Exacerbations and intent-to-treat analyses in randomised trials.

In 1998 during a flight from Athens (Greece) to San Francisco (CA, USA), A.M. Hanson, an asthmatic doctor aged 52 yrs, died due to an asthmatic reaction to second-hand cigarette smoke. In 2004, the US Supreme Court ruled that Olympic Airways was to pay the widow of A.M. Hanson US$1.4 million. This successful lawsuit by a passenger against an airline over smoking was unprecedented, and smoking on aeroplanes has become rare since the tragic incident occurred [1, 2]. A similar sudden death occurred in 1999, when Monica C., a 35-yr-old asthmatic, died from an acute asthma attack while working in the Paribas Bank in Milan (Italy). Asthma death was confirmed at autopsy. Monica C. had been hired by the bank under a programme providing tax incentives to employers who hire staff with physical handicaps, in this case severe asthma. She had complained for several months about the deleterious effects of second-hand cigarette smoke in her workplace and had requested several times to be moved to a smokefree office. In 2006, after a long and inconclusive lawsuit, in which the present authors were the plaintiff’s expert witnesses, the bank offered a monetary settlement to the victim’s family (husband and son), who accepted the settlement and suspended any legal action [3].