More dubious stats but what do they say about the smoking ban?
Wednesday, July 25, 2012 at 14:10 Diesel fumes are a "definite" cause of lung cancer, allegedly.
According to a report published this month:
The World Health Organisation recently reclassified the dangers of diesel exhaust fumes, upgrading the risk from probably carcinogenic to a definite cause of cancer.
The research into diesel exhaust fumes was conducted by the International Agency for Research on Cancer (IARC). It concluded that diesel exhausts were definitely a cause of lung cancer, and may also cause tumours in the bladder.
IARC said the evidence was overwhelming and that the Working Group’s conclusion was unanimous. It is reckoned that people working in at-risk industries have about a 40 per cent increased risk of developing lung cancer.
Full story: WHO report on diesel fumes puts sharp focus on need for effective monitoring (Environmental Expert)
Well, the think tank Policy Exchange has now published the results of their own investigation into air quality and yesterday I received this interesting memo from someone who has been following the debate:
Whilst the [Policy Exchange] report doesn’t directly compare [fine particle] PM2.5 deaths to passive smoking deaths, it does give some useful figures: “Each year, around 29,000 deaths are attributable to manmade fine particulate air pollution in the UK, at a cost to the economy of £15 billion a year.”
In 2005 during the debates on the proposed smoking ban, the Labour Government cited figures from a British Medical Journal study on deaths from passive smoke, which concluded: “Across the United Kingdom as a whole, passive smoking at work is likely to be responsible for the deaths of more than two employed people per working day (617 deaths per year), including 54 deaths in the hospitality industry each year. Each year passive smoking at home might account for another 2700 deaths in persons aged 20-64 years and 8000 deaths among people aged ≥ 65.”
Adding the BMJ figures together and comparing PM2.5 to passive smoke deaths we get the following: 29,000 deaths per year attributable to PM2.5 vs 11,317 deaths per year attributable to passive smoke (including 54 in the hospitality industry).
Frankly, I didn't believe the figure of 11,000 deaths attributed to secondhand smoke and I'm equally sceptical about the suggestion that diesel exhaust fumes are responsible for a 29,000 deaths a year.
It does raise an interesting question though about the excessive nature of the smoking ban when the alleged risk of working in a smoky bar is so small in relation to being exposed to diesel fumes. (With proper air filtration, of course, there is no need for any bar to be excessively smoky.)
Then again, if diesel fumes and secondhand smoke are so bad for our health one might have expected the average age of the population to fall in the second half of the last century, given that people's exposure to exhaust fumes and ETS was probably at its peak in the middle of the 20th century.
Instead the baby boom generation has lived longer on average than any generation in history and the average age continues to rise.
Of course other factors are responsible for our increased longevity including a decline in real (as opposed to relative) poverty, improved housing and better nutrition (although some might argue with that), but I am still waiting for hard evidence that even long-term exposure to moderate levels of carcinogens is a serious threat to our health.
Reader Comments (6)
Simon. Has anybody ever produced a death certificate showing the cause or secondary cause of death was due to second hand cigarette smoke?
I think you know the answer to that, Chas. To the best of my knowledge it's 'No' because given the science (not the junk science) it would be almost impossible to prove with any degree of certainty.
That said, I don't think it's a particularly good argument to use because you wouldn't expect 'mountaineering' to be given as the cause of death if a climber fell off a rock face and suffered multiple injuries. There are numerous examples like this.
Of course that doesn't stop a handful of doctors entering 'smoking' as the cause of death on some death certificates, but it's unusual. The last time I looked the figures varied between 600 and 800 a year in the UK. Compare that with the number of smoking-related deaths which is estimated to be 100,000 a year. (It seems to be coming down from a high of 114,000 a few years back.)
Now I'm not going to argue about the figures or the health risks of smoking which many of us believe are exaggerated (although they do exist!). I just want to explain why there are relatively few deaths attributed to directly to smoking on death certificates. (Most of you know this so apologies if I am preaching to the converted.)
1. Most if not all 'smoking-related diseases' are multifactoral and it would take a brave (or foolhardy) doctor to state categorically that someone had died as an exclusive result of smoking.
2. Technically, of course, you don't die of smoking, or drinking too much alcohol, or eating too many fatty foods or dairy products. You die of a stroke or heart or liver disease and lots pf other things that may have been caused by smoking or obesity or excessive drinking, but they are the cause (possibly) of the disease that kills you, not the disease itself.
So, to cut a long answer short, I sympathise with the point you are trying to make about the dangers of secondhand smoke but I don't think the point about death certificates (which has been made by other people too) is a particularly valid one.
Here endeth the lesson.
Now for the science bit. What second hand smoke (SHS) and diesel fumes have in common apart from the Particulate Matter (PM) 2.5 is the subset gas benzo(a)pyrene (BAP). 2.5 stands for the size of particles i.e up to 2.5 microns.
Dr. James Enstrom, even after being paid by the Californian Electric Car Institute does not believe diesel causes lung cancer. However it is theoretical. BAP causes genetic mutations of the lungs, more specifically the p53 gene which wards cancer off in the body. Some scientists dispute this as a cause of lung cancer, especially in smokers.
However BAP is basically a by product of everything burnt by heat, BBQs coal and gas fires and this is the killer point.
Levels of BAP in diesel engines, BBQs, fires etc are between 4 and 10 times higher than given out by cigarettes. It is possible that hardly anyone, if at all has contracted lung cancer from SHS. Killer point two, I found the provenance for this in a letter Professor Simon Chapman wrote to the Tobacco Control blog. His feet are both in his mouth with a bullet hole in each.
Enjoy!!
“Ott and Seigmann[8] and Wallace and Ott[9] provide data on fine and ultra-fine particle emissions from different sources: “Controlled experiments with 10 cigarettes averaged 0.15 ng mm-2 … ambient wood smoke averaged 0.29 ng mm-2 or about twice those of cigarettes and cigars … In-vehicle exposures measured on 43 and 50 min drives on a California arterial highway gave PC/DC ratios of 0.42 and 0.58 ng mm-2 … Interstate highways had PC/DC ratios of approximately 0.5 ng mm-2 with ratios above 1 ng mm-2 when driving behind diesel trucks. These PC/DC ratios were higher than the ”signature” value of the cigarette (0.11-0.19 ngmm-2)measured in a large Indian gaming casino with smoking.” [8]"
http://tobaccocontrol.bmj.com/content/20/1/e1/reply
Whenever one sees 'overwhelming' and 'unanimous' alarm bells should ring. I would rather see the study because, if the actual risk is very small indeed, then a 40% increase is neither here nor there. It is the old 'relative risk' trick again. What these studies say to me is that a few people are susceptible to lung cancer risks and that almost any 'cause' (or none) can trigger lung cancer. Extrapolating thousands of deaths from such statistical models is nonsense, unless age, genetic makeup, diet, viruses, etc are taken into consideration. A huge difference between tobacco smoke and other, airborne particulates is that you only breath in tobacco smoke in any significant quantity when smoking or in the presence of a smoker. You breath in diesel fumes and all the other noxious substances with every breath you take.
When lung cancer began to increase alarmingly in the 1930's, research began into the possible cause. Although extensive research had already happened in Germany (notice I have not used the 'N' word, as it is not relevant to what I am saying), it is the 'Doll' study which has become the benchmark.
The Doll study was first aired in 1953. It took ten years however for the RCP to say that the lung cancer epidemic was caused by cigarette smoking. Why? Simple. Because there was a large debate, Doll being part of it, as to whether the increase in lung cancer was cigarettes, a 20th century invention, or DIESEL (also a 20th century phenomenon). By the way, there were some other considerations as well, including tarmacadam.
The one thing that I find remarkable though, is that all these medical studies attempt to find a single cause, when they themselves know that the cause of cancer is synergenic, including old age!
I had an aquaintance several years ago who, at the time, would have been about 63. He also had a hole in his throat. He had had a laryngectomy. What caused his throat cancer? Well, he had been a cigarette smoker, so this was the cause. Was it? It may possibly have contributed synergetically. Does this mean that if he had not smoked, he would not have contracted throat cancer? Not necessarily. He spent his whole career working with buses. What if, as a smoker, he had worked on a farm in the countryside?
The Government is happy for people to work in conditions twice as carcinogenic as those claimed (most probably wrongly) for a living with a smoker for decades, yet will not allow someone to spend 15 minutes a night, of their own free will, collecting glasses from a smoking room with air cleaning. There is obviously a glaring inconsistency and hypocrisy regarding ETS and other airborne pollutants, but there is no point in trying to enter into a debate with the anti tobacco industry. Politicians are either too ignorant of the principles involved or too lacking in integrity to care. The only way forward is for smokers to set up smoking cafes with air monitoring for research purposes and so educate the public - most of whom don't care about smoking bans so long as they are confident they can find a creche serving microwaved lasange from which their precious children will emerge still on course to win a Nobel prize or an Olym*** medal. (Don't want to get you in trouble with the trade mark police, Simon)