Transcript: Your Health Season 3 Episode 20 | Feb 19, 2002

A slate reads "The advice given in the following program is of a general nature only. Viewers should consult their own medical professional for medical advice specific to their circumstances."

(music plays)

Against a gray background, an animated blue, green and gray grid shows clips of doctors and patients as the white letters of the title of the show fly forward: "Your Health."

Maureen says THIS WEEK.

Joel Lexchin is in his late forties, clean-shaven with receding brown hair. He wears a striped green, pink and white polo shirt.

Joel says SOMETIMES PEOPLE DON'T
REALIZE HOW THEY'VE BEEN
INFLUENCED.

Maureen says IS YOUR DOCTOR INFLUENCED
BY DRUG COMPANY MARKETING.

Marcia Herman-Giddens is in her sixties, with gray hair tied-up. She wears glasses, a brown jacket, brooch, blue earrings and blue and red necklace.

Marcia says WE NOW SEE GIRLS THAT ARE
ENTERING PUBERTY ABOUT A
YEAR YOUNGER.

Maureen says WHY IS PUBERTY HAPPENING
SOONER.

Paul Caldwell is in his late fifties, with a beard and receding white hair. He wears a gray shirt and patterned tie.

Paul says EVERY TIME YOU OPEN YOUR
MOUTH TO SPEAK, A TINNY
MIRACLE HAPPENS RIGHT HERE
IN YOUR VOICE BOX.

Maureen says AND SINGING PRAISES OF
THE LARYNX.

The animated grid appears showing clips of a woman holding a baby, pills, a surgery, a needle and a man doing exercise.

The title of the program reads "Your Health." The "R" in "Your" ends with an "X."

Maureen Taylor stands next to a screen in a studio. She is in her late thirties with shoulder-length light brown hair. She wears a red blazer and matching necklace.

Maureen says HI, I'M MAUREEN
TAYLOR, CELEBREX, ONE OF THE
MOST SUCCESSFUL NEW DRUGS
EVER DEVELOPED, THAT IS IF
YOU MEASURE SUCCESS BY SALES
AND PRESCRIPTIONS, BUT MANY
SAY CELEBREX HAS BEEN MORE
OF A MARKETING SUCCESS THAN
A MEDICAL BREAKTHROUGH.
IN CANADA WHERE DRUG
COMPANIES CAN'T ADVERTISE
PRODUCTS DIRECTLY TO THE
CONSUMER THEY MUST INSTEAD
PITCH THE DRUGS TO THE
DOCTORS WHO WRITE THE
PRESCRIPTIONS.
BUT DOCTORS DON'T NEED ADS,
THEY NEED EDUCATION ABOUT
WHICH DRUG FOR THEIR PATIENT.

The TV screen next to her shows hands handling pills and pharmaceutical ads.

Maureen continues WE LOOKED AT HOW THEY GET
THAT EDUCATION AND HOW IT
CAN AFFECT YOUR HEAL WHEN
THE EDUCATION IS COMING FROM
DID COMPANIES.

[monitor beeps]
A blue slate reads "Pushing Drugs. Produced by Maureen Taylor."

A clip plays.

Maureen says MEDIA HEADLINES CALL THEM
BREAKTHROUGHS AND MIRACLE
DRUGS.
EVERY YEAR HEALTH CANADA
APPROVED BETWEEN 20 AND 30
NEW DRUG THERAPIES.
BUT MOST OF THEM DON'T
IMPRESS DRUG INDUSTRY
CRITICS.

Newspaper headlines read "Drug approved for advanced breast cancer. New drug could be breast cancer breakthrough. Pills cut heart deaths 22 percent, study says."

A caption appears on screen. It reads "Doctor Peter Mansfield. Director Healthy Skepticism. org." Peter is in his mid-fifties, clean-shaven with gray hair. He wears glasses, blue shirt and patterned blue tie.

Peter says WITH VERY FEW EXCEPTIONS
THE DRUGS THAT HAVE COME ON
THE MARKET IN THE LAST TEN
YEARS HAVE NOT BEEN BIG
BREAKTHROUGHS BUT HAVE BEEN
MORE EXPEN@VE.
BUT THEY'VE BEEN
DISAPPOINTMENT.

The caption changes to "Doctor Joel Lexchin. Member Healthy Skepticism. org."

Joel says MOST DRUGS THAT COME OUT
ON TO THE CANADIAN MARKET OR
THE FRENCH MARKET ARE REALLY
ESSENTIALLY NO BETTER THAN
WHAT WE ALREADY HAVE.

Peter says TEN PERCENT OF THE U.S.
POPULATION SINCE 1997 HAVE
BEEN EXPOSED TO DRUGS THAT
HAVE SUBSEQUENTLY BEEN
WITHDRAWN FOR SAFETY REASONS.
SO YOU KNOW, PEOPLE BELIEVE
THAT NEW IS BETTER, A NEW
COMPUTER USUALLY IS.
HOWEVER WITH DRUGS IT IS A
DIFFERENT STORY.

Maureen says ONE EX...
EXAMPLE IS CELEBREX, A DRUG
THAT TREATS OSTEOARTHRITIS.

A zoom in shot shows a white and green medicine box.

Maureen continues AFTER ITS RELEASE IN '99 IT
QUICKLY BECAME ONE OF THE
BEST-SELLING DRUGS OF ALL
TIME AND THE MOST HEAVILY
MARKETED.

Peter says CELEBREX HAS SET THE
RECORD FOR A DRUG IN
AUSTRALIA FOR THE MOST
ADVERSE DRUG REACTION
REPORTS.
THIS DRUG IS A MAJOR
DISAPPOINTMENT TO US.
THERE WERE REASON FOR
THINKING THAT IT MIGHT BE
BETTER.
THERE MAY BE A SMALL
ADVANTAGE FOR ALL
CERTIFICATES... ULCERS BUT
THERE IS REAL CONCERN ABOUT
CARDIAC FAILURE, HEART A TAX
HEART NOT BEING STRONG
ENOUGH ANY MORE AND ALSO
KIDNEY FAILURE.
SO THIS DRUG IS NOT LOOKING
SO GOOD.
IT'S A LOT MORE EXPENSIVE.
MANY PATIENTS WILL BE MUCH
BETTER OFF USING LARGE DOSES
OF ACETAMINOPHEN RATHER THAN
ONE OF THESE ASPIRIN-LIKE
DRUGS LIKE CELEBREX.

Maureen says Dr. ED KEYSTONE
SAY WELL-KNOWN
RHEUMATOLOGIST IN IT THE HE
SAYS THE VIEW THAT NEW DRUGS
ARE NO BETTER THAN OLDER
DRUGS IS DATED.

The caption changes to "Doctor Ed Keystone. Rheumatologist."

Ed sits at a desk. He is in his mid-fifties, clean-shaven with short brown hair. He wears a white doctor apron, white shirt and patterned dark tie.

Ed says WE ARE NOW GETTING A NEW
MEDICATION ON THE MARKET
EVERY YEAR.
THIS YEAR WILL THERE WILL BE
THREE NEW MAJOR MEDICATIONS
ON THE MARKET FOR ARTHRITIS.
IT IS CRITICAL TO KEEP UP
BECAUSE THESE MEDICATIONS
ARE MAKING AN ENORMOUS
IMPACT ON THE CALL OF LIFE
OF OUR PATIENTS.

Maureen says DRUG COMPANIES
SPENT MILLIONS OF DOLLARS
RESEARCHING AND TESTING NEW
MEDICINES.
ONCE THEY ARE APPROVED THE
COMPANY WANTS TO RECOUP ITS
INVESTMENT BY BEATING OUT
THE COMPETITION.
SO THEY MARKET THEIR DRUGS
JUST AS ANY OTHER BUSINESS
WOULD.
BUT IN CANADA THEY CAN'T
ADVERTISE THEM TO CONSUMERS,
SO INSTEAD THEY MARKET TO
THE PEOPLE WHO WRITE THE
PRESCRIPTIONS, OUR DOCTORS.

A male doctor counts colourful pills. Then, an article on a magazine reads "You can use a different medication for each condition Or you can use one."

Peter says THE PROBLEM FOR FAMILY
DOCTORS LIKE ME IS WE'VE GOT
LIMITED TIME AND THE DRUG
COMPANIES COME TO US AND
THEY USE TECHNIQUES THAT
HAVE BEEN PROVEN TO WORK.
THEY ARE ALWAYS TRYING TO
EXAGGERATE THE BENEFITS AND
MINIMIZE THE SIDE EFFECTS.
AND THEY DO IT AS A PACKAGE
THEY FOUND THAT ADVERTISING
IS THE MOST COST-EFFECTIVE
WAY TO BUILD AWARENESS AN TO
KEEP DOCTORS PRESCRIBING
THEIR DRUG PRESCRIBING IT.

Maureen sits at a table with drug samples and a booklet sitting on it.

Maureen says EVERY DAY ARMIES
OF DRUG REPRESENTATIVES ARE
SENT INTO DOCTORS OFFICES
AND HOSPITALS TO LEAVE SMALL
GIFTS, FREE DRUG SAMPLES AND
A PACKAGE OF INFORMATION
ABOUT THEIR DRUGS.
OR A REP MIGHT TALK TO
DOCTORS AT A HOSPITAL OVER
LUNCH WITH PIZZA AS AN ADDED
INCENTIVE.
AND THE THIRD WAY COMPANIES
PITCH THEIR PRODUCTS TO
DOCTORS IS THROUGH CME OR
CONTINUING MEDICAL EDUCATION
WHERE DOCTORS GO TO DINNER
OR A WEEKEND CONFERENCE TO
HEAR AN EXPERT TALK ABOUT A
SPECIFIC DISEASE, AND THE
DRUGS TO TREAT IT.

Peter says YOU KNOW, IT'S SENSIBLE
FOR US TO RELY ON EXPERTS
FOR ADVICE ABOUT WHAT IS THE
BEST THING TO DO.
THE PROBLEM IS THAT THERE IS
ALWAYS A RANGE OF OPINIONS
MOST EXPERTS.
AND GUESS WHICH EXPERTS GET
CHOSEN BY THE DRUG COMPANIES
TO BE THE ONES THAT THEY
AMPLIFY THE ISS.
SO WHO IS IT THAT WE GET TO
HEAR.

Joel says ARE THEY GOING TO CHOOSE
PEOPLE THAT WILL BE NEGATIVE
ABOUT THEIR PRODUCT?
ARE THEY GOING TO CHOOSE
PEOPLE WHO ARE GOING TO SAY
WELL, THE COMPANY THAT
SPONSORING THIS MAKES DRUG X,
AND IT'S NOT BAD BUT IF YOU
REALLY WANT TO DO A GOOD JOB
WILL YOU CHOOSE THE
COMPETITOR.

Maureen says BUT Dr. KEYSTONE WHO IS
OFTEN ASKED BY DRUG
COMPANIES TO PRESENT
RESEARCH AT THESE CME EVENTS
SAYS THERE IS NO ATTEMPT TO
CONTROL HIM.

Ed says THEY TAKE GREAT PAINS TO
ENSURE THAT I, IN FACT, AND
PHYSICIANS LIKE ME ARE
BALANCED IN OUR
PRESENTATION.
AND AT THE END OF IT THEY
COME UP TO SOMETIME AND SAY
GEE, THAT WAS REALLY
BALANCED, WE WERE PLEASED.
YOU WERE BALD.
YOU DIDN'T OVERDUE OUR
PRODUCT.
THEY DON'T WANT TO US
OVERDUE THEIR PRODUCT.
THEY JUST SAY GIVE US THE
DATA, PUT IT OUT THERE, LET
THE PHYSICIANS MAKE THEIR
JUDGMENTS AND DECISIONS
BASED ON THE DATA.
BECAUSE AT THE END OF THE
DAY THEY ARE GOING TO KNOW
HOW THE PATIENTS ARE DOING
AND IT IS TO THE GOING TO BE
ME, IF I GIVE THEM
MISINFORMATION THEY WILL
FIND OUT PRETTY QUICKLY THAT
I WAS WITH.

Joel says NOT EVERYBODY IS BOUGHT,
THAT'S TRUE.
THERE ARE LOTS OF PEOPLE WHO
GIVE TALKS GIVE TALKS BASED
ON SCIENTIFIC INFORMATION.
BUT SOMETIMES PEOPLE DON'T
REALIZE HOW THEY HAVE BEEN
INFLUENCED.

Maureen says FOR MONTHS YOUR HEALTH
CONTACTED A LONG LIST OF
PHARMACEUTICAL COMPANIES,
FOR PERMISSION TO ATTEND A
CME WITH OUR CAMERAS
ROLLING.
EACH TIME OUR REQUEST WAS
EITHER IGNORED OR DENIED.

Animated pharmaceutical companies logos such as Bayer, GSK, Pfizer, Aventis, Pharmacia and others appear and fade against a letter on a blue background.

She continues Dr. KEYSTONE INVITED US TO
ATTEND ONE OF HIS TALKS ON
NEW THERAPIES FOR RHEUMATOID
ARTHRITIS.
IT WAS BEING HELD AT THE
MILLCROFT INN NEAR
ORANGEVILLE, ONTARIO.
BUT WHEN THE SPONSOR DRUG
COMPANY, WYETH-AYERST
LEARNED OUR STORY WAS ABOUT
DRUG MARKETING, WE WERE
ASKED TO LEAVE.
CRITICS ALSO OBJECT TO THE
ENTERTAINMENT AND PATCHERING
THAT SURROUND THESE EVENTS
WHETHER AT A SWANKY
RESTAURANT, AN EXPENSIVE
RESORT OR ON A CRUISE SHIP,
DOCTORS OFTEN ENJOY PERKS
THAT HAVE NOTHING TO DO WITH
MEDICAL EDUCATION.

Fast clips show Ed examining a woman’s leg and a casual meeting in a large room.

Joel says YOU WILL HAVE EVENTS
TAKING PLACE UP IN MUSKOKA
DURING THE SUMMER, THESE
WILL BE START ON A FRIDAY
NIGHT, YOU WILL GET THERE,
HAVE DINNER, THERE WILL BE A
COUPLE OF HOURS IN THE
MORNING WHERE YOU GO TO
TALKS, IN THE AFTERNOON YOU
CAN PLAY TENNIS OR GOLF, YOU
HAVE DINNER SATURDAY EVENING,
YOU HAVE BRUNCH SUNDAY
MORNING AND YOU GO HOME.
THIS IS COMPLETELY PAID FOR
BY THE DRUG COMPANY.

Maureen and Murray Elston talk in a room. Murray is in his early fifties, clean-shaven with grayish hair. He wears glasses, gray suit, blue shirt and gray and dark blue tie.

Murray says WOULD YOU PREFER THEM TO
DO IT IN ROOMS WITHOUT
WINDOWS, WITHOUT THE LATEST
AIDS IN PROVIDING SOME KIND
OF COMFORT WHILE THEY ARE
LEARNING.

Maureen says MURRAY ELSTON IS
THE PRESIDENT OF RX and D, THE
UMBRELLA ORGANIZATION THAT
REPRESENTS CANADIAN
PHARMACEUTICAL COMPANIES.

The caption changes to "Murray Elston. President, Rx and D."

Murray says I DON'T THINK THAT THERE
IS ANYTHING WRONG WITH
PEOPLE WHEN THEY ARE ASKED
TO TAKE TIME FROM THEIR
PERSONAL LIFE LIVES, BECAUSE
THAT IS WHAT THEY HAVE TO DO
TO GO TO THESE EVENT, TO BE
THINKING THAT THEY ARE ALSO
GOING TO END UP WITH LITTLE
HAUTE CUISINE, I DON'T MIND
THAT PROVIDED THIS, THAT THE
EVENT IS DRIVING THEM TO
LEARNING, AND THAT THEY ARE
GETTING REALLY GOOD AND
ACCREDITED TYPE OF MATERIAL.

Maureen says BUT CRITICS SAY
THIS MARKETING DISGUISED AS
EDUCATION PUTS DOCTORS IN A
CONFLICT OF INTEREST AND
MAKES THEM BAD PRESCRIBERS.

Peter says WE KNOW FROM STUDIES IN
AUSTRALIA THAT FREQUENTSY OF
ATTENDING CME CORRELATES
WITH LESS APPROPRIATE
PREKRAK OF EXPENSIVE NEW
DRUGSES THAT ARE NOT
JUSTIFIED BY THE EVIDENCE.
WE KNOW THAT CME IS HARMFUL
FOR PATIENTS AS IT IS
CURRENTLY DONE.

Joel says I OBJECT TO ANY KIND OF
PHARMACEUTICAL MARKETING
THAT LEADS TO POORER
PRESCRIBING.

Peter says OFTEN THERE IS A PROBLEM
OF USING A NEW DRUG WITH
UNKNOWN RISKS INSTEAD OF A
SAFER ONE.
SOMETIMES THERE IS A PROBLEM
OF USING A DRUG WHEN A
NONDRUG TREATMENT WOULD BE
BETTER.
SOMETIMES IT IS LESS
EFFECTIVE DRUG.
THAT IS INVOLVED.
ALMOST ALWAYS WE ARE TALKING
ABOUT MORE EXPENSIVE DRUGS.

Maureen says BUT Dr. KEYSTONE SAY
SOMETIMES THE BEST DRUGS DO
COST MORE.

Ed says I THINK DOCTORS HAVE AN
ETHICAL RESPONSIBILITY TO
TREAT THE PATIENT THE BEST
THEY CAN.
THEY ARE CONSTANTLY,
CONSTANTLY WEIGHING THE
COSTS VERSUS THE MEDICATION.
THEY ARE CONSTANTLY DOING
THAT.
I THINK TRULY IN THE LONG
RUN AND I MUST SAY THIS IS,
I MAY BE AT FAULT AT THIS
BUT I WANT MY PATIENT TO GET
THE BEST MEDICATION AND
COSTS BECOME SOMEWHAT
SECONDARY.
IT SHOULDN'T BUT IT DOES
BECAUSE MY PATIENT DESERVES
HIS BEST MEDICATION.

Maureen says STUDIES DO SHOW THAT
DOCTORS WHO SEE DRUG REPS
AND ATTEND DRUG SPONSORED
CMES ARE MORE LIKELY TO
PRESCRIBE THE FEATURED DRUGS
BUT RX and D'S MURRAY ELSTON
SAYS THAT MAKES SENSE.

Murray says BUT WOULDN'T YOU EXPECT
IF THEY GOT THE MOST RECENT
INFORMATION ABOUT A NEW
PRODUCT THAT USUALLY THESE
ARE DONE IN RELATION TO NEW
PRODUCTS THAT ARE COMING ON
THE MARKET.
YOU GET NEW ADVANCES SO
PEOPLE FIND OUT ABOUT THEM
AND SO THEY DO TRY THE
PRODUCTS WHICH THEY HAVE
DISCOVERED WILL ALLEVIATE
CERTAIN SIDE EFFECTS FOR
EXISTING PATIENTS.
SO I DON'T THINK IT'S AN
UNUSUALLY EVENT AT ALL.

Ed says PHYSICIANS HAVE THE
CAPABILITY OF BEING
DISCERNING, TO READ THE
LITERATURE, TO BRING THE
VOLUME OF DATA TOGETHER AND
MAKE THEIR OWN OPINIONS.
ALL IT IS AN EDUCATIONAL
PROCESS TO BRING NEW DATA TO
THE FORE.
BUT THEY WILL MAKE THEIR
JUDGMENT.
AND I GOT TO TELL YOU, IN
THE LONG RUN PATIENTS MARCH
WITH THEIR FEET.
AND THE PHYSICIANS MARCH
WITH THEIR FEET.
SO IT DOESN'T MATTER WHAT
KIND OF INFLUENCE YOU MIGHT
THINK THE PHARMACY INDUSTRY
IS PUTTING ON YOU, IF YOUR
PATIENTS AREN'T GETTING
BETTER ARE YOU NOT GOING TO
USE THE PRODUCT.
I DON'T CARE HOW MANY
MEETINGS THE PHYSICIANS AND
PHARMACEUTICAL COMPANIES
SEND YOU TO, IF IT WORKS FOR
YOUR PATIENT THAT IS WHAT
COUNTS IN THE LONG RUN.
THAT IS WHAT INFLUENCES
DECISIONS TO USE DRUGS.

Maureen says ULTIMATELY THEY
WOULD LIKE TO SEE DOCTORS
JUST SAY NO TO DRUG COMPANY
MARKETING.
IN THE MEANTIME THEY HAVE
ADVICE FOR PATIENTS.

Joel says WHEN YOU GO TO A DOCTOR
YOU WANT TO ASK A NUMBER OF
QUESTIONS.
FIRST OF ALL, WHAT HAVE I
GOT, WHAT IS MY PROBLEM.
WHAT ARE THE OPTIONS AN
THERAPY, DO I NEED DRUGS.
IF I NEED DRUGS, WHAT ARE
THE RANGE OF DRUGS CONSUMERS
SHOULD WANT TO KNOW WHERE
DOCTORS ARE BETTING THEIR
INFORMATION ABOUT DRUGS.
ARE YOU GETTING THEM FROM
LISTENING TO THIS LAST SALES
REP WHO WENT IN OR ARE YOU
GETTING THEM BY READING SOME
OF THE OBJECTIVE SOURCES OF
INFORMATION THAT ARE
AVAILABLE.

Peter says DRUGS ARE VERY DIFFERENT
FROM SOAP POWDERS.
IF YOU BUY A SOAP POWDER AND
IT DOESN'T WORK IT MAY
DAMAGE YOUR CLOTHES.
DAMAGING YOUR... YOU CAN BUY
SOME NEW CLOTHES.
DAMAGING YOUR HEALTH MAY BE
MUCH, MUCH MORE DIFFICULT TO
REPAIR.

The clip ends.

Maureen says SPEAKING OF
DRUGS, HOW MUCH DID THE
AVERAGE CAN DID SPEND ON
MEDICINES IN THE YEAR 2000?

A gray slate reads "Quiz."

Maureen continues 478 DOLLARS.
255 DOLLARS.
OR 512 DOLLARS.
GET OUT YOUR CALCULATOR,
WE'LL HAVE THE ANSWER LATER
ON "YOUR HEALTH."

Back at the studio, Maureen says IT'S AS IF A WHOLE
GENERATION OF YOUNG GIRLS
HAD BEEN PUT ON HORMONEAL
FAST FORWARD, FOR THE LAST
DECADE DOCTORS HAVE NOTICED
MORE AND MORE GIRLS ARE
DEVELOPING BREASTS AND
GROWING PUBIC HAIR AT
YOUNGER AGES.
SOME AS YOUNG AS FIVE, SIX
AND SEVEN YEARS OLD.
OBVIOUSLY THIS IS A HEALTH
CONCERN BUT PARENTS ARE ALSO
WORRIED ABOUT THE
PSYCHOLOGICAL HE EFFECTS OF
PREMATURE SEXUAL
DEVELOPMENT.
WE SAT DOWN WITH THE LEADING
RESEARCHERS IN THE FIELD OF
EARLY PIRBT.
SHE IS A PROFESSOR AT THE
UNIVERSITY OF NORTH CAROLINA'S
SCHOOL OF PUBLIC HEALTH.

A clip plays.

Maureen and Marcia sit in a large room with a library behind them.

Maureen says WHAT IS GOING ON, ARE WE
SEEING GIRLS REACHING ERT AT
A YOUNGER AND YOUNGER AGE.

The caption changes to "Marcia Herman-Giddens. Professor. University of North Caroline."

Marcia says I THINK WE ARE.
I THINK WHEN WE LOOK AT
OLDER STUDIES FROM 40 OR 50
YEARS AGO, WHERE IT WAS
THOUGHT TO HAVE STABILIZED,
WE NOW SEE GIRLS THAT ARE
ENTERING PUBERTY ABOUT A
YEAR YOUNGER, WE'VE GOT ON
AVERAGE, IF YOU ARE WHITE
THE GIRLS IN THE FOURTH
GRADE F SHE IS
AFRICAN-AMERICAN SHE IS IN
THE THIRD GRADE, NOW THAT IS
AWFULLY YOUNG.
AND I THINK THERE ARE A LOT
OF THINGS GOING ON.
IT IS NOT ANY ONE CAUSE.
I THINK ONE OF THE THINGS
THAT WE HAVE TO DO IS LOOK
AT THE ENVIRONMENT AND SAY
WHAT IS GOING ON HERE.
AN NOT ACCEPT THIS AS THE
NORM JUST BECAUSE IT IS
AVERAGE, IF DOES NOT MEAN IT
IS NORMAL OR HEALTHY.
WE NEED TO LOOK AT THE
UNDERLYING CAUSES AND SEE
WHAT WE CAN DO ABOUT IT.

Maureen says LET'S TALK ABOUT
ENVIRONMENTAL FACTORS THAT
MIGHT BE CULPRITS HERE.
I HAVE READ ABOUT THINGS
LIKE PESTICIDES AND PCBs,
WHAT DO WE KNOW ABOUT HOW
THOSE WOULD AFFECT A GIRL'S
DEVELOPMENT.

Marcia says THAT'S CORRECT.
THERE ARE A LOT OF CHEMICALS
IN THE ENVIRONMENT, THEY ARE
OFTEN CALLED ENDOCURRENT
DISRUPTERS INCLUDING PCBs,
PESTICIDES, PLASTIC, A LOT
OF THE PLASTIC WRAP ON OUR
SANDWICH, DENTAL SEALANTS ON
CHILDREN'S TEETH, THESE
CHEMICALS ARE UBIQUITIOUS
AND HAVE HORMONEAL LIKE
AFFECT ON THE BODY, OFTEN
MOST USUALLY ESTROGEN LIKE
AFFECTS.
AND THERE ARE NUMBERS OF
ANIMAL STUDIES THAT HAVE
SHOWED THAT THEY CAN AFFECT
OR DO AFFECT THE AGE OF
ONSET OF PUBERTY, MAKING IT
LOWER GENERALLY, AND THEY
HAVE OVER REPRODUCTIVE
AFFECTS THAT ARE NOT GOOD
AND NOW THEY ARE BEGINNING
TO BE STUDIES SOME VERY
INTERESTING AND VERY
CONCERNING STUDIES IN HUMAN
BEINGS THAT HAVE BEEN
AFFECTED BY THESE CHEMICALS.
ONE OF THEM NOT TOO FAR FROM
CANADA WAS A MICHIGAN STUDY
WHERE A TRAGIC ACCIDENT
OCCURRED AND A FIRE
RETARDANT CHEMICAL THAT IS
AN ENDOCRINE DISRUPTER
SPILLED SOMEHOW INTO CATTLE
FEED, CATTLE ATE IT, THE
MOTHERS WHO WERE PREGNANT
WITH THE YOUNG GIRLS WERE
DRINKING THE MILK FROM THE
COWS SO THE AT THE TIMEUSES
GOT EXPOSED.
AND THEN THE MOTHERS THAT
WENT ON TO BREAST-FEED AFTER
THE GIRL BABIES WERE BORN,
THOSE BABIES THAT HAD THE
HIGHEST EXPOSURE WHEN THEY
LOOKED AT THESE GIRLS
RECENTLY, WHEN THEY ARE TEN,
12, 13 YEARS OLD, THE GIRLS
THAT HAD THE HIGHEST
EXPOSURE AS FETUSES AND
INFANTS STARTED MEN
STRAIGHTING A FULL YEAR
EARLIER THAN THE OTHER GIRLS
IN THE AREA THAT DID NOT
HAVE AS HIGH AN EXPOSURE.
THAT IS JUST ONE EXAMPLE.

Maureen says WHAT ABOUT THE HORMONES
THAT ARE GIVEN TO LIVESTOCK
AND THEN WE GIVE OUR LITTLE
GIRLS MEAT OR MILK.

Marcia says RIGHT.
THAT OF COURSE IS A QUESTION
THAT EVERYONE ASKS.
AND UNFORTUNATELY, TO MY
KNOWLEDGE, THE RESEARCH TO
EXAMINE THAT QUESTION HAS
NOT BEEN DONE.
THERE IS PROBABLY, I'M
GUESSING, THAT THERE IS
GOING TO BE RESISTANCE FROM
THE MEAT AND DAIRY INDUSTRY.
CERTAINLY IT WOULD SEEM THAT
IT MATE HAVE AN EFFECT
BECAUSE IT IS WELL KNOWN
THAT THEY USE ESTROGEN TO
STIMULATE GROWTH AND
PROBABLY BRING ON EARLIER
PUBERTY TO SAVE MONEY.
AND IT... I KNOW THAT I HAVE
READ THAT OFTEN IT IS
COUNTERED BY SAYING IT IS
SUCH A LITTLE BIT IT IS NOT
GOING TO AFFECT PEOPLE BUT
YOU SEE, IF IT HASN'T BEEN
STUDIED, HOW DO WE KNOW.

Maureen says AND YOU ARE
SAYING THAT SOMEONE LIKE
YOURSELF, IF YOU TLID TO
STUDY T YOU THINK THERE
WOULD ACTUALLY BE ROADBLOCKS
PUT IN YOUR WAY.

Marcia says I WOULD GUESS THAT THERE
MIGHT BE.
BECAUSE THIS IS VERY TYPICAL
OF THE CHEMICAL INDUSTRY,
THE PLASTIC INDUSTRY HAS NOT
BEEN HAPPY ABOUT THE STUDIES
THAT HAVE LOOKED AT
ENDOCRINE DISRUPTERS.
BECAUSE COURSE THESE ARE
MULTIMILLION DOLLAR, I
SUPPOSE BILLION DOLLAR
INDUSTRIES.
AND ANY KIND OF INFORMATION
THAT IS GOING TO QUESTION
THE HEALTH AFFECTS OF THEIR
PRODUCTS AND MIGHT DIMINISH
PROFITS, THEY ARE PROBABLY
NOT GOING TO BE TOO HAPPY
ABOUT.

Maureen says LET'S MOVE TO
ANOTHER CAUSE THAT ONE THING
A LOT OF PEOPLE HAVE NOTICED
IS THAT AS GIRLS DEVELOPMENT
COMES DOWN IN AGE, OBESITY
IS INCREASING IN THESE SAME
CHILDREN.
DO YOU THINK THERE IS A LINK
THERE.

Marcia says WELL, THERE DEFINITELY IS
A LINK AND THAT IS AN
EXCELLENT QUESTION.
THERE HAVE BEEN SOME STUDIES
DONE, ONE USING THE DATA
FROM THE 1997 GIRL'S PUBERTY
STUDY THAT SHOW THAT THERE
IS A STRONG ASSOCIATION
BETWEEN BEING OVERWEIGHT,
NOT NECESSARILY OBESE BUT
OVERWEIGHT AND HAVING
EARLIER PUBERTY.
NOW THAT... IT NEEDS TO BE
SAID THAT THAT MEANS EVERY
OVERWEIGHT GIRL WILL HAVE
PUBERTY EARLIER BUT ON THIS
DO.
WE DON'T KNOW WHY.
WE CAN'T SAY THAT BEING
OVERWEIGHT CAUSES EARLIER
PUBERTY BUT THERE DEFINITELY
IS AN ASSOCIATION.

Maureen says WE'VE BEEN
TALKING A LOT ABOUT GIRLS
DEVELOPMENT.
IS THIS HAPPENING TO BOYS AS
WELL.

Marcia says I BELIEVE IT PROBABLY IS.
WE DON'T HAVE THE KIND OF
SOUND DATA THAT WE NEED TO
BE ABLE TO SAY THAT
DEFINITIVELY.
WE HAVE DATA THAT I FOUND
BOYS WERE DEVELOPING EARLIER
IN THE PAST BUT THERE WERE A
LOT OF ISSUES AND WE CAN'T
DEFINITIVELY SAY.
BUT THERE IS ALSO ANECDOTAL
EVIDENCE IN THE SAME WAY
THERE IS WITH GIRLS AND
THERE IS ALSO THE GROWTH
DATA THAT I MENTIONED
EARLIER.
AND BOYS ARE ALSO HAVING A
GROWTH SPURT EARLIER.
AND THAT MEANS THEY RENT ERG
PUBERTY EARLIER.
THERE IS JUST NO WAY THAT
THAT WOULD BE SEPARATE.

Maureen says SO WHAT ARE
PARENTS TO DO IF THEY SEE A
SIX OR SEVEN-YEAR-OLD
DAUGHTER DOING BREASTS?
DO THEY FREAK AND GO TO THE
DOCTOR TO GET HORMONES TO
PUT THE BRAKES ON THE
DEVELOPMENT.

Marcia says WELL, I DO THINK THAT
THEY SHOULD TAKE THEIR CHILD
TO THEIR PEDIATRICIAN.
I THINK A LOT OF THOSE GIRLS
WILL NOT NECESSARILY NEED A
REFERRAL TO AN ENDOCRINEOLOGIST
BUT I DO THINK IF THEY ARE
THAT YOUNG, SIX OR SEVEN
THEY DO NEED TO BE LOOKED
AT.
AND THE IMPORTANT THING OR
ONE IMPORTANT THING IS
ASSESSING THE RATE OF THE
DEVELOPMENT AND IF
EVERYTHING IS NORMAL.
IN OTHER WORDS, IF SOMETHING
IS VERY OUT OF SYNC LIKE SAY
VERY ADVANCED BREAST
DEVELOPMENT AND NO PUBIC
HAIR GROWTH OR VICE VERSA,
OR THE CHILD IS GROWING VERY
FAST, OR HAS DEVELOPED
SEVERE ACNE AT A YOUNG AGE,
THOSE THINGS ARE NOT NORMAL.
THEY ARE NOT PART OF A
NORMAL PROGRESSION OF
PUBERTY.
THAT SHOULD ALERT THE
PHYSICIAN OR THE MEDICAL
PROVIDER THAT SOMETHING IS A
LITTLE OUT OF WHACK AND THEY
WOULD NEED TO MAKE A
REFERRAL TO AN
ENDOCRINEOLOGIST.
SO I THINK WITH THE CHILDREN
THAT ARE UNDER SIX OR SEVEN,
DEFINITELY.
AND EVEN A LITTLE OLDER.
AND OF COURSE AT ANY AGE IF
THE THINGS I JUST MENTIONED
ARE PRESENT, YOU KNOW,
INDICATING THAT IT IS NOT A
NORMAL PROGRESSION OF
PUBERTY.

Maureen says BUT VERY OFTEN I
SUPPOSE THERE IS REALLY NO
MEDICAL TREATMENT FOR THIS.

Marcia says EXACTLY.
OF COURSE THE GIRLS THAT
HAVE VERY, VERY EARLY, THE
PRECOCIOUS PUBERTY THERE ARE
SOME DRUGS THAT CAN BE USED
TO BASICALLY SHUT EVERYTHING
DOWN.
AND THAT IS USUALLY DONE TO
PRESERVE THE HEIGHT, THE
FINAL ADULT HEIGHT BECAUSE
VERY EARLY PUBERTY, THE
ESTROGEN STOPS THE GROWTH OF
THE BONES, AND SO THERE IS
ALWAYS A CONCERN, ASIDE FROM
SOCIAL ISSUES, IF THEY DON'T
FIND ANY MEDICAL CAUSES, AND
THE GIRL IS SAY THREE OR
FOUR, THERE ARE SOCIAL
REASONS AND ADULT HEIGHT
REASONS TO WANT TO TREAT
THAT CHILD.

Maureen says OKAY, I THINK WE
ARE ALL LARMED AT THIS FROM
A SOCIAL PERSPECTIVE BUT
BEFORE WE GET INTO THAT.
WHAT ARE THE HEAT RISKS OF
HAVING OUR DAUGHTERS ENTER
PUBERTY EARLIER.

Marcia says WELL, OF COURSE YOU CAN
LOOK AT TWO AREAS.
ONE IS THE PSYCHOLOGICAL,
YOU KNOW, PSYCHO SOCIAL
ISSUES.
AND OF COURSE THERE ARE
QUITE A NUMBER OF RISKS.
AND THEN THERE ARE THE
ACTUAL PHYSICAL HEALTH RISKS.
ONE THING WE DO KNOW FROM
OTHER STUDIES IS THE RISK
FOR BREAST CANCER, WE WERE
JUST MAKING THE ASSUMPTION
BUT I THINK IT IS FAIRLY
VALID TO MAKE THAT
ASSUMPTION BECAUSE IT IS
WELL-KNOWN THAT EXPOSURE TO
ESTROGEN IS THE RISK FACTOR
FOR BREAST CANCER.
AND SO THESE GIRLS THAT
START DEVELOPING BREASTS
WHEN THEY ARE SIX, SEVEN OR
EIGHT YEARS OLD HAVE A
LONGER LIFE... EXPOSURE TO
ES THROW AGAIN SINCE THAT IS
THE HORMONE CAUSING THE
BREAST DEVELOPMENT.
SO THEY WOULD, THAT IS WHY I
SAID WE CAN ASSUME THAT THEY
WOULD BE AT HIGHER RISK FOR
BREAST CANCER.

Maureen says LET'S TALK THEN
ABOUT THE PSYCHOLOGICAL AND
SOCIOLOGICAL EFFECTS OF
BEING INTO PUBERTY AT EIGHT
OR NINE.

Marcia says WELL, OF COURSE ONE CAN
IMAGINE IT DOESN'T TAKE MUCH
TO THINK WELL, IN THE THIRD
GRADE OR FOURTH GRADE IF
THESE LITTLE GIRLS ARE
BEGINNING TO DEVELOP, THAT
BACK IN THE OLD DAYS,
CHILDREN WERE REALLY
CHILDREN THEN.
AND THEY WEREN'T HAVING TO
DEAL WITH BECOMING SEXUAL
BEINGS AND THEY WEREN'T
HAVING TO DEAL WITH OLDER
BOYS QUOTE, UNQUOTE, HITTING
ON THEM.
THAT IS A BIG PROBLEM OF
CHILDREN, LITTLE GIRLS
COMPLAIN ABOUT.
AND AS ONE OF MY COLLEAGUES
PUT IT VERY WELL, ADULT
WOMEN HAVE A HARD ENOUGH
TIME DEALING WITH UNWANTED
SEXUAL ATTENTION.
HOW DO YOU TRY TO EXPLAIN TO
AN EIGHT-YEAR-OLD OR
NINE-YEAR-OLD GIRL HOW TO
DEAL WITH THAT KIND OF
PROBLEM.

Maureen says VERY
INTERESTING.
THANK YOU VERY MUCH FOR
DOING WITH US.

Marcia smiles and says YOU ARE WELCOME.

Maureen says COMING UP.

In a clip, IF THE EDGES OF THE
MUSCLE DON'T TOUCH AT ALL
THAT LETS LOTS OF AIR RUSH
BY.

Maureen says THE VOICE BOX ON
MEDICINE 101.

The opening sequence rolls again.

Now, Maureen stands next to a screen that reads "Health Digest."

Maureen says NOW SOME STORIES
MAKING HEALTH NEWS.
NEXT TIME ARE YOU TEMPTED TO
RECLINE YOUR PASSENGER SEAT
ON A LONG TRIP YOU MIGHT
WANT TO CONSIDER THIS.

The TV screen next to her shows a picture of seat belts and a car. A caption reads "Sit straight."

Maureen continues NEW
RESEARCH SUGGESTS THAT
PEOPLE WITHOUT RIDE IN A
RECLINED POSITION WITH A
SEAT BELT ON PUT THEMSELVES
AT GREATER RISK OF INJURY.
WHEN SCIENTISTS LOOKED AT A
SERIES OF CAR CRASHES THEY
FOUND THAT ALTHOUGH THE SEAT
BELTS DEFINITELY SAVED LIVES
THE VICTIMS IN A RECLINING
POSITION RECEIVED INJURIES
TO THEIR NECK, CHEST AN EVEN
THEIR SPINAL CHORD, INJURIES
CAUSED BY THE POSITION OF
THE BELT.
RESEARCHERS SAY SEAT BELT
WERE DESIGNED TO PROVIDE
PROTECTION WHEN THE CAR SEAT
IS IN AN UPRIGHT POSITION.

The caption changes to "Lasik Approval." A picture shows a green laser and an eye chart.

Maureen continues IT HAS TAKEN YEARS BUT THE
AMERICAN ACADEMY OF
OPHTHALMOLOGISTS HAS FINALLY
GIVEN A QUALIFIED
ENDORSEMENT TO THE POPULAR
LASIC EYE SURGERY IF KANSAS
CITYING NEARSIGHTED FERNS.
IT HAS ALLOWED MILLIONS IN
NORTH AMERICA TO THROW AWAY
THEIR EYEGLASSES, BUT THERE
HAVE BEEN COMPLICATIONS.
IN RARE CASES PEOPLE HAVE
BEEN LEFT PERMANENTLY BLIND.
A COMMITTEE OF
OPHTHALMOLOGISTS DETERMINED
IT WAS SAFE AND EFFECTIVE
FOR PEOPLE WITH LOW TO
MODERATE MYOPIA BUT WAS LESS
PREDICTABLE FOR MORE SEVERE
CASES.
DOCTORS AT THE UNIVERSITY OF
TORONTO SAY FEWER WOMEN
WOULD GIVE UP BREAST-FEEDING
IF THEY JUST HAD SOMEONE TO
CALL.

The caption changes to "Group Support." A picture shows a telephone and a woman breastfeeding.

Maureen continues IN A STUDY OF 256
BREAST-FEEDING MOTHERS
RESEARCHERS FOUND THAT THOSE
WHO WERE PART OF A PEER
SUPPORT GROUP OVER THE
TELEPHONE WERE MORE LIKELY
TO STILL BE BREAST-FEEDING
THEIR BABIES 12 WEEKS AFTER
GIVING BIRTH.
ALTHOUGH THE RESEARCHERS SAY
SOME WOMEN STILL NEED
PROFESSIONAL COUNSELLING
FROM LACKTATION EXPERTS,
THERE IS GOOD EVIDENCE THAT
MANY BENEFIT FROM JUST
TALKING TO ANOTHER WOMAN WHO
HAS EXPERIENCED
BREAST-FEEDING.

(music plays)

Maureen says HERE IS OUR HEALTH QUIZ
ANSWER, IN 2000, THE AVERAGE
CANADIAN SPENT AN ESTIMATED
478 DOLLARS DRUGS, THAT IS AN
INCREASE OF 8.1 percent OVER THE
PREVIOUS YEAR.

The Quiz slate appears. The answer "1. 478 dollars" appears highlighted in yellow.

At the studio, Maureen says PAVAROTTI, CELINE DION
AND YOU, WE ALL HAVE A VOICE
BOX.
SOME OF US JUST KNOW HOW TO
PUT IT TO BETTER USE.
HERE IS Dr. PAUL CALDWELL.

Paul sits at a table with a stethoscope and other objects on it. Behind him, a human anatomy model sits on a piece of furniture.

Paul says EVERY TIME YOU OPEN YOUR
MOUTH TO SPEAK, A TINNY
MIRACLE HAPPENS RIGHT HERE
IN YOUR VOICE BOX.
A LITTLE BIT OF AIR, AND A
LOT OF PHYSIOLOGY PRODUCE
THE SOUND WE HUMANS KNOW AS
SPEECH.

The caption changes to "Doctor Paul Caldwell. Family Physician."

He continues THE LARYNX OR VOICE BOX IS A
COLLECTION OF TUBING AND
FINE MILLSES PROTECTED BY
PLATES OF THICK CARTILAGE,
SUCH AS THE ADAM'S APPLE.
THE MAIN FUNCTION OF THE
LARYNX IS NOT SPEECH BUT
RATHER PROTECTION.
AS WE SEE HERE IN THIS
SPECIMEN FROM A PIG, WHEN
THE LARYNX IS CLOSED IT
PREVENTS ANY FOOD OR DRINK
FROM ENTERING THE LUNGS
INSTEAD OF THE STOMACH.
YOUR MOTHER WAS RIGHT WHEN
SHE SAID TO THE TO TAU WITH
YOUR MOUTH FULL.
IN THE MIDDLE OF THE LARYNX
TWO HORIZONTAL MUSCLES COME
CLOSE TOGETHER LIKE THIS,
THEIR STIFF EDGES ARE CALLED
VOCAL CHORDS OR FOLDS,
ANATOMICALLY THESE WHITE
EDGES OF MUSCLES ARE
RESPONSIBLE FOR MUCH OF OUR
SUCCESS AS A SPECIES.

A clip captioned "January 16 2002, 2:10 pm" shows a woman’s vocal cords vibrating as she speaks.

He continues BECAUSE THEY ALLOW HUMANS TO
COMMUNICATE, TO TEACH EACH
OTHER, TO WORK TOGETHER, TO
TRANSMIT INFORMATION AND
EMOTION.
AND EVEN TO ENTERTAINMENT
EACH OTHER.
THE MUSCLES ARE STRONG AND
THEY STRETCH ACROSS THE
TRACHEA OR WIND PIPE
CARRYING AIR UP FROM THE
LUNGS.
WHEN WE BREATHE OUT, THESE
MUSCLES JUST TOUCH TOGETHER,
STOPPING THE FLOW OF AIR OUT
OF THE LUNGS.
THEN THEY QUICKLY OPEN AND
CLOSE AGAIN, PRODUCING A
PULSE OR PUFF OF VIBRATION
AND THAT PRODUCES THE SOUND.
IN THIS LIGHT, WE GET A
SENSE OF HOW FAST IT OPENS
AND CLOSES, ABOUT 120 TIMES
A SECOND.
INCREDIBLY WE CAN CONTROL
HOW IF THIS OPENING AND
CLOSING HAPPENS AND ALSO THE
LENGTH AND SHAPE OF THE TWO
MUSCLE EDGES OF THE VOCAL
CHORDS.
IF THE MUSCLES ARE THICKENED
AND DON'T TOUCH PROPERLY
SOME AIR LEAKS PAST.
THAT IS THE HOARSENESS OF
LARYNGITIS.
IF THE EDGES OF THE MUSCLES
DON'T TOUCH AT ALL, THAT
LETS LOTS OF AIR RUSH BY
PRODUCING A WHISPER.
SINGERS TAKE THESE LOWLY
MUSCLES TO GREAT HEIGHTS
TRAINING THEM TO VIBE RATE
ON COULD PANNED AND USING
THE REST OF THE THROAT AS A
RESONATER, IT REALLY IS AN
AMAZING SYSTEM.
WE ALL HAVE THE SAME ANATOMY
AND YET IT ALLOWS SUCH
INDIVIDUAL VARIATION.
WE CAN EASLEY RECOGNIZE A
FRIEND'S VOICE ON THE
TELEPHONE.
I DON'T KNOW ABOUT YOU, BUT
THE WHOLE THING LEAVES ME,
WELL, SPEECHLESS.

Maureen says THE SILENT
VERSIONS OF Dr. CALDWELL'S
MINIMEDICAL LESSONS ARE
POSTED ON OUR WEB SITE AT
WWW.TVO.ORG/YOURHEALTH.
BEFORE WITH GO, A LOOK AT
ONE OF THE STORY NASS WE
WILL NEXT WEEK ON "YOUR
HEALTH."

A clip plays.

A man with black hair says I CAN MAINTAIN FULL-TIME
JOB I OWN AND DRIVE A CAR, I
HAVE A GIRLFRIEND, I HAVE A
LOT OF FRIENDS.
PEOPLE SEE ME AND THEY SEE I
AM A HAPPY PERSON, I AM
HAPPY WITH MYSELF, I'M HAPPY
WITH WHAT I HAVING PRO RESD,
I'M HAPPY WITH MY LIFE.

Maureen says GROWING UP WITH AUTISM,
NEXT WEEK ON "YOUR HEALTH."

The clip ends.

Maureen concludes I'M MAUREEN TAYLOR, THANKS
FOR WATCHING.

(music plays)

A final slate reads "Your Health. Email: yourhealth@tvo.org. Fax: 416-484-4519. Mail: Box 200, Station Q, Toronto, ON, M4T 2T1."

The end credits roll.

Executive Producer, Patricia Ellingson.

Host and Producer, Maureen Taylor.

Producer, Cathy Perry.

Director, Michael Smith.

Logo: CEP Local 72m.

A production of TVOntario. Copyright 2002, The Ontario Educational Communications Authority.

Watch: Your Health Season 3 Episode 20