Ad linking alcohol to cancer most effective at curbing drinking, study finds

A graphic Australian advertisement that highlights the link between alcohol and cancer has been nominated by drinkers as the most effective in leading them to reconsider their alcohol intake.

The video advertisement, titled Spread, was developed and funded by the Western Australia government. It shows alcohol being absorbed into the bloodstream, spreading and causing cancerous cell mutations in the liver, bowel and throat.

Researchers led by renowned international behavioural scientist Professor Melanie Wakefield tested 83 English-language alcohol advertisements from around the world on 2,174 Australian adults who regularly consume alcohol.

Study participants ranked each advertisement on a five-point scale, with a score of “one” representing a low motivation to reduce drinking after viewing and “five” representing high motivation to reduce drinking after viewing.

Spread ranked the highest with an average score of 3.77 and was favoured across a range of groups including men, women, young and older adults, and low and high-risk drinkers.

Four out of the top 10 most effective advertisements were from Australia and of those, all were from Western Australia. The least motivating ad, from New Zealand, was titled Add Nothing, and encouraged drinking water instead of beer. The results were published on Thursday in the medical journal BMJ Open.

The McCusker Centre for Action on Alcohol and Youth gave input into the development of the highest-ranked ad. The centre’s executive officer, Julia Stafford, said Spread was successful because experts in the field had been approached for input.

“We are really pleased that the evidence base for these harm-reduction ads is building and that we are learning more about what works in designing and running them,” Stafford said.

“It is important that very careful, research-based approaches are being taken.”

According to the Cancer Council of Australia, more than 3,200 cases of cancer each year could be prevented nationally if people limited their alcohol consumption.

But the CEO of Cancel Council Victoria, Todd Harper, said the carcinogenic properties of alcohol were still widely unknown in the community.

“Our 2015 survey of Victorian men and women found that nearly half of the respondents either believed that alcohol made no difference or were not sure if it had any effect on a person’s risk of cancer,” Harper said.

“It’s worrying because alcohol is a group one carcinogen – the highest classification available. It means that there is strong evidence that alcohol causes cancer at some body sites in humans.”

He said that “every drink” increased the risk of mouth, throat, bowel, liver and female breast cancers.

This risk as well as other alcohol-related harms has prompted some public health experts and health professionals to call for plain packaging on alcohol products that warn people of their risk, similar to that used on tobacco products.

But Alcohol Beverages Australia executive director Fergus Taylor dismissed the Spread adas “off the mark” and “scaremongering”.

“The industry has long advocated for targeted measures to deal with specific areas of problem consumption and misuse, as opposed to broad-based, population-wide measures like ads that use cynical scare tactics to frighten responsible drinkers,” he said.

“These ads will just be dismissed as scaremongering by the vast majority of Australians who drink responsibly and are well aware that alcohol should be consumed in moderation.”

Taylor accused researchers of “simply demonising a product that has well-established health benefits when consumed at moderate and responsible levels”.

Evidence from the World Cancer Research Fund and American Institute for Cancer Research identifies a causal relationship between alcohol and cancer. While any level of drinking increases cancer risk, this risk increases in line with the level of consumption.

Ad linking alcohol to cancer most effective at curbing drinking, study finds

Recorded childhood cancers rise by 13% worldwide, study finds

Childhood cancers have risen across the globe by 13% over 20 years, according to data from the World Health Organization’s cancer section.

Cancer in children is comparatively rare; when it does occur it is more likely to have been triggered by something in the child’s genetic makeup than by anything to do with lifestyle or the environment.

Part of the reason for the rise is thought likely to be better detection. But experts say it is vital to collect better data from all over the world to establish all the causes, which could include infections and environmental pollutants.

The International Agency for Research on Cancer (IARC), which has published its findings in the medical journal Lancet Oncology, says the numbers recorded in cancer registries around the world have gone up since the 1980s. Between 2001-2010, there were 140 children in every million who were diagnosed with cancer under the age of 14, which represents a 13% increase.

IARC for the first time gives numbers for adolescents with cancer. There were 185 adolescents in every million diagnosed with cancer, most commonly lymphomas, which are cancers of the white blood cells.

“Cancer is a significant cause of death in children and adolescents, in spite of its relatively rare occurrence before the age of 20 years,” said IARC’s director, Christopher Wild. “This extensive new set of information on the pattern and incidence of cancer in young people is vital to raise awareness and to better understand and combat this neglected area of health early in life.”

A third of the cases under the age of 15 were of leukaemia, a cancer of the blood that is now successfully treated in Europe and the US.

A second paper, published in the Lancet Haematology journal, looks at the stark variation in survival from acute lymphoblastic leukaemia (or ALL) in childhood around the world between 2005 and 2009. In Germany, 92% of children survived for at least five years but in Colombia the figure was 52%.

Survival rates have improved significantly in all countries. From 1995-99 and 2005-09, five-year survival for the disease ALL, in children, increased from 79% to 89% in the UK, and from 83% to 88% in the US.

Regarding a second form of the disease, acute myeloid leukaemia (AML), five-year survival increased from 59% to 68% in the UK and from 52% to 63% in the US. Survival in China increased substantially over the same period – from 11% to 69% for ALL survival, and 4% to 41% for AML survival.

The IARC study on the global cancer rise has gathered information from cancer registries worldwide. But while the data covers 100% of children in Europe and North America, it accounts for only 5% or a lower percentage in Africa and Asia, where the information is not routinely collected.

In poorer countries, some children’s cancers are never diagnosed and their deaths will not be investigated. Social factors may explain why the cancer numbers for girls and small babies are very low.

In wealthier countries, greater understanding of cancers affecting children and adolescents and the development of better tools will account for much of the rise in numbers.

“It’s likely that this reported rise in children’s cancers is, in part, due to improvements in diagnosis,” said Anna Perman, Cancer Research UK’s senior science information manager. “We now have a better understanding of the symptoms of children’s cancers, which helps doctors to spot those who might have gone undiagnosed before. It’s unlikely environmental factors that children are exposed to either early in life or during development in the womb play a big role in this rise. Although some environmental and lifestyle factors that do play a role in cancer are on the rise, these usually take many years to influence cancer risk and would be unlikely to cause cancer at a young age.”

Recorded childhood cancers rise by 13% worldwide, study finds

Pets Help Kids Build Immunity Even Before They’re Born, Study Finds

If you’ve been considering adopting a dog or a cat, this new study might help you make up your mind: According to research published in Microbiome, children born into homes with pets have higher levels of gut microbes that protect against allergies and obesity. Researchers say that indirect exposure to furry friends is especially beneficial to babies in their first three months of life, and even while they’re still in the womb.

This period appears to be a “critical window of time when gut immunity and microbes co-develop,” says lead author Anita Kozyrskyj, PhD, a pediatric epidemiologist at the University of Alberta. Disruptions to this development process—for example, the introduction of foreign bacteria—can change immunity and have implications for long-term health, she adds.

Kozyrskyj’s study compared fecal samples from 746 Canadian infants. Some of the infants were from families with pets (70% of which were dogs), some were from families who had pets during their pregnancy but not once the babies were born, and some had no recent pets.

The researchers found that babies from households with pets had twice the amount of two specific bacteria, Ruminococcus and Oscillospira, that have been linked with reduced risk for childhood allergies (such as dermatitis and asthma) and obesity, respectively.

Even when pets had been given up for adoption before the babies were born, this benefit was still seen. This shows that pet exposure affected the babies’ microbiomes indirectly, with influential bacteria transferring from the animal to the mother to the unborn child.

This bacterial exchange occurred regardless of the type of birth (vaginal versus C-section), regardless of whether the babies were breastfed, and regardless of whether antibiotics were used during birth. This is important, say the authors, as previous research has shown that C-sections, antibiotics, and not breastfeeding can all negatively impact babies’ immunity.

The presence of pets in the house during a woman’s pregnancy was also associated with a reduced likelihood that she would transmit group B strep bacteria—which can colonize in the vagina and cause pneumonia in newborns—to her baby during birth.

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The study builds on decades of research showing that exposure to dirt and bacteria can help children build up immunity, and that kids who grow up with pets have lower rates of asthma and allergies, says Kozyrskyj. (This effect is strongest with dogs but is true with cats, as well.) “Pets have always been our best friends and they appear to be good for our babies too,” she says.

But further studies are needed to provide definitive evidence that a “dog intervention” during pregnancy can actually prevent allergies. “Our next step is to pursue the ‘does it matter’ question, to determine the allergy and obesity outcomes of studied infants at ages 1, 3, and 5,” Kozyrskyj says.

And of course, allergies and obesity aren’t products of the environment alone; genetics also play a role. It also makes sense that kids with pets have natural protection against allergies, since parents with allergies are less likely to have dogs and cats in the first place.

RELATED: 13 Fun Ways to Work Out With Your Dog

But the study’s results were adjusted to account for whether the mothers had asthma or allergies, and still held true. Kozyrskyj says her team’s findings “are independent of these two possible explanations.”

It’s not far-fetched to think that pet exposure during pregnancy could one day be an official recommendation from doctors, Kozyrskyj says. It’s even possible that scientists could develop a “dog in a pill” supplement, she adds, for mothers to take as a preventative measure against allergies and asthma.

More research is needed for these scenarios to actually happen, however. For now, families have have another reason (on top of plenty already!) to snuggle up to their fur babies—and that includes moms-to-be.

Pets Help Kids Build Immunity Even Before They’re Born, Study Finds

Two in five GPs in south-west of England plan to quit, survey finds

About two in five GPs in the south-west of England are planning to quit, exposing a potential doctors’ crisis in the NHS. A survey of more than 2,000 GPs in the region revealed the impending healthcare problems.

Figures published last month showed there had been a drop in the number of GPs working in the NHS despite the government aim of recruiting 5,000 more by 2020.

The survey, carried out by the University of Exeter, also found that seven in 10 GPs intended to change their working patterns in a way that would mean less contact with patients. This included leaving patient care, taking a career break or reducing their hours.

The researchers said the data provided a snapshot of low morale which, if echoed in other regions, could point to a deeper and more imminent crisis than previously anticipated in relation to the worsening shortage of GPs nationwide.

John Campbell, a professor who led the research, which is published in BMJ Open, has called for a move away from “sticking plaster solutions” towards robust, joined-up, action to avert the crisis nationwide.

Campbell, a practising GP, said: “We carried out this survey because of a nationally recognised crisis in the shortage of GPs across the country, and our findings show an even bleaker outlook than expected for GP cover, even in an area which is often considered desirable, and which has many rural communities,.

“If GPs have similar intentions to leave or reduce their hours in other regions, as many are reporting, the country needs to take robust action more swiftly and urgently than previously thought.”

The research team sent surveys to 3,370 GPs across the region and received responses from 2,248, with 54% reporting low morale.

Campbell said: “We know that there’s an ageing workforce in general practice, with 30% of GPs being over 50 years old. Previous research has found that GP morale is low because of workload pressures, and many younger GPs do not want the financial risk and responsibilities of taking on a practice.

“Yet if the GPs we surveyed fulfil their intentions to leave or to cut back their patient contact, and no action is taken to address the issue, the south-west of England will experience a severe shortfall of GPs in the next five years.

“Whilst numerous government-led initiatives are under way to address recruitment, there is a need to address the underlying serious malaise which is behind this data.

“We are in a perilous situation in England, with poor morale of the current GP workforce, and major difficulties with recruitment and retention of GPs reflected in the stark overall reduction in the GP workforce. Reactive, sticking-plaster, approaches are not the answer.”

Campbell said GPs and their teams delivered nine in every 10 patient contacts with the NHS but attracted just seven pence in every pound of NHS spending.

“The government needs to work with the Royal College of General Practitioners, the British Medical Association and universities to obtain evidence on the causes of the problem, to develop and implement relevant strategy, and to effect fundamental change in healthcare resourcing and planning nationwide,” he said.

Two in five GPs in south-west of England plan to quit, survey finds

Recorded childhood cancers rise by 13% worldwide, study finds

Childhood cancers have risen across the globe by 13% over 20 years, according to data from the World Health Organization’s cancer section.

Cancer in children is comparatively rare; when it does occur it is more likely to have been triggered by something in the child’s genetic makeup than by anything to do with lifestyle or the environment.

Part of the reason for the rise is thought likely to be better detection. But experts say it is vital to collect better data from all over the world to establish all the causes, which could include infections and environmental pollutants.

The International Agency for Research on Cancer (IARC), which has published its findings in the medical journal Lancet Oncology, says the numbers recorded in cancer registries around the world have gone up since the 1980s. Between 2001-2010, there were 140 children in every million who were diagnosed with cancer under the age of 14, which represents a 13% increase.

IARC for the first time gives numbers for adolescents with cancer. There were 185 adolescents in every million diagnosed with cancer, most commonly lymphomas, which are cancers of the white blood cells.

“Cancer is a significant cause of death in children and adolescents, in spite of its relatively rare occurrence before the age of 20 years,” said IARC’s director, Christopher Wild. “This extensive new set of information on the pattern and incidence of cancer in young people is vital to raise awareness and to better understand and combat this neglected area of health early in life.”

A third of the cases under the age of 15 were of leukaemia, a cancer of the blood that is now successfully treated in Europe and the US.

A second paper, published in the Lancet Haematology journal, looks at the stark variation in survival from acute lymphoblastic leukaemia (or ALL) in childhood around the world between 2005 and 2009. In Germany, 92% of children survived for at least five years but in Colombia the figure was 52%.

Survival rates have improved significantly in all countries. From 1995-99 and 2005-09, five-year survival for the disease ALL, in children, increased from 79% to 89% in the UK, and from 83% to 88% in the US.

Regarding a second form of the disease, acute myeloid leukaemia (AML), five-year survival increased from 59% to 68% in the UK and from 52% to 63% in the US. Survival in China increased substantially over the same period – from 11% to 69% for ALL survival, and 4% to 41% for AML survival.

The IARC study on the global cancer rise has gathered information from cancer registries worldwide. But while the data covers 100% of children in Europe and North America, it accounts for only 5% or a lower percentage in Africa and Asia, where the information is not routinely collected.

In poorer countries, some children’s cancers are never diagnosed and their deaths will not be investigated. Social factors may explain why the cancer numbers for girls and small babies are very low.

In wealthier countries, greater understanding of cancers affecting children and adolescents and the development of better tools will account for much of the rise in numbers.

“It’s likely that this reported rise in children’s cancers is, in part, due to improvements in diagnosis,” said Anna Perman, Cancer Research UK’s senior science information manager. “We now have a better understanding of the symptoms of children’s cancers, which helps doctors to spot those who might have gone undiagnosed before. It’s unlikely environmental factors that children are exposed to either early in life or during development in the womb play a big role in this rise. Although some environmental and lifestyle factors that do play a role in cancer are on the rise, these usually take many years to influence cancer risk and would be unlikely to cause cancer at a young age.”

Recorded childhood cancers rise by 13% worldwide, study finds

Antibiotics overuse could increase bowel cancer risk, study finds

The overuse of antibiotics could increase a person’s risk of developing bowel cancer, the findings of a US study suggest.

Research published in medical journal Gut found extended use of antibiotics significantly increased the chance of polyp formation in the colon, a precursor of bowel cancer.

The findings add weight to emerging evidence that the type and diversity of bacteria in the gut may have a key role in the development of cancer, according to the authors of the study.

An Australian bowel cancer expert, Associate Professor Graham Newstead, the head of the colorectal unit at the Prince of Wales private hospital and director of Bowel Cancer Australia, said the research had “credence”.

“We know already that if you take antibiotics you frequently get diarrhoea,” Newstead said.

This happened because the antibiotic killed some of the normal bacteria, leading to an overgrowth of the abnormal bacteria in the gut.

But Newstead said the study did not look at the effect of antibiotics on the colon and caution must be taken.

US researchers monitored the health of more than 120,000 nurses, aged between 30 and 55, who were part of the the Nurses Health Study launched in 1976.

Between 2004 and 2010, 1,194 abnormal growths in the colon and rectum were diagnosed.

Those who had taken antibiotics for two months or more between the ages of 20 and 39 were 36% more likely to be diagnosed with an adenoma, or polyp, compared with those who had not taken antibiotics for any extended period in their 20s and 30s.

Similarly, women who had taken antibiotics for two months or more during their 40s and 50s were 69% more likely to be diagnosed with an adenoma.

And those who had taken these drugs for 15 days or more between the ages of 20 and 39, and between the ages of 40 and 59, were 73% more likely to be diagnosed with an adenoma.

“It does seem to indicate that people who have too many antibiotics might be at more risk of of getting polyps than people who have less of them,” Newstead said.

“And, remembering that not all polyps turn to cancer but the cancer comes from the polyps. If you have more polyps or tendency to get polyps then maybe you are slightly more at risk of getting cancer.”

The message to be taken from the study was not to use antibiotics for a “tickle” in the throat or a cold, Newstead said.

Antibiotics overuse could increase bowel cancer risk, study finds

Cancer patients have 55% greater risk of suicide, study finds

Cancer patients have a 55% greater risk of suicide than people without the potentially deadly disease, according to preliminary research findings.

Previous research has found suicide rates to be higher than in the general population but a paper being presented at this week’s European Congress of Psychiatry in Florence, Italy is an attempt to quantify the size of the increased risk.

Co-author Dr Raffaella Calati from the department of emergency psychiatry and post-acute care at Lapeyronie hospital, Montpellier, described the results, derived by pooling data from 15 studies, as “extremely preliminary” but nevertheless significant.

“The key message that remains is that in the majority of the studies there is an increased risk,” she said. “We are quite sure the risk would be higher, although I cannot say the exact number.”

The analysis, which also looked at suicide attempts and suicidal thoughts, included studies published between 1983 and 2015 from Australia, Canada, China, Norway, South Korea, Sweden, the UK and the US.

Patients with cancer were found to have a 55% higher suicide rate compared with people without the disease. But the analysis revealed no increased risk of suicide attempts ( 8,147,762 participants) or suicidal thoughts (42,700 participants) in patients with cancer.

The authors are currently seeking to add more studies into the mix and, in their initial analysis, did not seek to rule out other external factors that might influence the results, hence their emphasis on it being preliminary.

They say: “The assessment of suicide risk in patients with cancer is crucial. We suggest there is a need in cancer patients to be screened and cared not only for anxiety and depression, but also specifically for those people with suicidal thoughts and a lifetime history of suicide attempts, in particular during the period immediately subsequent to the diagnosis of cancer.”

A 2014 study by Cancer Research UK and the Scottish government found that three-quarters of cancer patients who also have clinical depression were not receiving any treatment for depression.

As the analysis is ongoing, it has not yet been submitted to a medical journal for publication but to be accepted for the European Congress of Psychiatry it had to undergo a peer review process set out by the European Psychiatric Association.

• In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here

Cancer patients have 55% greater risk of suicide, study finds

Doctor was "dishonest" in screening nurse who had Ebola, tribunal finds

A doctor acted dishonestly when she lied to investigators about the dangerously high temperature of a nurse who went on to develop Ebola, a tribunal has found.

Dr Hannah Ryan, who had been working in Sierra Leone during the west Africa Ebola outbreak of 2014, was one of the medics who assessed Pauline Cafferkey following the Scottish nurse’s return to the UK in December 2014.

Ryan did not raise the alarm when a colleague wrote down Cafferkey’s temperature as 1C lower than it actually was during a “chaotic” screening process at Heathrow airport on 28 December 2014, a medical practitioners tribunal found on Monday.

A raised temperature can be the first sign of Ebola, which can kill within five days. Cafferkey, who twice nearly died from the virus, went on to develop one of the worst cases on record for people treated in the west.

During screening at Heathrow, Cafferkey insisted she was feeling fine and was eventually allowed to catch her connecting flight to Glasgow. The following day, she developed further Ebola symptoms and was admitted to hospital for urgent treatment.

The tribunal found that Ryan had acted in a “misleading” manner when she agreed that the form recording the lower, wrong temperature be submitted to screening staff from Public Health England (PHE) at the airport.

But Ryan, who had only just graduated from medical school, did not intend to conceal Cafferkey’s real temperature at the airport, knowing it to be at least 38.2C – higher than the 37.5 considered normal – the panel found.

However, the tribunal decided that the doctor had later been “dishonest” when she concealed her role in taking Cafferkey’s temperature during a conversation with Dr Nick Gent on 2 January 2015. Gent, deputy head of the emergency response department at PHE, had phoned her during PHE’s investigation into when Cafferkey’s symptoms first emerged.

Ryan did not tell him she had taken Cafferkey’s temperature and told him words to the effect that the nurse’s temperature was “normal”, the panel found.

The tribunal heard that Ryan and Cafferkey were one group among many British medics who put their own lives at risk by volunteering their medical skills and going to west Africa to help fight the outbreak.

Deployed on 22 November 2014, they were based at an 80-bed treatment centre in Kerry Town, a village in Sierra Leone, working “tirelessly in dangerous and highly pressurised conditions” during which they “formed a strong bond of friendship”, according to Fraser Coxhill, representing the General Medical Council.

The medical practitioners tribunal, which is independent of the GMC, will decide later this week whether Ryan’s fitness to practice as a doctor was impaired due to her actions and whether to impose sanctions.

Doctor was "dishonest" in screening nurse who had Ebola, tribunal finds

Less than half of women breastfeed after two months, survey finds

Almost three-quarters of women in England start breastfeeding after giving birth but less than half are still doing so two months later, according to NHS and Public Health England data.

PHE recommends exclusive breastfeeding for the first six months, as does the World Health Organisation, because it boosts a baby’s ability to fight illness and infection. But a comparison of initial breastfeeding rates and those after six to eight weeks in the final quarter of 2015 found that they were 40% lower for the latter (44% compared with 73%).

A survey of 500 mothers commissioned by PHE found that fears about breastfeeding among women included that it could be painful (74%), prevent them taking medication (71%) and be embarrassing in front of strangers (63%).

The PHE’s chief nurse, Viv Bennett, said:“We can all help women feel comfortable breastfeeding their baby wherever they are. Creating a wider culture of encouragement and support will help make a mother’s experience all the more positive.”

PHE has launched an interactive breastfeeding friend chatbot, accessed through Facebook messenger, to provide personal support for breastfeeding 24 hours a day. Bennett said it would help women through the “crucial” initial period, after which things generally became easier.

A study published in the Lancet last year found the UK had the lowest rate of breastfeeding in the world, with only one in 200 women breastfeeding their children after they reach their first birthday.

The WHO recommends that breastfeeding form part of a baby’s diet up to two years of age. As well as reducing the likelihood of babies getting diarrhoea and respiratory infections, breastfeeding also lowers a mother’s risk of ovarian and breast cancer and burns about 500 calories a day.

The PHE survey found that many women were not only embarrassed about breastfeeding in front of strangers, but also their partner’s family (59%) and around siblings and wider family members (49%).

The results, published on Thursday, suggested high-profile figures who promote breastfeeding can have a positive influence on other mothers. Just under half of respondents said the example of household names such as The Only Way is Essex star Sam Faiers, broadcaster Fearne Cotton and actor Blake Lively, who have recently championed breastfeeding on social media, had inspired them to do so themselves. About two-thirds (64%) said they felt more confident to breastfeed in public because of celebrity mums.

Other concerns raised by more than half of women were not being able to tell if their baby was getting enough or too much milk and that it could potentially place restrictions on the mother.

Jacque Gerrard, the director for England at the Royal College of Midwives, said: “Any initiative that goes towards helping mothers start and sustain breastfeeding for longer is positive as we know the health benefits from being breastfed last a lifetime.”

Less than half of women breastfeed after two months, survey finds

Three-quarters of older people in the UK are lonely, survey finds

Almost three-quarters of older people in the UK are lonely and more than half of those have never spoken to anyone about how they feel, according to a survey carried out for the Jo Cox commision on loneliness.

The poll by Gransnet, the over-50s social networking site, also found that about seven in 10 (71%) respondents – average age 63 – said their close friends and family would be surprised or astonished to hear that they felt lonely.

Gransnet is one of nine organisations – including Age UK, the Alzheimer’s Society and the Silver Line helpline for older people – working to address the issue of loneliness in older people, which is the current focus of the commission, set up by Cox before her murder last June.

They are urging individuals and businesses to look for signs of loneliness and refer people to organisations that can help. But they also want people to take time to speak to neighbours, family, old friends or those they encounter randomly.

The chairs of the cross-party commission, the Labour MP Rachel Reeves and Conservative MP Seema Kennedy, said there was a stigma around loneliness that must be tackled.

“We all need to act and encourage older people to freely talk about their loneliness,” they said. “Everyone can play a part in ending loneliness among older people in their communities by simply starting a conversation with those around you.

“How we care and act for those around us could mean the difference between an older person just coping, to them loving and enjoying later life.”

Almost half (49%) of the 73% who described themselves as lonely in the online poll said they had been so for years, 11% said they had always felt lonely and 56% said they had never spoken about their loneliness to anyone.

Laura Alcock-Ferguson, the executive director of the Campaign to End Loneliness – another organisation working with the commission – said the percentage of lonely older people had stayed the same for five decades, but an ageing population meant the number was increasing in absolute terms.

“Loneliness is a serious public health issue and dealing with it will take the strain off the NHS and social care services,” she said.

Common trigger events said to have contributed to feelings of loneliness were bereavement, retirement and children leaving home. Being shy, living alone or far from family and low income were other commonly cited contributory factors.

The rise of social networking to the detriment of face-to-face interaction has been blamed for contributing to an “epidemic” of loneliness, but the survey of just over 1,000 people found it could also offer solace.

Almost three in five respondents (59%) said social media helped people feel less lonely and about eight in 10 (82%) said talking about loneliness was much easier when anonymous and online.

While the results indicate the potential benefits of online interaction, the older people are the less likely they are to have access to the internet, particularly women.

The commission is encouraging supporters and followers to post #happytochat on social media to create discussion around loneliness and for people to wear badges with the same slogan. Ultimately, they hope some customer-facing organisations will encourage their staff to wear the badges.

Respondents highlighted greater public awareness – a key goal of the commission – as the best way to combat loneliness.

Caroline Abrahams, charity director at Age UK, said: “There are reasons to believe that we can all do something to change things for the better: a simple thing like saying hello and having a chat can brighten up an older person’s day and do more good than most of us would ever guess.”

In coming months the commission will focus on loneliness in other groups, including men, people with disabilities, carers, refugees, children and parents.

Three-quarters of older people in the UK are lonely, survey finds

Male construction workers at greatest risk of suicide, study finds

Men working in the construction industry and women employed in culture, media and sport, healthcare and primary school teaching are at the highest risk of suicide, official figures for England suggest.

The research, commissioned by Public Health England (PHE), found people in roles as managers, directors and senior officials – the highest paid occupation group – had the lowest risk of suicide.

The Office for National Statistics (ONS) looked at all 18,998 deaths of people aged 20 to 64 – a rate of about 12 deaths for every 100,000 people per year – who killed themselves in England between 2011 and 2015. Of these records, 13,232 had information on the deceased’s occupation.

Suicide is the leading cause of death for men under 50 and about four in five (10,688) deaths included in the analysis were among men.

The ONS found low-skilled male construction workers had the greatest risk, at 3.7 times above the national average.

Building finishing trades, including plasterers, painters and decorators, had a risk twice the national average and the risk for low-skilled workers in process plant operations was 2.6 times higher. The agricultural sector also carried an elevated risk for men, more than 1.5 times above the average for both low-skilled and high-skilled workers.

For women, the risk was elevated among those working in culture, media and sport occupations, at 0.69 times higher than the national average, compared with 0.2 times higher for men.

The risk of suicide among female health professionals was about a quarter higher than the national average, largely driven by suicides among nurses, and it was 0.42 times higher for primary and nursery school teachers, although lower than average for the teaching and education profession as a whole.

The risk among male and female carers was almost twice the national average but among corporate managers and directors the risk was more than two-thirds lower for both sexes.

The ONS said previous studies suggested an occupation may have a high risk because of low pay and job security and/or access to or knowledge of methods of suicide.

The Samaritans chief executive, Ruth Sutherland, said: “We spend a third of our lives at work and one fifth of us experience suicidal thoughts, so these resources are much needed. We shouldn’t stop there though – it is up to us to create a culture in our workplaces where people feel safe enough to talk about their feelings and get support if they need it.”

PHE said the research, published on Friday, will help build a better understanding of factors that influence suicide and help identify where inequalities exist among different groups.

The PHE chief executive, Duncan Selbie, said: “People who die from suicide are usually not in contact with health services, and often push through in silence as their ability to cope deteriorates. With more than two-thirds of adults in employment, the workplace offers an opportunity to reach people who need extra support.

“I urge all employers, large or small, public or private sector to treat mental health as seriously as physical health. Early action can stop any employees reaching a desperate stage. Simple actions can make a huge difference – talking with a manager or colleague can help people get the support they need, and ultimately save lives.”

PHE, Business in the Community and the Samaritans have published toolkits to help employers prevent and respond to suicides.

The ONS limited its analysis to occupations where there were 50 suicides or more so that relative mortality rates could be estimated more precisely.

• In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here

Male construction workers at greatest risk of suicide, study finds

Constant restructuring of NHS is demoralising staff, survey finds

The number of NHS reorganisations in recent years is a key reason for the health service’s struggle to retain staff, a poll has found.

The NHS has been struggling to meet rising demand with a chronic shortage of staff and the results of a survey, published on Friday, suggest that a feeling of constant upheaval is at least partially to blame.

The poll by Wilmington Healthcare UK of more than 2,000 nurses, GPs and hospital doctors across the UK found that 64% blamed staff retention problems on the continuous and “demoralising” national changes in NHS workforce planning that had occurred since 2000.

The concerns about the state of flux are revealed as as the health service faces further big upheaval, in the shape of the controversial sustainability and transformation plans (STPs), which are intended to improve productivity and efficiency and so plug the NHS funding gap. The STPs will mean some hospitals and beds lost and more services being delivered in the community.

Wilmington Healthcare’s managing director, Gareth Thomas, said: “Our survey shows that continued changes in workforce planning since 2000 have been a major factor in NHS staff retention problems.

“This is of particular concern as the planned introduction of STPs in April 2017 is set to bring the biggest shake-up to NHS services since the publication of the Five Year Forward View.

“As the NHS moves towards a truly devolved health and social care system, it is clear that urgent action must be taken to support staff and help them manage the huge changes that are envisaged.”

Changes in NHS workforce planning, due to organisational changes, and said to have affected staff retention, included the establishment of primary care trusts, workforce development confederations and strategic health authorities, all since abolished (within three years of their creation in the case of WDCs). Primary care trusts were replaced by clinical commissioning groups.

Other key factors cited by respondents as adversely affecting the NHS’s ability to retain staff were low morale (92% of respondents) and poor pay and rewards (72%).

With concerns raised that the UK’s exit from the EU would exacerbate the shortage of NHS staff – 59,000 NHS staff are nationals of other EU countries – the survey also asked respondents about the impact of Brexit. Just under half (48%) said it would bemore difficult to recruit and retain staff, 45% said it would make no difference and 7% said it would be easier to recruit and retain staff. According to the Nuffield Trust, 10% of doctors and 4% of nurses are from the EU.

More than eight in 10 respondents (85%) said access to training and development was the key requirement of the future NHS workforce, closely followed by flexible working and career progression (both 78%).

An NHS England spokeswoman said: “This poll is wide of the mark and at odds with our own thorough and robust staff survey which garnered 423,000 responses. It found 80% of frontline NHS staff say they are able to do their job to a standard they are personally pleased with, 90% of staff say their job makes a difference for patients, and 92% of staff feel trusted to do their jobs, which does not seem to suggest a low morale workforce.”

Constant restructuring of NHS is demoralising staff, survey finds

Calls for ibuprofen sale restrictions after study finds cardiac arrest risk

There have been fresh calls for restrictions on the sale of the painkiller ibuprofen after another study found it heightens the risk of cardiac arrest.

Taking the over-the-counter drug was associated with a 31% increased risk, researchers in Denmark found.

Other medicines from the same group of painkillers, known as non-steroidal anti-inflammatory drugs (NSAIDs), presented an even higher risk, according to the findings published on Wednesday in the European Heart Journal.

Diclofenac, available over the counter in the UK until 2015 and still taken on prescription, raised the risk by 50%.

Prof Gunnar Gislason of the University of Copenhagen, who led the study, called for tighter controls on the sale of ibuprofen and other NSAIDs. He said: “Allowing these drugs to be purchased without a prescription, and without any advice or restrictions, sends a message to the public that they must be safe.

“The findings are a stark reminder that NSAIDs are not harmless. Diclofenac and ibuprofen, both commonly used drugs, were associated with significantly increased risk of cardiac arrest.”

The findings are the latest to raise alarm about the use of NSAIDs. Last September a study in British Medical Journal found they were linked to an increased risk of heart failure. Previous studies have linked the drugs to abnormal heart rhythm – which can cause heart failure – and an increased risk of heart attack and stroke if taken regularly.

Gislason urged people with heart problems to avoid ibuprofen and other NSAIDs. “NSAIDs should be used with caution and for a valid indication. They should probably be avoided in patients with cardiovascular disease or many cardiovascular risk factors,” he said.

“I don’t think these drugs should be sold in supermarkets or petrol stations where there is no professional advice on how to use them.”

Gislason suggested they should only be taken after consulting a doctor. “Over-the-counter NSAIDs should only be available at pharmacies, in limited quantities and in low doses,” he said.

He added: “The current message being sent to the public about NSAIDs is wrong. If you can buy these drugs in a convenience store then you probably think: ‘They must be safe for me.’

“Our study adds to the evidence about the adverse cardiovascular effects of NSAIDs and confirms that they should be taken seriously and used only after consulting a healthcare professional.”

The Danish investigators studied data on almost 29,000 patients who suffered an out-of-hospital cardiac arrest recorded in Denmark between 2001 and 2010. They found that use of any NSAID raised the likelihood of cardiac arrest by 31%.

The researchers speculated that the results could be explained by the effect of the drugs on the cardiovascular system, as they influence platelet aggregation and the formation of blood clots. They may also cause arteries to constrict, increase fluid retention and raise blood pressure.

Gislason said people should not take more than 1,200mg of ibuprofen in one day.

The Proprietary Association of Great Britain, the trade body representing manufacturers of over-the-counter medicines said the study had “several limitations,” and insisted that NSAIDs are safe.

John Smith, its chief executive, said: “Information about daily dosage was only based on estimates rather than accurate data and didn’t account for over-the-counter use. Prescribed NSAIDs would normally contain a higher dosage than those medicines available over-the-counter and would typically be used for longer durations.”

He added: “NSAIDs available over-the-counter, such as ibuprofen, are an effective and appropriately safe way to provide short-term pain relief if used in accordance with the clear on-pack instructions and the patient information leaflet inside. NHS Choices recommends NSAIDs to help relieve pain, reduce inflammation, and bring down a temperature.

“It is important for people with a history of heart disease or other long term condition to speak to a pharmacist before taking any over the counter medicine to check for any potential drug interactions or health concerns.”

Calls for ibuprofen sale restrictions after study finds cardiac arrest risk

Over half of NHS staff work unpaid overtime every week, survey finds

This past year has sent shockwaves through an already challenging working environment in the NHS. From the withdrawal of nursing bursaries and junior doctors’ strikes to the uncertain impact of Brexit on 58,000 EU nationals currently working in the health service, workforce pressures continued to build for an already overstretched service.

So what do the findings of the latest NHS staff survey, released on Tuesday, tell us about how staff are coping? Covering 316 participating NHS organisations, the survey is the biggest in the world, capturing the experiences of more than 423,000 healthcare professionals across the country.

The good news is that despite the tremendous pressures the NHS faces, nearly three quarters of staff remain enthusiastic about their job, while 70% said they would be happy with the standard of care provided by their organisation if a friend or relative needed treatment. The proportion of staff who reported feeling unwell due to work-related stress is at its lowest since 2012, down to 37%.

Responses addressing another key aspect of staff motivation – feeling empowered to contribute suggestions for improving work practices – also signalled positives. More than 70% of staff said that there are frequent opportunities to show initiative in their role, and 75% reported making suggestions to improve the work of their team or department. The survey did indicate room for improvement, however. Only a small majority of staff (56%) stated that these suggestions were actually acted upon – staff feedback does not appear to always translate into tangible change.

As is to be expected in such a pressured working environment, the survey does highlight some challenges for the NHS. More than half of staff (56%) report having attended work in the last three months despite feeling unwell, due to pressure from either their manager, colleagues or themselves. This is, however, a significant improvement since 2012, when 64% attended work despite illness. Most of this pressure comes from staff themselves (92%), rather than from managers (26%) or other colleagues (20%).

Generally, staff report feeling that managers are invested in their health and wellbeing. Most say that their immediate manager takes an interest in their health and wellbeing (67%) and that their organisation more broadly takes positive action on the health and wellbeing of staff (90%). These figures are on a par with those from last year’s survey and describe a workforce committed to working together and supporting one another to deliver high quality care – one that struggles more with heavy workloads and external pressures.

A key aspect of wellbeing is maintaining a healthy work-life balance and this is another area that contains some worrying figures. Staff report being satisfied with the opportunities to work flexibly – but 59% are, on average, working additional unpaid hours each week. Overall, the proportion of staff working additional hours is 72%, indicating that not enough has been done to alleviate workloads in light of similar results in recent years. The steady increase in both paid and unpaid overtime since 2012 is concerning as research repeatedly suggests that relying on tired and over-worked staff can lead to poorer standards of care.

The results of the 2016 staff survey suggest NHS staff are showing remarkable resilience despite the huge pressures that have been placed on the system. However, with external pressures such as Brexit likely to exacerbate existing problems in future years, a concerted effort is required from the government and NHS England to ensure that the positives to be found in staff motivation and engagement this year are not lost. NHS staff are subject to immense pressures that are unlikely to ease without significant support.

• Rory Corbett is a senior research associate at Picker, a charity that co-ordinates the NHS staff survey on behalf of NHS England
  

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Over half of NHS staff work unpaid overtime every week, survey finds

Fragrance Sensitivities Can Actually Be Very Severe, Study Finds

You may not love the scent of your coworker’s hand cream, or the perfume wafting across the aisle on the train. But for some people, fragrances like those can trigger a range of very real symptoms, according to a new Australian study, from migraines to difficulties with breathing.

For her research, Anne Steinemann, PhD, a professor of civil engineering at the University of Melbourne School of Engineering, asked nearly 1,100 people to complete questionnaires about their exposure to fragranced products—such as personal care products, air fresheners, cleaning solutions, and laundry supplies—and any reactions those products may have triggered.

The findings, published in the journal Preventive Medicine Reports, suggest that fragrance sensitivity is not only a common issue, but can be quite severe. One-third of the study participants reported experiencing one or more health issues from scented products (whether they used the items themselves, or were exposed to them in public places).

The most common reaction was respiratory difficulties, including coughing and shortness of breath. Almost 17% of participants reported this effect.

Fourteen percent reported mucosal symptoms (such as congestion and watery eyes); 10% had experienced migraines; and 9.5% said they developed skin problems (like rashes, hives, tingling skin, and dermatitis).

RELATED: 20 Ways to Stop Allergies

Other reactions reported included asthma attacks (7.6%) and gastrointestinal problems (3.3%). Almost 5% of people said they suffered neurological symptoms (dizziness or fainting, for example); and 4.1% reported cognitive problems, such as trouble with their memory and difficulty concentrating.

What’s more, nearly 8% of the respondents said they had missed work or lost a job(!) in the past year as a result of feeling ill from exposure to fragrances in the workplace.

“Based on my findings, it’s clear that the health effects of fragrance sensitivities can be immediate, severe, and potentially disabling,” says Steinemann. Her previous research in the United States found that 19% of Americans experience adverse reactions to air fresheners. 

“Some people feel like they can’t enter public restrooms or walk inside shops because they don’t want to risk an asthma attack,” says Steinemann. “This loss of functionality makes a fragrance sensitivity not just a health issue, but a societal and economic one too.”

For anyone who reacts to fragrances, there are a few simple things you can do to protect yourself, she says. First, get rid of air fresheners, which don’t actually improve air quality; and open windows for ventilation instead. You can also try to go old school with your cleaning supplies, she suggests, using products like vinegar or baking soda to wipe down your kitchen and bathroom.

Finally, don’t be afraid to let colleagues know a second-hand scent (from a candle, for example, or an odor-eliminating spray) is making you sick. “Speak up!” urges Steinemann. “It’s a health hazard and workplace liability that doesn’t help productivity.”

Fragrance Sensitivities Can Actually Be Very Severe, Study Finds

NHS poll finds public think service getting worse

Growing numbers of Britons think the NHS is getting worse and fear for its future, a survey has found.

Ipsos Mori polling last month found that 57% of people believe that the NHS’s ability to deliver the care and services it provides worsened over the last six months, up from 52% in January. One in four (24%) said it had got “much worse”, 33% “slightly worse”. Only 8% said “better”. The same proportion – 57% – were pessimistic about the NHS’s future. Asked how they expected it to fare in the next few years, 37% said “worse” and another 20% “much worse”; 21% said better.

The polling may reflect the NHS’s worst winter crisis in years. Record numbers of patients were forced to endure long waits – often on a trolley – and more than half of hospitals went on alert because they could not cope.

The over-75s were the only group in which more people thought the NHS would get better (41%) than worse (35%). Conservatives were less pessimistic (50%) than Labour voters (61%).

“This survey shows the public is realising that the NHS is buckling under the strain of meeting rising demand for services and maintaining standards of care,” said Chris Ham, chief executive of the King’s Fund health thinktank.

Chris Ham, chief executive of the King’s Fund health thinktank. Photograph: Frank Baron for the Guardian

A separate international study by Ipsos Mori found that Britons are more pessimistic about their healthcare system than people in 22 other countries. Almost half (47%) of Britons believe the quality of the healthcare they and their families can access will get worse in coming years.

However, Britons are also among the most positive internationally about the care they currently receive. Some 69% say that they and their family get good quality healthcare, well above the 47% seen across the 23 countries.

“Britain’s love for the NHS is one of our defining characteristics, and we remain among the most positive countries in the world about the quality of care we receive. But we’re also the most worried for the future of the service. This fear has been growing and is now at record levels”, said Kate Duxbury, Ipsos Mori’s head of healthcare research.

A spokesman for NHS England said: “It’s welcome news that a far higher proportion of people in Britain than in other countries rate the quality of their healthcare highly. And it’s noticeable that those people who use the NHS most and who therefore know most about it – the over-75s – are in fact the most optimistic about its future.”

He pointed to the very high scores recorded by 12 different types of NHS services in December under the “friends and family” ratings test. Dental care got the highest patient satisfaction rating, at 97%, while even the lowest scores – 86% for both A&E and mental health care – were still high.

Meanwhile, doctors and hospital bosses want some of the £700m-£1bn of extra government money expected to be given to social care in this week’s budget to be used to help cover the cost of “bed blocking”. They want to ensure that local councils do not use the cash to fill other holes in their budgets and ensure that any extra funding benefits both social care and the NHS.

The call has come from NHS Providers, which speaks for hospitals, and medical royal colleges representing A&E doctors, surgeons and hospital physicians. They want Philip Hammond, the chancellor, to make the money conditional on councils spending it on people who have had a spell in hospital, so that it reduces the 723,000 bed-days a year lost because patients who are medically fit to leave cannot be safely discharged for lack of social care support.

“If extra money is coming into social care it should either be spent on local authority packages of care or, if this doesn’t happen, on the alternative – the cost of keeping patients in hospital,” the four organisations said, in a joint statement to the Observer.

“Any solution to benefit NHS patients must be clear, simple and not capable of being manipulated. Local authorities would receive more funding if they support the NHS and less if they don’t.”

NHS poll finds public think service getting worse

New screening test cuts bowel cancer risk by a third, study finds

A one-off screening test being introduced across the NHS cuts the risk of developing bowel cancer by a third, a long-term study has found.

The test, which is being rolled out across England, will invite men and women to have bowel scope screening around the time of their 55th birthday.

This is in addition to the current test from the age of 60, the faecal occult blood test (FOB), which is posted to people’s homes.

FOB detects blood hidden in small samples of faeces, with further tests recommended if blood is detected.

Research published in the medical journal the Lancet has found that the bowel scope test reduces the risk of all cases of the cancer by a third. Experts predict it will save thousands of lives every year.

It works by threading a tiny camera attached to a thin flexible tube into the lower part of the bowel. As well as detecting tumours, it helps spot small growths, called polyps, on the bowel wall. If left untreated polyps can become cancerous, and any found during a bowel scope can usually be removed immediately.

Bowel scope screening will not detect cancers higher up in the bowel and patients may need a colonoscopy if they have persistent symptoms.

But the research found the new test was able to prevent 35% of bowel cancers overall and 40% of deaths.

In the lower bowel, the test prevented more than half of potential cancers from developing in that area.

Researchers from Imperial College London followed more than 170,000 people for 17 years on average, of whom more than 40,000 had the bowel scope test.

There are more than 41,000 new cases of bowel cancer every year in the UK, and about 16,000 deaths.

Prof Wendy Atkin, Cancer Research UK’s bowel screening expert and lead author at Imperial, said: “Although no screening test is perfect, this study shows that bowel scope is effective in reducing cancer deaths for at least 17 years.

“Bowel cancer can be prevented. And the bowel scope screening test is a great way to reduce the number of people diagnosed with the disease so it’s vital that no one misses out on the opportunity to get the test.”

Julie Sharp, Cancer Research UK’s head of health information, said: “Like other types of screening, bowel scope is meant for people without symptoms. It’s a great way to help reduce the number of people developing or dying from bowel cancer, but it can’t pick up everything.

“So it’s still important to take part in the rest of the bowel screening programme and not ignore the home testing kits when they arrive.”

The government estimates the bowel scope test will take at least another three years before it will be offered to everyone eligible across England. This is in order to train specialist staff to carry out the tests. Governments in Scotland, Wales and Northern Ireland have not yet committed to introducing the test.

The research was funded by the Medical Research Council and National Institute for Health Research. About half of bowel cancers occur in the lower part of the bowel and the rectum – the area covered by the bowel scope test.

The health secretary, Jeremy Hunt, said: “This report is really encouraging – prevention and early diagnosis are key to improving outcomes, and this new screening test could help us save thousands more lives.

“Cancer survival is at its highest rate ever, but more must be done: we are investing £300 million a year by 2020 to increase diagnostic capacity for all cancers, so we can save more from this devastating disease.”

New screening test cuts bowel cancer risk by a third, study finds

New screening test cuts bowel cancer risk by a third, study finds

A one-off screening test being introduced across the NHS cuts the risk of developing bowel cancer by a third, a long-term study has found.

The test, which is being rolled out across England, will invite men and women to have bowel scope screening around the time of their 55th birthday.

This is in addition to the current test from the age of 60, the faecal occult blood test (FOB), which is posted to people’s homes.

FOB detects blood hidden in small samples of faeces, with further tests recommended if blood is detected.

Research published in the medical journal the Lancet has found that the bowel scope test reduces the risk of all cases of the cancer by a third. Experts predict it will save thousands of lives every year.

It works by threading a tiny camera attached to a thin flexible tube into the lower part of the bowel. As well as detecting tumours, it helps spot small growths, called polyps, on the bowel wall. If left untreated polyps can become cancerous, and any found during a bowel scope can usually be removed immediately.

Bowel scope screening will not detect cancers higher up in the bowel and patients may need a colonoscopy if they have persistent symptoms.

But the research found the new test was able to prevent 35% of bowel cancers overall and 40% of deaths.

In the lower bowel, the test prevented more than half of potential cancers from developing in that area.

Researchers from Imperial College London followed more than 170,000 people for 17 years on average, of whom more than 40,000 had the bowel scope test.

There are more than 41,000 new cases of bowel cancer every year in the UK, and about 16,000 deaths.

Prof Wendy Atkin, Cancer Research UK’s bowel screening expert and lead author at Imperial, said: “Although no screening test is perfect, this study shows that bowel scope is effective in reducing cancer deaths for at least 17 years.

“Bowel cancer can be prevented. And the bowel scope screening test is a great way to reduce the number of people diagnosed with the disease so it’s vital that no one misses out on the opportunity to get the test.”

Julie Sharp, Cancer Research UK’s head of health information, said: “Like other types of screening, bowel scope is meant for people without symptoms. It’s a great way to help reduce the number of people developing or dying from bowel cancer, but it can’t pick up everything.

“So it’s still important to take part in the rest of the bowel screening programme and not ignore the home testing kits when they arrive.”

The government estimates the bowel scope test will take at least another three years before it will be offered to everyone eligible across England. This is in order to train specialist staff to carry out the tests. Governments in Scotland, Wales and Northern Ireland have not yet committed to introducing the test.

The research was funded by the Medical Research Council and National Institute for Health Research. About half of bowel cancers occur in the lower part of the bowel and the rectum – the area covered by the bowel scope test.

The health secretary, Jeremy Hunt, said: “This report is really encouraging – prevention and early diagnosis are key to improving outcomes, and this new screening test could help us save thousands more lives.

“Cancer survival is at its highest rate ever, but more must be done: we are investing £300 million a year by 2020 to increase diagnostic capacity for all cancers, so we can save more from this devastating disease.”

New screening test cuts bowel cancer risk by a third, study finds

Millions of premature births could be linked to air pollution, study finds

Air pollution could be a contributing factor in millions of premature births around the world each year, a new report has found.

Nearly 15 million babies are born annually before reaching 37 weeks gestation. Premature birth is the leading cause of death among children younger than five years old, and can cause lifelong learning disabilities, visual and hearing problems, the World Health Organization (WHO) reports.

Researchers for the Stockholm Environment Institute (SEI), the London School of Hygiene and Tropical Medicine and the University of Colorado, have concluded that as many as 3.4 million premature births across 183 countries could be associated with fine particulate matter, a common air pollutant, with sub-Saharan Africa, north Africa and south and east Asia most impacted by the issue.

“Preterm birth and associated conditions are one of the biggest killers of children in the US and worldwide,” said Dr Paul Jarris, chief medical officer at the March of Dimes, a US-based nonprofit focused on maternal and baby health. “Yet, there’s a lot of things we don’t know about what causes preterm birth, so every bit of information we can get is helpful.”

“We have known for a long time that air pollution contributes to asthma and heart disease in adults,” said Jarris. “What I think people fail to recognise is that so many of these risk factors impact babies before they are even born.”

Previous studies have looked at how effects of air pollution in utero might negatively impact babies’ birth weight, or the likelihood that they will be born early. SEI’s study, which examined data from 2010, attempted to calculate how those factors might influence the global rate of premature births.

“By showing in our study that 18% of preterm births are associated with air pollution, we are quantifying the health impacts of fine particulate matter on babies before they are born,” said Chris Malley, a researcher in SEI’s York Centre, at the University of York and lead author on the study.

Each year, around one in every 10 babies worldwide are born prematurely, according to the WHO. Africa and south Asia bear a disproportionate burden of premature births, accounting for 60% of all premature births globally. That region also dominated SEI’s report of premature birth associated with air pollution.

South Asia had the most preterm births associated with air pollution. Photograph: Harish Tyagi/EPA

SEI’s new report provides an estimate of potential birth impacts associated with air pollution, but the authors acknowledged that the study had considerable caveats because of a lack of research in some of the most affected areas.

This is one more reason why we need to be good stewards of the environment

Dr Paul Jarris

Still, two experts who reviewed the study called estimates “conservative”.

A number of factors have been identified in playing a part on premature birth, including poverty, infection, smoking and substance use, physical activity and maternal education. However, even with the report’s limitations, it is still one of the first to argue that reducing air pollution could also be effective in reducing premature births across the world.

Because of a lack of research in regions such as south and east Asia and Africa, researchers used studies conducted in the US and Europe to estimate global outdoor air pollution exposure.

Indoor cooking fires could play a larger role than the study allows for. “The exposure in Asia, and in part in say, China and India, to outdoor air pollution is significantly higher than outdoor air pollution in the US,” said Malley. “So that’s the other part of the uncertainty, that at these higher levels of exposure we don’t know whether this same relationship holds.”

The report focused on one kind of air pollution considered especially harmful to human health: fine particulate matter. This pollution is made up of tiny particles from a variety of emissions, such as diesel emissions and agricultural fires.

The particles, smaller than 2.5 micrometres in diameter, are considered harmful because they can lodge deep in the lungs, affecting the pulmonary and cardiovascular systems. Past studies have looked at these factors as ways that air pollution may impact preterm birth and low birth weight in babies.

South Asia had the most preterm births associated with particulate matter pollution – as many as 1.6 million associated births. Notably, even though China has a relatively low rate of preterm births, researchers found that as many as 521,000 preterm births could be associated with air pollution because of high concentrations of particulate matter.

A similar study conducted in the US found that air pollution had a costly impact on unborn children, estimating that the economic impacts cost $ 4.33bn in 2010.

Researchers said the estimates support their conclusion that “reduction of maternal [air pollution] exposure through emission reduction strategies should be considered alongside mitigation of other risk factors associated with preterm births.”

“This is one more reason why we need to be good stewards of the environment,” said Jarris. “The most vulnerable among us – unborn children – are affected, and really in a way that impacts families’ lives for generations.”

Guardian Cities is dedicating a week to exploring one of the worst preventable causes of death around the world: air pollution. Explore our coverage here and follow Guardian Cities on Twitter and Facebook to join the discussion

Millions of premature births could be linked to air pollution, study finds

Tens of thousands of new mothers can"t reach a midwife, study finds

Tens of thousands of new mothers a year are seeking help at an A&E unit or GP surgery because they cannot reach a midwife to ask them for advice, a new study has found.

Mothers worried about a problem with their own or their baby’s health are adding to the strain on family doctors, emergency departments and walk-in centres because of midwife shortages and because they have “nowhere else to go”, says the parenting charity the NCT – which undertook the research.

“It’s completely unacceptable that new mums have to get themselves to already fit-to-burst A&E departments,” said Elizabeth Duff, the NCT’s senior policy adviser. “The first weeks are challenging enough for parents without the added stress of waiting around for hours in casualty with their babies.”

The NCT estimates that around 37,000 women every year in England and Wales resort to accessing these services because NHS care in the six weeks after a baby’s birth is so “patchy”.

The NCT’s findings are contained in a survey it conducted alongside the National Federation of Women’s Institutes of 2,500 women who gave birth between 2014 and mid-2016. While women were mostly positive about their experiences, postnatal care emerged as a major concern, including not seeing a midwife as often as they would like soon after their delivery.

Overall, 18% said they did not have the access they wanted to a midwife. Of those, 29% – around 37,000 of the 700,000 women a year who give birth in England and Wales – said they went to a GP, A&E or walk-in centre instead.

Their main concerns were their baby not feeding properly (64%), their own emotional or mental wellbeing (50%), the healing of stitches or sutures (35%) and the healing of the scar from a caesarean section (18%).

“If the NHS provided better postnatal support, new parents would not be adding to the pressure on overburdened A&E departments and GP surgeries,” Duff said.

Almost 37,000 women went to a GP, A&E or a walk-in centre because they didn’t have access to a midwife between 2014 and mid-2016. Photograph: Lynne Cameron/PA

It was worrying that the same proportion of women who could not see a midwife as often as they wanted to postnatally had not improved since the NCT carried out a previous survey four years ago, Duff said. A&E staff and GPs do their best to help women in such circumstances but are not properly trained to help with problems such as those that concerned new mothers typically present with, she added.

One woman told the NCT how she felt obliged to go to her local A&E after her midwife did not come out and see her at home when her legs and feet became swollen, even though they were potential signs of deep vein thrombosis, which her own mother had suffered from after giving birth to her. Another said she had gone to A&E when she and her baby son were discharged too quickly after his birth even though he was not breastfeeding and he soon became dehydrated.

Cathy Warwick, chief executive of the Royal College of Midwives, criticised the NHS’s failure to allocate proper resources to postnatal care as a short-term policy that stored up more problems and longer-term costs.

“Underfunding and under-resourcing postnatal care not only puts pressure on other parts of the NHS, it also fails mothers and babies who may not be getting the care, support and advice they need,” she said. “I am hearing increasing reports of babies requiring readmission to hospital because of lack of breastfeeding support.

“It is also widely acknowledged how critical it is to have early detection of women who are suffering from mental health problems postnatally. Early intervention can prevent very serious problems for the mother as well as separation of mother and baby.”

A series of reports in recent years into weaknesses in postnatal care led to NHS England’s maternity care taskforce and Better Births report last year recommending improvements, including that women can contact a midwife in the weeks after the birth. However, Warwick warned that pressure on hospital maternity units and serious shortages of midwives meant that some midwives are being taken away from home visits to help out there.

NHS England declined to respond directly to the findings, but insisted that it was making progress on implementing the recommendations contained in Better Births.

“It is safer than ever to give birth in this country and the vast majority of mothers report that they received great NHS care,” a spokesman said.

“We are now working to implement the recommendations made by Better Births across the NHS including providing better postnatal care and access to a small team of midwives for continuity throughout the pregnancy, birth and postnatally, ensuring all women receive the best possible care.”

Case study

When Leigh Jerzeyszek, 33, gave birth to her first son, Charlie, last October, the baby didn’t take to breastfeeding at first.

“I’m a new mum, I’d never breastfed before, so I didn’t know what was happening and what was normal,” she said. “He was just very, very gentle, so I thought, this is easy.”

She asked the nurses for some help with breastfeeding, but didn’t receive help before being discharged, the day after giving birth. “For three days, Charlie had barely anything to drink, and every time I tried to breastfeed him he was distressed, like I was trying to poison him,” Jerzeyszek said.

Leigh Jerzyszek and Charlie. Photograph: Leigh Jerzyszek

“I thought, this can’t be right … he’s going to dehydrate if I don’t give him something, so I tried him with formula. He couldn’t latch to my breast, and he couldn’t latch to the normal teat of a bottle, either.”

Unlike many of the mothers in the NCT study, Jerzeyszek did have a visit from a midwife the day after being discharged, and the following day a healthcare visitor, who said she should tickle Charlie to make him try to eat. But it wasn’t until three days after she left the hospital, and becoming increasingly anxious about Charlie’s inability to feed, that she saw an infant feeding specialist.

“As soon as she saw him, she said, ‘get him to A&E, because that’s not a normal cry’,” said Jerzeyszek. “It was really whimpery, just no energy. She looked at his tummy and it was quite sunken. We went back to the hospital in a panic. No one in A&E could feed him.”

Charlie was tested for meningitis and sepsis, and was given lumbar punctures.

Jerzeyszek was exhausted, awash with postnatal hormones and terrified. “I went into the toilet and cried,” she said. “I hadn’t slept, this tiny, innocent little baby’s not feeding, it’s just really surreal.”

Charlie spent three nights in hospital being fed on a tube, as an ear, nose and throat specialist and eventually a speech therapist tried to work out why he wouldn’t feed. He ended up needing special teats until he was four months old.

“I was discharged too soon … they just basically didn’t check that Charlie was feeding properly,” Jerzeyszek said. Although she received frequent visits, “they just didn’t identify the problem … I would have thought as an experienced care professional, rather than thinking he doesn’t want it or he’s lazy, he actually couldn’t feed”.

She remains angry at the impact it had on her family in their very first week. “I think because at the time it’s all a whirlwind … you just deal with it,” Jerzeyszek said.

“But now that he’s settled, sometimes I get upset about it. There was a lot of trauma to him that could have been prevented if they’d only checked [his feeding] in the first place.”

As told to Alice Ross

Tens of thousands of new mothers can"t reach a midwife, study finds