Thursday, June 26, 2003

Driven to distraction

'Missing a call won't kill you; an accident quite possibly could.' So said UK transport minister David Jamieson, announcing legislation to ban the use of mobile phones while driving. 'Our decision to introduce this new offence will make the roads safer for us all', he said. According to research conducted by the Royal Society for the Prevention of Accidents (RoSPA), driving while using a mobile can increase the risk of an accident four-fold. Nineteen road deaths reported in the press in the period 1988 to 2001 were due to mobile phone use.

The truth is that nobody knows how many accidents are caused by drivers using mobile phones. It is worth differentiating relative risk from absolute risk. Road accidents, even quite minor ones, happen quite rarely for most drivers. In 2001, there was one fatal or serious accident for every 10million miles travelled. If drivers are four times more likely to have an accident when using a phone, that is still a small risk.

Another study conducted in the USA, and quoted by RoSPA, looks at the small number of crashes - eight percent - that are caused by driver distraction. An object or person outside the car is blamed for about 29 percent of such accidents; fiddling with the car stereo accounts for about 11 percent; and being distracted by other passengers for 10 percent. Mobile phones account for 1.5 percent of these accidents, which means that even if this research could be extrapolated to all drivers in the UK, mobile phones would cause just 0.12 percent of the total number of accidents. On this basis, if the government was really keen to reduce accidents, it would ban car stereos, which apparently cause eight times as many accidents as mobile phones do.

Such a law isn't even necessary. If someone causes an accident while distracted by a phone call, they can be charged with careless driving. This is not about actually reducing accidents but responding to the minor irritations of life with the sledgehammer of law. If we start banning every form of stupid behaviour, we'll end up getting nowhere at all.

Road-safety groups welcome ban on hand-held mobile phone use in car, Scotsman, 25 June 2003
The risk of using a mobile phone while driving, RoSPA [pdf, 255KB]
Fatal and serious road accident rates, Office of National Statistics [Excel format]


Perhaps this could be a new term for someone who is obsessed with weight as a public health problem... just a thought.

In this vein, BBC News reports on a proposal to produce a 'polypill' of different drugs that could be given to everyone over 55 to reduce their risks of suffering a heart attack, stroke etc. While the whole idea seems like a good wheeze for drug companies, nonetheless it may have some merit.

What is interesting is the reaction of the health campaigners. Sir Charles George of the British Heart Foundation is quoted as saying. 'There is no doubt that the idea of a "pill for all ills" is enticing but whether we like it or not the rising tide of obesity, inactivity, diabetes and continued smoking rates cannot be ignored. A 'polypill' should never be a licence for people to lead unhealthy lifestyles - known risk factors will always compete with progress in medicine and can lead to other debilitating conditions such as cancer, arthritis, and bronchitis.'

No. Apart from smoking, the evidence supporting the effect of the other factors mentioned is still contentious. Wouldn't the whole point of such a pill be that we can eat, drink and be merry, and live longer in the process. In fact, isn't that what doctors are for?

'Miracle heart pill' for all, BBC News, 26 June 2003

Tuesday, June 24, 2003

Interview with Greg Critser

I interviewed him for an article I've written for spiked last Friday. I've published the transcript here.

Essentially, my view of this book has changed quite a lot while thinking about it. At first, my main criticism of it was that there it was a bit of a 'dog's dinner'. That is, it tried to include every possible reason why obesity has been on the increase in America rather than giving a considered analysis of what was important, and what was not. To that extent, the book is all things to all men.

However, on reflection, and with a bit more research, I've realised that the 'obesity epidemic' is overstated. While there seems to be an increased risk of certain chronic diseases associated with obesity, the nature of the relationship is still not clear. For example, it is assumed that obesity causes, for example, heart disease. But perhaps a feeble heart tends to discourage people from exercising, hence causing them to be fatter on average. Or, as some researchers have pointed out, maybe the key factor is fitness. Fit, fat people have less heart disease than unfit, thin people. Maybe the determining factor is that fat people tend not to exercise.

What is clear is that obesity is a major risk factor for younger people - when they are unlikely to die, no matter how fat they are - and less so in older people, where age is a much more important factor. More importantly, life expectancy continues to rise in developed countries. In the great scheme of things, being overweight isn't that big a problem.

The only illness where the obesity-disease link strongly suggests that obesity may be the cause is type II diabetes, as far as I can tell.

Sunday, June 22, 2003

Shared reading

Today, I'm starting a new series of articles, which are basically just notes on books that I'm reading. It helps me, because I know where to find the notes, and it may be of assistance to others.

The first book is James Le Fanu's The Rise and Fall of Modern Medicine