Respectful Insolence

Wendy, I’m home.

Oh, wait a minute. I’m not that crazy. Yet.

Sometimes, though, it does seem as though the constant barrage of quackery, anti-vaccine pseudoscience, and pseudoscience in general might drive me to become like poor Jack Torrence of the Stephen King novel and movie The Shining. Fortunately for me, I discovered that there really are people out there who share my passion for science and reason and my dislike of woo. Unfortunately, I waited several years before venturing forth to gatherings of like-minded (and sometimes not-so-like-minded) skeptics to meet people in person and start to do something more than just blog. Don’t get me wrong, blogging is something I love to do, and somehow through it I’ve managed–gasp!–to become fairly popular in the medical blogosphere. But something was missing, and that something was the human touch, the fun of face-to-face wrangling and sometimes arguing with my fellow skeptics. It’s also opened the door to other opportunities, including giving talks and interviews.

So, after coming home from Vegas last night, I was all fired up. I wanted to take a scientific paper or issue and do an in depth discussion. Unfortunately, my trip home wasn’t exactly smooth. Not only was the flight late because of a mechanical problem with the emergency slide on one door, which ended up having to be replaced, but then a passenger became ill, provoking one of those dreaded requests of, “Is there a doctor on the plane?” Fortunately, there were, including me, and, even better, there was a physician who was more suited than I to handle the nature of the medical problem the passenger had. Then, as we approached the airport, we had to go into a holding pattern for a while because there were storms going through. Then after landing we got to drive for a while through a torrential downpour, only to see that our lawn was all trashed, thanks to the incompetence of our lawn service. So by the time I got home the spirit was willing but…well, the spirit wasn’t all that willing anymore because I was so damned tired.

It’s a good thing there’s always Mike Adams to provide me with blogging material that’s so brain dead, so monumentally full of flaming stupid, that it requires no effort to deconstruct. Slumming? Yeah, this time I guess so, but I hope you’ll forgive me just this once.

As if I won’t do it again sometime when the situation demands.

In any case, while I was on the plane, everyone’s favorite Quackmeister Supreme, second in line only to Joe Mercola for the regular promotion of pure quackery on the Internet, Mike Adams, dropped a steaming, stinking, Ecuadorian jungle turd on his website entitled Pharmacists give themselves cancer from dispensing toxic chemotherapy chemicals. It’s beyond a black hole of stupid, sucking all science, reason, and intelligence out of the surrounding sector of space. In fact, intellectually speaking it’s the equivalent of the collapse of all matter in the universe back into the singularity from which it emerged. Adams begins, as usual, with a lie. Actually, it’s either pure delusion or a lie; I have a hard time telling the difference with Adams:

One of the side effects of chemotherapy is, ironically, cancer. The cancer doctors don’t say much about it, but it’s printed right on the chemo drug warning labels (in small print, of course). If you go into a cancer treatment clinic with one type of cancer, and you allow yourself to be injected with chemotherapy chemicals, you will often develop a second type of cancer as a result. Your oncologist will often claim to have successfully treated your first cancer even while you develop a second or third cancer directly caused by the chemo used to treat the original cancer.

There’s nothing like cancer-causing chemotherapy to boost repeat business, huh?

Yes, the stupid definitely burns. It brands those who read it with a big red “S” across the chest. Meanwhile, Adams must have been branded with a big read “S” on his forehead. Either that, or a big read “L” for liar. For one thing, oncologists don’t “hide” the risks of chemotherapy, including the possibility of secondary malignancies. Second, it’s not “often” that cancer patients develop secondary malignancies attributable to chemotherapy (or radiation therapy, for that matter). In fact, if you search PubMed for “secondary malignancy chemotherapy,” you’ll find over 8,000 references. For the most part, the risk of secondary malignancies attributable to chemotherapy is a problem with the treatment of childhood malignancies. Saying so is not in any way meant to downplay the risk, but here’s something that needs to be remembered. These children would die of their disease without treatment. With treatment, they have an 80% or better chance of surviving, but one of the risks of surviving is a small risk of a secondary malignancy. It’s a tradeoff, I daresay, that any parent would accept for her child. Even in adults, where for some cancers the benefits of chemotherapy are more modest (but nonetheless real), again it’s often a very reasonable tradeoff: Survival now for the price of a small risk of a secondary malignancy 20 years from now.

Of course, reason and subtleties were never Mike Adams’ strong points, as he demonstrates by abusing the case of Sue Crump, a pharmacist who handled chemotherapy drugs and ultimately developed pancreatic cancer and died. Hers is a very, very sad case. There’s no doubt about it. It truly sucks that she died prematurely of pancreatic cancer. However, this is a classic case of correlation not necessarily equaling causation. It is possible that Crump’s pancreatic cancer might have been due to her occupational exposure to chemotherapeutic drugs, but it is more likely that it was not, given that the risk factors for pancreatic cancer are fairly well known, including chronic pancreatitis, smoking, family history, and some other factors. As is the case with many cancers, most patients with pancreatic cancer don’t have any identifiable risk factors.

Now here’s where Adams makes an astonishing claim:

The Occupational Safety and Health Association (OSHA), it turns out, does not regulate workplace exposure to toxic, cancer-causing chemotherapy chemicals. At first glance, that seems surprising, since OSHA regulates workplace exposure to far less harmful chemicals. Why not chemo?

Quite simply, this is not true. There are most definitely guidelines in the U.S. for the safe preparation, dispensing, and administration of hazardous medications coming from the National Institute for Occupational Safety and Health (NIOSH), American Society of Health-System Pharmacists (ASHP), Oncology Nursing Society (ONS), and Occupational Safety and Health Administration (OSHA). In fact, OSHA has rather detailed section in its technical manual entitled Controlling Occupational Exposure to Hazardous Drugs that encludes extensive guidelines for handling and preparing chemotherapy drugs, as well as cleaning up spills when they occur. Of course, Mike Adams is lying, as usual. Even the primary source that he uses to claim that OSHA “does not regulate” exposure to chemotherapy drugs states that it in fact does. The problem, if the article is to be believed, is that OSHA may not be stringent or aggressive enough in doing so. In fact, this source even quotes Deputy Assistant Secretary of Labor for OSHA Jordan Barab:

Deputy Assistant Secretary of Labor for OSHA Jordan Barab said in written response to questions from InvestigateWest that the agency doesn’t have resources to regulate workplace drug exposures, although it is concerned about the issue. “Although this is an important safety and health issue, OSHA has not considered a standard to specifically address hazardous drugs in the healthcare setting,” he wrote.

This may be a real problem, but it seems to be more due to lack of resources than the reason Adams invokes:

The answer is because the toxicity of chemotherapy has long been ignored by virtually everyone in medicine and the federal government. It has always been assumed harmless or even “safe” just because it’s used as a kind of far-fetched “medicine” to treat cancer. This, despite the fact that chemotherapy is a derivative of the mustard gas used against enemy soldiers in World War I. Truthfully, chemotherapy has more in common with chemicals weapons than any legitimate medicine.

No, chemotherapy has not been assumed to be “harmless” or “safe” for workers to prepare. That’s just Mike Adams’ fantasy view. He’s also either incredibly ignorant or intentionally inflammatory when he states that chemotherapy is a derivative of mustard gas. Some chemotherapy is, such as cyclophosphamide, and melphalan), but these days most chemotherapy is not. Not even close. Adams, as is usual with him, is simply using the scariest language he can come up with to demonize chemotherapy. Language like this:

The cancer industry, though, has never stopped injecting patients long enough to ask the commonsense question: Why are we in the business of dispensing poison in the first place? Poison, after all, isn’t medicine. Not when dispensed in its full potency, anyway.

The whole idea of “safety” in the cancer industry is to find new ways to protect the health care workers from the extremely dangerous chemicals they’re still injecting into the bodies of patients. Something is clearly wrong with this picture… if health care workers need to be protected from this stuff, why not protect the patients from it, too?

The reason we dispense “poison” to cancer patients is because it works. We know it works through science and clincial trials. Interestingly, though, I see something from Adams that I’ve never seen before in this passage. Note how he actually qualifies his usual “chemotherapy is poison” rant. Believe it or not, Adams seems to show an actual recognition that the dose makes the poison when he says, “Poison, after all, isn’t medicine. Not when dispensed in its full potency, anyway.”

Well, duh! This is something every physician knows. All drugs are in essence poisons; it is the dose that determines whether they are ineffective, therapeutic, or toxic. It’s something so simple that it’s taught the first day of medical school, but coming from Adams it seems revelatory. Well, not really. It just seems a shockingly nearly sane addendum to a sentence full of Adams’ usual anti-medicine craziness. Too bad Adams then moves on to this:

In contrast to all this, consider the truthful observation that no naturopath ever died from handling medicinal herb, homeopathy remedies or nutritional supplements. These natural therapies are good for patients, and as a bonus, you don’t have to wear a chemical suit to handle them.

Furthermore, medicinal herbs, supplements and natural remedies don’t cause cancer. They support and protect the immune system rather than destroying it. So they make patients healthier and more resilient rather than weaker and fragile.

Of course, homeopathy is safe. It’s water. It would be very unusual for a homeopath to be poisoned by water. As for medicinal herbs, not all of them are entirely benign. In fact, some of them can be quite dangerous, such as the foxglove plant. In fact, many of these horrifically “toxic” chemotherapy agents come from natural plants, drugs such as vincristine, Taxol, campothecin, irinotecan. These are powerful drugs from nature itself, and they have powerful effects. If you’re going to handle water or herbs without any demonstrable effects against cancer, you’re unlikely to be harmed, but you’re also unlikely to help cancer patients. I wish it were otherwise, but it isn’t, Adams’ rants otherwise notwitstanding. And, not surprisingly, Adams ignores the fact that “natural” products can be deadly, as a recent story from China demonstrates.

One thing that Adams does that drives me crazy is to cite various studies without any names of investigators or citations. I did a brief attempt to look a couple of them up, but I got tired and decided that I’d try again later. Even if the results of all of these studies were accurate, then what it would argue for is not giving up the use of chemotherapy, as Adams rants, but stricter regulations governing workplace safety where chemotherapeutic agents are prepared and administered. Adams doesn’t see that because he’s too busy using this story as an excuse to engenge in one of his patented tirades against the “cancer industry.” He even calls the cancer industry “quackery,” and yet another one of my irony meters died in flames, as Adams regurgitated the long-debunked myth promoted by cancer quacks that chemotherapy only benefits 2% of cancer patients. I’ve discussed this particular myth in detail before; so there’s no need to rehash it now. It’s one of those unsinkable rubber ducks of myths that no amount of debunking seems to kill. No wonder Adams can say things as mind-meltingly dumb as:

This is not an idle question. It is perhaps the most important question of all for someone considering conventional cancer treatment using chemotherapy. The question is essentially this: If chemotherapy causes cancer, how can it treat cancer?

One can’t resist asking homeopaths how like cures like. I know, I know, homeopathy is nonsense and this argument doesn’t prove anything, but, given that Adams believes in homeopathy, it’s hard not to ask in this context. But that isn’t the funniest thing that Adams spews. This is:

Treating cancer with chemotherapy is like treating alcoholism with vodka. It’s like treating heart disease with cheese, or like treating diabetes with high-fructose corn syrup. Cancer cannot be cured by the very thing that causes it.

Homeopathy. I know. I can’t help it, and I know that chemotherapy doesn’t work like homeopathy. It consists of actual drugs whose mechanisms are grounded in science, not sympathetic magic. Adams, however, just can’t see how his claim that cancer drugs can’t possibly work because they “cause” cancer (which they only do a very small percentage of the time) doesn’t exactly jibe with his belief in homeopathy, but then consistency never was part of Adams’ message other than consistent hatred of “conventional” medicine coupled with neuron-apoptosing ignorance.

Here’s where Adams gets vile (big surprise):

And to those who deal in poison, watch out for the cause-and-effect laws of biology. If you deal in chemotherapy chemicals, don’t be surprised if you get cancer one day. If you deal in chemical pesticides, don’t be surprised if you get Alzheimer’s. If you’re a dentist installing mercury fillings in the mouths of clients, don’t be surprised if one day you just go stark raving mad (because mercury causes insanity, and dentists breathe in mercury vapor thrown into the air from their drills).

If you work around chemicals, they will eventually impact your health, and never in a good way. There’s a karmic element in all this, too: If you spend your life dishing out chemotherapy drugs as a pharmacist, you have a lot to answer for. You have been an enabler of a very real chemical holocaust against the people. Don’t be surprised if that holocaust turns against you one day. Karma tends to work that way. Cause and effect is a universal law that cannot be escaped.

Funny Adams should invoke karma. Karma’s a bitch, and if karma exists it would see to it that Mike Adams gets cancer himself, a treatable, potentially curable cancer (with science-based oncology, of course). Then karma, if it existed, would make sure that Adams wastes every last penny he has on the quackery that he has promoted on his website for years until his cancer advances to the point where it’s stage IV and beyond cure. Then, on his deathbed, he’d realize that he didn’t have to die, that science-based medicine could have cured him if he had just pursued it.

Not that I’d wish that on anyone. Not even Mike Adams. If karma truly existed, though, that’s what would happen to Adams some day.

More likely, though, Adams will die old, fat, and happy, rich from the proceeds of fleecing believers in alt med who do throw away their chance for a cure of their cancers along with huge sums of money on the sort of quackery that Adams promotes on his website.

Comments

  1. #1 Phillip IV
    July 14, 2010

    Sometimes, though, it does seem as though the constant barrage of quackery, anti-vaccine pseudoscience, and pseudoscience in general might drive me to become like poor Jack Torrence of the Stephen King novel and movie The Shining.

    Oh, you just know that that statement will be quote-mined to claim ‘Orac habitually threatens his critics with violence’.

  2. #2 Lindypharm
    July 14, 2010

    Off to self-flagellate for being one of those chemotherapy-pushing pharmacists causing a chemical holocaust, lest karma catch me out later with a nasty bout of cancer.

    Anyone got a non-chemical, non-drug, non-electromagnetic radiation, organic, vaccination-free, wholesome vacancy they might be willing to offer me instead?

    Sadly, only a serious but curable disease mishandled by ignorance and resulting in suffering and death to him or a loved one will demonstrate his silliness, and that’s not something that should be wished on anyone.

    Important post, thanks. Adams on cancer always leaves me sickened.

  3. #3 Todd W.
    July 14, 2010

    It stuns me when people lie so blatantly while acting all holier-than-thou. What stuns me even more is that others actually believe the liars. Adams is just one, among many, that challenge my faith in the generally good nature of human beings.

  4. #4 Rene Najera
    July 14, 2010

    @Todd Cheer up, my friend. They’re in the minority. Unfortunately, they’re very vocal. It’s because we refuse to stoop to their level that we are not heard louder… But we are heard clearly. There is no doubt, no waffling, when it comes to facts.

  5. #5 Pablo
    July 14, 2010

    I find it kind of funny that Adams is worried about OSHA providing guidelines for handling chemo drugs in the workplace. Aren’t chemo drugs controlled substances that are to be distributed by licensed pharmacists? You know, people who have had a lot of chemistry education, in the classroom and in the lab? Pharmacists know very well when they are working with things that can cause issues (they can read and understand labels, that’s for sure) and have the knowledge and training in how to handle them. Do pharmacists REALLY need OSHA to tell them how to handle drugs safely?

    That doesn’t mean that it wouldn’t be a good idea for OSHA to have SHPs for these things, but if they were to have them, they would end up being written by people like…pharmacists, who know what the heck they are doing.

  6. #6 Jojo
    July 14, 2010

    I saw the article that prompted Adam’s to write this when I was scanning MSNBC yesterday. It was not as bad as Adam’s rant, but it included the same tactics. That’s where the reference to mustard gas came from, and that where Adams picked up the names of the pharmacists that are sick or have died from cancer. While the story wasn’t as vile and extreme, it wasn’t all that good either.

    http://www.msnbc.msn.com/id/38114586/ns/health-cancer/

  7. #7 Adam_Y
    July 14, 2010

    This may be a real problem, but it seems to be more due to lack of resources than the reason Adams invokes:

    Actually it is a lack of resources. There was a CBS news report a while back that dealt with dust explosions. OSHA admitted that it didn’t have the resources to effectively enforce these regulations.

  8. #8 Calli Arcale
    July 14, 2010

    Pablo: pharmacists may know better (though history is rife with examples of experts who knew better but still took dangerous and sometimes inadvertently suicidal shortcuts), but that doesn’t mean they’ll be able to do anything about it. How many pharmacists these days actually run their own pharmacies? They’re at the mercy of their employer, which may or may not provide them with the resources and institutional procedures to ensure safe handling of materials. That’s where OSHA comes in, because OSHA is about workplace safety. It’s not so much about telling you how to do your job as it is about telling your employer how to keep you safe at your job.

  9. #9 Rogue Medic
    July 14, 2010

    It’s a tradeoff, I daresay, that any parent would accept for her child. Even in adults, where for some cancers the benefits of chemotherapy are more modest (but nonetheless real), again it’s often a very reasonable tradeoff: Survival now for the price of a small risk of a secondary malignancy 20 years from now.

    That should read any reasonable parent. As you do mention in the next paragraph, and throughout the article, Mike Adams is not remotely reasonable.

    The Occupational Safety and Health Association (OSHA), it turns out, does not regulate workplace exposure to toxic, cancer-causing chemotherapy chemicals. At first glance, that seems surprising, since OSHA regulates workplace exposure to far less harmful chemicals. Why not chemo?

    Maybe he is not aware of the requirement for MSDSs (Material Safety Data Sheets) for all chemicals that workers may come into contact with on the job.

    Why are we in the business of dispensing poison in the first place? Poison, after all, isn’t medicine. Not when dispensed in its full potency, anyway.

    The most important rule of pharmacology contradicts what he wrote.

    All things are poison and nothing is without poison, only the dose permits something not to be poisonous.

    This was written by Paracelsus in the 16th century, so it is not anything remotely new.

    All medicine is poison, when used in the wrong dose.

    Everything that exists in the body is a poison in a large enough dose. Just ask Gary Null, who nearly killed himself with Vitamin D.

    Too small of a dose can be dangerous as well, but the homeopaths will never understand this. Some medications have different effects at different doses. Atropine is one. It is commonly used to treat asystole and/or bradycardia, but if the dose is too small, the effect may exacerbate the condition requiring treatment. while it is not likely to make an asystolic patient more asystolic, it may cause the patient to be less responsive to other treatments. For bradycardic patients, it certainly can cause the patient to become more bradycardic and more hypotensive. Not that I would expect Mike Adams to have the slightest understanding of this.

    In contrast to all this, consider the truthful observation that no naturopath ever died from handling medicinal herb, homeopathy remedies or nutritional supplements.

    What does he base this on?

    Are we supposed to believe that no herbal remedies, naturopathic remedies, or homeopathic remedies have any toxic properties at any point in their preparation?

    That is nonsense.

    They are dealing with substances of unknown purity, with the possibility for contamination and/or misidentification, but he claims that there is no possibility of harm to the quacks during the preparation of their quack sauces?

    Nonsense.

    Even if the results of all of these studies were accurate, then what it would argue for is not giving up the use of chemotherapy, as Adams rants, but stricter regulations governing workplace safety where chemotherapeutic agents are prepared and administered.

    And stricter regulations governing workplace safety where naturopathic and homeopathic agents are prepared and administered.

    Of course, he might object that this was infringing on the rights of these frauds to operate without any oversight, unlike those who manufacture real medicine; unlike those who administer real medicine.

    Treating cancer with chemotherapy is like treating alcoholism with vodka. It’s like treating heart disease with cheese, or like treating diabetes with high-fructose corn syrup. Cancer cannot be cured by the very thing that causes it.

    I use a derivative of opium (naloxone) to reverse the overdoses of people who have taken derivatives of opium (heroin).

    I use sugar to treat diabetic alterations in consciousness. Not precisely high-fructose corn syrup, but highly concentrated dextrose – a 50% solution in water.

    If only Mike Adams understood using the appropriate treatment for the condition he is trying to treat, he might abandon his corrupt and fraudulent sale of inappropriate chemicals to unsuspecting superstitious victims.

    chemical holocaust?

    This might be 1000C hyperbole. Possibly more powerful than a nuclear weapon. More toxic than the synaptic chaos that pervades Mike Adams’s brain. ;-)

  10. #10 Calli Arcale
    July 14, 2010

    Another thought. If Mike Adams is shocked that OSHA doesn’t enforce regulations pertaining to chemotherapeutic drugs very well, he should look around a bit. Chemotherapeutic drugs are hardly unusual in that regard. OSHA will often only step in at all after a complaint or a reported injury. Say a food processing plant is following full health and agricultural rules as far as food processing goes, but it isn’t having the chicken deboners wear chainmail gloves to prevent accidental injuries, or perhaps the swing area around a particular piece of equipment isn’t properly marked to warn people away, or has become cluttered and poses a hazard for that reason. And those are much more obvious hazards, because they constitute *immediate* threats to life and limb. If those are insufficiently enforced, there’s no chance something like proper handling of chemotherapeutic agents will be sufficiently enforced.

  11. #11 MikeMa
    July 14, 2010

    Enforcing regulations is most critical in environments where workers have less control of the procedures that place them in contact with dangerous situations. Factories, production lines, and such have many workers who may have rules to protect them but supervision with other incentives.

    This is not usually the case with pharmacists. They are often the supervisor or at least not in the direct line of fire from malicious supervision. Pharmacists also personally understand the danger of exposure far better than the average line worker in a chemical plant. Although OSHA does have a very extensive Right to Know policy, I venture to say that only a small percentage of workers avail themselves of it. Compared to pharmacists where the knowledge, one would assume, is near 100%.

    OSHA enforcement is far more important where knowledge is less.

  12. #12 Denice Walter
    July 14, 2010

    While I don’t believe in karma, there is perhaps,reality-based poetic justice : a person’s behavior or beliefs lead to disaster in a manner that fittingly critiques his or her original premise, e.g. a well-known radio woo-meister pooh-poohs EBM and self-poisons with self-branded vitamins,a cancer quack eschews EBM and dies of cancer. Adams has expanded his *oeuvre* beyond his original area of incompetence to a widening universe of ineptitude, including politics and economics.Like the aforementioned idiot of the airwaves, Mikey’s opinions are loud and shallow – I catch *just* a hint in his – and Null’s- rants that perhaps the economy is not entirely to either’s liking these days. People strapped for money do not spend $300 on a juicer or $60 for vitamin C (figures: approxiamations from both idiots’ website stores)….perhaps the comeuppance will be fiscal: Null is leaving his NYC “center of operations”, citing the “economy”, for the greener (and cheaper) pastures of a rural “sustainable homestead” and Mikey is selling his Vilcabamba paradise for more “privacy”. One hopeful note: if these dudes prognosticate on politics and the economy, perhaps they’ll spend less time giving bad medical advice.

  13. #13 jaranath
    July 14, 2010

    I can’t help asking: What happened to your lawn?

  14. #14 Calli Arcale
    July 14, 2010

    Rogue Medic:

    chemical holocaust?

    This might be 1000C hyperbole. Possibly more powerful than a nuclear weapon. More toxic than the synaptic chaos that pervades Mike Adams’s brain. ;-)

    That, sir, is brilliantly said. :-D

    And yay, you mentioned nuclear weapons, allowing me to add one more thing to my comment to Pablo, about how the expertise of pharmacists should not be considered adequate to prevent them from harming themselves by unwise handling of drugs. My favorite example is the story of the Demon Core. It killed not just one person who took unwise risks performing criticality experiments but *two*, in separate incidents.
    http://en.wikipedia.org/wiki/Demon_core

  15. #15 Diane
    July 14, 2010

    I saw the original article in our paper. It’s largely the result of the daughter’s promise to get her mother’s story known. The part I enjoyed the most of the article was the brief detailing about the history of handling the chemo drugs. I felt like the author of the original story made the same leap Mike Adams did, but of course Adams always has to go 11 in the stupid.

  16. #16 jane
    July 14, 2010

    It’s obvious that your argument is overall more reasonable than Mike Adams’, but there are a couple of instances of questionable logic:

    “Even in adults, where for some cancers the benefits of chemotherapy are more modest (but nonetheless real), again it’s often a very reasonable tradeoff: Survival now for the price of a small risk of a secondary malignancy 20 years from now.”

    Now, it seems to me that in those cases where chemo offers only “modest” benefit, it means one of two things, or some combination thereof. One possibility is that, as with almost all drugs for end-stage cancer, it extends life (or the dying process) for a few more weeks or months but almost never puts patients into remission. In that case, though (or since) they are not really gaining “survival,” it does not matter if there’s a risk of secondary malignancy in 20 years; they just won’t be around that long. The other possibility is that a few patients gain decades of life, whereas most gain nothing (the case, for example, in early stage breast cancer where the vast majority would not have recurrences anyway). In that case, having to choose between a small risk of naturally recurring cancer and a small risk of cancer that you paid for, the former (depending upon exact numbers) might look better.

    “It is possible that Crump’s pancreatic cancer might have been due to her occupational exposure to chemotherapeutic drugs, but it is more likely that it was not, given that the risk factors for pancreatic cancer are fairly well known, including chronic pancreatitis, smoking, family history, and some other factors. As is the case with many cancers, most patients with pancreatic cancer don’t have any identifiable risk factors.”

    Well, which is it? At first, you seem to suggest that workplace exposure is unlikely to be a cause because other known causes adequately explain the distribution of pancreatic cancer – but the second says that we do not have such understanding.

    It is true that that particular woman’s cancer might or might not have been caused by her handling of chemo, but that’s true of any representative patient who could ever be shown on TV – even the guy who weighs 500 pounds and has a heart attack *might* have had one if he were thin. The fact that epidemiological studies show increased cancer risks at the population level is what needs to be addressed.

  17. #17 David N. Brown
    July 14, 2010

    “It would be very unusual for a homeopath to be poisoned by water. ”
    What about injesting it through the lungs?

  18. #18 Tammy
    July 14, 2010

    As a dentist, I am but one drilling session from going ‘stark raving mad’, so my comments may be dismissed as the rantings of a lunatic, but here goes….

    On a consistent basis I have patients come into the office clutching ‘facts’ they have printed from the internet extolling the virtues of one home remedy or another and why everything that I do is bad for them. While I applaud the efforts of patients to take an active role in their health, its the websites and writings of folks like Mr. Adams that make it difficult to do my job at times. The average consumer is ill-equipped to determine what is a valid, controlled study and what is not. He and his ilk should have a permanent disclaimer attached to their names….

  19. #19 Jarred C
    July 14, 2010

    A friend of mine once told me that she would never receive chemotherapy, that she would rather die of cancer. Her reasoning is that chemotherapy changes your personality for the worse, and her evidence is that every person (a small handful, I think) she knows who has received chemotherapy has returned with a complete change in personality.

    I don’t know the truth to this, nor do I know to what extent the “personality change” goes, but I was wondering if anyone else has heard this type of claim before?

  20. #20 augustine
    July 14, 2010

    Tammy the dentist: “He and his ilk should have a permanent disclaimer attached to their names….”

    If you’re drilling mercury into people’s mouths then YOU should come with a WARNING label.

  21. #21 Greg F.
    July 14, 2010

    ” It’s beyond a black hole of stupid, sucking all science, reason, and intelligence out of the surrounding sector of space. In fact, intellectually speaking it’s the equivalent of the collapse of all matter in the universe back into the singularity from which it emerged.”

    Wow… Seems pretty grandiose.

    I’d just say that it’s Adams’ usual routine of pulling a story from his lower descending colon without even bothering to do a cursory reading on Wikipedia, much less any resource that could contain anything ther than cranks’ and quacks’ whiny and ignorant temper tantrums.

  22. #22 Pablo
    July 14, 2010

    It killed not just one person who took unwise risks performing criticality experiments but *two*, in separate incidents.

    If they knew there were risks but did it anyway, then that has nothing to do with what we are talking about here, which is how OSHA needs to protect people from dangers they don’t know about.

    Government regulations will not protect people who know that an activity is dangerous and choose to take the risk.

  23. #23 Calli Arcale
    July 14, 2010

    They knew the risks and did it anyway, but there weren’t really rules in place. Not yet. Those were the early days of nuclear research, and the mistakes made informed the rules. (That’s how it usually ends up working, for better or worse.) You seemed to be arguing that OSHA regulations are unnecessary for pharmacists, because they are well educated and know what they are doing. On the contrary, people tend to have an inflated opinion of their own expertise, and in the absence of any accountability for doing something safely, will tend to take shortcuts when possible. There are many accidents, on many scales, in many industries of this problem. You are correct that rules won’t stop all of them, but they will stop enough of them to make it worth the while.

  24. #24 cuco3
    July 14, 2010

    #19 Jarred C

    I don’t know the truth to this, nor do I know to what extent the “personality change” goes, but I was wondering if anyone else has heard this type of claim before?

    None of the admitedly few cancer sufferers I have known has had a noticeable change of personality. Certainly my mother seems much the same as she’s always been except, thankfully, older. However, it’s not hard to understand that cancer can be a life-changing experience for all involved so if some people seem different afterwards it’s hardly surprising.
    A work colleague of mine changed quite noticeably after his wife was diagnosed with cancer. Not “traumatic brain injury” changed, but different none the less. Possibly for the better, actually.

  25. #25 MikeMa
    July 14, 2010

    @Jarred C,
    One source of personality change might be the result of dealing with the cancer, not the treatment. Being told you have cancer is a huge jolt. Facing an altered reality of being nearer death than one might wish has a way of focusing one’s thoughts and shedding mental dead weight.

    @augie,
    WTF? Mercury fillings? Really? I’ve got just a couple links for your pea brain. More than that will flag the post and tax your intelligence beyond reason.
    Quaclwatck on mercury fillings
    and
    Webmd on mercury fillings
    Augustine, please go play in heavy traffic.

  26. #26 Margaret Toigo
    July 14, 2010

    @19, I don’t know of any specific claims of personality changes, but I have heard that surviving cancer — or any serious illness or injury — can often change someone’s outlook on life.

  27. #27 Pablo
    July 14, 2010

    On the contrary, people tend to have an inflated opinion of their own expertise, and in the absence of any accountability for doing something safely, will tend to take shortcuts when possible.

    WHEN POSSIBLE

    The other thing that comes with expertise is knowing when it is possible to take shortcuts and when it isn’t.

    OSHA rules do not keep me from taking some liquid nitrogen in my hand and putting it in my mouth. In fact, I have done that (many times), despite there being (I’m sure) OSHA regulations against it. OSHA regulations DO prevent most people from doing that. However, because of my expertise, I know how to do it much more safely than most people, so that it does not present a risk. Moreover, and more importantly, I also know how to do it less safely, and avoid doing it that way. Again, not because of any OSHA regs, but because I know enough to recognize the dangers.

  28. #28 MikeMa
    July 14, 2010

    Pablo,
    Film of the liquid N activity or it didn’t happen! :)

  29. #29 David
    July 14, 2010

    while mercury fillings in people’s mouths have been fairly conclusively exhonerated as a source of mercury exposure to the patient, the issue of dentist’s occupational health is far from settled. See: Ritchie et al (2002)Health and neuropsychological functioning of dentists exposed to mercury. in Occup Environ Med. v59(5):287–293. Dentists have elevated urinary mercury excretion and an elevated risk of kidney disorders and memory disturbance. See also: Moen et al (2008) J Occup Med Toxicol. v3:10 – dental assistants have increased risk of some neurological symptoms. The jury is out on this topic.

    Everything else M.A. wrote, though, does indeed look like nonsense.

  30. #30 Tsu Dho Nimh
    July 14, 2010

    My dad was a pharmacist. He died of cancer. Therefore handling all those drugs during is what killed him!*

    * He was in his mid-eighties, and died of prostate cancer. If he’d done what he should have done, and gotten regular physicals, they would probably have spotted the cancer, cured it and he would have died (maybe a year or two later) of something else.

  31. #31 jay.sweet
    July 14, 2010

    Actually, in the US, homeopathy kills an average of something like nine people per day

  32. #32 T. Bruce McNeely
    July 14, 2010

    A friend of mine once told me that she would never receive chemotherapy, that she would rather die of cancer. Her reasoning is that chemotherapy changes your personality for the worse, and her evidence is that every person (a small handful, I think) she knows who has received chemotherapy has returned with a complete change in personality.

    Everyone I know who has died of cancer has also undergone a complete change in personality.

  33. #33 LovleAnjel
    July 14, 2010

    “Treating cancer with chemotherapy is like treating alcoholism with vodka.”

    You do treat severe cases of alcoholism with vodka. It prevents life-threatening withdrawal symptoms.

    Again, the dose makes the poison. MA needs to take an intro toxicology course at his local community college.

  34. #34 Sean
    July 14, 2010

    Don’t be surprised if that holocaust turns against you one day. Karma tends to work that way. Cause and effect is a universal law that cannot be escaped.

    Ugh.

    Before I started coming to sites like this I literally didn’t believe that people this stupid existed. Seriously, I would have laughed at you if you’d told me someone could say something this moronic.

    Oh, to relive that idyllic time…

  35. #35 speedwell
    July 14, 2010

    Most people who use, and die from, the same alternative therapies they promote are victims. My mother died from treatable breast cancer because she insisted that glanular extracts, noni juice, essiac, and prayer would cure her. (No, it’s true, she did go to a real doctor to have her mammogram that showed the malignancy.) Yes, she had a change in personality due to the chemo we eventually pressured her into undergoing (on the advice of the excellent oncologist we talked her into seeing). She noticed it wasn’t working as well as she and the oncologist hoped, and she gave in to despair, blaming herself for her own lethal gullibility.

  36. #36 Dr. P
    July 14, 2010

    The whole idea of “safety” in the cancer industry is to find new ways to protect the health care workers from the extremely dangerous chemicals they’re still injecting into the bodies of patients. Something is clearly wrong with this picture…

    and here I thought things like lead aprons for radiology technologists and such was a reasonable idea….silly me…

    Again, the dose makes the poison. MA needs to take an intro toxicology course at his local community college.

    MA’s combined willful ignorance and arrogance isn’t the kind of thing I’d wish on my most hated teachers.

  37. #37 Donna B.
    July 14, 2010

    MikeMa – I think it’s very poor form and extremely rude for you to suggest Augustine go play in heavy traffic.

    Have you no common sense? Do you have any idea how dangerous that is? Best case scenario is that he would only cause a major traffic jam and inconvenience many people, but he could also cause injury to innocent EBM supporters.

    Please be more considerate in the future!

  38. #38 MikeMa
    July 14, 2010

    Sorry Donna B. I will endeavor to find a more solitary way for Augustine to amuse and abuse himself.

  39. #39 ScienceCat
    July 14, 2010

    Bah. I used to handle experimental chemotherapy drugs (and experimental antivirals) every day at work for years. These tended to be drugs in the early stages of clinical trials and we didn’t even know what the side effects were at that point. Of *course* they were treated with due caution and a respect for possible unknown effects. After all, we didn’t *have* leukemia or HIV infection so for us the risk equation from exposure was all cost and no benefit (other than our salaries, which weren’t stellar). Minimizing exposure is normal good work practice for chemical wranglers these days, although not for the previous generation of “wash my hands in benzene” chemists (my father is unusually healthy for an older former chemist – most of his generation of chemists seem to have had shorter lives. Then again he never smoked and has a saying about old bold chemists). I’m using “chemist” in the North American sense here but of course the older vs recent exposure scenarios may also apply to pharmacists.

    I don’t think sending people out to play in traffic is a good idea when there are natural herbal treatments for the willfully and dangerously stupid available, such as smacking them with giant hogweed on nice sunny days :)

  40. #40 Ana Observer
    July 14, 2010

    When I saw the story on Sue Cumber in the Seattle Times I knew — I just knew — that Mikey would work his magic on it. Lo and behold, he did! I guess I must be psychic. Either that or Mikey is predictable. I vote for the second.

    @Sciencecat — no giant hogweed where I live so I’ll have to use thistles to smack them with. Wonderfully spiny, and guaranteed to get somebody’s attention. Ooh, a new form of acupuncture!

  41. #41 ScienceCat
    July 14, 2010

    @speedwell (post 34)- I’m sorry about your mother. Having a relative fall for alt-therapies is what drove me to the more outspoken end of the antiquackery spectrum (fortunately, my aunt came to her senses fairly early in the process although I still wonder if the delay cost her years that she should have had). I think there are a lot of us on this blog who have had experiences like that. My deepest sympathies for your loss.

  42. #42 Ana Observer
    July 14, 2010

    Speaking of big steaming stinking turds, Gillian McKeith is losing a Twitter catfight with Ben Goldacre. She’s deleting messages but he has them cached. A small but fun stupid.

  43. #43 speedwell
    July 14, 2010

    Thanks, ScienceCat. My mother was so into the garbage she got sucked into that Nature’s Sunshine scam. I was pointing out that I think there’s a world of difference between someone who attempts to recommend and sell unproven remedies because they don’t understand the science involved and they’ve been worked over by alties who made them scared of mainstream medicine, and cynical schemers who don’t care whether people die so long as money and (maybe even more important) attention is directed toward themselves.

    I’m not defending Mike Adams and I’m not defending my mother’s selling of questionable supplements, either. But I know Mom really believed in what she was selling (and paid, of course, with her life). I’m not as familiar with Mike Adams as some people here are. I think it’s clear that he is monumentally ignorant, even willfully so. But is there any evidence that he fully understands that he’s lying? Is he a danger to himself, as well as a danger to others?

  44. #44 gwen
    July 14, 2010

    As an longtime RN who has cared for chemotherapy patients, I can’t figure out if he is lying or really that stupid… Wow, I wonder what we REALLY use all of those gowns, gloves, masks, spill kits, and hoods for. Not to mention the yearly refresher classes on how to handle chemo drugs.

  45. #45 Otto
    July 14, 2010

    @LovleAnjel: “You do treat severe cases of alcoholism with vodka. It prevents life-threatening withdrawal symptoms.”

    This would be in the Land That Benzodiazepines Forgot?

  46. #46 Mary
    July 14, 2010

    Back in the early 1970′s, I once splashed Daunomycin all over my arm. I was an intern with no experience drawing up medications — but the nurses didn’t do chemo, and so it was the intern’s job. It wasn’t done in a hood either, just in a corner of the prep room. And yes, OSHA did get involved. Now, anybody who handles chemotherapy has to get annual training in handling it safely. Drawing up chemo is done only with proper ventilation. OSHA may not come around checking up on pharmacies, but they will certainly show up if an employee is exposed or someone makes a complaint about improper procedures.

  47. #47 Jeanmarie
    July 14, 2010

    This is my first time to this blog. Very interesting discussion. I have a lifelong interest in health and nutrition. To some that makes me a “nut,” but I think it’s only sensible to be careful of what I put into my mouth. I’ve learned from my mistakes — one was vegetarianism, specifically macrobiotics, which represented the least healthy period in my life — and am always seeking to improve my knowledge. To be sure, there are a lot of frauds (or well-meaning deluded folks) in the alternative medicine field, but I have also had very positive experience with acupuncture while living in Japan, which helped turn around some of the problems that were exacerbated by my temporary vegetarianism. The rest of the turnaround was a gradual discovery of the truth behind some claims of “mainstream” nutrition. I found that the anti-fat propaganda had not served me well, and that increasing healthy fats in my diet (along with moderate protein and nutrient-dense vegetables like kale and broccoli) has had very positive effects on my health. I’ve also gradually realized that a lot of the money I spent on food supplements over the years was a waste. I should have spent it on better-quality food. But enough about me.

    Thanks for the info about Gary Null’s credentials. His supplement formulas sound largely like a waste of money (again, whole foods are a better buy, and I think nutrients generally work synergistically in combination, not in isolation), but why does no one here concern themselves with pharmaceutical disasters like Avandia, Vioxx, and the like? It would be over the top to characterize all the pharmas as “evil” but there has been a lot of hanky-panky over the years, and they do have undue influence on health-care legislation, and not to our benefit. Supplements may be largely a waste of money (again, whole foods are a better buy and more effective), but they have a pretty safe track record (occasionally you find someone doing something stupid like taking ephedra and working out too long in the sun without water etc, not at all like the use in traditional Chinese medicine).

    Bad behavior on all sides should be called out. Where is the condemnation of doctors prescribing antibiotics for colds just because they couldn’t bear to turn down their patients who want *something* to make them better? (Even though antibiotics work against bacteria, not cold viruses, and their overuse is thought to contribute to the evolution of anti-drug resistant bacterial strains such as MRSA that are devastating to those afflicted.) What about prescribing statins to elderly women and children, groups that have not been shown to benefit from lowered cholesterol? What about all the costly medical mistakes that result in unnecessary pain and suffering?

    I used to follow the pharmaceutical industry closely as an editor on the health-care industry and science team at Bloomberg News and usually read medical studies myself so as to catch reporters’ errors, and the experience convinced me there is much to be critical of — though not necessarily what Mike Adams rants about. The fact that his rants are often (usually? always?) mistaken doesn’t mean Big Pharma are the good guys, either.

    One more point on Gary Null. He’s no “guru” to me though I’ve heard of him through the years, but hadn’t heard of his illness before this so I read a couple of stories about it just now. It seems few people (whether writers or commenters) can distinguish between the protein shake (or whatever it was) that he designed, and the manufacturing mistake that greatly exceeded the Vitamin D dosage
    beyond safe levels (especially without the appropriate ratio of preformed Vitamin A to D). So the fact that he got sick on his own shake doesn’t make him a fraud (there may be sufficient *other* evidence to draw that conclusion, but not this) nor this incident particularly ironic, when it was a manufacturing mistake not under his control. Just a really bad thing for him and whoever else trusted the work of the manufacturer. (Personally, I try to avoid reliance on food that has been “manufactured” as opposed to grown or raised in nature.)

    Personally, I like reading a clear explanation of the facts about why and how someone’s views are incorrect, not rants about someone’s stupidity, so I hope you’ll emphasize the former over the latter. I am always eager to be shown where my own views are mistaken, and I change my views as fast as I find better evidence to justify doing so, but I can’t see why that can’t be done in a civilized way (referring to some commenters). Keep up the good work!

  48. #48 Travis
    July 14, 2010

    Jeanmarie,
    As you admit this is your first time here I am going to cut you some slack but at the same time, if this is your first time here how do you know anything about the views of those who are commenting and the Orac?

    but why does no one here concern themselves with pharmaceutical disasters like Avandia, Vioxx, and the like?

    This has been talked about an endless number of times on this blog and elsewhere. No one is ignoring it.

    Also, I doubt anyone here would encourage doctors to prescribe antibiotics for viral infections. I am not sure why you bring it up. No one is going to disagree that it is a problem.

  49. #49 LovleAnjel
    July 14, 2010

    @Otto

    I’ve seen the “take two shots and call me in the morning” thing on several episodes of Intervention. Perhaps reality TV rehab is the Land that Benzos Forgot.

  50. #50 Dan J
    July 14, 2010

    I will be getting another session of ABVD regimen chemotherapy tomorrow afternoon. It works. It’s healing me. I feel better now, after several sessions, than I did before I started them. Chemotherapy works, and I can’t wait to rip Adams apart on my own blog. Thanks for the wonderful post, Orac.

  51. #51 Mephistopheles O'Brien
    July 14, 2010

    @Jeanmarie – re: Gary Null

    hadn’t heard of his illness before this

    In my understanding, Mr. Null was not so much “ill” as poisoned.

    It seems few people (whether writers or commenters) can distinguish between the protein shake (or whatever it was) that he designed, and the manufacturing mistake that greatly exceeded the Vitamin D dosage beyond safe levels

    I thought the distinction was pretty clear in this blog.

    a manufacturing mistake not under his control

    Here I have to disagree with you. Mr. Null or someone working for him arranged for this manufacturer to produce a product that had to conform to certain specifications. The incident suggests that this manufacturer did not follow good manufacturing practices, nor did it have adequate quality controls. The manufacturing “mistake” should have been avoided; if not avoided it should have been caught before, well, poisoning people. Mr. Null had a responsibility to ensure his product was made competently.

    After all, had a contract manufacturer for a large pharmaceutical company made “mistakes” of this caliber we would not be saying it was not under their control.

  52. #52 Rogue Medic
    July 14, 2010

    @ 46 Jeanmarie,

    Regarding Gary Null:

    Gary Null advocates taking excessive doses of supplements.

    Gary Null opposes regulation of these supplements.

    Gary Null almost kills himself with his own supplements, that he claims are too safe to be regulated.

    Gary Null was, as Orac stated, hoist on his own petard.

    If he hadn’t gone to a medical doctor, he would have continued to try to heal himself with his own quackery – quackery which was killing him.

    Regarding not criticizing problems with medications, since the alternative medicine stuff is not medicine – alternative medicine is for entertainment purposes only:

    Some of us do write about other medical problems. What led you to conclude otherwise?

    You describe things you claim are not supported by the facts. I have responded to your semi-defense of Gary Null. That is something that is debatable.

    Then you make up this claim that neither Orac, nor those who comment negatively about the scams reported here, ever comment negatively about problems with medicine.

    You have not read enough to make that judgment. You are mistaken. You might read half a dozen posts and not see anything on acupuncture, but that does not mean that Orac does not address acupuncture.

    You come to the conclusion that Orac does not criticize problems with real medicine based on how many posts?

    You criticize those of us commenting. How many of our comments have you read and how many of our blogs have you read to arrive at that conclusion?

    You act as if someone who wants to criticize one aspect of fraud must cover all aspects of bad medicine, in order to avoid being considered partisan. You accuse us of this, but base it on inadequate information. Where is your objectivity?

    I write about a variety of mostly medical topics. I do not cover every possible medical mistake. Does that make me partisan?

    I do write critically about the treatment of patients by EMS (Emergency Medical Services). Some of my writing is critical of treatments that are not based on good evidence, some critical of treatments not based on any evidence, and some is critical of the decision to not use treatments that are based on excellent evidence.

    I tend to write about alternative medicine as a way to demonstrate flawed logic to those who may react defensively when I am critical of their favorite EMS treatment that works – they just know it.

    Sometimes I write about bad judgment that is not due to belief in alternative medicine. Economics is a good source of material, but it is even more difficult to get people interested in, while still providing a good concise explanation of the problem.

    Regarding acupuncture:

    Orac wrote this –

    http://scienceblogs.com/insolence/2009/05/another_acupuncture_study_misinterpreted.php

    It seems that research that shows that acupuncture is not even as good as placebo is spun as somehow being evidence that acupuncture works. Even real doctors have made this mistake.

  53. #53 Kimbo Jones
    July 14, 2010

    Adams’ accidental refutation of homeopathy is absolutely effing hilarious. I want that on a T-Shirt.

  54. #54 augustine
    July 14, 2010

    “It works. It’s healing me. I feel better now, after several sessions, than I did before I started them.”

    That’s called placebo.

  55. #55 augustine
    July 14, 2010

    MikeMa,

    Quackwatch as a source? Really, Mike? Really?

  56. #56 hibob
    July 14, 2010

    Regardless of whether work exposure caused her cancer, the working conditions were still scary: No gloves, no gowns, and hoods that blew any vapors right back at the pharmacists (but kept the hoodspace sterile).
    http://www.oregonlive.com/health/index.ssf/2010/07/health_workers_who_worked_with.html

    Crump started at Swedish Medical Center in the early 1980s, before pharmacists used special protective “hoods” over countertops to contain spray and contamination. They didn’t use gowns or gloves. They had no reason to think they should. Occasionally, drugs would spill on the countertops.
    “We would wipe if off and throw (the towels) in the garbage,” Crump said.

    and if that didn’t prick up lawyers’ ears, how about this:

    Ten years into Crump’s career, reports of health effects related to chemo exposure surfaced in Europe, and health care workers started to adopt rudimentary safety procedures.
    Her pharmacy manager took the warnings seriously and installed ventilated hoods considered state-of-the-art at the time. The trouble was the hoods were designed to keep chemicals sterile by blowing contaminants away from them and back out of the hood. That meant the worker standing outside the hood was still getting exposed, Crump said.

  57. #57 Adam_Y
    July 14, 2010

    Bad behavior on all sides should be called out. Where is the condemnation of doctors prescribing antibiotics for colds just because they couldn’t bear to turn down their patients who want *something* to make them better? (Even though antibiotics work against bacteria, not cold viruses, and their overuse is thought to contribute to the evolution of anti-drug resistant bacterial strains such as MRSA that are devastating to those afflicted.) What about prescribing statins to elderly women and children, groups that have not been shown to benefit from lowered cholesterol? What about all the costly medical mistakes that result in unnecessary pain and suffering?

    READ THE DAM BLOG. I know you haven’t read the blog because if you did you wouldn’t come up with such an idiotic complaint.

  58. #58 Adam_Y
    July 14, 2010

    Regardless of whether work exposure caused her cancer, the working conditions were still scary: No gloves, no gowns, and hoods that blew any vapors right back at the pharmacists (but kept the hoodspace sterile).
    http://www.oregonlive.com/health/index.ssf/2010/07/health_workers_who_worked_with.html

    Ummmm…. You are doing some fear mongering. I’ve heard of those hoods before. They aren’t dangerous and they aren’t designed to blow back vapors into the face of the user. Our safety officer would have a fit.

  59. #59 Toxicology Kat
    July 14, 2010

    Adam_Y, are you familiar with both basic types of hoods used in laboratories?

    1. Fume hood: Sucks room air up the vent at the back of the hood to protect the user from toxic chemicals in the hood. Commonly found in chemistry labs.

    2. Laminar flow hood: Blows HEPA-filtered air from the rear to the front opening of the hood (or from the top to the bottom) to protect the materials in the hood from bacteria/mold/etc. contamination. Commonly found in biology labs. Some models also have an air intake at the front that prevents the airflow from leaving the hood. Some don’t. I’ve used both kinds, luckily with harmless stuff like agar plates, but the basic ones without an enclosed front and air intake would definitely blow vapors at the user.

    See diagram here:
    http://www.aircleansystems.com/process_horizontal.htm

    And regarding safety precautions with chemo in general: Back around 1990 (+/- 5 years) I had a temp job editing procedures for home health care nurses who needed to administer chemo to patients. They took it very seriously, full hazmat suits and everything.

  60. #60 Calli Arcale
    July 14, 2010

    Pablo @ 27:

    On the contrary, people tend to have an inflated opinion of their own expertise, and in the absence of any accountability for doing something safely, will tend to take shortcuts when possible.

    WHEN POSSIBLE

    The other thing that comes with expertise is knowing when it is possible to take shortcuts and when it isn’t.

    You have far more confidence in people’s sense of self-preservation than I do. Taking shortcuts has killed a lot of people who thought they knew what they were doing, because they were highly trained engineers/pilots/doctors/technicians/etc and knew this stuff better than anyone. Your playing with liquid nitrogen is a prime example. You believe you know better than OSHA, because you have not suffered frostbite from it. But that’s an unreasonable conclusion, and a skeptic ought to be able to recognize that.

    Just because you haven’t gotten hurt doesn’t mean you won’t get hurt next time. OSHA rules aren’t perfect, and they’re about workplace safety, not necessarily best practices and certainly not efficiency. But just because breaking a rule hasn’t caused a catastrophe for you, personally, does not mean it won’t in future.

    For a more present-day example, see the Deepwater Horizon accident. They knew what they were doing. They decided to take shortcuts, because it was easier and cheaper and faster. They convinced the inspectors to look the other way. They had probably done so without problems several times before, but statistically, sooner or later, their number was going to come up. It did so in very deep water, magnifying the resulting catastrophe. Eleven people died, and that was just the beginning.

    There are examples in rocketry; multiply-redundant systems defeated in the interest of making the launch window (“go fever”, they call it), and that working fine until one day there is a failure and without any redundancy, the whole thing goes up in flames. It’s happened. Workplace pressure. Performance anxiety. Sometimes just ennui — after a while, with nothing going wrong, you get a bit blase about safety and procedure. Doesn’t matter how skilled you are, or how responsible you are. It can happen to any of us if we’re not constantly on the lookout for it.

    But we’re digressing. The point is that Mike Adams is taking OSHA way out of context; just because something is hazardous to handle in an industrial context definitely doesn’t mean it’s unsafe to use as a drug.

  61. #61 ScienceCat
    July 15, 2010

    Adam: to be fair, I don’t see where hibob claims that the hoods (laminar flow hoods?) blow vapours into the user’s *face*. The laminar flow hoods that I worked with around that era do blow towards the operator (not that they blow very hard and they blow to the operator’s hands, unless the operator is very silly and shoves their face at the opening). They are *supposed* to do that – their purpose is to protect the items in the hood from contamination by the operator not the other way around (as per the conventional fumehood). I’m finding it very disheartening to read that such little common sense was applied when handling chemotherapy drugs (and other things) back then. Were pharmacists that careless about handling other drugs back then? In the late 80′s I wore labcoat, disposable apron, gloves, safety goggles and a mask for handling steroids and a number of other drugs in an analytical chemistry lab and those were piddling little quantities by comparison. It made sense to do so since I did not want to deal with the effects of accidental exposure to chemicals that had significant biological effects at low doses. You would think that a pharmacist would be aware of how chemotherapy works and take suitable precautions to protect themselves from exposure, given that (selective) mammalian cell toxicity is what the treatments are all about, yes? Do pharmacists underestimate the risks of exposure to the drugs that they work with because they are so familiar with them? This is an issue with many occupational exposures and also with exposures from common everyday things outside of work. We don’t tend to think twice about our exposures to the carcinogens in gasoline, burnt toast and broccoli(all natural carcinogens not pesticides or other synthetic bogeymen) because those exposures are so “normal”. When that relaxed attitude gets extended to high workplace exposure scenarios, it means trouble. Anyhow just my opinion. (and yes, someone definitely needs to read the damn blog and Ben Goldacre’s blog too before accusing this community of letting Big Pharma off the hook)

  62. #62 ScienceCat
    July 15, 2010

    and darn it, I got caught in the “someone else’s better response was caught in blog post limbo while I was typing mine” vortex, Hi Toxicology Kat!

  63. #63 Chris
    July 15, 2010

    I hate when that happens… though sometimes I love it!

  64. #64 ScienceCat
    July 15, 2010

    Chris – I’m definitely on the “love” side – beats the heck out of posting then realizing that while you were in the vortex, someone else made a brilliant post that completely undermined yours ;)

    But the coincident names are weirding me out a little – which of us gets to be the evil twin/evil alternate universe version? I was hoping it was me but checked mirror and alas, no black chin whiskers :P

    Still sad about the misuse of laminar flow hoods – if these pharmacists really thought that they were good for spill/vapour containment like a fumehood then it reflects poorly on the safety attitude of their employers and a lack of proper training. It’s like sneaking a normal screwdriver in the toolbox of an electrician who usually uses ones with insulated handles >:|

  65. #65 MI Dawn
    July 15, 2010

    I am not a pharmacist, but I am a nurse, married to a pharmacist. I would have to say that chemotherapy exposure definitely depended on the place done. But, even going back to the very early 80′s when spouse and myself were in college/newly employed, chemotherapy drugs were handled with masks, gloves, gowns by everyone from the pharmacist to the nurse hanging the IV. And this was inpatient hospital, outpatient hospital and some of the nice free-standing chemotherapy centers. So it seems to me that the employer in the story may have been at fault for not training their employees better, and not providing the needed protective gear.

    Calli Arcale: I have a question for you. In your posting at #8, you said: “How many pharmacists these days actually run their own pharmacies?” Since chemotherapy drugs (at least in the states I have worked in) are pretty tightly controlled, those pharmacists would have no contact with chemo drugs. Of course, you may have been referencing other medications and pharmacists who compound them. Were you?

    As for no naturopath patient being poisoned by natural items…I seem to remember a story about some guy, Greek, I think, who was given some natural thing to drink and actually died! After all, hemlock is from nature, so it can’t possibly kill anyone, could it? /snark

  66. #66 DuWayne
    July 15, 2010

    Pablo –

    Having a great deal of experience with a field that has gone from fatalities on the job being a metric that projects were measured by, to time lost injuries replacing it due to OSHA, I have to rather strongly disagree with your assessment.

    There are a whole lot of folks who get paid by the hour, who know better, yet who still insist that they can take shortcuts. It is only through a combination of massive fines and insurance company demands, that their employers are forcing construction workers to work safely. There are a lot of rules in place that are easy to argue are unnecessary, because injuries are rare – until you happen to be one of those rarities.

    It is a lot like an idiot I used to roof with, who was very fond of having a beer or two at lunch time and smoking pot on roofs. He was actually indignant that our boss didn’t want him to do those things on the job. His argument was, “I’ve never gotten hurt because I was high yet, so what’s the big deal.” The point is that we don’t want to actually have those injuries occur and so there are rules in place to help prevent them.

    I am not saying that you aren’t expert enough to know what you are capable of, with what you work with. What I am willing to say though – with absolute certainty, is that there are far more people who would claim that they are too, than there are people for whom that is an accurate assessment.

    I am not trying to be a total asshole, but I cringe every single time someone claims that OSHA isn’t necessary to a given field. Especially when they claim that expertise means they don’t need it. There are plenty of experts in the fields that I am sure you think OSHA is needed for. Indeed, most workers in most fields with relatively complex safety requirements (ie. more than push “x” button/belly band/foot pedal for emergency shutdown of machine) tend to either be experts or learning and rather more supervised.

    I sincerely doubt that simply because enforcement is rather more complicated, it just isn’t necessary.

  67. #67 Calli Arcale
    July 15, 2010

    MI Dawn:

    Calli Arcale: I have a question for you. In your posting at #8, you said: “How many pharmacists these days actually run their own pharmacies?” Since chemotherapy drugs (at least in the states I have worked in) are pretty tightly controlled, those pharmacists would have no contact with chemo drugs. Of course, you may have been referencing other medications and pharmacists who compound them. Were you?

    No, because I have no idea what kinds of drugs wouldn’t be dispensable via podunk small town pharmacies as opposed to Uber Huge Chain pharamcies. I’m a software engineer; my experience with pharmacists is purely as a customer. ;-)

    I was just responding to the suggestion that pharmacists can control their own workplaces by pointing out that it isn’t generally true; most pharmacists that I’ve bought from are employees of Uber Huge Chain and have to play by Uber Huge Chain’s rules if they want to stay employed.

  68. #68 MI Dawn
    July 15, 2010

    @Calli Arcale #67 Ah. OK. I just wanted to make sure I was understanding what you were saying, and I wasn’t. Thank you. Well, to be fair, I have no experience with software engineers. :)

  69. #69 stuv.myopenid.com
    July 15, 2010

    I am not trying to be a total asshole, but I cringe every single time someone claims that OSHA isn’t necessary to a given field.

    No shit. Even in my wimpy desk job. People in my field like to whine about ergonomics until they meet my now disabled, out-of-work friend at a party, sitting in a corner with two braces on his wrists (which luckily cover up the even half-dozen scars on each arm from failed operations). From RSI. From typing & using a mouse.

  70. #70 Marc
    July 16, 2010

    My wife is a Hem/Onc clinical pharmacist, and you better believe that they wear protective clothing, use hoods, etc. Also, they generally have the power to shut down the mixing of chemo if they consider the environment unsafe. I know she had a situation where the hood in her lab was broken and she shut down chemo for a week until they fixed it. Unfortunately, she worked for the VA at the time and it really did take a week :p

    What I really want to know is if chemo causes pancreatic cancer, was this really what Patrick Swayze was doing in those years after “Roadhouse”? I mean, Adams sure seems to think there’s clear cause and effect here….

  71. #71 Jeanmarie
    July 17, 2010

    @mephistopheles, love the name.

    I should think being poisoned makes one ill.

    I should have been more clear. After reading a reference to Gary Null’s illness -er- poisoning, I looked up a few articles about it and most headlines and commenters seemed to delight in his misfortune and definitely did not seem to understand that he wasn’t poisoned by his own recipe, but because of a gross mistake in the recipe.

    Yes of course the manufacturing mistake should have been avoided. But holding him to blame is like blaming the person who hires an accountant that absconds with their money. We can’t all be specialists in all the areas of life or even business that touch us, and ultimately we sometimes have to take the word of someone we consider an expert at some point. It’s not always possible to hire the right people if they are deceitful and take pains to lie about who they are or what they will do or are doing in your name. I don’t know what the point is of blaming Mr. Null in this. It’s clearly his ultimate responsibility — meaning he’s the one taking the hit for it — but it is just as clearly the manufacturer who is in the wrong here. But if he did not take steps to correct the situation once he became aware of it, it most certainly would be his fault, too.

    Gary Null is no hero of mine but I find it petty and mean-spirited for people to delight in his poisoning.

  72. #72 Rogue Medic
    July 17, 2010

    @ 71 Jeanmarie,

    Yes of course the manufacturing mistake should have been avoided. But holding him to blame is like blaming the person who hires an accountant that absconds with their money.

    You need to remember that Gary Null operates in that shadowy unregulated/minimally regulated part of the market for items that are sold for entertainment purposes only, because you would have to be pretty gullible to believe that these quack remedies have any evidence of safety or efficacy. They do not.

    He appears to have been a victim of someone who treats patients the same way he treats patients. They are just suckers for him to fleece.

    The only pleasure I take in the self-inflicted poisoning of Gary Null is the hope that people will realize how little he knows about what he is doing and how little he should be trusted.

    He is a fraud.

    He is operating in the medical equivalent of sub-prime mortgages. They appear to be safe for a while, but they are not safe.

  73. #73 Vicki
    July 17, 2010

    Jeanmarie–

    It’s more like blaming someone who has recommended their accountant to all their friends and acquaintances, and given the impression that he is an expert on accounting. If you put your name on a product, that should mean something: you don’t get to collect the fees for endorsements and then go “I had nothing to do with it” when the nostrum has poisonous levels of vitamin D, or the car you recommended turns out to be dangerously defective. This isn’t like an athlete endorsing a line of clothing, when nobody thinks that means he’s gone into clothing design.

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