How many people have heard of an NHS ‘yellow card’ on which suspected side-effects should be reported?

23 Oct

Dr Mark Porter is a part-time partner in a busy rural NHS GP practice in the Cotswolds. He spends the rest of his time writing about medical matters in his weekly column and delivering his Radio 4 series Inside Health. He was awarded an MBE for services to medicine in 2005

In the Times recently, he asked, ‘How safe are your medicines?’ and informs all that In the UK a form anyone can use to report suspected side-effects is called ‘the yellow card’.

Last year there was a fall in the number of cards received and Dr Porter asked if drugs really are causing fewer problems or if ‘we have taken our eye off the ball’.

In 2018 the monitoring authority – the Medicines and Healthcare Products Regulatory Agency (MHRA) – received 42,500 yellow cards, down from 44,000 the previous year.

Most patients have never heard of yellow cards, or assume that their doctor will report problems for them but healthcare professionals are stretched and may not link the side-effect to a drug.

New drugs are more risky because they may have been tested on only a few thousand people before gaining a licence, and even then often only for short periods.

It was the MHRA, with the help of yellow cards, that warned people taking the cholesterol-lowering drug simvastatin on which this site reported in 2012. It also warned against taking the anticoagulant warfarin with grapefruit juice because it interfered with the way the drugs were metabolised, increasing the risk of side-effects such as muscle aches and bleeding.

Dr Porter emphasises the importance of reporting side-effects experienced whilst taking a new drug (identified by a black triangle on the patient leaflet), even if you think it may be a coincidence because it’s often a pattern of such “coincidences” that produces a signal.

An online yellow card can be filled in at yellowcard.mhra.gov.uk to report problems or incidents with medicines, vaccines, herbal or homeopathic remedies, medical devices (from pacemakers to blood glucose monitors).

A printable Yellow Card form for members of the public is available at Member Of Public Yellow Card Reporting Form (December 2018) (379kb .pdf); for healthcare professionals a printable Yellow Card form may be downloaded from Healthcare Professional Yellow Card Reporting Form (February 2017) (110kb .pdf).

Patients who do not use computers will have to ask friends, family or a carer to do this for them.

 

 

 

 

 

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Post 1945: a plague of profitable but destructive chemicals

14 Sep

2010 research findings: 34% of UK cancers in 2010 (106,845) were linked to smoking and alcohol and one in 25 cancers is linked to a person’s job – other causes included exposure to chemicals. The percentages may well have risen. Pollution is one of many factors thought to be responsible for rising rates of allergy.

Despite this knowledge, harmful substances are freely sold in order to enrich a few and any attempt to change this is met with powerful resistance which influences most politicians.

Richard Bruce sent a link to this parliamentary debate opened by the Countess of Mar, a doughty campaigner on behalf of farmers, whose health seriously deteriorated after being compelled by government to use organophosphate sheep dip. Lord Blyth referred to Richard’s experience, but a fuller account is given on his website.

Agriculture: Health & Safety Responsibilities

6 Feb 1996: Column 183

The Countess of Mar rose to ask Her Majesty’s Government what are the statutory duties of the Health and Safety Executive and the Minister of Agriculture, Fisheries and Food to ensure that employers and employees carrying out exclusively agricultural operations are kept informed of, and adequately advised on, matters relating to health and safety.

The noble Countess said: In asking the Question standing in my name on the Order Paper, I declare an interest. I have been exposed to organophosphate sheep dip and believe that I suffer chronic ill health as a result.

Some of the points made in the seven page report:

  1. In 1951, Solly Zuckerman, later Lord Zuckerman, chaired a working party which investigated the health effects on workers using dinitro and organophosphorus compounds in agricultural sprays
  2. It found that repeated low level exposures could result in chronic effects on human health
  3. and recommended simplifying labelling and including the words “Deadly poison” in large letters on containers.
  4. But not until 1994 were manufacturers required to put a skull-and-crossbones symbol on OP sheep dip containers to warn of toxicity.
  5. MAFF introduced national dipping orders in 1976
  6. The orders were rescinded in 1992
  7. GPs, untrained in chemical toxicology, used irrelevant tests & many decided that these patients’ symptoms were psychosomatic.
  8. Effective tests were not recommended by the HSE to GPs and consultants.
  9. The Health and Safety Commission did not consider it appropriate to advise and inform farmers of the inherent dangers of these substances.
  10. The Health and Safety Executive actively suppressed a 1990 field research project.
  11. Internationally research published in the Lancet in May 1995 found damage to farmers and that there was a dose relationship.
  12. Veterinary Products Committee rejected these research findings.
  13. The Countess of Mar asked the Minister how many members of the VPC had the relevant neurobehavioural expertise to assess this research. (Ed: an undated account VPC Members Specialisms and Biographical Details Indicates that none had this expertise, though Dr Karin Burnett had studied several aspects of toxicology).
  14. OPs are said to be too toxic to test on humans and maximum levels of exposure are arbitrarily set.
  15. T.C. Marrs, senior medical officer at the Department of Health, adviser to Ministers and government committees, said at a meeting of farmers in October 1991, “You don’t have to convince me there is long-term damage. I know it”, but did not inform ministers.
  16. Though the National Poisons Unit (NPU) at Guy’s Hospital confirmed that Richard Bruce had been poisoned by organophosphates and this was reported to the HSE, their inspectors did not visit Mr. Bruce or the farm where he worked to investigate the incident.
  17. Lord Blyth asked: How serious does an incident have to be before it is thoroughly investigated? What powers do health and safety inspectors and EMAS doctors have to inspect premises and obtain other evidence?
  18. The NPU withdrew the diagnosis of OP poisoning in a letter to the HSE, copied to Mr. Bruce’s GP on 2nd December 1994, but confirmed the diagnosis to the Benefits Agency in a letter of the same date.
  19. Lord Beaumont cited an Australian case with damages awarded in a court of law and recommended that OP sheep dips be classified as prescription products until the results of the Government’s delayed researches are known.

Baroness Turner said “It is clear from the information received from a number of sources that much needs to be done to improve health and safety standards in this vital industry. Many in it are suffering the effects of pesticide poisoning, and many are dying as a result.

 

The report may be read here.

 

 

 

 

 

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BBC & Nuffield Trust: Merck’s MMR more convenient for working mothers

20 Aug

 

Health experts are particularly concerned about the UK’s 87% uptake of the second MMR vaccination, which is far below the WHO’s 95% goal.

A remedy?

Some doctors have refused to administer the MMR vaccine and Dr Michael Jarmulowicz (FRCPath, MBBS) seeks a compromise, writing in the BMJ:

“What I find puzzling is the adamant refusal of the authorities to facilitate the availability of the single measles vaccine, to the point that the Department of Health has banned its use within the NHS. How does this fit with the growing acceptance of patient autonomy and patient choice? . . .

“Other countries with equivalent medical and ethical standards make them freely available.”

Meanwhile Merck’s influence increases as its profits soar, giving $1,481,549 during the US presidential 2018 Election, according to the Center for Responsive Politics.

A new advantage of the MMR vaccine was heard on Radio 4 or 5 Live this morning (19.8.19). Extensive ‘listening again’ failed to find the precise time and location, but It was stated at some length that the MMR vaccine was more convenient for working mothers as they would only need to attend one appointment.

This ‘convenience’ factor was also traced to the website of the Nuffield Trust:

“The availability of a single, combined vaccination may have simplified the childhood vaccination schedule for children and parents.”

Mothers for whom convenience is a priority could continue to enable their children to have the MMR and those who have seen or heard of adverse effects could thankfully return to the earlier practice.

For wider coverage, as Dr Jarmulowicz suggests, “the medical profession should support a parent’s wish for single dose vaccine, however irrational the establishment might view that wish”.

 

 

 

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Prime Minister Johnson ignores the GM elephants in the room: superweeds and pesticide resistance

1 Aug

Technical, scientific, agricultural and news media are focussing on Boris Johnson’s call on the steps of 10 Downing Street, in his first speech as UK Prime Minister, to “liberate the UK’s extraordinary bioscience sector from anti genetic modification rules . . . and let’s develop the blight-resistant crops that will feed the world.”

Does he know anything about the problems besetting growers in countries such as America, Canada and India: herbicide resistant (super) weeds (below) and pesticide resistant insects?

He makes no reference to the plague of superweeds and the growth of pesticide resistant creatures such as the ‘out of control’ Indian bollworm (below right) and European corn borer (below left, showing the effect of the corn borer) plaguing farmers who are growing GM crops which now require ever larger applications of a different range of herbicides and pesticides .

The Verdict points out that the European Union (Withdrawal) Act 2018 means the rules currently restricting GM crops in the UK through EU law will continue to apply through UK law after the UK has left – whether or not a deal has been done. This will give Mr Johnson time to think more carefully about his liberation plans.

 

 

 

 

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Pakistan suspends licenses for import and field trials of GM corn and bans trials of GM maize

21 Jul

Despite January’s news that the federal ministry of national food security had halted the GM approval process, the Cornell Alliance for Science reported, on July 9, 2019, that Pakistani farmers and scientists expressed the need for genetic modification at a recent Crop Life Pakistan Association event.

A reader now sends news that all biosafety licenses regarding import and field trials of GM corn in Pakistan have been suspended. There is also a ban on further trials of GM maize for an unspecified period in order to avoid crop contamination that can subsequently hurt maize exports.

Rafhan Maize, a major exporter, has given their view publicly that their exports may be compromised if GMO is introduced. The Lahore based company provides maize for industrial applications, animal nutrition and food products.

In its set of recommendations, members of a parliamentary committee, headed by the Speaker of the National Assembly, recommended Pakistan to follow the example of China, India, and Turkey. None of these countries has adopted GM food crops.

Pakistan Economist

In June Market Screener reported that the unprecedented near-consensus against GM is amazing: “All the major stakeholders of agriculture sector including farmers, food processors, national seed companies and agribusiness exerts, vehemently oppose cultivation of genetically modified maize in Pakistan”.

It added that at another meeting at Department of Agriculture, Government of Sindh, the former World Bank project Head Shahajahn Hashmani said that now all progressive countries in the world are working hard towards preserving their own indigenous varieties.

Further reading: Pakistan Economist article.

 

 

 

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Pakistan fends off cultivation of GM corn: Jan. – May 2019

30 May

 JANUARY

The News reported that the Pakistan Agriculture Research Council (PARC) called a meeting of Variety Evaluation Committee (VAC) to seek approval for the commercial farming of genetically modified corn varieties developed by multinational seed companies.

The Federal Minister for National Food Security Sahibzada Mehboob Sultan asked for a cancellation of meeting, saying that this was due to the request of Faisalabad Agriculture University as its team was not ready to show up.

Some stakeholders in the seed business strongly opposed the introduction of genetically modified corn’s commercial cultivation for several reasons:

  • it would increase the cost of farming for farmers due to high royalty fees,
  • it would lead to contamination of local germplasm, particularly in maize, which is a wind pollinated crop,
  • it would have an adverse effect on the investment in locally developed hybrid varieties and discourage local production and research and development in seed business and
  • Pakistan would not be able to export GM products to a wide range of GM-free regions and countries.

They said Pakistan’s per hectare production of corn was already showing an upward trend and with five tons per hectare output of corn hybrids, Pakistan was already ahead of several countries that allowed genetically modified corn. “We are sufficiently meeting our needs of corn through local production and there is no need to experiment with genetically modified organisms, which have several proven issues,” sources said.

FEBRUARY

The Technology Times reported that Pakistan Kissan Mazdoor Tehreek (PKMT) – an alliance of small and landless farmers including women farmers – fully support the position of the Ministry of National Food Security & Research which has distanced itself from going ahead with approval of genetically modified maize in Pakistan by intervening to cancel the VAV meeting in January. PKMT reiterates their demand for a moratorium on genetically modified seeds and foods in the country as it violates farmers’ collective rights to seed.

They stress that the recent lawsuit against Monsanto won by a USA citizen suffering from cancer due to the company’s herbicide Roundup Ready clearly shows the critical health hazard to Pakistani famers who will be forced to use the herbicide along with GM seeds and add that in India, Monsanto’s Bt Cotton has failed drastically; and the story is no different in Pakistan.

For many years, they add, ‘the company’ (Monsanto?) has been lobbying for commercial use of GM maize; which – if approved – will cross-pollinate and rapidly destroy the local maize seed varieties.  Pakistan’s per hectare production of maize was already showing an upward trend that is already ahead of many countries that are using genetically modified maize.

The News reports that – despite strong opposition from farmers, local seed companies, officials and experts of agriculture – multinational companies have increased efforts to get genetically modified (GM) maize registered at the Variety Evaluation Committee (VEC) and start its production in the country.

MARCH

In order to create awareness among journalists about science-related communication, the Lahore chapter of Pakistan Biotechnology Information Center and The International Service for the Acquisition of Agri-biotech Applications (ISAAA) organised a one-day workshop at the Forman Christian College University (FCCU) Lahore on March 3, 2019.

Pakistan Today reports that, during the workshop, Malaysian Biotechnology Information Center (MABIC) Executive Director Dr Mahaletchumy Arujanan gave a brief presentation on biotechnology, Genetic Modification (GM) Technology and the industrial challenges.

FCCU Dean of Postgraduate studies Dr Kauser A Malik told the audience of science writers and journalists that they could play an important role in informing the public about scientific and technological developments by bridging the gap between the common person and scientist, ensuring the ‘formulation of appropriate government policies conducive to the development of science in the country’.

APRIL

Business Recorder published an interview in two parts with a team from CropLife Pakistan Association, an association of multi-national biotech firms working on seed technology in the country, currently advocating the introduction of Genetically Modified seeds, specifically GM maize. Part 1 – focussing on developing an understanding of the science behind GMOs – may be read here. A few days later the second part was published, focussing on the environmental safety and regulatory aspects.

MAY

Representatives of seed companies warned that Pakistan will not be able to export its products to many regions and countries in Europe and Africa. A case in point follows:

Bulgaria, which told the European Union in 2015 that it was to ban the cultivation of crops with genetically modified organisms (GMOs), attended the second meeting of Pakistan-Bulgaria Inter-Ministerial Commission. On Monday 20th May, the Bulgarian Minister for Economy, Liliya Ivanove Ivanove, stated that Bulgaria is looking forward to extensive cooperation in the field of agriculture including sustainable imports of cotton and rice from Pakistan.

But USDA is undeterred: Dawn reports that the Foreign Agricultural Service of the United States Department of Agriculture (USDA) said future collaborative projects between the US and Pakistan include using American GM soybean feed in poultry, fish farming and dairy industries, introducing genetically-engineered maize and working with various government departments to develop uniform food safety standards.

 

 

 

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5G? Belgium observes the precautionary principle – will Gloucestershire?

23 May

 

A Bournville resident draws attention to plans for a pilot project to provide high-speed 5G wireless internet in Brussels, which have been halted due to fears for the health of citizens

The Brussels Times, Belgium’s premier daily online newspaper in English, reports that in July, the government concluded an agreement with three telecom operators to relax the strict radiation standards in Brussels.

However, the region has found it ‘impossible’ to estimate the radiation from the antennas required for the service. 

“I cannot welcome such technology if the radiation standards, which must protect the citizen, are not respected, 5G or not,” Environment minister Céline Fremault (right) said, “The people of Brussels are not guinea pigs whose health I can sell at a profit. We cannot leave anything to doubt.”

A pilot project is not feasible with the current radiation standards, and Céline Fremault has said that she does not intend to make an exception.

The Brussels region has particularly strict radiation standards for telecom applications. The standard of 6 volts per metre has already led to problems in the past with providing fast mobile internet via 4G in the capital.

In March, the various governments in Belgium failed to reach agreement on the auctioning of the 5G licences. It will be up to the next government to handle the proposal, said Telecom Minister Philippe De Backer.

Today news of a Gloucestershire-based 38 degrees petition has been received. It urges political leaders to challenge 5G, invoking the Precautionary Principle, and to delay Gloucestershire’s 5G expansion until it can be verified through reputable, independent and peer-reviewed studies that 5G and the total radiation levels caused by RF-EMF (i.e. 5G, together with 2G, 3G, 4G, and WiFi) will not be harmful for the environment or to the citizens of Gloucestershire –especially infants, children and pregnant women.

 

 

 

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