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HealthWeek No. 148

ANNOUNCER: Funding for HealthWeek is provided by the Howard Heinz Endowment and the Teresa and H. John Heinz III Foundation.

SHARYL ATTKISSON: Today on HealthWeek... She's only a few days old. But she's already getting her hearing checked. What every parent needs to know about testing babies for hearing loss.

It's a living. But why would anyone choose to be a human guinea pig?

ROB DAVIS: "Easy money, as long as you follow the protocol. Easy money."

SHARYL ATTKISSON: Find out if professional research subjects are helping or hurting your health care.

And those big guys and their big rigs. A new effort to get truckers on the road to fitness.

ELECTROMAGNETIC FIELDS/CANCER

Hello, I'm Sharyl Attkisson. Welcome to HealthWeek. Today we begin with news about the possible health risks of electric power. For most of us, not a day goes by when we don't use dozens of electrical gadgets and appliances. But there's an ongoing debate over the dangers of the invisible magnetic forces that surround all those products. Some studies have linked these so called electromagnetic fields to cancer, especially leukemia and brain tumors.

ANDREW HOLTZ: In the study, scientists measured electromagnetic fields in the bedrooms of more than 200 women in Washington State. They also monitored the women's levels of the hormone melatonin which normally go up at night. Researchers found, on average, the greater the strength of the magnetic field in a woman's bedroom, the less melatonin her body produced.

SCOTT DAVIS, PHD, FRED HUTCHINSON CANCER RESEARCH CENTER: This is the first evidence in humans in a normal living environment, that would suggest that relatively small changes in magnetic fields do have an observable impact on lowering melatonin levels.

ANDREW HOLTZ: That's important because low melatonin may raise estrogen levels. And high estrogen levels are known to increase the risk of breast cancer. In some animal studies, even relatively weak electromagnetic fields have depressed melatonin production and accelerated the growth of breast tumors. And previous human research has found slightly higher rates of breast cancer in men who work around high-intensity power lines. It was outdoor power lines that produced the strongest fields in some of t

"What an 8 percent, 10 percent, 20 percent decrease in melatonin means in terms of health effects or even impact on physiology, we don't know."

ANDREW HOLTZ: Two years ago, this report by a national research council panel concluded electromagnetic fields have little apparent effect on health. A member of that panel says despite this latest study, he's convinced that magnetic fields are not a serious cancer threat.

BRUCE KELMAN, PHD, TOXICOLOGIST: If I were to make a list of what I thought was important, I would put this way down at the bottom of the list.

ANDREW HOLTZ: Still, the research, the controversy and the concerns about electricity and breast cancer are sure to continue.

SHARYL ATTKISSON: Joining us now is Curt Suplee, a science reporter for the Washington Post who's covering this issue. This study was not published, it was simply presented at a seminar. What's the significance of that?

CURT SUPLEE, WASHINGTON POST: Well, certainly the results of a rigorously peer reviewed journal article are doubtless more credible than an interim result like this one. On the other hand, this is the Hutchinson Cancer Center which has a superb reputation. It was funded by the National Cancer Institute, and the sample size, 200 women, is quite large.

SHARYL ATTKISSON: And so in this study, the researchers found that some of the strongest electromagnetic fields were found near old electric clocks. Does that mean that women who feel they are at special risk of breast cancer, just to play it safe, should get rid of the clocks?

CURT SUPLEE: Well, you could get rid of all appliances, for that matter. Appliances that have electric motors in them are going to have slightly higher field effects than almost anything else. On the other hand, the field diminishes by the square of the distance. In other words, if you double the distance between you and the offending object, you only have one-fourth the exposure to the magnetic field. So if any object in your home worries you that much, simply back off the distance.

SHARYL ATTKISSON: So how could I find out? I saw them using a gizmo or a gadget in the story to measure the electromagnetic fields and the strength of them. Can we buy these by ourselves and do it?

CURT SUPLEE: There is a device for sale, largely to professional houses, called a Gauss meter. And you can use it to run around your home and see if the levels inside, whatever rooms you're looking at, happen to exceed the two milligauss level, which is normal for American homes. On the other hand, you may wish to hire a consultant to do it. Or, on the other hand, you may wish not to do it at all because this is a risk of marginal importance to most Americans.

SHARYL ATTKISSON: Why is there so much uncertainty over the risks of electromagnetic fields when they've been studied now for quite some time. Why can't we have a clear answer as to what the potential dangers are?

CURT SUPLEE: Well, there's at least two answers to that. One is that cancer is an odd sort of disease that has both a genetic and an environmental component in almost all cases. And it's very difficult to sort out which is which. The other is that even though they've studied EMFs extensively, they have not yet determined exactly how EMFs influence individual cells, and therefore they haven't pinpointed a mechanism whereby EMFs might initiate or promote cancer.

SHARYL ATTKISSON: Well, thank you for giving us some perspective on this study, Curt Suplee.

CURT SUPLEE: Always a pleasure.

HEALTHFUL HINTS

NANCY SNYDERMAN, MD: Hello, I'm Doctor Nancy Snyderman with this week's Healthful Hint. With all the new things out there to help you quit smoking, it should be easier than ever to kick the habit. But as any ex-smoker can tell you, it takes far more than slapping on a patch or popping a pill to overcome nicotine addiction. It takes a change of attitude. First, set a date for quitting and if possible, try to get a friend or a relative to quit along with you. As that date approaches, switch to a br

can substitute for the kick you get from nicotine. And be sure to reward yourself each day you don't smoke: pay yourself. Take the money you save from not buying cigarettes, put it into a jar. And then use that money to treat yourself to a movie, a favorite meal, maybe even a well-deserved vacation! With Healthful Hints, I'm Doctor Nancy Snyderman.

INFANT HEARING

SHARYL ATTKISSON: Sometimes children just don't seem to listen. Part of the problem might be that they really can't hear. And often, hearing problems aren't detected until it's too late. It's now possible to test newborns for hearing loss. But HealthWeek's Nancy Olson explains why not all hospitals are doing it.

NANCY OLSON: Seven-year-old Hugh Kenety has the hardest time trying to pronounce words that begin with the letter "F." But with regular speech classes, he's improving all the time. His parents say Hugh's trouble with speech was the first clue to a more serious problem.

CHRISTINE KENETY, HUGH'S MOTHER: When he was two and he wasn't talking, I started to become suspicious so I brought the subject up with the pediatrician.

NANCY OLSON: What the Kenety's learned was that their happy, active two-year-old son was living in a world of distorted sounds.

KENNETH HENRY, PhD, AUDIOLOGIST: Predominantly muffled speech. In other words, it might be something like this... (muffled) where they are hearing very little of the speech itself.

NANCY OLSON: Testing revealed Hugh had been born with a serious hearing problem in both ears. A diagnosis that caught his parents by surprise.

BILL KENETY, HUGH'S FATHER: If a door slams and makes a noise... and the child turns around, you assume they've heard the door slam; but, in fact, instead what they've felt is a wind current.

NANCY OLSON: Hearing impairment is the most common disability among newborns. At least three out of every 1,000 babies is affected. Common, yet often undetected until it's too late. Most parents don't learn of a hearing problem until their child is about age three - well beyond the critical time for speech and language development.

KENNETH HENRY, PhD: If language acquisition is not in place by approximately 18 months of age, that child may never, in fact, acquire all of the language skills necessary for normal speech and language development.

NANCY OLSON: With that in mind, this report, issued in 1993 by a panel of experts convened by the National Institutes of Health, recommended the screening of all newborns for hearing impairment prior to hospital discharge. Today, about 400 hospitals follow that recommendation, using one of two tests to screen every newborn. Three-day-old Reagan Matthews is being tested at Fair Oaks Hospital in Virginia with a procedure called OAE. It measures how the inner ear responds to sound.

GILBERT HERER, PHD, AMERICAN SPEECH-LANGUAGE HEARING ASSN.: We have the expertise to identify all babies before six months of age who have hearing losses. And by doing that, we will give those babies the opportunities for normal development.

NANCY OLSON: Case in point, one-year-old Matthew Reilly. His hearing problem was detected when he was just a day old. Now he wears hearing aids and attends special developmental classes.

BRENDAN REILLY, MATTHEW'S FATHER: We had no risk factors, no family history. We certainly weren't expecting any "problems."

MICHELE REILLY, MATTHEW'S MOTHER: We're very, very lucky. And as a parent, I cannot imagine going through two and a half years of my child's life without knowing something so important.

NANCY OLSON: So if testing can make such a big difference, why aren't all hospitals doing it?

"Most hospitals aren't aware of the opportunity for universal newborn hearing screening. They are not familiar with the technology, nor the purposes of it, and once they do become aware of it, the first question that's asked is who's going to pay for it."

NANCY OLSON: Others say more research is needed before these tests are used routinely.

JACK PARADISE, MD, UNIV. OF PITTSBURGH SCHOOL OF MEDICINE: I don't support universal screening because I don't think we know enough about the possible adverse consequences of that screening and because I don't think we're really geared up to carry out all the necessary follow-up procedures that such a program would require.

NANCY OLSON: Doctor Paradise worries the technology isn't foolproof. Some children who've failed screening initially are later found to have no problem, which may put needless stress on both children and parents. Despite such drawbacks, Hugh's parents wish screening had been an option for them.

HUGH'S MOTHER: He's just a little below in reading and language arts. He'll continue to need some special help, but we hope that he'll be mainstreamed within a couple of years.

NANCY OLSON: As for Matthew, because his hearing loss was detected so early, doctors expect him to develop normal speech in time to start school.

SHARYL ATTKISSON: So what if your child's hearing wasn't checked right after birth? You might want to discuss it with your pediatrician. And you should learn the signs of possible hearing loss. For babies three months and under, there may be a problem if the child doesn't turn toward you when you speak or doesn't smile when spoken to. From three to six months, warning signs include failing to notice toys that make sounds, and not responding to the word "no." And by the time children reach their first

HUMAN GUINEA PIGS

Medical research is big business. More facilities are testing more new treatments than ever before. And that means a need for more people to test the treatments on. Many volunteer because they have an illness, and finding a cure is important to them. But thousands of healthy people are now making a living as research subjects. Some want their identities protected, but others were willing to speak to HealthWeek's Diane Bakos.

"I'm good for one more. Just give me something really freaky."

DIANE BAKOS: It's loads of laughs when actor Marlon Wayans sells his body to science in his new movie.

"Uh-huh... And you're familiar with the procedure."

DIANE BAKOS: But for real-life human guinea pig Rob Davis, it's serious business.

ROB DAVIS: I consider it a job. That's what it is. You're getting a paycheck.

DIANE BAKOS: Rob is one of a growing group of career guinea pigs. People who let themselves be poked and prodded in study after study - for cash.

ROB DAVIS: I make from $800 to $2400 for like, sometimes a month, or it could be within two to three months.

DIANE BAKOS: Career guinea pigs usually learn about studies through ads. At an initial orientation meeting, they're given details of what to expect. Those who decide to continue, go through a thorough medical screening process. Bob Helms has done this close to 25 times now. He details his experiences in his magazine "Guinea Pig Zero," and rates the various research facilities. He also writes about experiments gone awry. Like the case of a woman who enrolled in a study for $150 and died.

BOB HELMS, EDITOR, "GUINEA PIG ZERO": It's just a, what should have been a totally routine thing. She was getting a drug that's been on the market for decades. It was Lidocaine, and they gave her too much by mistake.

DIANE BAKOS: But the tragedies are rare, so Bob lets researchers put tubes in his nose, give him blood thinners and new migraine medications. He says for him, it's a matter of practicality.

BOB HELMS: You know, your body is doing the work. And you can talk on the phone and do business, you can write, you can catch up on reading, if you're a student you can study.

ROB DAVIS: Easy money, as long as you follow the protocol. Easy money.

DIANE BAKOS: Indeed, the money may be too easy.

ARTHUR CAPLAN, PHD, THE CENTER FOR BIOETHICS: There is a danger that we exploit, that we rip people off, that we misuse them. It's relative to their financial need; if you're desperately poor, small rewards can be very attractive to you.

DIANE BAKOS: It's a temptation that can lead some guinea pigs to lie to researchers. Lies Bob Helms says some researchers even encourage.

BOB HELMS: There's not full disclosure on either side. And there's also a certain amount of curving the information. Like, "You're not feeling a headache, are you?" The nurse will say like this, shaking her head.

DIANE BAKOS: There are safeguards in place to protect research subjects, such as institutional review boards, or IRBs, which examine every study before it's approved. But some in Congress question the effectiveness of IRBs, since board members generally are paid by the very facilities doing the research.

REP. CHRISTOPHER SHAYS, R-CONNECTICUT: And they can be created by anyone, and you can shop anywhere you want for an institutional review board that will be sympathetic to your project.

DIANE BAKOS: Jim Leslie, head of Pharmakinetics, an independent research facility, says his IRB's word is law.

JIM LESLIE, PHARMAKINETICS: They only look at studies that are conducted at Pharmakinetics, but they are very much at arm's length from us. Their role is to scrutinize the protocol purely for the safety and the well-being of the volunteer.

DIANE BAKOS: Volunteers are also protected by "informed consent," a statement they sign saying they understand and accept a study's risks. But this has become as much a protection for the research facility as for the subject.

ARTHUR CAPLAN, PhD, UNIVERSITY OF PENNSYLVANIA: Informed consent has become a shield: don't sue us. We told you there was risk. Don't blame us, we told you you might get sick.

DIANE BAKOS: Critics say another victim may be the science itself. That studies using paid guinea pigs may yield questionable findings.

ARTHUR CAPLAN, PhD: If you're getting paid money and you only test people who are willing to come forward for that, then you get a skew in the population. There aren't going to be a lot of necessarily 60-year-old business executives who come forward to get $50 to be in heart medicine studies. But they may be the ones who take all those heart medicines.

DIANE BAKOS: Many researchers agree that career guinea pigs don't always make ideal subjects, but they say they're necessary to move research forward.

"The point is, that in order to be sure that we have, we, the United States and the world, have a supply of safe medicines, medicines have to be tested."

DIANE BAKOS: For career guinea pigs, that need for testing means job security.

ROB DAVIS: Just say I'm living the American dream. I'm never unemployed, I'm always in the field. You know, someone is always wanting my work. You know, "Hey, Mr. Davis, we've got a study going on, would you like to come down?"

SHARYL ATTKISSON: And so, as we've heard, some people take part in medical testing for the money. But many others volunteer for trials at leading medical centers because they want to get state-of-the-art treatment. And here to give us the basics on that kind of testing is Doctor John Gallin, director of the Clinical Center at the National Institutes of Health.

Doctor Gallin, say I'm somebody with a disease or a condition like arthritis and I want to find out who might be doing studies that could benefit me, if I take part in them. How would I get the information?

JOHN GALLIN, MD, NATIONAL INSTITUTES OF HEALTH: There are several places you can go to get the information. You should go to your physician who should have the information from multiple sources about available studies. Or you could go onto your computer to the Worldwide Web and look at home pages such as the home page for the Clinical Center at NIH or another home page called "Center Watch" which has studies that are available in multiple places as a listing.

SHARYL ATTKISSON: What about the ads that we sometimes hear on the radio or see in the newspaper that ask for people with certain types of conditions to take part in studies. Are those legitimate as far as you know?

JOHN GALLIN, MD: They're usually legitimate. And the patient should focus on going to places affiliated with major medical centers or speak to your physician to make sure that they are indeed legitimate.

SHARYL ATTKISSON: Should there be any cost to the person taking part in the study?

JOHN GALLIN, MD: There should not be costs for the study. There may be costs for the standard care that's incurred surrounding the study, but there should not be costs associated with participating in a study.

SHARYL ATTKISSON: Would insurance cover that, what you're talking about?

JOHN GALLIN, MD: Insurance would not cover the costs of participating in the study but they should cover the standard care that might be involved around that.

SHARYL ATTKISSON: And what are the potential benefits? Because we know that if anyone who takes part in a study may be given the placebo and might not know it. So if you're not assured of getting the potential treatment that could be good for you, then what is the benefit?

JOHN GALLIN, MD: The benefits are that first of all you'll be in a major medical center and you'll be getting attention from experts related to your problem. And these experts can often give you help that is unrelated to the study. You'll also know that you're participating in study. And often you will have care that is beyond the standard of care that may be very, very important and beneficial.

SHARYL ATTKISSON: Thank you so much, Doctor John Gallin.

If you'd like more information on clinical trials or any other HealthWeek story, you can call our toll free number shown at the end of the program.

ASK THE DOCTOR

"I often bruise easily. And I was wondering if there's some vitamin or supplement I could take?"

BRUCE DAN, MD: Some people are just naturally more prone to bruising than others. But you're right about vitamins being a big factor. People who don't get enough vitamin C in their diets tend to turn black-and-blue easily. That's because vitamin C is essential in building collagen, a substance necessary for the strength of blood vessels. Nearly everyone knows that oranges and other citrus fruits are brimming with vitamin C. But other good sources include cranberry juice, bell peppers, and even broccoli.

TRUCK STOP GYM

SHARYL ATTKISSON: Well, there's no question they're king of the road - those 18 wheelers and their drivers that zip right by you on the interstate. But when it comes to their health, a lot of truckers are still stuck in low gear. Healthweek's John Hammarley shows us what one Arkansas truck stop is doing to change that.

JOHN HAMMARLEY: Tractors to Tulsa. Metal to Memphis. If you have a haul, truckers have the wheels.

"On the road again... going places that I've never been."

JOHN HAMMARLEY: Being on the road has its fair share of problems for truckers, like all those hours just sitting behind the wheel. And then there are all those helpings of stick-to-your-ribs food at truck stop diners. It's no wonder that 70 percent of truckers are overweight.

JEFF ABRAMS, ROLLING STRONG GYMS: The key is truck drivers don't have an opportunity to exercise on the road, so what we're doing is creating a network of gyms across the country at convenient truck stops for the drivers.

JOHN HAMMARLEY: Little Rock is the first location for this unusual chain of fitness centers. And there are plans for more than 10 other gyms along the country's most heavily traveled highways. On the road, truckers want their rigs equipped against every danger the long-distance hauling can throw at them.

But in here, they actually want to lose something they want their trucks to have, and that's a spare tire.

In just two years of long haul trucking, Martin O'Connell picked up some unwanted, hazardous material: an unwanted 20 pounds.

MARTIN O'CONNELL: And it's all gone right on in the middle. Sitting behind the wheel for 8 or 10 hours a day. Not real active.

JOHN HAMMARLEY: As an incentive for more truckers to become active, the federal government is paying for 500 memberships.

RONALD KNIPLING, PHD, FEDERAL HIGHWAY ADMINISTRATION: It's a holistic approach to driver health and fitness. We think a healthy driver is more likely to be an alert driver and therefore more likely to be a safe driver.

JOHN HAMMARLEY: Joe Boughton, a long-time, long-haul trucker, was among the first to pull in to pump some iron.

BOUGHTON: I've seen guys who can't even walk across the truck stop without losing their breath and breaking a sweat. I've always told myself I'd never let myself get that bad. I have more endurance, more alert, better condition to do the job.

JOHN HAMMARLEY: In addition, truckers get to sweat off their stress.

RUCKER: You get frustrated in traffic with cars darting in and out. Delays at shippers. This just helps work it all out.

"I want to get physical. Let's get into physical."

JOHN HAMMARLEY: While truckers may join the trend toward trimmer tummies, there's one trend you'll never see in these gyms: spandex.

TRUCKER: Never. I wear sweat pants and T-shirts and that's me.

SHARYL ATTKISSON: That's it for us but you can keep on trucking with us throughout the week at our site on the Worldwide Web. To reach the HealthWeek home page, go to PBS ONLINE at the Internet address on your screen. That address is: www.pbs.org

Next time on HealthWeek, we'll look at one of the latest crazes in alternative medicine - aroma therapy. Can scents really heal, or do some marketers just smell a quick profit? Until then, I'm Sharyl Attkisson. Be well!

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