Sunday, 20 October 2019

Life is a soup and I'm a fork


The first time I went to Russia was in 2001. At the time I was teaching social anthropology and medical sociology to nursing students in Finland. They were doing their degree in English and I was one of the native speaking English lecturers supporting the programme. I would usually go there two or three times a year and stay for two weeks. It was on one of these trips that I took the opportunity one weekend to fly to Moscow. It was an interesting trip. The hotel I stayed in had a ‘matron’ on every floor, someone who kept an eye on the propriety of the hotel guests. I was hosted by a young man from the Moscow State University. Sadly, I can no longer recall his name, but I do recall his enthusiasm for showing me around his great city.

One other thing I remember was him taking me out for a meal, not to a fancy restaurant, but to the local eatery and eating my way through a mountain of pancakes and vegetables, and using aluminium cutlery to do so. I remember feeling slightly anxious as I had a sense that using aluminium in cooking or anything to do with food could lead to health problems, particularly dementia. More of which later.
 
What I didn’t know at the time was that Russia was once the third largest producer of aluminium in the world. Today, it still produces over five million tons of aluminium and accounts for ten per cent of the global production. What I did know at the time was eating a meal with aluminium cutlery felt very strange and comes close to trying to eat a meal with plastic knife and forks, something I had to do last week at an event I was attending.

There is nothing worse than a plastic knife to cut through something that is meant to be cut by a metal one. I don’t even like those little blue forks you get with your take away chips, I would rather use my fingers. What I also didn’t know until last week was that the NHS used 16 million pieces of plastic cutlery last year. In a fascinating piece in The Hospital and Catering News (thank you Roy Lilley), it was reported that in 2018 the NHS actually purchased over 196 million items of single use plastic for catering, including 163 million plastic cups, 15 million straws, 2 million plastic stirrers and those plastic knives and forks.

That is lot of plastic! Its also a lot of plastic to get rid of once used! So, it was not surprising that even with everything Brexit filling our screens and newspapers that the NHS use of single use plastic became a major news story in its own right. Plastic use is a political issue. My grandchildren are like miniature Extinction Rebellion activists and have learnt in school about the damaging effects of plastic and plastic pollution. They are trying to create plastic-free homes, which is a lot harder than it sounds. Globally, 350 million tons of plastic are produced each year. That is a combined weight higher than the weight of humanity, estimated to be 316 tons in 2013. I do like Tiki the Penguin’s measure though: in explaining to children Tiki talks about the amount of plastic produced each year equalling 30 million elephants. Half of this plastic is single use plastic.  

Plastic is everywhere, and more worrying are what’s called microplastics. Microplastics are defined as all forms of plastic less than 5mm. Primary microplastics are to be found in personal care products and in the microfibres of some clothing. They can also be a consequence of larger plastic items which have been slowly broken down into smaller pieces. The average fish and meat eating person eats 70,000 microplastics each year (that’s about 100 bits of microplastic each meal). Plastic chemicals are known to act as endocrine disruptors. Endocrine disruption is linked to health problems such as some cancers, birth defects and developmental problems in children.    

Like my grandchildren’s efforts to lead a plastic free life, ridding the NHS of single use plastic is likely to be equally difficult. However, the NHS Chief Executive, Simon Stevens, issued a statement in which he said ‘…it’s right that the NHS and our suppliers should join the national campaign to turn the tide on plastic waste. Doing so will be good for our environment, for patients and for tax payers who fund our NHS’. He noted that many of the major retailers operating in hospitals have committed to cutting their plastic usage starting with straws, stirrers, cups and cutlery. That said, I didn’t see any evidence of this being translated into practice at the hospital cafĂ© I was in last week. Time will tell as to how effective the pledge to stop the use of single use plastics in hospital catering will be.

And back to aluminium and dementia. There was research carried out in 1965, that showed a connection between aluminium and what are called toxic tau tangles in the brain – the consequence of which is dementia. However, the research was undertaken on rabbits and involved high doses injected into the rabbits. Although one large study did show high doses of aluminium in drinking water being linked to the progression of Alzheimer’s in those who already have the disease, most contemporary research has shown that this cause and effect is simply not present. 

And yesterday I found a really poignant tweet on my Twitter timeline from a paramedic who had attended a call out to a man who was clearly a researcher, but was also living with dementia. I end this week’s blog with her words:

Met the most amazing man yesterday, 6 doctorates, 2 masters, 1 PGCert and 3 undergrads. Such a shame I met him due to his dementia. Such a great loss for the patient and society as a whole. Still an amazing man to meet and talk to and a pleasure to help’.  

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