Tuesday, May 5, 2009

HBOT and FUD

I don't like being right.  As I suggested in an earlier post the tragic accident at the HBOT center Florida is being turned into a talking point against the potential use of this treatment for autism.

A have been a few more details released about the incident.  The two people injured were a young child with cerebral palsy and his grandmother.  The grandmother has died from her injuries and the child is still in critical condition.  This is truly a tragedy for the family.

As I pointed out before this accident does not diminish the excellent safety record of HBOT clinics and has nothing to do with autism.  Yet there is an attempt to turn this into a rallying cry against HBOT for treating autism. 

Starting with Lisa Jo Rudy's post at autism.about.com - Hyperbaric Oxygen Chamber Explosion Raises Questions for Families with Autism - in which she raises the alarm that  explosion is a risk of HBOT chambers -
Because HBOT involves the use of pressurized oxygen, it is obviously a fire and explosion hazard. Typically, hospitals and treatment centers that offer HBOT follow specific safety protocols, though clearly even such protocols aren't foolproof.

Of even greater concern, though, are home HBOT systems. Recent blogs and online discussions suggest that families are purchasing such systems and using them without a full understanding of the possible dangers. Parents, for example, join their autistic children in the chambers while using electronic devices such as ipods and laptops.
I don't believe that pressurized oxygen is an explosion hazard - pure oxygen can't explode but it can accelerate the combustion of other materials.  I am even less sure that home HBOT systems have enough extra oxygen to cause a problem - I think that a typical gas stove or gas fire place  would pose more of a fire hazard than a typical home HBOT.  But my grasp of physics isn't what it used to be so I could easily be wrong here.  

But lay that aside for a moment and consider the risks involved and the safety record of the technology involved.  I can't find another reference to an explosion like this in an HBOT center in this country nor any references to a commercial HBOT system causing fires at home.  So while it is clear that fire or explosion is a potential risk it is also clear that in practice the real risk here is very, very, very, very small. 

It is far more likely that your child would be injured in a swimming pool at someone's house than it is that they would be hurt by an explosion of an HBOT tank.

But simple facts can't get in the way of a good ideological on a rant.  Take for example the comments by Kev -
We have one study from Dan Rossignol et al which has some fairly serious issues with it as regards autism. There is also no indication it does a damn thing for cerebral palsy either. People being told it will help and who are paying hundreds of thousands of dollars as this family were are victims of quackery.
and this one -
Bottom line: there’s no good evidence, despite looking that HBOT does a darn thing for CP or autism. Despite that, this boy was in a chamber when it caught on fire. If he hadn’t been in the chamber nothing would’ve happened to him. Now he’s got 90% first degree burns - and all it cost his family was hundreds of thousands of dollars! Cool!
So the kid was hurt because his parents believe in "quackery".  By this logic if you are driving your child to any experimental therapy and you are in a car accident then clearly it is the fault of the experimental therapy because you clearly would not have been in the car at that point without it.    

And then we have another post back at Left Brain Right Brain by DoC - 

Fire, Fatal Injury, and Claims of Certification in an Independent HBOT Clinic

With a title like that I would be running for the hills - you have fire, death, and hints of fraud.  All the good things that FUD (Fear, Uncertainty, and Doubt) are made of.  However if you  look at the actual post though there is little in the way of fire and death - just a quick mention at the top of the post about the known facts of the case.  

The meat of the post, what little there is, is that the director of a medical center is not really "certified".  This claim is "proven" by doing web searches based on assumptions of how an organization works that are gleamed from its web pages.  

I know this is may be a radical concept, but, if I had questions about a doctors certifications, instead of guessing I would ask the doctor directly about their certifications and what entity  provided said certifications.  I would definately do this before publishing something a potentially slanderous article.

The conclusion of the post is lightly hung on the certification issue by a thread - 
...this may contribute to an explanation of why this facility appears to treat conditions like cerebral palsy and autism in the first place – conditions for which there appears to be very little legitimate scientific support behind the use of hyperbaric oxygen therapy (some have even called the use of hyperbaric oxygen therapy for such conditions, “quackery”).
I really like the "some have even called it quackery at the end".  It makes it sound so legitimate.  Too bad for DoC that the "some" that are calling it quackery are his co authors on the site.

The insinuation is that "little scientific support" plus "is he really certified" with a dash of fire and death makes this  potential treatment "quackery".  Most rational people would call it experimental or if they were feeling generous "promising" but that's ideologues for you, always grinding that axe.

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