Specifically, the below list of things that may be worth worrying about more because they:

(a) could be more likely to impact you than you realize

(b) could have severe consequences if they do affect you

(c) are at least moderately preventable

My hope is that this post will help prevent at least one person’s life from being ruined by dangers they never even considered before.

Personal Dangers to Consider

(1) Repetitive Strain Injuries

If you are one of the many people who spend most of your day at a computer, then you are asking for trouble if you don’t use good form when typing. You may be typing 1000 hours a year, so even slight issues can compound into chronic injuries, which could be crippling to your work (at least temporarily, but in some cases, permanently).

How common it is: this paper [5] says that carpal tunnel has “a prevalence in the general adult population ranging from 2.7 to 5.8 percent”, but this is hard to interpret because carpal tunnel is not the only repetitive stress injury you can get from typing, and you can, of course, get carpal tunnel syndrome from other activities. This paper [15] studied bank workers in Brazil and found that the “estimated prevalence of clinically confirmed cases” was 22%, which is disturbingly high!

What to do about it: my understanding is that you should keep your keyboard at a height where your wrists are in a neutral (straight) position and comfortably relaxed (not flexed up or down). You also should avoid reaching across the keyboard while typing (use the left hand for the left half of the keys and the right hand for the right half). If you are a “hunt and peck” typist, you should strongly consider learning to touch type (there is plenty of software out there to teach you how, and it will raise your productivity). When typing, my understanding is that your elbows should be bent at roughly 90 degrees. If you start getting wrist, thumb, or hand pain while typing, take it seriously (especially if it lasts more than two days) and adjust your form, try a more ergonomic keyboard, take a couple of days off from using the computer, go to physical therapy, try doing wrist stretches designed for RSI periodically throughout the day, etc. You really don’t want to ignore it if it’s getting worse because it may become a chronic condition or dramatically harder to treat. If your work involves heavily using a computer, then your livelihood depends on the health of your wrists.

I once had a seemingly quite serious repetitive stress injury from typing, but thankfully after throwing every technique I could find at it (a special ergonomic hand separating keyboard [1], a vertical mouse [2], daily use of a special wrist strengthening device [3], splints while sleeping, physical therapy) it went away in six months or so. I have no idea which of these interventions helped, or if, perhaps, it was just time that helped. While it was happening, though, the RSI was painful, stress-inducing, and hurt my productivity. Don’t let it happen to you!

Another intervention you could try is switching to a Dvorak keyboard layout (with most computers, you can do this simply by switching software settings), which is designed to (theoretically at least) reduce the amount of finger movement needed and increase typing speed. The problem with Dvorak is that it takes quite a while to learn, and you’ll very likely eventually lose your ability to use the standard QWERTY layout that everyone else uses. A better alternative to Dvorak may be Colemak [16] since it’s designed to be easier and faster to learn and may have other advantages over Dvorak as well.

(2) Chronic Back Pain

Chronic back pain can significantly lower your quality of life. It’s simply a lot harder to enjoy the positives in life when in pain, and it’s harder to stay focused on whatever you’re doing. Back pain also can limit your behaviors a lot, for instance, preventing exercise or preventing you sitting or walking at length. It’s also absurdly common, especially lower back pain (perhaps due to a combination of the amount of time we spend sitting, the commonness of bad posture, and the physical structure of the back itself). Of course, back pain is also sometimes caused by impact injuries (e.g., car accidents, sports injuries, falling), but we’ll focus on work-related back pain here.

How common it is: this NIH article [6] says: “about 80 percent of adults experience low back pain at some point in their lifetimes. It is the most common cause of job-related disability and a leading contributor to missed workdays.” This article [15] claims that “nearly one in 10 people across the globe suffer from an aching lower back.”

What to do about it: first of all, get a good chair. I ended up experimenting with three over a period of years until I found one that was really perfect for me. I recommend trying out other people’s office chairs (ideally sitting in them while typing for at least 20 minutes) until you find one you love. Once you’ve found a good chair, make sure that you create a routine of sitting in it in a healthy position. As I understand it, your back should be supported by the back of the chair, and you shouldn’t be hunched or feel uncomfortable (consider a lumbar cushion [7] if your lower back is not well supported by the chair). Make sure your computer screen isn’t too low (e.g., buy a riser for it or stack it on something and consider an external keyboard and laptop stand for laptops). Ideally, you shouldn’t have to bend your neck down or hunch to any substantial degree to look at the screen. Don’t get in the habit of twisting your body or putting a leg up on your knee (put your feet back flat on the floor when you notice this happening – you also don’t want your feet to be dangling ideally). Stop for a moment and pay close attention to how your body feels when you are sitting in your chair. If you notice any tension, then find a way to sit more comfortably since you’ll probably be like that many hours every day. You also could consider getting a standing desk or adjustable desk (note though that you can still hurt yourself standing all day, so switching back and forth between standing and sitting is probably ideal – and if you do get a standing desk, consider getting a pad to stand on to make it less painful on your feet). When working, consider taking periodic breaks where you walk or stretch, as that might help as well. If you start to have back pain that lasts more than two days, take it seriously. See a doctor or physical therapist, do appropriate exercises or stretches daily, adjust your chair and posture, get a lumbar cushion, get a stand and external keyboard for your laptop, etc. You may want to consider buying a device [14] to remind you whenever you slouch. It’s best to build good sitting habits before it’s too late. One more thing to note: lifting excessively heavy objects can ruin your back in mere seconds. If something is really heavy, ask for help. If you really have to lift it, make sure to use your legs heavily in the lifting and not to lift from your back.

(3) Car Accidents

If you spend a lot of time in cars, then you should be concerned about car safety. Cars frequently ruin people’s lives.

How common are they: According to the CDC [8], if you are age 25 to 74, your base rate chance of dying due to a car accident in a single year is about 1 in 2500. Of course, some of these are deaths of pedestrians, bikers, etc. If a 1 in 2500 chance of death each year doesn’t scare you, then it’s worth noting that the injury rate from car accidents is dramatically higher than the death rate, more than 15x higher according to this article [9]. And even if you don’t injure yourself, you may kill or injure someone else when you’re driving (e.g., your passengers or pedestrians), which is also, of course, horrible.

What to do about it: here’s a very helpful article [10] by Michael Curzi summarizing things you can do to be safer when driving, but some of the main things from the article, and some from common sense, are:

(a) always wear your seatbelt (even at 25 miles an hour, an accident can mangle you pretty bad)

(b) don’t do anything distracting while driving (apparently, 25-50% of accidents have a distraction as the root cause)

(c) be extra careful on dark streets and at night in general (apparently, 49% of fatal crashes happen at night)

(d) also, be extra careful in bad weather such as rain and snow (apparently 75% of crashes involve wet pavement, and the first day it snows for the year is especially dangerous, perhaps because drivers haven’t adapted to it yet)

(e) don’t drive when you’ve been drinking or taking drugs because it can impair your judgment, slow down your reflexes, and distract you (plus the penalties if you get caught can be huge, and if you accidentally hurt someone while driving under the influence, you could face a criminal sentence even if the accident isn’t really your fault)

(f) don’t go above the speed limit except when it’s clearly safe to do so (the chance of dying goes up dramatically with higher-speed collisions)

(g) don’t drive when sleepy (ask someone else to drive instead, take a taxi or drink some caffeine).

(4) Medical Error

If you are hospitalized, or you are considering undergoing a serious procedure, you should be concerned about medical error and take the steps you can to prevent it.

How common it is: according to this article [11], medical error may be the third leading cause of death in the U.S. after heart disease and cancer. How crazy is that! Whether this is an exaggeration or not, who knows (clearly, it’s something that’s tricky to estimate), but the point is that the risk is a serious one.

What you can do about it:

(a) if you’re undergoing a procedure, be absolutely certain that they have correctly ID’d you and that they know exactly what they are operating on (including which side of the body and which body part) and what they are trying to accomplish

(b) when dealing with a very serious condition, pay up (if you can afford it) to go to a truly amazing doctor (your life may literally depend on it). When it’s sufficiently serious, it may be worth going off your insurance plan to find someone spectacular (at least to consult with, even if they won’t be carrying out your procedure).

(c) look at meta-analyses and randomized controlled trials on your own to double-check what your doctor says (e.g., using the Cochrane Library online and google scholar). If what you find contradicts your doctor’s recommendations, don’t immediately assume they are wrong, but they might be, so definitely show them what you found and see what they say. Doctors haven’t necessarily seen the latest studies, and it can take many years for evidence to percolate. There are still lots of surgeries performed annually where evidence suggests they are totally pointless (or even harmful).

(d) if you’re given medication at the hospital, double-check that it is what you’re supposed to be taking before taking it

(e) remember that nearly all hospital stays have an element of risk (e.g., you might pick up an infection or be given the wrong medication) so only stay at the hospital if it’s important to do so.

(f) remember that all surgery carries risk and can have complications, so weigh the costs and benefits carefully.

(g) before undergoing a medical procedure, talk to your doctor in detail about all the risks and what you can expect post-surgery in terms of recovery. I’ve found that doctors sometimes don’t tell you how bad recovery will be and will spring it on you with a “post-operative care” sheet after it’s already done.

(h) If you’re getting a procedure done, consider asking the doctor how many times they have done the procedure. If it’s small, find another doctor. If it’s large, ask the doctor how many times they’ve seen the different risks / serious complications occur in their patients.

(i) If they try to have a med student in training do a serious procedure on you, tell them bluntly that you would like the experienced doctor to do it instead.

(5) Suicide

People are not usually concerned about committing suicide because they assume that (a) they’d never do it themselves or (b) that even if they did do it, that would be their own well-reasoned choice, so it wouldn’t make sense to proactively prevent it. However, I think it’s quite unlikely that most people who commit suicide would have been able to predict five years earlier that they were going to do it, and suicide is often carried out very impulsively (rather than being a rational choice that is made). For instance, according to this article [12], 70% of people who attempt suicide and fail never attempt it again (of course, this includes some people who may not have been truly trying to kill themselves, but the point still stands that suicide is rarely a rational decision). One of the best reasons not to keep a gun is because you (or someone else in your house) might one day use it to impulsively commit suicide. The easier it is to commit suicide, the more likely you’ll be to do it, hence why guns are so problematic. As I understand it, societal shifts that make suicide harder are sometimes associated with large changes in suicide rates – even a minor extra inconvenience matters because of suicide’s frequently impulsive nature. Note that, according to this website [15], 25-34-year-olds in the U.S. are about 1.5 more likely to die from suicide than homicide, 45-54-year-olds are about four times more likely to from suicide than homicide, and 55-64-year-olds are more than six times more likely. People think that guns make the U.S. dangerous, and they are right, but what they don’t realize is that suicide is a far bigger problem than homicide.

How common it is: according to the CDC [13], in 2010 in the U.S., it was the 2nd great cause of death for 25-34-year-olds and the 4th highest for 35-54-year-olds.

What you can do about it: don’t keep a gun in your house. If you find yourself having frequent suicidal thoughts, and especially if you’ve begun to formulate a suicide plan (e.g., coming up with specific details), immediately tell someone that you fully trust and who can handle the situation well. Additionally, strongly consider seeing a well-trained psychologist who specializes in depression. Keep in mind that if they feel you are an immediate threat to yourself, they may have to take action. Please discuss this with them before you tell them about your suicidal thoughts. They won’t report you for merely asking about the rules they have to follow; then, you can decide whether you feel comfortable sharing your suicidal thoughts with them.

If you are on the verge of suicide, immediately call the national suicide preventions hotline at 1-800-273-8255 or chat with them online at http://chat.suicidepreventionlifeline.org. If you are outside the U.S., you can use this list of hotlines: http://www.suicide.org/international-suicide-hotlines.html. More generally, whether you are suicidal or not, you should take depression very seriously. Even though you may well feel hopeless about your depression (that’s a symptom of depression after all), the statistics say it usually is treatable. Please don’t let it ruin your life unnecessarily. Go to a therapist (I especially recommend someone whose specialty is CBT since it’s more evidence-based for depression than most other modalities. Even if you’ve tried therapy before, CBT is likely very different than what you’ve tried). Or go to a psychiatrist (if you prefer to try medicine-based options). If you’re very depressed, a combination of CBT (with a psychologist) plus antidepressants (with a psychiatrist) are your best bet to feeling better as fast as possible. If you don’t do either of those things, please at least read a book about depression that has lots of useful advice, such as Feeling Good (by David Burns). Note that if you have tried a few treatments before and none of them have worked, there are actually quite a large number of different depression treatments available, and it’s almost certain that you have not tried them all.

For instance, if you think that social issues are a major factor in your depression, consider trying Interpersonal Psychotherapy (IPT). If you think that sleep problems are a major factor, go to a sleep doctor to see if you might have sleep apnea which could be causing it, or consider chronotherapy. If your depression is seasonal, consider trying a very bright SAD light in the morning. There are many useful things to try; this is just scratching the surface of your options.

(6) Injuries from Falling

People generally don’t consider just how dangerous and common falling is for older adults. It’s not just that falls can occasionally be deadly, but rather that they cause injuries that can land you in the hospital. Some people never recover from these injuries and are bedridden, crippled, or hospitalized for the rest of their lives.

How common it is: according to the CDC [16], older Americans experience about 29 million falls annually, leading to about 7 million injuries, and are a “leading cause of injury and death in older Americans.”

What you can do about it: first of all, you absolutely need to exercise. If you are not exercising at least twice a week (ideally, more than that), you are taking significant risks (not just from falls, but from a variety of health problems as well). Both cardio and weight-bearing exercise are important, and you really should be doing both. As people age, they tend to decline in both bone density and muscle mass (with injury rates from falls skyrocketing), so exercise becomes an important way to compensate. You should also probably be taking vitamin D3 supplements if you are over 65. This meta-analysis of eight randomized controlled trials [17] concludes that “High dose supplemental vitamin D [i.e., 700-1000 IU per day] reduced fall risk by 19%” but “falls were not notably reduced by low dose supplemental vitamin D [i.e., less than 700 IU per day].” You should also be sure that the shoes you wear regularly have a good grip on the bottom. Furthermore, you should be very careful walking around when it’s wet outside, especially when it’s icy, or when you’re carrying a lot of stuff. Finally, make sure that in your own home, there is nothing that can be tripped over.

Even medical experts in the U.S. and Europe can’t seem to agree about the benefits and costs. As one fairly recent paper put it:

The American Academy of Pediatrics recently released its new Technical Report and Policy Statement on male circumcision, concluding that current evidence indicates that the health benefits of newborn male circumcision outweigh the risks. The technical report is based on the scrutiny of a large number of complex scientific articles. Therefore, while striving for objectivity, the conclusions drawn by the 8 task force members reflect what these individual physicians perceived as trustworthy evidence. Seen from the outside, cultural bias reflecting the normality of nontherapeutic male circumcision in the United States seems obvious, and the report’s conclusions are different from those reached by physicians in other parts of the Western world, including Europe, Canada, and Australia. In this commentary, a different view is presented by non–US-based physicians and representatives of general medical associations and societies for pediatrics, pediatric surgery, and pediatric urology in Northern Europe. To these authors, only 1 of the arguments put forward by the American Academy of Pediatrics has some theoretical relevance in relation to infant male circumcision; namely, the possible protection against urinary tract infections in infant boys, which can easily be treated with antibiotics without tissue loss. The other claimed health benefits, including protection against HIV/AIDS, genital herpes, genital warts, and penile cancer, are questionable, weak, and likely to have little public health relevance in a Western context, and they do not represent compelling reasons for surgery before boys are old enough to decide for themselves.

When experts disagree we’re in a bind. We have little choice but to fall back on our own thinking and research to separate bias from the truth. There are, of course, many people who circumcise their children for religious reasons. For those who have no religious reason, is there any reason to do it?

It seems to me  that we can  formulate a pretty strong argument about circumcision, before we even start to dig into the evidence:  circumcision should only be performed routinely on all male infants if we can identify strong benefits to the child from doing so. That is, without a strong reason to perform the procedure, we should not do it. I conclude this for three reasons:

1. Some of the costs of circumcision are obvious to everyone and very real (e.g. the monetary cost to parents and insurance companies, the pain inflicted on the baby, and the very occasional surgical error, maiming and death). Performing the procedure only makes sense if there are compelling positives that outweigh these well-known costs.
2. The foreskin is a natural part of the human body, and therefore very likely promotes a useful survival or mating purpose. There have been different proposals for what this purpose might be (like keeping in moisture, protecting the penis, or increased sexual pleasure). But one can reasonably assume that foreskin is not merely a fluke, and therefore may well have some use we care about, even if we don’t know quite what that use is.  Because of this, it seems we should not remove the foreskin unless there is a pretty useful reason to do so.
3. Since adults can elect to get circumcised, we should be careful about forcing children to get this procedure at ages where they are too young to make such a choice. If a strong general reason to circumcise children is not found, it would make sense to let each person choose whether they want that procedure when they are old enough to make such a choice.

This line of reasoning leads us to ask: is there compelling evidence that circumcision adds significant value in the form of increased health, improved sexual function, or reduced disease transmission?

Well, you can take a look at the claims and evidence yourself. Here is a table I compiled of the many, many alleged pros and alleged cons of circumcision that I’ve heard made by people on the different sides of the debate. For each claim, I try to link to some studies that support or deny that claim. I focus on meta-analyses of randomized controlled trials, and randomized controlled trials themselves, since they provide far stronger evidence than other study designs. This does not provide a comprehensive set of all studies on male circumcision of course, nor is it a formal systematic review of the literature. But some conclusions quickly emerge:

• Some of the alleged pros and cons that people throw around have randomized controlled trials contradicting them, but continue to be used to support agendas anyway.
• A number of studies are themselves contradicted by other studies (for instance, various results about the impact of circumcision on sexual pleasure seem to point in opposite directions).
• Circumcision does seem to substantially reduce the rates of transmission of HIV from women to men in countries where HIV prevalence is very high.
• Even so, it’s not obvious that this HIV reduction effect is worth it for those who practice safe sex in areas of the world where HIV prevalence is low.
• There is some (small) amount of evidence that hints that male circumcision may make woman more at risk for HIV, but without more studies it’s hard to say.
• Many of the studies used to support claims on both sides are of low quality (for instance, a lot of the evidence of reduced urinary tract infections for circumcised infants is based on observational studies, which are very bad for answering this sort of question…we need randomized controlled trials).
• This topic is extremely complicated! There are tons of different claims being made and there are inconsistent research results for some of the claims. In many cases, few studies have ever been done in the first place, and even fewer high quality studies have been done (though keep in mind that this table is not anywhere close to a complete listing of all circumcision studies).

Click here for the complete table with studies that support and deny each claim.