FACT CHECK: GOP senator gasps for facts on asthma (AP)

WASHINGTON � It was a startling claim: Air pollution has no connection to asthma, Kentucky GOP Sen. Rand Paul said on the Senate floor.

But Paul, and a chart he used to make his case against the health benefits of a new federal air pollution rule, relied on some creative sourcing and pseudoscience.

Paul's chart was a graph showing air pollution declining in California as the number of people diagnosed with asthma rose. The chart attributed the data to a May 2003 paper by what was then called the California Department of Health Services. But the department never plotted the relationship between those two factors.

The real source was a 2006 paper "Facts Not Fear on Air Pollution" from the National Center for Policy Analysis, a conservative think tank. The paper, by independent consultant Joel Schwartz, contends that most information on air pollution from environmentalists, regulators, scientists and journalists is exaggerated or wrong. The paper was not subjected to the normal peer-review process demanded for most published science.

Paul, an ophthalmologist and eye surgeon, cited Schwartz in his Nov. 10 remarks, saying: "We have decreased pollution and rising incidence of asthma. Either they are inversely proportional or they are not related at all."

At best, the chart suggests that air pollution alone cannot explain the rise in asthma, a chronic lung disease that inflicts approximately 34 million Americans and whose exact cause is unknown.

It certainly can't be used to say that air pollution plays no role in causing asthma.

"They may think there is a pattern there, but in fact it has no basis," said Dr. Richard Kreutzer, head of environmental and occupational disease control at what is now California's Department of Public Health, the agency cited on Paul's chart. Kreutzer said there is evidence that some pollutants can cause asthma and even more research showing that air pollution aggravates asthma in those who have the disease.

The National Institutes of Health said last year that "recent findings have conclusively demonstrated a link between asthma and air pollution, especially ground-level ozone."

But Schwartz, who now works for Blue Sky Consulting Group, discounts even studies linking pollution to asthma attacks, saying "they are probably not related."

In an interview with The Associated Press, Schwartz defended his work. "The fact that they move in opposite directions shows that air pollution is not a large factor in the cause," he said.

Dan Greenbaum, the president of the nonprofit Health Effects Institute, said such arguments "miss the point." The institute receives funding from both the Environmental Protection Agency and the auto industry.

"No pulmonary doctor has said that the primary reason for the increase in asthma is air pollution. That is not the concern with air pollution and asthma," Greenbaum said. "The concern is that if you have asthma, we have very strong evidence that you are sensitive to air pollution."

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Follow Dina Cappiello on Twitter (at)dinacappiello

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Online:

California Department of Public Health paper: http://www.bit.ly/s3RAen

National Center for Policy Analysis paper: http://www.bit.ly/w06uJC

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Is economy best birth control? US births dip again (AP)

ATLANTA � The economy may well be the best form of birth control.

U.S. births dropped for the third straight year � especially for young mothers � and experts think money worries are the reason.

A federal report released Thursday showed declines in the birth rate for all races and most age groups. Teens and women in their early 20s had the most dramatic dip, to the lowest rates since record-keeping began in the 1940s. Also, the rate of cesarean sections stopped going up for the first time since 1996.

Experts suspected the economy drove down birth rates in 2008 and 2009 as women put off having children. With the 2010 figures, suspicion has turned into certainty.

"I don't think there's any doubt now that it was the recession. It could not be anything else," said Carl Haub, a demographer with the Population Reference Bureau, a Washington, D.C.-based research organization. He was not involved in the new report.

U.S. births hit an all-time high in 2007, at more than 4.3 million. Over the next two years, the number dropped to about 4.2 million and then about 4.1 million.

Last year, it was down to just over 4 million, according to the new report from the Centers for Disease Control and Prevention.

For teens, birth rates dropped 9 percent from 2009. For women in their early 20s, they fell 6 percent. For unmarried mothers, the drop was 4 percent.

Experts believe the downward trend is tied to the economy, which officially was in a recession from December 2007 until June 2009 and remains weak. The theory is that women with money worries � especially younger women � feel they can't afford to start a family or add to it.

That's true of Mary Garrick, 27, an advertising executive in Columbus, Ohio. She and her husband, David, married in 2008 and hoped to start having children quickly, in part because men in his family have died in their 40s. But David, 33, was laid off that year from his nursing job and again last year.

He's working again, but worries about the economy linger. "It kind of made us cautious about life decisions, like having a family. It's definitely something that affected us," she said.

Kristi Elsberry, a married 27-year-old mother of two, had her tubes tied in 2009 after she had trouble finding a job and she and her husband grew worried about the financial burden of any additional children. "Kids are so expensive, especially in this day and age. And neither of us think anything's going to get better," said Elsberry, of Leland, N.C.

Many of the report's findings are part of a trend and not surprising. There was a continued decline in the percentage of premature births at less than 37 weeks. And � as in years past � birth rates fell in younger women but rose a little in women 40 and older, who face a closing biological window for having children and may be more worried about that than the economy.

But a few of the findings did startle experts.

One involved a statistic called the total fertility rate. In essence, it tells how many children a woman can be expected to have if current birth rates continue. That figure was 1.9 children last year. In most years, it's more like 2.1.

More striking was the change in the fertility rate for Hispanic women. The rate plummeted to 2.4 from nearly 3 children just a few years ago.

"Whoa!" said Haub, in reaction to the statistic.

The economy is no doubt affecting Hispanic mothers, too, but some young women who immigrated to the United States for jobs or other opportunities may have left, Haub said.

Another shocker: the C-section rate. It rose steadily from nearly 21 percent in 1996 to 32.9 percent in 2009, but dropped slightly to 32.8 last year.

Cesarean deliveries are sometimes medically necessary. But health officials have worried that many C-sections are done out of convenience or unwarranted caution, and in the 1980s set a goal of keeping the national rate at 15 percent.

It's too soon to say the trend has reversed, said Joyce Martin, a CDC epidemiologist who co-authored the new report.

But the increase had slowed a bit in recent years, and assuming the decline was in elective C-sections, that's good news, some experts said.

"It is quite gratifying," said Carol Hogue, an Emory University professor of maternal and child health and epidemiology.

"There are strong winds pushing against C-sections," she said, including new policies and education initiatives that discourage elective C-sections in mothers who have not reached full-term.

Hogue agreed that the economy seems to be the main reason for the birth declines. But she noted that it's possible that having fewer children is now more accepted and expected.

"Having one child may be becoming more `normal,'" she said.

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Online:

CDC report:http://www.cdc.gov/nchs/

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Lower birth rates for young women tied to economy (AP)

ATLANTA � Birth rates for the nation's youngest mothers hit new lows last year � further evidence that few forms of birth control are as effective as the economy.

The national birth rate dropped for the third straight year, with declines for most ages and all races, according to a federal report released Thursday. Teens and women in their early 20s had the most dramatic dip to the lowest rates since record-keeping began in the 1940s.

Also, the rate of cesarean sections stopped going up for the first time since 1996.

Experts suspected the economy drove down birth rates in 2008 and 2009 as women put off having children. With the 2010 figures, suspicion has turned into certainty.

"I don't think there's any doubt now that it was the recession. It could not be anything else," said Carl Haub, a demographer with the Population Reference Bureau, a Washington, D.C.-based research organization. He was not involved in the new report.

U.S. births hit an all-time high in 2007, at more than 4.3 million. Over the next two years, the number dropped to about 4.2 million and then about 4.1 million.

Last year, it was down to just over 4 million, according to the new report from the Centers for Disease Control and Prevention.

For teens, birth rates dropped 9 percent from 2009. For women in their early 20s, they fell 6 percent. For unmarried mothers, the drop was 4 percent.

Experts believe the downward trend is tied to the economy, which officially was in a recession from December 2007 until June 2009 but remains weak. The theory is that women with money worries � especially younger women � feel they can't afford to start a family or add to it.

That's true of Mary Garrick, 27, an advertising executive in Columbus, Ohio. She and her husband, David, married in 2008 and hoped to start having children quickly, in part because men in his family have died in their 40s. But David, 33, was laid off that year from his nursing job and again last year.

He's working again, but worries about the economy linger. "It kind of made us cautious about life decisions, like having a family. It's definitely something that affected us," she said.

Many of the report's findings are part of a trend and not surprising, but a few did startle experts.

One involved a statistic called the total fertility rate. In essence, it tells how many children a woman can be expected to have if current birth rates continue. That figure was 1.9 children last year. In most years, it's more like 2.1.

More striking was the change in the fertility rate for Hispanic women. The rate plummeted to 2.4 from 3 children just a few years ago.

"Whoa!" said Haub, in reaction to the statistic.

The economy is no doubt affecting Hispanic mothers, too, but some young women who immigrated to the United States for jobs or other opportunities may have left, Haub said.

Another shocker: The C-section rate. It rose steadily from nearly 21 percent in 1996 to 32.9 percent in 2009, but it dropped slightly to 32.8 last year.

Cesarean deliveries are sometimes medically necessary. But health officials have worried that many C-sections are done out of convenience or unwarranted caution, and in the 1980s set a goal of keeping the national rate at 15 percent.

It's too soon to say the trend has reversed, said Joyce Martin, a CDC epidemiologist who co-authored the new report.

But the pace of increase had slowed a bit in recent years, and assuming the decline was in elective C-sections, that's good news, some experts said.

"It is quite gratifying," said Carol Hogue, an Emory University professor of maternal and child health and epidemiology.

"There are strong winds pushing against C-sections," she said, including new policies and education initiatives that discourage elective C-sections in mothers who have not reached full-term.

Hogue agreed that the economy seems to be the main reason for the birth declines. But she noted that it's possible that having fewer children is now more accepted and expected.

"Having one child may be becoming more `normal,'" she said.

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Online:

CDC report:http://www.cdc.gov/nchs/

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Women more likely to have 'broken heart syndrome' (AP)

ORLANDO, Fla. � A woman's heart breaks more easily than a man's.

Females are seven to nine times more likely to suffer "broken heart syndrome," when sudden or prolonged stress like an emotional breakup or death causes overwhelming heart failure or heart attack-like symptoms, the first nationwide study of this finds. Usually patients recover with no lasting damage.

The classic case is "a woman who has just lost her husband," said Dr. Mariell Jessup, a University of Pennsylvania heart failure specialist who has treated many such cases.

Cyndy Bizon feared that was happening when her husband, Joel, suffered a massive heart attack in 2005. "May God work through your hands," the Maine woman told the surgeon as her husband was wheeled past her into the operating room. She later collapsed at a nurse's station from "broken heart syndrome" and wound up in coronary care with him. Both survived.

Japanese doctors first recognized this syndrome around 1990 and named it Takotsubo cardiomyopathy; tako tsubo are octopus traps that resemble the unusual pot-like shape of the stricken heart.

It happens when a big shock, even a good one like winning the lottery, triggers a rush of adrenaline and other stress hormones that cause the heart's main pumping chamber to balloon suddenly and not work right. Tests show dramatic changes in rhythm and blood substances typical of a heart attack, but no artery blockages that typically cause one. Most victims recover within weeks, but in rare cases it proves fatal.

Dr. Abhishek Deshmukh of the University of Arkansas had treated some of these cases.

"I was very curious why only women were having this," he said, so he did the first large study of the problem and reported results Wednesday at an American Heart Association conference in Florida.

Using a federal database with about 1,000 hospitals, Deshmukh found 6,229 cases in 2007. Only 671 involved men. After adjusting for high blood pressure, smoking and other factors that can affect heart problems, women seemed 7.5 times more likely to suffer the syndrome than men.

It was three times more common in women over 55 than in younger women. And women younger than 55 were 9.5 times more likely to suffer it than men of that age.

No one knows why, said Dr. Abhiram Prasad, a Mayo Clinic cardiologist who presented other research on this syndrome at the conference.

"It's the only cardiac condition where there's such a female preponderance," he said.

One theory is that hormones play a role. Another is that men have more adrenaline receptors on cells in their hearts than women do, "so maybe men are able to handle stress better" and the chemical surge it releases, Deshmukh said.

Bizon was 57 when her attack occurred; she's now 63. She and her husband are pharmacists and live in Scarborough, Maine.

"I remember grabbing the counter and a black curtain coming down before my eyes," she said in a telephone interview. Her attack was so severe that she went into full cardiac arrest and had to have her heart shocked back into a normal rhythm. Although most such attacks resolve without permanent damage, she later needed to have a defibrillator implanted.

About 1 percent of such cases prove fatal, the new study shows.

"In the old days, we'd say someone was scared to death," said Prasad.

About 10 percent of victims will have a second episode sometime in their lives. And although heart attacks happen more in winter, broken heart syndrome is more common in summer.

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Online:

Heart Association, http://www.americanheart.org

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Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

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Blood type may affect stroke risk, study finds (AP)

ORLANDO, Fla. � Your blood type might affect your risk for stroke. People with AB and women with B were a little more likely to suffer one than people with O blood � the most common type, a study found.

The research can't prove such a link. But it fits with other work tying A, B and AB to more risk of blood clots in the legs and heart attacks. Blood type O also has been tied to an increased risk of bleeding, which implies less chance of clots, the cause of most strokes.

"There's increasing evidence that blood type might influence risk of chronic disease," said one of the study leaders, Dr. JoAnn Manson, chief of preventive medicine at Harvard's Brigham and Women's Hospital.

"It's not at the level where we want to alarm people and we want to make that clear. But it's one more element of risk that people would want to know about," and it could give them one more reason to keep blood pressure and cholesterol in line, she said.

The study, led by Brigham's Dr. Lu Qi, was presented Wednesday at an American Heart Association conference. It involved 90,000 men and women in two observational health studies that have gone on for more than 20 years.

Looking at the 2,901 strokes that have occurred and taking into account other things that can cause them, such as high blood pressure, researchers found:

_Men and women with AB had a 26 percent increased risk of stroke compared to those with type O.

_Women but not men with B blood had a 15 percent greater risk compared to those with O.

What's the explanation?

Blood type depends on proteins on the surface of red blood cells. A pattern of immune system responses forms early in life based on them. Certain blood types may make red cells more likely to clump together and stick to the lining of blood vessels, setting the stage for a blood clot, Manson said.

"You can't change it, and we don't know if it's the blood type per se or other genes that track with it" that actually confers risk, said Dr. Larry Goldstein, director of Duke University's stroke center.

"There are other things that are more important" than blood type for stroke risk, such as smoking, drinking too much and exercising too little, he said.

About 45 percent of whites, 51 percent of blacks, 57 percent of Hispanics and 40 percent of Asians have blood type O, according to the American Red Cross. Such people are called "universal donors" because their blood can safely be used for transfusions to any other blood type.

AB blood type is the least common type, present in 4 percent of whites and blacks, 2 percent of Hispanics and 7 percent of Asians.

B is second least common overall, in 11 percent of whites, 19 percent of blacks, 10 percent of Hispanics and 25 percent of Asians.

A is in 40 percent of whites, 26 percent of blacks, 31 percent of Hispanics and 28 percent of Asians.

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Online:

Heart Association: http://www.americanheart.org

Blood types: http://www.redcrossblood.org/learn-about-blood/blood-types

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Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP

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UK doctors call for ban on smoking in cars (AP)

LONDON � The British Medical Association is calling on the government to ban smoking at all times in cars, a step that would go beyond regulations elsewhere.

In research released on Wednesday, the group that represents U.K. doctors said the confined environment in cars exposes drivers and passengers to 23 times more toxins than a smoky bar. Children are particularly vulnerable to second-hand smoke since they absorb more pollutants. Smoke can linger in cars long after cigarettes have been smoked.

In countries including Australia, Canada, and parts of the U.S., smoking in cars is banned when children are present. In the U.K., smoking in public vehicles like buses and trains is banned but there is no law against smoking in private cars.

Dr. Vivienne Nathanson of the association said Wednesday that the government should now take a "bold and courageous step."

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