How dangerous is it…REALLY?

Everyone knows arsenic is bad for you. Today we discuss where arsenic comes from, its history as a medicine, how much is bad for you, and how it got its awful reputation. Welcome back, everyone.  I hope you are all weathering the Coronavirus pandemic well.  I'm sure the world will survive this pandemic like it has the others, but individually I hope you all stay safe and healthy. Today’s topic is Arsenic: who eats old lace anyway? Arsenic as a medicine As the world searches for a cure to the Coronavirus, could I make a suggestion?  Let’s not try arsenic.  Through the centuries, it seems that arsenic has been advertised as a cure for many major illnesses.  Since Hippocrates first recommended arsenic as a cure for ulcers and abscesses, it seems that arsenic was recommended for about every conceivable illness.  It has been used to “cure” skin conditions, stomatitis, gingivitis in infants, asthma, rheumatism, hemorrhoids, cough, a fever reducer, and an all-around great health tonic. https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2141.2009.07623.x From 1910 till the introduction of penicillin, an arsenic derivative known as Salvarsan was the primary cure for syphilis, and indications are that it actually did a pretty good job of killing the bacteria without killing the patient, something that not all syphilis cures could claim. https://www.sciencehistory.org/distillations/magazine/early-solution Today, arsenic trioxide is used to treat lymphoma and leukemia. https://pmj.bmj.com/content/79/933/391 However, arsenic is most famous as a cure for rich relatives who were too stubborn to exit this world and leave behind a well-earned birthright.  A little sprinkle of some inheritance powder and suddenly the money started to flow again. Arsenic is a metalloid element with an atomic number of 33.  While it can be naturally found as a pure element, it is often found bonded with sulfur or oxygen.  Mankind has known about arsenic since before the Egyptians used it to embalm their dead to preserve the bodies until heat and moisture could prevent natural decay.  Arsenic in groundwater The most common natural way to encounter arsenic is through contaminated groundwater.  While occasionally human activity is responsible for the presence of arsenic in water, generally most contaminated wells are a result of the leaching of naturally occurring arsenic.  As a child, I remember having our well tested several times to determine arsenic levels.  The areas most affected by natural arsenic in the US are the southwest, northwest, northeast, and Alaska.  Arsenic in groundwater can be a hazard because dangerous levels of arsenic don’t affect the taste of drinking water.  Generally, the only way to detect these levels is through laboratory testing.  The EPA limit for arsenic in groundwater is 10ppb.  They also estimate that 2% of water supplies exceed 20ppb.  2ppb is a normal level, but levels of up to 1000 ppb have been found in drinking water.  https://www.atsdr.cdc.gov/csem/csem.asp?csem=1&po=7  The USGS estimates over 2 million people in the US may be drinking water high in arsenic. https://www.usgs.gov/mission-areas/water-resources/science/arsenic-and-drinking-water?qt-science_center_objects=0#qt-science_center_objects Arsenic contamination can also be from sources such as arsenic-treated lumber, coal-fired power plants, smelting, and mining activity. Other sources of arsenic likely to be encountered in industry include algaecides, cotton harvesting, glass manufacturing, herbicides and pesticides, and treated lumber were common in the past.  Today, the electronics industry is one of the most significant modern users. https://www.atsdr.cdc.gov/csem/csem.asp?csem=1&po=5 Incidence of arsenic poisoning In 2005, there were almost 1000 cases of exposure to non-pesticide arsenic, with over ¾ of these being in adults.  For the 371 cases of exposure to arsenic

In today's podcast we answer a listener's question about the dangers of radon. What do you need to do to protect your family from this monster in the basement? Hello everyone.  Thanks for tuning in to another podcast.  I appreciate all of you taking time out of your day to listen.  As always, I’d love to hear from you if you have a topic you would like me to discuss or suggestions for improvement.  The best way to reach me is through my website sci-vs-fear.com. Before I get started with today's topic, I got some feedback on the childbirth podcast from Gretchen.  She included some research from the CDC that showed a large disparity in maternal mortality between black and white women.  This study showed that black women had 2-5 times the maternal deaths of white women. https://www.cdc.gov/media/releases/2019/p0905-racial-ethnic-disparities-pregnancy-deaths.html Upon looking into it, there were several studies exploring the reason for the discrepancy.  All of the authors acknowledged that attributing cause in cases like this is very difficult.  I really appreciate Gretchen bringing this to my attention.  In the 4-5 hours I have to research a topic, I am bound to miss something.  The interesting thing to me is that the study I cited in the podcast was also from the CDC, and it showed white women having slightly higher maternal mortality.  So, who is right?  I don't know.  Usually, when there is a discrepancy in data the truth lies somewhere in the middle.  These studies are a good demonstration of how the sample population can change the study outcome.  One study that I looked at found that some of the discrepancy is possibly due to the quality of the hospitals more likely to be used by black mothers.  They found that white mothers using the same hospitals, had similar outcomes.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5915910/#R20  That would make sense since much of the improvement in mortality we saw in the 1930s was attributable to improvements in medical care. Gretchen also mentioned that in the US, maternal mortality is on the rise and higher than Europe.  I too had found this during my research.  Determining the factors responsible for this uptick would certainly be worth investigating.  I suspect the answer is quite complex but worth pursuing.  Thanks again for checking my facts and the input. For today's podcast, I got a question from Brett. "I recently had a salesman come to my house wanting to test it for radon.  He said that our area has high radon levels and that my house could be poisoning my family.  How dangerous is radon and am I putting my family at risk?" So, today’s topic is Radon: the monster living in the basement Well, Brett, deciding to get your house checked and potentially mitigated is a personal decision I can't make for you but there is a lot of interesting information available. The US attention to Radon began in 1984 when construction engineer Stanley Watras headed into work at the Limerick nuclear power plant in Pottstown Pennsylvania.  The plant had recently installed monitors to detect any radiation contamination as workers left for the day, but as Stanley entered the plant, the alarms went off.  Eventually, the cause was traced to his home where radon levels were found to be 2700pCi/L.  http://hyperphysics.phy-astr.gsu.edu/hbase/Nuclear/radon.html#c4 This is the highest level ever detected in a home and is similar to concentrations found in Colorado uranium mines in the 1950s. http://www-ns.iaea.org/tech-areas/communication-networks/orpnet/documents/cn223/8-chambers-keynote.pdf What is radon? So, what is radon? If you will remember from my radiation podcast, nuclear isotopes have a half-life, or how long an isotope sticks around.  Now, these isotopes don't just magically become non-radioactive, but rather they decay into other elements.  Eventually, they decay into an element that is happy with the ratio of protons, neutrons,

We've all heard the stories, a simple cut rapidly turns into a life threatening infection that destroys muscle, skin, and tissue. Flesh eating bacteria, how worried should you be? Thanks for joining me again.  Thanks for all of you who provided feedback on the podcast.  Next week’s podcast will be a listener suggested topic.  For those of you who haven’t yet suggested a topic, I would still love to hear from you.  Sci-vs-fear.com Today's topic is: Flesh-eating bacteria: It's not just a flesh wound I first heard of flesh-eating bacteria as a young microbiology student.  It is pretty scary stuff.  It starts out as a minor scrape or cut and within a few days can result in a gruesome death. Take for instance the 2008 case of a 5-year-old Wisconsin boy.  He fell off his bike and skinned his chin and bit his lip.  Not an uncommon event in the life of a five-year-old.  One day later, he was in the ICU fighting for his life against flesh-eating bacteria.  Over the next three days, he underwent five different surgeries to remove dying and infected tissue.  As his body fought the infection, his blood pressure began to drop precipitously.  As the illness progressed, it became increasingly likely that he might not survive.  Thanks to aggressive antibiotic therapy and surgical interventions, after a week in the hospital, his condition began to improve and eventually he recovered completely. https://www.livescience.com/19722-flesh-eating-bacteria-early-treatments.html Flesh eating bacteria: also known as necrotizing fasciitis The medical term for the disease caused by flesh-eating bacteria is “necrotizing fasciitis”.  While many different organisms have caused necrotizing fasciitis, the most common bacterial cause is group A Streptococcus.  This is the same organism that causes strep throat, however, the infection takes a completely different course. Flesh eating bacteria is the same organism that causes strep throat Within 24 hours of infection, the symptoms are readily apparent.  The area of the cut or abrasion becomes red, warm, and swollen.  There is a significant amount of pain at the site of the infection, much more than you would normally associate with a minor cut or scrape.  The redness and swelling can begin to travel to other parts of the body.  Other symptoms include diarrhea, nausea, fever, dizziness, weakness and intense thirst. If not treated immediately, within 3-4 days the symptoms can become much more severe.  Swelling increases, often accompanied by a purplish rash.  This rash can spread, then it transforms into blisters filled with a dark, foul-smelling liquid.  The skin begins to discolor, flake and even peel away as it dies.  If not treated aggressively death can occur in four to five days due to a drop in blood pressure, toxic shock, and organ failure. https://www.webmd.com/skin-problems-and-treatments/necrotizing-fasciitis-flesh-eating-bacteria#2 While the most shocking cases are those who are otherwise healthy, most individuals who acquire the illness have underlying medical conditions that weaken the immune system.  These secondary causes include diabetes, kidney disease, cirrhosis of the liver, cancer and occasionally chickenpox in young children. Invasive strep infections The CDC estimates 11,000-13,000 cases of invasive group A strep occur every year in the US.  Of those 1100-1600 people die.  In addition to necrotizing fasciitis, these illnesses also include cellulitis, pneumonia, and toxic shock syndrome.  That’s roughly a 10% case fatality rate. https://www.cdc.gov/groupastrep/surveillance.html Flesh eating strep fatalities As a class, group A strep becomes more prevalent as people age.  For the 18-34 age group, 0.005% of people are likely to acquire the illness, while the 85+ age group had a prevalence of 0.02%.  Even with the increased prevalence associated with aging, group A strep diseases are relatively rare.  https://www.cdc.

Childbirth has been a constant in human history. Unfortunately, death among mothers was far from rare. We discuss how dangerous it was and how far we have left to go. Welcome, everyone.  With this episode, I have over 20 podcasts under my belt.  It has been a lot of fun and I appreciate all of you.  I have a completely self-serving request of you.  I'm trying to make my podcast better and I really need some good feedback to do so.  I would like to know your favorite episode and one topic that you would love for me to discuss.  Simply go to my website sci-vs-fear.com and click on the red contact button or if it is easier, email me directly at prometheusvsfear@gmail.com.  Again, I’d like to know your favorite podcast so far and one topic you would like for me to discuss.  Thanks again for all of your support! Today’s topic is: Childbirth: There’s got to be a better way As most of you could guess, the only direct experience I’ve had with childbirth is being born and those memories are a bit fuzzy.  I have four kids and so I’ve had plenty of experience on the Dad side, but doesn’t really count.  Not too long ago, we were in the hospital with our daughter, welcoming our first grandchild into the world.  As I watched her struggle to bring my grandson into the world, I thought “this has to be one of the most dangerous things ever.”  This episode goes out to my daughter and my wife. Today’s podcast is going to look at how dangerous childbirth is for the mother.  Making it to 5 years old is a big gamble for the baby and is a topic for another podcast.  US Childbirth deaths In the US, about 700 women a year die due to complications with pregnancy. https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pregnancy-relatedmortality.htm  For a country with the population of the US, this is a pretty low rate.  Other causes of death with similar rates are slipping and tripping falls, falls from ladders, drowning in swimming pools, and freezing to death. https://injuryfacts.nsc.org/all-injuries/preventable-death-overview/odds-of-dying/data-details/ As we will discuss in a minute, it has taken a lot of hard work to get to this place.  The leading causes of maternal death are cardiovascular conditions, hemorrhage, infection, embolism, cardiomyopathy, mental health conditions, and preeclampsia/eclampsia.  Interestingly, the death rates were very similar for black and white women, except that deaths due to mental health conditions were noticeably absent among black women. Of these fatalities, a quarter occurred during pregnancy, 15% on the day of delivery, 18% 1-6 days postpartum, another 18% 7-42 days postpartum, and the remaining quarter 43-365 days postpartum. The fatalities can be categorized as preventable, and non-preventable.  Hispanics had the lowest rate of preventable deaths at 62%, blacks at 63%, and white at 68%.  I found it interesting that of the maternal deaths in this CDC study, over 65% were still preventable. https://www.cdc.gov/reproductivehealth/maternal-mortality/erase-mm/mmr-data-brief.html Childbirth in Africa and South Asia So that is in the US, but how about the rest of the world?  In 2015, over 300,000 women died from pregnancy-related causes.  Of those, the US contributed about 700 with Europe, the Middle East, and Latin America all having similar contributions.  The vast amount of pregnancy-related deaths come from South Asia and Sub-Saharan Africa.  Since 1990, South Asian deaths have shrunk from 200,000 per year to about 100,000.  However, Sub-Saharan Africa has held steady at about 200,000 deaths per year.  Clearly, Africa has some problems. Historic childbirth deaths Surprisingly, it could be much worse.  If we use the 1800 Sweden/Finland mortality rate of roughly 1% ( 900 deaths per 100,000 live births), the expected mortality would be about 1.25 million per year.  If we use the current European Union mortality rates of 0.01% ( 8 deaths per 100,000),

The next pandemic flu is an inevitability. The 1918 flu killed more people than WWI. Today we talk about steps you can take to protect yourself and family. Thanks for joining me for this bonus podcast.  As we talked in the flu podcast, a global flu pandemic is pretty much inevitable.  Proper preparation is the vaccination for fear, and today we will discuss what you can do. Today’s episode is: Pandemic influenza:  You can’t fight the flu with kung fu As we talked previously, if the next flu pandemic is like the 1918 Spanish Flu, the worldwide death toll could approach 1 million.  This is despite all the medical advances that have been made since 1918. Were we prepared for the 2009 flu? The problem with the flu is that it is a constantly morphing threat.  An evaluation of the 2007 pandemic flu strategy is a good illustration.  When this plan was made, the assumption was that the next pandemic would be a highly pathogenic avian strain in the H5N1 family.  To this end, vaccine for this family was strategically stockpiled for rapid response. Another assumption was that the virus would emerge overseas, lengthening the available response time. When the next pandemic strain emerged in 2009, it was from the H1N1 family, a swine-origin virus rather than avian.  Instead of emerging overseas, the strain emerged in Mexico and rapidly spread to California. Fortunately, the strain proved to have a fairly low lethality and so the consequences of being wrong were not catastrophic.  Once the strain was recognized in April production of a vaccine was immediately started.  However, the vaccine wasn’t completed until October-6 months later.  It wasn’t until December that enough vaccine could be produced to protect the general public.  That’s 8 months to produce enough vaccine to protect the public once the strain is identified.  Can't we just make a vaccine for pandemic flu? These vaccines will be central in slowing a pandemic, but remember that the efficacy of most vaccines is only ~40% and the protection begins to wane rapidly.  Unless we get very lucky or better at predicting future strains, our most effective medical intervention will be unavailable for at least half a year. https://www.cdc.gov/mmwr/volumes/66/rr/rr6601a1.htm If the strain follows the 1918 model, where the first wave of the pandemic isn’t particularly lethal, this delay before the more deadly waves may be the advantage we need to get ahead of the virus.  There is no telling whether the next pandemic will follow this model. I wouldn't feel comfortable waiting 6 months before I took action to protect myself.  There are things we can do besides medical treatment.  The CDC calls these actions Non-Pharmaceutical Interventions. Communities fight the pandemic These include both community-based and personal protective measures.  Community-based interventions could include cancellation of schools, cessation of public gatherings and working from home or not at all. These measures would not be without difficulties.  As we are seeing in the coronavirus outbreak, interference with employment is likely to have nationwide and personal economic consequences.  School cancellations can further interfere with work attendance for at least one adult in the family.  While it would be easy to think that cancellation of community activities would be easy, remember that the mass fatalities will result in potential funerals.  While China appears to be having success disposing of bodies without funerals, I’m not sure this would fly here in the US.  Mass fatalities with a limited support network due to the pandemic could increase the mental health burden. How can you fight pandemic flu? As far as personal protective measures, the CDC recommends the following: voluntary home isolation of sick individuals, respiratory etiquette, use of face masks, and hand hygiene. https://www.cdc.gov/mmwr/volumes/66/rr/rr6601a1.htm

Tens of thousands of people die from the flu every year, yet most of us tend to ignore it. In today's podcast we discuss the dangers of influenza, the effect it has had on history, and what the future holds. Greetings all.  Hard to believe that my podcast has been going for almost 4 months.  I really do appreciate all of you tuning in every week.  Hope you’ve enjoyed listening as much as I have enjoyed making them. Today’s podcast is Influenza: I think there is a shot for that All the coverage the coronavirus has been getting has made me want to talk about the flu.  It is always easy to be scared of the new unknown thing, while we easily disregard the common everyday hazards. Year-in and year-out the flu kills almost as many people as traffic deaths.  Yet, we almost completely ignore this illness every fall. I pretty much ignored the illness, after all, what's the worst that could happen?  You just feel lousy for a couple of days and then get back to everyday life. Prevalence of the flu However, that illusion was shattered when one of my co-workers had a child catch the flu.  After a couple of days in the hospital, she passed away.  Everyone was shocked and heart-broken.  How does this happen in our day of advanced medical care? Turns out, these deaths aren’t really all that rare.  In the US, during the 2018-2019 flu season over 35 million people were infected.  Of those, 16 million sought medical care, half a million were hospitalized, and over 34,000 people died.  https://www.cdc.gov/flu/about/burden/2018-2019.html This was actually a fairly mild year.  In the 2017-2018 season, these numbers were almost doubled with an estimated 60k deaths due to the flu.  https://www.cdc.gov/flu/about/burden/2017-2018.htm Just to put that number in perspective, between 2016-2018 each year there were about 40k deaths due to traffic accidents in the US.  Who's at risk from influenza? Of those 60k flu fatalities, the 0-5 age range fared the best, representing only 0.1% of all fatalities.  Generally, most diseases target the young and the old, but with our current influenza strains, the risk increases with age.  Only six percent of flu deaths occur in people under 50 years old even though they account for nearly 60% of all flu illnesses.  For this age group, the flu is generally just an unpleasant, but not fatal, experience.  On the other hand, the 65+ age group represents only 13% of total flu illness, but 83% of all flu deaths. https://www.cdc.gov/flu/about/burden/2017-2018.htm Clearly, the elderly are at much greater danger from the flu than the general population.  The reasons for this get pretty complex, but it is hard to argue with the numbers. Like the coronavirus, influenza is a virus.  While we have multiple antibiotics to treat bacterial infections, our viral treatment options are still amazingly limited.  Because viral reproduction occurs in a host cell, targeting of viruses is something we still have a long way to go on.  I believe we will eventually figure this out, but until we do, vaccinations are the best tool we have.  The flu vaccine Our immune system is remarkably efficient at destroying viruses, if it has seen them before.  Vaccinations are how we prime the body to effectively fend off viral illnesses. While vaccinations are the key, we still have a long way to go in preventing the flu among adults.  In the 18-19 season, only 45% of US adults were vaccinated for the flu.  Nevada, Louisiana, Florida, Wyoming, Georgia, and Mississippi all have less than 40% vaccination rates, while Rhode Island, Massachusetts, Connecticut, Maryland, and North Carolina lead the nation with greater than 50% vaccination rates. https://www.cdc.gov/flu/fluvaxview/coverage-1819estimates.htm A recent study looked at the effect increasing vaccination rates could have on illness.  They estimated that every nationwide 5% increase in vaccination could result in ¾

I thought it was time for an update on the Coronavirus or COVID19 now that things have progressed a little bit. Hope you enjoy listening to the update. I didn't have time to transcribe the podcast, but below are my references. https://www.cnn.com/asia/live-news/coronavirus-outbreak-02-12-20-intl-hnk/index.html https://www.cdc.gov/media/dpk/diseases-and-conditions/coronavirus/coronavirus-2020.html https://www.cdc.gov/coronavirus/2019-nCoV/summary.html https://jamanetwork.com/journals/jama/fullarticle/2761044 https://jamanetwork.com/journals/jama/fullarticle/2761043 https://www.busiweek.com/the-economic-consequences-of-the-coronavirus/ https://www.bloomberg.com/graphics/2020-global-economic-impact-of-wuhan-novel-coronavirus/ https://www.bloomberg.com/graphics/2020-global-economic-impact-of-wuhan-novel-coronavirus/ Listen to the original Coronavirus podcast

I've wondered for a long time how dangerous energy drinks are. In today's podcast we talk about caffeine and investigate the dangers posed by the booming energy drink industry. Glad you could join me today.  Hope you find today’s podcast as interesting as I did.  If you enjoy the podcasts, you could really help me out by sharing them with friends and family. Today’s podcast is: Energy Drinks:  I like to measure my caffeine intake in grams At work, we have recently been discussing energy drinks.  While we all partake from time to time, one individual ingests a remarkable amount of caffeine.  The last time we figured out his caffeine intake, it was almost 2 grams per day.  We all agreed that there is no way this could be healthy.  However, opinions based on gut instinct are rarely reliable and so I decided to dig into the facts and see what the science says. I realize I am treading dangerous ground by potentially interfering with people’s morning routines, but here goes. Caffeine has been a sacred part of the morning ritual for most of the history of mankind.  About 85% of Americans consume caffeine daily.  It is probably one of the most widely consumed substances in America.  This is great from a scientific standpoint as it gives us a huge human test population.  With these types of numbers, even very rare adverse outcomes should be readily visible. How does caffeine work? We all know that caffeine makes us more alert, but how does that happen.  I found a couple of different explanations but they all have to do with the adenosine receptor.  Adenosine is created by the brain to let the body know when it needs sleep.  Adenosine binds to the nerves slowing down nerve cell activity and prepares the body for sleep.  Caffeine preferentially binds to these receptors preventing the attachment of adenosine without slowing the nerves.  This increases neuron firing causing us to feel more alert and improves athletic ability by decreasing the reaction time of our nerves.  Over time, the caffeine degrades and there is a large amount of accumulated adenosine waiting to bind to the receptors.  This sudden binding is what leads to the crash after caffeine consumption.  https://science.howstuffworks.com/caffeine4.htm https://www.mentalfloss.com/article/54536/how-does-caffeine-work Can you die from caffeine overdose? Lethal overdoses of caffeine have occurred, but they are rare.  Most of these overdoses occur through ingestion (often intentional) of purified caffeine rather than through the ingestion of beverages.  In fatalities, 10 grams or more are ingested in a single dose. In 2016 there were over 3700 cases of caffeine poisoning reported to Poison Control Centers in the US.  Of these poisonings, 846 required treatment at a hospital and 16 of those had negative outcomes. https://www.ncbi.nlm.nih.gov/books/NBK532910/?report=printable How much caffeine is in an energy drink How much caffeine is in your typical energy drink?  While there is no “typical” energy drink, National Institutes of Health says the caffeine ranges from 47-80mg per 8oz serving.  Energy shots can have over 200mg of caffeine in as little as 2oz. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5583516/ While energy drinks are popular, the majority of Americans get their caffeine from coffee and soft drinks.  A quick scan of different Starbucks coffee brews shows that caffeine content ranges from 75 to 280mg of caffeine per 8 oz serving.  The vast majority of the coffee blends have over 80mg which is the high end of the energy drinks.  I had assumed that energy drinks contained significantly more caffeine than coffee, but the reverse is actually true. https://www.caffeineinformer.com/the-complete-guide-to-starbucks-caffeine Soft drinks are a very popular way to get some caffeine on board.  In the same 8oz serving, sodas have between 15 and 35mg of caffeine.  https://www.math.utah.edu/~yplee/fun/caffeine.html

Fentanyl has caused a large increase in opioid related drug overdoses. In today's podcast we discuss fentanyl's history, uses, why drug dealers love it, and the dangers it poses. Welcome back, everyone.  Thanks to all you who have shared the podcast with friends and family.  As a reminder, all my show references and as well as bonus content can be found on my website at sci-vs-fear.com Today our topic is: Fentanyl: When straight heroin just isn’t enough In the past couple of years, there has been a significant rise in the number of opiate-related overdoses.  Opiates like heroin are nothing new, they have been used by mankind for thousands of years.  As a pain-reliever, it is difficult to match.  However, the addiction associated with opiates has always been an unfortunate side-effect.  This addiction often leads to death by overdose as addicts continually chase a better high. In the US, from 2016-2017, opiate overdoses increased by 47% primarily due to the synthetic opioids.  That’s an additional 24,000+ deaths a year due to man-made opiate-like drugs.  These drugs have names like fentanyl, acetylfentanyl, acrylfentanyl, carfentanil, furanylfentanyl, and U-47700.  In this podcast, we are going to refer to all of these substances as fentanyl. History of fentanyl Fentanyl was invented in 1959 by Belgian physician Paul Janssen.  He synthesized a chemical similar to morphine, but slightly different.  It had a couple of medical advantages over morphine.  It acted faster and was much stronger.    https://www.npr.org/sections/health-shots/2019/09/04/757089868/fentanyl-as-a-dark-web-profit-center-from-chinese-labs-to-u-s-streets In fact, fentanyl is 50-100 times more potent than morphine. This means you don’t have to use nearly as much to treat the same amount of pain.  https://www.cdc.gov/drugoverdose/opioids/fentanyl.html  As we mentioned, there are different flavors of fentanyl, over 30 different unique compounds so far.  These different compounds have vastly different strengths.  For instance, carfentanyl is estimated to be 10,000 times more potent than morphine. https://www.cdc.gov/drugoverdose/data/fentanyl.html The normal IV fentanyl dose is ~ 120 ug which is roughly equal to 2 grains of salt.  The lethal dose of fentanyl for a normal adult is as low as 2mg (equal to about 32 grains of salt).  That’s not a lot. Now let’s look at carfentanil.  Its’ normal use is as a large animal tranquilizer.  Like elephant large.  It takes about 10 mg to sedate an elephant. The lethal dose for a human is ~20ug.  Keep in mind that a single grain of salt is ~ 60ug, so a single grain of carfentanyl contains 3 lethal doses.  Needless to say, this is pretty toxic stuff.  Fentanyl as an illicit drug As with any other legitimate medication, as soon as it enters common use, someone will find a way to abuse it.  One of the first people to profit from fentanyl was a self-taught chemist from Wichita, Kansas, named George Marquardt.  Not only did he figure out how to make fentanyl, he would make different batches so that they wouldn’t all have the same signature.  Some people have referred to him as the original Walter White (referring to the breaking bad character).  Agents who worked the case said that Walter White pales in comparison to real-life Marquardt. http://interactive.fusion.net/death-by-fentanyl/the-walter-white-of-wichita.html The fentanyl he made in 1991-1992 killed somewhere between 126 and 300 people, we will never be sure of the exact numbers. He was sentenced to 25 years.  The fentanyl he produced, also known as china white, was so potent that some of the Philadelphia drug users died so swiftly that syringes were still embedded in their arms.  Similar to today, the victims and the dealers probably thought they were buying heroin. https://www.baltimoresun.com/news/bs-xpm-1993-02-17-1993048223-story.html So why would anyone use fentanyl?  It is a matter of economics.

Any time a novel disease emerges it gets a lot of attention. Today we discuss the history of the coronavirus, where this strain came from, and how dangerous it might be. Today’s topic is: Coronavirus:  I’d like mine with lime, chilled, and on a beach I first heard of the new coronavirus outbreak a couple of weeks ago.  First off, in full disclosure, I did terrible in virology while getting my first degree in microbiology.  Once something gets so small that I can’t see it with a normal microscope, I lose interest. Maybe you had better news coverage than I did, but the information I first heard wasn’t super specific or particularly informative.  The first report I heard made it seem like coronavirus was a newly discovered virus. What we know about coronavirus The first coronavirus was discovered in 1965 by Tyrell and Bynoe and named B814.  Pretty catchy name huh?  We’ve gotten better at making new diseases sound much scarier.  Since then, we have discovered dozens of corona viruses in a wide variety of mammals, birds, and reptiles.  https://journals.lww.com/pidj/fulltext/2005/11001/history_and_recent_advances_in_coronavirus.12.aspx Corona in Latin means crown.  The surface of the coronaviruses is covered with spikes that make it look like a solar corona under electron microscopy. The coronavirus is a  ~125 nm round particles.  For those of you like me, for whom the metric system is still a bit of a mystery, that’s 125 billionths of a meter.  Pretty dang small.  They are known as a positive-sense RNA virus.  I won’t go any further into what this means as it bored me to tears in virology, but I’ve referenced several papers in my show notes that explain it in depth. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747522/ There is still debate as to whether viruses are actually alive.  Viruses are essentially packets of DNA/RNA that hijack a cell's machinery to produce more viruses.  Without a host, viruses cannot reproduce.   Coronavirus is no different.  The outside of the virus contains receptors that bond with the surface proteins in the cell.  Once it binds, the viron starts a process that enables it to become part of the cell wall, barfing its RNA into the cell cytoplasm.  This causes the cell to produce viral proteins and RNA.  These are then packaged by the cell using the Golgi apparatus and other processes which then releases the newly formed viral particles from the cell. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1306801/ You have likely been infected by a coronavirus as some point in your life.  Fifteen to 30% of all common colds are caused by a member of the coronavirus family.  We've all had colds, and while they are pretty miserable, they are generally pretty minor and stay in the upper respiratory tract where they don’t interfere with breathing in a life-threatening way.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3416289/  Serious coronavirus outbreaks Before 2002, due to mild disease symptoms, coronavirus was considered more of a pest than a serious health problem.  In 2002, the disease known as SARS (severe acute respiratory syndrome) emerged from China.  Now that's a proper scary name.  In the 2 years it took to contain the outbreak, 8098 cases were identified with 774 deaths.  With a case fatality rate of nearly 10% (over 50% in elderly individuals), this disease got the world's attention.  While the world wondered for a while if this might be the next great pandemic, person to person transmission of SARS is fairly inefficient and so outbreaks were generally localized to households and hospital settings.  Because of this trait, the outbreak was contained. In 2012, another strain known as MERS (middle east respiratory syndrome) emerged from Saudi Arabia.  In the early stages, the mortality rate was nearly 50%.  When the outbreak was finally contained there were over 2000 cases reported worldwide with a case fatality rate of over 30%.  Like SARS,

Have you ever heard of ricin? It is one of the most dangerous toxins out there. A favorite of terrorists and the KGB. How common is it and should you be worried? Hey all, thanks for listening again.  I especially appreciate everyone who has shared my podcast with their friends.  Thanks for giving me a reason to dive into each of these topics and put my thoughts into words. Today’s episode is: Ricin: These beans taste terrible I’m not sure if you’ve ever heard of ricin, but in my line of work, ricin seems to pop up quite often.  It is incredibly toxic, yet relatively easy to come by.  This combination makes it a favorite of terrorists, criminals, and even spy organizations.  In addition to this, there is an occasional accidental poisoning.  Where ricin comes from Ricin is a poison extracted from the castor bean.  Many of you may have seen the castor plant.  It is a very ornamental plant with large green and red leaves.  The first time I recognized one, it was in a planter in front of a local hospital.  I bet they didn’t know that their entrance was being guarded by one of the world’s most toxic plants.  While the entire plant can be toxic, the beans are the main source of the toxin.  Take a look at my website for a picture of the plant and the beans. You’ve probably heard of castor oil.  It is also extracted from castor beans, but the process removes the poison.  That's a good thing because my Grandma was a big believer in castor oil for many different ailments.  Not sure if it ever helped, but the taste left something to be desired. Obviously, I'm not going to go into how the poison is obtained from the bean, but it is fairly easy.  Thankfully, it is a little more difficult than most of the illicit internet sites make it seem.  If you want a fairly pure ricin, that requires some advanced techniques. Accidental ricin poisonings Most of the accidental poisonings are a result of pets, children, and even occasionally adults eating the beans.  As long as the beans aren’t chewed, most people recover, but a couple of thoroughly chewed castor beans is enough to kill an adult.  I’m not sure of the episode, but one of the contestants on Discovery’s Naked and Afraid realty show, is shown eating some beans from an unknown plant and then getting violently ill.  When they showed the plant, I was surprised to see that it was a castor plant.  Apparently his preparation methods attenuated the toxin to some extent, but the man is lucky to have survived. In a case study from Morocco, 7 and 10-year-old girls became very ill in separate incidents after eating castor beans.  Both girls arrived at the ER unconscious and suffering from seizures. Both girls reported abdominal pain and vomiting about 2 hours after eating the beans.  When stomach contents were emptied, castor bean remnants were present.  With intubation and supportive care, both girls were able to completely recover. https://www.srlf.org/wp-content/uploads/2015/11/1209-Reanimation-Vol21-N5-p555_p556.pdf Intentional ricin poisonings Intentional poisonings are more common than you might think.  Looking at Wikipedia, there are 27 different ricin incidents listed.  I'm aware of a couple of others that aren't listed, so it isn't an all-inclusive list by any means, but that gives you an idea of its prevelence. https://en.wikipedia.org/wiki/List_of_incidents_involving_ricin Probably the most famous ricin poisoning is the murder of Georgi Markov.  Markov, a dissident from Bulgaria, was author, playwright, and outspoken critic of the Soviet Union.  He published multiple books and plays demonstrating the flaws of communism in his native Bulgaria.  At the time of his murder, he worked for the BBC. In September of 1978, he was waiting at a bus stop on his way home from work.  He felt a slight pain in his thigh and turned around to see an individual picking up an umbrella.  The man, who had a foreign accent, apologized to Markov.

In this podcast, we ask the question, how dangerous is football? As one of America's most played sports, you need to know just what the risks are. Hi everyone.  I hope you have been enjoying listening to these podcasts as much as I have enjoyed recording them.  If you know anyone who might also enjoy listening to the podcast as well, please feel free to share it with them.  It would be much appreciated. Today’s podcast is Football: Who doesn’t love a concussion First off, for those joining me today outside the US, we are discussing American football.  I fully admit that for those of you who play rugby, are MMA fighters or bull-riders, American football isn’t that much of a contact sport.  However, for most of the US, football is the physical, high contact sport.  In my podcast on statistics, we discussed a study on brain injury among football players.  The claim often made about the study was that 99% of all football players suffered from brain injuries which wasn't a valid conclusion for the study.  That study did get me wondering how dangerous football really is. Just for full transparency, playing sports isn't something I enjoy much.  I played a little soccer as a kid and in high school, the closest I came to team sports was cross-country running and wrestling. As a father, one of my boys played football prior to high school and since he enjoyed it, I supported his decision to play.  However, I do remember attending his 6th-grade end of year football banquet.  The introduced the players individually and said something about their accomplishments.  I do remember that a large number of boys had spent at least part of the season not playing due to injuries.  At the end of the introductions, the coach mentioned it too saying "if you don't get hurt playing football, then you probably aren't playing hard enough".  To this day, I'm trying to find something important enough about 6th-grade football to justify an injury that could be with you for a lifetime. However, I never really actually looked at the data to see if my opinion had any validity. First off, let’s take a look at youth football.  Most people would agree that youth football isn’t comparable to college football and that college football isn’t very similar to professional football. High school football injury statistics According to Stanford, 3.5 million children 14 and under get hurt every year from sports and recreational activities.  About 215k children visited the emergency room due to football injuries (both organized and informal).  Just to put this in perspective, the number injured in bicycling accidents was 200K, basketball 170K, skateboarding/inline skating 113k, baseball/softball 110k, soccer 88k, and trampolines 65K.  All of these were compared to 215K football injuries.  As you can see, a lot of children 14 and younger visit the emergency room. A different study by UC Denver has been tracking sports injuries at selected schools since 2005.  They estimate that annually there are 1.2-1.4 million high school sports injuries per year across all sports.  From 2013-2018 football accounted for 39% of all injuries.  For comparison, girl’s soccer was 17%, boy’s soccer 12%, boy’s basketball 6%, and girl’s volleyball 4% of high school sports injuries. However, keep in mind that the different sports have different team sizes.  A football team with 50 players would be expected to have higher total injuries than a basketball team with 15 players.  The injury rate, which takes into account the actual numbers of individuals playing each sport, for football from 2005-2018 was 3.9%.  With girls’ soccer at 2.4%, boys’ soccer 1.8%, boys basketball 1.5%, and girls volleyball 1.2%. As would be expected, football has higher injury rates than lower contact sports.  With football, the primary injury of concern has been head injuries.  In 2018, head injuries were 21.7% of football injuries, with ankle 12%, knee 7.9%, hip 5.6%,

In this episode, we discuss Anthrax. It has a fascinating history of disease and use as a biological warfare agent. Learn how dangerous it really is. Hello everyone.  A Special thanks to all the new subscribers out there and to my veteran listeners.  The show has grown faster than I ever thought possible.  I would love to hear from everyone.  I have a list of about 200 topics, but if you have an idea or would like me to get to one sooner, drop me a note on my website sci-vs-fear.com. This week’s topic is: Anthrax: Almost 20 years since I’ve had a powdered brownie Anthrax: my experience I’ve long been acquainted with Anthrax.  My first introduction to Bacillus anthracis was my first day in my undergraduate microbiology lab.  The first experiment was to isolate Anthrax from soil.  Back in those days, it wasn’t uncommon at all to work with anthrax in the classroom and on the benchtop, it actually poses little hazard. My next brush with anthrax was in graduate school. Shortly following the Amerithrax event, my major professor was asked to determine the parameters for irradiating mail to kill any possible anthrax.  Anthrax is really hard to kill.  It takes about 40KGy (40,000 Gy) to kill it, where 3-8Gy will kill you and I.  2001 was a rough year between 9/11 and the anthrax letters.  My innocence was shattered and that was when I first realized the world could be a dark and dangerous place.  My desire to make sure my kids didn't have to deal with these threats was what put me on my career path of evaluating and mitigating dangerous things. The next stop on the anthrax train was when I helped with a study on how to best sample anthrax.  The study used a cousin of Anthrax, Bacillus globigii in its weaponized form.  Anthrax powder is not at all like powdered sugar or coffee creamer.  The slightest breeze or wave of the hand will make it disappear into the air.  When a pea-sized ball drops from the height of couple inches, it never hits the table, it simply disappears into the air. Anthrax is really hard to kill.  I learned this when I assisted in sampling a building that had been exposed to the same cousin, then tented and fumigated with chlorine dioxide.  Immediately following fumigation, no samples were positive.  When we tested again 6 months later, a significant number of samples contained viable organisms. Every year I get a reminder of my relationship with anthrax when I get my annual vaccination.  No vaccination is pleasant, but anthrax always seems to take pleasure in stinging for a couple of extra days. Anthrax: What is it? Anthrax is a bacteria classified as a gram-positive rod, that is about 1/millionth of a meter long.  To give you an idea of how small this is, about 1000 organisms could fit on the end of a hair- give or take a few.  Anthrax belongs to a group of bacteria know as spore formers.  Most bacteria aren’t particularly tough, but the spore formers are a notable exception.  I think of a spore as a seed.  Being from the west, I’ve heard of corn seeds that were thousands of years old from cliff dwellings growing just fine once planted. When growing anthrax, known as vegetative cells, senses that the environment is changing, it begins a transformation.  It grows a tough outer layer that protects it from the environment and becomes a spore.  How tough you ask.  You can literally boil anthrax for 10 minutes and still not kill it.  If you want to kill anthrax with heat you need a pressure cooker. Anthrax: the natural cycle Anthrax outbreaks in animals follows a predictable cycle.  An animal dies from an Anthrax infection.  Once the animal dies, this changes the internal environment and triggers the formation of spores.  As the animal decomposes, the spores are released into the environment.  The spores will sit there, just waiting for an opportunity to start growing. Eventually, you will have a very wet spring, which washes

In this bonus content podcast, we discuss the actions you should take in the unlikely event you should ever be contaminated by a chemical weapon. Thanks for listening to this bonus podcast.  Normally, my bonus podcasts are only available through my website, but I feel this information is really important so I decided to put it on my normal feed.  If you enjoy this podcast, feel free to listen to my other bonus podcasts by visiting my website sci-vs-fear.com In my previous podcast, we talked about the different types of chemical weapons. Today we will take about what you should do if you become exposed. Chemical weapons: I’ve been slimed, what do I do now? In this podcast, we will be discussing what you should do in the unlikely event you get slimed with a chemical warfare agent.  That's a highly scientific term by the way. For the past couple of years, I’ve been asking myself this question from a professional standpoint.  Generally, when we deal with dangerous chemicals, we use a full suite of protective gear.  Removing someone from contaminated protective gear without getting the person dirty is very important.  It is much more complicated than I ever imagined, but some basic principles help us do a good job. Should you get chemical weapons or any other chemical on your clothing or skin,   there are some important steps you can take.  I’m not the only one who has been thinking about this.  Public Health England has been taking the question very seriously.  Public Health England, chemical weapons statement They state “The deliberate use of toxic materials represents a serious threat to society. In particular, chemical warfare agents are indiscriminate weapons that can have a devastating impact when used on unprotected civilian populations, as recently evidenced in Syria.  Any complacency based on the notion that chemical warfare agents are limited to politically unstable regions was recently dispelled by the use of a ‘novichok’ nerve agent in the UK. The current threat level for international terrorism in the UK is presently classed as ‘severe’. Exposure of individuals to liquid or particulate substances presents a particular challenge to the emergency services, as casualties will need to undergo immediate disrobe and decontamination in order to mitigate the risk of adverse health effects.” https://emj.bmj.com/content/emermed/36/2/117.full.pdf Because of this concern, they sponsored a series of research trials called ORCHID.  The principles I discuss today come directly from their research and conclusions.  To date, I’m not aware of any more thorough research available. Traditionally, response to a chemical agent exposure would be a water-based shower type of cleaning.  However, in a terrorist scenario, the resources probably won't be available, therefore, they recommend using absorbent materials rather than water in most cases.  There are a couple of advantages to this.  First, it creates much less waste than the water-based cleaning, especially if the run-off contains toxic substances.  Water-based cleaning can tend to spread contamination all over a person while dry cleaning physically removes most of it.  Using water on contaminated clothing can also drive the chemicals through the clothing onto the skin.  Finally, water can actually drive chemicals through the skin. Step 1: Remove contaminated clothing Should you become slimed, the first thing you would want to do is remove your clothing.  While people can be reluctant to remove their clothes due to modesty concerns, removal of clothing by itself can eliminate up to 90% of the contaminant. Step 2: Pat down contaminated areas with absorbent material The quicker you can remove the “slime” the better your likely outcome.  Once the clothing has been removed, then any remaining chemical should be removed with an up and down blotting motion using paper towels, diapers, napkins, toilet paper, clean

In today's episode we discuss past chemical warfare agent attacks and talk about the different classes of agents and what they are used for. Thanks for joining me today.  As we start the new year, I just wanted to say thanks to all of you.  In just a few months, this project has gone from no listeners to over 300 subscribers.  Thanks for sharing this podcast with your friends and feel free to share it with a few more.  As always, my references are found on my website sci-vs-fear.com.  Please stop by and take a look. In future episodes, I plan on looking at some of the chemical warfare agents or CWAs in-depth, but before I do, I wanted to talk about the group as a whole to provide the big picture. So what is a chemical warfare agent?  A chemical warfare agent is simply any chemical that is used to harm or kill people. WWI chemical warfare While there are other historical instances, chemical warfare agent use began in earnest in WWI.  The first use was in August of 1914 when the French used teargas in the battlefield.  By October of 1914, the Germans had deployed over 3,000 shells of chlorosulfate, although they were relatively ineffective as the chemical was mostly destroyed in the explosion. In January 1915, the Germans tried again against the Russians using xylyl bromine, but this time it was ineffective due to the extreme cold.  In April of that year, the first large scale deaths (~1100 with 7000 injuries) due to CWAs are documented at Ypres, Belgium where the Germans deployed almost 170 metric tons of chlorine gas.  Chlorine gas tends to sink and so was quite effective in trench warfare applications, assuming the wind didn’t blow it back into your trench. By September, the British begin using chlorine against the Germans.  Shortly after that, the Germans introduce phosgene.  So began a CWA arms race.  By 1918, nearly 10% of all US arterial shells contain mustard.  Interestingly, Adolf Hitler was temporarily blinded by Mustard in October shortly before the end of the war.  There is some supposition, that this is the reason Germany didn't use more CWAs during WWII.  All told, there were more than 1.3 million casualties and 90K+ deaths due to CWAs (mostly phosgene) during WWI. WWII chemical warfare preparations In the run-up to WWII, most nations developed mustard and nerve agents.  Among these are sulfur and nitrogen mustard, tabun, sarin, soman, and VX.  Many of these compounds were discovered in pesticide research, but most nations had a specific CWA development program.  In 1972, the Biological and Toxin Weapons Convention sought to end all offensive research into CWAs.  This was moderately successful with countries like the US and Britain abiding, with other countries, Russia, Iran, Iraq, and others, continuing with research and production. https://www.sciencehistory.org/distillations/a-brief-history-of-chemical-war Tokyo sarin chemical weapon attack Let's look at two well-known uses of chemical weapons.  The first is of interest to developed countries, as our largest threat from CWAs is terrorism.  On 20 March 1995, a Japanese cult known as the Uhm-Shinrikyo released sarin on the Japanese subway.  Their attack was fairly crude, but it got the world's attention.  Between 7:30 and 7:45 AM, five different cult members boarded trains headed to different parts of the city with 2-3 plastic bags full of sarin carried in an outer paper bag.  At 7:48, the members punctured the bags with sharpened umbrellas.  Although the sarin was only 30% pure and the dissemination method was somewhat crude, mass casualties soon ensued. https://www.belfercenter.org/sites/default/files/legacy/files/consequence_management_in_the_1995_sarin_attacks_on_the_japanese_subway_system.pdf Twelve people died with over 50 victims being so severely injured that they needed mechanical ventilation to survive.  The closest hospital received over 600 casualties at one time.

 In the previous episode we looked at 9 different statistical pitfalls. -Sampling bias -Different types of averages -Small sample size -Confidence intervals -Graphs -Linking unrelated statistics -Correlations -vs- causation -Computer models - Search engine results and social media That is an awful lot of things to keep track of.  Today I am going to simplify it a bit into 5 questions you can ask about any statistic.  Like the previous podcast, most of the ideas in this podcast come from Darrell Huff’s How to lie with statistics. Question 1: Who says so? Everyone who does research has a motivation.  That motivation will tell you a lot about what their conscious and unconscious biases may be.  For instance, in a study by a drug company an obvious conscious bias is the desire to sell more product.  That bias should be considered when interpreting the results.  An unconscious bias is that the majority of studies are done using educated, fairly prosperous individuals from first world countries.  Will the results be applicable to other populations?  Hard to say until we study it in those populations. Is the study backed by someone well known or famous?  As a general rule, if someone needs a famous spokesperson, then I am automatically suspicious.  However, the nature of the spokesperson can change that a bit.  If the spokesperson is a Nobel laureate in that field, then their endorsement may have a little more weight.  If they are an athlete, movie star, etc… I have to ask myself, what would make them an expert in this field they are endorsing?  Chances are probably not much. Question 2: How do they know? What was their sample size?  Sample size makes a huge difference.  Generally, with a couple of caveats we will talk about in a second, the larger the sample size the more we can trust it.  Have you ever had anyone who didn’t have kids try and tell you how to raise yours?  Their sample size is effectively zero.  When I only had one child, I thought I was getting it figured out pretty well.  When child number two came along, I realized that I still didn’t know anything. In a narrow field, say treatment for a very rare disease, a sample size of 10 or 20 might be enough.  In making general conclusions about a large population, a sample size of 100 or even 1000 might not be enough.  Most political polls have a sample size of ~1000.  Is asking 1000 people a question good enough to determine how the 300+ million people of the US would answer that question?  Have you ever wondered why so many medications are recalled for serious side-effects shortly after they go through the long and difficult FDA approval process?  It has to do with sample size.  If the serious side-effect only happens to 1/10,000 people, a study involving 5000 people isn’t large enough to detect the side effect.  However, when it is released to the general public, the sample size grows dramatically, and suddenly we start seeing many side effects never detected during the trials.  Sample size matters. However, a large sample size can be totally invalid if it was improperly selected.  Someone who is willing to talk about their political beliefs to a perfect stranger over the phone may not represent the average American very well.  If I only ask people on the east and west coast a question, I am likely to get a much different answer than if I ask that same question only to people from the center of the country. Is a person who is willing to try a risky experimental treatment (often because they are dying) really a good representation the total population with the illness?  This group of critically ill individuals may be so sick that an effective treatment would do them little good. If they have a good, well-chosen sample size, are they confusing correlation with causation?  Going back to Tyler Vigen’s spurious correlation site https://www.tylervigen.com/spurious-correlations

In this episode, we discuss how dangerous statistics can be.  People often confuse statistics with facts, but anytime someone quotes a statistic, there are a few things you need to keep in mind. This topic has bonus content Thanks for joining me for another podcast.  I really appreciate all my new subscribers and those of you that have left reviews on iTunes and other places.  As always, I appreciate both positive and constructive suggestions.  Today’s episode is: Statistics: 9 common ways the numbers are lying to you I’m not going to lie, this has been the most difficult podcast to produce so far.  I’m not a statistician, and trying to simplify complex statistical concepts is definitely tricky.  I have at least 15 hours into the production of this episode.  I hope you enjoy it. The content in this podcast is adapted from How to lie with statistics by Darrell Huff. As I mentioned in my intro podcast, statistics can actually be quite dangerous As a young grad student, someone much older and wiser than me recommended I read How to lie with statistics.  It was spot on when it was first printed in 1954 and is still very relevant today Today I am going to discuss some common pitfalls we can run into when interpreting statistics Statistics pitfall #1: Sampling bias For a study to be accurate, it must faithfully represent the population of interest.  For example, a political telephone survey that uses only landline numbers misses a large portion of the US population who only have cell phones.  No matter how much data a study collects, if it doesn’t represent the group in question, it is pretty worthless. The problem with studying humans, is that we can’t just randomly assign people to different groups for the sake of science and so almost all study participants self-select to some extent This sampling bias can be conscious, or unconscious.  We can correct to some extent for conscious bias, but unconscious bias is particularly dangerous because we often don’t realize it is happening. For example, when YouTube created a new video loading feature, about 10% of videos were loaded upside down.  When they began trouble shooting why so many users loaded them incorrectly, they discovered that most of the upside-down videos belonged to left-handed people.  Because of an unconscious bias towards right-handed people, the app left out about 10% of the population. https://www.eliinc.com/five-real-world-examples-of-unconscious-bias/ Another example of self-selection bias occurred in Boston University’s study of brain trauma in American football players.  The results of the study were widely reported as “99% of football players had CTE” even though the researchers admitted that the study population was biased.  How was it biased? All of the 202 brains examined in the study were from players who exhibited neurological symptoms while living.  For the results of the study to be accurate to the population, brains would have to be taken across a wide range of people who had at one point in their life played football, not just those with symptoms.  Additionally, nearly half of the brains studied were from professional football players, which is a very small subset of those who play football. https://greatbrook.com/biased-survey-samples/ Statistics pitfall #2: Different types of averages Another common pitfall is using the wrong type of average In statistics there are 3 types of averages: mean, median and mode Mean is the classic average that we are all used to: add up all the numbers and then divide by total numbers used Median is the middle value of a group of responses (five responses, order high-low, it is response #3) Mode is essentially the most common number in a group of responses Why does this matter you might ask? If you look at a graph of how long Australians live, the majority of people live longer than average.  How does that work?  This is

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In this bonus content, we discuss steps you can take to avoid getting, or to survive smallpox. Should it escape the freezer, this information could be vital.

In this podcast, we discuss smallpox, the only disease successfully eradicated from mankind. Destruction of smallpox has eliminated much suffering in the world, but the disease lurks in the shadows threatening to re-emerge.

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Today we will be discussing the terminology and effects of radiation. Radiation can be pretty scary, but its effects are pretty well known and we have excellent detection equipment that can detect even the smallest changes. It can be dangerous, but we will try to put it into perspective. From my childhood, I vividly remember the scene from Indiana Jones where they open the Ark and all the bad guys faces melt off Until I started working with radiation, this is how I always visualized it Today, of all the things I work with, radiation is the thing I fear the least Can measure in real time Using 100 year old technology (if it hasn’t changed in that time, it must work really well) All I have to do is back up What is radiation? http://hps.org/publicinformation/ate/faqs/whatisradiation.html Radiation you might be familiar with, also called non-ionizing radiation               Light               Radio waves               Microwaves Radiation we will be discussing is called ionizing radiation because it can produce charge particles when it strike something (me or you) This radiation produced by unstable atom (uranium, plutonium, radon) or high voltage (x-ray) These unstable atoms are trying to become stable and do so by emitting particles and/or energy We are exposed to radiation at low levels everyday https://www.epa.gov/radiation/radiation-sources-and-doses These doses come from               Sun and stars (if you live at a higher elevation you receive a higher dose, because you are closer to the source)               Radioactive elements in the earth and our bodies (radon produced in areas with large amounts of uranium, potassium 40 in many foods and Carbon 14 becomes a part of us used in dating of organic items Another source is man made radioactive sources associated with nuclear power and more commonly medicine The sum of these exposures we call a dosehttps://www.nrc.gov/images/about-nrc/radiation/factoid2-lrg.gif Average American receives 310mR per year A whole body CT scan can give a dose up to 1 rem Most people’s eyes start to glaze over when they here Rems, curies, sieverts, gray, bq, roentgens, etc These are just units of measure just like many things we are already used to inch, cm, grams, oz, mph etc Just like these units of measure, it gets more complicated because you have traditional units (oz) and metric units (g) To simplify things I’m going to use only two, the curie and the Rem https://www.cdc.gov/nceh/radiation/emergencies/measurement.htm In simple terms, a curie tells you how often a rad source is shooting at you, but not what caliber it is using               Is it a sniper rifle or a bb gun? The dose tells you how much radiation you have absorbed, one hit from a sniper rifle imparts much more energy than 100 hits from a bb gun Turns out we can measure radiation down to very very very small amounts (micro rems or millionths of a rem) https://www.remm.nlm.gov/radmeasurement.htm Don’t start observing effects (radiation isn’t really dangerous until we receive 100s of rems) When it comes to rad unit matter One of the scariest images is a Geiger counter needle swinging from one end of the scale to the other However, this may not actually mean anything at all Lets use real world example Lets say something has to be traveling 15 mph to hurt a human We can measure a snail that moves 10 feet an hour (.002 MPH) pretty accurately Now we measure bee that can move 1000 feet in an hour (.2MPH).  The bee is moving 100 times faster than the snail But it isn’t dangerous because it is well below the threshold of 15 MPH Because we can measure very small amounts accurately there is a large area a measurement that doesn’t mean much to our health Once we reach a threshold, small increases can have dramatic effects think car going 15, 30, and 60 MPH Bottom line, when you are talking radiation,

This topic has bonus content Every time I step foot in the ocean, I can't help but think about sharks. In this episode, we look at the actual number of shark attacks, the type of sharks involved and which type of activities are most likely to result in an encounter. Review the year of the shark https://www.theguardian.com/theguardian/2001/sep/05/features11.g23 The summer of the shark had no rise in actual shark attacks https://news.ufl.edu/archive/2002/02/summer-of-the-shark-in-2001-more-hype-than-fact-new-numbers-show.html The rescue of Jessie Arbogast set the stage for a slow news summer Although most of these interactions result in minor injuries akin to that of a dog bite, about six of the 75–100 unprovoked attacks that currently occur worldwide each year result in human mortality [12].       (Note that an unprovoked attack is defined as a bite or near bite (fended off by human intervention) of a person (or the board on which he/she is perched) in the shark’s natural environment in the absence of any human provocation.) https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0211049&type=printable Shark species Three shark species that attract much of that attention are the bull shark (Carcharhinus leucas), tiger shark (Galeocerdo cuvier), and white shark (Carcharodon carcharias). These species are of interest to biologists because they are large, migratory species of cosmopolitan distribution While shark populations are poorly defined, shark-human interactions in the form of unprovoked attacks have been increasing in raw numbers for more than a century and in increasingly diverse places Outcomes of shark attacks Although not the focus of this contribution, the majority of all shark attack outcomes were non-fatal (85%), and typically less than about 25% of attacks were fatal in countries with >50 attacks since 1960. https://www.floridamuseum.ufl.edu/shark-attacks/factors/victim-activity/ https://www.floridamuseum.ufl.edu/shark-attacks/yearly-worldwide-summary/ Shark attacks vs other events https://www.floridamuseum.ufl.edu/shark-attacks/odds/compare-risk/death/ https://www.floridamuseum.ufl.edu/shark-attacks/odds/compare-risk/lightning-strikes/ https://www.floridamuseum.ufl.edu/shark-attacks/odds/compare-risk/rip-currents/ Listen to my other topics https://sci-vs-fear.com/podcasts/

For the past few weeks, you can't hardly listen to a news broadcast with hearing about vaping. This brings up the question: should I quit vaping? We look at the likelihood of getting vaping related illness and put the risk in perspective compared to smoking. The public health anti-smoking campaign has centered around that fact that smoking makes you stink Vaping is the free market answer to this objection 26 deaths in 21 states 1299 cases reported (8 Oct 2019) https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html Most patients admit to vaping THC 76% No single product is linked https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html 28-year-old previously healthy man who presented in acute respiratory failure 2 weeks after initiating use of a street-purchased THC-containing vape cartridge. Bronchoalveolar lavage cytology with oil red O staining confirmed the diagnosis of acute lipoid pneumonia. Diffuse alveolar hemorrhage and eosinophilic pneumonia were excluded. Evolving evidence supports a clinical entity of acute respiratory failure due to acute, exogenous lipoid pneumonia induced by THC Vaping-Associated Acute Respiratory Failure Due to Acute Lipoid Pneumonia. They say black market operators are using more thickening agents to dilute THC oil because of a crackdown by state authorities that has made the oil scarcer on the black market https://www.washingtonpost.com/health/potential-culprits-in-mystery-lung-illnesses-black-market-vaping-products/2019/09/24/cb5b708e-d98d-11e9-ac63-3016711543fe_story.html Black market manufacturers buy the cartridges in markets like this, fill them with THC oil or other mixtures and package them for sale by distributors. One thickening agent that is a key focus of investigators is vitamin E oil, known as vitamin E acetate. It is also colorless and odorless, has similar viscosity to THC oil, and is much cheaper Characteristics of a Multistate Outbreak of Lung Injury Associated with E-cigarette Use, or Vaping - United States, 2019. 805 cases reported, basic patient data (i.e., demo­graphics and dates of symptom onset and hospitalization) were received for 771 (96%) patients. Ninety-one percent of patients were hospitalized. Median duration between symptom onset and hospitalization was 6 days Of 514 studied 395 (76.9%) reported using THC-containing products, and 292 (56.8%) reported using nicotine-containing products in the 30 days preceding symptom onset; 210 patients (40.9%) reported using both THC-containing and nicotine-containing products, 185 (36.0%) reported exclu­sive use of THC-containing products, and 82 (16.0%) reported exclusive use of nicotine-containing products. Lipoid pneumonia is a rare condition that occurs when fat particles enter the lungs. Lipoids, also known as lipids, are fat molecules. Pneumonia refers to inflammation of the lungs. Lipoid pneumonia is also called lipid pneumonia. https://www.healthline.com/health/lipoid-pneumonia#symptoms In 2017, an estimated 14.0% (34.3 million) of U.S. adults were current cigarette smokers. Of these, 75.0% smoked every day Wang TW, Asman K, Gentzke AS, et al. Tobacco Product Use Among Adults — United States, 2017. Morbidity and Mortality Weekly Report 2018;67:1225–1232. DOI: In 2015 CDC estimated that 3.7% of US adults regularly use e-cigarettes (tobacco) https://www.cdc.gov/nchs/data/databriefs/db217.pdf   US population327 million= ~12 million people vape tobacco From 2017 to 2019, the vaping increased among 12th graders (11% to 25%), 10th graders (8% to 20%) and 8th graders (4% to 9%), according to preliminary data from the University of Michigan’s Monitoring the Future (MTF) survey. https://bmjopen.bmj.com/content/bmjopen/9/6/e028535.full.pdf ~3000 north Carolina high school students 14-18 yo9.6% had vaped THC~16-17 million kids in US in this age range1.6-1.7 million THC adolescent smokers

Thanks for listening to my first podcast. I will be discussing why I decided to podcast, and different considerations when you are assessing the risk of a certain hazard. Deciding to do a podcast has been a big decision for me I am comfortable presenting in front of large audiences I have no problem discussion complex scientific issues with people of varying opinions But until this point I have been comfortable working with my peers However, recently I have begun to notice how often the world around us sells so much fear It seems like everywhere I turn there are voices telling me how afraid I should be of waking up tomorrow Given my scientific background and especially my skills at assessing risk, it has been relatively easy for me to silence the voices applying the scientific method and reason I’ve also been able to share my insights with friends and family and I have enjoyed seeing them learn to judge risk on their own Lately, I’ve realized that my sphere of influence is really really small I don’t claim to have all the answers or even that my assessments are always 100 percent accurate, but I’ve felt like there is a larger audience out there who might value  being able to put risks into perspective To be honest, I’ve always avoided technology as much as possible But the more I thought about it, the more I felt compelled to share what I have learned via a podcast Learning a new media has been more difficult that I had originally imagined Learning how to build a website, use recording software, editing properly, deciding how to best use social media have all had steep learning curves There are many true dangers out there, but for every true danger there are many perceived dangers that are actually pretty minor I envision a community where we can use data, science, and logic to help each other really understand the true natures of the dangers that surround us I hope you will be patient with me as we learn together in this new media While trying to clarify for myself exactly what I wanted to achieve with this podcast I came up with the following analogy I enjoy doing outdoor activities Being cooped up in the house for more than a few hours is almost painful I, like many of you, live in an area where  the weather changes significantly day to day The weather can have a significant impact on how much I enjoy my limited time outdoors For many years I would rely on the latest weather forecast to try and get the most out of my time What I found was that I was more often than not disappointed in the accuracy of the forecast One day, I was looking at the radar map for the past few hours As I watched it, I realized that I could roughly see what might be happening in my area for the next few hours As I tried it out, I wasn’t always 100% successful in my predictions, but I was consistently better than the forecaster who was predicting for the whole region rather than my specific area Now I almost never look at the weather forecast, instead I look at the radar and predict for myself If you are the type of person who would rather just get the weather forecast from an expert, there is nothing wrong with that But this podcast probably isn’t for you If you would rather look at the maps yourself and make your own predictions then I have a feeling you and I will get along quite well If you aren’t sure which one describes you, tag along for a while and see if we are a good fit Like all good friends, I expect we will disagree from time to time In fact, I hope we do I don’t have all the answers, none of us do But as we work through the science of the world’s most dangerous things together we can create a much clearer picture than any of us could alone I am a timid and cautious person by nature.  For much of my childhood, I was content to enjoy other people’s adventures by reading about them in the safety of my own bedroom.