Monthly Archives: April 2007

What dangers lurk in your lab?

Posted on by
1

The Israeli health ministry released a rather sobering study yesterday: apparently, women who work in a lab are at a 26% higher risk of developing certain cancers.

The scientists are careful to avoid saying anything about cause and effect — they didn’t discover links to any particular chemicals that might be the trigger, for example. But there is a convincing correlation. The study took into account 9,000 hospital, health fund and university lab workers who had worked in the labs for 20 years or more, according to this news article.

Depending on the kind of lab they worked in, the women seemed to be at higher risk of breast cancer, melanoma, lip cancer (that one I find a bit strange, I must admit) and non-Hodgkin’s lymphoma, but at lower risk of lung cancer (which also I find strange).

Because of the findings, the health ministry began organizing courses on lab safety. Good news is, the researchers say, the study was conducted over the 80s and 90s, when conditions were much worse than they are today, so women working in labs today are probably safer.

Do you buy that?

Trouble in the HIV field

Posted on by
3

When I went to the HIV vaccine meeting in Whistler last month, I heard some rather disturbing tales of people upset at the NIH. Some of the behind the scenes complaining I wrote about here. The rest became a news story about conflicts between HIV scientists and the NIH that runs in our May issue.

Before I wrote it, some scientists privately asked me not to write it, saying it would only stir up more trouble in the field. Others assumed—wrongly—that the story would be based on the complaints of only a few disgruntled researchers. But in fact, the discontentment is widespread, and CHAVI, the NIH’s HIV vaccine project, is perhaps unfairly bearing the brunt.

Even those who have little to do with HIV vaccines seem to be aware of the swirling bitterness. It’s understandable that CHAVI is stirring up resentment when established scientists are having to downsize their labs and young researchers are giving up on science, says Paul Bieniasz, who works at the Aaron Diamond AIDS Research Center in New York.

Bieniasz serves as chair of an NIH study section on AIDS molecular and cellular biology, so he has seen first hand the effect of the tightening budget on the peer review process. Like many others I quoted when CHAVI was first launched, he doesn’t believe sinking $350 million into one project is the way to solve the vaccine challenge. But unlike most of the people I tried to speak to for the most recent article, he was willing to go on the record.

“What if they’re (CHAVI is) wrong?” he says. “People have to speak out, we shouldn’t be living in an environment of fear.”

So… how about it? Here’s your chance to break out of the environment of fear…

The malaria dance

Posted on by
6

Have you seen this picture?

bush.jpg

That’s President Bush, dancing at a benefit for Malaria Awareness Day. The picture is priceless, but I’ll restrain myself. This is once I can’t fault the administration too much.

In 2005, Bush launched the President’s Malaria Initiative which has, among other things, helped support the use of DDT in many African countries.

Yesterday, Africa Fighting Malaria (AFM), a NGO that helped bring DDT back, scored donor countries on their efforts fighting malaria. On their scorecard, the US ranks above everyone else, getting an impressive B+. Considering most other countries got themselves big, fat Fs that’s really good.

Things weren’t always so rosy, of course. In fact, before AFM and others took the US Agency for International Development to task, the agency was spending about 7% of its budget on actual interventions. the rest went to “other” costs. After Congress intervened, things at USAID have improved dramatically and they’re now working closely with AFM.

But that still leaves all the other donors, who are—litreally—failing in their efforts to fight malaria.

For the purposes of the scorecard, those countries “got an F because they never even responded,” AFM’s Richard Tren told me yesterday at a fundraiser in New York for the NGO.

Maybe it’s time to rustle up pictures of those leaders.

Smoke and dumplings

Posted on by
1

After the fall of the Soviet Union, state-owned tobacco companies in the former Eastern block fell by the wayside as multinational tobacco companies took over and instituted Marlboro-style marketing campaigns. Many of these countries have some of the highest smoking rates in the world. One counter-influence is the Framework Convention on Tobacco Control, a legally-binding international treaty designed to limit smoking by regulating marketing, increasing taxes and other measures (see our editorial ). Georgia was the 124th country to ratify the treaty. Suzaynn Schick, a friend of mine and a postdoctoral fellow at the University of California, San Francisco, traveled to Georgia this February and got a first hand look at the country’s efforts to enforce the new regulations. I asked Suzaynn to tell us about her trip. She paints a picture of a country with bad air but great food.

georgia 1.jpg

One quiet afternoon in late January I answered the phone, heard the raspy, nasal voice of my ex-boss Stan Glantz and tensed up. Working with Stan, a high-profile tobacco researcher at the University of California, San Francisco, had been exciting and very good for my career—but it had also featured some experiences common to demonic possession.

11 months after leaving his group I was almost done with our last paper and enjoying my autonomy in a new job. Stan, who was on the phone with Tom Novotny, fellow UCSF researcher and former US Assistant Surgeon General, said " We have a project you might be interested in." Tom asked me if I’d like to go to Tbilisi, Georgia to assist local public-health scientists in monitoring Georgia’s compliance with their new ban on smoking in health care facilities. I immediately said yes.

My task was to deliver 50 passive nicotine monitors to scientists at the Institute for Public Health, a Georgian Nongovernmental Organization. The monitors are small cassettes of filter paper, impregnated with a compound that binds nicotine present in the air. We spent Tuesday chatting up directors and doctors and being stared at by patients as we climbed on top of chairs, desks, gurneys and ladders, hanging the monitors in nine hospitals and clinics in Tiblisi and the vicinity.

Ultimately, I visited seven of the nine facilities—all gray, concrete block Soviet style. Two had been upgraded but five were broken down—-with cold dark corridors, shattered light fixtures, and water damage.

Despite the grim surroundings, the doctors and nurses seemed engaged, caring and confident—and they worked in a haze of smoke. People smoked cigarettes everywhere and no one seemed to think anything about it.

We visited a cardiology facility where people smoked in the stairwells just across from critical care wards. Patients and visitors smoked in the hallways as they waited in the clinics. The doctors smoked. In terms of prevalence, Georgia is probably worse off than United States was in the 1950s: more than 40% of men smoke and the percentage of women who smoke is rising rapidly.

However, there is hope. For instance, the director of one the new facilities I visited actually enforced the federal smoking ban. My Georgian colleagues will use the data we collected to pressure the federal and local governments to start enforcing the ban on smoking in health care facilities.

By Wednesday I had time to relax. The monitors were in place, my luggage finally arrived, my jet lag was beginning to relent and I started to enjoy the visit. Georgia was beautiful when I saw it in cold, gray February. I can only imagine how it looks in spring when the fruit trees blossom and the grapevines leaf out.

My hosts were incredibly kind and solicitous: I never ate lunch or dinner alone and suspect that I was taken to the very best restaurants in Tbilisi. I had some truly amazing food. Georgian food reminded me of Yugoslavian food, Persian food, Indian food and even Chinese food. Traditional Georgian bread is baked in an oven like an Indian tandoor, but it’s heftier, with a stout European crust. The stews were like Persian stews: tart with sour plums or pomegranate and full of green herbs. Kinkhali dumplings reminded me of succulent Shanghai soup dumplings, but the seasoning was herbal, an ineffable combination of celery, coriander, dill, garlic and pepper.

On the last two days I carried my aerosol particle monitor with me everywhere. The outdoor air pollution level in downtown Tbilisi was about four times higher than in downtown San Francisco. Indoors it was much worse. The man who owned my hotel was a chain smoker, so at breakfast I imbibed more than 600 ug/m3 particulates (40 times the EPA limit for continuous exposure) along with my coffee, yoghurt and wildflower honey.

One night we went to a restaurant/nightclub. The later it got, the smokier the air became. We lingered until the monitor showed over 3,000 ug/m3. To be honest, I’m not sure it was any worse in that nightclub than in the smoky bars I used to frequent in San Francisco. It’s been almost 10 years since Californian bars went smoke-free though, and I’ve become accustomed to it. I loved visiting Georgia, but I was glad to get home to clean air.

georgia 2.jpg

On guard against Gardasil

Posted on by
4

The hot topic on the talk radio circuit here in DC lately has been whether to make vaccination against the human papillloma virus mandatory for school-age girls. The subject, predictably, has brought out the crazies—but it’s also been a good month for airing some legitimate concerns.

Sometime this week, the DC city council is slated to vote on such a mandatory-vaccination bill. Events here in DC might reflect events going on across the country, since similar bills are pending in about 24 states.

The council members behind the bill have acted firmly and swiftly—lining up vaccine advocates to testify in favor of the bill, and soundly thrashing anyone who opposes it. For instance, at a city council meeting I went to last February, one councilman harshly criticized the city’s Children’s Hospital for failing to take a stance on mandatory vaccination.“I am taken back and disappointed,” he said.

But the council might not have bargained for the skepticism in the community. Most callers on the talk shows are against mandatory use, and the fear of vaccines and the pharmaceutical industry is alarming, with words like “sterilization campaign” and “experimentation on our children” being thrown around the airwaves.

Merck didn’t exactly engender confidence among skeptics with its heavy-handed lobbying campaign—which it has since shrewdly withdrawn—for compulsory vaccination with its HPV vaccine, Gardasil (for a great perspective on this see the March editorial in Nature Biotechnology).

To find out more about opposition to the vaccine, I went to a community forum on it at a local library back in March. As expected, representatives of religious groups, such as the Archdiosese of Washington, attended—presumably concerned that the vaccine could lead to promiscuity among young girls.

But the religious folks didn’t say much, because they didn’t need to. The anti-Merck, anti-pharmaceutical industry rhetoric was out in force—it had passed no one by that Merck was behind the Vioxx scandal a few years ago. A few people ventured into full-blown conspiracy scenarios,

“This is a recombinant vaccine, made by GENE SPLICING,” said one participant, “It changes the entire structure of the human race.”

While that might be exaggerated, other arguments against mandatory vaccination were more sane and well-reasoned. Most compelling to me was the argument that the long-term efficacy is unknown (for more on this and related issues see our news story). Studies show the vaccine protects for a few years, but whether girls vaccinated at age 11 will be protected if they become sexually active in their late teens seems unclear—given this uncertainty, is worth the public health investment?

Even some members of the CDC panel that recommended voluntary vaccination are skeptical that it’s time for mandatory measures.

While we aren’t in danger of changing the entire structure of the human race, I can understand the reasons for caution—if only to give people time to get used to a new type of vaccine in their doctors’ offices.