Autism epidemic not caused by shifts in diagnoses; environmental factors likely

Byoliveridley

California’s sevenfold increase in autism cannot be explained by changes in doctors’ diagnoses and most likely is due to environmental exposures, University of California scientists reported. The scientists who authored the new study advocate a nationwide shift in autism research to focus on an array of potential factors in the environment that babies and fetuses are exposed to, including pesticides, viruses and chemicals in household products.

Autism epidemic not caused by shifts in diagnoses; environmental factors likely — Environmental Health News

One of the most common arguments you will see about a lot of mental health diagnoses is that doctors have changed their diagnostic practices significantly. While there is evidence of this occurring in diagnoses of childhood depression, anxiety, or even bipolar disorder due to the millions of dollars involved in medication and the attendant corruption, autism is different.

This population study used 17 year data in California and concluded that diagnostic changes were only responsible for a 2 fold increase, not the seven fold increase seen. The rest is unexplained, and the authors attribute it to a confluence of environmental and genetic factors.

And no, for the last time, VACCINES DO NOT CAUSE AUTISM!

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    The real terrorist: Pollution

    Byoliveridley

    It is true. A staggering number of people die every year due to lack of access to clean water, air or food. Aggregate statistics like these are a good way to summarize the humongous nature of the problem. While reams and reams of coverage and attention are focused on “terrorists”, people all around the world die of much more mundane causes such as bacteria in water, smog, poverty, starvation, malnourishment, etc.

    ScienceDaily: Pollution Causes 40 Percent Of Deaths Worldwide, Study Finds

    About 40 percent of deaths worldwide are caused by water, air and soil pollution, concludes a Cornell researcher. Such environmental degradation, coupled with the growth in world population, are major causes behind the rapid increase in human diseases, which the World Health Organization has recently reported. Both factors contribute to the malnourishment and disease susceptibility of 3.7 billion people, he says.

  • Is Chronic Occupational Pain a Class Issue?

    Byoliveridley

    Americans in households making less than $30,000 a year spend nearly 20% of their lives in moderate to severe pain, compared with less than 8% of people in households earning above $100,000

    Millions of Americans in Chronic Pain – TIME

    Based on a study published in the Lancet (much moolah required to read, funny that the authors of an article on the class/money based nature of pain would publish in a journal that requires all kinds of money to read, heard of PLOS?), one would have to say yes. People in low paying service jobs don’t have the luxury of mid afternoon yoga, or that once a week massage, or being able to take a “mental health” day, or any such luck. Also, the work is physically demanding, long hours of standing, heavy lifting, and repetitive motions the body was not designed for.

    Krueger notes that the type of pain people reported typically fell on either side of the rich-poor divide. “Those with higher incomes welcome pain almost by choice, usually through exercise,” he says. “At lower incomes, pain comes as the result of work.” Indeed, Krueger and Stone found that blue-collar workers felt more pain, from physical labor or repetitive motion, while on the job

    It is very sad, but a lot of this pain is avoidable. Next time you go to the grocery store, notice that the people at the check out counter stand all the time. Why? What about their job requires continuous standing? I’ve been to other countries, Germany for instance, where they are provided with high chairs that help them move the items from the conveyor through the scanner to the bagging area with much less effort. How many chairs have you seen in a grocery store lately?

    Why can’t this very simple system be implemented? It would provide much relief. Three major issues:

    1. Lack of bargaining power: Unions are a dirty word. Last I heard, the unionization rate in the states was 12%. No one speaks for the cashier. It is considered a low paying, low skill occupation where people can be replaced easily and without “pain”. So, you’re on your own, ask for a chair, and you’ll be seated in one very soon (at home, your ass fired and tired).
    2. Money: And this is linked to point 1. Implementation of any programs designed to make workers’ lives a little easier costs money up front. Since workers are expendable and have no voice, it’s easiest to steal from them and deny them basic comforts.
    3. The American notion of individualism: You deserve what you get based on how hard you work and how intelligent you are. Grocery store cashiers must be lazy and dumb to be where they are. they “deserve it”

    I don’t see it changing at all. But next time you walk into a grocery store and find a rather sullen clerk, it’s not that she’s lazy or has a bad attitude, she may just be in a lot of pain.

    Happy Sunday!

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    Break the link between employment and healthcare!

    Byoliveridley

    Cross-posted from Interrobang:

    The US Supreme Court ruled along political lines on the 30th of June, 2014 that “closely held corporations”, over 90% of all US businesses, are now free to discriminate against women (and it was specifically women and birth control) if their religion leads them to believe birth control kills babies, or that women who use birth control are Satan’s spawn (the belief does not have to be factual).

    The Supreme Court says corporations can hold religious objections that allow them to opt out of the new health law requirement that they cover contraceptives for women.

    The justices’ 5-4 decision Monday is the first time that the high court has ruled that profit-seeking businesses can hold religious views under federal law. And it means the Obama administration must search for a different way of providing free contraception to women who are covered under objecting companies’ health insurance plans.

    Salon AP coverage

    I am not going to debate the wrongness of this decision, the notion that businesses can have religious beliefs, and can use them to discriminate against certain types of people is not up for debate. And, the discrimination is very specific and targeted…

    The other, more ubiquitous discrimination is in the notion that the health care you get has anything to do with the work-for-pay arrangement you have with the organization you work for. I am probably the millionth person to mention this, and whole books have been written on the subject, but, the link between healthcare and your employer is wrong because it anchors discrimination. This particular egregious case goes one step further and discriminates based on gender as well, not just work status.

    The US had a chance to sever health benefits from employment when they had a three-year debate on expanding health insurance coverage. Thanks to the ability of small political minorities to filibuster and block action, and a corporate-funded reluctance for change, the US kept their employer-based health insurance system in place, and with it, all the discrimination that entails. Uwe Reinhardt reiterated a number of these points recently in the New York Times.

    Back Home

    Is BC any better? Yes and no. Thanks to Canada’s Medicare, parts of our health care system are universal and not subject to employment ties. But, there are several exceptions making us a two-tier health care system:

    1. The health insurance tax or MSP (what our government cutely calls a “fee” in order to not call the yearly increase in this fee a tax increase): Many employers will pick up part/all of this tax for their employees, whereas one that doesn’t can pay more than 1000 dollars a year for a family. While there is an element of progressiveness to the pricing with very low-income people paying less/nothing, it is weak, families making > 30K per year pay full price.
    2. Drugs: For some reason, drugs are not covered by our “universal” healthcare system and are provided by workplace “supplemental benefits”, as if taking a thyroid pill every day is a “supplement”. The CCPA makes an excellent case for universal pharmacare, if you need more convincing. 10% of Canadians cannot fill prescriptions for financial reasons.
    3. Our public health insurance system assumes people don’t have eyes or teeth. So, if you want your cavities filled, a root canal, or want to see clearly, you need “supplemental benefits”, and these are mostly employer-provided. Oral health is a clear marker of health inequality.
    4. Mental health is not covered, this is inexcusable, as Andre Picard notes.
    5. Treatments that improve overall health, like massages, are not really covered. Once again, your employment status determines whether you have the “luxury” of holistic preventative measures to reduce stress, pain, and many other issues.
    6. Historically and currently oppressed groups, Canada’s indigenous people for example, get a short shrift on the benefits like massage, nutrition, counselling and holistic treatment they need because of disparity in employment availability.

    This quote from the Andre Picard article I mentioned summarizes the discrimination.

    The well-to-do pay. The middle-class scrape together the money the best they can, sacrificing so their child can get care. And those without the means wait, or do without care.

    There are other side-effects. Because “benefits” are expensive, companies have a vested interest in only having certain “valuable” employees benefit. The rest get treated as contractors, have their hours strategically reduced, and much more.

    It’s almost as if there’s an unspoken moral argument here, you don’t deserve good teeth or a massage if you don’t work for a living.

    Yes, you can buy individual supplemental insurance, or pay per use, but neither of these are cheap because you as an individual have no bargaining power.

    We in BC also have a long way to go to break the link between healthcare and employment. Will it cost the average BC resident more money? Let’s consider:

    1. A simpler system with one buyer is administratively efficient. It takes the thousands of decision points every HR administrator or group in every company/union has to make and transfers that to a single entity. Public universal plans are about four to ten times more efficient (pdf) than fragmented private plans.
    2. A bigger entity can negotiate much better rates for you, whether it is for drugs, or for dentistry, or for anything else (a bigger risk pool). If all of Canada administered one simple pharmacare system, we would negotiate much lower prices with pharmaceutical companies. We would also have better funding to run and evaluate effectiveness studies.
    3. Funding preventative, holistic healthcare means fewer hospital visits. In a universal system, there are no artificial barriers between a massage, drug treatment, surgery, stress reduction counselling, or ergonomic counseling for back pain. You don’t have to prove your work injured you in order to get the right treatment, your first point of contact with a medical professional (not necessarily a doctor) decides which path works best. You do not have to get sick enough to go to the hospital before you get treatment covered by insurance.

    Pitfalls

    There are concerns with a universal single-payer system:

    1. As Vox points out, if a government administering the single-payer system decides not to pay for contraception, then no one gets it. So, getting good universal healthcare is about constantly winning political battles. The good thing about universal healthcare in Canada is that it is incredibly popular, polling near 90% approval (pdf). So once quality is improved, governments will find it hard to cut back.
    2. Like any other public system, the quality of the institutions drafting policy and administering the system is vitally important. Well run public systems are efficient. But conservative movements in the last 30+ years have worked hard to dismantle the quality of public institutions and trust in such institutions. In this reality of shrinking budgets and staff levels where bureaucrat is a term of insult, ensuring that public system expansion is handled efficiently is no given. There is an entire industry of political parties, think tanks and media devoted to tearing down the concept of a publicly administered good, and ready to pounce on every little misstep (Remember the Obamacare roll out anyone?)
    3. Will employers raise wages from all the savings they get from not providing health benefits, and will these raises cover the increase in taxes we will pay for universal healthcare? Probably not right away, but it will happen eventually.

    Transitions

    Clearly, we can’t transition tomorrow. A public system would need to be in place and functioning before our employers get out of the health insurance business. I would phase universality in the following order:

    1. Drugs
    2. Teeth and eyes
    3. Preventative and palliative care.

    We would also need to rethink the”fee for service”, where healthcare providers are paid per widget, and think about a different system closer to a salaried model, more on that in future blog posts.

  • How Safe Is The US Food Supply?

    Byoliveridley

    A good summary of the state of food safety regulation in the United States.

    How Safe Is The Food Supply?

    These known cases make up a tiny fraction of the overall problem–an estimated 76 million illnesses and 5,000 deaths in the U.S. from food poisoning each year. Meanwhile, imports of food, some from countries without strict controls, soared to more than 9 million shipments last year doubling since 2002. The cash-strapped FDA is able to inspect less than 1% of imports. It’s a recipe for disaster. “Our food-safety system in this country is broken,” warned former FDA Commissioner Dr. David A. Kessler at a recent congressional hearing.

    Few incidents ever have a body count high enough to shock the country into making fundamental changes. Overall, “we do have a very safe food supply,” says Sanford A. Miller, former director of the FDA’s Center for Food Safety & Applied Nutrition. But the alarms over pet food and vitamin A have lit a fire under lawmakers and executives. On May 2 the Senate rushed to pass a bill by a vote of 94-0 giving the FDA more responsibilities, such as creating databases of adulterated food. Meanwhile, food producers have been holding emergency meetings with suppliers, looking for problems in their factories or supply chains. Companies are “feverishly examining their own purchasing policies and trying to ensure they are followed,” says Kovacs.

    Note that it is always tempting to blame the bureaucrats here. Bureaucracy is a dirty word in this country, associated with “red tape”, “corruption”, “standing in the way of business”, “pencil pushers”, “big government”, you name it, they get called it. But, agencies like the EPA and the FDA have competent scientists who know what they are doing. But, without the money and the authority, which is given to them by the political arm of the government, they cannot do much. They have also, in recent years, been headed by political appointees who come from the industry they are supposed to regulate and show a distaste for regulation which is in complete opposition of the mandate they are supposed to fulfill as the head of a regulatory agency.

    It’s easy to take potshots at the FDA, but remember who gives them the money, makes the rules and tells them what not to oversee.

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    Canada loves asbestos (in third world lungs)

    Byoliveridley

    In a normal world, when something is severely restricted in your country, you would not export it to another country under the pretense that used under certain, very restricted conditions, your product only causes a moderate increase in cancer.

    While the federal government projects an image of being a helpful, international Boy Scout on issues ranging from peacekeeping to nuclear proliferation, Canada has a peculiar relationship to asbestos.

    globeandmail.com: Asbestos shame

    But we don’t live in a normal world, because asbestos is exported from Canada to India where it is added to cement.

    Tushar Joshi, a noted New Delhi occupational health expert, is flabbergasted over asbestos sales by a country of Canada’s stature. “As a developed country, you expect more civilized behaviour,” Dr. Joshi says. Canada’s activities are “beyond comprehension,” he adds, calling Ottawa’s promotion of asbestos “a black spot on a sparkling white dress.”

    yes, well said. It is very mysterious that asbestos use in India went up in the 1980s just as evidence about its incredibly destructive effects on respiratory systems had curtailed use in most of the first world. Clearly, third world lungs are not as important as Canadian lungs.

    Asbestos is one area where Canada lags even behind the US. And Canada’s environmental practices are going to come under increasing scrutiny as climate change unfreezes the great white North and exposes the resources underneath.

    Canada, the world is watching.

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    Arsenic in the News

    Byoliveridley

    Professor wins $1M for arsenic filter – Yahoo! News

    The National Academy of Engineering announced Thursday that the 2007 Grainger Challenge Prize for Sustainability would go to Abul Hussam, a chemistry professor at George Mason University in Fairfax. Hussam’s invention is already in use today, preventing serious health problems in residents of the professor’s native Bangladesh.

    This British Geological Survey website provides a good primer to the problem. Some key points:

    1. Arsenic is very toxic
    2. Arsenic is naturally occurring in the shallow groundwater aquifers of Bengal and Bangladesh at a toxic level
    3. The surface water is contaminated with bacteria and was responsible for high infant mortality, so aid agencies in the ’70s encouraged the use of tube wells and other groundwater pumps. While this contributed to a decline in infant mortality from gastrointestinal infections, it also dosed unsuspecting people with disease causing levels of arsenic
    4. The technology for removal of arsenic is very well known. But most solutions require electricity/periodic maintenance/technical skills and are thus not universal or sustainable.
    5. Simplicity is the key. You can’t tell the people to not drink the water, it is the only clean water available. You can’t install water treatment plants, there is no running water, you can’t rely on solutions that are centralized.

    So with all that in mind, here’s what Prof. Hussam did:

    The Gold Award-winning SONO filter is a point-of-use method for removing arsenic from drinking water.  A top bucket is filled with locally available coarse river sand and a composite iron matrix (CIM).  The sand filters coarse particles and imparts mechanical stability, while the CIM removes inorganic arsenic.  The water then flows into a second bucket where it again filters through coarse river sand, then wood charcoal to remove organics, and finally through fine river sand and wet brick chips to remove fine particles and stabilize water flow.  The SONO filter is now manufactured and used in Bangladesh. That’s great, and easy!

    That’s pretty much freshman chemistry right there, further proof that most innovation does not need new science, only people willing to spend some time on problems that don’t necessarily get looked at.