Health Wanted: Clinical Trials

September 27, 2024
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HEALTH WANTED, a weekly radio show and podcast produced in partnership with WABE, brings need-to-know public health headlines and breaks down the science behind trending topics.

The Episode

The topic: Clinical trials play a crucial role in advancing medical knowledge and developing life-saving therapies, but it has taken decades for medical testing and human research to become scientifically and ethically sound. On this week’s episode of Health Wanted, host Laurel Bristow and guest Seema Lakdawala, PhD, cover the evolution of clinical trials and highlight their importance in studying flu transmission dynamics.

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The takeaway: Long ago, clinical trials lacked clear guidelines and rules around how to conduct ethical experimentation. Today, clinical trials are highly organized, and all participants must provide their full consent to participate. Now, clinical trials are an essential part of medical advancement and development and help ensure that drugs on the market are safe and effective before they are distributed widely to populations.

  • Before there were modern clinical trials, people tested interventions haphazardly or not at all. However, a tragedy in 1937 that involved an antibiotic that accidentally killed almost 100 people, mostly children, inspired the creation of the Federal Food, Drug, and Cosmetic Act of 1938.
  • The Kefauver-Harris Drug Amendments, passed by Congress in 1962, required drug makers to prove the safety and efficacy of their products before they could be marketed. It also required institutional review board approval to make sure the study was ethical. Today, participating in clinical trials is completely voluntary, and participants are required to provide full consent before participating.
  • The first part of many clinical trials is pre-clinical trials, where potential interventions are tested for safety on animals or microorganisms to determine whether they are worth examining in humans. Then, over the course of four phases, the drug is carefully administered to greater numbers of people and monitored for safety.

The Interview

The guest: Seema Lakdawala, PhD

The key takeaways:

  • Lakdawala’s flu trial is one of the first since the 1960s to infect people with the flu experimentally. The long gap between the trials exists because these types of experiments are highly regulated and involve a lot of planning. Researchers must ensure that, while participants are intended to get the flu, they are not exposed to the risk of serious illness.
  • The goal of Lakdawala’s flu trial is to understand better how flu transmission occurs. They already know that increasing ventilation does not decrease the chances of flu transmission in close contact settings but are also exploring what other contexts may contribute to flu spread and which environments pose the greatest risk.
  • The spread of bird flu (H5N1) is particularly concerning, especially since it has now entered the cow population. This poses a risk due to the close interactions between people and cows, as the virus can be shed into the milk and become infectious. The lab is also investigating flu transmission between cows and the presence of virus on milking equipment, which is not cleaned between animals, adding to the risk of contamination.

The Listener Questions 

Is DEET safe for kids?

So long as you are applying it correctly, DEET and picaradin are safe for kids.

People sometimes get DEET mixed up with DDT, a different pesticide that the U.S. no longer uses because of its potential damage to the environment and people, but DEET is different. If you recall from our episode about mosquitoes, mosquitoes can sense and are attracted to your special stink.

When applied to the skin, DEET can mask that scent and confuse biting bugs to prevent them from landing on you and deter them from biting you. It’s not like you’re putting something toxic to the bugs on you, you’re basically putting on a very specific anti-perfume.

For little kids, it’s always a good idea to make sure an adult applies the bug spray. You can use either a lotion or spray it on your hands first to rub it into the face to avoid kids accidentally inhaling any of it.

If you don’t want to use DEET, you can use picaridin, which was developed to resemble the natural compound piperine found in black pepper producing plants, which are known to deter bugs.

Why is there fluoride in drinking water when we also get it at the dentist?

Fluoride is an essential mineral that helps strengthen teeth and prevent tooth decay and cavities. Many municipalities add fluoride to drinking water, but it’s not a mandate that places do this.

So why would we put fluoride in water that we are drinking and only has momentary contact with our teeth? Two reasons: one is for people who don’t yet have a mouth full of chompers. I’m talking about kids. Ingesting fluoride is important for the growth of their teeth and there are no special water wells for kids, so we put it in all the water.

Two, it also benefits those of us who have our teeth out in the open. Drinking water throughout the day bathes the teeth in low levels of fluoride. Studies have repeatedly shown that fluoridated water reduces cavities across all age groups by 25%.

Fluoridation has gotten a bad rap because people don’t like the government putting things in their water. But the recommended level of fluoride is lower than what is naturally found in some natural water sources and those areas have not seen adverse outcomes due to their own, natural, higher, fluoridation.

Catch all the listener questions and Laurel’s answers on the full episode of Health Wanted by:  

 

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