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As the public health community mourns the loss of a great scientist and colleague, The Pump Handle would like to share some of what has been written about Kate Mahaffey.  Please leave your own remembrances in the comments section below.

“I have known Kathryn as a colleague for more than a decade, but most recently have been impressed with her steadfast scientific integrity while at the U.S. Environmental Protection Agency.  She always managed to honestly communicate scientific findings that while unpopular with some, were critically important to protecting public health.   …Kathryn is a role model for the next generation of environmental public health practitioners.   [The skills she developed were] often learned through ‘trial by fire’ and Kathryn has certainly experienced that, but has always maintained her scientific integrity grounded in the best science available.”  Henry A. Anderson, MD, chief medical officer, state environmental and occupational disease epidemiologist, Wisconsin Division of Public Health.

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by revere, cross-posted from Effect Measure

My sciblings at Scienceblogs have done a pretty thorough fisking of the Andrew Wakefield affair.To recap breifly, a paper by Wakefield and others in The Lancet in 1998 raised an alarm that the widely used measles-mumps-rubella (MMR) vaccine was the cause of some cases of childhood autism and a chronic inflammatory bowel disease. The incriminated agent was alleged to be measles virus contained in the vaccine (MMR has never contained mercury preservative). The impact was dramatic and this issue became a powerful engine propelling the anti-vaccine movement. The result has been a real public health crisis as falling vaccination rates in the UK and elsewhere have allowed measles and mumps to make a comeback after being almost eradicated. While all three of these diseases are usually relatively mild childhood maladies, some case are serious or even fatal. They are also totally preventable.

So over the weekend when an investigative report by The Times in London was published that seemed to show fairly conclusively Wakefield had doctored the data to have in come out the way he wanted, it was a big deal. This explains why no one has been able to replicate his findings: in fact there was no demonstrable relationship between the autism seen in his 12 child case series and the vaccination itself. Since others here at Scienceblogs have covered this extensively I want to discuss another aspect of it, the role (or lack of it) of the respected medical journal, The Lancet, in publishing what is apparently bogus if not fraudulent research. Before I do so, you need to know the nature of the doctored evidence.

The Times has published a fairly extensive catalog of each case but I will only present two here, so you can get the idea of what was involved:

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What do the Alaska Community Action on Toxics, the Migrant Clinicians Network, Center on Race, Poverty & the Environment, and 65 other organizations have in common?  They’ve all endorsed the “Protecting Workers on the Job Agenda”, a collaborative product of the American Public Health Association’s Occupational Health and Safety Section and the National Council for Occupational Safety and Health.  The platform, released just in time for Labor Secretary-Designee Hilda Solis’ confirmation hearing on Friday, outlines seven goals for improving our nation’s programs for preventing work-related illnesses, disabilities and death, and ensuring that workers who have been harmed on the job are cared for justly.  In a letter transmitting the platform to Ms. Solis, the groups wrote:

Safeguarding fundamental rights to fair wages, healthy and safe working conditions, freedom to form a union, and protection from retaliation for exercising these rights are crucial responsibilities of the Labor Department.  In difficult economic times, such as those faced now by workers, defending these rights is even more important.  We are confident you will work diligently to restore the Labor Department’s dedication to workers, ensuring that federal labor laws are enforced vigorously and are enhanced appropriately to meet the conditions faced by workers today. 

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by revere, cross-posted at Effect Measure

Like a lot of other research scientists supported by NIH I got an email yesterday from NIH Director Elias Zerhouni announcing his intention to leave his position “to devote much of my attention to writing.” At least it wasn’t the hackneyed “to spend more time with my family.” While Zerhouni won’t actually leave until the end of next month, the federal health research establishment is essentially leaderless, awaiting the next administration. The main public health institute within the NIH system, the National Institute for Environmental Health Sciences (NIEHS) has been under “Acting” (although quite capable) for many months after its previous Director resigned under fire (see here, here, here, here and here). That scandal reached all the way to Director Zerhouni’s office, although Zerhouni himself left no fingerprints. In any event, his departure is not a surprise. It was widely predicted he would resign over the summer in time to take an academic job. His plans to “devote time to writing” and the timing of the announcement after the start of the academic year suggest he wasn’t able to secure a top level academic position.

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A quick look at “Chernobyl: Relationship between Number of Missing Newborn Boys and the Level of Radiation in the Czech Regions” by Miroslav Peterka, Renata Peterková, and Zbyneˇk Likovsky´ in Environmental Health Perspectives.

As a rule, more boys than girls are born. But in November 1986 in the eastern regions of the Czech Republic, the reverse was true – more girls than boys. It appears that radiation exposure released by the Chernobyl nuclear accident in April 1986, brought to earth by rain over the area, increased radiation exposure. Fetuses that were approximately three months old at the time appear to have been effected, resulting in a reduction of newborn boys six months later.

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A quick look at two papers and an editorial on the effects on lung function of exposure to levels of air pollution below current EPA standards, published in this week’s New England Journal of Medicine.

Epidemiologic studies of the health effects of air pollution keep improving, with scientists designing studies able to measure small but important effects of relatively low levels of exposure. There are implications for policy: our pollution current standards are not sufficiently protective, especially for individuals who already have lung disease or are otherwise more sensitive or susceptible to environmental exposures.

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A quick look at “Predictors of Psychostimulant Use by Long-Distance Truck Drivers” by Ann Williamson in the American Journal of Epidemiology.

An Australian study finds that paying truck drivers by the job (instead of by the hour or week) leads to increased driver use of amphetamines and other stimulants, which is associated with increased risk for highway crashes.

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A quick look at Blood Lead Concentrations Less than 10 Micrograms per Deciliter and Child Intelligence at 6 Years of Age by Todd A. Jusko, Charles R. Henderson, Jr., Bruce P. Lanphear et al., published online in Environmental Health Perspectives.

The current CDC definition of elevated blood lead in a child is 10 micrograms of lead per deciliter of blood (written as 10 μg/dL). However, there is increasingly compelling evidence that lower blood lead levels are associated with decreased performance on intelligence testing. At the same time, it has just been reported that the EPA has just rejected the advice of scientific staff and an advisory committee to strengthen its environmental lead exposure standard, because of the deleterious effects of low level lead exposure. The study is still more evidence that lead remains a threat to children, even at levels previously thought to be safe, and that a stronger standard is needed.
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As we approach the Bush Administration’s final year, the gap between science and policy grows wider each day. Advances in science that could be used for the public good are rarely incorporated into public policy; some federal agencies seem almost unaware that the scientific literature exists and new studies are being published all the time.

A new wind is coming, though. The noteworthy failures of the FDA, EPA, OSHA, MSHA , CPSC, and other federal agencies that we’ve been chronicling here at the Pump Handle have led to increased demands for a government that uses science to protect the public.

To contribute to this effort, we are starting a new feature, Journal Scan, to report on articles in the scientific literature that inform, or should inform, public policy aimed at protecting our health and environment. In a few short paragraphs, we will try to summarize important scientific papers in non-technical language and discuss their policy implications.

We hope you, our readers, will contribute to this occasional feature. Please add not just your comments but send us full entries, as you see scientific papers which need to be part of the policy discourse.


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