Customer Reviews

Hyping Health Risks: Environmental Hazards in Daily Life and the Science of Epidemiology

5 star:		(3)
4 star:		(1)
3 star:		(0)
2 star:		(1)
1 star:		(0)

 

 

Dr. Kabat's analysis of how the media presents scientific studies and how the public is easily fooled into fear by perceptions that the "cause of the day" represents a real and imminent threat to their lives is beautifully done.

Dr. Kabat avoids the easy road of political polemic and presents his work in a style that's rigorous and above attack. I spend an inordinate amount of time researching current news and opinions regarding one of the subjects he treats (the "secondhand smoke scare" issue) and have observed that the critics who might normally be expected to attack a work like this are simply dead silent: they have no substantive criticisms to offer and the style of his work doesn't lend itself well to simple silly mudslinging. And while he treats each of several different problems independently within their own sections of the book, he does a beautiful job of couching those analyses within a larger themed structure that draws a compelling picture of a need for a wide reassessment of how scientific research is done and presented to the public in today's world of headline-hungry media.

The approach and style is more formal than some other books in the same area (My own work, while sticking tightly to a high standard of accuracy, tends to be a bit more polemic than Kabat's.) and the font size could have been just a bit larger (Hey, I'm being picky here, but once you get over 40 or so you appreciate bigger fonts!) but the content is absolutely stellar and I have no hesitation at all in giving both the book and Dr. Kabat a five star review. It's difficult for a scientist or researcher in today's competitive grant-seeking market to step outside the "popular" approach to research that simply accepts the strictures of rubber stamping the politically correct views that control the pursestrings, but Kabat evidently has more integrity than most who are out there and as you read "Hyping..." I think you'll agree he has what it takes to back up his stand.

It's just sad that there aren't more professionals with similar courage.

Michael J. McFadden

Author of Dissecting Antismokers' Brains

Professor Kabat does an excellent job in describing how a combination of zealous regulators, activists, and media can combine to magnify "alarming" results of preliminary, usually inadequate or poorly done studies. Once these headlines are in the public psyche, it can take years, even decades, of further, expensive studies to demonstrate the early alarms were false. Meanwhile, many are scared, and billions of dollars are spent to "fix" or "avoid" the so-called problem.

Four examples are explored in detail, complete with literature references. They are: a) environmental chemicals can cause breast cancer, b) electromagnetic fields (mostly from power lines) can cause various cancers, c)radon gas in homes can cause lung cancer, and d)the (lack of)effects of second-hand smoke. The discussions are thorough and convincing. In addition, Professor Kabat has a chapter describing the science of epidemiology, and points out the usefulness as well as the weakness of the technique.

This is an excellent read for both the layman and the professional in the field.

In a dispassionate and painstaking way, Kabat sheds light on four health scares: radon, electromagnetic fields from power lines, DDT as a cause of breast cancer, and second-hand tobacco smoke.

If epidemiologists are to contribute useful insights, they need to be mindful of strengths versus weaknesses in evidence. Kabat quotes a distinguished pioneer of risks associated with cigarettes, Sir Richard Peto: "epidemiology is so beautiful and provides such an important perspective on human life and death, but an incredible amount of rubbish is published." After hyping by journalists, rubbish can be given undue credibility by governments eager to respond to public concerns. John Ioannadis: "In the past, we had few research findings, while currently we have too many research findings. Therefore, getting rid of tentative but wrong research findings should become at least as important as finding new ones." Kabat supports weighing evidence in a critically-minded, inter-disciplinary way. The only way to overcome misinformation is via still stronger science.

Chapter 2 overviews the field of epidemiology. Kabat mentions examples of valuable achievements: cholera as a water-borne disease; smoking and cancers; alcohol and cancers; risk factors for heart disease; estrogen, progesterone and breast cancer; sleep position and sudden infant death syndrome; solar radiation and skin cancer; hepatitis b and liver cancer. Cholera was a clear cause, a problem amenable to investigation by mapping victims and water supplies.

Kabat readably integrates narrow articles into an understandable big picture. Physicist William R. Bennett (pioneer of gas lasers) calculated a barefoot railroad worker standing on wet tracks bearing electric current would receive a dose orders of magnitude lower than fields normally inside our bodies. New England Journal of Medicine: "all these epidemiological studies have been conducted in pursuit of a cause of cancer for which there is no plausible biologic basis." Kabat: "it is hard to escape the impression that the reluctance of the National Institute for Environmental Health Sciences working group to close the door on the possibility of electromagnetic force as a cause of leukemia had more to do with its members' stake in this area of research than with scientific rigor." Self-interest may have blinded them to "fundamental insights about the phenomenon whose effects they were investigating." Epidemiology should work in conjuction with other disciplines, not disregard them.

It is when health scares are at their most contentious that society is in most need of scientists willing to look honestly at a topic, without succumbing to prevailing fashion. Without an unswerving commitment to seek the truth, science ill-serves the public good. Kabat offers worthy lessons to epidemiologists who aspire to serve via honest practice. Well done.

Kabat's book should be required reading for all public health graduate students and single-issue health activists. From the office of the Surgeon General to city hall, advocacy has frequently supplanted sound science in the service of "good public health policy". The hallmark of advocacy triumphing over science is a selective and result oriented use of data, starting with the institutions that fund the studies. It is currently heresy to challenge the science behind ETS research and regulation. You cannot get a study approved that challenges the validity of the questionnaires and other proxy measures used to characterize ETS exposure, or openly seeks to challenge inadequate measures of bias and confounding. As a consequence, a mountain of research money is being spent piling on more biased studies conducted by advocates. It's not a conspiracy. It is what political correctness does to public health. We need more public health heretics like Kabat.

Dr. Kabat argues that out of control regulation-zealot scientists twist the results of epidemiology studies to show that dangers exist where there are none. You should be aware that Dr. Kabat has been a highly paid consultant (over a period of many years) for industries using and manufacturing the allegedly dangerous chemicals mentioned in this book. These companies (they include Philip Morris, R.J. Reynolds, and the American Tobacco Company)paid him handsomely to do research that would show that their products were safe. He is well known in scientific circles as a scientist for hire and his own studies are frequently criticized as horribly designed or even specifically designed to get the answers he is looking for. This information is all public record, and I suggest that if you are curious, you should look it up to verify that I am telling the truth.

I do not feel that you should chose not to read this book because of Kabat's obvious conflict of interest, however. I do recommend that you read it alongside either "Bending Science" or "Doubt is their Product."