Marijuana liability: The Canadian Medical Protective Association (CMPA) recommends that doctors who sign declarations giving their patients access to medicinal marijuana should ask their patients to sign a release-from-liability form at the same time. Recently revised regulations governing Health Canada's medicinal marijuana program (CMAJ 2005;173:473) reduced the onus on physicians as gatekeepers, but they could still potentially face liability for allowing patients to use the unproven drug. The release form is available on the CMPA Web site: www.cmpa-acpm.ca
Chernobyl's legacy: Nearly 4000 people could eventually die from radiation exposure as a result of Chernobyl's nuclear power plant disaster in 1986. A new report from the Chernobyl Forum states that at the time of the disaster, approximately 1000 staff and emergency workers were exposed to high-level radiation. An estimated 2200 radiation-caused deaths are expected among these and other recovery operation workers exposed in the ensuing months. Related deaths have also resulted from leukemia, acute radiation exposure and thyroid cancer. Although thyroid cancer has caused only 9 deaths, its occurrence has skyrocketed among children and teenagers, with almost 4000 cases reported. The largest public health issue is mental health problems, which are associated with relocation (350 000 people were moved out of affected areas), “paralyzing fatalism” and a belief in short life expectancy. The report also considers ways that Belarus, the Russian Federation and Ukraine can address major economic and social problems resulting from the disaster.
Car crashes and cell phone use: Drivers using mobile phones have a 4-fold increased risk of crashing and suffering injuries that require hospital attendance. A recent study (BMJ 2005;331:428) found that the increased risk occurred whether or not a hands-free device was used. Policymakers in Australia tried to reduce risk of accidents in 2001 by banning hand-held mobile phones while driving and advocating for hands-free sets. However, the BMJ study of 456 people attending emergency departments showed that the risk was constant across both types of mobile phones. The researchers are concerned that new wireless technology such as voice activation may lead to increased use of mobile phones in cars, despite the clear risk. Driving using a hand-held mobile phone is also banned in most of the European Union, several US states and in Newfoundland and Labrador.
Nobel for ulcer scientists: An Australian scientist was awarded the 2005 Nobel Prize for Medicine 23 years after infecting himself with Helicobacter pylori to prove it caused stomach ulcers. Drs. Barry Marshall and Robin Warren, the joint Nobel prize recipients, were the first to show a bacterial cause of ulcers, drastically changing ulcer treatment. Warren first identified the curve-shaped H. pylori from patient samples of inflamed stomach lesions in 1982. Warren cultured the bacteria after accidentally leaving a petri dish out in his lab over an Easter break. Marshall joined Warren that same year. “In the beginning nobody believed us,” Marshall told an Australian news channel. “They said, well, we know the cause of ulcers, we don't need any new causes.” Scientists believed that stress caused ulcers and that the stomach environment was too acidic to support bacteria. Eventually, Marshall drank a container of fluid containing H. pylori and developed a vomiting illness and had severe gastric inflammation for about 2 weeks. Marshall underwent an endoscopy to prove that the bacteria had caused inflammation in his stomach. In its citation, the Nobel Committee said the scientist's “pioneering discovery” has led to “an increased understanding of the connection between chronic infection, inflammation and cancer.” Their work has stimulated research into infective causes of other chronic inflammatory conditions, such as Crohn's disease and rheumatoid arthritis. — Compiled by Sally Murray, CMAJ
DOI:10.1503/cmaj.051338