Press releases Saturday 6 March 2004

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(2) LONG TERM RISKS OF MEDICAL RADIATION OFTEN IGNORED

(3) NEW BILL "WILL ULTIMATELY FAIL THE PUBLIC"

(4) TOBACCO SHOULD BE EXCLUDED FROM FREE TRADE AGREEMENT

(1) SMOKING LINKED TO BLINDNESS

(Editorial: Smoking and blindness)
http://bmj.com/cgi/content/full/328/7439/537

Smokers are up to four times as likely to become blind in later life from age related macular degeneration (AMD) than non-smokers, but many remain largely unaware of this risk, warn researchers in this week's BMJ. AMD is the most common cause of adult blindness, which results in severe irreversible loss of central vision.

One in five cases of AMD in the UK may be attributable to smoking. This represents around 54,000 people over 69 years of whom nearly 18,000 are blind.

Evidence also shows that quitting smoking slows the development of age related macular degeneration, whereas continued smoking can affect the long term response to treatments such as laser therapy.

A sustained public health campaign in the UK is warranted to raise awareness of the link between smoking and blindness, say the authors. This should include offering smoking cessation support to people attending eye clinics and more novel, varied, and specific pack warnings of the impact of smoking on eyesight.

Contact:

Richard Edwards, Senior Lecturer in Public Health, Evidence for Population Health Unit, University of Manchester, UK
Email: richard.edwards@man.ac.uk

(2) LONG TERM RISKS OF MEDICAL RADIATION OFTEN IGNORED

(Sustainability of medical imaging)
http://bmj.com/cgi/content/full/328/7439/578

Doctors and patients should be more aware of the long term risks of radiological investigations such as x-rays and CT scans, argues a researcher in this week's BMJ.

Use of radiation for medical examinations and tests is the largest manmade source of radiation exposure, yet doctors are insufficiently aware of the long term health risks associated with radiological imaging, while long term risks are often ignored in cost effectiveness analysis of medical imaging.

According to the author, up to a third of radiological examinations are totally or partially inappropriate. To avoid this misuse, he believes that doctors should be required to have a radiological "driving licence" with penalty points given for inappropriate prescriptions.

Patients should be required to sign an explicit and transparent informed consent form for each radiological examination. This would help reduce pressure from patients for redundant examinations. Journals should also encourage reporting of radiation doses in papers.

The current culture has taught patients that the mot expensive tests are likely to be the most effective, says the author. In a culture of shared responsibility, any useless risk±no matter how small±should be avoided.

Contact:

Eugenio Picano, Senior Medical Researcher, Consiglio Nazionale delle Ricerche, Institute of Physiology, Pisa, Italy
Email: picano@ifc.cnr.it

(3) NEW BILL "WILL ULTIMATELY FAIL THE PUBLIC"

(Editorial: The human tissue bill)
http://bmj.com/cgi/content/full/328/7439/533

The new human tissue bill threatens medical research and will ultimately fail the public, argue experts in this week's BMJ.

Although the bill is necessary to regulate the use of human organs and tissues taken after death, it applies to any material that contains human cells - even urine and spit.

Using such material for research, or for staff training that's not "incidental to the diagnostic process" will be a criminal offence unless "appropriate" consent has been obtained. Possible penalties include three years in jail.

But politicians have underestimated the size of this problem, say the authors.

Across the United Kingdom, about 150 million samples from living patients are examined each year. If just one minute of staff time was taken for each sample, this would equate to 1,339 full time jobs - comparable to the entire staff of a medium sized NHS hospital. But as yet, the Government has allocated no money for this task at all.

Other problems surround tissue storage and DNA analysis, which threatens to criminalise bona fide public health research.

Possible solutions include using anonymised 'residual' tissue samples (which would otherwise be incinerated as waste) without consent or seeking 'up front' consent at the time of booking into hospital or registering with a general practitioner.

If the human tissue bill is not amended then it will ultimately fail the public, say the authors. "A requirement for consent sounds good, but unless there's a way for staff in NHS laboratories to know what patients want, it actually becomes a prohibition."

Perceived improvements in the regulation of human tissue will then come at the price of less medical research, education, and training. Those who suffer will be the very individuals the bill claims to protect.

Contact:

Professor Peter Furness, Department of Pathology, Leicester General Hospital, UK
Email: peter.furness@leicester.ac.uk

(4) TOBACCO SHOULD BE EXCLUDED FROM FREE TRADE AGREEMENT

(Letter: Tobacco should be excluded from free trade agreement)
http://bmj.com/cgi/content/full/328/7439/581

Tobacco should be excluded from free trade agreements to protect health, argue researchers in this week's BMJ.

Their call comes in the week that the European Union and the South American trading bloc Mercosur will continue negotiations towards a free trade agreement.

Every day, doctors see the deadly effects of tobacco, write the authors. While trade liberalisation can bring benefits, free trade in tobacco leads to increased consumption. This inevitably leads to more tobacco related illness and death.

Excluding tobacco from free trade agreements would protect health. It is compatible with international law, which exempts other harmful products such as landmines, and World Trade Organisation commitments to protect human life.

Negotiators from the European Union and Mercosur must act to protect the future health of generations by excluding tobacco from this agreement. Such action would not only show leadership but would set an important precedent for future trade agreements, whether bilateral, regional, or international, they conclude.

Contacts:

Sinead Jones, Director, Tobacco Control Resource Centre, British Medical Association, Edinburgh, Scotland
Email: sjones@bma.org.uk

Eduardo Bianco, Representative, Sindicato Medico del Uruguay, Montevideo, Uruguay (Spanish speaking only)

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