Friday, March 29, 2013

The cancer clusters that weren’t

A recent post in ACSH Dispatch examines an interesting question: How likely is it that some U.S. communities have elevated cancer rates, a.k.a, “cancer clusters,” because of chemical pollution? The answer: not very.

ACSH points to an enlightening article published in Slate by George Johnson, who notes:

    "Time after time, the clusters have turned out to be statistical illusions—artifacts of chance. … The Erin Brockovich incident, one of the most famous, is among the many that have been debunked. Hexavalent chromium in the water supply of a small California town was blamed for causing cancer, resulting in a $333 million legal settlement and a movie starring Julia Roberts. But an epidemiological study ultimately showed that the cancer rate was no greater than that of the general population. The rate was actually slightly less."

Erin Brockovich, the loud-mouthed extrovert who got it totally wrong  -- at huge expense to others

Johnson also discusses the alleged cancer cluster in Toms River, N.J., which is the subject of a new book: Toms River: A Story of Science and Salvation, by Dan Fagin. But contrary to Fagin’s book, Johnson concludes: “… no matter how hard I squinted at the numbers, I found it hard to be convinced that there had been a cancer problem in Toms River.”

It is true that chemicals cause cancers where people are exposed for long periods of time to very high levels. For example, populations in Taiwan whose drinking water was contaminated with extremely high levels of arsenic for many decades experienced elevated rates of skin cancer. Is that a cluster? Surely it is. Does it convey information about the risks to populations exposed to much lower concentrations? Not particularly.

Yet activists focus on relatively low-level exposures to generate headlines and push regulations, and trial lawyers bring cases to extort large settlements because no one can prove their claims wrong — or right. Ironically, there’s evidence that low-level and long-term exposures to chemicals may have benefits, an effect that scientists refer to as hormesis.

Hollywood has sensationalized “cancer cluster” allegations, producing two major motion pictures – A Civil Action and Erin Brockovich – on the alleged effects of chemicals on various communities. In both cases, tort lawyers claimed that drinking water contaminated by industrial facilities caused cancers in nearby areas. Despite the ability of trial lawyers to win such cases, it is nearly impossible to pin down the causes of such clusters. In 1990, the Centers for Disease Control and Prevention reported on 22 years of studies that covered clusters in 29 states and five foreign countries. They could not establish a clear cause for any cluster.

Part of the problem is that clusters occur by mere chance. Raymond R. Neutra of the California Department of Health Services finds that we can expect nearly 5,000 such random cancer clusters to exist in any given decade in the United States (Scientific American 275, no. 3 (1996): 85–86.).

The risks of cancer clusters resulting from low-level exposures to chemicals in the environment are simply too low to detect. But allegations about such clusters are good fodder for trial lawyers looking to make a buck, and they serve the agenda of activists who want to pass regulations on chemicals.


When The Nanny State Kills

The government told people to switch from saturated animal fats to unsaturated vegetable fats. But that advice may have killed a lot of people. As David Oliver notes, a recent study “in the British Medical Journal” shows that ”those who heeded the advice” from public-health officials “to switch from saturated fats to polyunsaturated vegetable oils dramatically reduced their odds of living to see 2013,” incurring up to a “60% increase in risk of death by switching from animal fats to vegetable oils.” This possibly deadly medical advice has a long history:

Fifty years ago the medical community did an about-face . . . and instead went all in on polyunsaturated fats. It reasoned that since (a) cholesterol is associated with cardiovascular disease and (b) polyunsaturated fats reduce serum cholesterol levels, it inescapably followed that (c) changing people’s diet from saturated fats to polyunsaturated fats would save a lot of lives. In 1984 Uncle Sam got involved – Time magazine reported on it in “Hold the Eggs and Butter” – and he made a big push for citizens to swap out animal fat in their diet for the vegetable variety and a great experiment on the American people was begun.

As Oliver, an expert on mass torts, points out, it is hard to ”think of any mass tort, or combination of mass torts, that has produced as much harm as the advice to change to a plant oil-based diet” may have done.

Some federal food-safety regulations have also harmed public health, such as the “poke and sniff” inspection method “that likely resulted in USDA inspectors transmitting filth from diseased meat to fresh meat on a daily basis.” The Obama administration has foolishly discouraged potato consumption, even though potatoes are highly nutritious, even as it has subsidized certain sugary and fatty foods, and promoted bad advice about salt.

Governments are killing smokers by banning safer alternatives to cigarettes. The Economist notes that Brazil and Singapore ban e-cigarettes, even though they could save countless lives, since they do not emit the smoke that makes cigarettes lethal. As it points out, “E-cigarettes do not just save the lives of smokers: they bring other benefits too. Unlike cigarettes, they do not damage the health of bystanders. They do not even smell that bad, so there is no public nuisance, let alone hazard, and thus no reason to ban their use in public places.” Countries like Austria and New Zealand restrict their sale, deeming them to be regulated “medical devices.” The Economist laments, “Instead of embracing e-cigarettes, many health lobbyists are determined to stub them out. . . .these objections seem to be driven by puritanism, not by reason. Some health lobbyists are so determined to prevent people doing anything that remotely resembles smoking—a process referred to as ‘denormalisation’—that they refuse to endorse a product that reproduces the pleasure of smoking without the harm.”

Cyprus may be in chaos, threatening another financial crisis in the European Union (EU), but as CEI’s Iain Murray notes, the good old EU knows where its priorities lie — in an effort to ban e-cigarettes. As The Commentator reports:

“On December 19th 2012, the EU produced a proposal for new laws controlling tobacco and e-cigarettes. Under the new proposals, packets of both will likely have to be brazenly branded with warning signs and unsightly images. Fine if you believe this deters people from smoking (which there is scant evidence for), not so fine if you believe that smokers should be more free or indeed encouraged to take up something less harmful to wean themselves off cigarettes."

“The proposed EU directive will make it harder for smokers to switch, and will also ban outright the least harmful tobacco products on the market – a product known as ‘snus’. It will treat e-cigarettes as ‘medicinal products’, causing concern over impossibly high standards and regulations leading to higher manufacturing costs. This means that e-cigarettes may no longer be able to compete in a lower, or even the same price band as cigarettes, which would likely cause smokers to think twice about adopting the healthier option.”

Of course, the EU isn’t alone. The FDA has been riding this pony for years. As my colleague Hans Bader wrote in 2009:

“The FDA is now moving towards banning e-cigarettes, reports syndicated columnist Jacob Sullum. Cigarettes, which contain lots of toxins and cancer-causing agents, aren’t banned, but the FDA wants to ban e-cigarettes, which contain infinitely-smaller amounts of carcinogens, complaining that e-cigarettes contain “detectable levels of known carcinogens and toxic chemicals to which users could potentially be exposed”.

“As public-health expert, and tobacco-industry critic, Michael Siegel notes, this is terrible reasoning by the FDA, since all tobacco replacement products now on the market contain small but “detectable” amounts of known carcinogens. The FDA used to be more reluctant to block smoking alternatives that have small or imaginary risks, but that seems to be changing over the last year.

“A bill supported by the nation’s largest cigarette maker that was signed into law earlier this year by Obama will keep producers of smokeless tobacco from truthfully telling smokers about the fact that smoking is more dangerous to their health than smokeless tobacco. That will harm public health, as advocates like Bill Godshall of Smoke Free Pennsylvania have noted.”


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