(10f) Have certain scientists become too scared of science?

In the UK, the Royal College of Obstetricians and Gynaecologists published a list informing pregnant women, their husbands and everyone who is interested what (not) to eat and which products to avoid to prevent harm to the unborn child. Of course, it is a noble thing to advice pregnant women against smoking or drinking (too much) or using pesticides or suggesting to see a doctor before taking medicines to be sure they can't harm the foetus, without exaggerating and refusing even life-saving medicines.

The article starts with the notion that for a large part women determine the future of their unborn child and should be careful with certain molecules. They also mention it is a complex matter because often the effects of many individual molecules are not completely known or at what concentration they become dangerous, let alone the effect of the cocktail of chemicals we take in on a daily basis. The article recognises the effects are generally small while some cited studies show no association between chemical exposure and disease. The article is quite well-written with examples to illustrate the complexity but also describes measures taken to protect the public (e.g. DDT has been banned as a pesticide ones its dangers became obvious and has been replaced with less harmful products, with instruction on its use so that when the food is sold on the markets it is save to eat). But I think that the article ends on a bad note. Because, although they acknowledge it is complex, they list a number of steps to reduce overall chemical exposure while admitting that it is unlikely any are harmful for the unborn baby. And then I fear that when scientists become too scared of what they invented (amongst the advice given to pregnant women is to avoid using toiletries (of course, too much is never good) and to avoid processed food or even new cars), then their advice starts to become worthless as they join a certain public that is scared of science and the latter may even use the article to proof they were right to condemn many useful things. As a consequence, the public may no longer accept the advice of experts when they may decide experts have lost commonsense. On the other hand, such a list may stimulate companies to develop even less harmful products.

Although I understand why this is happening. Firstly, out of a real concern that certain products may harm and thus should be avoided. Indeed, some products can harm and thus it is to protect the public.

But I think a second reason may be because when scientists and health professionals continuously fear that people may sue them whenever something goes wrong, then rules and guidelines may become too general or restrictive so the responsibilities are no longer with the professionals but with the users when they continue to use the listed products against the experts' advice. I think one should be specific and not be to general when writing down warnings because otherwise too little flexibility is left to use products as everything become unsafe. Therefore, I think the article is good to inform the public about the difficulties experts face to decide whether products are save or not while the list should have been a work document for specialists as a guide. But when lawyers prostitute themselves on streets outside hospitals where they sell their services to vulnerable people who might have lost a relative, when they try to convince people to sue health professionals for possible errors they made while trying to save someone's life, then health professionals will react to protect themselves against those bullies. Although, when something goes wrong, health professionals should acknowledge they can make mistakes and when errors happen than the correct actions should be taken (e.g. pay compensation, recheck the procedure) while if a person couldn't be saved because e.g. he/she responded differently to a treatment than expected (maybe because of an underlying undiscovered illness), then this should be explained and lessons should be learnt to avoid something similar may happen again in future. Openness often softens anger although there will always be people who will sue. Lawyers too should be fair during trials, not only think about winning even when that means the career of a person who tried to save someone's life is over or even ends up in prison.

E.g. the list warns pregnant women not to use shower gels while everyone should know by now that good hygiene saved millions of lives and that in lesser developed countries many women still die while giving birth because of unhygienic conditions. The list also advises that the use of non-stick frying pans should be minimised. But how much evidence is there children over the past decades were born with birth defects because their mother used such a pan? While eating burned food because an ordinary pan was used may be more questionable as certain molecules are formed that may cause cancer. And should we avoid sun creams on children because we fear some chemicals may be present and as a result expose children unprotected to the dangers of the sun or keep them inside during the summer (of course, children should avoid the midday sun because too dangerous)? Indeed, as the article states, it is a complex matter, even for experts.

As can be read in the Guardian (08/06/2013), I am not the only person criticising the list: Dame Sally Davies (UK government's chief medical officer) said some recommendations went to an absurd point with unrealistic and unnecessary suggestions such as avoiding shower gels. She claims some recommendations may increase anxiety and confusion and even mistrust of longstanding advice about drinking and smoking.

Also Dr John Harrison (director of PHE's centre for radiation, chemical and environmental hazards) and Tracy Brown (managing director of Sense About Science) agree that although there are useful warnings for pregnant women on the list about certain chemicals (e.g. avoid paint fumes), others are not. I agree that when something is considered unsafe it should be mentioned so the public is informed about its possible dangers and about its correct use (e.g. moderate drinking) but one should remain realistic. Although, the paper is more balanced than one thinks from reading newspapers.

If certain shower gels are harmful for the unborn baby, then this should be mentioned on the packaging of the concerned products and maybe they should no longer be allowed to be sold, certainly when safer products exist. But it is not good to condemn all gels as possible harmful as most if not all women who used shower gels during pregnancy delivered healthy babies and thus the advice becomes ridiculous. While maybe it may be useful to warn against the use of (too much) deodorants as these are much more concentrated.  Indeed, the above mentioned women say the article is "safety first" gone to far. As a consequence, other more useful advice may also be ignored as nonsense or disappear in the long list such as the correct advice that pregnant women should avoid contact with pesticides and fungicides as indeed these products contain molecules that are intended to kill damaging organisms and thus are potentially dangerous, even for adults. When pesticides are needed for pest control, others should use them correctly. Or women may ignore the advice against using alcohol and smoking while there is sufficient evidence they are harmful. Although, I think many women and men now accept the dangers of these two products.

While some women may ridicule the list, others may start worrying too much and e.g. stop eating vegetables because they fear pesticides were used or they were canned and as a result some foetuses may not receive all necessary nutrients such as vitamins. Of course, fresh vegetables are better than processed ones and mostly preferred (e.g. taste is better), but one has to ask the question why certain people still eat processed food. Maybe they can't afford anything else. Or I read ones a story about a woman taking antidepressants to treat post-pregnant depression who read they are released via breast milk and to avoid exposing her child to them (thus she tried to protect the baby), she stopped taking the essential medicines (instead of stopping breast feeding). As a result, she killed her child during a moment of madness. I am not claiming this should not be mentioned in leaflets, but doctors should inform their patients and thus reduce their worries.

Indeed, the pressure from society on pregnant women may become even larger after the publication of the list when they eat certain food that is considered unsafe and thus women may follow the list to avoid being called bad mothers. E.g. already mothers who do not breastfeed are considered bad mothers in some societies while maybe these women don't produce enough milk to feed the child or takes medicines.

We live in a time when never before so many people became old, when food was never as save as today with its strict rules and control (although these controls may go down during the crisis because of limited budgets) concerning production and the development of safer pesticides. And although we live longer than ever, we fear death as never before and start to exaggerate demanding too much control because errors will be punished. While being too protective can also kills.

We are becoming like people with anorexia who fear becoming fat, therefore exercising too much and eating too little, sometimes shortening their life with many years unless they receive help.

It is indeed the duty of scientists to investigate the safety of the products we use and invent ever safer products to replace products that are less safe. But scientists should not join those who scare everyone about everything because than our safety may be in danger. Then we may end up as in Italy: because a judge condemned scientists for not adequately predicting an earthquake while another scientist was correct, now after each small tremble scientists warn people to leave their homes. As a result, people may get tired of listening to false warnings and having to leave their home each time. Then one day people may no longer take the scientists serious and ignore warnings that almost certainly a major earthquake may follow. They may stay in their homes and thus a major earthquake may kill many. Therefore, scientists should explain people that certain things can be dangerous but are investigated but we still don't know everything and thus there is an uncertainty while rulers should listen although they should investigate whether scientists made errors that could be avoided. In Italy for instance, some claim the scientists reassured the public, playing down the risk of a quake after a number of tremors while correct information during quakes is: if the earth moves, go out of the house if possible, otherwise hid under a table or door frame to prevent things falling on you.

It is similar for abortion: forbid abortion in all circumstances and women die because life-saving abortions are denied or women go for an illegal abortion while allow experts some freedom and lives can be saved. But experts should also explain (inform) with examples why they believe abortion is sometimes necessary because if they join those who oppose than who can educate and change society for the better?

If scientists become too precautious and ban too many things, then people will find it elsewhere, e.g. via the internet. An example are painkillers. Certain painkillers are available over the counter by pharmacists while stronger and sometimes more addictive ones are only available on prescription by a doctor. Thus, a headache after a night out can be softened without seeing a doctor while strong or lasting pain forces people to see a doctor so stronger painkillers can be described. As a result, doctors can investigate the origins of the pain, maybe discover an illness and try to cure the illness and not its symptoms (i.e. pain). However, when all painkillers become on prescription, than doctors will become overworked, the system too expensive while many people will start buying products over the internet, increasing the risk as many of these products may be produced out of the control of regulatory agencies.

In conclusion, warning people about the dangers of products is a noble thing to do but should remain within reason. Sometimes it is better to avoid taking a risk than not in case of for instance pesticides. But when over decades no risk has been seen with the use of certain products, than it becomes absurd to think one should first know the potential risk before people should be allowed to use the products although that doesn't mean it is forbidden to develop even safer products. Because there will always be a certain amount of risk taking in our lives, whatever precautions we may take. And to avoid boredom (e.g. climb a mountain).

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