News Diesel exhausts do cause cancer
Exhaust fumes from diesel engines do cause cancer, a panel of experts work- ing for the World Health Organization says. It concluded that the exhausts were definitely a cause of lung cancer and may also cause tumours in the blad- der. The findings were based on research in high-risk workers such as miners, railway workers, and truck drivers. However, the panel said everyone should try to reduce their exposure to diesel exhaust fumes. The International Agency for Re-
search on Cancer, a part of the World Health Organization, had previously labelled diesel exhausts as probably carcinogenic to humans. IARC has now labelled exhausts as a definite cause of cancer, although it
Kenyan doctors push for drive to reduce cervical
cancer deaths In Kenya non-communicable diseases (NCDs) such as cancer have not, in the past, been seen as a priority. Many public health specialists are saying that must change. ‘Every year, Kenya loses approximately 3400 women to cervical cancer,’ says Dr Lucy Muchiri, a pa- thologist who specialises in the disease at the Kenyatta National Hospital and the University of Nairobi. Dr Muchiri suspects that the num- bers of cervical cancer fatalities are significantly higher because there is no accurate tally of cancer rates in remote rural areas. ‘Not everyone has access to laboratory diagnosis,’ she says, ‘so a lot of Kenyans die of disease or are being treated at home without medi- cal diagnosis.’ Health advocates and researchers estimate that fewer than 5% of Kenyan women are screened for cervical cancer annually. Fortunately, the past decade has yielded another powerful tool in the
10 Africa Health
does not compare how risky different carcinogens are. Diesel exhausts are now in the same group as carcinogens ranging from wood chippings to pluto- nium and sunlight to alcohol. It is thought people working in at- risk industries have about a 40% in- creased risk of developing lung cancer. Dr Christopher Portier, who led the assessment, said, ‘the scientific evidence was compelling and the Working Group's conclusion was unanimous, diesel engine exhaust causes lung cancer in humans. Given the additional health impacts from die- sel particulates, exposure to this mix- ture of chemicals should be reduced worldwide.’ The impact on the wider popula-
tion, which is exposed to diesel fumes at much lower levels and for shorter periods of time, is unknown. Dr Kurt Straif, also from IARC, said, ‘For most of the carcinogens when there is high exposure the risk is higher, when there is lower exposure the risk is lower.’ There have been considerable efforts to clean up diesel exhausts. Lower sul- phur fuel and engines which burn the fuel more efficiently are now in use.
fight against cervical cancer world- wide. In 2006, the pharmaceutical companies Merck and GlaxoSmith- Kline both released vaccines designed to protect women from the human papillomavirus (HPV), which causes cervical cancer. By 2009, 33 devel- oped countries had included the HPV vaccine as part of their national immu- nisation programmes. Up to now, appeals to Kenyan poli-
cymakers – including targeted lobby- ing of women representatives – have failed to achieve provision of the HPV vaccine as part of the government’s reproductive health strategy. But gov- ernment agencies recently said they are beginning the process of applying for HPV vaccines to enable mass vac- cination campaigns. KNH’s Dr Gathari Ndirangu cautions, however, that more than acquiring vaccines is needed. Careful planning, he says, will be required to handle the HPV vaccine, which must be kept at an appropriate temperature. ‘Logistics for vaccines,’ Ndirangu says, ‘take up much more re- sources than the actual procurement.’
Awards 1. Kenyan wins award for improving health in the
community Rolex Awards for Enterprise are given to exceptional individuals in the fields of science, the environment, and tech- nology. This year one such award has been
given to Aggrey Otineo, who returned to the Nairobi slum of his birth deter- mined to use his US masters degree to improve the health of the community in which he grew up. Korogocho is the fourth largest slum in Nairobi and among its estimated 200000 inhabit- ants many mothers and babies die in childbirth each year.
Otieno proposes to build a slum telemedicine centre with an on-call doctor and van. The centre will ad- vise birth attendants via text message and, if necessary, dispatch the van to transport the woman to hospital. The service will be enhanced with a com- munity education package on mater- nal health.
2. UK doctor wins award
for work in Africa A UK doctor has won the prestigious title of Junior Doctor of the Year for his work in helping promote health edu- cation in Africa. It was the third year the category has run at the British Medical Journal Group Improving Health Awards. Dr Finlayson won the award for his ‘varying and impressive’ work across clinical medicine, including his most notable achievement, MedicineAfrica. The programme was initially set up in Somalia and it aims to offer medical students and doctors in the country the chance to receive expert health education, often where there is no ob- vious career path for them. ‘MedicineAfrica is supporting iso- lated healthcare workers in low- and middle-income countries using UK NHS [National Health Service] work- ers’ expertise and using their experi- ence to offer the support for people where there is no natural career path in difficult circumstances,’ Dr Finlay- son said. The programme has been successful and has now incorporated the African countries Tanzania and Ghana, as well as spreading into Asia in Palestine.
July 2012
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