Thursday, July 07, 2016

Do Johnson products cause cancer ? Here is what the evidence says ...


Doubt with the Bathwater

Johnson & Johnson reformulated their shampoo to remove formaldehyde, but that occurred years ago and was based on consumers' unrealistic fears of chemicals.


Claim:   Johnson & Johnson admitted their products contain "cancer-causing formaldehyde" in August 2015.
   MOSTLY FALSE
WHAT'S TRUE:   In January 2014, Johnson & Johnson products announced the completion of product reformulation to remove formaldehyde due to consumer fears.
WHAT'S FALSE:   The level of formaldehyde contained in shampoo has been proved to pose a cancer danger to humans.
Example:   [Collected via e-mail, September 2015]
Just saw this on Facebook: Johnson & Johnson Admits: Our Baby Products Contain Cancer Causing Formaldehyde. I am having a hard time
believing this.
It has been posted on healthnutnews.com that Johnson & Johnson has admitted that there baby products contain carcinogenic chemicals. Is
this true? Thank you!
Origins:   On 14 August 2015, the blog Healthy Food House published an article titled "Johnson & Johnson Admits: Our Baby Products Contain Cancer-Causing Formaldehyde" that claimed:
Although the company claims that the amount of formaldehyde isn’t large enough to be detrimental to humans — even infant humans — the fact is that it still has allowed this chemical for as long as they have been making the No More Tears shampoo.
But now, the company has announced the removal of formaldehyde from that shampoo and they are removing it from one hundred other products that they manufacture as well.
It could be seen as a sign of good intentions that the company is removing it from their products.But the real question is: why hasn’t it been removed before now?
Actually, the "real question" about removing formaldehyde from their shampoo products had been addressed by Johnson & Johnson nearly two years earlier, as noted in a 17 January 2014 New York Timesarticle titled "The 'No More Tears' Shampoo, Now with No Formaldehyde":
What’s different about the shampoo, and 100 other baby products sold by Johnson & Johnson, isn’t so much about what’s been added; it’s what’s missing. The products no longer contain two potentially harmful chemicals, formaldehyde and 1,4-dioxane, that have come under increasing scrutiny by consumers and environmental groups.
In response to consumer pressure two years ago, the company pledged to remove both chemicals from its baby products by the end of 2013, and this month, it said that it had met that goal. The reformulated products are making their way to store shelves around the world and will replace existing products over the next several months.
The push for removing formaldehyde to which the Times referred was not a recent occurrence: it had occurred as early as 2012, according to a Scientific American article. Moreover, Johnson & Johnson expressed at the time that the reason behind their reformulation was entirely rooted in implicitly baseless consumer fears:
Johnson & Johnson pledged last August [2012] to eliminate formaldehyde, parabens, triclosan and phthalates from all baby products. For adult products, it has removed triclosan and phthalates, but will keep using three parabens, and use formaldehyde in exceptional cases where other preservatives wouldn't work, according to the company’s new policy.
Driving Johnson & Johnson's initiative is the consumer. In recent years, its customers have been asking questions about chemicals in the products, said Samantha Lucas, a corporate spokeswoman, in an interview from its New Brunswick, N.J., headquarters.
"We've been replying with evidence of the science that ensures safety. Now we have to go beyond science and be responsive to our consumers because it's really about their peace of mind,” she said.
A 3 March 2014 Slate piece on "chemophobia" titled "No More Formaldehyde Baby Shampoo: How Chemophobia Made Johnson & Johnson Reformulate Its Product" examined how social media users spread outsized fears about common and non-harmful ingredients:
So why did Johnson & Johnson remove quaternium-15 if it’s safe? ... [E]very minute of every day on every inch of this planet, formaldehyde is all around you and inside you. Always.
Yet we’re not all dropping dead from cancer. That’s thanks to one of the most fundamental principles of toxicology: The dose makes the poison. “Unfortunately, all molecules are potentially toxic,” says American University chemist Matthew Hartings. “Toxicity is not just about the molecule but is about both the molecule and its concentration.”
The concern about formaldehyde in personal care products reveals a bit of chemophobia, which Dartmouth chemistry professor Gordon Gribble defines as “an irrational fear of chemicals based on ignorance of the facts.” He says, “people don’t know how small molecules are, and they believe that single molecules of some chemical pose a health threat.”
The article also noted that formaldehyde occurs naturally in fruits and vegetables, and that any link between formaldehyde and cancer hinged on exposure that included inhalation and involved both long-term and large-quantity usage:
In fact, the only studies that link formaldehyde to cancer are related to humans inhaling it, and inhaling large amounts of it. Funeral industry professionals with more than 34 years of experience or who had performed more than 500 embalmings and factory workers who spent years working around formaldehyde before the 1990s had higher risks for leukemia and Hodgkin’s lymphoma. The amount of exposure required to cause cancer is so high that other studies of factory workers have been inconclusive.
Formaldehyde occurs naturally in common fruits and vegetables (even organic ones). “Unless people calling for removal of quaternium-15 are also keeping their children from eating apples and french fries,” Hartings says, “I think their activism might be misplaced.”
Finally, a larger point of diminishing returns exists when it comes to "chemicals" (primarily of the preservative type) and consumer safety. Personal care products formulated without the use of common preservatives are not without attendant health risks of their own, as grooming formulations of that type are more susceptible to becoming compromised (such as by the growth of mold) in the absence preservatives.
So while it's true Johnson & Johnson reformulated its products due to growing consumer "chemophobia," the decision was driven by a marketing initiative and not a proven health safety issue. Moreover, the reformulations were announced in 2012 and completed in late 2013; they were not at all recent by September 2015.
LAST UPDATED: 29 January 2016
ORIGINALLY PUBLISHED: 18 September 2015

Friday, June 10, 2016

Vaccination FAQs - Which Immunization schedule to follow in India ?


Dear Concerns,
What is the standard vaccination chart to be followed for the child, as i have seen many hospital have there own vaccination chart than others.
Please help

Ans. You are quite correct in asking this question. Unlike other developed countries, we do not have a single publicized schedule . Also the govt schedule does not provide comprehnsive protection for everyone.
The recommended schedule is from IAP - Indian Academy of Pediatrics - the official body of the Pediatricians in India. This is issued yearly. 
This is the schedule recommended in 2014.
http://www.iapindia.org/page.php?id=129

And this is the latest guidelines issued for 2015
http://www.indianpediatrics.net/oct2014/785.pdf

There are no recommendations for 2016 as yet.

Warm regards
Dr Gupta

Monday, June 06, 2016

Ethical Dilemma, A Battle Between Clinical And Emotional Soul - challenges faced by doctors daily in clinical practice

(requires free registration, for doctors only)


We often talk about the medical ethics or ethical clinical practice that should be the hallmark of a "good" physician. Did we ever think that how many dilemmas a clinician may face while implementing those ethical aspects in their practice? This article tries to list out some big ethical dilemma a clinician face at some pint of their life.   Reporting an incompetent or impaired colleague If a physician colleague of yours is impaired, like sick, alcohol or drug addicted or is no longer competent to do surgery or treating a critically ill patient and still he/she is refusing your help, what should be the right step? Should you report it to concerned authority, like the medical council or your employer? Patient confidentiality and your clinical conscience When one-half of a couple is HIV positive and the other half doesn't know, how should a physician handle such situation? Should he still bother about the confidentiality of patient data or reveal it to the other half of the couple, so that a fast and effective treatment can be started. Prolonging futile care for a dying patient Many times you find it futile to give a life-sustaining therapy but you need to prolong such therapy due to different kinds of associated pressure. Similarly, many times you find that there is a pressure from patient’s family to halt the life support when you still think it is premature. It raises the everlasting dilemma of legalizing the physician-assisted termination of life. Whether to honor a family's request not to tell a relative that he/she has a terminal illness It is really a conflict between your medical ethics and emotional demand of patient’s family that torn the doctor apart mentally. Sometimes, it is the physician who himself decided not to reveal the fact to the patient to bolster his confidence. Exaggerating a patient's condition to get insurance coverage The patient often demands an exaggerated and falsified note from a doctor about his/her condition to get a higher insurance coverage or to get a medical leave from the employer. Treating a family member or friend This dilemma has been discussed earlier in this platform too and received a mixed opinion. However, most of the doctors opined that doctor should perform their duty irrespective of his relation with the patients. Still the other opinion also surfaced out. The emotional attachment, conflict of financial interest, or fear of failure of treatment keep the doctor in a dilemma to treat his family and friends. Placebo or defensive medicine Did not it happen ever that your patient got dissatisfied as you did not write a medicine for him/her? Would you consider writing a placebo for the patient? Studies says placebo works on many occasions. Still it remains a physician’s personal choice whether to satisfy with a placebo or just denying straight on his face. Being in a Romantic or physical relationship with patient An international survey reported that physicians generally tend to avoid a relationship with his/her patient beyond clinical periphery. However, a loss of such restriction may put both the patient and doctor into a great dilemma. The same survey reported a section of doctor have no objection to get emotionally involved with the patients after a certain period of time such as 6-8 months post completion of treatment, but never during the tenure of treatment. It has become a trend to recommending a diagnostic test or treatment or even surgery that is not necessarily the best option for the patient, but an option that mainly serves the function to protect the physician against the patient as the potential plaintiff. As patient can sue the doctor for delayed or under-diagnosis but never for over-diagnosing. Besides the points mentioned above, there can be many other ethical issues that leave a doctor indecisive in his practice such as treating a non-paying or underpaying patient, hiding a medical error that won't affect the treatment outcome and much more. However, the decision making is highly relative and depends on the particular situation and obviously on the moral, confidence and experience of the individual physician. What is the toughest ethical dilemma you have faced in your practice?


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