By Martha Perske
Copyright 2001 Junkscience.com
February, 19 2001

In a recent paper entitled “Sorting Out Junk Science,” published by the American Council on Science and Health, a toxicologist notes that she most often sees junk science when a regulatory agency “puts political objectives ahead of scientific integrity.” It occurs, for example, when an agency adopts a political position and then “selectively seeks data that support and further that position, even to the point of actively excluding any results which are inconsistent with that position.”

Such could be said of a “position statement” issued by the prestigious-sounding American College of Occupational and Environmental Medicine, the world’s largest organization of occupational and environmental physicians. While this organization is not a regulatory agency, one of its stated missions is “guiding public policy.”

Indeed, its position statement, entitled “Epidemiological Basis for an Occupational and Environmental Policy on Environmental Tobacco Smoke,” seeks to ban smoking in the workplace, including public places such as restaurants and bars. Lead author of the position statement is Alan M. Ducatman, M.D.; co-author is Robert K. McLellan, M.D.

Ducatman and McLellan claim, for one thing, that there is “robust epidemiologic evidence” implicating environmental tobacco smoke as a cause of lung cancer in nonsmokers.

It appears, however, that in this case, “robust” evidence is little more than cherry-picked evidence. Misleading and selective data are presented. Results that are inconsistent with the desired position (banning smoking) are simply excluded.

Touting a small Chinese study while ignoring a larger U.S. study

In building their case for smoking bans in the workplace, Ducatman and McLellan claim that Chinese women exposed to environmental tobacco smoke in the workplace experience excess heart disease. The source they cite is a 1994 study consisting of 59 cases of nonsmoking Chinese women with coronary heart disease in Xi’an, China.

Not mentioned by Ducatman and McLellan is a more recent and much larger U.S. study published in the American Heart Association’s journal, Circulation, entitled “Environmental Tobacco Smoke and Coronary Heart Disease in the American Cancer Society CPS-II Cohort.”

In contrast to the Chinese study, the authors of the U.S. study state “We did not generally find an increase in CHD [coronary heart disease] risk associated with ETS exposure at work or in other settings.”

The U.S. study found a small increased risk from living with a smoker; however, the authors caution that the “observed relative risks are small and could be due to confounding by unmeasured risk factors.”

And while Ducatman and McLellan reference a 1991 study by an anti-smoking activist claiming that environmental tobacco smoke causes thousands of heart disease deaths in nonsmokers, they inexplicably omit any mention of a 1999 editorial published in the New England Journal of Medicine, in which statistician John C. Bailar III, M.D., Ph.D. concludes that “we still do not know, with accuracy, how much or even whether exposure to environmental tobacco smoke increases the risk of coronary heart disease.”

Keeping a major study under wraps

Conspicuously missing in the position statement is any reference to a 1998 World Health Organization (WHO) study, one of the largest ever done on environmental tobacco smoke and lung cancer risk. Overall findings from this study, published in the Journal of the National Cancer Institute, show no statistically significant increased lung cancer risk for nonsmokers exposed to environmental tobacco smoke in the home, the workplace, vehicles, or public places such as restaurants.

As acknowledged in the WHO’s own press release (3-9-98), a small increased risk was found for nonsmokers living or working with smokers, but “neither increased risk was statistically significant.”

Furthermore, in contrast to the current anti-smoking hysteria to ban smoking in restaurants, the WHO study states that “public indoor settings [including restaurants] did not represent an important source of ETS exposure.”

Giving credence to a discredited report

Referencing the U.S. Environmental Protection Agency’s 1993 report, Ducatman and McLellan say that the EPA “has estimated that 3,000 excess lung cancer deaths occur yearly among non-smokers due to environmental tobacco smoke.” What Ducatman and McLellan don’t disclose is that the EPA’s findings were ruled null and void in 1998 by U.S. District Judge William Osteen who found that the Agency manipulated the data in order to arrive at a desired and predetermined conclusion.

As reported in the Washington Post, July 19, 1998, “A federal judge has ruled that the Environmental Protection Agency wrongly declared secondhand tobacco smoke a dangerous carcinogen in a landmark 1993 report, a decision that could imperil hundreds of local and regional ordinances banning indoor smoking.”

Dr. Ducatman ducks questions

Ducatman and McLellan go on to claim that “Accumulated evidence now includes more than 40 studies, establishing the causal role of ETS in the induction of lung cancer.” In support of this claim, they reference a paper published elsewhere.

I e-mailed Dr. Ducatman, telling him that I could not find this statement in the paper he referenced. It says only that “Over 40 studies have examined the relationship between spousal smoking and risk of lung cancer.” I asked him to direct me to where the paper states or shows what he claims.

Dr. Ducatman replied that he would respond to my question only if I submitted it in a letter to the editor of the journal that published his position statement. He stated this is “the best way to get a forum for your inquiry.”

I need a forum in order to get an answer from the lead author of a published paper? I don’t think so.

And neither, apparently, does the managing editor of the journal that published Ducatman and McLellan’s position statement. In a response dated January 30, 2001, the managing editor says yes, the lead author of a paper published in their journal can be contacted directly with a question, and no, there is no need to submit the question in a letter to the editor.

Nevertheless, Dr. Ducatman remains unwilling to answer my question directly. In his e-mail he tells me “I do not intend to correspond informally with you further.”

Summing it up

The above examples are not meant to argue the science on environmental tobacco smoke one way or another, but simply to make known some of the data that were excluded from the position statement -- data, apparently, that were not helpful in building the case against environmental tobacco smoke.

No matter how prestigious-sounding a professional organization may be, if there is deliberate omission of facts in order to promote a point of view or goal, that organization cannot be seen as a credible source of information for determining public policy.

The position statement by Ducatman and McLellan -- which was approved by the American College of Occupational and Environmental Medicine’s Board of Directors – was published in the Journal of Occupational and Environmental Medicine, December 1, 2000. It appears online at http://www.acoem.org/paprguid/papers/etspaper.htm.

Martha Perske is a professional illustrator living in Connecticut. As a private citizen, she has spent the last several years investigating the environmental tobacco smoke issue.