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30 Oct 1997 : Column WA249

Written Answers

Thursday, 30th October 1997.

COT: Members' Financial Interests

Earl Baldwin of Bewdley asked Her Majesty's Government:

    Whether they will identify those members of the Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment who have declared financial or other links with pharmaceutical companies.

The Minister of State, Department of Health (Baroness Jay of Paddington): A complete list of the financial interests declared by members of the Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) was published in the 1995 committee annual report. A copy of this report has been placed in the Library. The 1996 annual report is due to be published later this year. A copy of the draft list of financial interests declared by COT members for the relevant period has also been placed in the Library.

Malathion Exposure

The Countess of Mar asked Her Majesty's Government:

    Whether they are aware of research conducted by Rodgers and Ellefson at the Southern California School of Medicine in 1992 indicating that "an allergic type response was occurring within four hours of exposure to malathion at concentrations over a thousand times lower than the levels known to produce inhibition of acetylcholinesterase" in laboratory mice and that "malathion exposure has been correlated to certain changes in the mouse immune system, implying that similar changes in the human immune system might occur upon exposure to malathion"; and what research has been, or is being, conducted in this field in the United Kingdom and with what results.

Baroness Jay of Paddington: The paper by Rodgers and Ellefson relates to findings in laboratory mice receiving oral malathion to the environmental exposure of humans to malathion through insecticide spraying. Some people may suffer allergic reactions to malathion-containing medicinal products and the product information contains warnings about the use of these products in patients who are sensitive to the ingredients. We are not aware of any research being undertaken in the United Kingdom into malathion.

The Countess of Mar asked Her Majesty's Government:

    Whether they will make available to all medical practitioners, nurses, parents and others involved in providing or recommending treatment to eradicate head lice, particularly for children and pregnant

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    women, the information contained in the New Jersey Department of Health fact sheet on malathion.

Baroness Jay of Paddington: The New Jersey Department of Health fact sheet relates to occupational exposure to malathion--mainly long term chronic exposure or acute exposure to toxic doses of malathion. This is not relevant to the use of malathion in medicinal use and there is no evidence that users of licensed medicinal products containing malathion have experienced serious adverse effects. Product information for shampoos an lotions containing malathion warns against prolonged use (for example, stating that it should not be used more than once a week and for not more than three consecutive weeks).

The Countess of Mar asked Her Majesty's Government:

    What is their response to the results of the research conducted on behalf of "World in Action" by Health and Safety Executive scientists in Sheffield and broadcast on 6 October 1997 which demonstrated that the levels of absorption of the organophosphate malathion from head louse treatments was many times higher than that of workers in agriculture and industry and was five to 10 times higher than safety limits; and,

    Whether they are aware of several research papers which indicate that organophosphates are liable to be absorbed in larger quantities through the skin of scalp, face and scrotum than other parts of the body, and whether they are satisfied that the tests conducted to determine the safe exposure limits to these chemicals in louse and scabies treatments containing organophosphates adequately reflect this property.

Baroness Jay of Paddington: The Medicines Control Agency and Committee on Safety of Medicines are reviewing the evidence provided by "World in Action", and will consider the need for further studies or changes in the recommendations for use. Malathion is absorbed slowly through human skin and is rapidly detoxified in the blood and there is no evidence that people exposed to malathion through the use of head-lice and scabies treatments have experienced serious adverse effects. Product information for shampoos and lotions containing malathion warns against prolonged use (for example, stating that it should not be used more than once a week and for not more than three consecutive weeks). The papers referred to regarding organophosphate absorption relate to occupational exposure to malathion, that is long term chronic exposure or acute exposure to toxic doses. The safety limits advised for occupational exposure are not relevant to the medicinal use of malathion.

Pesticide and Chemical Pollutant Exposure: Survey Proposal

The Countess of Mar asked Her Majesty's Government:

    Whether they will commission a population study into the effects that lifestyle, diet and exposure to pesticides and chemical pollutants have upon the

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    ability of children and adults to utilise vitamins, minerals and trace elements.

Baroness Jay of Paddington: There are no plans to carry out such a survey because population studies are not suitable to determine the ability of children and adults to utilise vitamins, minerals and trace elements. The Department of Health and the Ministry of Agriculture, Fisheries and Food jointly commission a series of national diet and nutrition surveys of children and adults. Each survey collects detailed information on lifestyle characteristics, intakes of food and nutrients and blood levels of many vitamins, minerals and trace elements. The same surveys are used to estimate the exposure to pesticides and chemical pollutants of the subjects.

Partial-birth Abortion

Lord Braine of Wheatley asked Her Majesty's Government:

    How many cases of partial-birth abortion were recorded in this country in each of the last three years.

Baroness Jay of Paddington: None. We are not aware of this procedure being used in the United Kingdom.

The Reference Nutrient Intake

The Countess of Mar asked Her Majesty's Government:

    At what date and upon what scientific basis the reference nutrient intakes were established.

Baroness Jay of Paddington: The reference nutrient intake (RNI) is the amount of a nutrient which is sufficient, or more than sufficient, to meet the nutritional needs of practically all healthy people. The scientific basis for the establishment of reference nutrient intakes can be found in the Committee on Medical Aspects of Food and Nutrition Policy report "Dietary Reference Values for Food Energy and Nutrients for the United Kingdom" published in 1991. A copy of this report is available in the Library.

Euthanasia and Advance Directives

Lord Alton of Liverpool asked Her Majesty's Government:

    Whether they continue to support the British Medical Association's opposition to the legalisation of euthanasia; and whether they accept that the use of advance directives can create circumstances in which euthanasia is practised.

Baroness Jay of Paddington: The Government have no plans to change the law relating to euthanasia.

It is a general principle of law and medical practice that any person with the mental capacity to make a valid

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decision may choose whether or not to accept medical treatment. An advance directive is a way for a patient to plan ahead for a time when he/she may lose the capacity to make or convey his/her own treatment decisions. An advance directive which is clearly applicable in the circumstances pertaining is as legally binding on health professionals as a contemporaneous refusal would be. An advance directive cannot authorise a medical practitioner to do anything which is illegal.

Abortions and Human Embryos

Lord Alton of Liverpool asked Her Majesty's Government:

    How many abortions were performed in Great Britain between 1967 and 1997; and how many human embryos have been destroyed in British laboratories since the passage of the Human Fertilisation and Embryology Act 1990.

Baroness Jay of Paddington: Between 27 April 1968, when the Abortion Act 1967 came into operation, and 31 March 1997, the latest quarter for which figures are available, the total number of abortions performed in Great Britain was 4,673,674. The figures requested for human embryos are not routinely collected. However, on the basis of information provided by the Human Fertilisation and Embryology Authority last year, the number of embryos that were neither frozen nor used for treatment or other purposes between 1 August 1991 and 31 December 1994 was 90,491.

Vitamin B6 Supplements: Adverse Reactions

The Countess of Mar asked Her Majesty's Government:

    Further to the Written Answer given by Lord Donoughue on 30 July (WA 54), what were the signs and symptoms of the 410 reported adverse reactions to products containing vitamin B6 alone and what clinical investigations were made as to pre-existing medical conditions or co-exposure;

    Further to the Written Answer given by Lord Donoughue on 30 July (WA 54), whether all the 649 adverse reaction reports to products containing vitamin B6 between 1964 and 1997 were confined to the United Kingdom, and if not, from which other countries were reports included; and

    Whether any of the fatalities associated with vitamin B6 were associated with patients suffering from tuberculosis and receiving isoniazid.

Baroness Jay of Paddington: A Drug Analysis Print (DAP), listing signs and symptoms associated with all suspected reactions reported to the Committee on Safety of Medicines between 1 July 1963 and 30 July 1997 for products containing vitamin B6 has been placed in the Library along with an information sheet to aid interpretation.

The yellow cards completed by physicians in order to report suspected adverse drug reactions have sections

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where the reporting doctor can indicate any details of pre-existing conditions and co-exposure that he feels may be relevant to the report.

The 411 reactions now reported to have occurred in this period (one further report of a reaction during this period has been received) originated from 160 spontaneous reports. Of these 11 reports had more than one drug listed as suspected to have caused the reaction, 78 reports had details of other medications not suspected to be related to the reaction, and five included information on pre-existing conditions. Clinical investigations are at the discretion of the reporting physician.

All 649 reports referred to the Written Answer given by Lord Donoughue on 30 July at column WA 54 were from the United Kingdom.

There was one fatality associated with vitamin B6 in a patient suffering from tuberculosis, who was receiving a combination of rifampicin and isoniazid.


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