May 12, 2015 10:52 AM
Last month, researchers at the University of Florida published a study in the American Journal of Public Health that concluded, “Increases in alcohol excise taxes, such as the 2009 Illinois act, could save thousands of lives yearly across the United States as part of a comprehensive strategy to reduce alcohol-impaired driving.” Their study presented the case that the 2009 tax increase resulted in a statistically significant reduction in alcohol-related deaths in Illinois. However, as I pointed out in a blog post, there only appears to be a reduction in fatalities because of the authors’ selective inclusion and exclusion of data. Rebecca Goldin, Director of STATS.org and Professor of Mathematical Sciences at George Mason University, found even more flaws in the research.
In her post, Rebecca takes a bird’s eye view of the crash data in Illinois between 1999 and 2013. She finds a steady decline during this 10-year period with “hardly anything special at all going on at the end of 2009.” Looking closer at the data, she noted (as did I) the curious exclusion of data after 2011. “Results should be resilient to changes in choices, such as whether to use data published 2011-2013,” Goldin notes. When added to the evaluation, this 2011-2013 data shows a small decrease immediately after 2009, but then shows a steady increase in alcohol-related traffic deaths in Illinois. She also found that as a proportion of total traffic fatalities, alcohol-related fatalities on the road have been increasing since 2009 (though only by 2 percent—a statistically insignificant amount).
Of course, the real story here is that breaking the data at year 2009 may not be an appropriate way of measuring the trends, and certainly it’s not appropriate to “blame” the excise tax for the proportionally increased alcohol deaths in the context of decreasing deaths associated to alcohol. But by the same logic neither is it appropriate to conclude that the excise tax has been saving lives.
Finally, in addition to the “creative math” and error of conflating correlation with causation (bad scientists, bad!), there’s another potential problem with the study. The grant provided by the National Institutes of Health lists the purpose as “to develop a research program of HIV prevention focused on the intersection of event-level alcohol use… and sexual partner selection among adolescents.” There is no mention in the grant description about taxes or motor vehicle crashes. I say this is a “potential” problem because I have been unable to get answers from anyone at the NIH or the University of Florida researchers who worked on the project. My questions were simple: What was the rationale behind using an AIDS grant for alcohol tax research? And is this sort of change in scope common practice?
It’s one thing to have public health advocates peddling flawed research in order to advance personal agendas, but it’s another entirely to use taxpayer money to do so.
April 24, 2015 11:41 AM
Yesterday, Dr. Mehmet Oz launched his “counter attack” on several doctors who sent a letter last week to the dean of Columbia University’s medical department complaining about controversial positions and advice that Oz has offered on his show. Oz, who holds faculty and administrative positions at Columbia, exclaimed that he “will not be silenced” by his critics, casting the issue as an attack on his freedom of speech. In an article for Time magazine, Oz stated:
The dean politely reinforced that the academic tradition of all institutions protects freedom of speech for their faculty, and I assumed the matter was over…. I know I have irritated some potential allies. No matter our disagreements, freedom of speech is the most fundamental right we have as Americans. We will not be silenced. We’re not going anywhere.
Yet no one is trying to deprive Oz of his right to free speech. The doctors listed on the letter are simply exercising their own right to free speech—and that includes speaking truth to the powerful Oz. They shined a light on Oz’s often questionable, TV-publicized, health advice for good reasons, as many others have done so here, here, here, here, here, here, here… and the list could go on and on.
And apparently, shining a light on Oz’s questionable approaches did some good. It prompted eight of Dr. Oz’s colleagues from Columbia University to speak out as well in a USA Today commentary. These doctors note:
We are members of the Columbia faculty who recognize that the Dr. Oz Show performs a public service by bringing alternative therapies which are generally under-researched and under-regulated into the public forum. However, a 2014 report in The BMJ (formerly the British Medical Journal) reported that less than half of the recommendations on his show are based on at least somewhat believable evidence. This report raises concerns that Dr. Oz's presentations of anecdotal therapies as "miracle cures" occur in the absence of what we see as obligatory discussions of conflicts of interest, possible side-effects and evidence-based medicine (or lack thereof). Many of us are spending a significant amount of our clinical time debunking Ozisms regarding metabolism game changers. Irrespective of the underlying motives, this unsubstantiated medicine sullies the reputation of Columbia University and undermines the trust that is essential to physician-patient relationships.
And last spring, members of Congress also attempted to rein in Oz when they invited him to testify on Capitol Hill about his claims related to “miracle” weight loss supplements. And apparently, it worked to some degree. On his show yesterday, Oz says that he’s backed away from making claims about miracle supplements. In addition, after the rebuke by his Columbia colleagues, he’s even said he regrets comments he has made about such supplements. That’s progress, but there’s more to do.
While Oz thanked his colleagues at Columbia for speaking up, he attacked the doctors on the first letter because he says they have an “agenda.” And rather than address their arguments, he attacked them personally on his show. Apparently, it’s inconceivable to Oz and his crew that people can disagree with them based on informed, moral personal views.
In particular, he focused on the work of CEI friend and scholar Dr. Henry I. Miller of the Hoover Institution. Dr. Miller’s writings and research on the topic of genetically engineered food are among the most informed and scholarly in the world (he was also the founding director of the FDA’s Office of Biotechnology), and his positions are humanitarian. Rather than attack, it’s time for Oz to take a closer look at this issue and reconsider his position, as he has with supplements.
Genetic engineering allows researchers to precisely modify plant genes in a process that is far more precise and safer than cross-breeding plants. Using GM, researchers have been able to add vitamin A to rice to reduce vitamin-A deficiency, a major cause of blindness and death, particularly among children, in parts of the world were rice is the staple of the diet, although anti-GM activists have fought this “golden rice.” Scientists also use genetic engineering to make food production easier and more affordable, which is essential to feeding a growing world population.
Dr. Oz says he’s ambivalent about such foods, although his shows are laced with fear-generating suggestions about these technologies, and his “experts” are mostly anti-biotechnology activists. He did, however, allow one biotech apple farmer to appear on his show last week to offer a little balance in that one segment.
April 21, 2015 9:22 AM
What do two-time world poker champ Doyle “Texas Dolly” Brunson, presidential-hopeful Rand Paul, and Fraternal Order of Police President Chuck Canterbury have in common? They’ve all come out against the so-called Restoration of America’s Wire Act (RAWA), which would create a national prohibition on Internet gambling.
They are just three of the thousands of Americans who oppose a law that was written by and for the benefit of one casino owner: Sands Chairman Sheldon Adelson. RAWA is not only a threat to those who want the freedom to gamble online, but also to those who value personal liberty, consumer protections, and a limited federal government.
A two-time World Series of Poker champ, an inductee to the Poker Hall of Fame, and author of the poker bible, Texas Dolly is without question the most famous professional poker player alive. He regularly tweets using his handle @TexDolly, and on April 2, he posted a tweet to his 415,000 followers, requesting signatures for the White House petition, asking President Obama to veto RAWA should it land on his desk (add your signature here).
April 9, 2015 2:46 PM
A new study from the University of Florida asserts that because Illinois instituted an alcohol tax increase in 2009 and the rate of alcohol-related traffic fatalities have declined 26 percent since 2009, the tax must certainly be responsible for the decline in deaths. Of course, news outlets have begun touting the study as evidence that increasing taxes results in fewer deaths. Are they right?
A team of UF Health researchers discovered that fatal alcohol-related car crashes in Illinois declined 26 percent after a 2009 increase in alcohol tax. The decrease was even more marked for young people, at 37 percent.
So, was it the alcohol tax increase that led to the state’s declining alcohol related traffic deaths? To answer that question, one need only examine the rate before and after the tax increase went into effect and compare it to the rest of the United States. Looking at these numbers (provided by DISCUS), it becomes clear that the rate of alcohol related traffic fatalities was declining faster in the year before the tax increase went into effect. Furthermore, since the state jacked up the alcohol taxes, Illinois has experienced a slower decline than the rest of the nation.
Repeat after me: correlation does not equal causation. The study’s authors claim that since the 2009 tax increase went into effect, Illinois saw a 26 percent reduction in traffic fatalities. That certainly is an impressive decline. But just because two things correlate, doesn’t mean that there is a causal relationship. For example, just because the divorce rate in Maine correlates almost one-to-one with the rate of margarine consumption in the U.S., it doesn’t mean one caused the other.
Furthermore, the whole nation saw a decline in alcohol-related traffic deaths between 2001 and 2011.
April 1, 2015 1:59 PM
At recent hearings on the Frank R. Lautenberg Chemical Safety for the 21st Century Act (S. 697), senators, environmental activists, and local government officials claimed that the Toxic Substances Control Act (TSCA) law is not sufficient protect public health. As I have argued before, that’s certainly not the case.
There may be an economic reason to reform this law—to preempt a growing patchwork of nonsensical state-level consumer product regulations—but there’s no legitimate “safety” reason for reform.
Still, activists and some members of Congress at the hearing complained that TSCA’s risk standard has prevented the EPA from banning “a known human carcinogen,” i.e., asbestos. Cosponsor of S. 697 Senator Tom Udall (D-N.M.) exclaimed at the hearing, “I think we all agree: TSCA is fatally flawed. It has failed to ban even asbestos.”
Activists and members of Congress point out that EPA failed to address asbestos in part because TSCA requires EPA to pick the “least burdensome” regulation to achieve its goals.
But how can that be a bad thing? Shouldn’t we want to achieve our goals at the lowest costs? It doesn’t say EPA should pick a regulation that is less safe; rather, it says that EPA should simply pick a less expensive means to meet the safety goal.
That requirement is part of TSCA’s robust risk standard that holds regulators accountable and prevents them from passing rules that do more harm than good. Under TSCA, EPA may regulate when the agency finds that a chemical may pose an “unreasonable risk of injury to health or the environment.” This standard requires weighing the risks of the chemical against the risks of the regulatory action.
People who use the asbestos case to push TSCA reform are either grossly misinformed about the case or they are simply being disingenuous. It is true that the rule was thrown out by a federal court in part because EPA did not bother to find the “least burdensome” approach to meet its goals. In addition, the court pointed out that the rule might have produced more deaths than theoretical lives saved. Accordingly, this is not a TSCA failure, it’s a life-saving success!
March 26, 2015 2:23 PM
Dan Nosowitz in Modern Farmer offers some insights on the recent class action lawsuit filed against California winemakers. The plaintiffs found that some inexpensive wines contained arsenic at levels exceeding the federal drinking water standard for this substance. Nosowitz rightly points out that the standard is for water, not wine and “people don’t, or shouldn’t, drink as much wine as water.”
Well, let’s not go that far… kidding of course! Moderation is surely a good idea when it comes to alcohol consumption. Yet even if you drank as much wine as you do water, there’s still no reason to be alarmed about arsenic. The levels in wine are still too low to have any significant adverse impacts, and ironically, such small amounts might even have health benefits.
Arsenic is an element that naturally occurs in the earth’s crust, so traces of arsenic inevitably appear in food and water. Certainly, high levels of arsenic are not healthy and concentrated exposures can be immediately deadly. But the trace levels found in water and food are rarely an issue. Problems have emerged primarily in developing nations like Bangladesh where poor people drink from untreated water sources with arsenic levels that range in the hundreds of parts per billion (ppb), and sometimes more than 1,000 ppb.
It’s worth noting that the levels allegedly found in wine are reportedly just five times greater (or 500 percent higher as noted in the press) than the federal drinking water standard of 10 ppb. So, some number of samples—we don’t know how many—tested by the plaintiffs in this case had some level of arsenic near the 50 ppb level. But did you know that until 2006, that was the allowable level in drinking water in the United States and it had been for decades?
The U.S. Environmental Protection Agency (EPA) changed the standard to 10 ppb in 2001 with full compliance not required until 2006. The 10 ppb standard for arsenic in drinking water is excessively overcautious. When EPA proposed it, it was very controversial because the cost to small drinking water systems was substantial and the benefits highly questionable. EPA’s Science Advisory Board highlighted lots of problems with EPA’s science and maintained that the change could actually undermine public health. The SAB explained that the costs might cause some small communities to disconnect their water systems, forcing people to use untreated well water, but EPA finalized the rule anyway.
If you look at the history, you can see that EPA did not change the standard for safety reasons; they did it for political ones. You may remember, environmental activists attacked the Bush administration for taking time to reconsider changing the standard, which the Clinton administration rushed out during the final hours of the Clinton presidency. Green groups made it sound like the Bush administration was adding arsenic to the water supply. And this bad press made a rational and scientific debate impossible.
March 19, 2015 1:57 PM
James Mills of the National Institute of Child Health and Human Development lamented in an article in the New England Journal of Medicine back in 1993: “‘If you torture your data long enough, they will tell you whatever you want to hear’ has become a popular observation in our office. In plain English, this means that study data, if manipulated in enough different ways can prove whatever the investigator wants to prove.”
Government regulators will resort to such data torture to justify an activist regulatory agendas if they can’t do it with good data and sound science. One approach includes selective use of data—excluding years or datasets that might change the conclusions of a risk assessment. The Consumer Product Safety Commission’s recent Chronic Hazard Advisory Panel (CHAP) report on the chemical class known as phthalates offers one new example of excluding inconvenient data.
In short, the CHAP report is being used to justify a proposed rule that would essentially ban the use of certain chemicals for toys that children might mouth or chew. These chemicals make plastics soft and pliable, suited for such things as a plastic version of a “rubber duckie.” For background on this issue, see my other blog posts here and here.
In addition, in the absence of any compelling body of data that any individual phthalate is the cause of human health effects, the panel relied on the possibility that the cumulative effects of phthalates as a class pose risks. Accordingly, they needed data on human exposure from all sources.
The panel developed a “cumulative risk assessment” that they maintained justified regulations. But pharmacologist Christopher J. Borgert, Ph.D., observes in a review of the CHAP report that the panel’s cumulative risk assessment: “failed to recognize obvious inconsistencies with human experience and clinical evidence”; “overstates the accuracy of its cumulative risk methods and conclusions”; and “appears to have grossly overestimated chemical potencies.” In other words, the panel failed to properly apply the available data and research.
To make matters worse, they used old and irrelevant data for their human exposure assessments even though more accurate and recent data was available. Former and current CPSC commissioners have noted that had the panel used the most recent data, their risk assessment would have produced the opposite result. This issue raises the prospect that the panel members were intentionally “selective” in their use of data because they desired to generate a particular conclusion, as appears to be the case with their selection of studies that they also reviewed.
March 18, 2015 2:00 PM
Many “stakeholders” have complained about the process through which the Consumer Product Safety Commission (CPSC) developed its proposed rule related to a class of chemicals called phthalates—and rightly so. In particular, the agency’s failure to allow public comment and open peer review of its Chronic Hazard Advisory Panel report (CHAP report) underscore the fact that bureaucrats want to avoid scrutiny that might hold them accountable for rash and unscientific decisions.
Designed to make plastics soft and pliable, these chemicals have many valuable uses for making a wide range of products from blood bags, to rain boots and swimming pool liners as well as children’s toys, which are the subject of this regulation. Safely used for decades, activists and regulators are poised to essentially throw away these valuable technologies based largely on junk science.
While this rule only affects toys that children might place in their mouths or chew, it sets a terrible precedent. I already detailed how this rule might harm consumers in a blog post last week. Now let’s look at the so-called “science” behind it.
The justification for the proposed regulations are found within the CHAP report, which is a review and risk assessment that the agency released in July 2014. A key problem stems from the fact that the CHAP report relies on a selective review of limited studies that offer scant evidence that individual phthalates or cumulative exposure pose any significant risk to humans at current exposure levels.
Most of the CHAP-report-identified “evidence” that these chemicals pose health risks comes from lab tests that over-dose rodents to trigger health effects. Such tests are not particularly relevant to humans that better metabolize the substance and who are exposed to traces that are multitudes lower.
The human research highlighted in the CHAP report is not particularly compelling either. Many of these human studies are noted to be “small,” which limits their value for drawing any conclusions. And many of them report associations between potential health effects in babies whose mothers’ phthalate exposure levels were measured in single “spot” urine samples during pregnancy. Given that humans metabolize phthalates relatively quickly, one time spot measurements may be misleading about actual exposures, raising important questions about the utility of such studies.
March 13, 2015 8:58 AM
On Monday, the Consumer Product Safety Commission will close the comment period for a proposed rule related to chemicals used to make soft and pliable plastics. While they claim to do this in the name of children’s health, it’s not clear that the rule will do more good than harm.
The process and the “scientific” review that brings us to this proposed rule has been controversial, to say the least. I detail some of those issues in comments that I will submit on Monday and will post some of that here on Monday as well.
Unfortunately, not enough attention has focused on the fact that the agency-commissioned study—referred to as the Chronic Hazard Advisory Panel (CHAP) report—failed to fully consider the potential implications of substitute products that will replace those they ban.
Before initiating a rulemaking that may remove chemical technologies from the marketplace that have been safely used for decades, CPSC should consider whether replacement products pose greater risks. The CHAP allegedly addresses replacement products by reviewing data on the potential environmental health effects of other chemical substitutes. But the CHAP did not address whether or not the substitutes that might actually win a place in the market would affect product performance in ways that help or harm public health and safety.
The rule should ensure net safety, considering all factors. It is incumbent that regulators don’t inadvertently increase risks with short-sighted decisions. Based on the CHAP, we lack reasonable assurance that regulatory action will increase net safety and, in fact, such actions might accidentally introduce new hazards and even greater public health and safety risks.
March 11, 2015 4:04 PM
According to a Gambling Compliance story (paywall) posted today, Rep. Jason Chaffetz (R-Utah) participated in a conference call last week with about 20 state and lottery officials to discuss his proposal to create a nationwide ban on Internet gambling. Chaffetz’s bill rewrites the 1961 Wire Act, which he claims was “reinterpreted” by Obama’s DOJ in 2011—which opened the door for states to legalize online gambling. When the participants voiced their concerns that Chaffetz’s bill would also criminalize lottery activities that were legal prior to 2011, Chaffetz responded by brazenly suggesting that when his bill passes, they can try to pass their own federal bill. “You can come back and re-start if you want,” Chaffetz concluded.
The call was organized by the Commerce Committee of the National Governors Association (NGA), which has voiced opposition to Chaffetz’s bill in the past. But some on the call noted surprise at his aggressiveness. Mark Hichar, a gaming attorney on the call, found Chaffetz’s statement “surprisingly aggressive.” According to Hichar, the bill would eliminate currently legal lottery offerings, such as online lotter ticket sales and subscriptions (currently available in 8 states), online real-time games like pull-tabs (legal in five states when Kentucky launches this year), and of course, online casino-style games legal in New Jersey, Nevada, and Delaware for almost two years now.