Australian Health Information Technology

Time To Call It A Day!

2025-10-05T15:22:00.000+11:00

This blog has been active daily for almost 20 years but in the last year readership and engagement has dropped off and comments have largely ceased!

With that being the situation - it is clearly time to do something else with my time.

So good luck to all! It has been fun...

Stay safe and well and good luck to all. Expect the occasional post when there is something that really needs a comment from me. Otherwise "thanks for all the fish!" (Douglas Adams)

David.

It Seems Applications Of AI In Medicine Are Expanding!

2025-10-03T08:00:00.007+10:00

This appeared last week:

17 September 2025

AI and a new renaissance in medicine

AI Comment Technology

Associate Professor Kees Nydam

I look forward to AI doing all the heavy lifting when it comes to the science of medicine, thereby allowing practitioners to return to the art.

Please join me on a trip into the future. It might sound a little like science fiction. Bear with me, as the future is circuitous.

The Human Genome Project was a landmark international research effort from 1990 to 2003. Following its completion, scientific inquiry shifted to the field of epigenetics. You could carry, for example, the gene for disease X, but the condition is not inevitable. Certain epigenetic triggers may need to be initiated first.

While scientific knowledge is iterative, currently there is a consensus that allostatic load in early life, plus the complex array of hormonal and other whole-body neuro-signalling, are critically involved in epigenetic trigger discharge. Hence the attention on the First 2000 Days.

One way of scoring allostatic load is the Adverse Childhood Experience (ACE) Score. While a high score does not absolutely predict mind-body “disease”, it significantly increases the odds. The ACE score sits between 0 and 10. A heightened burden of disease is set at scores of four or more. I work with patients who have scores of 8 to 10.

I am an addiction medicine specialist, working in the public sector. For my cohort, drugs were the solution, until they weren’t. Addiction for them is a secondary symptom of a more primary condition, early childhood trauma. Ironically, a traumatised child will get our sympathy, while that same child as an adult will provoke societal malevolence. Therein lies the paradox of stigma and the power of social network theory.

In the future, I predict that the Diagnostic Statistical Manual (DSM) and the International Classification of Disease (ICD) codes for mental, or brain conditions will evolve from their current categorical nature. Categorical coding is suited for a stocktaking, inventory or billing purpose. However, it provides little to enhance a deeper understanding of complex mental and behavioural disorder aetiology.

We are now seeing evidence of a gut-liver-brain-neuroendocrine axis. Substance use disorder, for instance, could just as well be named labelled a gut-liver-brain-neuroendocrine axis disorder. This does, of course, ignore the social network and larger environmental predisposing, precipitating and perpetuation factors. At any rate, the consequences of our new paradigm are that we can no longer differentiate between mind and body diseases.

If you accept that modern medicine began in the early 1900s, then the first 100 years were devoted to improving the medical response to acute emergencies.

In the future we will see a move away from acute “magic bullet cures” towards chronic disease management. This will require disinvesting in services at the bottom of the cliff and investing in services at the top of the cliff. In total the return on investment in illness care prohibits further outlay on a proverbial black hole.

We will still need to triage and initiate acute episodic “ambulance” treatments, but they have tended to consume all the oxygen in the room.

Only foolish doctors think they can save a life. At best we can prolong life. We aim to see how much difference we can make in the lives of others. At the micro level we can do this by including psycho-education in our care packages, at the macro level through advocacy.

The last 40 years have seen little shift in population health literacy rates. Around 60% of adult Australians have low health literacy, meaning they struggle to access, understand, appraise, and apply health information to make informed decisions about their health.

This lack of health literacy is a significant concern as it is linked to poorer health outcomes, increased hospitalisation rates, and a reduced ability for people to actively participate in their own care.

AI threatens to run rogue through the current workforce as we know it. If we do not know what the workforce needs will be, the best strategy is to retreat to an historical educational baseline. I refer to the dynamic duo of philosophy and rhetoric.

Philosophy teaches students how to think about thinking. Rhetoric teaches how to form an argument and, more importantly, how to spot a bad one. Combined they provide skills for critical thinking.

Most of our non-infectious chronic diseases are abetted by commercially motivated toxic propaganda, so sophisticated as to hoodwink the best of us.

To paraphrase Bertrand Russell, modern education was conceived more in terms of indoctrination by most schools than in terms of enlightenment. My own belief is that education must be subversive if it is to be meaningful. It should instil a desire to question and doubt. Without this the mere instruction to memorise information is empty. The attempt to enforce conventional mediocrity on the young is criminal.

The doctor-patient relationship needs to be replaced by a medical coach-person partnership. Often this will extend into addressing the underlying early allostatic load and ACE issues and navigating the propaganda swamping the environment.

I look forward to AI doing all the heavy lifting when it comes to the science of medicine, thereby allowing practitioners to return to the art of medicine by improving the patient journey and addressing the intricate human context of the tasks at hand.

The early part of the 20^th century had medical science search for the quick fix. A set and forget. This has never worked in chronic illness.

The American journalist HL Mencken had this to say about quick fixes: “Every complex problem has a solution which is simple, direct, plausible – and wrong.”

I foresee a future when doctors and patients alike, cease their fixation on “magic bullet cures” and focus more on the reality of lifestyle changes and lifelong self-care with a rejection of those parts of the material commercial world that make and keep us sick.

Associate Professor Kees Nydam was at various times an emergency physician and ED director in Wollongong, Campbeltown and Bundaberg. He continues to work as a senior specialist in addiction medicine and to teach medical students attending the University of Queensland, Rural Clinical School. He is also a poet and songwriter.

Here is the link:

https://www.medicalrepublic.com.au/ai-and-a-new-renaissance-in-medicine/119920

This is certainly a vision of medical practice, supported by AI, that could be both safer and richer than what we have now!

I wonder how long till it arrives?

David.

I Was Not Aware Concord Hospital Was In So Much Strife!

2025-10-02T08:00:00.006+10:00

Concord is one of my local hospitals – so this is not good news!

Delayed cancer diagnoses, broken bones missed: The patients caught up in a Sydney hospital fail

By Angus Thomson

Updated September 24, 2025 — 7.48pmfirst published at 6.35pm

A 92-year-old whose cancer diagnosis was delayed and a 13-year-old whose fracture was not identified for a year are among the patients affected by a backlog of more than 50,000 radiology scans at a Sydney hospital, a leaked government investigation has found.

In a sensitive report distributed to doctors at Concord Hospital this week, the NSW ombudsman found Sydney Local Health District was warned about issues with staffing and workload in the hospital’s radiology department years before the backlog threatened patient safety, but failed to respond to avert the crisis.

The NSW ombudsman found Sydney Local Health District failed to avert the crisis.Credit: James Brickwood, Chris Fowler

“The SLHD had ample warning, from as early as 2019, that a reporting backlog in radiology was accumulating, would worsen if not addressed and strategic intervention was required to manage the situation,” the report concluded. “Rather than proactively working in collaboration with the radiology department to address the issues, effective changes only took place after multiple resignations and external intervention.”

The scathing ombudsman’s report is another dramatic turn of events at Concord, where Health Minister Ryan Park was forced to intervene in July 2023 after the hospital’s medical staff won a vote of no confidence in health district chief executive Teresa Anderson, who left the job the following May.

It also highlights the challenges faced by a depleted healthcare workforce across the NSW health system dealing with an increased number and complexity of cases. Earlier this year at Westmead Hospital, for example, at least 21 patients had to wait up to 363 days for a cancer diagnosis due to the massive demand for endoscopies.

At the peak of the Concord backlog in the second half of 2023, the number of unreported radiology studies totalled 50,178 – 40 per cent of the total number of images reviewed by the department that year.

The vast majority of these were X-rays, leaving patients waiting an average of 131 days for results.

In one case, two incidents of delayed fracture diagnoses in a 12-year-old and a 14-year-old child were escalated to management in September 2022. In response, a new system was recommended to ensure chest and paediatric X-rays were prioritised and reported daily, but this was not implemented until May 2024. A new triage system took longer, coming into effect in August that year.

The health district argued in its submissions to the ombudsman it found only 14 “adverse incidents” affecting patients out of the 50,178 unreported scans, but the ombudsman noted the health district did not have a process for systematically identifying and addressing those risks until 2023 – “well into the backlog”.

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The Sydney hospital on its last warning

“Whilst the number of actual adverse incidents due to the backlog was relatively low, and certain actions, such as prioritising more complex imaging over X-rays, were put in place by the radiology department early on … the conduct of the Sydney Local Health District in responding to and managing the increasing backlog of radiology studies at Concord Hospital radiology was unreasonable,” the ombudsman said.

The ombudsman said multiple factors had driven the backlog, including increases in emergency presentations, an increase in the number of scans performed due to improvements in technology, and increased clinical workload for radiologists that took them away from reporting work.

These contributed to a 9 per cent increase in images assessed at Concord between 2012 and 2023, but the report noted the number of radiologists employed in the department decreased from 2019 to 2023.

This led the hospital’s director of medical services to warn management that most radiologists were “doing more than twice the workload that was recommended in the Australian literature”.

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‘It was hell’: Former Sydney hospital doctor speaks out

Instead of taking steps to recruit more radiologists, an executive took the extraordinary step of instigating an internal audit of the department due to allegations radiologists “were not working their required hours” – a claim the investigation found could not be substantiated.

A cultural review announced in July 2023, after the Herald revealed the backlog of 50,000 scans, found this audit of their working hours had resulted in “a number of the state’s most experienced and highly regarded radiologists leaving the public health system”.

While the health district said at the time it was actively recruiting for two full-time radiologists, the ombudsman noted the recruitment and retention rates on offer were lower than the state average.

The backlog had been reduced to 217 studies older than four weeks by September last year.

A health district spokesperson said they were unable to comment on individual patients due to privacy considerations, but open disclosure was provided to all affected patients and their families.

“Radiology images are often reviewed by clinicians as soon as they become available, even where a formal report has not yet been produced, to inform safe and timely treatment and care,” the spokesperson said.

Here is the link:

https://www.smh.com.au/national/nsw/delayed-cancer-diagnoses-broken-bones-missed-the-patients-caught-up-in-a-sydney-hospital-fail-20250924-p5mxlk.html

I wonder what is the root cause of the problems here – other than money - and if the separation from the Commonwealth system still has some unresolved problems?

I am sure locals can let us know!

David.

If This Goes Ahead In The UK I suspect We Won’t Be Far Behind!

2025-10-01T08:00:00.004+10:00

This appeared a day of so ago.

Identity cards

Keir Starmer says digital ID cards an ‘enormous opportunity’ for the UK

PM to set out plans for compulsory ‘Brit card’ but faces opposition from civil liberty groups over privacy concerns

UK politics – latest updates

Jamie Grierson

Fri 26 Sep 2025 17.53 AEST

Digital ID cards present “an enormous opportunity” for the UK, Keir Starmer has said, as the government braces for a civil liberties row over the proposals.

The prime minister will set out the measures on Friday morning at a conference on how progressive politicians can tackle the problems facing the UK, including addressing voter concerns around immigration.

The proposals for a “Brit card” would require legislation and are already facing opposition from civil liberty groups concerned about privacy.

Addressing those concerns, the culture secretary, Lisa Nandy, said the government had “no intention of pursuing a dystopian mess”.

Speaking on Friday, Starmer said: “I know working people are worried about the level of illegal migration into this country. A secure border and controlled migration are reasonable demands, and this government is listening and delivering.

“Digital ID is an enormous opportunity for the UK. It will make it tougher to work illegally in this country, making our borders more secure.

“And it will also offer ordinary citizens countless benefits, like being able to prove your identity to access key services swiftly – rather than hunting around for an old utility bill.”

The prime minister, writing in the Telegraph, said Labour had shied away previously from addressing concerns over immigration and that it was now “essential” to tackle “every aspect of the problem of illegal immigration”.

He argued that it was possible to be concerned about immigration while rejecting Reform UK’s “toxic” approach.

“There is no doubt that for years leftwing parties, including my own, did shy away from people’s concerns around illegal immigration,” he wrote.

Civil liberties groups reacted with concern over the proposals. Silkie Carlo, the director of Big Brother Watch, said digital IDs would turn the UK into a “checkpoint society that is wholly unBritish”.

“Digital IDs would do absolutely nothing to deter small boats but would make Britain less free, creating a domestic mass surveillance infrastructure that will likely sprawl from citizenship to benefits, tax, health, possibly even internet data and more,” Carlo said.

“Incredibly sensitive information about each and every one of us would be hoarded by the state and vulnerable to cyber-attacks.

“Starmer has no mandate to force the population to carry digital IDs and millions of us will simply not do it. The cost to the public purse will likely run into the billions, much like Blair’s failed scheme, but the cost to our freedoms would be even more serious. He is making an enormous mistake and should drop the plans sooner rather than later.”

Nigel Farage’s Reform UK called the plans a “cynical ploy” designed to “fool” voters into thinking something is being done about immigration, while the Conservative leader, Kemi Badenoch, dismissed the plans as a “gimmick that will do nothing to stop the boats”.

The Guardian revealed in June that Downing Street was exploring proposals for a digital ID card to crack down on illegal migration, rogue landlords and exploitative work.

The idea came from a Labour Together paper given to the No 10 policy unit proposing a Brit Card, which it claimed could help avoid another Windrush scandal.

The thinktank also said it would help reduce vast numbers of visa overstayers, saying half of those whose asylum claims were turned down over the past 14 years were probably still in the UK.

It proposed a free, secure digital ID, stored on a person’s smartphone using a planned gov.uk Wallet app, rebranded as the Brit Card app. That could then be verified by employers, immigration, banks and landlords using free software.

Under the possible plans, the technology is expected to be built on the government’s existing “One Login” infrastructure, which allows citizens to access about 50 government services, from applying for a job as a teacher to using a lasting power of attorney.

Here is the link:

https://www.theguardian.com/politics/2025/sep/26/keir-starmer-digital-id-cards-enormous-opportunity-uk

If the UK goes ahead and there is not too much of an outcry, expect Albo to be the next cab off the rank!

They know they want to do it!

David.

You Really Do Have To Wonder Why People Are So Easily Panicked!

2025-09-30T08:00:00.018+10:00

The good news upfront – 2 x 500 mg Panadol tabs every 4-6 hours for a few days is totally safe in adults with no known liver disease! The same dose is also safe in pregnancy.

This appeared a day or so ago:

Anatomy of a full-blown crisis for company that makes Tylenol (= Panadol In Australia)

Peter Loftus, Alyssa Lukpat and Sara Ashley O’Brien

The stakes are high – a direct assault on the brand by the US president could open up the company to legal challenges. Picture: Elizabeth Coetzee/WSJ

27 September, 2025

The chief executive of the company that makes Tylenol got a text message earlier this month that contained nothing but a single link to a Substack post.

In the post, a promoter of Covid-19 misinformation was connecting autism with acetaminophen, the active ingredient in Tylenol.

The text was from the nation’s top health official, Robert F. Kennedy Jr. At that moment, it was clear to CEO Kirk Perry that his efforts to convince Kennedy that there was no science behind such claims had failed.

On Monday, Perry faced a full-blown crisis. In an extraordinary public announcement that contradicted widespread medical consensus and even his own top health advisers, President Donald Trump warned that acetaminophen is a potential cause of autism, and urged expecting mothers to “tough it out” without the drug if they could.

“Taking Tylenol is not good,” the President told the world as Kennedy, the Health and Human Services secretary, looked on.

That claim has sent the medical establishment into panic mode. And it’s thrown Kenvue, the company that makes Tylenol, into crisis – just 70 days into Perry’s tenure as CEO.

Tylenol set the gold standard for corporate crisis management in 1982 after people died from taking its pain medication that had been tampered with and laced with cyanide. In a case now studied by business students and companies everywhere, the brand won back public trust with a quick recall, a redesign of its bottles to be tamper-resistant, and lots of coupons.

The stakes this time may be even higher. A direct assault on the brand by the president of the US could open up the company to legal challenges. That is one reason that Kenvue’s stock hit an all-time low this past week. Perry and his team are also grappling with the possibility that millions of pregnant women around the world will avoid Tylenol when they have fevers, infections or other symptoms.

Leaving those ailments untreated could increase birth defects and could itself contribute to a rise in autism, according to leading medical organisations and regulators in other countries.

Donald Trump speaks about autism at the White House during the week. Picture: AFP

Perry has been talking with his friend, pastor Brian Tome of Crossroads Church in Cincinnati, regularly over the past few days. Tome has reminded Perry of Bible verses that can be encouraging in hard times, and that Jesus said that his followers should “take up his cross daily, and follow me”.

“He doesn’t like what he’s going through,” Tome says of Perry. “He certainly wishes it was different, but I’m not seeing any bitterness in him and I think that’s because of his faith.”

Raised in Detroit by young parents who were assembly workers for Ford, Perry was the first in his family to graduate from college. He attended the University of Cincinnati after working at Wendy’s for about a year and a half to save up the tuition.

He met his wife, Jacki, at a Piggly Wiggly grocery store in Ohio when he was 18. They married in his senior year of college and have four children.

He has frequently said he leaned on religion when his then six-year-old daughter was being treated for kidney cancer. When a doctor told him and his wife that their daughter’s emergency colon surgery was successful, he dropped to the floor and wept. He said he realised God wasn’t making his daughter suffer, but God was with them when bad things happened.

Perry, 59, retired earlier this year after a career in marketing that included stints at Google and Procter & Gamble. His last job had been as CEO of market-research firm Circana. He was excited to coach high-school football, do mission work with his wife and hunt elk with friends. Then Kenvue called.

“Quite possibly the shortest retirement ever,” he wrote on LinkedIn this northern summer. Kenvue became independent two years ago when Johnson & Johnson split off its consumer-health unit. In addition to Tylenol, the Summit, New Jersey, company includes other famous brands such as Band-Aid, Johnson’s Baby Shampoo and the Neutrogena and Aveeno lines of shampoos and creams. J&J said the name Kenvue signified knowledge and sight.

Mother of autistic children slams Trump's autism comments

From the start, Kenvue fought attacks linking Tylenol to autism, but it didn’t get much attention. Some 500 lawsuits had been filed against Kenvue and other makers of acetaminophen products in federal courts, alleging that use of the drug during pregnancy caused autism and attention-deficit/hyperactivity disorder in children.

The lawsuits were based on a series of studies suggesting an association between acetaminophen and autism, though other studies had found no association.

An expert witness for plaintiffs was Dr Andrea Baccarelli, dean of the faculty of Harvard T.H. Chan School of Public Health. A federal judge in New York concluded that Baccarelli’s opinions about causation weren’t admissible in the litigation.

Kenvue argued in court that there was no credible evidence of a causal link. The judge sided with Kenvue in December 2023 and the cases were dismissed, though plaintiffs are appealing and some lawsuits have been filed in state courts.

Tylenol continued to sell well, though Kenvue’s beauty division was floundering. In July, the board ousted its CEO, a J&J veteran who had led the company since the spinoff, and brought in Perry while it searched for a permanent replacement.

Perry thought his challenge would be to turn around the beauty brands. On his first call with analysts to discuss quarterly results on August 7, he said he needed to streamline the product portfolio because the company made too many items that were generating only a small fraction of its sales.

Tylenol packages are seen in a pharmacy in Houston, Texas. About 500 lawsuits had been filed against its maker Kenvue and other makers of acetaminophen products in federal courts, alleging that use of the drug during pregnancy caused autism and attention-deficit/hyperactivity disorder in children. Picture: AFP

The company embarked on a review of strategic alternatives that some analysts say may include selling some assets – or even the entire company. The review is still under way.

A week later, there was an early sign of the trouble to come. A journal called BMC Environmental Research on August 14 published the results of an analysis by researchers from Harvard’s public-health school and other institutions.

They analysed past studies on the topic and said a majority of the studies found an association between acetaminophen and neurodevelopmental disorders including autism, though they stopped short of saying there was definitive evidence of causation.

The study was co-authored by Baccarelli, the Harvard dean whose expert testimony had been thrown out in court.

Baccarelli discussed his findings in recent weeks with Kennedy and Dr Jay Bhattacharya, the director of the National Institutes of Health, Baccarelli said in a statement provided by Harvard. Those phone calls took place in early September, a university spokeswoman added.

Kennedy’s autism views are based on “his ideology”, not science

“We've created an association that is false: The lack of vaccines and the lack of Tylenol is somehow associated with...

Kennedy reached out to Kenvue to set up a meeting with Perry. They arranged to meet the week of September 8. Days before the meeting took place, The Wall Street Journal reported that Kennedy was also working on a report that would say pregnant women’s use of Tylenol was potentially linked to autism.

In the meeting with Kennedy, Perry and Kenvue’s chief scientific officer, Caroline Tillett, made their case that there was no clear evidence linking autism and acetaminophen, and that there weren’t good alternatives to acetaminophen during pregnancy.

Kennedy agreed that there weren’t safe alternatives, according to people familiar with the matter. He discussed doing additional research, and asked that the executives set up follow-up meetings with Dr Mehmet Oz, the head of the Centres for Medicare and Medicaid Services, and Bhattacharya.

Centres for Medicare & Medicaid Services administrator Dr Mehmet Oz speaks in the Roosevelt Room of the White House during the week along with Mr Trump. AP Photo/Mark Schiefelbein

Perry and Tillett came away from the meeting thinking it had gone well, and that Kennedy’s request to set up additional meetings with Oz and Bhattacharya was a good sign that they could work with the administration.

But days later, Kennedy texted Perry the link to a Substack written by Sayer Ji, the founder of an alternative-health information platform called GreenMedInfo who has spoken at events alongside prominent members of Kennedy’s Make America Healthy Again movement. Ji has contended that vaccinations, prenatal ultrasounds and “stressors” from cesarean sections are among other factors that can increase autism risk.

Perhaps the meeting hadn’t been as much of a success as they’d thought. The Kenvue board of directors held a regularly scheduled meeting the week of Sept. 15. Perry and his management team briefed the board on Kennedy’s impending autism report, but there wasn’t much discussion, according to a person familiar with the matter. Certainly nothing that painted it as anything other than routine business.

00:05 / 00:53

Trump tying Tylenol to autism 'not based in fact': autism expert

U.S. President Donald Trump on Monday (September 22) linked autism to childhood vaccines and also to the use of...

Trump started to tee up his autism announcement a few days later, announcing on Friday, Sept. 19, that he was planning to hold a press conference. That Sunday, in a packed football stadium for the memorial service for assassinated conservative activist Charlie Kirk, Trump promised a Monday announcement about “an answer to autism”.

The company issued a statement, worded more strongly than its prior public comments. Science clearly shows that taking acetaminophen doesn’t cause autism, it said.

“We strongly disagree with any suggestion otherwise and are deeply concerned with the health risk this poses for expecting mothers.”

Kenvue on Monday cancelled its meetings with Oz and Bhattacharya.

Just before 5pm local time on Monday, at the start of his press conference televised from the White House’s Roosevelt Room, President Trump tripped up pronouncing acetaminophen as he said it was associated with a “very increased” risk of autism.

The President switched to referring to it as Tylenol for the rest of the news conference. “So taking Tylenol is not good, all right, I’ll say it. It’s not good,” he said, as Kennedy stood by.

President Donald Trump speaks in the Roosevelt Room of the White House during the week as Health and Human Services Secretary Robert F. Kennedy Jr listens. AP Photo/Mark Schiefelbein

The President acknowledged that he was diverging from the health leaders he chose to guide him: “Bobby wants to be very careful with what he says, ” Trump said, referring to Kennedy. “But I’m not so careful with what I say.”

The Wall Street Journal

https://www.theaustralian.com.au/health/medical/mark-butler-seeks-advice-on-autism-after-trump-suggests-paracetamol-link/news-story/272cfa434160560945a9977ac58b28c6

Trump autism claims spark debate about modern chemical exposure

The Therapeutic Goods Administration has advised women paracetamol is safe to take during pregnancy despite Donald Trump linking the medication to increased autism rates.

Natasha Robinson

Mark Butler has asked for advice on Donald Trump's link of the use of Panadol during pregnancy with autism.

5:36 AM September 24, 2025

One of Australia’s foremost researchers into neuroscience and the developing brain has urged medical bodies not to dismiss out of hand concerns around paracetamol use in pregnancy despite no causative link between the drug and autism being established.

The Florey Institute for Neuroscience and Mental Health’s division head for early brain science department and head of the neuroepidemiology research group, Anne-Louise Ponsonby, said the Trump administration had opened up an important conversation about the interplay between people’s significant exposure to environmental toxins in modern societies and its complex interplay with genetics.

Although Australia’s health regulator has advised women paracetamol is safe to take during pregnancy, Professor Ponsonby said the consistent findings across a string of high-quality studies that reported an association between paracetamol use in pregnancy and autism rates in children should not be dismissed completely.

“I think it’s a good idea to look at all types of manufactured chemicals and to review how much they’re needed for pregnant women,” Professor Ponsonby said. “The data is not causal evidence, but there are some positive links between Panadol and autism, and they do deserve further investigation.”

The US Department of Health issued a fact sheet on Tuesday pointing to a number of large-scale cohort studies that reported associations between in-utero exposure to paracetamol and later diagnoses of autism spectrum disorder, the incidence of which has risen markedly in the past two decades worldwide. It also acknowledged conflicting family-based studies which dismissed any association but pointed to Harvard and Mt Sinai university criticisms of these studies.

A Harvard study published in August this year reported that eight studies analysed paracetamol use in pregnancy and the development of autism, with five reporting positive associations. Evaluating those studies, the study said: “ultimately, there was strong evidence of a relationship between prenatal acetaminophen use and increased risk of ASD in children”.

Australia’s medicines regulator, the Therapeutic Goods Administration, said it had no current safety investigations for paracetamol and autism, or paracetamol and neurodevelopment disorders more broadly. Acetaminophen is known as paracetamol in Australia and many other countries.

“Paracetamol remains Pregnancy Category A in Australia, meaning that it is considered safe for use in pregnancy,” the TGA said.

Pregnancy Category A applies to drugs which have been taken by a large number of pregnant women and women of child-bearing age without any proven increase in the frequency of malformations or other direct or indirect harmful effects on the foetus having been observed.

The TGA’s present advice is that paracetamol can be used during pregnancy if clinically needed but should be used at the lowest effective dose for the shortest possible time. It classifies any risk to babies from paracetamol use by mothers during pregnancy as “remote” but urges women to discuss the use of the medication with their doctor.

Australia’s Health Minister Mark Butler had asked the TGA to provide advice on the use of paracetamol after Mr Trump flagged his announcement on the drug.

Professor Ponsonby said that while not causative, the association between autism spectrum disorder (ASD) and paracetamol across several studies might reflect that the development of autism involved a complex interplay of environment and genetics and rising incidence of the condition could not be solely explained by more frequent diagnosis.

“Multiple genes and multiple environment factors contribute to autism as it is a multifactorial disease,” Professor Ponsonby said. “At least part of the rise in incidence is thought to reflect a real increase in cases – driven in part by modern environment.

“Several key areas of evidence deserve attention: the interplay of genetic and environmental factors; consistent associations between ASD and air pollution, and links to toxic chemicals like bisphenol-A, PFAS and pesticides.”

Professor Ponsonby said these kinds of findings highlighted the need for deep molecular studies to identify causation. She said it might not be the drug itself but the underlying reason for using the drug that may be significant.

The Australian Academy of Sciences described evidence of any possible link between paracetamol and autism as weak.

“There is no causal evidence that paracetamol causes autism,” the AAHMS said in a paper on the issue. “Large, high-quality population studies do not find a causal relationship between paracetamol use and autism.”

The academy stressed that letting a high fever continue during pregnancy presented a much greater risk than using the medicine.

The American College of Obstetricians and Gynaecologists says acetaminophen is safe to use in pregnancy, though it recommends that pregnant women consult with their doctors before using it, as with all medicines.

“In more than two decades of research on the use of acetaminophen in pregnancy, not a single reputable study has successfully concluded that (its use) in any trimester of pregnancy causes neurodevelopmental disorders in children,” the American O & G college said.

The parent company of Tylenol’s maker also backed the product’s safety.

“We believe independent, sound science clearly shows that taking acetaminophen does not cause autism,” said a spokeswoman for Kenvue, the parent company of Tylenol’s maker. “We strongly disagree with any suggestion otherwise and are deeply concerned with the health risk this poses for expecting mothers.”

The National Institutes of Health in the US is leading a report on the causes of autism that was expected to be a review of existing scientific literature and be released on September 29, according to people familiar with the matter. It is unclear whether the full report will still be released, or when.

Mr Trump said autism rates have increased from one in 20,000 to one in 12 among boys in some populations. He also said there was “no autism” among the Amish, who he said don’t take medications.

Mr Kennedy also warned against Tylenol use for young children. “Prudent medicine suggests caution,” he said.

Here is a link:

https://www.theaustralian.com.au/business/the-wall-street-journal/anatomy-of-a-fullblown-crisis-for-company-that-makes-tylenol/news-story/c39413c36a2bc09836b16c65ca7d47a2

You really have to wonder about all this: ! Taking too much Panadol is dangerous and if you take too much it can cause liver failure and death. (Risk is only if an adult takes 20+ tablets all at the same time!) Taking 2 tables every 3-4 hours for a day or two for pain or fever is totally safe!

To say again, like most approved drugs, taken as directed (2 x 500mg tabs every 4-6 hours) Panadol is totally safe and good for fever and mild pain.

All the rest is a beat up – although people with known liver disease should ask their doctor for their recommendations as to dose! to be sure....

David.