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February 09, 2008


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It's more like "as Larry Solum would say . . . . "

In all seriousness, this is a provocative post -- in the good sense. Issues of occupational and environmental health, which are often though not always intertwined are likely a key determinant of population health, though I believe there is evidence that a relatively marginal proportion of people are proven to be exposed to known toxic chemicals.

Of course, the devil is in the details in this reporting, and there is no question that the biopsychosocial model of disease incorporates environmental concerns.

My colleague Winnie Hamilton, who does fabulous work at the CDRC (where I work), is PI on a landmark study of lead levels in Galveston. These levels absolutely qualify as a prime determinant on health, one that, through both prenatal and early developmental pathways, seem to initiate a cascade of phenomena that often results in inferior health outcomes.

On the other hand, one needs to beware of the awesome pattern recognition capacities of the human mind, which are so good as to find causal patterns where none exist.

For example, given the nonlinear dynamical pathways through which diseases cluster, given enough iterations one will predict certain pockets and clusters of, say, cancer. Some times, these clusters seem like too coincidental for comfort given the overall incidence in the population at large. In turn, sometimes these suspicions are well-founded, and other times they are not.

The difficulty of epidemiologic causality can give rise to a thorny epistemic problem: how can we tell the "random" occurrences from the "caused" occurrences?

In any case, fascinating stuff. As for references, as always, I'd strongly recommend Marmot & Wilkinson eds. (2006), and Markowitz & Rosner and Herbert Adams on the interrelation between environmental and occupational health.

I think those who are concerned about "cancer clusters" are well aware of the complex epistemic and scientific issues that arise in such cases.

Re: "I believe there is evidence that a relatively marginal proportion of people are proven to be exposed to known toxic chemicals."

First, I wonder about the standard of "proof" here, and secondly, I suspect there's not a sufficient amount of evidence in this regard but I'm open to persuasion. Let's take just one toxic chemical, mercury, for example: "In America one-in-six children born every year have been exposed to mercury levels so high that they are potentially at risk for learning disabilities and motor skill impairment and short-term memory loss. That type of mercury exposure is caused by eating certain kinds of fish, which contain high levels of the toxin from both natural and man-made sources such as emissions from coal-fired power plants. One government analysis shows that 630,000 children each year are exposed to potentially unsafe mercury levels in the womb. If the government and its scientists know about the mercury problem, why do so many people continue to be poisoned?" See http://www.pbs.org/now/science/mercuryinfish.html

Then we might think about nuclear waste, dioxins, PCBs, asbestos....

Some interesting data about a host of other toxins found here (with links to govt. docs.): http://www.scorecard.org/env-releases/us-map.tcl

An important book by way of background information: Carl F. Cranor's Regulating Toxic Substances: A Philosophy of Science and the Law (New York: Oxford University Press, 1993). Two other works I would recommend here are Kristin Shrader-Frechette's Risk and Rationality: Philosophical Foundations for Populist Reforms (Berkeley, CA: University of California Press, 1991) and her Environmental Justice: Reclaiming Equality, Reclaiming Democracy (New York: Oxford University Press, 2002).

And stories like this, "Study finds human medicines altering marine biology," might prompt one to think twice about eating fish:

"Sewage-treatment plants in Southern California are failing to remove hormones and hormone-altering chemicals from water that gets flushed into coastal ocean waters, according to the results of a study released Saturday.

The preliminary findings were part of the most ambitious study to date on the effect of emerging chemical contaminants in coastal oceans. It confirms the findings of smaller pilot studies from 2005 that discovered male fish in the ocean were developing female characteristics, and broadened the scope of the earlier studies by looking at an array of man-made contaminants in widespread tests of seawater, seafloor sediment and hundreds of fish caught off Los Angeles, Orange and San Diego counties.

The results, outlined by a Southern California toxicologist at a conference in Boston, reveal that a veritable drugstore of pharmaceuticals and beauty products, flame retardants and plastic additives are ending up in the ocean and appear to be working their way up the marine food chain."

See: http://www.latimes.com/news/local/la-me-pollute17feb17,1,6811201.story

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