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City blood banks need modern gear

Check out your chocolates

Clinics can’t deny emergency service

Is the vaccine more dangerous than the cure?

Vitamin A drive violated national guideline

How safe is your branded lipstick?

Escalators are safe only when You’re Cautious

Celebrate the season with joy, not accidents

Is the vaccine more dangerous than the cure? 

Published:  Times of India, February 8, 2002 ,

 By Soumi Ghosh

CUTS Centre for Sustainable Production & Consumption- Calcutta

Viral hepatitis, an infection of the liver caused by the hepatitis B virus (HBV) has shown an alarmingly increase menace not only in our country but all over the world. In India, hundreds of people die of this infection.
 
As newborns can be infected by the virus from their mothers’ blood during childbirth, vaccination against hepatitis B has been recommended in the childhood immunisation schedule for 2002 to all US newborns before leaving the hospital. But how safe are these vaccines?
 
Hepatitis B vaccination is already a part of national immunisation programme in 120 countries including Indonesia, Sri Lanka, Bhutan and Maldives. Going by the WHO recommendations, Delhi government, last year, introduced free hepatitis B vaccine. The government of India also plans to include hepatitis B vaccination in the immunisation programme during the 10th Five Year plan.
 
There is no doubt that other immunisation programmes like National Pulse Polio Programme have greatly improved public health in our country but the government should consider expert opinion on the risk and safety of hepatitis B vaccination before including it in the immunisation programme.
 
The figures released in 1999 by The National Vaccine Information Centre (NVIC), Vienna, a vaccine safety advocacy organisation, revealed that the number of vaccine-associated ‘adverse events’ and deaths reported in US children under the age of 14 significantly outweighed the reported cases of hepatitis B disease in that same age group.
 
Independent analysis of raw computer data generated by the government-operated Vaccine Adverse Reporting System (VAERS) confirmed that in 1996, there were 827 serious ‘adverse events’, in the US reported to VAERS in children under 14 who had been injected with the hepatitis B vaccine. In contrast, during that same period, there were only 279 reported cases of hepatitis B disease in children under 14.

In 1998, France became the first country to suspend the routine immunisation programme for school children after reports that many children were developing chronic arthritis and symptoms resembling multiple sclerosis (MS) following the administration of hepatitis B vaccine.
 
However, WHO, with the assistance of external experts in neurology, epidemiology, immunology and public health, has carefully reviewed the scientific evidence on whether hepatitis B vaccine can cause diseases such as multiple sclerosis. 

WHO believes that available scientific data does not demonstrate a casual association between HB immunisation and central nervous system diseases, including multiple sclerosis. WHO also claimed that 1 billion doses of hepatitis B vaccine have been used since 1981 with an outstanding record of safety and efficacy.
 
So the debate is still going on whether the hepatitis B vaccine is safe or risky. More over, in India there are other administrative and infrastructural bottlenecks. Dr. T Jacob John, former president of Indian Academy of Paediatrics has opined that unlike in other countries the Indian Government does not have a policy on vaccines and their use.

Pharmaceutical companies run the show. Few months earlier, one pharmaceutical firm in Mangalore created mock panic on dangers of hepatitis B vaccine highlighting that HBV is more dangerous than HIV. After that six doctors in Mangalore in a letter to Union Minister for Health and Family Welfare Dr. C.P. Thakur urged him to formulate a national policy on HBV vaccination and publicise it widely. The doctors opined that HBV poses risk only to the ‘high-risk group’ and not the general public. Unlike AIDS, the HBV in 90 percent of cases is cured spontaneously through the body’s immune system.
 
Hence, before including hepatitis B vaccination in the immunisation programme, the Government should initiate a debate on its effectiveness and the risk involved in it.  

Simultaneously infrastructure should be developed nationwide for proper implementation of such programme. Steps should also be taken against the manufacturers who are creating artificial terror.

Moreover, there should be a law to compensate children adversely affected from any vaccine. Once these are done, the Government can think of including hepatitis B vaccination in the immunisation programme.

Vitamin A drive violated national guideline

Published:  The Times of India, January 17, 2002

 By Soumi Ghosh

CUTS Centre for Sustainable Production and Consumption

Recently, sixteen children died in Assam after being administered Vitamin A doses in UNICEF-Assam Government jointly organised Pulse Vitamin A programme. Several hundred children were treated in hospitals with stomach ailments and cramps.
 
Since there is always chance of fatalities during vitamin A administration, the national consultation on Vitamin A had clearly expressed the view that heavy doses of Vitamin A should not be administered along with the Pulse Polio programme. Therefore what has happened in Assam is a serious violation of this national directive.
 
After analysing the reports, three possible reasons for the tragedy could be identified. The death might be due to overdose. In the third phase of the programme, a plastic measure cap capable of holding 2.5 times more than the normal dose replaced the usual spoon of exact measure.

Moreover, the volunteers were not properly trained to make the parents understand the exact dose and the risk involved in administration of overdose. However, nutrition experts opined that overdose could not be the likely cause of death of the children as in few cases deaths were also reported from places where the old spoon of exact measure had been used.
 
Few experts questioned the quality of medicine used. After analysing the vitamin samples used in the campaign, the Drug Testing Laboratory in Kolkata has confirmed that they were in perfect condition.
 
However, no screening was done. Vitamin is a micronutrient that has to be administered carefully. Nutritionists and child specialists strongly feel that screening is necessary to ensure that a child is not suffering from diarrhoea or liver disorder. 

But, the state health minister said that it was not possible to screen every child in a campaign of such magnitude. He said that the parents should have informed the volunteers if their children had such problems. The question is, had the parents been informed in advance about this risk?

If it was so difficult to take minimum precaution, then the state should not have gone for such programmes. The authorities have also admitted that children who been given the Vitamin A dose, belonged to areas prone to intestinal diseases like diarrhoea, amoebiasis and malaria. 
 
Now, question could be raised about the justification of such mass health campaigns without prior assessment of administrative capabilities. What could be the objectives of such programmes?
 
UNICEF opines that a special drive like this helps boost the coverage that otherwise remains at a very low level. At present, mild cases of Vitamin A deficiency are found in certain pockets of the country, that hardly call for such a drastic and potentially dangerous preventive remedies. A recent survey shows that only 0.3 percent children in Assam had symptoms of Vitamin A deficiency. So, there was really no need to target all the children for the programme. Only children with malnutrition or clinical Vitamin A deficiency should have been targeted.  

Nutrition expert C. Gopalan thinks that such supplementation programme is totally unnecessary when green leafy vegetables and seasonal fruits, plentifully available in the countryside and within the reach of the poor, can control the problem.
 
It has been reported that in order to get political mileage, some state governments have launched such massive campaigns for Vitamin A administration. The Centre has now asked all the states to stop Vitamin A campaigns for children and emphasised on improving routine immunisation work.
 
Some nutritionists believe that the supplement industry is exploiting people for commercial gain. Efforts are being made to expand the market for synthetic Vitamin A in poor South Asian countries.
 
All this has raised a big question about the safety of these health campaigns. The Centre has admitted that such drives require intensive training of field staff and an effective monitoring system, which the present system is unable to take care of, especially in areas having weak infrastructure.
 
The Assam chief minister has ordered a CBI enquiry. We urge the CBI to investigate whether any vested interest was using human being as guinea pigs, as had happened earlier at the Regional Cancer Centre in Kerela, where one of the scientists of The John Hopkins University tested experimental cancer drugs on patients without any prior approval from the authority.

How safe is your branded lipstick?

Published on:  The Times of India, January 13, 2002

 By Soumi Ghosh

CUTS Centre for Sustainable Production and Consumption

For thousands of years, people have been applying cosmetics to satisfy their desire to look beautiful. However, the use of chemical cosmetics grew rapidly from the beginning of the 20th century.

India, with its population of more than one billion, has become an attractive market for the cosmetics industry. Currently, the market is being flooded with both domestic and foreign products.

Apart from the branded items, there are hundreds of non-branded products as well. Due to lack of purchasing power, a majority of the population buy low quality products, which are seldom manufactured following standard procedures. Bureau of Indian Standards (BIS) warns that substandard cosmetics could contain strong acids and alkalis harmful for skin.

Dermatologists say that the poor quality cosmetics could cause itching, swelling, and pigmentation. Harmful chemicals in cosmetics could also cause toxic effects on skin which may lead to cancer.

Even branded cosmetics could be a source of allergic reactions depending on the skin type. Ingredients such as fragrance and preservatives could cause allergic reactions to some people.

The synthetic adhesive used in bindis might lead to itching, skin irritation, eczema and leucoderma. Sometimes, natural ingredients could also cause skin problems.

Nearly half of the people questioned over telephone in a quick survey by CUTS in November, 2001 responded “yes” to having suffered an allergic reaction to personal care products, mostly in case of sunscreen lotion, fairness cream, body deodorant, soap and bindi.

As a precautionary measure, the consumer should check the ingredient list on the container. Doctors, while treating patients suffering from cosmetic-induced illness, do not often find the ingredient list on the pack although it is a mandatory requirement. Even if it is available, in most of the cases the names of the ingredients sound unfamiliar to consumers.

Most importantly, illiterate consumers cannot even read the list. As a solution to these problems, we could think of some symbol that signifies the safety of the product, just as there are ISI marks for cement, electrical appliances or gas oven.

This is needed to save consumers from spurious cosmetics. The sale of these fake cosmetics is not confined to small shops in rural markets as is commonly believed. Even big shops in urban markets sell spurious products. Since there is no quality check, consumers run the risk of suffering from skin reactions.

To protect Indian consumers from this enormous risk, the best option is to make Ecomark (Indian Ecolabel) mandatory for any cosmetic product, as Ecomarked products will have to satisfy the quality, performance and safety requirements of BIS. Those products will also declare the list of critical inputs and would not be manufactured from any carcinogenic or harmful ingredients.

A working group comprising Central Pollution Control Board (CPCB), Delhi, Consumer Unity & Trusts Society (CUTS), Kolkata, and Pharmacopoeial Laboratory of Indian Medicine (PLIM), Ghaziabad, was formed in 1994 to verify the detailed technical information of ingredients of liquid bindi, sticker bindi and sindoor before awarding Ecomark. However, as the ecolabel has not been made mandatory, no producer of those products has applied for it till date.

After liberalisation, many foreign companies are entering Indian market with their products. As a safety check, it should be examined whether these multinational companies have procured the official Ecolabel of their respective countries. The symbol of Ecolabel, on the pack of the cosmetics would help the consumers to identify a safe and eco friendly product.

This is high time that the consumers should start demanding such cosmetics and Ecolabel could be an important tool to achieve that objective.

Escalators Are Safe Only When You’re Cautious

Published on:  The Times of India, December 18, 2001

 By Arjun Dutta & Soumi Ghosh

CUTS Centre for Sustainable Production and Consumption

Ritu Bose was returning home using the Metro rail. At one station, instead of using the staircase she tried the escalator. Unfortunately her dupatta got caught in the comb plate and was torn. She remained unharmed. Not knowing whom to blame and embarrassed, she decided not to report this to the authorities.

Such instances of user's foot or an article of clothing getting caught between the escalator steps are not rare to people who are unaware of safety precautions to be taken while using escalators.

The fatality of escalators hogged the limelight in December 1999 when Jyotsna, an eight-year-old girl, got crushed to death while descending an escalator at Indira Gandhi International Airport.

After this incident, Airports Authority of India came up with unconvincing theories and the manufacturer had inconclusive answers.

In cities, installation of escalators is increasing at airports, railway stations, auditoriums and supermarkets. However, day-by-day they are becoming very risky. No attempt is being made by the manufacturers or the installers to educate users on their proper use.

Most escalators do not have alarms that passengers can press midway if something happens. Neither they have automatic sensors that stop a moving escalator if some objects get stuck.

Sudden malfunctioning of the escalator, leading to jerks in the reverse direction may cause riders to fall backwards.

Falling down while getting on the escalator because of poor illumination impairing visibility at the foot of the escalator and children's feet getting caught in the side of the escalator are some common causes of escalator accidents. In India, the foremost need is to formulate mandatory safety standards for all escalators.

There should be signboards near all escalators indicating safe use. Every escalator should carry stickers with date of servicing and next due date

Any escalator that fails to meet mandatory safety standards should be shut down till they are certified as safe. Every escalator should indicate prominently the location of emergency shut-off switches and such switches should be at the top and bottom of the escalator.

Escalators are safe provided its user is aware about the safe use of escalators. Users are advised to take the following steps:

·         Make sure that shoelaces are properly tied before stepping on an escalator. Besides shoelaces, loose drawstrings 

      attached to children’s dress, duppattas, dhotis and sarees can also get trapped in escalators

·         Stand towards the middle of the steps avoiding the sides to avoid entrapment

·         Always face forward and hold the handrail

·         Step on the escalator carefully and be cautious if you wear bifocals

·         Step off yourself instead of letting your feet roll off the steps of the escalator. This would prevent the feet from getting caught 

      in the escalator

·         Always hold the hand of children while going on escalators and keep them away from the edges

·         Never allow children to sit or play during an escalator ride

Celebrate the season with joy, not accidents

Published on:  The Times of India, November 14, 2001

 By Arjun Dutta & Soumi Ghosh

CUTS Centre for Sustainable Production and Consumption

Every year, the sound of firecrackers announces the celebration of Diwali. The festival is characterised by a mega firecracker burning session in the evening. But many accidents take place during this merrymaking. The major accidents are reported but the minor accidents go unaccounted.

Flying crackers have been a menace near puja pandals. According to data provided by the West Bengal Fire Service (WBFS), in Kolkata and its suburbs, nine pandals caught fire due to fireworks in 2000. In entire West Bengal, 21 pandals caught fire due to fireworks.

As a safety precaution, the WBFS suggests that each pandal should have separate exit and entrance gate, and entry passage in pandals should be such that fire engines can enter the pandal without any obstruction. Further, burning firecrackers near pandals should be discouraged.

Accidents are most likely to occur when children play with firecrackers. As the first safety measure, parents should accompany their children when they light firecrackers and should keep watch that they do not get close to the firecrackers when they are about to burst. Children should only wear tight cotton clothes. The parents should also try to convince their children to buy only less harmful firecrackers like sparklers, fountains and wheels.

Accidents also take place while making firecrackers. This year, 11 people, including five children, lost their lives in a blast of gunpowder for making crackers at Vijayawada.

Diwali has also become synonymous with noise, smoke and smog with bursting of firecrackers. Harmful gases like copper, magnesium, zinc, nitrate potassium and lead are emitted from fireworks and firecrackers. These gases are causing people to become more prone to bronchitis, asthma and heart attacks, besides various skin and eye irritations.

An increase in noise pollution beyond 125 decibels, which is beyond tolerable limits, can cause deafness in acute cases. The Supreme Court has already banned firecrackers generating noise greater than 125 decibels.

Even the West Bengal Pollution Control Board has advertised asking the public not to use fireworks generating noise above 90 decibels and restricted the use of firecrackers between 6.00pm and 10pm.

However, implementation of these rules would only be possible if people decide to make it a festival of joy and not of accidents.