Drug deaths in health workers, reassessing vitamin D, anaesthesia and children, after-effects of breast cancer

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Health Report 28 min 3 speakers 4 chapters transcribed 1 day ago

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What is the main topic discussed in this episode?

Dr. Norman Swan 0:00

Hello and welcome to this week's Health Report with me, Norman Swann. Today, should parents delay their child's surgery because the anesthetic might damage future school performance? Is there really as much vitamin D deficiency around as some people say? With women living longer and longer after a diagnosis of breast cancer, what support do they need? And new and troubling findings about drug-caused deaths amongst healthcare professionals. There's been lots of research suggesting that doctors and others are at increased risk of. suicide because of the stressful work, perhaps the kind of person attracted to those professions, and the access to dangerous medications. But until this study from the Department of Forensic Medicine at Monash University, not much has been known about Australian healthcare professionals.

Dr. Norman Swan 0:44

Much less the full range, including paramedics, nurses and vets, as well as doctors and dentists. And some of the results are quite surprising. The lead researcher was Jennifer Pilgrim.

Jennifer Pilgrim 0:55

We looked at deaths reported to an Australian coroner between two thousand and three and two thousand and thirteen, where the death was caused by drugs and involved a healthcare professional.

Dr. Norman Swan 1:06

And what did you find?

Jennifer Pilgrim 1:07

We found four hundred and four deaths. Most of these involved intentional self harm or suicide and also mental illness. And professional and personal stresses were also very common. So financial problems, relationship problems, workplace stress, those sorts of things.

Dr. Norman Swan 1:26

These are cases that came to the coroner.

Jennifer Pilgrim 1:29

Yes, that's right. So these are all deaths that were reported to the coroner. And have you any

Dr. Norman Swan 1:34

sense of what goes beyond that? Of how many you might have missed that don't go to the coroner but might be deaths that are self harm?

Jennifer Pilgrim 1:43

All deaths that are unnatural or unexpected uh reported to an Australian coroner. So it it should have captured all of these sorts of deaths, but obviously it doesn't capture any of the living cases of drug abuse and intent to self harm in this population. So

Dr. Norman Swan 1:59

near misses and so on.

What does the new Australian study reveal about drug‑related deaths among health‑care professionals?

Jennifer Pilgrim 2:00

Yeah.

Dr. Norman Swan 2:01

So what numbers did you come up with?

Jennifer Pilgrim 2:03

So there were 404 deaths altogether. Most of these involved females and nurses. The rate of deaths, which takes into account the number of people employed in these professions in Australia, was highest for the veterinarian group. And most of these vets involved intentional self-harm where they took an excessive amount or an overdose of barbiturates. which are drugs commonly used in animal euthanasia.

Dr. Norman Swan 2:31

Did did nurses come up top because there are far more nurses than any other healthcare professional in Australia or

Jennifer Pilgrim 2:37

Exactly. Yeah. I mean there were more cases involving nurses. However, when we broke this down and put it in proportion of the number of nurses as well as the other occupations working in these professions across Australia, that's where the vets came up on top. So the veterinarian group was smaller, but in proportion to the number of vets employed in Australia, the rate was highest for vets.

Dr. Norman Swan 3:01

So let's dissect the gender split. So is it more women than men because of the numbers of nurses or that showed up in veterinarians as well?

Jennifer Pilgrim 3:10

There were mere more females in the cohort overall, but obviously nursing is dominated by females and that was the largest category. So when we looked at the doctors and other medical practitioners, men were highest in this group. So I think the number of females is just the overrepresentation of females in nursing.

Dr. Norman Swan 3:30

Before we get to the causes, it's been often said that anaesthetists are a very common group within the medical profession who take their own lives. Is that true in this group?

Jennifer Pilgrim 3:40

We did find a high mortality rate for the anesthesiology group and most of these involved taking the anesthetic drugs from work.

Dr. Norman Swan 3:49

And what about nursing specialty? Did you manage to dissect that further?

Jennifer Pilgrim 3:53

Because of the coding on the National Cronial Information System database which we used for this research, some was more specific than others, so we just looked at the nursing group as a whole. There were some that were more specific that we could break down into the different groups, but we tended just to look at the group as a whole.