Is Benzene a Teratogen?

Back when I was an associate we had a refinery client with a benzene unit and the unit generated litigation along with the benzene. Interestingly, the union knew that benzene could cause fatal blood diseases back when the unit was built in the late 1950s. The union even sent down a benzene safety poster which was framed and hung in the control room. The operators were issued cartridge respirators for aromatics and had blood samples taken for testing on a regular basis. Far from being a worry, even after the Emergency Temporary Standard for benzene came out the unit was a favorite of those union members with the seniority to bid on to it. So much so that women with the requisite seniority would have hysterectomies so they could get around the so-called fertile female policy that prevented them from working on it.

Some early, and I might add poorly done, studies had suggested that benzene might cause birth defects. Accordingly many companies adopted policies that kept women who were otherwise qualified from working with materials or in operations feared to be teratogenic. Eventually the U.S. Supreme Court struck down such policies. See: International Union, United Automobile, Aerospace & Agricultural Implement Workers of America, UAW, et al v. Johnson Controls, Inc.

Nothing ever came of the claim that benzene was a teratogen and even in southeast Texas where injury and illness would otherwise not exist but for deep pocketed corporations we never had any benzene birth defect claims.

Now however there's a new study in Environmental Health Perspectives that compares EPA estimates of benzene exposures in Texas and the rates of spina bifida among people living in those areas during a recent five year period. It found for the area with the highest exposure a 2.3-fold increase in spina bifida; an association which was statistically significant.
Read all about it (free) in "Maternal Exposure to Ambient Levels of Benzene and Neural Tube Defects Among Offspring, Texas, 1999 - 2004"

Hat tip: The Houston Chronicle

"What Can We Get Away With?"

That's not the kind of question about the current state of medical science that you'd expect to hear from someone charged with understanding and promoting public health. On the other hand, if the point is to demonize food, in this case a drink with sucrose (glucose + fructose),  it makes perfect sense.

The NYTimes has gotten a look at the e-mail exchanges between New York's anti-soda crusading health commissioner and his subordinates and published some of them in "E-Mail Reveals Dispute Over City's Antisoda Ad". The email conversation reveals a determined effort to ignore, dispute and ultimately fudge the science in order to come up with an ad campaign that the commissioner hoped would "go viral". The meme he sought to develop was an equivalence between soft drinks and gooey disgusting fat. The ad is propaganda in its purest and, considering it's governmental origin, most disturbing form.

The demonization of sugar is a head scratcher. Your brain burns glucose and during periods of real starvation your body will start to cannibalize itself so that the brain can have that with which it cannot do without - sugar in the form of glucose. On a typical day of normal brain functioning the brain alone burns as much sugar as is found in three cans of sugary sodas.

Too much of a good thing is never good for you but those people who've joined the anti-sugar crusade and who are pledging to lead "sugar-free lifestyles" are either brain dead or are soon about to be.

Texas Supreme Court Declares a Provision of House Bill 4 Unconstitutional

Last week in Robinson v. Crown Cork & Seal the Texas Supreme Court provided an in depth analysis of the constitutionality of retroactive laws and held that the “innocent successor” limit on liability for asbestos-related personal-injury claims included in House Bill 4 is an unconstitutional retroactive law. The Supreme Court concluded that Texas Civil Practice & Remedies Code Chapter 149, which the Legislature enacted as part of the 2003 tort reforms “significantly impacts a substantial interest” that Robinson had in a “well-recognized common law cause of action” for asbestos claims.

The Court also concluded that “the public interest served by Chapter 149 is slight,” rejecting the 14th Court of Appeals' holding that the purpose for which the statute was enacted is a valid exercise of the Legislature’s police power. In the opinion the Court compares this case to other analogous opinions which established that the constitutional prohibition against retroactive laws “protects settled expectations that rules are to govern the play and not simply the score, and prevents the abuses of legislative power that arise when individuals or groups are singled out for special reward or punishment.” The Supreme Court cited three factors to be considered in determining whether a statute violates the Texas Constitution’s prohibition against retroactive laws: 1) the nature and strength of the public interest the statute serves as evidenced by the Legislature’s factual findings; 2) the nature of the prior right that the statute impairs; and 3) the extent of the impairment of that right.

In a dissenting opinion Justice Wainwright wrote, “The Court’s new balancing test reaches the wrong result” and ignores an important principle. Justice Wainwright goes on to state that “[t]he constitutional retroactivity doctrine does not protect an asserted entitlement to property one does not own, and until a final judgment in the case, we do not know whether a claim will be vindicated or refuted.”

Tags: ,

High Priestess of Climate Change Questions IPCC Inerrancy; Declared Apostate

Industry and military scientists get rewarded when they come up with things that work. Academic scientists tend to get rewarded when they come up with narratives that generate more grant money. Ok, nothing new there. But what happens when an academic scientist suggests that a prevailing academic paradigm be subjected to the same criterion of falsifiability as any other claim to knowledge? Hilarity ensues, though only for those on the outside looking in at the absurdity of simultaneously dismissive and panicky academic internecine warfare.

Though she does not question the idea that man influences climate and may well do so harmfully, Judith Curry, from one of those few remaining institutions (e.g. the Ramblin' Wreck of Georgia Tech) that yet dare to question societal dogma has gathered the courage to question the prevailing groupthink of the Intergovernmental Panel on Climate Change (IPCC) and for her trouble has garnered the enmity of the Global Warming clergy and its laity.

Read all about it (free) at Scientific American in "Climate Heretic: Judith Curry Turns on Her Colleagues. Why Can't We Have a Civil Conversation About Climate?"

Q. How Long Has Your Union Been Discussing the Asbestos Problem? A. Since 1966.

Talk about old school!  Here's part of the transcript from the case that started it all, Borel v. Fibreboard.  Ward Stephenson doing the direct; George Weller and John Tucker taking cross examination.

Risk Assessment From In Vitro Testing: Staggeringly Complex or Just Impossible?

In vitro testing has been proposed as a way to clear out the backlog of toxicity testing on thousands of chemicals currently in use. It's quicker and cheaper and lab animals needn't be "sacrificed". The plan is to use the results to estimate the dose response curve in humans so that regulatory agencies can regulate accordingly. Too bad it won't be that easy.

In this month's Environmental Health Perspectives, Kenny Crump et al discuss the daunting task of using data from in vitro testing to set reasonably safe exposure limits. See (free): "The Future Use of In Vitro Data in Risk Assessment to Set Human Exposure Standards".

The problem of course is that it's not a matter of exposing some cells in a petri dish to the chemical of interesting and watching what happens. There are multiple pathways and multiple feedback mechanisms involving multiple types of cells that define the pathways to toxicity, not to mention any that work to offset and fix the ill effects. How many might there be and in how many ways might they interact? A model of how E. coli protects against heat shock "consists of a set of 31 differential-algebraic equations with 27 kinetic parameters, data for many of which are not yet available." Just finding these pathways will be a huge undertaking and billions of dollars in funding are being sought over the next decade to find and elucidate them.

Nevertheless, the authors conclude: "Use of in vitro data in risk assessment has great promise toward allowing chemicals to be tested more quickly and cheaply and for reducing or eliminating the need for subjecting animals to toxic insults. It is our hope that the bar for accepting approaches based on in vitro data will not be set too high. In view of the numerous serious limitations of current approaches, results from these methods based on whole-animal data should not be held up as gold standards. This point is particularly important considering that almost all whole-animal data are obtained from high doses that may operate through different sets of [toxicity pathways] than do low doses."

That last sentence is the key. We're entering a whole new world of toxic torts. One in which many heretofore innocuous chemicals will be claimed to be toxic at very low doses.

People Really Hate to be (Thought to be) Wrong

One of my pet theories is that people would desperately rather be considered right in their pronouncements (though actually wrong) than actually right (though considered wrong). It's all to do with signaling, I think, but more on that another day. If indeed people prefer being thought right to being in fact right, all other things being equal, what response would you expect when their beliefs are shaken? You'd expect them to dig in. And so they do.

In fact, shaking their world view typically turns them into advocate warriors for those very beliefs. So be mindful when approaching your jurors' beliefs head on. Best to find another approach that fits within their world views than unleash martyrs to their own causes on the rest of your jurors. See: "When In Doubt, Shout - Why Shaking Someone's Belief's Turns Them Into Stronger Advocates".

Tags:

Biases, Fear and Thyroid Cancer

In the NYTimes' "Consults" today an endocrinologist answers questions about whether thyroid cancer has to do with toxins or genes. The first question from "Toxins, Genes and Thyroid Cancer" inquires as to whether a cancer "cluster" in an office could be due to environmental (i.e. man-made) toxins. The endocrinologist correctly responds that the incidence of thyroid cancer has increased dramatically over the last two decades. He goes on though to hedge that "no specific chemical or environmental factor has been demonstrated to commonly cause thyroid cancer in humans." With regard to whether the illness is hereditary he takes a firmer position stating that most forms of the cancer are not considered to be so. Only three wrote in to comment. They wondered whether too much iodine, "hundreds of chemicals in our bloodstream" or flame retardants and the linings of cat food tins might be to blame.

If you defend toxic tort litigation or have ever tried to explain the sudden rise and then plateau in rates of breast or prostate cancer you know it's time to pause and beat your head on the desk for a bit.

Feel better? Now for something to fit with the other puzzle pieces. Read: "Increasing World Incidence of Thyroid Cancer: Increased Detection or Higher Radiation Exposure?" As the authors make clear, improved detection and screening may well be, but has not quite yet been confirmed to be, the answer. In any event the evidence for better detection is a whole lot stronger than for cat food tins and copy machines.

Listeria Monocytogenes Outbreak Traced to Celery; Or Was It?

 

The Texas Department of State Health Services (DSHS) has shut down a San Antonio packager of produce for restaurants and schools following its determination that a L. monocytogenes outbreak thought to have been responsible for five deaths of immune compromised individuals originated at its facility. The company targeted for the shutdown is disputing the claim saying that its testing showed no L. monocytogenes and questioning whether the samples taken from which the bacterium was cultured were contaminated thanks to shoddy procedures by DSHS personnel. Read about it in "San Antonio Produce Plant Closed by Health Agency" in the Houston Chronicle. The DSHS news release can be found at "DSHS Orders SanGar Produce to Close, Recall Products".

L. monocytogenes contamination of ready-to-eat foods is a world-wide problem. See: "Occurrence of Listeria Monocytogenes in Ready-To-Eat Foods From Supermarkets in Southern Italy". For a recent discussion of molecular markers for detection and attribution and biomarkers for surveillance and epidemiological investigations see: "Future Challenges to Microbial Food Safety".

Beryllium Exposure Associated With Several Types of Cancer

A follow-up of workers at beryllium processing plants showed significant associations with lung cancer, cancers of the nervous system, urinary tract cancers and chronic obstructive pulmonary disease. Most diseases of interest showed a dose-response relationship and peak dose relationship. See: "Cohort Mortality Study of Workers at Seven Beryllium Processing Plants: Update and Associations With Cumulative and Maximum Exposure".

Don't Point Your Guns at Your Children

For whatever reason CNBC has decided to dredge up an old controversy; one over the safety of the Remington Model 700.

Back in the day we worked on these cases and as a baby lawyer I got a lesson from one of the partners to whom I reported. He'd been an officer in the Army and recounted the tale of how the U.S. Army had instilled in him the good habit of never pointing a weapon at anyone he didn't intend to shoot. It came in handy.

He was going to be away from his wife for the first time in their marriage and she, with two young children, was afraid. So, he showed her how to use his Colt .45. Sitting in their bedroom he demonstrated how it worked just as he had to his men. After dropping out the clip he pointed it towards the ceiling saying "whatever you do, don't point it at anything you don't mean to kill. Everything else can fail but if you're pointing it away from everyone you'll be ok." Having forgotten he'd chambered a round he then put a .45 hole through the roof of his house.

The Model 700 has been extremely popular for decades. Nevertheless, the fact that it's not surprising that pick-up trucks have been in more accidents than Bugatti's seems to have been lost on the reporters in "Remington Under Fire: A CNBC Investigation".

Tags:

Benzene Against Leukemia

Benzene was once used to treat leukemia. See: "Benzene Treatment of Leukemia" for the discussion and a good review of what was known about the hazards of benzene by 1915.

A Placebo a Day Keeps the Doctor Away

Do you comply with your doctor's orders? If you're on a daily medication do you always take it, every day, at the same time, with say the recommended glass of water? If you do, even if there's no medicine in the pill, your odds of living a long and healthy life are good and getting better and it's because you've made yourself the beneficiary of the compliance effect.

I was reminded of a recent study of the so-called compliance effect while reading "Secrets of the Centenarians" in today's NYTimes. In the Times piece the author examines the long life and sharp mind of Mrs Esther Tuttle and her particularly keen insight into the source of good health. She says:"If you respect what the doctors tell you to do, you can live a long life, but you have to do it. You can't ignore the advice."

Though currently inexplicable it turns out that people who follow their doctor's orders, even if it's just to take a sugar pill a day (they don't know it's a sugar pill, of course), do better than those who take a less disciplined approach to their health. The article of which I was reminded is: "The Relationship Between Bisphosphonate Adherence and Fracture: Is it the Behavior or the Medication? Results From the Placebo Arm of the Fracture Intervention Trial". In it the authors report the results of a study of the outcomes of those women on placebo in a drug trial for a drug designed to prevent bone loss (osteoporosis). Even though they didn't get any real medicine and even though they were on the same sugar pill as the women who didn't strictly adhere to their doctor's orders regarding the drug, those women who took their sugar pill religiously had significantly lower bone loss and fewer hip fractures.

This and other recent research on the compliance effect confirm what Mrs Tuttle somehow figured out: resolve (along with resourcefulness, resilience and a refusal to succumb to cynicism) somehow, some way, keeps you alive and keeps you healthy.

Why So Much Peer Reviewed Science Is So Wrong

Ever since Daubert , lawyers have been fending off motions to exclude by proclaiming that the scientific studies on which their experts relied were peer reviewed and thus unassailable. Sadly, judges tend to think that a peer reviewed paper must indeed be some incremental addition to the field's body of knowledge. But are the claims in a paper that's been peer reviewed guaranteed to be true? No. But surely they're at least likely to be true, right? No. In fact, the conclusions reported in most peer reviewed scientific literature are wrong. Even those papers published in the journals with the highest impact factors are either wrong or have never even been tested an alarming percentage of the time.

Peer review is not some sort of certification of a high truth value for someone's research. Peer review exists to make sure no paper gets published whose author had gone about measuring temperature with a yardstick.

Science these days isn't what it was 100 or even 25 years ago. Seldom is what's found in prominent journals simply the reporting of observations (e.g. mesothelioma in a 2 year old girl) or the results of laboratory experiments (e.g. drinking an petri dish of H. pylori and developing peptic ulcer). In recent decades "science" has come to mean in many, many cases the sifting and re-sifting of data until some result so unlikely to have been due to chance alone appears. That result is then deemed knowledge.

But how unlikely, how very rare, must the result have been before it's crowned "Truth"? As unlikely, as rare, as being dealt two pair in a 5 card poker hand.

If you've ever played poker and bet the house on such a hand you're probably homeless. On the other hand, if you've made a living peddling liability theories resting on such odds down at the courthouse you're likely to have several homes.

Anyway, if you want to read about how science went so wrong and why, you can't do better than "Lies, Damned Lies, and Medical Science" just published in The Atlantic. It's the best and most important article you'll read this year about the current state of medical science.

Toxoplasma gondii: Sheep and Goats Have a Vaccine Against It. Why Don't We?

It''s becoming apparent that Toxoplasma gondii is responsible for an awful lot of human suffering around the world. The parasitic organism causes birth defects and spontaneous abortions, neurolgical impairment, eye damage and is increasingly suspected in Alzheimer's, schizophrenia and Parkinson's.

T. gondii infects human cells and reproduces within them eventually setting up shop in cysts throughout the central nervous system, heart, muscle, bone marrow and other organs. Persons infected are infected for life. Human infection is most commonly the result of consuming un-/under-cooked cyst-bearing meat though contact with the feces of animals, especially cats, T. gondii's ultimate host, are another avenue of exposure.

While 11% of Americans are infected with the parasite, that figure rises to as high as 70% in some South American countries. The European Food Safety Authority, worried that foodborne infection by T. gondii is on the rise and is responsible for significant yet underreported and undetected diseases within the EU, has recommended Toxoplasma monitoring of lifestock. Recent estimates of the impact of T. gondii-induced disease reveal it to be "one of the most significant causes of foodborne disease worldwide."

The good news is that thanks to demand from sheep and goat producers there's a vaccine that works well in sheep and goats. The problem is that it's a live cell preparation like the Sabin vaccine discussed during oral argument in Bruesewitz, et al v. Wyeth, Inc.,So what's the problem? The problem is that while it works really well, much better than bits of a dead organism, it's more likely to cause adverse effects. Meanwhile, finding all the bits of a dead organism that prime the immune system while weeding out those that might produce harm is a terribly complicated and expensive process. Add to that the threat posed by litigation over the inevitable errors in science's slow but steady progress through trial and error and it ought not be surprising that sheep and goats get protected while human suffering due to T. gondii spreads.

For a new, free and enlightening paper on the topic see "Vaccination Against Toxoplasma gondii: An Increasing Priority for Collaborative Research?"

Really? The Maker of the Sabin Polio Vaccine Should Have Been Subjected to Ruinous Liability?

Bruesewitz, et al v. Wyeth, Inc., et al just had to be bloggable but at first glance the debate appeared to rest largely on the interpretation of a typically modern law in which Congress had produced (probably intentionally) an incoherent mess. Digging further into oral argument, the government's claim that the CDC regularly updates its advice on the best and most efficacious vaccines in its Morbidity and Mortality Weekly Report (MMWR) looked promising until I read a few issues. Perhaps the kindest thing that can be said is that the government significantly overstated its case. Yet finally, around page 55, I found something worth blogging about.

The question put to plaintiffs' appellate counsel was as follows: "Under your understanding of [the vaccine compensation] scheme, if a person suffered a very serious injury as a result of the Sabin vaccine during the period when the CDC recommended that over the Salk vaccine, would that injured person have a claim for desing defect if the person could produce experts who said the CDC was wrong ...?" "...but your answer to my question is that [under your interpretation] that would permit a lay jury relying on experts produced in court, [to find that] the CDC got this wrong; [that] the Salk vaccine was really the better one." To which plaintiffs' counsel responded "Yes, yes, that would be a viable design defect claim."

Wow. You should read up on the Sabin and Salk vaccines and why the OPV was recommended despite the attendant risks. Would the world really have been a better place with thousands more children in iron lungs? Would Congress really want the maker of a vaccine against a modern scourge like HPV subjected to jackpot justice so that other vaccine makers abandon the promising field of anti-cancer vaccines? Would the people?

I'm just glad I grew up in an age when common sense trumped hysteria so that I could get my sugar cube.

 

Tags:

Getting the Causation Cart Before the Benzene Horse

Let's assume you're trying to prove that benzene causes a host of cancers of the hematopoietic system - essentially all lymphohematopoietic neoplasms. Wouldn't it be clever to argue that the best studies are those that confirm your bias; i.e. that benzene just has to cause acute nonlymphocytic leukemia (ANLL, AML, etc.)? Better yet, wouldn't it be really clever to enforce plaintiffs counsels' demand that, thanks to a little ex post reassessment, studies including subjects prospectively assessed to have been exposed but after the fact, in an instance or two, found to have spent more time in an office, be marginalized or excluded outright? Finally, wouldn't it be brilliant to assume that those with an increased risk of AML just had to have had higher exposures thereby bringing all their similarly situated brethren into the study along with them?

Well, when you don't do experiments but merely look at the literature and run statistical tools over the top of those papers you cherry pick until the stars align (i.e. show that benzene causes everything hematopoietic) it ought not be a surprise that you wind up verifying your preconceptions. And such was the case with "Occupational Benzene Exposure and the Risk of Lymphoma Subtypes: a Meta-Analysis of Cohort Studies Incorporating Three Study Quality Dimensions".

If benzene was indeed some sort of universal blood carcinogen you'd think the statistical evidence wouldn't need to be so tortured before yielding.

Some Very Old Articles About Asbestosis

From 1924: "Fibrosis of the Lungs Due to the Inhalation of Asbestos Dust"; from 1928: "A Case of Pneumoconiosis: Result of the Inhalation of Asbestos Dust". ; from 1929 "Asbestos Dust and the Curious Bodies Found in Pulmonary Asbestosis"; also from 1929: "Clinical Aspects of Pulmonary Asbestosis";  and from 1931: "Recent Views on Pneumonoconioses".These short but well written papers, now free online, detail a story that you've probably only seen or heard in executive summary form.

It's been years since I've seen a case of disabling asbestosis in a plaintiff. The malignancy cases are pretty much all that's left of asbestos litigation and the most difficult ones are those involving mesothelioma. Here's a 47 year old publication on asbestos and mesothelioma: "Exposure to Asbestos Dust and Diffuse Pleural Mesotheliomas". Appearing as it did, after a commentary about birth defects and thalidomide, it's easier to understand how that era precipitated the decades of deep suspicion of all things man-made that followed.

That said, did your eyes wander such that you read the suspicion of the wayward mutton bone? If so, here's an even older paper that may shed some light on the new era (or older era, whichever) that we're entering and a 57 year old paper that may point the way forward.

Schools: Highly Effective Virus Transmission Sites

Two weeks after kids go back to school, doctor visits for flu-like symptoms spiked in 2009. Why? It looks like schools catalyzed "community-wide transmission" of H1H1 pandemic influenza. See "School Opening Dates Predict Pandemic Influenza A(H1N1) Outbreaks in the United States". The authors suggest vaccination begin before kids return to school.

There's good news for people (like me) who hate getting vaccinated. It looks like "Needle-Free Influenza Vaccination" is on the way.

Finally, here's the CDC's picture of the week from the Public Health Information Library. It's what influenza vaccines help your immune system recognize and inhibit.

PHIL Image 10073

They're Walking, Yes Indeed, They're Talking, 'Bout You and Me

Bacteria are amazing. Each new discovery only adds to our awe. We know that bacteria talk to each other about us and now we learn that they can get up on their feet, special pili, and walk right on up catheters and other surfaces to us. There's a video of one going vertical and running off and the paper that discusses the phenomenon, "Bacteria Use Type IV Pili to Walk Upright and Detach from Surfaces" and its importance in the effort to understand biofilm formation in today's Science Magazine. Hat tip: Houston Chronicle which has a great writeup.

Citing a 16% Increase in Risk of Major Adverse Cardiovascular Events FDA Recommends Meridia Use be Discontinued

New data from the Sibutramine (Meridia) Cardiovascular Outcomes (SCOUT) trial showed little weight loss but significant increased risk of non-fatal heart attack, stroke, a cardiovascular event requiring resuscitation and cardiovascular death. The FDA suggests that those taking Meridia for weight loss stop taking it, speak to their physician about alternate treatments and contact a physician "right away" should they experience chest pain, palpitations, etc. The FDA recommends physicians stop prescribing Meridia, contact patients currently on Meridia and ask that they stop taking it, inform patients of these risks, assess patients for evidence of outcomes associated with Meridia use and to report any side effects to the FDA's MedWatch program.

Abbott Laboratories has agreed to withdraw Meridia and advises patients to discontinue the use of sibutramine and to consult their physician for alternatives. Abbott's press release contains an extensive discussion of the risks, what patients need to do and the potential side effects of which they ought to be aware. For additional information see www.sibutramine.com .

Given what's happened of late with any drug remotely associated with the treatment of Type II diabetes I'll go out on a limb and predict that companies will in the future be very wary of developing treatments for this malady or any underlying factor such as obesity.

Chronic High Noise Exposure and Coronary Heart Disease: A Strong and Consistent Association

In "Exposure to Occupational Noise and Cardiovascular Disease in the United States: the National Health and Nutrition Examination Survey 1999 - 2004"  researchers report a doubling or tripling of the risk for coronary heart disease among workers chronically exposed to high occupational noise. Meanwhile, other studies are showing that men subjected to aircraft noise from nearby airports and overflights face an increased risk of hypertension. See "Aircraft Noise and Incidence of Hypertension-Gender Specific Effects", "Exposure-Response Relationship of the Association Between Aircraft Noise and the Risk of Hypertension" and, for evidence that helicopter noise is most strongly associated with an increased risk of hypertension see "The Effects of Chronic Exposure to Aircraft Noise on the Prevalence of Hypertension".

Here are a few Power Point presentations (.pdf format) from the WHO on the topic of the health impacts of chronic noise exposure:

"Noise and Children"

"Quantifying Burden of Disease from Environmental Noise"

"Health Effects of Noise"

All Things in Moderation: Drinking While Pregnant Edition

Does the dose make the poison? In toxic tort litigation plaintiffs have long argued that at the unmeasured and unobserved low dose end of the dose-response curve risk doesn't reach zero until the dose reaches zero. To support their claim they point to regulators' linear no-threshold risk models, they try to throw the burden of proof on defendants and they conclude by saying that since defendants can't prove there's an absolutely safe level for exposure, all levels must therefore be unsafe.

This "no safe level" argument isn't confined to cancer cases and plaintiff lawyers aren't the only ones who make it. Advocacy groups for a variety of human ailments stake out similarly extreme positions. For example, March of Dimes claims that some 40,000 American children are born annually with fetal alcohol syndrome disorders (FASDs). In addition to claiming "no level of alcohol use during pregnancy has been proven safe" they cherry pick data from weak studies to assert that mothers who consume as little as one alcoholic drink per week have children with (a) small heads ("a possible indicator of brain size"); (b) a 300% increase in risk of growing up to be delinquents; (c) a variety of emotional and learning disorders; and, (d) an increased risk of becoming alcoholics and drug addicts. Finally, March of Dimes flatly states "[t]here is no cure for FASDs."

The good news is that there never has been much evidence to support these horror stories and the better news is that there's a brand new study showing that not only are the children of light drinkers at no increased risk of cognitive defects (at least through age 5), they're likely to have fewer problems, be less prone to hyperactivity disorders and have higher cognitive test scores. See "Light Drinking During Pregnancy: Still No Increased Risk for Socioemotional Difficulties or Cognitive Deficits at 5 Years of Age?"

There's no doubt that chronic binge drinking during pregnancy can do lasting harm to a woman's fetus. Similarly, there's no doubt that roasting yourself in the sun all summer and continuing to irradiate yourself in a tanning bed the rest of the year can lead to malignant melanoma. Yet extrapolating from such findings to declare that there's no safe level of exposure to sun or alcohol or whatever not merely panics parents needlessly; it may well result in the infliction of needless harm on the very people for whose benefit such advocacy is intended.

Mounting Evidence That Delaying Introduction of Certain Foods to Infants' Diets Causes Allergies

The idea that children, and especially infants, are somehow exquisitely susceptible to environmental harm such that exposures to immune system challenges should be put off until that system is "strong enough" has been around for awhile. The lack of any good science to support the claim hasn't prevented it from becoming established medical guidance; especially when it comes to allergenic foods like peanuts, wheat, cow's milk and eggs. Now there's evidence that the advice to delay by a year or more the introduction of such foods into a child's diet until after she's a year or two old is actually the cause of food allergies.

In "Can Early Introduction of Egg Prevent Egg Allergy in Infants? A Population-Based Study" 2,589 children children were tracked by risk factors (especially a sibling or family member with a food allergy), breast-feeding status, diet, timing of introduction of eggs and finally skin-prick tests to determine sensitization status. Giving babies cooked eggs early significantly reduced their risk of egg allergies irrespective of risk factors or breast-feeding status. On the other hand, delaying the introduction of eggs to the diet significantly increased the risk of egg allergies even in those without risk factors.

If there's ever an accounting of all the harm done by the scaremongers the tally is certain to be staggering. In the meantime, they've created a whole generation of eggshell plaintiffs.

2010 FETTI Conference Presentation

I was out the end of last week to attend the FETTI conference in Chicago. Here's the PowerPoint from my presentation: Food-Borne Illness And a New Day for Toxic Torts