The General Medical Council is currently recruiting for a chair of a new programme board that will oversee the delivery of revalidation.

The board, which will include representatives from the four administrations, the Academy of Medical Royal Colleges, the GMC, BMA and patient organisations as well as the NHS and other healthcare providers, will ensure revalidation is delivered in a co-ordinated and consistent way in all four countries of the United Kingdom.

Revalidation is a new approach to medical regulation that aims to improve patient safety, encourage the professional development of doctors, and increase patients’ confidence in the medical profession.

Sir Graeme Catto, President of the GMC, said: “We are looking for an exceptional individual who can help to coordinate and oversee plans for the delivery of medical revalidation; someone who can work independently and with integrity to command the confidence of key interest groups.

“We are already working very closely with the organisations that will be members of this new board. However, we look forward to the opportunities that this board will create for even closer cooperation and coordination.”

The UK Revalidation Programme Board will report directly to the GMC.

The General Medical Council plans to introduce licences to practise in the autumn of 2009. Licensing will be the first step towards the introduction of revalidation.

1. For further information about the Chair of the UK Programme Board, please visit odgers/25929 for a candidate brief containing application details. The closing date for applications is Friday 14th November 2008.

2. The Report of the Chief Medical Officer for England’s Working Group, published in July 2008, charged the GMC with establishing a UK programme board to oversee the delivery of revalidation.

3. For more information about the GMC’s proposals for licensing and revalidation, please visit gmc-uk/about/reform/index.asp.

General Medical Council

Following the success of the first Boots Centre for Innovation’s university roadshow event at Oxford University in June, the hunt for innovative new technologies for the health and beauty sector continues with a second event at Imperial College, London on 25 November in partnership with the university’s technology transfer arm Imperial Innovations.

Held at the Imperial Incubator, Imperial’s physical incubation facility, the event will provide university scientists and entrepreneurs with a unique chance to learn about opportunities in the sector, from applying for funding for developing and launching their own products to understanding emerging global healthcare trends and other new technologies.

The seminar will also outline the Boots Open Innovation model and the key areas of consumer need the company has identified. These include finding improved ways to diagnose, treat and monitor key aspects of health, beauty and well-being; supporting positive ageing through products and devices for mind and body, and minimising the complications of living with chronic conditions.

A week after the first event there will then be a follow-up session where 10-15 of the attendees will be given the opportunity to pitch their product ideas to a ‘Dragons Den’ style panel. This panel will include senior product managers from Boots and from the Centre, as well as Ron Peterson, board director of Boots Centre for Innovation and founder of Longbow Capital LLP, the Centre’s venture capital partner.

“Our first roadshow in Oxford was very successful, and we are now looking to roll these events out across the country,” says managing director of Boots Centre for Innovation, Dr Ged O’Shea. “There are some amazing technologies being developed in universities across the country, and these events allow us to stimulate the developers to introduce their ideas to the mainstream market.”

O’Shea adds: “During the next event, at Imperial, we aim to stimulate the development of new applications that can benefit the general public, and highlight business opportunities for their inventors. There are market opportunities for new solutions across the healthcare spectrum, and these events offer universities a unique combination of advice, funding and a route to market for their inventions.”

Seminar details

The New Product Innovation seminar takes place on Tuesday 25 November 2008 from 9am to 11am at Imperial Innovations, Imperial College, London.

About Boots Centre for Innovation

Boots Centre for Innovation is a dynamic, not-for-profit organisation that identifies and facilitates the development of pioneering health and beauty products to improve the quality of life for Boots consumers. Established in 2007, it is a partnership between Boots, Longbow Capital and The Institute of Life Science, Swansea University. The centre has been set up to identify future customer needs, stimulate global innovation and provide the expertise and network to bring ideas to life. For more information visit bootsinnovation

About Imperial Innovations

Imperial Innovations is one of the UK’s top technology commercialisation companies. The company was founded in 1986 and its ordinary shares admitted to trading on the AIM Market of London Stock Exchange plc in July 2006, raising ВЈ25 million at an offer price of 365p and ВЈ1 million by means of a public offer. In November 2007, the company raised a further ВЈ30 million by means of a placing of new ordinary shares with investors.

The company’s integrated approach encompasses the identification of ideas, protection of intellectual property, development and licensing of technology and formation, incubation and investment in technology businesses. A wide range of technologies are commercialised within the areas of healthcare, energy, environment and emerging technology trends.

Based at Imperial College, London, the company has established equity holdings in 89 technology businesses and is managing 156 commercial agreements as of 31 July 2008. Imperial Innovations also commercialises technologies originating from outside Imperial College.

Source
Louise Bryce, Marketing Manager
Boots Centre for Innovation

Debbie Smith
Associate Director
Freshwater Technology

Both Democratic presidential nominee Sen. Barack Obama (Ill.) and Republican presidential nominee Sen. John McCain (Ariz.) support prescription drug reimportation but cite the need to ensure the safety of medications purchased from other nations, CQ HealthBeat reports. At the annual conference of the Generic Pharmaceutical Association last month, advisers to both candidates said that recent cases of contaminated heparin and other products from China highlight the need to ensure the safety of medications purchased from other nations.

Obama campaign adviser Neera Tanden said, “We have not changed our position on this issue, but obviously there have been concerns in countries like China,” adding, “Our plan does not envision importing drugs from China … but from countries with strong records of safety, like Canada and Europe.”

McCain campaign spokesperson Brian Rogers in an e-mail said that McCain understands the need to have a “properly documented” prescription drug supply chain, adding that as president McCain would require all medications purchased from other nations to “meet state and federal standards for safety.” According to Rogers, FDA would require additional funds to ensure the safety of such medications.

FDA Center for Drug Evaluation and Research Director Janet Woodcock said that the agency would require $225 million in additional funds to inspect such medications (McCarthy, CQ HealthBeat, 10/27).

Editorials
Summaries of recently published editorials that addressed issues related to health care in the presidential election appear below.Dayton Daily News: U.S. voters should “know where the two presidential candidates stand on how to insure some or all of the 45 million uninsured and to keep costs down,” a Daily News editorial states. “The changes that both Sen. Barack Obama and Sen. John McCain are talking about are so big and fundamental that estimates about costs are just wild guesses,” the editorial states, adding, “If you really overturn the current system, people’s behavior will change in ways that computer models haven’t even begun to anticipate.” According to the editorial, experts “say that Sen. Obama’s plan would be much more costly than Sen. McCain’s but that Sen. Obama’s would bring more uninsured people into the system.” During the second presidential debate, “McCain said access to health care was a responsibility,” and “Obama said it was a right,” the editorial states, adding, “Ideally, it should be considered a right,” but “getting there is tough and becoming tougher” as a result of the recent economic downturn (Dayton Daily News, 10/25).

New York Times: “The nation’s health care system is desperately in need of reform,” and Obama and McCain “are offering starkly different ideas for how to fix that system,” a Times editorial states. The editorial states, “We believe that Mr. McCain’s plan … is far too risky” and “is likely to erode employer-provided group health insurance and push more people into purchasing their own insurance on the dysfunctional open market.” According to the editorial, “Obama’s plan is a better start than Mr. McCain’s,” but “it is still not likely to help all Americans who need and deserve affordable, high-quality medical care.” The editorial states, “Obama’s plan is the better one because it would cover far more of the uninsured, spread risks and costs more equitably and result in more comprehensive coverage for most Americans,” adding, “We fear Mr. McCain’s plan would jeopardize employer-based coverage without providing an adequate substitute.” The editorial concludes, “At a time when so many employers are reducing or dropping coverage, that is not a risk that the country can afford to take” (New York Times, 10/28).

Opinion Pieces
Several newspapers recently published opinion pieces that addressed issues related to health care in the presidential election. Summaries appear below.Gilbert Omenn, Detroit News: Obama’s plan “permits everyone to keep health insurance they have and like, while offering others affordable options through large-group plans rather than the notoriously expensive and selective individual insurance market that the McCain plan relies on,” Omenn — a professor of internal medicine, human genetics and public health at the University of Michigan Medical School — writes in a News opinion piece. He adds that “it is bewildering that John McCain chooses the individual market when large-group private insurance is available around the country.” The piece concludes, “Health care reform has been unfinished business for 70 years in this country,” and when “this divisive campaign is over, I hope Obama’s centrist principles and comprehensive elements will provide a foundation for a bipartisan solution that most Americans will support and Congress could pass in 2009″ (Omenn, Detroit News, 10/28).

Alan Beattie/Krishna Guha, Financial Times: The candidates’ health care plans “go in radically different directions,” but “in some ways they face the same problem: ensuring that both relatively high-risk and relatively healthy people get good and cost-efficient coverage,” columnists Beattie and Guha write in the Financial Times. Obama “thinks government intervention can overcome market failures,” while McCain “wants to increase competition to make health care work more like other markets,” the authors write, adding that “experts say both plans are vulnerable to costing more than advertised while leaving some people uninsured, for different reasons.” Beattie and Guha conclude, “The low profile health care has in the election may not be because voters think it does not matter, but because they are skeptical federal government will do much about it” (Beattie/Guha, Financial Times, 10/27).

David Cutler/J. Bradford DeLong, Forbes: “Obama wants to address the health care crisis head-on” and “will try many strategies and be guided by results, not predetermined ideological conviction,” according to a Forbes opinion piece by National Bureau of Economic Research associates Cutler, the Otto Eckstein professor of applied economics at Harvard University and an adviser to Obama, and DeLong, an economics professor at University of California-Berkeley. Obama’s strategies “fall into four general areas”: “information”; eliminating “perverse incentives in medical care”; helping the “small players — individuals and small firms — get the same deals as large buyers”; and making prevention a greater priority, the authors write. “As the reforms take hold, costs will drop,” and as “costs drop, insurance will become more affordable,” they write. On the other hand, “We are skeptical of the value of McCain’s plan for three reasons:” the “tax increase McCain proposes and the resulting dislocations it creates are the last thing American businesses need now”; the private insurance market is “nowhere near as rosy as McCain makes it out to be”; and the plan “has a huge financial hole — between $1 and $2 trillion over the next decade,” according to Cutler and DeLong. They write, “Obama’s health care reform plan is much better for the country, and much more likely to be successful” (Cutler/DeLong, Forbes, 10/28).

Uwe Reinhardt, Philadelphia Inquirer: It is troubling “that McCain appears to believe that a mere $5,800 can buy American families the protection they need against the costs of illness,” Princeton University health care economist and professor Reinhardt writes in an Inquirer opinion piece. He cites the annual employer survey from the Kaiser Family Foundation and the Health Research and Educational Trust, which found an average family premium for employer-sponsored coverage of more $12,600 per year. Reinhardt asks, “What kind of coverage, then, could an annual premium of $5,800 get you, even if your whole family were healthy? And what if one or more members had a chronic illness, or had had a bout with cancer?” He writes, “If you are uninsured or fear that you might lose your coverage, go to the candidates’ Web sites and carefully check out” their proposals, adding, “Leave aside any ideological baggage and clichГ©s, such as socialized medicine — which Sen. Barack Obama’s plan … certainly is not.” Reinhardt concludes, “And then support the health plan that you believe protects your own family best” (Reinhardt, Philadelphia Inquirer, 10/28).

Sen. Sheldon Whitehouse (D-R.I.)/Newt Gingrich, Washington Times: Next year “must be the year that Congress and the president, whoever he may be, pursue meaningful and thorough health reform,” according to a Times opinion piece by Whitehouse and Gingrich, former House Speaker and founder of the Center for Health Transformation. “To be sure, every American deserves health insurance,” but “[r]ight now, simply having health coverage is no guarantee of quality care,” they write. The authors continue, “First and foremost, we must make a serious investment in health information technology,” adding that “health IT will allow us to capture data and then determine which treatments work and which do not.” In addition, the authors write that “we must change the way we pay for care” so that “[w]e … pay more for what we want more of, and less for what we want less of.” They add, “We will never cover the uninsured or resolve the looming budgetary nightmare without” such efforts (Whitehouse/Gingrich, Washington Times, 10/28).
Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation.В  All rights reserved.

In the first large study to explore possible unconscious bias among physicians, researchers have found that doctors mirror the attitudes of the majority in society and implicitly favor whites over blacks.

“This supports speculation that subtle race bias may affect health care, but does not imply that it will,” said University of Washington researcher Janice Sabin, who presented the study here Tuesday (Oct. 28) at the American Public Health Association’s annual meeting. “This research is too preliminary to know if there is a direct relationship between physicians’ implicit, or unconscious, racial attitudes and the quality of medical care.”

Sabin, who is an acting assistant professor of medical education and biomedical informatics, said: “Our findings fit with previous research showing bias is common in the general population. But we have to remember people are not racist if they hold an implicit bias.”

Data from the study were drawn from a sample of more than 400,000 anonymous people who took the race attitude Implicit Association Test online during a 28-month period between 2004 and 2006. More than 2,500 of those test-takers identified themselves as doctors. The race attitude and a variety of other tests that examine various forms of bias are found on the Web site of Project Implicit operated by the University of Washington, University of Virginia and Harvard University.

The Implicit Association Test captures subconscious, or implicit, bias by asking people to quickly associate positive or negative words with a series of photographs. In the race test the photographs are of black and white faces.

“We don’t call what these tests show prejudice. We talk about it as hidden bias or unconscious bias, something that most people are unaware they even possess,” said Anthony Greenwald, a UW psychology professor who created the Implicit Association Test and was part of the research team on the new study.

The people who took the test were predominantly American. Overall, 86 percent of participants said they lived in the United States. Of 2,535 physicians taking the test, 76 percent identified themselves as U.S. residents. Test-takers were predominantly white – 69 percent of the entire sample and 66 percent of the doctors. There were smaller samples of blacks, Asians and Hispanics.

The majority of physicians in all racial and ethnic groups showed an implicit preference for white Americans compared to black Americans except for black physicians, who on average did not favor either group.

The researchers also looked at the factors of gender and other advanced college education and found virtually the same results. Women exhibited slightly lower, but still significant, implicit preference for whites. The story was the same for more than 6,100 people who said they had law degrees and more than 7,900 individuals who said they had doctoral degrees.

“The implicit bias effect among all the test-takers is very strong,” said Sabin. “People who report they have a medical education are not different from other people, and this kind of unconscious bias is a common phenomenon.

“Although it may be a common assumption that high levels of education expose people to diverse ideas and ways of not being biased, subtle biased associations about race are nevertheless common. We have come a long way, but people may be unaware of these common unconscious biases. In medical education, we need to include examination of personal attitudes and beliefs in diversity training and continuing medical education to increase self-awareness so that doctors are alert to hidden attitudes and beliefs that may affect care for minority populations.”

Other members of the research team are Brian Nosek, an assistant psychology professor at the University of Virginia, and Dr. Frederick Rivara, a UW professor of pediatrics. The research was funded by the Agency for Healthcare Research and Quality, the National Institute of Mental Health and a UW Magnuson Health Scholars Award.

The Implicit Association Test was developed a decade ago to measure the unconscious roots of people’s thinking and feeling. Since it was created, more than 6 million people have taken versions of the test that have measured unconscious attitudes about such topics as race, gender, sexual orientation, age and various ethnic groups.

More information about the black-white Implicit Association Test and other tests that measure other types of unconscious bias is available at https://implicit.harvard.edu/implicit.

University of Washington
u.washington.edu

Development planners and policymakers in developing countries need accurate information about the poverty of the population. The risk of food shortages or other poverty-related problems is an ever present threat. This is certainly the case in rural Uganda where there is a lot of poverty among smallholder farmers. However, the usual method of assessing poverty in terms of expenditure often fails to work here, as the farmers frequently produce for their own consumption.

Therefore in order to make statements about the economic status of the population in these regions, Pouw developed a method for measuring possessions instead of expenditure. She itemised the different categories of possessions in the rural areas of Kabarole, Mpigi and Kapchorwa. In this system each category has its own hierarchy. For example, in the case of sustainable household goods, the priority of most households is the acquisition of basic goods such as chairs, a table, a bed, blankets and a mattress. The more luxury goods such as a fridge, TV or car are only acquired once the basic needs have been met. Pouw applied a similar highlighting to the other categories, namely clothing, housing quality, food consumption, land ownership, agricultural equipment and livestock.

Some differences were observed in terms of what people consider to be valuable. For example, female farmers were found to attach more value to certain agricultural equipment than male farmers and some Ugandan cultures consider it inappropriate for a woman to own a bike. In addition, the most important basic requirements were equally spread over the three regions, with firstly the welfare characteristic sustainable possessions, followed by agricultural equipment and thirdly clothing.

The research did a lot to clarify the type of poverty that prevailed in the regions concerned. Whereas in Kapchorwa district the farmers mainly suffered from a shortage in housing, land and sustainable possessions, people in Kabarole had relatively little clothing and in Mpigi there was a relative deprivation in food consumption. This type of information can be of immediate importance for development planners and policymakers at the district level. It reveals the most pressing problems in a given area at a certain moment in time. For example, the information about food consumption can be used as an early warning system for food uncertainty. As soon as households only have maize and beans to eat, this can be a sign of imminent food shortages.

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Source: Nicky Pouw

Netherlands Organization for Scientific Research

The Austin American-Statesman recently published a series of articles on medical tourism. Headlines and summaries appear below.”Issues Can Arise After Surgery Far From Home”: The article examined how U.S. residents who travel abroad for medical procedures can face questions about “how to safely travel on a long-haul flight” and liability in the event of complications and how “follow-up care can be difficult” (MacLaggan [1], Austin American-Statesman, 10/24).

“Doctors’ Views Differ on Hip Procedures”: The article examined how, as more U.S. residents travel abroad for hip resurfacing surgery, “doctors are divided in their opinions of the procedure” (MacLaggan [2], Austin American-Statesman, 10/24).

“U.S. Insurers Consider Sending Patients Overseas for Cheaper Treatment”: The article examined how some U.S. health insurers “are considering paying for patients to go overseas for care, which could spark major growth in the medical travel industry” (MacLaggan [3], Austin American-Statesman, 10/24).

“Options Vary Depending on Who You Are”: The article examined how many public hospitals in India have “doctors with the same qualifications as those at private ones, but India’s wealthy — and its rapidly growing middle class” — and foreign patients “often choose corporate facilities” (MacLaggan [4], Austin American-Statesman, 10/24).

“Austin Entrepreneur Markets Medical Tourism”: The article profiled MedTrava Group, a company based in Austin that “brings American patients who can’t afford medical treatment at home to the Indian hospitals that want to take them” (MacLaggan [1], Austin American-Statesman, 10/26).

“In Pain and Uninsured, a Texas Truck Driver Goes to India To Get His Hip Fixed”: The article profiled an uninsured Texas resident who traveled to India for hip replacement surgery (MacLaggan [2], Austin American-Statesman, 10/26).
Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation.В  All rights reserved.

The first stage of the U.S. Department of Defense-funded clinical trials exploring the role of hospital touch surfaces in the transmission of infectious pathogens has been completed and the researchers reported their findings in a poster session at the Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) in Washington, D.C. on Tuesday, October 28. The data presented describe the first results of a three phase study where the bioload found on stainless steel, plastic and aluminum objects in intensive care unit rooms were measured. Phases two and three of the study are ongoing. During these phases, the bioload on identical objects made of microbiocidal copper will be measured to determine the effectiveness of copper at combating hospital-acquired infections.

The findings being presented at ICAAC show that the most heavily contaminated objects are those in closest proximity to the patients: bed rails, call buttons and chairs were found to have the highest levels of staphylococcus, methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE). These pathogens can survive for extended periods of time on such objects, which act as reservoirs for the bacteria.

Independent laboratory studies have shown that copper, brass and bronze are more than 99.9 percent effective in killing potentially deadly pathogens, such as MRSA, which are commonly found in healthcare facilities. In response to these findings, the Environmental Protection Agency has registered copper, brass and bronze as antimicrobial materials, allowing public health claims to be made about them.

A similar clinical trial is also being conducted at Selly Oak Hospital, University Hospital Birmingham in the U.K. Results from this trial, also being presented at ICAAC, show a 90-95 percent reduction in contamination on copper alloy surfaces compared to the controls.

###

The U.S. studies are being conducted at Memorial Sloan-Kettering Cancer Center in New York City, the Medical University of South Carolina and the Ralph H. Johnson VA Medial Center, both in Charleston, South Carolina. They are being funded by the U.S. Department of Defense under the aegis of the Telemedicine and Advanced Technologies Research Center (TATRC), a section of the Army Medical Research and Materiel Command (USAMRMC).

About Copper Development Association Inc.

The Copper Development Association is the information, education, marketing and technical development arm of the copper, brass and bronze industries in the USA.

Source: Geralyn Lederman

Copper Development Association

A study surveying patients in more than 1,500 physician practices has found racial and ethnic disparities in patient health-care experiences, with minority patients having worse experiences than white patients. The findings suggest that while all doctors should be attentive to differences in patient experiences, Hispanic, Native American, and black patients are often visiting physician practices that are less patient-centered. The study, which was led by a health services researcher at the University of Washington, appears in the October issue of the Journal of General Internal Medicine.

“Our findings suggest that there are statistically significant ethnic disparities in physician-patient communication, access to care, and care coordination, even among comparably insured patients in a variety of health-care markets,” said Dr. Hector Rodriguez, lead author and assistant professor of health services at the UW School of Public Health and Community Medicine.

The study is the first of its kind to look at the contribution of individual physician practices to racial and ethnic disparities in patients’ experiences of care. Rodriguez said the finding that Asian and Pacific Islander patients experience disparities in care within the same practices as whites suggests that these patients experience discrimination in physician practices or tend to report lower quality experiences because of cultural norms.

A previous study of racial and ethnic disparities in diabetes care quality found that black patients received lower quality care in the same practices as whites. The new study, however, found that Hispanic, black, and Native American patients were concentrated in lower-performing primary care practices, while Asian and Pacific Islander patients reported worse experiences in the same practices as whites. This new study relied upon surveys about the experiences of about 49,000 patients in 27 medical groups in California, as part of the Integrated Healthcare Association’s public-reporting initiative.

What’s the best way to reverse or improve the situation? Rodriguez said that ethnic disparities in patient experiences might be best addressed by targeting patient experience and quality improvement efforts in low-performing practices with high concentrations of racial and ethnic minority patients. Primary care practices that serve high concentrations of Latinos and some other minority groups, however, are located in health-care markets with severe physician shortages and lots of uninsured patients. As a result, efforts to improve the performance of these lower-performing practices should also consider these important market constraints.

###

This study included researchers at Tufts University in Boston and the Pacific Business Group on Health in San Francisco. The project was supported by the UW and the Commonwealth Fund, a private foundation supporting research on health-care quality.

Source: Mary Guiden

University of Washington

The Baltimore Sun on Monday examined the national trend known as “boutique” or “concierge” medicine as it gains popularity in Maryland. Under the practice, physicians charge patients a flat annual fee while offering improved services, including 24-hour access to physicians, same-day appointments, longer appointments, home visits and more thorough annual physicals.

In 2006, the Government Accountability Office reported 146 physicians in the country with concierge practices. MDVIP, an association representing concierge practices, reports that currently there are 260 physicians in 24 states and Washington, D.C., serving roughly 90,000 patients. Proponents of concierge medicine say it allows physicians to increase their income, lower the number of patients and provide higher-quality care.

Edward Goldman, founder of MDVIP, said the current health care system does a disservice to patients because it values fast diagnoses of illnesses to manage patient volume. Proponents also note that insurance reimbursement rates for primary care physicians are lower than for other specialties, which has led some physicians to quit practicing or take on larger patient loads to keep their practices viable.

Critics argue that concierge practices in Maryland will increase the states’ shortage of primary care physicians and that it leaves too many people who cannot afford the flat rate without a primary care physician. The Sun profiled Charter Internal Medicine in Maryland, which notified its 9,000 patients this month that it will no longer accept private insurance or Medicare and instead will charge patients $2,000 annually plus $500 for each child ages 14 to 25 (Dixon/Brewington, Baltimore Sun, 10/26).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation.В  All rights reserved.

Recent studies hint that exposure to the toxic chemicals, such as methylmercury can cause harm at levels previously considered safe. A new analysis of the epidemiological evidence in the International Journal of Environment and Health, suggests that we should take a precautionary approach to this and similar compounds to protect unborn children from irreversible brain damage.

Philippe Grandjean of the Department of Environmental Health at Harvard School of Public Health, in Boston, and the University of Southern Denmark in Odense, explains that the causes of suboptimal and abnormal mental development are mostly unknown. However, severe exposure to pollutants during the development of the growing fetus can cause problems that become apparent as brain functions develop – and ultimately decline – in later life. Critically, much smaller doses of chemicals, such as the neurotoxic compound methylmercury, can harm the developing brain to a much greater extent than the adult brain.

Methylmercury is a chemical compound formed in the environment from released mercury. Unfortunately, the methylmercury can be transported quickly around the body and may enter the brain. Serious problems will ensue if important developmental processes are blocked as there will be only one chance for the brain to develop.

The researchers point out that until recently research into the effects of pollutants on the brain has been clouded by the lack of information on actual exposure. Moreover, finding a direct link between specific problems with the brain and exposure relies on statistical, or epidemiological, analysis rather than case-by-case understanding. The researchers say that neurodevelopmental disorders of possible environmental origin affect between 5% and 10% of babies born worldwide, leading to dyslexia, mental retardation, attention deficit/hyperactivity disorder, cerebral palsy, and autism.

The toxicity of methylmercury is well known, but the researchers believe that the medical world has underestimated the risk of brain damage associated with exposure to this compound as well as numerous others. Professor Grandjean emphasizes that little research has been carried out into the effects of other neurotoxic chemicals.

“Until there is enough evidence to rule out effects of certain chemicals on the developing nervous system, a cautious approach would involve strict regulation of suspected developmental neurotoxicants and prudent counseling of expectant mothers regarding exposures to untested substances,” the researchers conclude.

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Source: Philippe Grandjean

Inderscience Publishers