Tag Archives: absolute risk

Fail and Shameful Scaremongering

From the Daily Mail:

Fail
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And another story aimed at scaring pregnant mothers: ‘Babies born at night in hospital ‘have higher risk of dying‘. Now, we looked at absolute risk and relative risk the other day, so this article is using the same scary trick:

Pregnant women have been warned their delivery is nearly fifty per cent more likely to go wrong if they give birth at night rather than during the day due to poor staff cover.

A worrying study has uncovered a link between drastically higher rates of newborn death and admission to neonatal intensive care for deliveries in the evenings and early hours…

The chances of death in some hospitals could be as much as 47 per cent higher if the babies are born between 6pm and 8am than if they are born during the day. [My emphasis]

So, in order to assess how worried mothers would need to be, and whether this rate is ‘drastically higher’ we have to look at the percentage of children dying:

between 0.05 and 0.09 per cent of infants died during or soon after birth.

Rates were higher among infants born at larger hospitals, but were still less than 1 per cent.

So, as we know, 47% higher relative risk when the absolute risk is less than 1% it not something pregnant mothers should worry about or even consider, yet undoubtedly this article aims to make them do just that. This is pathetic scaremongering and typical of the Daily Mail outlook on life. Just shameful.

How the Daily Mail Manipulates Risks and Belittles Health and Safety

An important disclaimer: I am not using real figures in the examples used in this post. Also, the maths is my own, so the examples may well be wrong, as might my shaky understanding of various risks. If so, please feel free to correct me in the comments.

Yet more hilarity on the Daily Mail website today with a story on how ‘elf’ and safety killjoys have put up a sign near a public paddling pool WARNING parents about the dangers of paddling in cold conditions. ‘Bemused parents’ – according to the Daily Mail – claimed that the sign was ‘health and safety gone mad’ not once but twice in the article and the sense of outrage simmered throughout. The Council would shut the pool if the air temperature dropped below 15 degrees but any temperature above that it would be at the discretion of the parent. A council spokesman said:

‘This sign gives people some basic information that might be useful in helping users decide how to best enjoy the paddling pool with their families.

‘If the temperature gets quite low it can have effects – it can be dangerous.’

Doesn’t seem hugely controversial to me, in a society that demands information and wants to know what risks they face. It is funny how the Daily Mail screams ‘elf and safety gone mad’ at every attempt by a council or employer to identify and warn against risk (remember, health and safety normally comes in the form of advice that you are free to ignore at your own risk, it rarely ‘bans’ anything) yet they constantly pinpoint minute risks to their readers. For instance, today’s front page contains a dire warning to mothers; ‘RISK FOR BABIES BORN 1 WEEK EARLY’ screams the headline and the tagline makes it clear what the risk is: ‘Serious health problems more likely, finds study on UK children’.

Firstly, as a newspaper, why froth about health and safety identifying risks that people can take simple steps to avoid or reduce and laugh about why a council should bother pointing them out, when you are perfectly happy to publish largely unavoidable risks on the front page of your newspaper? The Daily Mail are actively against reducing avoidable risks, but in favour of scaring people with largely unavoidable risks.

Secondly, presumably the thing that annoys the Daily Mail – and leads to them trotting out the ‘health and safety has gone mad line’ – is that the risks identified by councils are tiny, and therefore it is a waste of time for an overbearing nanny state to even identify that they exist, let alone produce information on avoiding them. Yet, conversely, they are prepared to scare people – pregnant mothers and new mothers of all people – with a tiny unavoidable risk on the front of their newspaper.

When it comes to risk it is vital to realise how newspapers use percentages to make it sound like a risk is massively increased by either doing or not doing something, consuming or not consuming something; or, as in this case, having a child even 1 week early. First of all, you need to understand what absolute risk is in this case. For example (IMPORTANT: these are not real figures, just an example), say out of every 10,000 babies born at 39 weeks (1 week early) 1,000 developed special needs. Risk is always a figure between 0 an 1, 0 being an impossible event (probability of 0) and 1 being an inevitable event (probability of 1).

To get the absolute risk figure here we merely divide 1,000 by 10,000 to get 0.1. So the probability of having a child at 39 weeks with special needs would be 0.1 or 10% (10 in every 100 children would develop special needs). If you did the same for children born with special needs at 40 weeks (the ‘full term’), say 100 out of every 10,000 developed special needs, then the probability of full term babies developing special needs would be 0.01 or 1% (1 in every 100 would develop special needs).

You can then start looking at the relative risks involved and it is these figures that the media commonly uses. In this instance to work out the relative risk you would divide the percentage of children developing special needs at 39 weeks (10) by the percentage of children developing special needs at 40 weeks (1). 1 into 10 goes ten times, meaning a child is ten times or 1000% more likely to develop special needs if born at 39 weeks instead of 40.

So, what are the real scary relative risk percentages that the Daily Mail lined up? Well, for a child born at 36 weeks: they are 36% more likely to develop learning difficulties, which in our example above would mean that 1.36 children in every hundred would develop learning difficulties as opposed to 1 (remember, to double the absolute risk you need to increase the relative risk by 100%).

For a child born at 38 weeks: they are 19% more likely to develop learning difficulties, which in our example above would mean that 1.19 children in every 100 would develop learning needs as opposed to 1 in 100.

For a child born at 39 weeks (remember the headline: ‘RISK FOR BABIES BORN 1 WEEk EARLY’) the increased risk is just 9%, meaning that using our above example figures the risk would rise from just 1 in 100 to 1.09 in 100. Hardly significant, and certainly not worthy of a front page scare story.

What is worse is that the reasons for delivering babies early are often closely related to the health of the unborn child and parent and that because early deliveries are normally carried out to offset different risks more research would be needed before it could even be implied that babies born early are at more risk than if their mother waited the full term before delivery.

The report raises some interesting questions, but before you could make any conclusions or offer any advice to expectant mothers (or indeed to doctors making the decisions) you would have to weigh up the relative risks of not inducing an early delivery or using a C-section, against the known relative risks of waiting for the baby to be in the womb for the full term. Without balancing these risks it is quite conceivable that it is riskier to not deliver a baby early than it is to wait until 40 weeks. This is the conclusion that the medical profession reach during the Daily Mail article yet the Daily Mail completely ignore this with a typical scaremongering headline that neatly ignores the complex reality of childbirth – and even the content of the article that follows.

The hypocrisy with which the Daily Mail tries to scare people with the identification of tiny risks – real or imagined – whilst simultaneously frothing if a council acknowledges a risk and produces information to counter it, is typical of a tabloid newspaper.

It also misses a key point: health and safety advice serves a clear purpose; it helps prevent avoidable accidents and even deaths. For example, whilst the Daily Mail froths and laughs in equal measure about the paddling pool ‘story’ they are also running a story on how popular artist Govinder Nazran has died – aged just 44 – as a result of head injuries. Head injuries caused by a fall directly related to using a spray varnish on his paintings in a room without suitable ventilation, as the coroner pointed out:

‘The underlying cause was two-fold – the chronic damage from the volatile solvent and the acute effect of the alcohol intake contributed to that final fit and fall.’

…He warned: ‘People using this product and similar products must be extremely careful. They must read the instructions and take precautions.’

Still, I guess any advice on reading such instructions if given by a council would be classed as ‘elf and safety gone mad’ and bemused people would scramble to let the Daily Mail know that they find such advice ‘laughable’ and so forth. The sad truth is that this death was easily avoidable, if the product had been applied in a well ventilated area this death would never have happened. The trouble with the media promoting such a blase attitude towards health and safety is that human beings are very irrational and often ignore basic instructions.

Perhaps if a little more media time was spent highlighting easily preventable deaths – and the consequences of ignoring instructions – we would live in a nation that respected that we live in a dangerous world and that health and safety is an attempt to make it slightly safer – and nothing else. Furthermore, perhaps if the media stopped regularly de-sensitising the population through the repetition of minute relative risks relating to doing or eating pretty much anything people might take more significant absolute risks a bit more seriously.