Health Risk of Mobile Phones

In an article published in the CNN IBN on June 7, 2010, questions were raised about the effects of mobile phone base stations and mobile phone use in general and their effect on health. It was stated that ICMR would conduct a study to determine the effects of electromagnetic radiation emitted from mobile phones on health, whether it has any adverse effect on health and if so, what would be the recommended level of exposure. In true journalistic fashion, the report was skeptical about the use of mobile phones and almost seems to suggest that they were harmful, though probably the reporters themselves had a mobile phone in their pocket and were most likely using it.

Let ICMR take its own course but we can review the available scientific evidence on the use of cell phones and whether it has any adverse health effect. Firstly let us see what the WHO has to say. There are two WHO fact sheets titled Electromagnetic Radiation and Public Health: Mobile telephones and their base stations and Electromagnetic Radiation and Public health: base stations and wireless technologies. In these two fact sheets, WHO clearly states that there is no short-term health risk associated with the use of mobile phones and long term risk for 15 years usage also does not demonstrate any associated health risk.

It is worthwhile to note that FM radio signals and TV signals are absorbed by our body 5 times more than signals used in mobile telephones. Despite long continued exposure to FM radio waves and TV signals, no significant health risks have been demonstrated till date. Hence, in the same note, it would be unscientific to assume that use of mobile phones would be associated with a health risk.

In a recent study titled “Brain tumour Risk in Relation to Mobile telephone Use: Result of INTERPHONE International Case-Control Study” published in the International Journal of Epidemiology 2010, 39(3), 675-694, an interview based case-control study with 2708 glioma and 2409 meningioma cases and matched controls in 13 countries was conducted using a common protocol. Without going into the statistical details of the study, we can just state the conclusion that there is no increased risk of glioma or meningioma associated with mobile phone use.

In another study published in the British Medical Journal on June 22, 2010, titled "Mobile phone base stations and early childhood cancers: case-control study" that investigated the effect of exposure of mobile telephone signals on pregnant women and the risk of development of early childhood cancers, no association was found between the risk of early childhood cancers and mothers exposure to mobile phone signals.

Bottom line is that whoever is telling about the health hazards of mobile phone use, they are just trying to scare you because hard scientific evidence states otherwise.

Links:

1. http://ibnlive.in.com/news/cell-phone-towers-a-big-health-risk-in-cities/123060-17.html

2. http://ije.oxfordjournals.org/cgi/reprint/dyq079
3. http://www.bmj.com/cgi/content/full/340/jun22_1/c3077

What do patients want?

Some times I wonder what do patients want? Do they want to be treated by a compassionate but average doctor or an excellent but obnoxious doctor?


It’s a simple enough question but it does not seem to have a simple answer. To me it depends on my illness. Let us consider that I have a disease that is making me considerably miserable. I have visited, say three doctors. They have been considerate and empathic to my suffering but have been unable to diagnose my condition. Hence they have not been able to cure my disease. Now I go to visit a fourth doctor who is really obnoxious but he does diagnose me and eventually helps me out of my misery. Would I be grateful to that doctor? Most likely I would. Would I be offended by his obnoxiousness? Would I think him to be eccentric genius? Probably I would.



On the other hand, if I have a common condition and the doctor is inconsiderate? What would be my reaction? Would I be less tolerant of him than I would have been in the previous case? I would be, most likely. If the doctor is obnoxious when I am in severe pain but he eventually cures my pain, what will I think of him then?



Do the patient’s perception of the doctor’s behavior varies with the disease they are suffering from? What I mean to say is that if I have a condition that I believe only a particular doctor can diagnose and treat then do I become more tolerant of the doctor’s behavior?



Personally I believe that if a few doctors were not able to diagnose the patient’s disease and it is diagnosed a very obnoxious one then the patient would be tolerant of the obnoxious doctor. I cannot give any evidence in its support but this is my personal opinion. But for a common disorder, I believe the patients are not tolerant of the doctor’s obnoxiousness. When we are in some situation that is beyond our control and no body seems to be able to help then we would tolerate even the most inconsiderate one who is actually helping us, though what we would think of him is a matter of debate.



To what degree I would tolerate the obnoxiousness of a doctor? Being a medical student I don’t think I would be able to tolerate even one instance of obnoxiousness. But how much will a patient tolerate? Again I believe that depends on the patient himself. If he feels the doctor can help him though being obnoxious, the patient might tolerate him. But to do this the doctor would have to earn the trust of the patient. How much can a patient trust a doctor who is inconsiderate and obnoxious? How does a patient trust a doctor? What is trust based on? Is it based on the results that the doctor provides such as diagnosing the disease and providing actual treatment or how the doctor behaves with the patient? May be both are necessary for the patient to trust a doctor, but which is more important? Results or behavior?

What happened to Swine Flu?

After all the media coverage of Swine Flu had died down, I thought it would be appropriate to have a look at the current status of the Influenza H1N1 pandemic.

Once I got hold of the relevant data, it was clear that H1N1 had two major peaks in terms of cases in India, one was in mid September, 2009 and another in late December, 2009. There after the incidence of new cases has diminished considerably though still occurring.

In the last update of WHO that I could get hold of, 18097 deaths have been reported from over 214 countries. This was on 16^th May 2010.

In India, as of 11^th May 2010, there has been 31837 lab confirmed cases, with 1511 deaths. The highest number of cases occurred in December 2009. 7708 lab confirmed cases with 382 deaths. The overall case fatality rate in India is 4.75%.

Now with the data available, I did some calculations.

Month	Cases	Deaths	Case Fatality Rate
September 2009	6017	177	2.94%
October 2009	3464	140	4.04%
November 2009	4290	96	2.23%
December 2009	7708	382	4.96%
January 2010	1917	245	12.78%
February 2010	847	121	14.29%
March 2010	545	81	14.86%
April 2010	400	42	10.5%

As we can see, there has been a jump in the case fatality rate since December 2009 though the number of cases has decreased considerably. What may be the cause of these? As of now, I could not find any answers. May be I have to search a lot more.

There have been 289 cases of oseltamivir resistant H1N1 influenza as reported by WHO till 12^th May 2010. Now that’s something every one should watch out for.

Sources:

1. Situational Update on H1N1 http://mohfw-h1n1.nic.in/documents/PDF/EpidemiologicalTrendsInIndia.pdf
2. WHO-Pandemic Influenza H1N1 update 101 http://www.who.int/csr/don/2010_05_21/en/index.html
3. Consolidated status of Influenza A H1N1 11^th May 2010 http://mohfw-h1n1.nic.in/documents/PDF/SituationalUpdatesArchives/may2010/Situational%20Updates%20on%2011.05.2010.pdf

Pseudo-scientific application of medicine

To start off the blog let me recount some thing I read in the newspaper a few days back. It was T2, the supplement with The Telegraph. An article was published to help inform the public on "How to rev up your immunity to beat the heat". 

Frankly, I have not come across such pseudoscience in a long time. Forgive me for my ignorance but I didn't knew that the immune system can beat the heat. I had the belief that the temperature center of the hypothalamus (remember its a part of our brain) was responsible for keeping us cool. So I thought I was terribly misinformed or may be my memory was failing me. I opened my long neglected Physiology book. It turned out that my belief was correct. The hypothalamus does keep us cool, not the immune system.

Now what can we expect from an article which got its tagline horribly wrong?

Let me enumerate:

1.  Too much sugar is bad for immunity.
2.  Large, fatty meals are bad for immunity.
3.  Vitamin C is an antiviral.

Nothing can be more illogical. Sugar is bad for immunity? Okay, so having sugar and not washing your mouth does cause tooth decay but depressing the immune system? Thats a bit stretching the concept. The more scientific pseudo-scientists might say "Hey, infections are more common in diabetics. Don't you know?". Well what can i say, the article did not mention it was for diabetics, it was for normal people. May be as it decreases the immunity, we can give sugar to patients with rheumatoid arthritis, or what ever other diseases that are caused by over activity of the immune system? It would be a great cure, would not it? Cure arthritis by having sugar. But sadly it does not work.


Large, fatty meals are bad for immunity- for it I had to do a bit of research. Fat is linked to metabolic syndrome, diabetes, coronary artery disease, hypertension, stroke and what not but infection? That was a first. But wait, a study actually found docosahexaenoic acid (DHA), eicosahexaenoic acid (EPA) (these are omega 3 fatty acids) to actually increase the immune response. It is given in Pubmed http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2696230/?tool=pmcentrez. Now I am not suggesting that we should go and eat large, fatty meals. I'm just not sure if it decreases the immunity.


Last but not the least, Vitamin C. I just love the way people talk about its antioxidant properties, how it fights bad free radicals. Well Harrison's Principles of Internal Medicine, 17th edition tells that Vitamin C might slightly decrease the duration and symptoms of viral upper respiratory tract infection. Thats might and slightly. It certainly does not have any preventive properties as suggested in the article.

The icing on the cake is about Vitamin C. "Viruses cannot survive in a Vitamin C- rich environment, making it an incredible antiviral agent". It makes me wonder. If its so, then how come so many people still die of AIDS?