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Soskolne CL. Exposing additional authors who suppress evidence about radiation-induced thyroid cancer in children: a Comment adding to Tsuda et al.'s response to Schüz et al. (2023). Environ Health 2023; 22:79. [PMID: 37974182 PMCID: PMC10652459 DOI: 10.1186/s12940-023-01033-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND The need to call out and expose authors for their persistence in improperly using epidemiology has been previously noted. Tsuda et al. have done well to expose Schüz et al.'s arguments/assertions in their recent publication in Environmental Heath. In this Comment, I point out that, also warranting being called out, are the arguments/assertions of Cléro et al. who, in their recent response to an article by Tsuda et al., reiterated the conclusions and recommendations derived from their European project, which were published in Environment International in 2021. Tsuda et al. had critiqued the Cléro et al. 2021 publication in their 2022 review article. However, in their response to it, Cléro et al. deflected by not addressing any of the key points that Tsuda et al. had made in their review regarding the aftermath of the Chernobyl and Fukushima nuclear accidents. In this Comment, I critique Cléro et al.'s inadequate response. Publication of this Comment will help in routing out the improper use of epidemiology in the formulation of public health policy and thereby reduce the influence of misinformation on both science and public policy. My critique of Cléro et al. is not dissimilar from Tsuda et al.'s critique of Schüz et al.: in as much as Schüz et al. should withdraw their work, so should Cléro et al.'s article be retracted. MAIN BODY The response by Cléro et al. consists of four paragraphs. First was their assertion that the purpose of the SHAMISEN project was to make recommendations based on scientific evidence and that it was not a systematic review of all related articles. I point out that the Cléro et al. recommendations were not based on objective scientific evidence, but on biased studies. In the second paragraph, Cléro et al. reaffirmed the SHAMISEN Consortium report, which claimed that the overdiagnosis observed in non-exposed adults was applicable to children because children are mirrors of adults. However, the authors of that report withheld statements about secondary examinations in Fukushima that provided evidence against overdiagnosis. In the third paragraph, Cléro et al. provided an explanation regarding their disclosure of conflicting interests, which was contrary to professional norms for transparency and thus was unacceptable. Finally, their insistence that the Tsuda et al. study was an ecological study susceptible to "the ecological fallacy" indicated their lack of epidemiological knowledge about ecological studies. Ironically, many of the papers cited by Cléro et al. regarding overdiagnosis were, in fact, ecological studies. CONCLUSION Cléro et al. and the SHAMISEN Consortium should withdraw their recommendation "not to launch a mass thyroid cancer screening after a nuclear accident, but rather to make it available (with appropriate information counselling) to those who request it." Their recommendation is based on biased evidence and would cause confusion regarding public health measures following a nuclear accident. Those authors should, in my assessment, acquaint themselves with modern epidemiology and evidence-based public health. Like Tsuda et al. recommended of Schüz et al., Cléro et al. ought also to retract their article.
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Affiliation(s)
- Colin L Soskolne
- School of Public Health, University of Alberta, Edmonton, AB, Canada.
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2
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Tsuda T, Miyano Y, Yamamoto E. Mistaken information can lead only to misguided conclusions and policies: a commentary regarding Schüz et al.'s response. Environ Health 2023; 22:62. [PMID: 37658452 PMCID: PMC10474698 DOI: 10.1186/s12940-023-01013-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 08/21/2023] [Indexed: 09/03/2023]
Abstract
BACKGROUND After reviewing selected scientific evidence, Schüz et al. made two recommendations in the 2018 International Agency for Research on Cancer (IARC) Technical Publication No. 46. Their first recommendation was against population thyroid screening after a nuclear accident, and the second was that consideration be given to offering a long-term thyroid monitoring program for higher-risk individuals (100-500 mGy or more radiation) after a nuclear accident. However, their review of the scientific evidence was inadequate and misrepresented the information from both Chernobyl and Fukushima. We wrote a review article published in Environmental Health in 2022 using the "Toolkit for detecting misused epidemiological methods." Schüz et al. critiqued our 2022 review article in 2023; their critique, based also on their 2018 IARC Technical Publication No. 46, was so fraught with problems that we developed this response. MAIN BODY Schüz et al. suggest that hundreds of thyroid cancer cases in children and adolescents, detected through population thyroid examinations using ultrasound echo and conducted since October 2011 in Fukushima, were not caused by the 2011 Fukushima Daiichi Nuclear Power Plant accident. Schüz et al. compared thyroid cancers in Fukushima directly with those in Chernobyl after April 1986 and listed up to five reasons to deny a causal relationship between radiation and thyroid cancers in Fukushima; however, those reasons we dismiss based on available evidence. No new scientific evidence was presented in their response to our commentary in which we pointed out that misinformation and biased scientific evidence had formed the basis of their arguments. Their published article provided erroneous information on Fukushima. The article implied overdiagnosis in adults and suggested that overdiagnosis would apply to current Fukushima cases. The IARC report did not validate the secondary confirmatory examination in the program which obscures the fact that overdiagnosis may not have occurred as much in Fukushima. The report consequently precluded the provision of important information and measures. CONCLUSION Information provided in the IARC Technical Publication No. 46 was based on selected scientific evidence resulting in both public and policy-maker confusion regarding past and present nuclear accidents, especially in Japan. It should be withdrawn.
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Affiliation(s)
- Toshihide Tsuda
- Department of Human Ecology, Graduate School of Environmental and Life Science, Okayama University, 3-1-1 Tsushima-naka, Kita-ku, Okayama, 700-8530, Japan.
| | - Yumiko Miyano
- Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
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Mordecai G, Bass AL, Routledge R, Di Cicco E, Teffer A, Deeg C, Bateman AW, Miller KM. Assessing the role of Piscine orthoreovirus in disease and the associated risk for wild Pacific salmon. BMC Biol 2023; 21:114. [PMID: 37208758 DOI: 10.1186/s12915-023-01548-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 02/20/2023] [Indexed: 05/21/2023] Open
Abstract
This paper is a response to Polinski, M. P. et al. Innate antiviral defense demonstrates high energetic efficiency in a bony fish. BMC Biology 19, 138 (2021). https://doi.org/10.1186/s12915-021-01069-2.
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Affiliation(s)
- Gideon Mordecai
- Institute for the Oceans and Fisheries, University of British Columbia, Vancouver, BC, Canada.
| | - Arthur L Bass
- Pacific Salmon Ecology and Conservation Laboratory, Department of Forest and Conservation Sciences University of British Columbia, Vancouver, BC, Canada
- Pacific Biological Station, Fisheries and Oceans Canada, Nanaimo, BC, Canada
| | - Rick Routledge
- Department of Statistics and Actuarial Science, Simon Fraser University, Burnaby, BC, Canada
| | | | - Amy Teffer
- Department of Environmental Conservation, University of Massachusetts Amherst, Amherst, MA, 01003, USA
| | - Christoph Deeg
- Pacific Salmon Foundation, Vancouver, BC, Canada
- Department of Forest and Conservation Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Andrew W Bateman
- Pacific Salmon Foundation, Vancouver, BC, Canada
- Department of Ecology and Evolutionary Biology, University of Toronto, Toronto, ON, Canada
| | - Kristina M Miller
- Pacific Biological Station, Fisheries and Oceans Canada, Nanaimo, BC, Canada
- Department of Forest and Conservation Sciences, University of British Columbia, Vancouver, BC, Canada
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Burdon J, Budnik LT, Baur X, Hageman G, Howard CV, Roig J, Coxon L, Furlong CE, Gee D, Loraine T, Terry AV, Midavaine J, Petersen H, Bron D, Soskolne CL, Michaelis S. Health consequences of exposure to aircraft contaminated air and fume events: a narrative review and medical protocol for the investigation of exposed aircrew and passengers. Environ Health 2023; 22:43. [PMID: 37194087 PMCID: PMC10186727 DOI: 10.1186/s12940-023-00987-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/31/2023] [Indexed: 05/18/2023]
Abstract
Thermally degraded engine oil and hydraulic fluid fumes contaminating aircraft cabin air conditioning systems have been well documented since the 1950s. Whilst organophosphates have been the main subject of interest, oil and hydraulic fumes in the air supply also contain ultrafine particles, numerous volatile organic hydrocarbons and thermally degraded products. We review the literature on the effects of fume events on aircrew health. Inhalation of these potentially toxic fumes is increasingly recognised to cause acute and long-term neurological, respiratory, cardiological and other symptoms. Cumulative exposure to regular small doses of toxic fumes is potentially damaging to health and may be exacerbated by a single higher-level exposure. Assessment is complex because of the limitations of considering the toxicity of individual substances in complex heated mixtures.There is a need for a systematic and consistent approach to diagnosis and treatment of persons who have been exposed to toxic fumes in aircraft cabins. The medical protocol presented in this paper has been written by internationally recognised experts and presents a consensus approach to the recognition, investigation and management of persons suffering from the toxic effects of inhaling thermally degraded engine oil and other fluids contaminating the air conditioning systems in aircraft, and includes actions and investigations for in-flight, immediately post-flight and late subsequent follow up.
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Affiliation(s)
- Jonathan Burdon
- Respiratory Physician, St Vincent's Private Hospital, East Melbourne, Australia
| | - Lygia Therese Budnik
- Institute for Occupational and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Xaver Baur
- European Society for Environmental and Occupational Medicine, Berlin, Germany
- University of Hamburg, Hamburg, Germany
| | - Gerard Hageman
- Department of Neurology, Medisch Spectrum Twente, Hospital Enschede, Enschede, The Netherlands
| | - C Vyvyan Howard
- Centre for Molecular Biosciences, University of Ulster, Coleraine, Northern Ireland, UK
| | - Jordi Roig
- Department of Pulmonary Medicine, Clínica Creu Blanca, Barcelona, Spain
| | - Leonie Coxon
- Clinical and Forensic Psychologist, Mount Pleasant Psychology, Perth, Australia
| | - Clement E Furlong
- Departments of Medicine (Div. Medical Genetics) and Genome Sciences, University of Washington, Seattle, USA
| | - David Gee
- Centre for Pollution Research and Policy, Visiting Fellow, Brunel University, London, UK
| | - Tristan Loraine
- Technical Consultant, Spokesperson for the Global Cabin Air Quality Executive, London, UK
| | - Alvin V Terry
- Department of Pharmacology and Toxicology, Medical College of Georgia, Augusta University, Augusta, USA
| | | | - Hannes Petersen
- Faculty of Medicine, University of Iceland, Akureyri Hospital, Akureyri, Iceland
| | - Denis Bron
- Federal Department of Defence, Civil Protection and Sport (DDPS), Aeromedical Institute (FAI)/AeMC, Air Force, Dübendorf, Switzerland
| | - Colin L Soskolne
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Susan Michaelis
- Occupational and Environmental Health Research Group, Honorary Senior Research Fellow, University of Stirling, Scotland / Michaelis Aviation Consulting, West Sussex, England.
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Molot J, Sears M, Anisman H. Multiple Chemical Sensitivity: It's time to catch up to the science. Neurosci Biobehav Rev 2023; 151:105227. [PMID: 37172924 DOI: 10.1016/j.neubiorev.2023.105227] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 05/06/2023] [Indexed: 05/15/2023]
Abstract
Multiple chemical sensitivity (MCS) is a complex medical condition associated with low dose chemical exposures. MCS is characterized by diverse features and common comorbidities, including fibromyalgia, cough hypersensitivity, asthma, and migraine, and stress/anxiety, with which the syndrome shares numerous neurobiological processes and altered functioning within diverse brain regions. Predictive factors linked to MCS comprise genetic influences, gene-environment interactions, oxidative stress, systemic inflammation, cell dysfunction, and psychosocial influences. The development of MCS may be attributed to the sensitization of transient receptor potential (TRP) receptors, notably TRPV1 and TRPA1. Capsaicin inhalation challenge studies demonstrated that TRPV1 sensitization is manifested in MCS, and functional brain imaging studies revealed that TRPV1 and TRPA1 agonists promote brain-region specific neuronal variations. Unfortunately, MCS has often been inappropriately viewed as stemming exclusively from psychological disturbances, which has fostered patients being stigmatized and ostracized, and often being denied accommodation for their disability. Evidence-based education is essential to provide appropriate support and advocacy. Greater recognition of receptor-mediated biological mechanisms should be incorporated in laws, and regulation of environmental exposures.
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Affiliation(s)
- John Molot
- Family Medicine, University of Ottawa Faculty of Medicine, Ottawa ON Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada; Department of Neuroscience, Carleton University, Ottawa Canada.
| | - Margaret Sears
- Family Medicine, University of Ottawa Faculty of Medicine, Ottawa ON Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada; Department of Neuroscience, Carleton University, Ottawa Canada.
| | - Hymie Anisman
- Family Medicine, University of Ottawa Faculty of Medicine, Ottawa ON Canada; Ottawa Hospital Research Institute, Ottawa, ON, Canada; Department of Neuroscience, Carleton University, Ottawa Canada.
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6
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Chartres N, Sass JB, Gee D, Bălan SA, Birnbaum L, Cogliano VJ, Cooper C, Fedinick KP, Harrison RM, Kolossa-Gehring M, Mandrioli D, Mitchell MA, Norris SL, Portier CJ, Straif K, Vermeire T. Conducting evaluations of evidence that are transparent, timely and can lead to health-protective actions. Environ Health 2022; 21:123. [PMID: 36471342 PMCID: PMC9720912 DOI: 10.1186/s12940-022-00926-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 10/20/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND In February 2021, over one hundred scientists and policy experts participated in a web-based Workshop to discuss the ways that divergent evaluations of evidence and scientific uncertainties are used to delay timely protection of human health and the environment from exposures to hazardous agents. The Workshop arose from a previous workshop organized by the European Environment Agency (EEA) in 2008 and which also drew on case studies from the EEA reports on 'Late Lessons from Early Warnings' (2001, 2013). These reports documented dozens of hazardous agents including many chemicals, for which risk reduction measures were delayed for decades after scientists and others had issued early and later warnings about the harm likely to be caused by those agents. RESULTS Workshop participants used recent case studies including Perfluorooctanoic acid (PFOA), Extremely Low Frequency - Electrical Magnetic Fields (ELF-EMF fields), glyphosate, and Bisphenol A (BPA) to explore myriad reasons for divergent outcomes of evaluations, which has led to delayed and inadequate protection of the public's health. Strategies to overcome these barriers must, therefore, at a minimum include approaches that 1) Make better use of existing data and information, 2) Ensure timeliness, 3) Increase transparency, consistency and minimize bias in evidence evaluations, and 4) Minimize the influence of financial conflicts of interest. CONCLUSION The recommendations should enhance the production of "actionable evidence," that is, reliable evaluations of the scientific evidence to support timely actions to protect health and environments from exposures to hazardous agents. The recommendations are applicable to policy and regulatory settings at the local, state, federal and international levels.
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Affiliation(s)
- Nicholas Chartres
- Program On Reproductive Health and the Environment, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California at San Francisco, 490 Illinois Street, Floor 10, San Francisco, CA, 94143, USA.
| | - Jennifer B Sass
- Natural Resources Defense Council, Washington, DC, USA
- George Washington University, Washington, DC, USA
| | | | - Simona A Bălan
- California Department of Toxic Substances Control, Berkeley, CA, USA
- University of California at Berkeley, Berkeley, CA, USA
| | - Linda Birnbaum
- Nicholas School of the Environment, Duke University, Durham, NC, USA
| | | | - Courtney Cooper
- Program On Reproductive Health and the Environment, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California at San Francisco, 490 Illinois Street, Floor 10, San Francisco, CA, 94143, USA
| | | | - Roy M Harrison
- School of Geography, Earth & Environmental Sciences, University of Birmingham, Birmingham, UK
- Department of Environmental Sciences/Centre of Excellence in Environmental Studies, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Marike Kolossa-Gehring
- Department of Environmental Hygiene, Section Toxicology, Health Related Environmental Monitoring, German Federal Environmental Agency, Dessau-Roßlau, Germany
| | - Daniele Mandrioli
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy
| | - Mark A Mitchell
- George Mason University, Fairfax, VA, USA
- Connecticut Coalition for Environmental Justice, Hartford, CT, USA
| | - Susan L Norris
- Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Christopher J Portier
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Department of Toxicogenomics, Maastricht University, Maastricht, Netherlands
- CJP Consulting, Seattle, WA, USA
| | - Kurt Straif
- ISGlobal, Barcelona, Spain
- Boston College, Newton, MA, USA
| | - Theo Vermeire
- Retired, National Institute for Public Health and the Environment (RIVM), Utrecht, The Netherlands
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Soskolne CL, Kramer S, Ramos-Bonilla JP, Mandrioli D, Sass J, Gochfeld M, Cranor CF, Advani S, Bero LA. Correction: Toolkit for detecting misused epidemiological methods. Environ Health 2022; 21:109. [PMID: 36368967 PMCID: PMC9652904 DOI: 10.1186/s12940-022-00938-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Affiliation(s)
- Colin L Soskolne
- School of Public Health, University of Alberta, Edmonton, AB, Canada.
| | - Shira Kramer
- Epidemiology International, Hunt Valley, MD, USA
| | | | - Daniele Mandrioli
- Cesare Maltoni Cancer Research Centre, Ramazzini Institute, Bologna, Italy
| | - Jennifer Sass
- Natural Resources Defense Council, Washington, DC, USA
- George Washington University, Washington, DC, USA
| | - Michael Gochfeld
- Environmental and Occupational Health Sciences Institute, Rutgers Biomedical and Health Sciences, Newark, NJ, USA
| | - Carl F Cranor
- Departments of Philosophy and Environmental Toxicology, University of California, Riverside, CA, USA
| | - Shailesh Advani
- Terasaki Institute of Biomedical Innovation, Los Angeles, CA, USA
- Georgetown University School of Medicine, Washington, DC, USA
| | - Lisa A Bero
- Center for Bioethics and Humanities, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Soskolne CL, Bero LA, Kramer S, Gochfeld M, Ramos-Bonilla JP, Sass J, Cranor CF, Advani S, Mandrioli D. Response to Toshihide Tsuda, Yumiko Miyano and Eiji Yamamoto [1]. Environ Health 2022; 21:100. [PMID: 36284322 PMCID: PMC9597996 DOI: 10.1186/s12940-022-00913-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/13/2022] [Accepted: 10/16/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND In August 2021, we published in Environmental Health a Toolkit for detecting misused epidemiological methods with the goal of providing an organizational framework for transparently evaluating epidemiological studies, a body of evidence, and resultant conclusions. Tsuda et al., the first group to utilize the Toolkit in a systematic fashion, have offered suggestions for its modification. MAIN BODY Among the suggested modifications made by Tsuda et al., we agree that rearrangement of Part A of the Toolkit to reflect the sequence of the epidemiological study process would facilitate its usefulness. Expansion or adaptation of the Toolkit to other disciplines would be valuable but would require the input of discipline-specific expertise. We caution against using the sections of the Toolkit to produce a tally or cumulative score, because none of the items are weighted as to importance or impact. Rather, we suggest a visual representation of how a study meets the Toolkit items, such as the heat maps used to present risk of bias criteria for studies included in Cochrane reviews. We suggest that the Toolkit be incorporated in the sub-specialty known as "forensic epidemiology," as well as in graduate training curricula, continuing education programs, and conferences, with the recognition that it is an extension of widely accepted ethics guidelines for epidemiological research. CONCLUSION We welcome feedback from the research community about ways to strengthen the Toolkit as it is applied to a broader assemblage of research studies and disciplines, contributing to its value as a living tool/instrument. The application of the Toolkit by Tsuda et al. exemplifies the usefulness of this framework for transparently evaluating, in a systematic way, epidemiological research, conclusions relating to causation, and policy decisions. POSTSCRIPT We note that our Toolkit has, most recently, inspired authors with discipline-specific expertise in the field of Conservation Biology to adapt it for use in the Biological Sciences.
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Affiliation(s)
| | - Lisa A. Bero
- Center for Bioethics and Humanities, University of Colorado Anschutz Medical Campus, Aurora, CO USA
| | | | - Michael Gochfeld
- Environmental and Occupational Health Sciences Institute, Rutgers Biomedical and Health Sciences, Piscataway, NJ USA
| | | | - Jennifer Sass
- Natural Resources Defense Council, Washington, DC USA
- George Washington University, Washington, DC USA
| | - Carl F. Cranor
- Departments of Philosophy and Environmental Toxicology, University of California, Riverside, CA USA
| | - Shailesh Advani
- Terasaki Institute of Biomedical Innovation, Los Angeles, CA USA
- Georgetown University School of Medicine, Washington, DC USA
| | - Daniele Mandrioli
- Cesare Maltoni Cancer Research Centre, Ramazzini Institute, Bologna, Italy
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Burgman M, Chiaravalloti R, Fidler F, Huan Y, McBride M, Marcoci A, Norman J, Vercammen A, Wintle B, Yu Y. A toolkit for open and pluralistic conservation science. Conserv Lett 2022. [DOI: 10.1111/conl.12919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Mark Burgman
- Centre for Environmental Policy Imperial College London UK
| | | | - Fiona Fidler
- School of Biosciences University of Melbourne Parkville Australia
| | - Yizhong Huan
- School of Public Policy and Management Tsinghua University Beijing China
| | | | - Alexandru Marcoci
- Centre for Argument Technology School of Science & Engineering (Computing) University of Dundee, Nethergate Dundee UK
| | - Juliet Norman
- Centre for Environmental Policy Imperial College London UK
| | - Ans Vercammen
- School of Communication and Arts The University of Queensland St Lucia Queensland Australia
| | - Bonnie Wintle
- School of Biosciences University of Melbourne Parkville Australia
| | - Yurong Yu
- Centre for Environmental Policy Imperial College London UK
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Tsuda T, Miyano Y, Yamamoto E. Demonstrating the undermining of science and health policy after the Fukushima nuclear accident by applying the Toolkit for detecting misused epidemiological methods. Environ Health 2022; 21:77. [PMID: 36002833 PMCID: PMC9400325 DOI: 10.1186/s12940-022-00884-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 07/14/2022] [Indexed: 06/15/2023]
Abstract
It is well known that science can be misused to hinder the resolution (i.e., the elimination and/or control) of a health problem. To recognize distorted and misapplied epidemiological science, a 33-item "Toolkit for detecting misused epidemiological methods" (hereinafter, the Toolkit) was published in 2021. Applying the Toolkit, we critically evaluated a review paper entitled, "Lessons learned from Chernobyl and Fukushima on thyroid cancer screening and recommendations in the case of a future nuclear accident" in Environment International in 2021, published by the SHAMISEN (Nuclear Emergency Situations - Improvement of Medical and Health Surveillance) international expert consortium. The article highlighted the claim that overdiagnosis of childhood thyroid cancers greatly increased the number of cases detected in ultrasound thyroid screening following the 2011 Fukushima nuclear accident. However, the reasons cited in the SHAMISEN review paper for overdiagnosis in mass screening lacked important information about the high incidence of thyroid cancers after the accident. The SHAMISEN review paper ignored published studies of screening results in unexposed areas, and included an invalid comparison of screenings among children with screenings among adults. The review omitted the actual state of screening in Fukushima after the nuclear accident, in which only nodules > 5 mm in diameter were examined. The growth rate of thyroid cancers was not slow, as emphasized in the SHAMISEN review paper; evidence shows that cancers detected in second-round screening grew to more than 5 mm in diameter over a 2-year period. The SHAMISEN consortium used an unfounded overdiagnosis hypothesis and misguided evidence to refute that the excess incidence of thyroid cancer was attributable to the nuclear accident, despite the findings of ongoing ultrasound screening for thyroid cancer in Fukushima and around Chernobyl. By our evaluation, the SHAMISEN review paper includes 20 of the 33 items in the Toolkit that demonstrate the misuse of epidemiology. The International Agency for Research on Cancer meeting in 2017 and its publication cited in the SHAMISEN review paper includes 12 of the 33 items in the Toolkit. Finally, we recommend a few enhancements to the Toolkit to increase its utility.
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Affiliation(s)
- Toshihide Tsuda
- Department of Human Ecology, Graduate School of Environmental and Life Science, Okayama University, 3-1-1 Tsushima-naka, Kita-ku, Okayama, 700-8530, Japan.
| | - Yumiko Miyano
- Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
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Abstract
Two tendencies have emerged in environmental epidemiology that hamper the translation of research findings into prevention of environmental hazards. One is the increased focus on highlighting weaknesses of epidemiology research that is clearly meant to explain away the research conclusions and weaken their possible implications for interventions to control environmental hazards. Another is the voluminous amount of information sharing that involves a substantial amount of misinformation, as part of the ongoing infodemic. In this light, the appearance of the catalogue of doubt-raising strategies, indeed the worst practices of scientific inference, is good news. Collected under the auspices of the International Network for Epidemiology in Policy, it serves to illustrate the range of possible (and impossible) forms of critique that may be raised on behalf of vested interests or other groups who for some reason disagree with the epidemiological conclusions. We believe that this systematic list will be useful in our field and help to identify critiques of policy options that are hidden and sometimes suppressed in weighing the epidemiological evidence.
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Affiliation(s)
- Ruth A. Etzel
- Milken Institute School of Public Health, The George Washington University, D. C, Washington, 20052 USA
| | - Philippe Grandjean
- Harvard T.H. Chan School of Public Health, Department of Environmental Health, Boston, MA 02115 USA
- Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - David M. Ozonoff
- Department of Environmental Health, Boston University School of Public Health, Boston, USA
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