Authors' Response by Lisa G. Gallagher, Veronica M. Vieira, David M. Ozonoff, Thomas F. Webster and Ann Aschengrau (Ann Aschengrau, 10 November 2011)
Dr. Bukowski, writing at the request of the Halogenated Solvents Industry Association (HSIA), calls into question our results on the grounds that they conflict with occupational studies he alleges show no increased risk of breast cancer at much higher PCE exposures. We understand why the HSIA would want to weigh in on this question because it might suggest that their product, PCE, which is in widespread use and causes extensive exposure in the occupational and general community environment, is an unreasonably dangerous product. Given the size of the exposed population, even relatively small risks could result in an unacceptable breast cancer burden on...
read full comment
Comment on the paper by Gallagher et al.: Risk of breast cancer following exposure to tetrachloroethylene-contaminated drinking water in Cape Cod, Massachusetts: reanalysis of a case-control study using a modified exposure assessment. (John Bukowski, 19 October 2011)
In this most recent iteration of the Cape Cod perchloroethylene (PCE) study, Gallagher et al. [1] have attempted to improve the exposure assessment used in the previous breast cancer articles [2,3]. However, these authors are still left with the same problem, trying to tease out relatively weak effects from residential exposure, when much higher occupational and laboratory exposures have failed to demonstrate them....
read full comment
Estimation of dispersion parameter sigma (Christian Schindler, 18 March 2011)
In section 5.4, describing the estimation of the dispersion parameter sigma_d it should be written "until a maximum of the likelihood function is reached".
read full comment
Comment on the paper by Dufault et al.: Mercury in foods containing high-fructose corn syrup in Canada (Karen Rideout, 21 July 2010)
In January 2009, contemporaneously with the Dufault et al. paper in Environmental Health [1], the Institute for Agriculture and Trade Policy (IATP), a non-profit organization focusing on food, agriculture, and trade, released a report of its own examining the mercury content of foods (such as sodas, syrups, and jams) containing high-fructose corn syrup (HFCS). Dufault et al. [1] tested 20 samples of HFCS from three manufacturers. Nine had detectable levels of mercury (≥0.005 µg/g), ranging from 12,000 to 570,000 ppt (0.012 to 0.570 µg/g) HFCS. Based on these results, the average daily exposure to mercury from HFCS could be 0 to 28.4 µg, about the same as that from dental amalgam [1]. This level of intake is potentially above the provisional tolerable weekly...
read full comment
Authors' response (Conor Reynolds, 09 February 2010)
It could be said that a gauge of an issue's importance is the passion it inspires, and the safety of cyclists is certainly an issue that people are passionate about. However, passions can be obstacles to collegial discourse. Our review was an attempt to conduct an objective review of the scientific, evidence-based literature on the influence of infrastructure on cycling safety. An important function of a review paper is to compile the relevant literature, so that everyone can use the list to locate and examine original sources. Readers can then evaluate the conclusions of the review paper, based on their own interpretation of the empirical evidence. We trust that interested readers will do just that, as Forester has done.
We have done our best to ensure that this literature...
read full comment
I tend to agree that the omission of the Copenhagen studies of before-and-after infrastructure installation tends to reduce the credibility of the paper and that there is some confusion regarding just what is considered "vehicular cycling." read full comment
Healthy Worker Effect among ex-asbestos workers: A prevalence study (V Murlidhar, 01 December 2009)
Healthy Worker Effect among ex-asbestos workers: A prevalence study V Murlidhar Occupational Health and Safety Centre, Mumbai, India. 6, Neelkant apts, Gokuldas Pasta Road, Dadar (E), Mumbai, 400014. India. www.ohscmumbai.com
The study identified those suffering from Asbestosis (parenchymal and pleural non-malignant disease) among the permanent workers of the Hindustan Composites Factory [1]. The prevalence rate of Asbestosis in study was 23%, which was less than the expected prevalence among workers exposed to asbestos for more than 20 years[1].The primary reason suggested for the lower prevalence was the “healthy worker effect”. Many affected workers had been forced to leave the company or to take voluntary...
read full comment
Authors' response to Morten Lange's comments (Conor Reynolds, 01 December 2009)
We thank Morten Lange for his comprehensive and thoughtful comments about our literature review. We are pleased that the article is of interest to the wider community of cycling advocates as well as academics who study cycling safety. The points made by Mr. Lange offer valuable insights into the challenges of increasing cycling rates, and the need to promote bicycling because it has a low-impact on the environment and is a sustainable mode of transportation. In general, and as the title so-alludes, we chose to constrain the scope of our literature review to topics directly related to the influence of physical infrastructure in the built environment, rather than expand it to include detailed discussion about regulation (e.g. pros and cons of helmet legislation), or cyclist education (e.g....
read full comment
Some caveats: Relative risk, Perceived risk,Helmet efficiency, Training (Morten Lange, 01 December 2009)
Thanks to the authors for carrying out such a large review of the research literature on roads/facilities and cycling safety, and bringing forth some of the multitude of arguments for increased cycling for transport.
I have several caveats though, many of which are shared with many that have put some long-term effort into understanding the issues and myths around cycling for transport. As such they should be known to the authors, as this is mostly readily available to those interested. This time around I'll mention them rather summarily :
A. This article is not primarily of academic interest, rather the connection to key concerns in society is spelled out in the article, and the authors seem to hope to bring an important piece to a puzzle helping...
read full comment
Biphasic model for chromosome aberrations in barley seeds (Alfred Koerblein, 17 March 2009)
Dear Dr Dropkin
I used your biphasic model ERR~f(dose,beta,sigma,tau) for chromosome aberrations in barley seeds (see Geras'kin SA, Oudalova AA, Kim JK, Dikarev VG, Dikareva NS. Cytogenetic effect of low dose gamma-radiation in Hordeum vulgare seedlings: non-linear dose-effect relationship. Radiat Environ Biophys. 2007 Mar;46(1):31-41.) Your model fits these data perfectly well. I determine a value of R of 8.4. If you are interested in my analysis just contact me (alfred.koerblein@gmx.de).
Response to Chlorine Institute's Comments (Renee Dufault, 11 February 2009)
RESPONSE TO CHLORINE INSTITUTE’S COMMENTS
We also share the public’s concern about the safety of our food supply. The order of preference for using chlor-alkali chemicals in HFCS manufacturing was provided by the manager of a high fructose corn syrup plant and stated as 1) mercury cell and then 2) membrane grade. The reason given for the preference stated was that mercury cell caustic enhances “product shelf life.”
A literature review of the uptake of mercury by the corn plant indicated that corn has very low levels of mercury even in soils with elevated mercury caused by sludge application (1, 2, 4, 5, 6). After the steeping step in the HFCS manufacturing process, the de-germing process separates the germ from the endosperm (3). The germ...
read full comment
Letter to the Editors Re: Dufault et al. in Environmental Health (2009) 8:2 (Arthur Dungan, 11 February 2009)
February 9, 2009
To the Editors:
While we share public concern about the safety of our food supply, we believe that you did a vast disservice to your readers and the chlor-alkali industry by publishing an article [Dufault et al. in Environmental Health (2009) 8:2] that, without any scientific evidence whatsoever, claims that chlor-alkali plants are the source of the mercury they found in samples of high fructose corn syrup and other food products. The report, “Mercury from chlor-alkali plants: measured concentrations in food product sugar,” carries nothing more than unsubstantiated, unwarranted speculation concerning a purported relationship between such plants and mercury in foods.
While the study raises important questions regarding...
read full comment
Response to Dr Joffe's coments (Luc Multigner, 08 August 2008)
We thank Dr Joffe for his comments, with which we largely agree. We have stressed in our publication that the comparative physiology, nature of exposure, development stage at exposure, and a number of ecological factors are of course different between human and rat. These differences must be considered when interpreting wild animals as sentinel species for human health risks. Our study, we feel, makes that abundantly clear, being essentially a prototype in advance of more detailed investigations to come. Concerning testicular cancer, our references to this topic and to the apparent decline in semen quality were made to situate our work in a more general context for readers interested in human reproductive health. We also agree with Dr Joffe that although the influence of substances with...
read full comment
Sentinel species for male reproductive disorders (Michael Joffe, 08 August 2008)
Dear Sir Multigner et al. are to be congratulated on their pioneering study on male reproductive parameters both in rats and in humans, comparing those highly exposed to pesticides in a banana plantation with those who are not highly exposed [1]. Their intention to investigate how well rats perform as sentinel indicators for humans is important. However, their findings cannot be taken at face value, because the two species are not comparable in respect of the developmental stage at which they were exposed to pesticides. One cannot be certain, but it appears that the men were exposed only as adults, whereas it is clear that the rats had been highly exposed at all stages of development as they were conceived in the banana plantation and grew up there. As it is highly likely that the male...
read full comment
Article nicely captures the frustrations of policy advice in New Zealand (Ralph Chapman, 09 April 2008)
Wilson and Horrocks have nicely captured many frustrating features of policy advice in contentious policy areas, such as environmental health, within the New Zealand policy advisory environment. I myself worked within policy advice in the New Zealand public sector for around 20 years, and often noted the sort of behaviours that Wilson and Horrocks point to, such as industry lobbying on policy matters, poor technical advice by some senior policy advisers who should have known better, and ideological decisions by Ministers based on selective reading of the evidence. Wilson and Horrocks have done a nice job illuminating these in this case study.
read full comment
link to actual elemental analyses, particle size, why limited elements (Stephen Pavel, 11 March 2008)
Thank you for the open access of an excellent article and valuable conclusion. Good news the common vacuum might reduce the toxic load in the house.However, I was most interested in the actual values of the 9 elements selected, but I could not find a table summary or link to actual values. I was also hopeful that the particle size of the sample might be available off-line. In any case, if it is possible I would like a link to actual results.I am also curious why researchers typically limit investigations to so few elements. In all likelihood, those pesticides and dust particles have more elements than those that were analyzed.In the refining industry upper and middle management limited staff to the minimum number of elements as they did not want to be responsible for the knowledge that...
read full comment
Moving toward a new paradigm (Richard W. Clapp, 13 January 2008)
The Commentary by Saracci and Vineis raises some cogent points regarding the recent attempts to attribute proportions of illness and especially cancer due to environmental exposures. They note the problems of estimating etiologic fractions when the studies on which the estimates are based may be of groups of workers with particular circumstances of exposure. They also point out that many diseases, including cancers, have multiple causes or constellations of causes which means that the sum total of all attributable causes must exceed 100%. This has been noted by many authors, including Doll (1), and it begs the question why the various lists of attributable proportions are commonly forced to sum to a number that everyone agrees is false. We have argued (2) that the attempt to ascribe...
read full comment
Environmental disease burden – the confused case of UVR exposure (Robyn Lucas, 12 January 2008)
The commentary by Saracci and Vineis and earlier papers by Boffetta et al and Pruss-Ustun raise important issues in the estimation of the disease burden attributable to environmental factors. Saracci and Vineis note, correctly, the importance of a consistent definition of environment in comparing estimates of environmental burden of cancer. Consistency alone, however, is not enough – and it is not clear what is the value of Boffetta et al’s narrow definition of environment. From a public health perspective preventability is a key issue – in this regard it becomes important to include not just those exposures to “(natural or man-made) agents encountered by humans in their daily life, upon which they have no or limited personal control” but also those...
read full comment
Pollutants, man-made products and human activities are probably major determinants of human cancer (Nicolas van Larebeke, 11 January 2008)
Comment on the paper by Saracci & Vineis. We agree with all considerations of Saracci &Vineis. However, while emphasising the importance of the notion “environment” and of preventive measures at the collective level, their paper does not elaborate on another important issue: the major impact that human activities, man-made substances and diverse pollutants have on cancer incidence. And indeed not only on cancer incidence, but probably also on the incidence and prevalence of many other “diseases of civilisation” such as atheromatosis, diabetes, Parkinson’s Disease and possibly also on the metabolic syndrome and on diseases related to immunological reactions such as astma, allergies and some auto-immune diseases. The publications, the most important of...
read full comment
Authors' response to Anthony McMichael (rodolfo saracci, 03 January 2008)
We had only tangentially alluded in the final section of our paper to the existence of special problems when trying to infer disease causation- the first step towards prevention- from widespread environmental exposures, and "a fortiori" from exposures of a global nature.Implied in McMichael's comments are new challenges hard to address with the standard methodological armamentarium of epidemiologists.There will never be- unless theoretical physics opens magic doors to "parallel universes" - evidence on the population effects of global climatic changes from randomized trials nor even from observational comparisons of concurrent worlds ; and no help can come from playing with nomenclatures of the factors involved. Materially and metaphorically global environmental changes "fall from the sky"...
read full comment
Widening a welcome debate (Anthony (Tony) J. McMichael, 02 January 2008)
The paper by Saracci and Vineis (‘Disease proportions attributable to environment’) underscores important conceptual and methodological issues, and confusions, that arise in the vexed matter of estimating population disease fractions attributable to ‘the environment’. It is as easy to under-estimate as it is to over-estimate. That estimation has always posed a challenge to epidemiologists. Most environmental exposures impinge upon whole areas or communities; they are often difficult to measure at the individual level (the ‘dose’ received’); and, anyway, there may be little difference between individual exposure levels within an exposed community. For related reasons, aetiological inferences about shared environmental exposures are often more...
read full comment
Advancing methods for environmental burden of disease calculations (Colin L Soskolne, 30 November 2007)
In response to the thoughtful commentary by Saracci and Vineis, "Disease proportions attributable to environment", I am inspired to hearken back to first principles, some more and some less relevant to their commentary:1. Any single summary measure can reflect only what it is: a single summary measure. As with a mean expressed alone, questions of the distribution of the parts are lost. Age, gender, social class, and other factors are submerged in any such single measure. 2. The scientist reporting overall summary measures, in bearing the above two points in mind, ought to consider also reporting additional measures to give some insight into what underlies and thereby explains the overall summary measure.3. The strengths and limitations of any measure need to be recognized, and the...
read full comment
Methylmercury and Risk in Adults - A Balanced View, and More Research, Are Needed (Dariush Mozaffarian, 12 November 2007)
We agree with Dr. Stern that the most important question with regard to methylmercury and fish intake is not the main effect, but the interaction: does the presence of methylmercury alter the beneficial effects of fish consumption related to marine n-3 polyunsaturated fatty acids (PUFA)? Unfortunately, most prior studies did not evaluate this interaction. The Kuopio study, however, did evaluate this interaction. Exposure to mercury mitigated the beneficial effect of marine n-3 PUFA consumption, so that less benefit was seen at higher levels of mercury, compared with lower levels of mercury.[1] However, whether mercury levels were higher or lower, greater n-3 PUFA consumption was still associated with lower risk – higher mercury levels simply attenuated the slope of this...
read full comment
Evaluating health benefits and chemical risks of fish intake (Jose L Domingo, 08 November 2007)
In this paper, Stern concludes telling “that there are easily available fish that offer both high polyunsaturated fatty acids (PUFAs) and low methyl mercury and that the consumers should chose wisely among the available fish so as to maximize the benefits and decrease the risks”. Stern is also very critical with a previous statement by Mozaffarian and Rimm [1], who in a recent review paper published in JAMA concluded that for major health outcomes among adults, “the benefits of fish consumption exceeded potential risks”. Based on the long experience of our research group, I would like to add some arguments to that important issue.Firstly, I would like to note that the evidence supporting the statement by Mozaffarian and Rimm [1] is very limited. Only the risks of a...
read full comment
Response to Mark Little (Greg Dropkin, 14 March 2007)
Dr. Mark Little questions my choice of cancers for analysis, and aspects of the statistical method.I focused on the 0 - 20 mSv dose range because the ICRP recommended annual occupational dose limit is 20 mSv. I then chose the 5 most common cancers in the 0 - 20 mSv subcohort.Other cancer sites mentioned by Mark Little have fewer cases (deaths) in this subcohort. I agree that it would be of interest to extend the analysis to consider radiogenic sites including the female breast and oesophagus. For this spare time project with limited computing power, I had to draw the line somewhere. But if a more extensive analysis were to find that the stomach, liver, and lung are the only specific sites to show significant results with these models in this dataset and dose range, even that limited result...
read full comment
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Latest comments
Authors' Response by Lisa G. Gallagher, Veronica M. Vieira, David M. Ozonoff, Thomas F. Webster and Ann Aschengrau (Ann Aschengrau, 10 November 2011)
Dr. Bukowski, writing at the request of the Halogenated Solvents Industry Association (HSIA), calls into question our results on the grounds that they conflict with occupational studies he alleges show no increased risk of breast cancer at much higher PCE exposures. We understand why the HSIA would want to weigh in on this question because it might suggest that their product, PCE, which is in widespread use and causes extensive exposure in the occupational and general community environment, is an unreasonably dangerous product. Given the size of the exposed population, even relatively small risks could result in an unacceptable breast cancer burden on... read full comment
Comment on: Gallagher et al. Environmental Health, 10:47
Comment on the paper by Gallagher et al.: Risk of breast cancer following exposure to tetrachloroethylene-contaminated drinking water in Cape Cod, Massachusetts: reanalysis of a case-control study using a modified exposure assessment. (John Bukowski, 19 October 2011)
In this most recent iteration of the Cape Cod perchloroethylene (PCE) study, Gallagher et al. [1] have attempted to improve the exposure assessment used in the previous breast cancer articles [2,3]. However, these authors are still left with the same problem, trying to tease out relatively weak effects from residential exposure, when much higher occupational and laboratory exposures have failed to demonstrate them.... read full comment
Comment on: Gallagher et al. Environmental Health, 10:47
Estimation of dispersion parameter sigma (Christian Schindler, 18 March 2011)
In section 5.4, describing the estimation of the dispersion parameter sigma_d it should be written "until a maximum of the likelihood function is reached". read full comment
Comment on: Hazenkamp-von Arx et al. Environmental Health, 10:13
Comment on the paper by Dufault et al.: Mercury in foods containing high-fructose corn syrup in Canada (Karen Rideout, 21 July 2010)
In January 2009, contemporaneously with the Dufault et al. paper in Environmental Health [1], the Institute for Agriculture and Trade Policy (IATP), a non-profit organization focusing on food, agriculture, and trade, released a report of its own examining the mercury content of foods (such as sodas, syrups, and jams) containing high-fructose corn syrup (HFCS). Dufault et al. [1] tested 20 samples of HFCS from three manufacturers. Nine had detectable levels of mercury (≥0.005 µg/g), ranging from 12,000 to 570,000 ppt (0.012 to 0.570 µg/g) HFCS. Based on these results, the average daily exposure to mercury from HFCS could be 0 to 28.4 µg, about the same as that from dental amalgam [1]. This level of intake is potentially above the provisional tolerable weekly... read full comment
Comment on: Dufault et al. Environmental Health, 8:2
Authors' response (Conor Reynolds, 09 February 2010)
It could be said that a gauge of an issue's importance is the passion it inspires, and the safety of cyclists is certainly an issue that people are passionate about. However, passions can be obstacles to collegial discourse. Our review was an attempt to conduct an objective review of the scientific, evidence-based literature on the influence of infrastructure on cycling safety. An important function of a review paper is to compile the relevant literature, so that everyone can use the list to locate and examine original sources. Readers can then evaluate the conclusions of the review paper, based on their own interpretation of the empirical evidence. We trust that interested readers will do just that, as Forester has done.
We have done our best to ensure that this literature... read full comment
Comment on: Reynolds et al. Environmental Health, 8:47
But isn't the survey rather incomplete? (J Thorne, 09 February 2010)
Perhaps we could have a response to the most obvious source of a negative review of the column.
I tend to agree that the omission of the Copenhagen studies of before-and-after infrastructure installation tends to reduce the credibility of the paper and that there is some confusion regarding just what is considered "vehicular cycling."
read full comment
Comment on: Reynolds et al. Environmental Health, 8:47
Healthy Worker Effect among ex-asbestos workers: A prevalence study (V Murlidhar, 01 December 2009)
Healthy Worker Effect among ex-asbestos workers: A prevalence study
V Murlidhar
Occupational Health and Safety Centre, Mumbai, India.
6, Neelkant apts, Gokuldas Pasta Road, Dadar (E),
Mumbai, 400014. India.
www.ohscmumbai.com
The study identified those suffering from Asbestosis (parenchymal and pleural non-malignant disease) among the permanent workers of the Hindustan Composites Factory [1]. The prevalence rate of Asbestosis in study was 23%, which was less than the expected prevalence among workers exposed to asbestos for more than 20 years[1].The primary reason suggested for the lower prevalence was the “healthy worker effect”. Many affected workers had been forced to leave the company or to take voluntary... read full comment
Comment on: Murlidhar et al. Environmental Health, 4:24
Authors' response to Morten Lange's comments (Conor Reynolds, 01 December 2009)
We thank Morten Lange for his comprehensive and thoughtful comments about our literature review. We are pleased that the article is of interest to the wider community of cycling advocates as well as academics who study cycling safety. The points made by Mr. Lange offer valuable insights into the challenges of increasing cycling rates, and the need to promote bicycling because it has a low-impact on the environment and is a sustainable mode of transportation. In general, and as the title so-alludes, we chose to constrain the scope of our literature review to topics directly related to the influence of physical infrastructure in the built environment, rather than expand it to include detailed discussion about regulation (e.g. pros and cons of helmet legislation), or cyclist education (e.g.... read full comment
Comment on: Reynolds et al. Environmental Health, 8:47
Some caveats: Relative risk, Perceived risk,Helmet efficiency, Training (Morten Lange, 01 December 2009)
Thanks to the authors for carrying out such a large review of the research literature on roads/facilities and cycling safety, and bringing forth some of the multitude of arguments for increased cycling for transport.
I have several caveats though, many of which are shared with many that have put some long-term effort into understanding the issues and myths around cycling for transport. As such they should be known to the authors, as this is mostly readily available to those interested. This time around I'll mention them rather summarily :
A. This article is not primarily of academic interest, rather the connection to key concerns in society is spelled out in the article, and the authors seem to hope to bring an important piece to a puzzle helping... read full comment
Comment on: Reynolds et al. Environmental Health, 8:47
Biphasic model for chromosome aberrations in barley seeds (Alfred Koerblein, 17 March 2009)
Dear Dr Dropkin
I used your biphasic model ERR~f(dose,beta,sigma,tau) for chromosome aberrations in barley seeds (see Geras'kin SA, Oudalova AA, Kim JK, Dikarev VG, Dikareva NS. Cytogenetic effect of low dose gamma-radiation in Hordeum vulgare seedlings:
non-linear dose-effect relationship. Radiat Environ Biophys. 2007 Mar;46(1):31-41.) Your model fits these data perfectly well. I determine a value of R of 8.4.
If you are interested in my analysis just contact me (alfred.koerblein@gmx.de).
Best regards,
Alfred Koerblein
read full comment
Comment on: Dropkin Environmental Health, 6:1
Response to Chlorine Institute's Comments (Renee Dufault, 11 February 2009)
RESPONSE TO CHLORINE INSTITUTE’S COMMENTS
We also share the public’s concern about the safety of our food supply. The order of preference for using chlor-alkali chemicals in HFCS manufacturing was provided by the manager of a high fructose corn syrup plant and stated as 1) mercury cell and then 2) membrane grade. The reason given for the preference stated was that mercury cell caustic enhances “product shelf life.”
A literature review of the uptake of mercury by the corn plant indicated that corn has very low levels of mercury even in soils with elevated mercury caused by sludge application (1, 2, 4, 5, 6). After the steeping step in the HFCS manufacturing process, the de-germing process separates the germ from the endosperm (3). The germ... read full comment
Comment on: Dufault et al. Environmental Health, 8:2
Letter to the Editors Re: Dufault et al. in Environmental Health (2009) 8:2 (Arthur Dungan, 11 February 2009)
February 9, 2009
To the Editors:
While we share public concern about the safety of our food supply, we believe that you did a vast disservice to your readers and the chlor-alkali industry by publishing an article [Dufault et al. in Environmental Health (2009) 8:2] that, without any scientific evidence whatsoever, claims that chlor-alkali plants are the source of the mercury they found in samples of high fructose corn syrup and other food products. The report, “Mercury from chlor-alkali plants: measured concentrations in food product sugar,” carries nothing more than unsubstantiated, unwarranted speculation concerning a purported relationship between such plants and mercury in foods.
While the study raises important questions regarding... read full comment
Comment on: Dufault et al. Environmental Health, 8:2
Response to Dr Joffe's coments (Luc Multigner, 08 August 2008)
We thank Dr Joffe for his comments, with which we largely agree. We have stressed in our publication that the comparative physiology, nature of exposure, development stage at exposure, and a number of ecological factors are of course different between human and rat. These differences must be considered when interpreting wild animals as sentinel species for human health risks. Our study, we feel, makes that abundantly clear, being essentially a prototype in advance of more detailed investigations to come. Concerning testicular cancer, our references to this topic and to the apparent decline in semen quality were made to situate our work in a more general context for readers interested in human reproductive health. We also agree with Dr Joffe that although the influence of substances with... read full comment
Comment on: Multigner et al. Environmental Health, 7:40
Sentinel species for male reproductive disorders (Michael Joffe, 08 August 2008)
Dear Sir Multigner et al. are to be congratulated on their pioneering study on male reproductive parameters both in rats and in humans, comparing those highly exposed to pesticides in a banana plantation with those who are not highly exposed [1]. Their intention to investigate how well rats perform as sentinel indicators for humans is important. However, their findings cannot be taken at face value, because the two species are not comparable in respect of the developmental stage at which they were exposed to pesticides. One cannot be certain, but it appears that the men were exposed only as adults, whereas it is clear that the rats had been highly exposed at all stages of development as they were conceived in the banana plantation and grew up there. As it is highly likely that the male... read full comment
Comment on: Multigner et al. Environmental Health, 7:40
Article nicely captures the frustrations of policy advice in New Zealand (Ralph Chapman, 09 April 2008)
Wilson and Horrocks have nicely captured many frustrating features of policy advice in contentious policy areas, such as environmental health, within the New Zealand policy advisory environment. I myself worked within policy advice in the New Zealand public sector for around 20 years, and often noted the sort of behaviours that Wilson and Horrocks point to, such as industry lobbying on policy matters, poor technical advice by some senior policy advisers who should have known better, and ideological decisions by Ministers based on selective reading of the evidence. Wilson and Horrocks have done a nice job illuminating these in this case study. read full comment
Comment on: Wilson et al. Environmental Health, 7:1
link to actual elemental analyses, particle size, why limited elements (Stephen Pavel, 11 March 2008)
Thank you for the open access of an excellent article and valuable conclusion. Good news the common vacuum might reduce the toxic load in the house.However, I was most interested in the actual values of the 9 elements selected, but I could not find a table summary or link to actual values. I was also hopeful that the particle size of the sample might be available off-line. In any case, if it is possible I would like a link to actual results.I am also curious why researchers typically limit investigations to so few elements. In all likelihood, those pesticides and dust particles have more elements than those that were analyzed.In the refining industry upper and middle management limited staff to the minimum number of elements as they did not want to be responsible for the knowledge that... read full comment
Comment on: Colt et al. Environmental Health, 7:6
Moving toward a new paradigm (Richard W. Clapp, 13 January 2008)
The Commentary by Saracci and Vineis raises some cogent points regarding the recent attempts to attribute proportions of illness and especially cancer due to environmental exposures. They note the problems of estimating etiologic fractions when the studies on which the estimates are based may be of groups of workers with particular circumstances of exposure. They also point out that many diseases, including cancers, have multiple causes or constellations of causes which means that the sum total of all attributable causes must exceed 100%. This has been noted by many authors, including Doll (1), and it begs the question why the various lists of attributable proportions are commonly forced to sum to a number that everyone agrees is false. We have argued (2) that the attempt to ascribe... read full comment
Comment on: Saracci et al. Environmental Health, 6:38
Environmental disease burden – the confused case of UVR exposure (Robyn Lucas, 12 January 2008)
The commentary by Saracci and Vineis and earlier papers by Boffetta et al and Pruss-Ustun raise important issues in the estimation of the disease burden attributable to environmental factors. Saracci and Vineis note, correctly, the importance of a consistent definition of environment in comparing estimates of environmental burden of cancer. Consistency alone, however, is not enough – and it is not clear what is the value of Boffetta et al’s narrow definition of environment. From a public health perspective preventability is a key issue – in this regard it becomes important to include not just those exposures to “(natural or man-made) agents encountered by humans in their daily life, upon which they have no or limited personal control” but also those... read full comment
Comment on: Saracci et al. Environmental Health, 6:38
Pollutants, man-made products and human activities are probably major determinants of human cancer (Nicolas van Larebeke, 11 January 2008)
Comment on the paper by Saracci & Vineis. We agree with all considerations of Saracci &Vineis. However, while emphasising the importance of the notion “environment” and of preventive measures at the collective level, their paper does not elaborate on another important issue: the major impact that human activities, man-made substances and diverse pollutants have on cancer incidence. And indeed not only on cancer incidence, but probably also on the incidence and prevalence of many other “diseases of civilisation” such as atheromatosis, diabetes, Parkinson’s Disease and possibly also on the metabolic syndrome and on diseases related to immunological reactions such as astma, allergies and some auto-immune diseases. The publications, the most important of... read full comment
Comment on: Saracci et al. Environmental Health, 6:38
Authors' response to Anthony McMichael (rodolfo saracci, 03 January 2008)
We had only tangentially alluded in the final section of our paper to the existence of special problems when trying to infer disease causation- the first step towards prevention- from widespread environmental exposures, and "a fortiori" from exposures of a global nature.Implied in McMichael's comments are new challenges hard to address with the standard methodological armamentarium of epidemiologists.There will never be- unless theoretical physics opens magic doors to "parallel universes" - evidence on the population effects of global climatic changes from randomized trials nor even from observational comparisons of concurrent worlds ; and no help can come from playing with nomenclatures of the factors involved. Materially and metaphorically global environmental changes "fall from the sky"... read full comment
Comment on: Saracci et al. Environmental Health, 6:38
Widening a welcome debate (Anthony (Tony) J. McMichael, 02 January 2008)
The paper by Saracci and Vineis (‘Disease proportions attributable to environment’) underscores important conceptual and methodological issues, and confusions, that arise in the vexed matter of estimating population disease fractions attributable to ‘the environment’. It is as easy to under-estimate as it is to over-estimate. That estimation has always posed a challenge to epidemiologists. Most environmental exposures impinge upon whole areas or communities; they are often difficult to measure at the individual level (the ‘dose’ received’); and, anyway, there may be little difference between individual exposure levels within an exposed community. For related reasons, aetiological inferences about shared environmental exposures are often more... read full comment
Comment on: Saracci et al. Environmental Health, 6:38
Advancing methods for environmental burden of disease calculations (Colin L Soskolne, 30 November 2007)
In response to the thoughtful commentary by Saracci and Vineis, "Disease proportions attributable to environment", I am inspired to hearken back to first principles, some more and some less relevant to their commentary:1. Any single summary measure can reflect only what it is: a single summary measure. As with a mean expressed alone, questions of the distribution of the parts are lost. Age, gender, social class, and other factors are submerged in any such single measure. 2. The scientist reporting overall summary measures, in bearing the above two points in mind, ought to consider also reporting additional measures to give some insight into what underlies and thereby explains the overall summary measure.3. The strengths and limitations of any measure need to be recognized, and the... read full comment
Comment on: Saracci et al. Environmental Health, 6:38
Methylmercury and Risk in Adults - A Balanced View, and More Research, Are Needed (Dariush Mozaffarian, 12 November 2007)
We agree with Dr. Stern that the most important question with regard to methylmercury and fish intake is not the main effect, but the interaction: does the presence of methylmercury alter the beneficial effects of fish consumption related to marine n-3 polyunsaturated fatty acids (PUFA)? Unfortunately, most prior studies did not evaluate this interaction. The Kuopio study, however, did evaluate this interaction. Exposure to mercury mitigated the beneficial effect of marine n-3 PUFA consumption, so that less benefit was seen at higher levels of mercury, compared with lower levels of mercury.[1] However, whether mercury levels were higher or lower, greater n-3 PUFA consumption was still associated with lower risk – higher mercury levels simply attenuated the slope of this... read full comment
Comment on: Stern Environmental Health, 6:31
Evaluating health benefits and chemical risks of fish intake (Jose L Domingo, 08 November 2007)
In this paper, Stern concludes telling “that there are easily available fish that offer both high polyunsaturated fatty acids (PUFAs) and low methyl mercury and that the consumers should chose wisely among the available fish so as to maximize the benefits and decrease the risks”. Stern is also very critical with a previous statement by Mozaffarian and Rimm [1], who in a recent review paper published in JAMA concluded that for major health outcomes among adults, “the benefits of fish consumption exceeded potential risks”. Based on the long experience of our research group, I would like to add some arguments to that important issue.Firstly, I would like to note that the evidence supporting the statement by Mozaffarian and Rimm [1] is very limited. Only the risks of a... read full comment
Comment on: Stern Environmental Health, 6:31
Response to Mark Little (Greg Dropkin, 14 March 2007)
Dr. Mark Little questions my choice of cancers for analysis, and aspects of the statistical method.I focused on the 0 - 20 mSv dose range because the ICRP recommended annual occupational dose limit is 20 mSv. I then chose the 5 most common cancers in the 0 - 20 mSv subcohort.Other cancer sites mentioned by Mark Little have fewer cases (deaths) in this subcohort. I agree that it would be of interest to extend the analysis to consider radiogenic sites including the female breast and oesophagus. For this spare time project with limited computing power, I had to draw the line somewhere. But if a more extensive analysis were to find that the stomach, liver, and lung are the only specific sites to show significant results with these models in this dataset and dose range, even that limited result... read full comment
Comment on: Dropkin Environmental Health, 6:1