacramento, Calif., area to monitor smoking content in newly released DVDs and movies.

Other stars are on the black list for either smoking in movies or flaunting their personal smoking habits during interviews. High on the list are Ben Affleck, Jennifer Aniston and her husband Brad Pitt, Ann Archer, Lara Flynn Boyle, Drew Barrymore, Tom Arnold and Aykroyd's sometime singing partner Jim Belushi, who has a well-advertised liking for cigars. Even Humphrey Bogart, the most famous screen smoker of all time, gets some posthumous negative comment on the website. Bogart died in 1957 of throat cancer in an era when smoking was at its most glamorous and few suspected it could kill.

The lung association campaign is deadly serious and is motivated by recent U.S. studies that offer the most conclusive evidence yet that tobacco use by popular actors and actresses has a direct and pervasive influence on youngsters. According to the studies, conducted at Dartmouth College in New Hampshire, smoking is increasing among North American teenagers and at least half of those who start smoking say they were influenced by movie stars or other celebrities.

"Star power sells movies," says the association on its website. "It can also sell tobacco use."

The lung association is trying to get cigarettes, cigars and pipes banned as movie props unless the subject of the film is a real person or historical figure.

"If the movie was about Winston Churchill, it would be acceptable to portray him smoking cigars," said Shelley Mitchell, senior project manager for the Thumbs Up, Thumbs Down anti-smoking project.

-- CanWest News Service

WINNEPEGFREEPRESS.COM


Blowing smoke I

By PAUL MOLLON
Saturday, December 18, 2004 - Page A26

Owen Sound, Ont.-- Re Ontario Unveils Smoking Ban (Dec. 16): It's so comforting to know that Ontario Health Minister George Smitherman is looking after us and plans a complete ban on smoking. After all, banning alcohol in the Twenties was such a rip-roaring success, and aren't we all so happy that the current "war on drugs" has stamped out the use and abuse of all other mind-altering substances?

The nanny state once again rides to the rescue. I'm quickly going to my cookie jar to flush all the high-fat, high-sugar goodies down the toilet. Mr. Smitherman will surely be coming for them next.

http://www.theglobeandmail.com/servlet/ArticleNews/TPStory/LAC/20041218/LETTERS18-13/TPHealth/


Blowing smoke II

By D. GRIFFIN
Saturday, December 18, 2004 - Page A26 Toronto -- Wouldn't it be great if the anti-smoking legislation, scheduled to take effect May 31, 2006, roughly coincided with the retirement of 100,000 nursing staff (One-Third Of Nurses Close To Retirement -- Dec. 15)? If the legislation actually accomplished its goal, we might not need that many replacement nurses after all

http://www.theglobeandmail.com/servlet/ArticleNews/TPStory/LAC/20041218/LETTERS18-14/TPHealth/


The anti-smoking gun

Friday, December 17, 2004

The campaign to discourage smoking and to protect the health of non-smokers is admirable, but the legislation proposed this week by Ontario Health Minister George Smitherman is so absolutist that it risks trampling fairness and common sense.

Consider the case of Toronto. In 1999, the Toronto Board of Health drafted abylaw to ban smoking completely inbars and restaurants by 2001. The politicians found this to be extreme. They brokereda deal between an anti-smoking coalition and the bar and restaurant industry that permitted the existence of enclosed,separately ventilated designated smoking rooms. The city council passed the amended bylaw (which also extended the deadline for bars) by a vote of 50 to 1. Many of Toronto's bars and restaurants, fearful of driving away customers who chose to smoke, invested between $20,000 and $300,000 in such rooms.

In May of this year, the Toronto Board of Health went over Toronto's head, urging Mr. Smitherman to close down the city-sanctioned smoking rooms by 2007. Mr. Smitherman, whose Liberal government had come into office keen to crack down on smokers, this week introduced provincial legislation that he said would, among many other controls, "eliminate so-called designated smoking rooms." (The bill would also ban smoking in Legion halls but permit it in nursing homes. Oh, the whims of power.)

Tobacco is an addictive, health-destroying substance. But as long as it remains a legal product, the crusade to ensure that an Ontario region can't even let adult smokers light up in an enclosed, separately ventilated room is punitive law, not good law. There may be an argument that smokers who retire with their drinks or their food to those rooms shouldn't expect regular service there -- the health of the waiters is at issue -- but such subtleties don't seem to be a factor in the government's crusade. Neither does the good faith in which establishments built their separate rooms to comply with the Toronto bylaw.

Mr. Smitherman this week proudlydescribed his government's proposed legislation as the "toughest, most comprehensive and far-reaching" in North America. He may well be right. Certainly his crusades have had an evangelistic zeal to them; consider his blanket ban, since aborted, on the sale in Ontario of sushi and other raw fish. What's missing is a sense of proportion.

http://globeandmail.workopolis.com/servlet/Content/fasttrack/20041217/ESMOKING17?section=Travel


Canada's highest court to hear tobacco companies' appeal of legislation

Greg Joyce Canadian PressDecember 19, 2004

VANCOUVER (CP) - The long-standing fight between British Columbia and three tobacco companies moved to the judicial big leagues Thursday after the Supreme Court agreed to hear an appeal by the companies.

The nation's highest court agreed to hear an appeal of B.C. legislation known as the Tobacco Damages and Health Care Costs Recovery Act.

Several provinces have been watching the case with a view to launching similar legislation of their own. However, the Supreme Court hearing means it could be years before any costs are recovered.

The B.C. Court of Appeal, in a unanimous decision last May, ruled the B.C. government's legislation is constitutionally valid.

"It's important and it's (the Supreme Court appeal) the right thing to do," said Dave Laundy, spokesman for the Canadian Tobacco Manufacturers' Council, which is also a part of the appeal.

In May, the province's Liberal government got a green light to proceed with the lawsuit that seeks to recover $10 billion in health-care costs from tobacco companies.

The lawsuit names Imperial Tobacco Canada, Rothmans, Benson and Hedges, JTI-Macdonald, the tobacco council and several foreign tobacco companies.

Attorney General Geoff Plant said the case is important to the province.

"I think the stakes are high for British Columbia because we believe that the actions of the tobacco companies in not telling the truth about their products have cost the health-care system billions of dollars over the years."

The attorney general may prod other provinces to get involved.

"We may well encourage other provinces to intervene in the Supreme Court of Canada decision here."

The B.C. Appeal Court ruling overturned the decision of the B.C. Supreme Court, which twice previously - dating back to 1998 - had declared the legislation unconstitutional.

Laundy said the legislation is unfair to the tobacco manufacturers because its wording restricts the industry from gaining evidence on health-related issues, including how many people have become ill from smoking.

But Plant disagreed.

"I don't think that's a fair characterization of what the provincial statute tries to do," he said.

"It certainly tries to change some of the usual rules about evidence but it does so in the context of a completely new kind of lawsuit."

The legislation alleges tobacco manufacturers failed to warn consumers of the dangers of smoking, marked light cigarettes as safe and targeted children in their advertising and marketing.

A policy analyst and lawyer with the Canadian Cancer Society also said the case was of great importance to both sides.

"Other provinces are watching this closely so a judgment by the Supreme Court that is favourable will really give a green light to provinces to move ahead with their own legislation," said Rob Cunningham.

"Clearly, the stakes are high on both sides of the issue."

In 1998, B.C.'s former NDP government became the first government in Canada to attempt to sue tobacco companies, but the suit was rejected by the courts as too broad.

The suit said tobacco companies should be held liable for the tobacco-related illnesses that cost British Columbia an estimated $500 million a year in health costs.

http://www.canada.com/health/story.html?id=941120d0-4a97-4528-8eed-db32e4e9e586


Italy's Smoking Ban Plan Meets Resistance

Published Monday, December 20, 2004 By ALESSANDRA RIZZO
Associated Press Writer ROME
A cigarette with that Chianti? No more - at least not in most of Italy's restaurants and bars, starting next month.
In this cigarette-loving country, a new law to ban smoking in public places has won support from nonsmokers. Restaurant owners, however, are fuming because it requires them to report diners who flout the law and light up.
They worry their new policing role will sour relations with customers.
"We are being asked to become informers, but we don't want to give up our relation with customers," lamented Edi Sommariva, the director general of the Italian federation that groups bars, restaurants and other public places.
If the law isn't changed, he said Monday, the association will go to court.
The new legislation goes into force Jan. 10. It was originally expected to take effect at the end of this month, but officials agreed to postpone enforcement to allow smokers a few last puffs on New Year's.
"We will not allow any more delays," Health Minister Girolamo Sirchia said over the weekend. "Those who want to smoke can do so in the streets or in their homes, not around those who do not tolerate it."
The legislation is the centerpiece of Sirchia's efforts to curb smoking in Italy. Italian regulations already restrict smoking in many places, although these laws are often ignored and rarely enforced. About 26 percent of the adult population lights up, according to Health Ministry figures.
The law bans smoking in all indoor spaces unless they have a separate smoking area with continuous floor-to-ceiling walls and a ventilation system. It raises fines by 10 percent for violators and envisages stiff penalties of up to $2,900 for personnel who do not report to authorities when a customer is smoking.
The outcry made headlines in many Italian newspapers Monday. Corriere della Sera, the country's largest daily, ran a front-page editorial headlined "The Sheriff's Trattoria."
Reporting violations is "the job of the state and of its public officials. A bartender and a restaurateur are not guards," said the editorial.
Sirchia - a prominent doctor before taking up the ministry job - shrugged off the protests, saying personnel "must merely invite the customer to avoid smoking if it's not the right area."
He received support Monday from the Codacons consumers' group, which said it would "unleash its inspectors in bars and restaurants to make sure the ban is enforced."
But even some members of the governing coalition distanced themselves from Sirchia's anti-tobacco campaign.
Ignazio La Russa, a prominent lawmaker in the National Alliance government party and an ex-chain smoker, said the law would stigmatize smokers as "people with a plague." Another lawmaker from the same party, Alberto Arrighi, said Sirchia "is a great doctor, but he seems to me a Taliban member on the political level," according to the ANSA news agency.
Italy's law follows a similar effort in Ireland, which forced a ban on smoking in all enclosed workplaces, including pubs, earlier this year. The move has caused 7,000 people to quit smoking and 10,000 to decrease their frequency, according to the European Union's top health official, David Byrne.
The British government said last month it was also seeking to impose a smoking ban in most public places, including restaurants and any pub or bar that serves food.
In Italy, only 10 percent of restaurants deemed it convenient to create a smoking area, according to Sommariva's association. The rest will become entirely nonsmoking.
"The law is exaggerated, and it's based on a terrorist approach I don't agree with," said Claudio Ferrari, a 27-year-old archaeologist - and smoker - sipping coffee in a bar in central Rome. "I don't share the idea that it's up to the state to educate citizens. A little common sense is all it takes."

http://www.theledger.com/apps/pbcs.dll/article?AID=/20041220/API/412200849


Lawyers Argue Over Tobacco Payments

 December 20, 2004

GREENSBORO -- More than 200 tobacco growers watched Monday afternoon as attorneys for cigarette companies and farmers squared off over whether Big Tobacco should make one last payment to leaf growers.

North Carolina Business Court Judge Ben Tennille told lawyers he hoped to make his ruling by Wednesday or Thursday.

That ruling would have a big impact on thousands of growers in 14 states.

These so-called "Phase Two" payments have compensated tobacco growers over for losses they were expected to suffer as a result of higher cigarette prices following the 1998 settlement.

Cigarette companies say they aren't obligated to make a payment this month because Congress approved a tobacco buyout this fall.

Tennille ruling's may be appealed to a higher court.

http://www.wxii12.com/news/4011989/detail.html


Hwy. Dept. kicks off litter hotline-AR
With roadside litter an escalating problem throughout the state, now over 60,000 cubic yards collected per year, the Arkansas State Highway and Transportation Department (AHTD) has announced a new violator reporting system and 24-hour, toll-free hotline to ask for motorist assistance in helping solve the problem.
After the Tuesday, Dec. 14 launch, highway officials are encouraging motorists who spot a littering violation along any street, road or highway to call 1-866-811-1222 to report the situation. All types of trash and all types of vehicles are subject to be reported, whether a cigarette butt or whether thrown from a commercial vehicle, as long as the license plate number is provided.
Litter reporting phone calls will be answered 24 hours a day by an office of the Arkansas Highway Police (AHP) who will record the incident. A letter will then be sent to the registered owner of the vehicle regarding the violation. "Information about recurring violations reported from the same vehicle will be tracked and may eventually result in a visit by an Arkansas police officer to investigate the problem," said AHP Chief Ron Burks. "Our goal is to let citizens know this is a problem we take seriously and will pursue thoroughly the enforcement of Arkansas' litter laws," added Burks.
Reporting a litter violation will be quick and simple, while allowing the caller to remain unidentified. Motorists using the reporting system will need to provide the date and location that the littering occurred, a description of the vehicle including the license plate number and a description of the item discarded. Roadway signs currently in place to forewarn motorists of potential fines for littering will now include the toll-free number asking motorists to report people who litter.
"We expect three benefits by implementing the new Litter Reporting System," said Director of Highways & Transportation, Dan Flowers, at a launch event held at the AHTD Central Offices. "Motorists who see the signs or become aware of the program will be reminded that they can be reported for littering by any other motorist and, then, may be more conscious of their own littering behavior. Second, the program will give citizens who see littering happen some remedy to the frustration of watching careless motorists trash the natural beauty of our state, and third, we hope that any person who receives the letter will be more thoughtful of their littering habits and will change their behavior."
"Currently there are eight other states that have implemented similar violator reporting systems with great success, so it's time for Arkansas to begin a serious effort to curtail this escalating problem," said Highway Commission Chairman Prissy Hickerson. "Not only will a reduction in roadside litter improve the enjoyment of residents and visitors who travel our highways, but it's a great preservation of our natural environment and will save taxpayer money being spent on cleaning up the discarded trash of careless motorists," added Hickerson.
The AHTD's violator reporting system is part of a comprehensive plan to curtail roadside litter in Arkansas. At the request of the Arkansas Highway Commission, the 2003 Litter Task Force was formed from federal, state and local governments and associations to review current litter prevention and removal activities and identify areas of improvement. Action teams were then established to focus on the areas of education and outreach, litter pick up, enforcement and legislative funding. In addition to the AHTD spearheading the litter reduction effort, representatives from associations and state agencies such as the Highway Police, Arkansas State Police (ASP), Chiefs of Police & Sheriffs Associations, the Departments of Environmental Quality and Parks & Tourism, Game & Fish Commission and the Keep Arkansas Beautiful Commission have diligently worked together to solve Arkansas' litter control problem.
Additional programs and policies are still in development as a result of the Litter Task Force efforts to create incentives for litter enforcement and clean up activities. A recognition program for law enforcement officers who are highly involved in anti-litter efforts, a program for corrections facilities that utilize prisoners in highway clean up efforts and highly publicized enforcement priority weeks will greatly raise the level of litter control action across Arkansas.
Also, an anti-litter citation guide is being distributed for easy reference by law enforcement officers, ASP will include litter laws on the inside cover of the Arkansas Drivers Manual and The Arkansas Law Enforcement Training Academy will include a section on litter law enforcement in their training curricula.

http://www.sherwoodvoice.com/Pages/12-16-04/Hwy.%20Dept.%20kicks%20off%20litter%20hotline.htm


The contribution of smoking, diet, screening and treatment to cancer mortality in the under-75s

20 Dec 2004

Cancer is a major cause of morbidity and mortality in England and Wales with 223,609 new cases of cancer registered in 2000. A new briefing paper The contribution of smoking, diet, screening and treatment to cancer mortality in the under-75s published by the Health Development Agency (UK) today reviews the impact that various measures have had in the treatment and reduction of certain types of cancer.
For men, lung, prostate and colorectal cancers account for about 50% of all cancer deaths and for women breast, lung and colorectal cancers account for 46% of all deaths. Lung, breast, colorectal, stomach and prostate cancers cause most deaths and it follows that public health approaches should focus on these cancers.
In addition to tobacco related cancer deaths, which account for one third of all cancer deaths, other lifestyle factors are significant risk factors for many cancers. For instance, it has been estimated that changes in diet could help prevent a third of all cancers. It is estimated that changes in diet could help prevent a third of all cancers. It is estimated that cancer mortality, attributable to specific factors or groups of factors in developed countries was tobacco 30%, diet and obesity 30%, alcohol 3%, inactivity 3% and occupational factors 5%. Research shows that overall, primary prevention seems to be around seven times more effective than secondary prevention.
Professor Mike Kelly, Director of Evidence and Guidance at the Health Development Agency said:
‘Primary prevention such as media campaigns or government legislation are effective with cancers such as lung cancer where not starting to smoke will drastically reduce your chances of developing lung cancer, whereas secondary disease detection, such as screening is not effective with lung cancer.
‘It is known after five years, men with lung cancer have a survival rate of only 5-7 %, as there is no really effective treatment for lung cancer. Whereas with breast cancer, treatment combined with screening (secondary prevention) can have a positive effect on survival rates.'
Incidence and survival have an impact on mortality rate. Incidence is a measure of the number of new cases in any given time period. Survival is a measure of the time from diagnosis to death. This complex interaction between incidence and survival provides the key to determining the extent to which primary or secondary prevention, or treatment, provide the most appropriate approach to tackling this disease.
The majority of people (65%) diagnosed with cancer are over the age of 65 and cancer is predominantly a disease of older people, this will affect future mortality and morbidity trends. We have an ageing population and it is important that strategies for prevention and treatment take this into account.
Possible implications on policy based on the reviewed patterns of cancer mortality include:
-- Different types of cancer need to be separated and the relative importance of incidence and survival examined if we are properly assess varying importance of factors such as smoking, diet, inactivity screening and treatment to cancer mortality.
-- An aggressive approach to reduce smoking will continue to drive down numbers of lung and other cancers. This will also impact on coronary heart disease. There should also be greater emphasis on smoking reduction in deprived areas as smoking is an inequalities issue. In poorer areas people are more likely to die form smoking related diseases than they are in richer areas.
-- Primary prevention of cancers associated with diet, lack of exercise, obesity and exposure to the sun could be effective.
-- Screening programmes for breast and cervical cancer should continue but the evidence does not support screening for lung or prostate cancer.
-- Treatment options need to be continually developed in areas where, up to now there has been limited success.
On the basis of the existing evidence and exposure trends, primary and secondary prevention have already reduced cancer mortality by almost 13% in comparison to the rates which would have been reached in the absence of these measures. In the next 20 years, a further reduction of about 29% is potentially achievable, mostly through primary prevention.
ENDS
Notes to editors:
1 The briefing paper is available on the Health Development Agency website: http://www.hda.nhs.uk.
2 The Health Development Agency is the national authority on what works to improve people's health and to reduce health inequalities. We work in partnership across sectors to support informed decision making at all levels and the development of effective practice.

http://www.medicalnewstoday.com/medicalnews.php?newsid=18079


National Academies news: Gulf War and Health

21 Dec 2004

The available evidence is too sparse or of insufficient quality to determine whether the majority of health problems that may be experienced by Gulf War veterans could be associated with exposures to fuels for military vehicles, propellents in Scud missiles, or substances given off by combustion sources such as oil-well fires, exhausts, and tent heaters, according to the latest report on the Gulf War and health from the Institute of Medicine of the National Academies. However, data from studies of occupational and environmental exposures to air pollution, vehicle exhaust, and other combustion products led the committee that wrote the report to conclude that exposure to such substances is associated with an increased risk of lung cancer.
"Studies of people exposed to air pollution, vehicle exhaust, and burning of coal or other heating and cooking fuels consistently show that such exposures are linked to an increased risk for developing lung cancer," said committee chair Lynn Goldman, professor, Bloomberg School of Public Health, Johns Hopkins University, Baltimore. "This provides sufficient evidence that exposure to combustion products during the Gulf War could be associated with lung cancer in some veterans." Military personnel may have encountered combustion products from diesel-fueled heaters in poorly ventilated tents, cooking stoves, vehicle exhaust systems, and oil-well fires. "It should be emphasized that smoking is the major culprit for lung cancer, accounting for 80 percent of all cases, according to the American Cancer Society," Goldman added.
The committee also found some evidence that exposure to combustion products is linked to asthma and cancers of the nose, mouth, throat, and bladder, as well as to low birth weight and premature births in women exposed while pregnant; the data were weaker in these cases, however. The data on whether the majority of cancers, neurological problems, and other health problems are associated with exposure to fuels, propellants, or combustion products were inadequate to draw conclusions. "While we would like to have more definitive answers to questions about the specific diseases that may be associated with these substances, in most cases the evidence simply is not strong enough or does not exist," Goldman said.
Because scant information exists on actual exposure levels experienced by individual service members -- a critical factor when assessing health effects -- the committee could not draw specific conclusions about Gulf War veterans' chances of developing lung cancer or any other health problems as a result of exposures. No systematic monitoring of air contamination from oil-well fires was conducted in the Persian Gulf region until May 1991, and this monitoring did not measure levels of contamination produced by other combustion sources, such as heaters or engines. Moreover, no data are available that would allow comparisons between levels of exposure to air contaminants during the Gulf War and exposures to similar contaminants in civilian occupational and environmental settings.
Veterans who have experienced chronic health problems following their service in the Persian Gulf region are asking whether exposure to various chemical, biological, or environmental agents might be responsible. This IOM report is the third in a series that responds to requests from the U.S. Department of Veterans Affairs and Congress to examine the health effects of potentially harmful agents to which Gulf War veterans might have been exposed. The first report focused on potential health effects from depleted uranium, pyridostigmine bromide, sarin, and vaccines; the second centered on insecticides and solvents. These reports did not directly assess whether health effects could occur as a result of service in the Gulf War.
For the current report, the committee evaluated the published, peer-reviewed research on exposure to unburned fuels, combustion products, and hydrazines and nitric acid -- components of the propellant used for Scud and other missiles -- for any evidence of links to specific cancers, neurological effects, or other health problems that persist after exposure. More than 600 oil-well fires were ignited in Kuwait by retreating Iraqi troops during the Gulf War conflict, sending up large plumes of smoke that occasionally remained low to the ground. Troops also may have been exposed to combustion products through vehicle exhaust, heaters in poorly ventilated tents, and cooking stoves. Military personnel may have had contact with hydrazines and nitric acid when they disarmed or disposed of Scud missiles or were downwind of a missile explosion. They also may have come into contact with fuels when refueling ground vehicles, aircraft, and equipment.
Of the approximately 800 studies reviewed in detail for this report, most involved individuals who were exposed to these agents in occupational settings over long periods of time. Only a small number actually studied veterans who may have been exposed while serving in the Persian Gulf. The committee carefully assessed the quality, limitations, and relevance of each epidemiologic study, and used five categories to describe the strength of the evidence.
SUFFICIENT EVIDENCE OF A CAUSAL RELATIONSHIP, the strongest level of evidence, means that many studies have established a clear link between exposure to an agent and a health outcome. Among the other requirements, there must be a plausible biological explanation for the relationship. None of the compounds evaluated in this report met these criteria.
Evidence that establishes a link between exposures and a health outcome with reasonable certainty, but fails to meet the higher standard of proof needed for causality, is characterized as SUFFICIENT EVIDENCE OF AN ASSOCIATION. The evidence for an association between lung cancer and combustion products falls into this category.
When a limited number of studies suggest that a link exists, but without reasonable certainty, the evidence is said to be LIMITED OR SUGGESTIVE OF AN ASSOCIATION. This category describes the evidence for links between combustion products and nasal, oral, laryngeal, and bladder cancers; asthma; and low birth weight and preterm births by women exposed while pregnant. Likewise, the evidence for an association between hydrazine exposure and lung cancer fits this definition.
If several studies of adequate quality consistently fail to show a positive association at any level of exposure, the evidence is described as LIMITED OR SUGGESTIVE OF NO ASSOCIATION. And evidence that lacks sufficient quality, consistency, or statistical power to draw any conclusion is judged to be INADEQUATE OR INSUFFICIENT TO DETERMINE WHETHER AN ASSOCIATION EXISTS. The majority of the evidence on fuels, combustion products, and propellants falls into this final category.
The study was sponsored by the U.S. Department of Veterans Affairs. The Institute of Medicine is a private, nonprofit institution that provides health policy advice under a congressional charter granted to the National Academy of Sciences. A committee roster follows.
A pre-publication version of GULF WAR AND HEALTH, VOL. 3: FUELS, COMBUSTION PRODUCTS, AND PROPELLANTS is available on the Internet at HTTP://WWW.NAP.EDU. Reporters may obtain a copy from the Office of News and Public Information (contacts listed above).
[ This news release and report are available at HTTP://NATIONAL-ACADEMIES.ORG ]

http://www.medicalnewstoday.com/medicalnews.php?newsid=18117


Potentially fatal toxicities occur with off-label use of cancer drugs

21 Dec 2004

Food and Drug Administration policies prevent pharmaceutical manufacturers from informing patients about potentially fatal toxicities that occur with some cancer drugs -- policies that should be revised immediately, according to Northwestern University researchers.
Andrew M. Evens, D.O., instructor in medicine, and Charles L. Bennett, M.D., professor of medicine, Northwestern University Feinberg School of Medicine, have called for an immediate revision of these FDA policies, particularly because the drug thalidomide, which was approved by the FDA as an off-label cancer treatment in 1998, has been reported to have caused potentially fatal blood clots in the legs and the lungs in over 190 cancer patients.
Virtually all patients who have received thalidomide over the past six years have received the drug for cancer, making this drug the only one in the country whose use is exclusively off label.
The FDA strictly restricts discussion or dissemination of information to physicians and patients to "on label" indications, which prevents the pharmaceutical manufacturer from advising cancer patients about the side effects of thalidomide when it is used to treat cancer.
Moreover, despite an FDA mandate that all health care personnel and patients involved with thalidomide treatments participate in the preventive System for Thalidomide Education and Prescribing Safety (STEPS), the program does not provide patients, pharmacists or health care providers with information on thromboembolisms.
Evens presented the RADAR (Research on Adverse Drug Events and Reports) data on the thalidomide-associated blood clots on at the 46th Annual Meeting of the American Society of Hematology in early December.
The Northwestern study identified the occurrence of potential fatal blood clots in the legs and the lungs in up to 20 percent or more of cancer patients who received thalidomide.
The highest rates of thromboembolism occurred in patients who received concurrent treatment with thalidomide plus chemotherapy (18 percent) versus blood clots associated with thalidomide-corticosteroid combinations (13 percent) and single-drug treatment (5 percent).
Thalidomide, banned initially in 1962, has had a remarkable resurgence since 1998 for cancer, although its formal FDA approval is as a treatment of skin complication of the rare illness, leprosy.
"Given the current controversies about the FDA and pharmaceutical safety, our findings provide additional evidence that dramatic changes in the way the FDA address patient safety are needed," Even said.
Evens and Bennett are faculty physicians in the department of medicine, division of hematology/oncology, at Northwestern University Feinberg School of Medicine and researchers at The Robert H. Lurie Comprehensive Cancer Center of Northwestern University. The RADAR project, led by Bennett, is supported by a $5 million grant from the National Cancer Institute.

http://www.medicalnewstoday.com/medicalnews.php?newsid=18111


Mobile phone radiation harms DNA, researchers say

21.12.04 1.00pm

MUNICH/AMSTERDAM - Radio waves from mobile phones harm body cells and damage DNA in laboratory conditions, according to a new study majority-funded by the European Union.
The Reflex study, conducted by 12 research groups in seven European countries, did not prove that mobile phones are a risk to health but concluded that more research is needed to see if effects can also be found outside a lab.
The $100 billion (51 billion pound) a year mobile phone industry asserts that there is no conclusive evidence of harmful effects as a result of electromagnetic radiation.
About 650 million mobile phones are expected to be sold to consumers this year, and over 1.5 billion people around the world use one.
The research project, which took four years and which was coordinated by the German research group Verum, studied the effect of radiation on human and animal cells in a laboratory.
After being exposed to electromagnetic fields that are typical for mobile phones, the cells showed a significant increase in single and double-strand DNA breaks. The damage could not always be repaired by the cell. DNA carries the genetic material of an organism and its different cells.
"There was remaining damage for future generation of cells," said project leader Franz Adlkofer.
This means the change had procreated. Mutated cells are seen as a possible cause of cancer.
The radiation used in the study was at levels between a Specific Absorption Rate (SAR) of between 0.3 and 2 watts per kilogramme. Most phones emit radio signals at SAR levels of between 0.5 and 1 W/kg.
SAR is a measure of the rate of radio energy absorption in body tissue, and the SAR limit recommended by the International Commission of Non-Ionising Radiation Protection is 2 W/kg.
The study also measured other harmful effects on cells.
Because of the lab set-up, the researchers said the study did not prove any health risks. But they added that "the genotoxic and phenotypic effects clearly require further studies ... on animals and human volunteers."
Adlkofer advised against the use of a mobile phone when an alternative fixed line phone was available, and recommended the use of a headset connected to a cellphone whenever possible.
"We don't want to create a panic, but it is good to take precautions," he said, adding that additional research could take another four or five years.
Previous independent studies into the health effects of mobile phone radiation have found it may have some effect on the human body, such as heating up body tissue and causing headaches and nausea, but no study that could be independently repeated has proved that radiation had permanent harmful effects.
None of the world's top six mobile phone vendors could immediately respond to the results of the study.
In a separate announcement in Hong Kong, where consumers tend to spend more time talking on a mobile phone than in Europe, a German company called G-Hanz introduced a new type of mobile phone which it claimed had no harmful radiation, as a result of shorter bursts of the radio signal.
- REUTERS

http://www.nzherald.co.nz/index.cfm?c_id=5&ObjectID=9004133


Pfizer Pulling Advertising for Celebrex
12.20.2004, 03:43 PM
Pfizer Inc. says it will immediately pull advertising for its top-selling arthritis pain reliever Celebrex, whose safety was called into question last week after a study found an increased risk of heart attacks in patients taking high dosages of the drug.
Pfizer spokesman Andy McCormick said the company was suspending Celebrex ads in newspapers, radio, TV and magazines. He said the company made the decision in discussions with the Food and Drug Administration.
McCormick also said Pfizer plans to have its sales staff meet with doctors to explain the findings of the survey, which were made public on Friday. He said Pfizer plans to keep Celebrex on the market.
The FDA said Friday it was considering warning labels for Celebrex or withdrawing the drug from the market. Celebrex is in the same class of drug, called a cox-2 inhibitor, as Vioxx, a rival pain reliever that Merck & Co. pulled from the market earlier this year after a study found the drug doubled the risk of heart attack or stroke.
For the first nine months of the year, worldwide sales of Celebrex more than doubled from a year earlier to $2.3 billion, accounting for 6 percent of Pfizer's total sales of $37.6 billion during that period.
Last year, Pfizer spent $87.6 million to advertise Celebrex, according to TNS Media Intelligence/CMR. It recently launched a new campaign for the drug and placed full-page ads in newspapers touting Celebrex's safety in the wake of Vioxx's recall.
The heart attack risk in the study disclosed Friday occurred when patients took the drug at two to four times the usual dose for many months.
News of the increased heart risk for Celebrex patients came in one of two long-term cancer-prevention trials.
On Monday, the FDA said it had asked Pfizer to suspend its consumer advertising of Celebrex while the agency evaluates new and conflicting information on the drug.
The National Cancer Institute, which was conducting the study for Pfizer, said patients in the clinical trial taking 800 milligrams of Celebrex had a 3.4 times greater risk of cardiovascular problems compared with a placebo.
For patients in the trial taking 400 milligrams of Celebrex, the risk was 2.5 times greater. The average duration of treatment in the trial was 33 months.
Pfizer's shares, which fell hard on Friday following the release of the news, fell another $1.48 or 6 percent to $24.27 in heavy trading Monday on the New York Stock Exchange.

http://www.forbes.com/business/services/feeds/ap/2004/12/20/ap1721635.html


Germany Tells Some Patients to Stop Using Celebrex

Mon Dec 20, 2004 11:43 AM ET

FRANKFURT (Reuters) - Germany's drug regulator on Monday told patients with cardiovascular risks to stop using Pfizer's arthritis drug Celebrex after new data emerged linking it to an elevated risk of heart attacks.

The drug regulator said in a statement it was not "justifiable" to treat patients with a history of heart attack and stroke with Celebrex.

The regulator urged the use of alternative drugs or to cut down the dose if a patient cannot be treated without Celebrex.

Pfizer last week said Celebrex more than doubled the risk of heart attack in a large cancer-prevention trial, a setback that comes just weeks after Merck & Co. recalled its similar Vioxx drug due to heart safety risks.

Pfizer said doctors should be made aware of the health risks in prescribing Celebrex to their patients, but the company does not plan to recall its popular arthritis drug.

Celebrex is one of Pfizer's biggest products, with 2003 sales of $1.9 billion.

http://www.reuters.com/newsArticle.jhtml?type=topNews&storyID=7141603


Genetic Mutations Not Being Detected Early Enough In Families with Hereditary Colorectal Cancer

According to the results of a study recently published in the Journal of Clinical Oncology, a genetic mutation that can cause colorectal cancer is not being detected early enough. These findings have led to the recommendation that families at risk for developing colorectal cancer be more closely monitored.

Colorectal cancer is the second leading cause of cancer related deaths in the United States. Colorectal cancer is a malignancy that involves both the large intestines (colon) and a distal portion of the colon known as the rectum. Hereditary nonpolyposis colorectal cancer (HNPCC) is a syndrome caused by specific genetic mutations that is characterized by an increased risk of colon cancer, as well as other cancers such as ovarian, stomach, liver, brain and skin. Genetic abnormalities among 4 genes (MLH1, MSH2, MSH6, and PMS2) can be detected by genetic testing and those found to have HNPCC have an 80% lifetime risk for developing colon cancer. The average age for colorectal cancer diagnosis among this group is 44. MLH1 and MSH2 mutations account for approximately 90% of all patients diagnosed with HNPCC. Mutation of the MSH6 gene occurs in 7-10% of families with HNPCC and mutation of the PMS2 gene accounts for less than 5% of families diagnosed with HNPCC. Patients with HNPCC typically undergo colonoscopy every 1-2 years starting at ages 20-25, or starting at 10 years younger than the youngest person to have developed colon cancer in the family. Patients with HNPCC who have a family history of cancer outside of the colon undergo rigorous and frequent screening for that type of cancer beginning at a young age.

In this recent study, the goal was to more closely evaluate the involvement of the MSH6 mutation in families suspected of HNPCC. Patients were chosen from 706 families who had been identified as not having an MLH1 or MSH2 mutation, but were suspected of having a form of HNPCC from family history of cancer. These patients were then subjected to MSH6 testing. This information was then compared to data collected from families with MLH1 and MSH2 mutations.

Results of the study found 27 families with 24 different MSH6 mutations, which represented 3.8% of the total families. The average age of onset for colorectal cancer in these patients was 10 years later (54years) than for patients with MLH1 and MSH2 mutations. When compared to other malignant tumors, colorectal cancer was less frequent among MSH6 families than those with MLH1 and/or MSH2 mutations; however, non-HNPCC associated tumors were increased.

Researchers concluded that the later onset of colorectal cancer as well as the lower incidence, may contribute to the lower number of identified MSH6 mutations in families that are suspected of HNPCC. However, further analysis reveals that in approximately half of these families, one or more of the family members developed colorectal or endometrial cancer in their 40s. This has led researchers to recommend equally rigorous surveillance of cancer for families with MSH6 mutations, as that for families with MLH1 and MSH2 mutations. Patients with a strong family history of colorectal cancer who test negative for MLH1 or MSH2 should speak with their physician about testing for MSH6, as well as the frequency of screening.

Reference: Plaschke J, Engel C, Kruger S, et al. Lower Incidence of Colorectal Cancer and Later Age of Disease Onset in 27 Families With Pathogenic MSH6 Germline Mutations Compared With Families With MLH1 or MSH 2 Mutations: The German Heredity Nonpolyposis Colorectal Cancer Consortium. Journal of Clinical Oncology. 2004; 22: 4486-4494.

http://patient.cancerconsultants.com/news.aspx?id=32833


Study links milk drinking with ovarian cancer

December 20 2004 at 11:22AM

Washington - A US study based on research in Sweden shows that consuming milk could increase the risk of ovarian cancer.
A study involving more than 60 000 women in Sweden found that drinking more than two glasses of milk a day significantly increased the chances of the most serious form of ovarian cancer.
It follows past claims that dairy products are linked to certain types of cancer, including breast and prostate cancer.
The study, published in the American Journal of Clinical Nutrition, followed 61 084 women aged 38 to 76 whose diet was assessed between 1987 and 1990 using a food-frequency questionnaire. They were followed up for around 13 years.

During this time a total of 266 women were diagnosed with ovarian cancer, of whom 125 had serious ovarian cancer.
The researchers, led by Dr Susanna Larsson from the Karolinska Institute, found that women who consumed more than four servings of dairy products a day had twice the risk of serious ovarian cancer than women who had fewer than two.
They found that milk had the strongest link with ovarian cancer, with those drinking two or more glasses facing double the risk of those who consumed it never or seldom.
The team concluded: "Our data indicate that high intakes of lactose and dairy products, particularly milk, are associated with an increased risk of serious ovarian cancer but not of other sub-types of ovarian cancer."
Despite the study other medical experts point to the benefits of milk and dairy products which they say is crucial in maintaining healthy bones and preventing osteoporosis in later life. - Sapa-dpa

http://www.iol.co.za/index.php?click_id=31&art_id=qw1103524743335B243&set_id=


Another child with ties to Fallon diagnosed with leukemia

By SANDRA CHEREB ASSOCIATED PRESS

RENO, Nev. (AP) - The toddler of a military family with ties to the Fallon area has been diagnosed with childhood leukemia, officials at Naval Air Station Fallon said Monday.

State health officials could not immediately be reached to comment on whether the case is the latest in a childhood leukemia cluster that has stricken the rural farming community 60 miles east of Reno.

Since 1997, 16 children with ties to Fallon have been diagnosed with leukemia. Three have died. In a town the size of Fallon, with about 8,300 residents, just one case of childhood leukemia would be expected in five years, according to health officials.

The latest case involves a 28-month old boy whose father is a Navy hospital corpsman, base officials said.

The toddler became ill earlier this month and initially was examined by doctors at Banner Churchill County Hospital and the naval base, officials said.

He was flown last Thursday to Children's Hospital in Oakland, Calif., where doctors on Saturday confirmed a diagnosis of acute lymphocytic leukemia, officials said.

Base spokesman Zip Upham said Navy officials alerted the state Health Department after the diagnosis was confirmed.

Upham said the boy's father wasn't based in Fallon but has been attending surgical technician school in San Diego, Calif., since April.

His wife and children have been staying in Fallon near family members, Upham said.

State and federal health experts studied Fallon's cancer cluster for more than two years, testing water, dirt and taking blood samples from residents searching for clues into why so many children were developing leukemia.

Tests could not pinpoint a cause.

"We were hoping we'd get more information here," Dr. Malcolm Smith of the National Cancer Institute said in February when a final report was presented to the community.

"The studies didn't do that - but they certainly told us a great deal about what does not exist as health threats to the community."

The studies turned up no link to high levels of naturally occurring arsenic in Fallon's water supply, a pipeline carrying jet fuel to the Navy base, pesticide spraying, high tungsten levels, or an underground nuclear test conducted 30 miles away about 40 years ago.

Dr. Thomas Sinks of the Centers for Disease Control and Prevention said at the time, "All of us would love to be able to identify what causes childhood leukemia.

"We simply can't afford to be disappointed every time we fail."

http://www.lasvegassun.com/sunbin/stories/nevada/2004/dec/20/122010213.html


Doctors say herbal blend can help cancer patients

Abram Katz, Register Science Editor 12/19/2004

Yale University, the Ivy League bastion of Western science, is turning to ancient Chinese formulas to develop new medicines for the 21st century.
Already physicians have demonstrated that an 1,800-year-old Chinese recipe of four plants can apparently ease the side effects of chemotherapy while boosting the healing power of the anti-cancer drug.

These intriguing preliminary results must be expanded and reconfirmed, doctors said, but a crucial principle is clear — combinations of compounds could be the key to treating a variety of intractable diseases.

Specifically, researchers believe that modernized "polychemical" Chinese remedies hold hope for diseases of aging like cancer, Alzheimer’s disease and other neurodegenerative diseases.
Yale is among a handful of American institutions exploring Chinese medicine and may be the closest to bringing an FDA-approved drug into clinical use.
Yale scientists have established PhytoCeutica Inc. in New Haven as a base of business operations and have already developed a unique method to ensure chemically consistent products.
The very antiquity of traditional Chinese medicine supports its effectiveness, said Dr.
Edward Chu, chief of medical oncology at the Yale Cancer Center.
"Herbs have been used in the Orient for 2,000 years with clear efficacy. Experience was passed down from generation to generation to generation.
My great-grandfather was a Chinese herbalist," Chu said.
But Chu is hardly a supplement store flake.
Chu is internationally recognized for his research on why abnormal cells proliferate and sprout into cancer. He is currently studying novel treatments for colon cancer.
Chu hopes to apply the same rigorous research methodology on herbal medicines.
"The essence of Chinese medicine is multiple ingredients and all are key. You may need two ingredients for efficacy and two to prevent toxicity," he said.
This is more than mere theory.
Chu and colleagues are working on a traditional medicine that they call PHY906.
PHY906 interested Chu because the medicine is traditionally used to ease gastrointestinal problems — the same kinds that plague people receiving chemotherapy for colon cancer.
Yale pharmacology professor Yung-Chi Cheng said the research team did not want to reveal the mixture’s commercial name.
This is because identically named products from several sources may have completely different ingredients, or may vary significantly from batch to batch.
In fact, Chinese medicine can only be integrated into the modern system if the compounds are rigidly consistent, Chu and Cheng said.
And that is a whole challenge unto itself.
Cheng said there was every reason to believe PHY906 would work.
"Chinese medicine has been used for ages and keeps evolving. Many formulas are used today. If it were useless, people wouldn’t still use it," he said.
"Modern medicine is only 50 years old, so there’s a big gap. You either deny the history or you take advantage of its historical use," Cheng said.
Eventually, Chinese medicine will complement modern medicine, he said.
Western physicians are suspicious of Chinese medicine because it was developed empirically, rather than experimentally, Cheng said.
"Even if you have a medicine that is evidence based, if you can’t make it consistent, the material is not a medicine," Cheng said.
"If we can overcome those two issues, then Chinese medicine may be useful for unmet clinical needs," he said.
Yale conducted a clinical test of PHY906 on patients receiving chemotherapy. Out of 30 patients, 17 were evaluated, Cheng said.
The patients experienced less vomiting, nausea and diarrhea. And tumor progression was halted in all but two patients.
"This is very encouraging. It is a preliminary result," Cheng said.
Another study of PHY906 is under way on patients with liver cancer at Yale and the City of Hope National Medical Center in Los Angeles.
The mixture seems to aid chemotherapy by increasing absorption in cells. PHY906 also apparently affects a protein involved in regulating cell proliferation, transformation and tumor development.
"This may be a totally novel way of treating diseases," Cheng said.
Cheng, Chu and PhytoCeutica analyzed the components of PHY906 using mass spectrometry and liquid chromatography. Both methods basically separate chemicals by molecular weight.
PHY906 contains about 150 different chemicals, about 90 of which have been identified. Eight of the compounds seem essential to the mixture’s effectiveness.
PhytoCeutica has developed a new way to test the consistency of the ingredients they will combine to produce PHY906.
A human cell culture is exposed to compounds.
The cells respond by producing proteins. During protein synthesis, messenger RNA is formed.
Robert Tilton, vice president of science and technology at PhytoCeutica, said the RNA is then traced back to the DNA from which is was encoded, using conventional DNA-chip technology.
About 200 to 300 genes out of 30,000 are either activated or inhibited by the mixture, Tilton said.
"We can quickly generate a unique gene pattern.
The novelty is to use this for quality control," he said.
Eventually, the technique will be useful in determining the mixture’s biological activity, but that work could take several years, Tilton said.
Meanwhile, the gene pattern can guarantee consistency to better than 90 percent.
"We have insight into how it’s working. There are multiple mechanisms," he said.
The FDA has provisions to approve botanicals as prescription drugs, and PHY906 is going through the conventional testing process, he said.
"We want to shift the focus from single molecules to collections of molecules to add a new level to Western medicine," Tilton said.
"In a way, we’re rediscovering the past, but with rigorous methodology," he said.

http://www.nhregister.com/site/news.cfm?newsid=13586119&BRD=1281&PAG=461&dept_id=517515&rfi=6


Judge Osteen's Ruling on the Tobacco Industry's EPA Lawsuit: Summary and Practical Implications

R.J. Reynolds Tobacco Company 7/23/98

Court Findings

A Federal Court has ruled that the EPA wrongly classified secondhand smoke as a Group A (known human) carcinogen.

Contrary to statements by the EPA Administrator, the Court’s ruling was not merely procedural. Among other things, the Court found (pp. 89-90) that EPA:

  • "publicly committed to a conclusion before research had begun"
  • "adjusted established procedure and scientific norms to validate the Agency’s public conclusion"
  • "aggressively utilized the Act’s authority to disseminate findings to establish a de facto regulatory scheme intended to restrict Plaintiff’s products and to influence public opinion"
  • "disregarded information and made findings on selective information"
  • "failed to disclose important findings and reasoning"
  • "left significant questions without answers"
  • "did not disseminate significant epidemiologic information"
  • "excluded industry by violating the [Radon] Act’s procedural requirements"
  • "deviated from its Risk Assessment Guidelines"

The Court noted as "particularly relevant" the fact that the EPA’s own internal risk assessment experts had told the Agency that the Risk Assessment did not support a Group A classification (p.64): "EPA’s Risk Criteria Office, a group of EPA risk assessment experts, concluded that EPA failed to reasonably explain how all relevant data on ETS, evaluated according to EPA Risk Assessment Guidelines’ causality criteria, can support a Group A classification."

The Court concluded that: "EPA produced limited evidence, then claimed the weight of the Agency’s research evidence demonstrated ETS causes cancer."

Bottom Line

It may be politically correct to attack secondhand smoke, but it is not scientifically correct nor, in the Court’s opinion, legally correct.

The Court’s ruling clearly confirms that:

  • EPA deliberately misled the American public about the science concerning secondhand smoke.
  • EPA was guilty of major scientific and procedural errors in preparing its Risk Assessment.
  • EPA cherrypicked information, changed the standards of scientific inquiry and tortured the data to reach a predetermined conclusion.
  • EPA abused its power and authority in an effort to force regulation on secondhand smoke when the scientific basis for the EPA’s claims simply did not exist.

Practical Implications

  1. While it is unlikely that there will be a rush to overturn smoking bans and restrictions currently in place, this ruling raises serious questions about whether there is a legitimate basis for severe and overly restrictive smoking regulations.
  2. Any legislative body currently considering smoking regulations cannot rely on EPA’s now invalid claim that secondhand smoke is a known human carcinogen.
  3. This ruling should create a new environment to foster the development of practical and reasonable solutions that accommodate the preferences of smokers and nonsmokers alike.
  4. Since the ruling goes to the very heart of the science concerning secondhand smoke, it supports the industry’s contention tha

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