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Nicholas Kristof: STATS winner of the worst “science” journalist of the year
Trevor Butterworth, December 14, 2009
Columnist promotes “fear-based science” as a solution to breast cancer and other diseases.

New York Times columnist Nicholas Kristof has won well-deserved praise for his heroic efforts to draw attention to genocide and child prostitution in the developing world. Recently, however, he has taken to warning about some “terrifying dangers” closer to home -- the tiny amounts of chemicals in everyday consumer items and their alleged links to a host of diseases.

His most recent column created panic on parent blogs with claims that the rise in cancers and asthma are linked to chemicals in the environment – specifically,  kitchen and plastic containers.

Most cancers are, in fact, environmental. But when cancer researchers use the word “environmental,” they use it in a different sense from environmentalists: it means everything in the environment, which includes cigarette smoking, alcohol consumption, exercise (or lack thereof) and diet. Kristof isn’t really interested in these factors. Instead, he writes:

“What if breast cancer in the United States has less to do with insurance or mammograms and more to do with contaminants in our water or air -- or in certain plastic containers in our kitchens? What if the surge in asthma and childhood leukemia reflect, in part, the poisons we impose upon ourselves?...

…Dr. Philip Landrigan, the chairman of the department of preventive medicine at Mount Sinai, said that the risk that a 50-year-old white woman will develop breast cancer has soared to 12 percent today, from 1 percent in 1975. (Some of that is probably a result of better detection.)”

Several days after this column appeared, the American Cancer Society, the Centers for Disease Control, the National Cancer Institute, and the North American Association of Central Cancer Registries announced that cancer incidence and death rates have been declining, including breast cancer incidence rates in women (because women are not giving up smoking fast enough, lung cancer rates are still increasing).

Cancer surgeon and researcher David Gorski, MD, Ph.D, who blogs extensively about medicine under the nom-de-blog “Orac,” described Kristof’s column as “simplistic and alarmist in the extreme.” As he explains:

“What's very important to realize is that 12% of women do not get invasive breast cancer as compared to 1% in the past. Moreover, "some of that" is not "probably" a result of better detection. Most of it is almost certainly a result of better detection of earlier breast cancer, including premalignant lesions, through widespread mammography screening programs. Indeed, as this report by the American Cancer Society shows, the incidence of invasive breast cancer per 100,000 women is not increasing nearly that fast, and, in fact, since 2002 breast cancer rates have plummeted, very likely due to the massive decrease in hormone replacement therapy use in the wake of the 2002 report from the Women's Health Initiative showing that HRT doesn't decrease cardiovascular risk but does increase the risk of breast cancer…"

Peter Lipson MD wrote on the blog Science-Based Medicine that

“The problem here from a science-based medicine perspective is not the implausibility but the oversimplification and naive, hyperbolic conclusions.  Kristoff cites a 56-page report from the Endocrine Society, which was much more circumspect and called for further study of the issue.  I can understand the desire to communicate an important health story to the public, but choosing an emotionally charged issue like breast cancer and linking it to everyday substances that everyone uses blurs the issue more than it clarifies.  It incites emotion without asking clear, important questions.”

In 2004, Aaron Blair, Ph.D., the chief of the Occupational Epidemiology Branch in the National Cancer Institute's (NCI) Division of Cancer Epidemiology and Genetics noted in an interview on the NCI’s website, that many of the chemical “substances that we suspected would cause cancer in animals actually do not. Of course, it is possible that they do cause cancer in humans, but, in fact, our experience has shown us that most of the chemicals we have tested don't cause cancer.”

There has, in fact, been growing research that alcohol consumption presents a moderate risk for breast cancer (but a possible protective benefit against heart disease), and it is interesting to note that one of the spikes in breast cancer incidence that occurred in Marin County, California was associated with higher than national levels of alcohol consumption among white women, along with increased use of fertility treatments. Again, this is not a reason for panic – researchers note that this is only a statistical association and not proof of a causal relationship – but there is considerably more data here than the risks Kristof chooses to focus on.

Chief among these is Bisphenol A. Citing a Consumer Reports claim that the American public was being subjected to potentially dangerous levels of the chemical in cans and plastic containers, Kristof wrote in an earlier column that he’d “come to terms with the threats from warlords, bandits and tarantulas. But endocrine disrupting chemicals — they give me the willies.”

Again, Kristof cherry-picked his sources to maximize the threat.

“But more than 200 other studies have shown links between low doses of BPA and adverse health effects, according to the Breast Cancer Fund, which is trying to ban the chemical from food and beverage containers.

'The vast majority of independent scientists — those not working for industry — are concerned about early-life low-dose exposures to BPA,' said Janet Gray, a Vassar College professor who is science adviser to the Breast Cancer Fund.”

This is not even remotely accurate. The EPA has twice failed to confirm the low dose risks of BPA in robust, well-designed, statistically rigorous studies. Moreover, the “industry-funded” studies that were used in risk assessments around the world, were supervised by European Union scientists. Because the statistical power to test the hypotheses generated by small studies on BPA makes a study so expensive, the habit is to send the bill to industry. But industry doesn’t get to determine how these studies are conducted. International protocols govern how the studies are conducted and, more importantly, the data from these studies is openly available to examine and reanalyze – unlike some of the “key” BPA studies claiming a risk.

Kristof could have contacted any of the regulatory agencies and found this out. It’s not a big secret. Instead, he relied on an anti-BPA activist talking point that originated with the leading critic of BPA, Frederick vom Saal, a scientist whose work has generated enormous controversy in the field of toxicology for the repeated failure of others to replicate his findings.

As for the otherwise estimable Consumer Reports, it appears the magazine turned to the vom Saal and other anti BPA activists for guidance on testing and interpretation. (Again, unlike the studies commissioned by the European Union and paid for by industry, Consumer Reports won’t divulge the details of its testing or even which outside lab it used, so their results cannot be independently verified).

However, Consumer Reports’ findings on BPA were so out of whack with what the European Union found that one of the lead authors of its BPA risk assessment described the magazine’s report as “highly biased.” Wolfgang Dekant, Professor of Toxicology at the University of Wurzburg, who has pioneered the use of radiation to track BPA in blood, told STATS that there was no need to avoid canned food. Consumer Reports also took a swipe at the research on BPA conducted by the EPA, which led one of the Environmental Protection Agency’s top experts on endocrine disruption, Earl Gray, to say that the magazine’s in-house expert on toxic chemicals didn’t understand basic biology.

STATS asked Kristof by email whether he had read the European Union’s risk assessment on BPA, its 2008 update, or Health Canada's fact sheet on BPA. He did not reply.

Since the European Union’s risk assessment in 2006, there has been a review by Japan’s National Institute of Advanced Industrial Science and Technology (2007), an examination of claims of neurotoxicity by the Norwegian Scientific Committee for Food Safety, (2008), an update to the European Union’s risk assessment  (2008), an evaluation by the French Food Safety Agency (2008), a risk assessment by NSF International, a World Health Organization collaborative center (2008), a review of new data by the German Federal Institute for Risk Assessment (2008), a joint regulatory review for manufacturers by the FDA and Health Canada, a survey by Health Canada (2009), a risk assessment by Food Standards Australia/New Zealand (2009), two more surveys by Health Canada, one on canned powdered infant formula, the second on bottled water products (2009), a hazard assessment by California’s Environmental Protection Agency (2009), and a modeling study of BPA in humans by the German Federal Institute for Risk Assessment (2009).

Even Health Canada, which banned BPA in baby bottles, admitted that it found no hard evidence that anyone was at risk – it was a risk management rather than a risk assessment decision. This invited a rebuke from France’s Health Minister, Roselyne Bachelot, “Canadian authorities banned bisphenol A under public pressure and without any serious scientific study.”

But perhaps the worst and most damaging aspect of Kristof’s brand of fear-based science reporting is that it ignores the immense amount of valuable, complicated, and unsexy scientific research being done by America’s regulatory agencies.

For instance, to those who study it, endocrine “disruption” doesn’t always mean harm. The body’s endocrine system is always reacting to different stimuli, and this has a less technical term; it’s called life. The act of living is constantly changing the body on a hormonal level, and the point is to distinguish among trivial, adaptive, and adverse endocrine disruption. It’s not easy – but you’d never guess any of this from the paranoid way this topic gets covered in the media.

Nor would you realize that the Environmental Protection Agency is devoting enormous resources to the issue. The complexity of its testing procedures would make a Times reader catatonic with boredom – and, frankly, require considerable journalistic skill to make comprehensible to the general reader.

Similarly, the Food and Drug Administration’s protocol for evaluating the evidence on Bisphenol A is exhaustively complex and comprehensive – more so than any article written on the subject in the American media has conveyed.

It’s this failure by the media (and by Kristof) to take the time and effort to talk to the EPA’s and FDA’s top toxicologists and endocrine-disruptor experts and translate those conversations without losing the rigor of science that is fueling a growing and misplaced public distrust of government’s power to protect its citizens’ health.

This disconnect was captured in a dramatic way when STATS surveyed almost 1,000 toxicologists on the risk from chemicals. They dismissed the media’s account of chemical risk as largely exaggerated, while expressing considerably more trust in the capacity of the CDC, FDA and EPA to gauge risk accurately.

In the vacuum created by this disconnect and distrust, fear and rage are ministered to by a mix of aggressive and well-funded activist campaigns and a virtual network of green publications and bloggers lacking in any apparent scientific training or skepticism.

Fear-based science may not pollute our bodies or even the physical environment, but it does something just as toxic – it poisons our minds to such a ridiculous degree that we’d prefer to deal with an armed warlord than a tin of beans. Kristof has used his prominence as an editorial writer at the New York Times to do  some great and laudable work. But because he has also used this perch to promote fear-based science, STATS regretfully bestows on Nicholas Kristof our “worst science journalist of the year” award for 2009.



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