Sickle Cell Anaemia and Deaths in Custody in the UK and the USA

Dyson, Simon; Boswell, Gwyneth

doi:10.1111/j.1468-2311.2006.00401.x

Cited by 12 publications

(8 citation statements)

References 18 publications

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“…53 The current finding of increased risk of VTE in sickle cell carriers adds a further dimension to the appropriate provision of information to patients in such screening contexts. Given the experience of African-American communities in the recent past, caution is needed to avoid stigmatisation and community anxiety11 54 55 in advancing appropriate care of people with SCT. Previous researchers have observed the Black community, at genetic risk of sickle cell, are also disadvantaged in society.…”

Section: Discussionmentioning

confidence: 99%

Venous thromboembolism in adults screened for sickle cell trait: a population-based cohort study with nested case–control analysis

et al. 2017

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ObjectiveTo determine whether sickle cell carriers (‘sickle cell trait’) have an increased risk of venous thromboembolism (VTE).DesignCohort study with nested case–control analysis.SettingGeneral population with data from 609 UK general practices in the Clinical Practice Research Datalink (CPRD).ParticipantsAll individuals registered with a CPRD general practice between 1998 and 2013, with a medical record of screening for sickle cell between 18 and 75 years of age.Main outcomes measuresIncidence of VTE per 10 000 person-years (PY) among sickle cell carriers and non-carriers; and adjusted OR for VTE among sickle cell carriers compared with non-carriers.ResultsWe included 30 424 individuals screened for sickle cell, with a follow-up time of 179 503 PY, identifying 55 VTEs in 6758 sickle cell carriers and 125 VTEs in 23 666 non-carriers. VTE incidence among sickle cell carriers (14.9/10 000 PY; 95% CI 11.4 to 19.4) was significantly higher than non-carriers (8.8/10 000 PY; 95% CI 7.4 to 10.4). Restricting analysis to confirmed non-carriers was non-significant, but performed on a small sample. In the case–control analysis (180 cases matched to 1775 controls by age and gender), sickle cell carriers remained at increased risk of VTE after adjusting for body mass index, pregnancy, smoking status and ethnicity (OR 1.78, 95% CI 1.18 to 2.69, p=0.006), with the greatest risk for pulmonary embolism (PE) (OR 2.27, 95% CI 1.17 to 4.39, p=0.011).ConclusionsAlthough absolute numbers are small, in a general population screened for sickle cell, carriers have a higher incidence and risk of VTE, particularly PE, than non-carriers. Clinicians should be aware of this elevated risk in the clinical care of sickle cell carriers, or when discussing carrier screening, and explicitly attend to modifiable risk factors for VTE in these individuals. More complete primary care coding of carrier status could improve analysis.

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Section: Discussionmentioning

confidence: 99%

Venous thromboembolism in adults screened for sickle cell trait: a population-based cohort study with nested case–control analysis

et al. 2017

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“…This can result in rhabdomyolysis (the breakdown of muscle fibres resulting in the release of muscle fibre contents into the bloodstream), myocardial ischemia, arrhythmias and sudden death (Scheinen and Wetli, 2009). Incidence of restraint‐related deaths of individuals with sickle cell anaemia is extremely rare but Dyson and Boswell (2006) found that:Statistically, sickle cell could not possibly explain the highly raised overrepresentation of deaths of African‐Caribbean males in custody.…”

Section: Pre‐existing Conditionsmentioning

confidence: 99%

Deaths in custody: the role of restraint

Duxbury

Aiken²,

Dale³

2011

Journal of Learning Disabilities and Offending Behaviour

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PurposeThe practice of restraint is controversial as deaths in care or custody have been a consequence of restraint. The purpose of this paper is to clarify research from national and international literature to ascertain any common findings in order to provide guidance for staff on safe and effective restraint techniques where there is no other resort in the management of violent and aggressive individuals.Design/methodology/approachThe researchers undertook a review of the literature on the medical theories relating to restraint‐related deaths and an analysis of deaths in custody in the UK for the time period 1 Jan 1999 to 1 Jan 2010.FindingsFindings showed that certain groups are particularly vulnerable to risks while being restrained. There are also biophysiological mechanisms which staff need to be aware of when restraining an aggressive or violent individual.Originality/valueIt is evident that those in vulnerable groups when restrained in a prone position, or in a basket hold, for a prolonged period and who are agitated and resistive, are most at risk of death in custody. Consistency in reporting relevant deaths locally and nationally is necessary to facilitate analysis of key information and prevent deaths in custody in the future. Staff training and awareness are also key factors.

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“…Designation of sickle cell trait as a cause of incustody death has been documented internationally. 3 The New York Times reported that the deaths in custody of at least 45 Black people were falsely attributed to sickle cell trait in the past 25 years. 4 Unlike sickle cell anaemia, which is a severe life-limiting illness, sickle cell trait is almost entirely benign.…”

mentioning

confidence: 99%

Sickle cell trait: an unsound cause of death

et al. 2021

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Sickle cell trait: an unsound cause of deathIn forensic pathology, cause of death is defined as the disease or injury that triggers the events that lead to death. If a chronically ill woman dies from a gunshot wound, it is this injury, not her underlying health issues, that led to her death. The same logic applies to injuries inflicted by law enforcement.As physicians, we harm patients and communities through complicity in a racist system of policing. Physicians deny justice to communities by providing medical cover for death at the hands of law enforcement officers and by perpetuating medical falsehoods to justify this practice. Although tragically not unique, the murder of George Floyd highlights the ways in which we reiterate an unjust and unfortunately common process."Man dies after medical incident during police interaction," read a press release from the Minneapolis Police Department on May 25, 2020. 1 An initial autopsy described his history of heart disease, substanceuse disorder, and sickle cell trait. Without Darnella Frazier's bravery,

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Sickle Cell Anaemia and Deaths in Custody in the UK and the USA

Cited by 12 publications

References 18 publications

Venous thromboembolism in adults screened for sickle cell trait: a population-based cohort study with nested case–control analysis

Venous thromboembolism in adults screened for sickle cell trait: a population-based cohort study with nested case–control analysis

Deaths in custody: the role of restraint

Sickle cell trait: an unsound cause of death

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