Taking an aspirin every day may help prevent heart disease and stroke but, for a middle-aged man, it is nearly as risky as driving a car or working as a firefighter, researchers said Tuesday.While people are poor at assessing true risks, they are often willing to take on those risks in exchange for the benefits — which can include simply having fun, said Joshua Cohen and Peter Neumann of Tufts-New England Medical Center.
Writing in the journal Health Affairs, they said federal regulators must take the true risks into account, and balance them against thebenefits, when deciding whether to approve or withdraw drugs.
People are bad at estimating risk, the researchers said.
“In general, they tend to overestimate the probability of small and especially dreaded risks while underestimating the probability of large risks,” Cohen and Neumann wrote.
They calculated the risks of various voluntary actions, starting with deaths associated with taking drugs.
“We included selected drugs for which we could develop a reasonable annual mortality risk estimate,” they wrote.
For 50-year-old men, taking a full-sized, 325 mg aspirin every day to prevent heart disease and stroke carries a risk of 10.4 deaths per 100,000 men per year over and above their overall death risk.
Using Vioxx for arthritis pain carried a risk of 76 deaths per 100,000 people per year. Merck and Co withdrew Vioxx in September 2004 after it was shown to double the risk of heart attack and stroke.
“The finding that taking Vioxx for a year is much more risky than a year of car travel, swimming or being a firefighter suggests that greater scrutiny of drug risks may be warranted,” the researchers wrote.
Using Tysabri, known generically as natalizumab, to treat multiple sclerosis raises the death rate by 65 per 100,000 people a year.
Biogen Idec’s and Elan Corp’s Tysabri was withdrawn from the U.S. market in 2005 afterthree patients contracted a rare brain disease, but the Food and Drug Administration re-approved it after many patients said they would use it despite the risks.Cutting trees risky
As for job-related deaths, the riskiest profession was being a tree-feller, with 55 deaths per year or a risk of 357 deaths per 100,000 people a year.
Firefighters have a risk of 10.6 deaths per 100,000 people per year, compared with 3.9 for all occupations and 0.4 for office workers.
Being a truck driver is risker than being a firefighter, with 44.8 deaths per 100,000 people per year.
Bicycling is more dangerous than skiing, the researchers found — bicyclists face a death rate of 2.1 per 100,000 people a year, compared with 0.49 for skiers.
Swimming has a death risk of 0.88 per 100,000 people a year but climbing mountains in the Himalayas carries a 13,000 per 100,000 climbers per year risk.
For transport, the researchers estimated risks both in terms of 100,000 people per year and per 100 million miles traveled.
Traveling by commercial airliner carries a risk of 0.03 deaths per 100 million miles or 0.15 deaths per 100,000 people a year.
Car and light truck travel has a 0.7 fatality risk per 100 million miles or 11 per 100,000 people per year, compared to 450 for motorcycle travel and 1.3 for using a cell phone while driving.