Over recent decades, other development disorders also appear to have proliferated, along with certain cancers in children and adults. Why? No one knows for certain. And despite their financial and human cost, they presumably won’t be discussed much at Thursday’s White House summit on health care.
Yet they constitute a huge national health burden, and suspicions are growing that one culprit may be chemicals in the environment. An article in a forthcoming issue of a peer-reviewed medical journal, Current Opinion in Pediatrics, just posted online, makes this explicit.
The author is not a granola-munching crank but Dr. Philip J. Landrigan, professor of pediatrics at the Mount Sinai School of Medicine in New York and chairman of the school’s department of preventive medicine. While his article is full of cautionary language, Dr. Landrigan told me that he is increasingly confident that autism and other ailments are, in part, the result of the impact of environmental chemicals on the brain as it is being formed.
Without getting way beyond my knowledge of the relevant science, I wanted to point out a couple of flaws in Kristof’s piece. First, the fact that someone has an important title doesn’t mean that he’s not a crank, or even a granola-munching crank. And even if someone isn’t a crank in general, he might still have crankish opinions on a particular issue. Surely, we have all met someone who is generally non-crankish, but believes, e.g., that Obama was not born in the U.S., or the U.S. government was behind the 9/11 attacks.
I’m not saying Landrigan is a crank—though tips from his “Rodale Organic Style Book” Raising Healthy Children in A Toxic World, like abstaining from using commercial baby wipes, suggest that his views on keeping kids safe from chemical exposure are extremely conservative—just that his title doesn’t mean his views aren’t “crankish.” A cabbage with a Ph.D. is still a cabbage.
Second, Kristof pulls a bait and switch. First, he assures us that the article in question was published in a “peer reviewed” journal (though not a leading one), giving at least some indication of mainstreamness. But then Kristof adds; “While his article is full of cautionary language, Dr. Landrigan told me that he is increasingly confident that autism and other ailments are, in part, the result of the impact of environmental chemicals on the brain as it is being formed.”
In other words, to get published in a peer-reviewed journal, Landrigan had to use “cautionary language.” Meanwhile, his “confidence” is apparently not sufficiently backed by scientific evidence that he can use “confident” instead of “cautionary” language in the peer-reviewed article. The casual reader, in short, might be fooled into thinking that Landrigan’s “confident” views have passed peer review, when in fact they seem to represent his own non-peer reviewed speculation based on the current evidence.
UPDATE: I should add that even one “confident” peer-reviewed article would be just that; many peer-reviewed articles, including ones published in the leading medical and scientific journals, have turned out to be wrong.
vepxistqaosani says:
The worry about ‘chemicals in the environment’ is one of my pet peeves. _Everything_ is a _chemical_. To worry about ‘chemicals’ is not merely to be a luddite, it is to be an utter moron.
_Of course_ some chemicals are dangerous — Dihydrogen monoxide is famously deadly and extremely prevalent (there have even been petitions to ban it; if you don’t recognize the name or are confused, Google). But the ‘logic’ in Kristof’s article is of the ‘post hoc, ergo propter hoc’ variety. One could just as validly say that, since life expectancies increase with the increased development of novel chemicals, that such chemicals cause long life.
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February 25, 2010, 9:23 am1040 says:
So, your point is...?
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February 25, 2010, 9:31 amDG says:
Its terribly politically incorrect to say so, but journalists (in general) have several serious issues when it comes to reporting on things like this. They tend to have absolutely no scientific background (even science and technology writers) and are attracted to those scientific viewpoints that best mesh with their own innate sense of correctness or simply pass a common-sense “smell test”. That actually works a good bit of the time, but can easily fall prey to those (many) cases where your gut feelings just aren’t enough. Journalists always play expert bingo — they try to piece together information from real experts. The biggest problem with this is when they go in with pre-conceived notions (frequent) and shop for the experts who meet them.
As someone in the “expert” category for something highly technical, and known as someone with “good quote”, I frequently speak to journalists. I can usually help them, but have run into folks from a few very well known publications (NYT, Businessweek) who will actually say “I need someone to say X, and if you won’t say X, can you tell me someone who will?”.
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February 25, 2010, 9:31 amJohn Neff says:
Landrigan’s results have to be independently confirmed to be credible and I wonder what he used as a control group.
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February 25, 2010, 9:44 amDOuglas2 says:
Why are there more diagnoses of X?:
Are we better at diagnosing it than before?
Do more children have access to medical care?
Are there incentives that would drive more the increase?
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February 25, 2010, 9:46 amKevin P. says:
Peer review seems to be becoming increasingly irrelevant as a tool to winnow the good science from the bad. It all comes down to which peers you can get to review your article for you, and where their sympathies and prejudices lie. And in the case of ClimateGate, if you can control all the peer reviewers, you can control the science itself.
It is time for peer review to fall by the wayside and to return to the old-fashioned way: prove it or shut up.
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February 25, 2010, 9:59 amKevin P. says:
In some ways, life is vastly better today with all the chemicals that have been invented for human health and comfort, especially when used safely. We take this all for granted. Journalists, being relatively clueless about everything in general and science and technology in particular have often actively participated in scares about this chemical and that chemical. A class case was the scare about the Dow breast implants:
http://en.wikipedia.org/wiki/Breast_implant#Claims_of_systemic_illness_and_disease
Having read Kristof, I have found him to be smart and articulate but clueless about the subjects that I happen to know a lot about. I wonder if he is also clueless about the subjects that I don’t know a lot about.
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February 25, 2010, 10:05 amarch1 says:
David, the bait-and-switch characterization is weak at best. Immediately before reporting what “Dr. Landrigan told me...” about Landrigan’s personal views, Kristof goes out of his way to point out that the article was full of cautionary language.
And what did Landrigan tell Kristof? That Landrigan’s level of confidence was rising over time. Your “casual reader” would have to be pretty darned casual to believe that a journal article’s level of confidence can rise over time.
No, I think it will pretty clear to even dihydrogen oxide-exposed readers that the cautionary language is in the (peer-reviewed) article, and that the increasing confidence is in the (non-peer-reviewed) brain of its author. Because that’s exactly what Kristof said.
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February 25, 2010, 10:10 amCameroda says:
But I couldn’t live without Dihydrogen monoxide.
The article reminds me of this quote:
You don’t use science to show that you’re right, you use science to become right. xkcd #701
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February 25, 2010, 10:22 amDavid Bernstein says:
I doubt Kristof wanted to make this clear, because it’s then obvious that his article comes down to, “there is one doctor who I spoke to who is increasingly confident that autism is caused by chemical exposures, but his confidence is not supported by any peer-reviewed literature, including his own articles.” Pretty thin gruel.
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February 25, 2010, 10:25 amBrett says:
What do you think Peer Review is? It is exactly that — fellow scientists reviewing the experimental work of the work sent in for potential publication. And I would hardly say it has become “increasingly irrelevant” — no doubt you still trust it to result in good science in, say, medicine or geology.
To be honest, this whole post by Bernstein seems like making a mountain out of a molehill. Yes, you can actually be “increasingly confident” while pointing out in “cautionary language” that further verification is needed.
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February 25, 2010, 10:26 amKevin P. says:
Performing a review of someone else’s article isn’t proof. Having someone else being able to reproduce the work by performing their own experimentation or empirical work is proof.
Peer review may still be useful but it seems to be degenerating into: “Yeah, it looks good and smells good, sounds good to me!” I wonder if this has always been the case, and if only recent politically charged scandals have brought this inherent weakness into the light of day.
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February 25, 2010, 10:33 amHouston Lawyer says:
Since there are now benefits to be received for being diagnosed with many maladies, suprise, the number of cases diagnosed has increased. This is in addition to our ability to correctly diagnose illnesses that we could not diagnose in the past. Neither of these factors indicate that the number of people suffering from these maladies has actually increased.
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February 25, 2010, 10:35 amfennel says:
C’mon, Bernstein, your criticisms are a joke.
As to the first, nothing in Kristof’s article states or implies that being a crank and professor of pediatrics at a major medical school are mutually exclusive categories. The only “flaw” appears to be your misreading of the piece as making such an assertion.
Second, there is no bait and switch here. The paragraph you quote is 100% accurate. The article said X; the professor told me Y in an interview. Not by any stretch of the definition of bait and switch does that qualify. Kristof simply reported two facts, and I’m at a loss to see how this could cause any confusion.
I found Kristof’s piece to be refreshingly straighforward and not sensationalistic in an area where much of the journalism is garbage. Ironically, you yourself seem to engage in precisely the kind of smoke and mirrors reporting of the kind you falsely accuse Kristof of conducting. From the end of the article, a part you (not surprisingly) chose to ignore in your blog post:
“Frankly, these are difficult issues for journalists to write about. Evidence is technical, fragmentary and conflicting, and there’s a danger of sensationalizing risks.”
Kristof’s article was measured and informative. Your criticisms, not so much.
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February 25, 2010, 10:36 am1040 says:
I think it is pretty clear that’s not what the article is about. He says there is mounting evidence to this effect, and cites other related studies about pthalates etc. I hold no brief for Kristof, however, your post cites no evidence and seems to be a knee-jerk reaction in the “liberals are anti progress” vein. Pretty much useless.
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February 25, 2010, 10:36 amKevin P. says:
This kind of article seems to be tailor-made for a like-minded journalist to take it and run with it, producing scary news coverage that may have the benefit of shaking up public opinion and ultimately providing research funding and/or political support for the scientist in question. This is an old game in the field of gun control “research”, for instance.
Please note that this theory of mine is only a theory, but I am increasingly confident of it although further verification is needed.
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February 25, 2010, 10:36 amyankee says:
Yes, strictly speaking, someone’s being a credentialed expert doesn’t necessarily mean they’re not a crank. Yes, Kristof’s wording might suggest to some readers that Landrigan’s “confident” views have passed peer review even though only the “cautionary” views have. But nothing of substance would be different if Kristof had identified Landrigan’s credentials without the phrase “granola-munching crank” or reworded the last sentence to make it even clearer that Landrigan’s confidence was not peer-reviewed.
You’re not pointing out flaws in Kristof’s piece, you’re quibbling with his choice of words.
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February 25, 2010, 10:41 amDavid Bernstein says:
Correction: it’s not that the entire article comes down to, “there is one doctor who I spoke to who is increasingly confident that autism is caused by chemical exposures, but his confidence is not supported by any peer-reviewed literature, including his own articles,” it that Kristof’s citation to his conversation with Landrigan comes down to this. Why should I (or anyone) care about Landrigan’s “increasing confidence” if it’s not backed up by the literature? Just about every “Junk science” torts case that I’m aware of involved legitimate scientists who took fragmentary, preliminary evidence of a problem, and became “increasingly confident” that the problem existed. Medical and scientific speculation is just that, and I don’t see any particular reason to trust Landrigan’s skills at predicting what future research will show.
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February 25, 2010, 10:44 amSteve says:
See, here is how the scientific method works. A scientist makes observations and creates a hypothesis to explain them. He then tests his hypothesis through experiments, which he may write up for a peer-reviewed journal. If the experiments are inconsistent with the hypothesis, then it is thrown out. If the experiments are consistent with the hypothesis, the scientist becomes increasingly confident in his hypothesis and conducts further experiments until the hypothesis becomes sufficiently well established as accurate.
There is nothing particularly strange or even remarkable about a scientist whose experiments are consistent with his hypothesis becoming increasingly confident that his hypothesis is correct.
DB seems to be playing word games by transforming the ordinary phrase “increasingly confident” — which expresses that one’s confidence is moving along a spectrum in a positive direction — into merely “confident,” so that he can argue the binary distinction that either you’re certain or you’re not. If I was 60% confident in my hypothesis before an experiment but now I’m 80% confident, I’m definitely increasingly confident, but you’d surely expect my journal article to include cautionary language to indicate that we can’t be sure yet and that additional experimentation is required to confirm the last 20%.
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February 25, 2010, 10:48 amDavid Bernstein says:
That’s all I wanted to point out. Given the hysteria over, e.g., vaccines and autism, readers should be aware that the one expert Kristof cites who is alarmed about chemicals doesn’t seem to be basing his views on established science (and, moreover, this expert seems to be far more alarmist in his views on chemicals more generally than the medical/scientific community as a whole).
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February 25, 2010, 10:50 amcommon_sense says:
I think this chemicals causing autism thing is particularly bad, though. We’ve been through this on this website before, but there are still plenty of people who don’t get their kids vaccinated because of this argument. Although the author’s characterization mighy be fine in a generic science article, I think it is important to be more careful in this particular area. Not that we shouldn’t continue to study environmental chemicals and their relationship to brain development–I just think that journalists need to be extra careful about autism. It seems the newest thing is to blame autism on ultrasounds. This at least has less impact on other people than the vaccine issue, and maybe if people focus on that, we can return environmental chemical science to its proper place and people won’t have to be so sensitive to journalists writing it up as business as usual.
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February 25, 2010, 10:55 am1040 says:
I think Kristof is both citing this expert’s opinion as well as other studies. It is bizarre to project your alarmist fears onto that article, and seems like a projection of some pre-existing prejudices, especially when Kristof has thoughtfully said such things in this article as:
One uncertainty is to what extent the reported increases in autism simply reflect a more common diagnosis of what might previously have been called mental retardation. There are genetic components to autism (identical twins are more likely to share autism than fraternal twins), but genetics explains only about one-quarter of autism cases.
Suspicions of toxins arise partly because studies have found that disproportionate shares of children develop autism after they are exposed in the womb to medications such as thalidomide (a sedative), misoprostol (ulcer medicine) and valproic acid (anticonvulsant). Of children born to women who took valproic acid early in pregnancy, 11 percent were autistic. In each case, fetuses seem most vulnerable to these drugs in the first trimester of pregnancy, sometimes just a few weeks after conception.
Frankly, these are difficult issues for journalists to write about. Evidence is technical, fragmentary and conflicting, and there’s a danger of sensationalizing risks. Publicity about fears that vaccinations cause autism — a theory that has now been discredited — perhaps had the catastrophic consequence of lowering vaccination rates in America.
On the other hand, in the case of great health dangers of modern times — mercury, lead, tobacco, asbestos — journalists were too slow to blow the whistle. In public health, we in the press have more often been lap dogs than watchdogs.
At a time when many Americans still use plastic containers to microwave food, in ways that make toxicologists blanch, we need accelerated research, regulation and consumer protection.
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February 25, 2010, 11:03 amDavid Bernstein says:
An expert’s opinion on a matter like this, not backed by actual evidence, is basically worthless.
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February 25, 2010, 11:07 amTRE says:
I’m increasingly confident that junk science presents one of the biggest dangers to our society.
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February 25, 2010, 11:08 am1040 says:
I think it is becoming increasingly clear that you are not fighting the article, just your own prejudices.
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February 25, 2010, 11:16 amrequired says:
DB’s point is that being a crank is not excluded by holding a prestigious position — for proof look only at the people who held the position of the US’s top doctor, the Surgeon General. Straight logical error.
As for the article, I don’t know they are wasting time on environmental chemicals. Epidemiology has already proven that the cause of autism is autism testing, now it merely remains to be shown the mechanism for how autism testing causes autism. The correlation is just too strong to ignore, autism rates are well over %1000 higher in children who live near specialist autism testers than for children who live far away from autism testers (and that’s not even counting the poor children who have been directly exposed to autism testers, the rate of autism in children who have been tested for autism is so much higher than that of children who have not been tested that it probably should be considered child abuse). And use the precautionary principal, stop autism testing now.
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February 25, 2010, 11:16 amlgm says:
It’s true, you shouldn’t take just one peer reviews article as proof. But Adler seems to imply that he would accept a number of consistent peer reviewed articles together with a large consensus of experts in the field. But even that doesn’t seem to be enough with climate change, where no amount of new confirmation is enough.
“Prove it or shut up” is peer review, with the extra feature that the person you prove it to is an expert in the field, not Glen Beck or some yokel hired by the Heritage Institute.
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February 25, 2010, 11:20 amSenatorX says:
An expert’s opinion on a matter like this, not backed by actual evidence, is basically worthless.
You’re right. Authority simply doesnt exist without evidence...
His opinion is no more valid than yours.
Epidemiology has already proven that the cause of autism is autism testing, now it merely remains to be shown the mechanism for how autism testing causes autism.
Except it hasn’t.
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February 25, 2010, 11:36 amDavid Bernstein says:
And I think it’s clear that you make a point of disagreeing in the comments with every single post I write.
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February 25, 2010, 11:38 am1040 says:
Well, Professor, I only intended to disagree with the stupid ones.
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February 25, 2010, 11:39 amDavid Bernstein says:
Oh, dear, an anonymous commentator called my posts stupid, I think I’ll go jump off a cliff.
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February 25, 2010, 11:45 amorca says:
Why shouldn’t a country that was willing to invade another country on scant evidence use Dr. Landrigan’s concerns to launch an attack on potentially harmful chemicals?
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February 25, 2010, 11:52 amBrianMac says:
That’d be a reasonable argument if his title was unrelated to the subject he was discussing. But in this case, the fact that he’s a professor of pediatrics suggests that his views on the links between chemical exposures and health aren’t crankish.
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February 25, 2010, 11:58 amDavid Bernstein says:
Not really.
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February 25, 2010, 12:07 pmJozxyqk says:
Or at least rise snapping and thrashing to embarrassingly weak bait.
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February 25, 2010, 12:08 pmfalafalafocus says:
That is the best irrelevant attempt to derail the thread I’ve seen this week. I say we run with that and turn this topic into a discussion of torture.
By the way, Orca, did you know that Seattle had the hostest temperature of record last year?
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February 25, 2010, 12:14 pmBrianMac says:
You realise that chemicals and health is his specific area of expertise? Do you have any reason to believe that he’s a crank?
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February 25, 2010, 12:15 pmJiffy says:
Both Kristof’s article and the abstract of the Landrigan paper to which it links refer to “proof of concept studies.” Does anyone know what that means?
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February 25, 2010, 12:15 pmorca says:
Not trying to derail the thread, just pointing out the American right’s level of proof required for action seems to depend not on science but on whether an action will hurt some wealthy Republican donor’s business or not.
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February 25, 2010, 12:20 pmMatt says:
Of course, what Bernstein doesn’t mention is the long line of mounting evidence that environmental toxins may be contributing to brain damage in the developmental phases of life. Perhaps, and just PERHAPS, that is why Dr. Landrigan expresses a stronger view to Kristof than that concluded in his piece.
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February 25, 2010, 12:20 pmegd says:
Reducto ad Saddam?
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February 25, 2010, 12:38 pmfalafalafocus says:
I can’t speak for DB, but personally, I only demand stricter proof when: 1) I know which Republican donor’s business is affected, and 2) how much they donated.
You obviously have this information. Don’t hold back!
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February 25, 2010, 12:39 pmLaura(southernxyl) says:
IMO the advice to eschew commerical baby wipes is kind of crankish. I remember standing my daughter up in the sink and using the spray nozzle to hose her down. I was tempted a few times to just take her outside, throw her clothes in the trash, and wash her off with the garden hose. A little aloe gel and lanolin and whatever else they feel like putting in those wipes can’t POSSIBLY be as toxic as what they’re meant to wipe off.
There’s some interesting epidemiology being done among Somalis in Minnesota, whose children have a high rate of autism. Evidently the same thing happens with Somalis in Sweden, which could point to a vitamin D deficiency in dark-skinned children who live in areas of low sunlight. It certainly can’t hurt to ask these questions.
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February 25, 2010, 12:54 pmThrobert McGee says:
Erm, because all other factors being equal, parents would rather hear “Your child is autistic” than “Your child is retarded”? When the doctor says “autistic,” parents think, “Well, maybe he’ll turn out to be really high-functioning, like Temple Grandin. Or, failing that, maybe he’ll at least have a phenomenal ability to count cards in Vegas.”
Do you realize that Tarot-card reading is Miss Cleo’s specific area of expertise? She knows Tarot up, down, and sideways, dude!
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February 25, 2010, 1:02 pmMatt says:
Throbert understands neither mental retardation nor autism.
If you want tarot-card reading, you go to Miss Cleo. She will know how to read tarot cards. If you want a pediatrician and the chairman of a medical school’s department of preventive medicine, you go to Dr. Landrigan. He will not know how to read tarot cards, but he’ll know about things related to pediatrics and preventive medicine. Or is that too obvious to even state?
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February 25, 2010, 1:07 pmDavid Bernstein says:
The Tarot-card reading point, I take it, is that being a physician who does research on pediatric health issues doesn’t give you any more or less predictive ability about what future research will show than if you read Tarot cards. I know at least one very reputable immunologist, not affiliated with any litigation party, who was absolutely convinced that future research would show that breast implants caused atypical immune system disorders.
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February 25, 2010, 1:37 pmKazinski says:
If you look at the very real damage that was done to children’s health by a rogue researcher that had a theory and not the facts to back it up, then Bernstein is right to point out the flaws in Kristof’s column.
I don’t think there is any doubt, either that there is an army of Luddites that are very suspicious of the benefits of technology and are perfectly willing to use junk science to restrict our access to technology. The hysteria and withdrawl from the market of breast implants is just one fairly trivial example of that. The vaccine controversy was much more serious, and the retraction of the vaccine-autism study is not going to completely fix the problem.
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February 25, 2010, 1:40 pmMatt says:
David: Why are you ignoring the other evidence (in the forms of studies) I cited in my previous post re: the link between environmental toxins and developmental damage (autism, etc.) as the reason why researchers (like Dr. Landrigan) may be “increasingly confident” about certain findings? Is that also too obvious to point out? Does it go without saying that the chairman of preventive medicine at a prominent medical school is already well-versed in the research landscape of his or her particular discipline?
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February 25, 2010, 1:47 pmthecabbage says:
I concur.
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February 25, 2010, 1:47 pmDavid M. Nieporent says:
Of course there isn’t. But why should we care? His personal confidence is utterly irrelevant. Science is not about handing down wisdom from a priesthood in lab coats; it’s about research. If he has research which strongly confirms his theory, he should publish it. If he hasn’t done so, then it’s just bloviating. (Not that there’s anything wrong with him saying it, but why is Kristoff publishing it as though it had meaning?
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February 25, 2010, 1:56 pmSigivald says:
From that: “It also revealed that no more than 56 percent of the estimated 600-to-700 percent increase, that is, less than one-tenth of the increased number of reported autism cases, could be attributed to the inclusion of milder cases of autism. Only 24 percent of the increase could be attributed to earlier age at diagnosis.”
Unless they wrote that in a horribly poor fashion, it sure looks like they’re saying that 80% of the “increase in autism diagnoses” might be related to “chemicals or microbes”.
That’s not a strong indication that we should be worrying about “toxins” (?) causing autism.
Whenever someone jumps to handwaving about unspecified “toxins” causing something, it’s an instant alarm bell — good scientists won’t call it a “toxin” until they’re sure what it is and that it’s actually causing a toxic effect rather than causing autism as a side effect maybe sometimes somewhere. (That being a negative effect, but not obviously a toxic one.)
(I also would not assume that a Chair at a “Prominent School” (appeal to authority?) is necessarily well-versed in the totality of the research “landscape” — or that being a Chair somehow makes one immune to unconscious cherry-picking or other biases. Because it doesn’t.)
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February 25, 2010, 2:02 pmray_g says:
“Do you have any reason to believe that he’s a crank?”
Yes — considering that there has been a long line of unfounded fears about environmental “toxins”, chemicals, power lines etc. causing any number of ailments, and many (if not most) of those promoting these fears have been cranks with PhD’s. The recent brouhaha about vaccines is a good example. Maybe this particular person is totally sincere and totally correct. Unfortunately for him, the atmosphere for debating these things has been poisoned by the cranks that came before him. I’m going to want to see a whole lot of evidence and replication by other researchers before I take him out of the “presumed crank” category.
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February 25, 2010, 2:09 pmjames says:
Um, reviewing your proof is good science on my part as well. If I as your peer look at your datasets and confirm that it meets the criteria for good science, there is value in a peer reviewing. I agree that running a new series of experiments with my own data, controls, and variables is better than peer review, but peer review absolutely has value.
I also agree that there is real danger from consensus-science-by-commitee ala the climategate folks where actual results get suppressed as a result of bad scientists and grant-challenged administrators.
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February 25, 2010, 2:27 pmpmorem says:
One chemical that has been linked to Autism is Oxytocin.
People may not like where that leads.
Based on what I’ve seen, read, and personally experienced, the possibility exists that exposure to too much Oxytocin during development may increase the risk of Autism.
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February 25, 2010, 3:01 pmLaura(southernxyl) says:
If peer review involved looking at datasets, I’d be more impressed by it.
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February 25, 2010, 3:14 pmA. Zarkov says:
“The author is not a granola-munching crank but Dr. Philip J. Landrigan, professor of pediatrics at the Mount Sinai School of Medicine in New York and chairman of the school’s department of preventive medicine.”
Pediatricians deal with the treatment of childhood diseases and developmental disorders. I don’t think their training includes much in the way of epidemiology, which tends to be heavily statistical. Dr. Landrigan might be very good at treating children and even offering advice to parents on how to avoid specific causes of childhood diseases, but how does that qualify him to do epidemiology?
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February 25, 2010, 3:15 pmMatt says:
It’s unfortunate that A. Zarkov (and David Bernstein) couldn’t have saved us all the effort of googling Dr. Landrigan and discovering that he does have a strong epidemiological background. From his bio page:
Specialty: Occupational Medicine , Pediatrics
Clinical Interests: Environmental Pediatrics; Occupational Medicine; Epidemiology
Education and Training MD, Harvard Medical School
M.Sc., London School of Hygiene and Tropical Medicine
Diploma of Institute Health, University of London
Residency, Epideminology, Center for Disease Control
Residency, Pediatrics, Children’s Hospital Boston
Residency, Medicine/Pediatrics, MetroHealth Medical Center
Awards 2009
Best Doctors
New York Magazine
2006
Lifetime Achievement Award
Children’s Health Environmental Coalition
2006
Children’s Environmental Health Champion Award
Environmental Protection Agency
2005
Health Achievement in Occupational Medicine Award
American College of Occupational and Environmental Medicine
2005
J. Lester Gabrilove Award
Mount Sinai School of Medicine
2003
David P. Rall Award for Advocacy in Public Health
American Public Health Association
2002
James Keogh Award
National Institute for Occupational Safety and Health
2002
Jacobi Medallion
Mount Sinai School of Medicine
2001 — 2006
Top Doctor. Preventive Medicine. New York Metropolitan Area and United States
Castle Connolly Ltd
2000
William Steiger Memorial Award
American Conference of Governmental Industrial Hygienists
Philip J. Landrigan, M.D., M.Sc., the Ethel Wise Professor and Chair of the Department of Preventive Medicine, is a pediatrician, epidemiologist, and internationally recognized leader in public health and preventive medicine. He has been a member of the faculty of Mount Sinai School of Medicine since 1985 and Chair of the Department of Preventive Medicine since 1990. Dr. Landrigan is also the Director of the Children’s Environmental Health Center.
Dr. Landrigan graduated from Boston College in 1961 and from Harvard Medical School in 1967. He completed an internship in pediatrics/medicine at Cleveland Metropolitan General Hospital and a residency in pediatrics at Children’s Hospital Boston. In 1977, he received a Diploma of Industrial Health from the University of London and a Masters of Science in Occupational Medicine degree from the London School of Hygiene and Tropical Medicine. He then served for 15 years as an Epidemic Intelligence Service Officer and medical epidemiologist at the Centers for Disease Control and Prevention (CDC) and the National Institute for Occupational Safety and Health (NIOSH). While at CDC, Dr. Landrigan served for one year as a field epidemiologist in El Salvador and for another year in northern Nigeria. He participated in the Global Campaign for the Eradication of Smallpox. Dr. Landrigan directed the national program in occupational epidemiology for NIOSH. He was awarded the Meritorious Service Medal of the US Public Health Service.
In 1987, Dr. Landrigan was elected as a member of the Institute of Medicine of the National Academy of Sciences. He served as Editor-in-Chief of the American Journal of Industrial Medicine and Editor of Environmental Research. He has published more than 500 scientific papers and 5 books. He has chaired committees at the National Academy of Sciences on Environmental Neurotoxicology and on Pesticides in the Diets of Infants and Children. The NAS report that he directed on pesticides and children’s health was instrumental in securing passage of the Food Quality Protection Act, the only environmental law in the United States that contains explicit provisions for the protection of children. From 1995 to 1997, Dr. Landrigan served on the Presidential Advisory Committee on Gulf War Veteran’s Illnesses. In 1997–1998, Dr. Landrigan served as Senior Advisor on Children’s Health to the Administrator of the U.S. Environmental Protection Agency and was instrumental in helping to establish a new Office of Children’s Health Protection at EPA. From 2000–2002, Dr. Landrigan served on the Armed forces Epidemiological Board. Dr Landrigan served from 1996 to 2005 in the Medical Corps of the United States Naval Reserve. He retired in 2005 at the rank of Captain. He continues to serve as Deputy Command Surgeon General of the New York Naval Militia, New York’s Naval National Guard.
Dr. Landrigan is known for his many decades of work in protecting children against environmental threats to health, most notably lead and pesticides. His pioneering research on lead toxicity at low levels persuaded the US government to mandate removal of lead from gasoline and paint, actions that have produced a 90% decline in incidence of childhood lead poisoning over the past 25 years. Dr. Landrigan has been a leader in developing the National Children’s Study, the largest study of children’s health and he environment ever launched in the United States. He has been centrally involved in the medical and epidemiologic studies that followed the destruction of the World Trade Center on September 11, 2001. He has consulted extensively to the World Health Organization.
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February 25, 2010, 3:24 pmThrobert McGee says:
Google on “retardation”, “classification”, and “autism.” The hypothesis that people who in past decades would’ve been categorized with some non-specific cognitive impairment are now being statistically subsumed into the “Autism Spectrum” is not something I just pulled out of my ass to make conversation on VC. The possibility that this kind of diagnostic reclassification may partly explain the apparent rise in autism has caught the attention of some reputable researchers in the field.
Apparently it’s NOT overly obvious that the doctor’s expertise in pediatrics and preventative medicine do not guarantee that he is a reliable expert on epidemiology or statistical analysis.
UPDATE: Whoops. I stand corrected. Thanks, Matt.
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February 25, 2010, 3:44 pmA. Zarkov says:
Excellent. You did the work for me. Landrigan’s training is somewhat unusual for a pediatrician. Assuming his bio is accurate, he does seem well qualified to identify possible causes of childhood developmental disorders.
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February 25, 2010, 3:54 pmChris Travers says:
I noticed that Kristof’s piece was full of cautionary language.
There is increasing concern that pollutants in our environment are leading to increased cancer rates, and various forms of birth defects and early-childhood-development issues. This is pretty clear. In some places, however, this isn’t just a hypothetical concern but a known risk. I lived downwind from Hanford for a few years, and it was well known that there was an area around where I was living that had a substantially increased risk of thyroid cancer for the elderly.
I guess I may be confused about Prof. Bernstein’s point. Is he arguing that pollutants are clearly not an issue and no cause for concern? Or is he saying anyone addressing anything relating to autism is a crank? If not, and he is willing to admit that there is a possibility that some of these things may be pollutant-caused, then is he agreeing with Kristof’s piece but uncomfortable saying so?
After all both seem to be saying “we don’t know for sure, but this is a real possibility....”
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February 25, 2010, 3:58 pmBrett L says:
I have a son who was recently placed on the autism spectrum. At first we tried to find any factors that could have contributed to this disorder. That being said I have no expertise.
If you look at reporting trends, it appears that increases in diagnoses are showing up in more educated communities (http://abcnews.go.com/Health/AutismNews/education-level-environment-tied-autism-clusters/story?id=9514773). Researchers believe that this is simply because parents with more education are more likely to have access to facilities to diagnose these disorders.
If you even look at pop culture from as recently as the 80’s, there are children portrayed as rambunctious, who would now be placed on the autism spectrum. (Look at the movie Parenthood, Steve Martin’s youngest son has some very telling personality traits.)
I’m not willing to say that environment does not have any affect on increased rates of autism, but certainly advancements in our understanding of human development has led to increased levels of diagnoses.
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February 25, 2010, 4:34 pmDavid Bernstein says:
Here’s the web page of Dr. Shanna Swan, who was testified against all evidence that Bendectin causes birth defects. Among other things, “Dr. Swan is currently Professor in the Department of Obstetrics and Gynecology and Director of the Center for Reproductive Epidemiology at the University of Rochester School of Medicine and Dentistry.” Impressive, no? She was still dead wrong about Bendectin. Don’t confuse a resume with insight on any given medical issue, especially when it comes to speculative issues of causation.
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February 25, 2010, 4:54 pmBrianMac says:
One time this doctor said he thought I might have diabetes. He totally turned out to have been wrong. Now I just ignore them all (white coats are no marker of expertise!), especially when it comes to speculative diagnoses.
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February 25, 2010, 5:16 pmdearieme says:
At least this post has led me to google “granola”. Goodness me, I think I’ll stick to muesli.
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February 25, 2010, 5:58 pmrequired says:
Erg you might wish to check your source, all it disproves is that the hypothesis that children who actually were borderline autistic but not tested were skewing the numbers by being compared with those which were being tested. This just reinforces that it is indeed autism testers who cause autism, and not an artifact of who is and isn’t being tested.
(of course some might argue that autism specialists are more likely to establish themselves in areas where thereis a higher incidence of autism, reversing causality. certainly this is worthy of research as is discovering the mechanism by which autism testers cause autism, but as a precautionary measure until we can determine the truth we should do something to keep autism testers away from children.)
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February 25, 2010, 6:11 pmDOuglas2 says:
Landrigan’s book pushes the myth of toxicity of poinsettias (Euphorbia pulcherrima) — is that a useful point in this discussion?
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February 25, 2010, 6:21 pmwfjag says:
Publication in a “peer-reviewed” journal doesn’t mean that the article’s conclusions are necessarily well-supported. Dr. Andrew Wakefield, M.D., also has an impressive resume, and published his (in)famous article in a first ranked peer-reviewed journal, Lancet. In article, Dr. Wakefield was, likewise, “full of cautionary language”.
This sounds like a distressingly familiar pattern.
The abstract you linked to answers that:
Or, as Audrey said in Little Shop of Horrors:
For a readible review of the language frequently found in abstracts and journal articles, I suggest A Layperson’s Guide to the Scientific Literature – Part 3 July 23rd, 2008, at
http://photoninthedarkness.com/?p=148 It explains the terms Meta-analyses, Pilot Studies, and Case Reports / Case Studies. A “Proof of Concept Study” looks like a type of Pilot Study — a study to determine whether the available evidence supports a more formal, better funded, study. (Keep in mind that studies that have negative results neither get published nor get additional grant fundings. So, there is a financial interest in finding something worth further funding to study even more).
Throbert McGee says:
Generally not true. However, if you want to maximize educational resources available for your SPED child, a lot more will be available with an ASD diagnosis than with a MR diagnosis. The additional services justify additional funding for the school and its teachers, aids, etc. So, actually, there is greater benefit for service providers for an ASD diagnosis than for parents. However, as the parent of an autistic child, I’ll confess that getting a diagnosis that increased the services he receives (in and out of school) isn’t something I discouraged.
Further, many people with ASD diagnoses are very intelligent. Today, Albert Einstein would likely receive an ASD diagnosis, and Bill Gates demonstrates many characteristics that could support an ASD diagnosis. Before autism was included as a diagnosis in 1980 in DSM-III-R (and the diagnostic criteria expanded significantly since then), lots of folks were diagnosed as “Geeks.” One of the rules for life that Bill Gates once laid out in a speech to some graduating High School Seniors was “Be nice to the Geeks in your class. In 10 years you’ve probably be working for one of them.”
For more information on the (alleged) autism epidemic, and the corresponding decrease in MR as a diagnosis, see Five Easy Graphs, January 28th, 2009
http://photoninthedarkness.com/?p=158 ; Another Perspective on the “Autism Epidemic”, October 26th, 2007 http://photoninthedarkness.com/?p=117 ; and,
Myths and Legends of Autism: Part 3 September 7th, 2007 http://photoninthedarkness.com/?p=107
The author is a research scientist with 2 Ph.D.s in different fields of biology, and the father of an autistic child.
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February 25, 2010, 6:50 pmleo marvin says:
Actually, I’ve found the beliefs that Obama wasn’t born in the U.S., and that the U.S. government was behind the 9/11 attacks, to be very reliable predictors of general crankishness. I don’t doubt there are exceptions, but no, I haven’t met any.
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February 25, 2010, 7:15 pmA. Criminal says:
I should add that even one “confident” peer-reviewed article would be just that; many peer-reviewed articles, including ones published in the leading medical and scientific journals, have turned out to be wrong.
It’s a lot worse than that (which is why ‘climategate’ didn’t surprise me):
“Why most published research findings are false”
http://www.ncbi.nlm.nih.gov/pubmed/16060722
Austism and climate are simiarly difficult cases because:
— they rely on historical measurements for comparisons.
— the measurements are difficult.
— there’s a lot of things to measure.
— it’s difficult or impossible to have proper control groups.
— emotional and political content and funding.
And yeah, most MSM accounts of science are bad.
For more information, try this: http://www.google.com/search?q=sowell+autism
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February 25, 2010, 8:38 pmKirk Parker says:
Kevin P.,
It can hardly “become increasingly irrelevant” for something that in never did in the first place.
Far too many people confuse “peer review” with “independent confirmation of results”. The former really only answers the question, “Does this paper pass the laugh test” (i.e. will we end up embarrassed to have published it in our journal?) That’s all, nothing more. It has never (outside the mind of some clueless journalists) had anything to do with proving or validating the claims made.
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February 25, 2010, 8:54 pmKevin P. says:
You have a misunderstanding of peer review. Peer review does not involve proving or reproducing anything. It is a review of a claim or article or publication without any attempt to reproduce the results independently. Any yokel could tell you this. Even Wikipedia has it generally correct: http://en.wikipedia.org/wiki/Peer_review
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February 25, 2010, 9:06 pmBrianMac says:
There’s not a small amount of irony in treating this article as gospel, without any discussion of the underlying assumptions, methods, or claims.
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February 25, 2010, 9:13 pmbyomtov says:
Hard to see what the problem is here.
I suspect lots of researchers are more confident of their results than they can reasonably say in a formal presentation, such as a journal article.
Peer reviewed articles are sometimes wrong? Big deal. What should we do? Let first-year graduate students decide what’s worth publishing? Oh. Wait.
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February 25, 2010, 9:58 pmraoul says:
I criticize you enough that I guess I should commend you when you are right. And you are 100% correct here. I also noticed the bait and switch; and though logically one can educe modern life tribulations are the cause of modern maladies the devil is in the details.
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February 26, 2010, 1:29 amSenatorX says:
required you do know that early intervention is they key to recovering an autistic child? It might make sense for you to ignore these children but for the children and parents of these children the earlier they become aware of the work they can do the better. More often it is exactly opposite what you describe as most pediatricians ignore a parents worries that something is off with their child. They are told its “just boys” or ear infections and given a pat on the ass and an anti-biotic. There has been alot of work for earlier diagnosis precisely because there is a window of opportunity for recovery and not because of some nefarious plot to create stats you don’t want to see.
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February 26, 2010, 2:08 amRSF677 says:
http://www.marginalrevolution.com/marginalrevolution/2010/02/nicholas-kristof-on-toxins-and-autism.html
some additional criticisms
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February 26, 2010, 7:42 amdearieme says:
“A cabbage with a Ph.D. is still a cabbage.”
Come, come; he’s Dr Cabbage.
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February 26, 2010, 10:56 amlgm says:
I do peer review every day. It is true that reviewers rarely repeat experiments. That makes peer review just the first step in scientific scrutiny. It is interesting that global warming deniers rarely get past even this screening process. If an interesting promising idea appears in a refereed journal, others will be motivated to test it further, repeat experiments, etc.
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February 26, 2010, 11:23 amChris Travers says:
A few flaws occur to me in Bernstein’s critique. The first is that there is a fundamental difference between noting the concern that increases in man-made organic and nonorganic pollutants may be causing health problems and calling for more research is very different from what Bernstein seems to be arguing against. In essence I am left with the feeling that Bernstein is cleverly creating a strawman here.
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February 26, 2010, 11:34 amChem2L says:
Hear, hear, Prof. DB. As a former chemist and current law student, your criticisms of the Kristof’s article, and the Good Doctor’s proffered opinion, ring true to me.
Scientists are people. They get invested in their position on a given issue. In fact, they are expected, once they reach a certain level in their careers, to have an opinion; strong opinions drive the debate forward, while weak ones are uninteresting. You have to fight for funding. Your reputation is the life of your laboratory and your institution, and all the people that depend on it, and becomes a valid end in itself. Under this pressure, it is difficult to maintain integrity — and by this I mean criticality — when your personal narrative, your social status, and the ability to continue your work are on the line. Recall the Hwang Woo-suk cloning controversy, and the historical case of Piltdown Man.
One of my former coworkers at a drug discovery company — a really bright and critical Ph.D., whom I still respect — once told me that he thought it should be all right for climate scientists to manipulate their data in order to better support the theory of global warming, because hey, the other side was clearly doing it, and the future of the planet was on the line. He wasn’t suggesting it was ok to falsify data, mind you, but to statistically interpret in a goal-directed way, such as through the strategic exclusion of outlying data points... was necessary. I was appalled. The choice of exclusion of outliers is an exercise that is performed in all scientific studies; outliers often indicate a limitation of the model or method, not a valid data point. You have to do it. It is part of being critical. It was his admission of bias as an active force in these choices that bothered me. I argued that the public had a right to the truth, even if it was not a compelling story. He agreed that the public had a right to the truth, but to a truth they could use — he argued that the public didn’t have the capacity to appreciate the totality of the data, and he had an obligation to represent what it was in terms they could digest, to speak for the data and its implications. We are both skeptics, in different ways.
These experiences tell me that when a scientist’s opinion and the data diverge, it is better to pay attention to the data, even if the only answer it gives is, “We really don’t know yet.” Though a viewpoint or theory may in fact prove to be correct, unsupported opinions should be actively identified and pilloried until the data can back them up. Credentialed plausibility is insufficient. Kristof is a layperson in this case, looking for answers that can be put to good use in living one’s life, on our behalf. We are all laypersons in most areas of expertise. But he is lending credence to suspicions that people will feel they have a right to rely on as fact. I think that’s wrong. I trust the big picture, not the charismatic leader.
Perhaps a different color of Kool-Aid, but there you have it.
And don’t even get me started on the terms “environmental chemicals,” “natural,” or my personal favorite, “toxins.” I spared you my speech on that and you’re all happier for it, trust me.
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February 26, 2010, 6:30 pmHarry Eagar says:
DG sez ‘I can usually help them, but have run into folks from a few very well known publications (NYT, Businessweek) who will actually say “I need someone to say X, and if you won’t say X, can you tell me someone who will?”.’
Bad practice, skirting on unethical.
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February 27, 2010, 2:06 pmAnatid says:
I love how misleading that article is. Any given study, yes, has an extremely low likelihood of gathering data that will produce a perfect, flawless, and universal model. So yes, from that perspective, most research findings are “false.”
But as Chem2L said, totality of data. A published paper might say “In A population, with B sampling methods, with C testing methods, conducted by researcher D, using analysis method E and conforming to definitions F and G, we found H.” The appropriate response to this is “Huh, that’s interesting” and to repeat the experiment in other labs, with other methods, in other cultures, under other conditions, longitudinally, to learn what biases are influencing the study and to eventually form an overall model.
So any given study will be “false,” but when you bring them together and conduct follows-ups, eventually an overarching theory may emerge. Developing that theory is the important part, not getting each individual study perfect.
I’m not sure I can trust you, Chem2L. This could be a really cool rant. Among other things, I want to compare notes with my own rant on “natural” and see what important points I’m missing.
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February 28, 2010, 3:26 amcheap nikeshox says:
I like it, very good
I like it, very good, Particularly in the Authority pages.
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May 27, 2010, 4:46 am