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Biomedical subjects

L G Bonneux

Publications and source records attributed to L G Bonneux.

2 recordsLinked to original sources

[Passive smoking: an environmental health risk].

The supposed health risks of passive smoking are leading to increasingly restrictive legislation on smoking. Tobacco smoke is undoubtedly irritating to the eyes, nose and throat of non-smokers, but politicians wanted more spectacular facts. There is some evidence of fatal consequences of passive smoking, particularly increases in lung cancer and heart-disease mortality among non-smokers exposed to tobacco smoke. Most studies compare the non-smoking partners of smokers and non-smokers. The observed relative risks are too small to be ascertained reliably. The more than twentyfold increased risk of lung cancer among smokers and the presence of tobacco-related metabolites in non-smokers' body fluids lend support to the hypothesis that passive smoking causes lung cancer. The less than twofold increased risk of heart disease among smokers and the documented social-risk factors cast doubt on the validity of the increased risk of heart disease in non-smokers, associated with having a smoking partner. The precautionary principle regulates potential environmental health hazards: the suspicion and the hazard must be sufficiently serious to take legislative action. There is ample evidence of tobacco smoke's carcinogenicity and the accumulated knowledge strongly suggests that the legal threshold of an acceptable environmental health risk has been exceeded.

Cardiovascular Diseases↗

[Breast cancer screening lacking effectiveness].

The recent Cochrane review on mammographic breast cancer screening disclosed no convincing reduction of breast cancer mortality, together with an increase in the number of aggressive treatments. Given this outcome, there no longer exists solid experimental evidence to support mass screening. In the Netherlands over 800,000 women are invited to participate in this activity yearly. Is this still justifiable? The final answer rests on the conclusions from the analyses carried out from three different perspectives. From the methodological viewpoint, a broad re-analysis is needed which also takes the long-term adverse effects of radiotherapy into account. From the tumourbiological perspective, whether 'early' diagnosis really has potential therapeutic consequences should be explored further. From a societal perspective, more detailed and balanced information is required, since expectations regarding the effect of screening are unrealistic. Given the preliminary outcomes of these analyses, there are now serious reservations as to whether continuation of screening is justified. Women should be informed about this matter promptly.

Adult↗