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The one-centimetre thick tube was forcing its passage steadily through my skin, ribs, flesh. When reaching the lung, a torrent of pus flowed straight out into a receptacle. Within a few seconds it was full.
“Excellent!” shouted the consultant who was directing the operation, “Almost two pints! Faster than in a pub! Well done!”.
This condition, pleural empyema, can strike anyone with rates of mortality reaching 50%. It starts with a pneumonia which develops into a pleural effusion -excessive fluid in the lungs- and that liquid changes into pus which solidifies. From being breathless, you cannot breath anymore…
According to the latest report from the ONS[1] on causes of death in the UK, pneumonia kills half a million people a year.
“We used to have an average of a person a day arriving at A&E with such a condition, now it’s two”, says Dr. Rebecca Lyall, at the time, consultant in thoracic surgery at the Whittington Hospital, London.
And the figures are increasing worldwide for unknown reasons, with the young the most affected. There are fears that a vaccine in immunisation programmes could be contributing to this rise.
A study[2] in Scotland shows a four fold increase in 25 years in purulent pleuritis
(another name for pleural empyema). In Canada, a survey directed[3] by Christian Fenton of the University of British Columbia shows a 400% rise in children under ten in ten years.
(another name for pleural empyema). In Canada, a survey directed[3] by Christian Fenton of the University of British Columbia shows a 400% rise in children under ten in ten years.
The sources for the disease can be bacterial, viral and fungal. But the reason remains a mystery to the scientific community.
When I reached A&E, a wave of media frenzy paranoia described the London underground as full of bacteria and virus.
GPs were advising the elderly and people at risk (like myself) to avoid the Tube.
Dr Ben Croxford of University College London calculated that a person spending
20 minutes in the most polluted part of the London Underground will inhale the equivalent of a cigarette. His research was followed by publications in the press
(The Independent, The Evening Standard) and on the BBC[4].
Dr Ben Croxford of University College London calculated that a person spending
20 minutes in the most polluted part of the London Underground will inhale the equivalent of a cigarette. His research was followed by publications in the press
(The Independent, The Evening Standard) and on the BBC[4].
It took nearly three years for the independent Institute of Occupational Medicine[5] to reach the conclusion that the Tube is neither harmful nor dangerous for the travelling public. However, it stated that “there is some increase in risk of pneumonia”.
Geoff Martin, Press Officer of the LMU, says: “we are still investigating such findings as we need to protect our members in one way or another”.
Nick Anthonisen, the Kojak-lookalike editor of the Canadian Respiratory Journal, concluded during an interview that despite all the surveys and facts, with the increase of pleural empyema: “we are left with a provocative finding without a clear explanation”.
Upon my discharge from the hospital, Dr Lyall, while arranging her blonde hair,
told me: “You had a chance out of a million to have contracted an atypical empyema and we don’t know why. You were just unlucky. If you had waited a day or two, you wouldn’t be here.”
told me: “You had a chance out of a million to have contracted an atypical empyema and we don’t know why. You were just unlucky. If you had waited a day or two, you wouldn’t be here.”
I resumed taking the underground only three years later. The following week,
I missed a Piccadilly line train by a couple of minutes with a suicide bomber inside.
I feel lucky.
I missed a Piccadilly line train by a couple of minutes with a suicide bomber inside.
I feel lucky.
[2] Roxburgh CSD, Youngson GG, Townend JA, Turner SW. Trends in pneumonia and empyema in Scottish children in the past 25 years. Arch Dis Child. 2008;93;316–8 37.
[3] Finley C, Clifton J, FitzGerald JM, Yee J. Empyema: an increasing concern in Canada. Can Respir J. 2008;15(2):85–9.effusions. Am J Respir Crit Care Med. 2004;170:49–53.
[4] http://news.bbc.co.uk/1/hi/england/2211929.stm (accessed on 25th January 2011)
[5] p.57 “Assessment of health effects of long-term occupational exposure to tunnel dust in the London Underground “
JF Hurley1, JW Cherrie1,2, K Donaldson3, A Seaton1,2 and CL Tran1.
JF Hurley1, JW Cherrie1,2, K Donaldson3, A Seaton1,2 and CL Tran1.
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