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The Guardian’s look at an inhaler to protect lungs from air pollution borders on puffery


3 Star



New inhaler protects lungs against effects of air pollution

Our Review Summary

Black ExhaustThis is a romp through a field of unsubstantiated claims on the benefits and promise of a new device that purports to protect the body from air pollution-induced illnesses. The hyperbole begins with the title and continues through the story.

The story hints at evidence but provides no substantiation of the claims made by the sources in the story.


Why This Matters

The clinical and financial impact of air pollution is an important public health issue that deserves coverage. While attempts to reduce the production of pollutants has been somewhat successful, other strategies are newsworthy, including the potential for a low cost and non-toxic preventive.

Although the research to date has been “promising” it is a long way from promise to fruition. Resorting to excessive claims of benefits leads readers astray and compromises the integrity of the research effort.


Does the story adequately discuss the costs of the intervention?


The expected cost to UK consumers is noted ($17 pounds/month).

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The reader is provided with no information on the presumed benefit of ectoine other than glowing comments and two references available via URL. The two studies noted include one in rats and one in human cell culture. No information is provided about studies in humans, although one source says the “inhaler has been tested in three small groups of patients particularly at risk from air pollution, due to asthma, COPD and bronchitis, with the positive results due to be published soon.”

This begs the question of the need for this story now rather than after the publication of the results.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

Harms are not explained. The comments of one doctor in the story suggest that the compound is inert, supporting the notion that there are no harms. But a quick check of a material safety data sheet reveals some concern about the potential for ectoine to produce pulmonary edema if inhaled, in addition to eye and skin irritation.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

Dr. Andreas Bilstein is quoted saying, “The inhaler has been tested in three small groups of patients particularly at risk from air pollution, due to asthma, COPD and bronchitis, with the positive results due to be published soon.” How many patients? Under what conditions? For how long? How were the benefits measured? Other than a series of positive quotes about ectoine, the reader is provided with little in the way of substantiation.

Does the story commit disease-mongering?

Not Satisfactory

There is a suggestion that all of us who live in cosmopolitan areas where particulate pollution is a problem will need to start and end our day with an ectoine inhaler or risk type 2 diabetes, Alzheimer’s disease, COPD and a host of other maladies.

Also, the article should be mindful of statements such as the ones below, which may unintentionally incite fear in the public.

“Outdoor air pollution is a global health crisis that kills over 3 million people a year…”

“In the UK, at least 40,000 people a year die prematurely from air pollution, with a cross-party committee of MPs calling it a “public health emergency.”

These types of statistics are, first of all, hard to wrap one’s mind around. Overuse of them has numbed people to their impact and effect.

Does the story use independent sources and identify conflicts of interest?


Comments from one independent source are provided and the potential conflicts of interest of Dr. Klutman and Bilstein are in part duly noted.

Does the story compare the new approach with existing alternatives?


The article does provide at least one alternative strategy, though it wasn’t explained clearly:

“Antioxidants can also provide some protection but there has been controversy over the effectiveness of such food supplements, he said: ‘Personally, I think it is much better to eat lots of vegetables and fruit rather than taking any supplements.'”

It also mentioned the need to reduce harmful vehicle emissions, though it said more short-term solutions were needed.

Does the story establish the availability of the treatment/test/product/procedure?


The story makes it relatively clear that the inhaler isn’t available but should be soon. More specifics would have been helpful, though.

Does the story establish the true novelty of the approach?


The use of a ectoine for prevention of pollution-related illness is novel and the story provided sufficient backstory with this detail:

“The protective effect of ectoine was discovered by Prof Jean Krutmann and colleagues at the Leibniz Research Institute for Environmental Medicine, while investigating whether the molecule could protect skin against sun damage. Bitop funded a series of studies, now published in prominent scientific journals.”

Does the story appear to rely solely or largely on a news release?


Technically, the story was not pulled from a press release. We do wonder however why the story was thought to be newsworthy at this time since trial results are apparently to be published soon.

Total Score: 6 of 10 Satisfactory


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