BMJ article on conflicts of interest in the tanning industry just published

Working at the CTCRE at UCSF allowed me to meet all sorts of medical practitioners aware of the influence of industry on the health of their patients.

One of those people I happened to meet, was Eleni Linos (now at Stanford), a dermatologist who had noticed throughout the years the influence of the tanning industry on spreading disinformation to the public on the health harms of tanning.

Lola Adekunle, Rebecca Chen, Lily Morrison, Meghan Halley, Victor Eng, Yogi Hendlin, Mackenzie R Wehner, Mary-Margaret Chren, and Eleni Linos’ paper “Association between financial links to indoor tanning industry and conclusions of published studies on indoor tanning: systematic review,” challenges the invisibility of industry as it attempts to blend in its research into the scientific public record. Our paper shows the impressive discrepancy between the scientific conclusions on the health harms of tanning studies with financial links to the indoor tanning industry found, versus those of independent, non-financially-interested researchers.

Figure 3 from our paper, available here: https://www.bmj.com/content/368/bmj.m7

Jerod Stapleton also published for the British Journal of Medicine an editorial on our article, concluding that “We must challenge industry attempts to change the conversation about tanning.” Stapleton is no stranger to the harms of tanning, having conducted significant research on the health outcomes, as well as leading a paper in JAMA Pediatrics titled “The American Suntanning Association: a “science-first organization” with a biased scientific agenda.” Indeed, according to the tanning industry’s January 2015 issue of Smart Tan, the ASA succeeded in convincing (bullying?) the CDC to remove claims of a 75% increase in melanoma risk from sunbed use that had previously been displayed on the CDC website.

Changing Hearts and Minds: Jan 30-31 conference at EUR

As co-organizer of the Positive state obligations concerning fundamental rights and ‘changing the hearts and minds’ conference at Erasmus University Rotterdam January 30-31, 2020, I cordially invite my colleagues working on cognate topics to attend.

The conference is free of charge, but registration must be completed beforehand.

This international conference will cover topics of enduring relevance and growing importance concerning (the reach of) positive state obligations in relation to prejudice and discrimination; and will address these from a multidisciplinary perspective.

While it stems from a legal perspective, the contributions go far beyond traditional definitions of the law to reach into the societal movements and norms that create and influence law.

The Failure of COP25

I recently read – from afar – the sorry state of the UNFCCC #COP25 in Madrid. According to 350.org, instead of barring fossil fuel companies from engineering the COP, the security guards at the UNFCCC forcibly removed hundred of activists and scientists who aimed to bring gravitas to an otherwise hypocritical and superficial discussion.

LIVE feed from the #COP25 UN climate meeting pic.twitter.com/KukPvMAtVx
— Dr. Lucky Tran (@luckytran) December 15, 2019

The de-badging of climate activists, who refused half-measures and rhetoric as adequate given the current hundreds of billions if not trillions of dollars of damages each year due to corporate- and government-induced climate chaos and decades of enforced ignorance, is not surprising–but it is the first time this has occurred on this scale at the UNFCCC.

As The Onion burlesques the denialism,

In response to the attention she was receiving for her vocal objections to international leaders’ refusal to address global warming, critics in the 2030s asked why teen climate activist Elisa Garcia-Reilly wasn’t in an abandoned school bailing water and shooting enemy foragers. “Instead of constantly screeching about how all our policies are selling out her generation and dooming them to unavoidable suffering, maybe this little hussy ought to spend more time in the remains of what was once a high school choosing which infants to save and defending her family’s food cache from scavengers,” said television pundit Caden Williams of the 16-year-old climate activist, voicing the sentiments of critics who declared that she had no clue what she was talking about and was trying to catastrophize being constantly starving and up to her waist in water.

A cinematic cityscape depicting a destroyed city.

Having myself attended the UN World Summit on Sustainable Development in Johannesburg, South Africa, in 2002, in an action with AdBusters, I too was de-badged as US representative to the meeting Colin Powell obfuscated effective action. That was 17 years ago. Things have gotten even worse since then, and now climate chaos is felt in every part of the world.

The question remains: what will it take before we prioritize life over profit?

Will the currents have to stop? Massive crop failures from extreme weather events? Heat waves that kill millions? Dikes cracking from prolonged droughts? Wild fires destroying trillions of dollars of real estate? The end of business as usual as commodity chains break down?

The problem is, in our current system, there simply is no circuit breaker. There is nothing that could happen – within our current dominant mindset – that would force action. It’s like the person bleeding profusely who swears they’re healthy until they fall over and die, instead of getting the help they need and interceding on the “inevitable.”

This clip is an apt metaphor for Capitalist Realism.

Climate chaos is a spectrum. The more we double down with ignorance and denialism, the worse it gets. The sooner we clean up our act, the less possibility that doomerism will be correct. The irony of deterministic ideas such as “Well, we destroyed the climate, so might as well enjoy the luxuries before they’re all gone,” is that the path is made by walking. Yes, we have created since the industrial revolution, a tremendous amount of path dependency, creating ozone holes, the 6th great extinction, and making life on earth very difficult for the next hundred (or thousand – our choice) years.

But, what we do now crucially influences whether we get to keep some of the goods of human civilizations while jettisoning as soon as possible the bads; or, if we take out the majority of complex life on earth out with our species. It’s our choice. But it requires completely reorganizing society according to our interspecies interdependence, and revere the processes of nature which human artifice and systems of control and domination have swerved into dysfunctional and perverse fragmentation.

National Geographic and Guardian Articles about Ecigarette Waste and EPR

In the flurry of the semester starting, I’ve been remiss in updating this blog with a couple important articles that have come out in the press discussing the environmental harms of electronic cigarette (ecig) electronic waste (ewaste).

Both The Guardian and National Geographic did excellent jobs surveying the topic and getting across the complexities as well as most important points. And I’m grateful to through interviews have been able to contribute to these articles.

I think the most important point I made in The Guardian article is the need for Extended Producer Responsibility, and how it practically works:

Hendlin said he and other environmental advocates have endorsed an Extended Producer Responsibility (EPR) model for e-cigarettes – one JUUL is considering. This would include charging users an extra deposit (ie $1.00 per pod, $5.00 per vape unit) that consumers get back when they return them, practices like returning old packaging to JUUL after receiving new pods each month, and refunding or giving credits for returned pods/vapes.

https://www.theguardian.com/society/2019/aug/26/vapings-other-problem-are-e-cigarettes-creating-a-recycling-disaster

ADDED BONUS:

What made me want to puke however, is just before I was settling down with my popcorn to watch the (excellent!) National Geographic video they made on the effects of e-cig waste, I was subject to a 15-second propaganda piece by the grandmasters of waste and treachery themselves, Nestle. Especially as in my piece in The Conversation, I write

The two largest global brands of capsule coffee, Nespresso and Keurig, are regarded by many as environmental nightmares. Billions of the throwaway nonrecyclable plastic products currently clutter waste dumps, waterways and city streets. Both inventor of the “K-cups” John Sylvan and former Nespresso CEO Jean-Paul Gaillard have publicly bemoaned the environmental consequences of the products they once championed. Sylvan has stated that the disposable (but not biodegradable) coffee capsule is “like a cigarette for coffee, a single-serve delivery mechanism for an addictive substance.”

https://theconversation.com/e-cigarettes-and-a-new-threat-how-to-dispose-of-them-105096

The comparison between cigarette butts and capsule coffee is surprisingly fitting. Both butts and capsules are intentionally designed to be convenient, single-use products. Both are also nonbiodegradable and unrecyclable. As pervasive and polluting as cigarette butts are, however, the e-waste from e-cigarettes presents an even more apt comparison.

https://theconversation.com/e-cigarettes-and-a-new-threat-how-to-dispose-of-them-105096

You can imagine how I felt then, when Nestle pimps this feel-good (Spanish language!) advertisement at me, never mentioning the billions and billions and billions of plastic-metal-paper non-recyclable single-use bad-tasting coffee hits it blights the planet with each year.

The Nespresso ad video before the cool National Geographic video. So nice (not!) that National Geographic is producing videos for Nespresso, to preempt people realizing that environmental health problems (having to do with the environmental determinants of health) are intersectional, too.

Fuel emission standards

Who is fueling the Alice in Wonderland media world which slowly is infecting and deceiving people around the world, spreading the ignorance virus?

Let’s take the way that Trump wanted to roll back the Obama-era federal fuel emission standards as an example. While Trump and the oil companies thought this would be a marvelous idea, to stick it to the liberals, so that we’d waste more oil, astonishingly the four biggest auto manufacturers were opposed to this, as they had already begun producing cleaner cars, and other big markets like Europe have similar fuel and pollution auto standards, so going Neanderthal in vehicle fuel and emissions standards didn’t make sense. It was a big surprise to the White House, apparently, that creating more pollution and costing individuals more to fill up their tank didn’t work, even with auto manufacturers. What a surprise for Trump and Co. to realize that even pandering to the worst possible arguments didn’t work. Then 4 of the largest automakers and the state of California made a pact that they would uphold the previous Obama-era emissions standards and fuel targets. Because it made good business sense. (Nevermind the fact that it saves consumers hundreds of billions of dollars and reduces pollution).

The New York Times somehow thought it fitting to ask the Trump Whitehouse to weigh in.

“Unfortunately, California is trying to impose its failed policies on the rest of the country by making new cars significantly more expensive for American consumers and less safe,” said Russ Vought, the acting director of the White House Office of Management and Budget, in an emailed statement. “Even worse for Americans on the road, a handful of irresponsible automakers are aiding California’s radical agenda that will hurt every one of us.”

https://www.nytimes.com/2019/09/05/climate/trump-auto-pollution-california.html

This completely up-is-down-and-down-is-up response, which is about as far away from reality you can get unless some giant loaded you in one of those dog ball-throwing launchers and whipped you into a few galaxies down the lane, not only reaffirms that US Government has become a premier propaganda machine, in their attempts to rival North Korea and China, but also shows how the New York Times is working for the same corporate masters. Why? Two reasons.

First of all, the dumb idea to force California to not enforce it’s laws is a non-starter. What ever happened to states’ rights? Oh yeah, that was only a corporate tool, and to gain libertarian votes and then give them the finger. Classy, tea partiers and Koch Co.

Second, there’s the fact that California will not comply with unreasonable federal the-sky-is-falling threats. Sorry, California is the world’s 5th largest GDP, you can’t push it around like that. We control your freaking internet ;) But why is the NYT giving more platform to the Competative Enterprise Institute, a well-known rabid racist, misogynist, and overall ahistorically-inclined corporate front-group? There are a million intelligent people to interview about how laughable this proposal is, how the Trump administration will never achieve this, and that it’s just shirtcocking posturing from Mr. smallfingers. But no, the NYT goes for its one interview with the humpback goon of Trump. Great balanced reporting, right there.

Of course,

“The Obama-era tailpipe pollution rules that the administration hopes to weaken would require automakers to build vehicles that achieve an average fuel economy of 54.5 miles per gallon by 2025, cutting about six billion tons of carbon dioxide pollution over the lifetimes of those vehicles. The proposed Trump rule would lower the requirement to about 37 miles per gallon, allowing for most of that pollution to be emitted.”

https://www.nytimes.com/2019/09/05/climate/trump-auto-pollution-california.html

And of course,

“Xavier Becerra, the California attorney general, restated his intention to sue over any attempt to undermine his state’s legal authority to set its own pollution standards. “California will continue its advance toward a cleaner future,” he wrote in an email.”

https://www.nytimes.com/2019/09/05/climate/trump-auto-pollution-california.html

Hypocrisy at the International Society for Environmental Epidemiology

The ISEE, or the International Society for Environmental Epidemiology, is an organization that one would expect to walk its talk. After all, it has been around for 31 years with its annual conferences, and is one of the most sophisticated and cutting edge of the biological medical sciences. Environmental epidemiology’s ability to aggregate data across many different scientific domains in a meaningful way, to build off of findings in genetics, population biology, medicine, and public health, is truly extraordinary. Furthermore, the field has demonstrated a commitment to addressing questions of environmental racism, classicism, and gender inequality, and is actively diverse.

isee_2019_meeting_graphic

Why then, at my first ISEE conference, in Utrecht, which was a 30 minute train ride from my home in Rotterdam, am I bombarded with 1960s style catering?

I know, I know. Why pick on such a minor detail? After all, the content of the meeting is driving policies far more important than some PC peccadillo having to do with food, right?

I do not dispute the good of bringing people together here. I do not dispute the good of the research, the necessity of the work. But I do object to the weak argument that because of all the other good being done, that we can ignore our own personal emissions and harms, that we can refuse responsibility to do our part, to do better, to be the change we wish to see in the world.

The metaphor is how discredited Al Gore has been for flying all around the world on his private jet to promote sustainability. It doesn’t pass the smell test. How can we say, “Do as I say, not as I do?” It’s this sort of elitist thinking that got us into this quandary in the first place.

Example A. In a Symposium session today on “A World less dependent on fossil fuels — scientific evidence and corporate influence,” a presenter brought up the fact that the way academic conferences are organized are going to have to change. But, the presenter said the AMA (American Medical Association) has to change, but immediately addended his comment with, “But not the ISEE.” I and a few others blurted out “Why not?” Why is our precious little conference exonerated? How are we any different, except for our smaller size? People still are arriving from all over the globe via airplanes to spend 3 days presenting a 10 minute paper and then hanging around nervously at the peripheries hardly communicating with people they didn’t already know.

Thanks for the trash, ISEE!

Which leads me to the point of my post.

I have been to APHA and many other larger and smaller conferences, in Europe and the US, and I am sorry to say that this is the least environmentally sustainable conference I have ever been to. The fact that hundreds of thousands of pieces of single-use plastic are being used every day for this conference should be sobering to us all.

And the fact the majority of the food is meat and animal-based shows the height of hypocrisy on environmental issues—not leadership.

Therefore, I propose that the ISEE adopt the following two binding resolutions, effective immediately, and for all future conferences:


(1) Conference organizers and any other contracted companies and caterers shall only use reusable forks, knives, spoons, plates, bowls, cups, and other food ware items. This includes no longer relying on single-use creamers, sugars, etc. 

(If the ISEE and its conference organizers are still addicted to disposables, at least have them be PLA (compostable bioplastics), which is a far second-best to washing actual silverware and dishes, but is still better than sucking down more on the plastic-petrol pipeline.)

(2) In light of the well-documented harmful effects to personal and planetary health, ISEE conferences and gatherings shall only serve vegetarian meals, with a minimum of 50% of all meal items being vegan (and clearly labeled). This is consistent with the evidence base and ISEE’s leadership in walking our talk on health and climate change.
Please forward these resolutions to the authorizing boards, and let me know the outcome of the vote.

I see this as a beginning, not a destination. Complacency on these issues will just make the ISEE less relevant. For example, the name badges are oversized non-recyclable hard plastics. A huge amount of waste. And instead of giving steel water bottles out at every conference, just start selling them, and advertise in large font “BRING YOUR OWN REUSABLE WATER BOTTLE.” A little prevention goes a long way. But we, more than anyone, environmental epidemiologists, already knew that.

CODA

It turns out, that in the ISEE’s 2018 meeting in Ottowa, Canada, a country quickly becoming synonymous with oil power obliterating public health, that affiliated societies part of the ISES-ISEE joint conference received financial sponsorship by ExxonMobil — a huge conflict of interest! That the ISEE, and its local organizers let this one “slip past them,” is a huge cognitive-ethical bungle. How can public health researchers be credible in evaluating the science of pollution when they are lining their pockets and funding their meetings with those very same polluters’ dollars?

In the Introduction to the symposium on “A world less dependent on fossil fuels – scientific evidence and corporate influence” Prof. Dr. Manolis Kogevinas, Research Professor of the NCDs Program at the Barcelona Institute for Global Health, gave a talk on August 26th, 2019 that included the following abstract:

The Symposium organised by the Policy Committee of ISEE originated following the widespread surprise and annoyance of our members from the sponsorship of the 2018 ISES-ISEE joint conference in Ottawa by ExxonMobil. ISEE did not directly accept these funds but other societies are more willing to accept them.
We will argue that organizations representing health researchers should not accept support from the fossil fuel extraction companies.
Banning health research funded by the tobacco industry helped bring major public health gains; we will argue that we should do the same with BigOil. We further argue that ISEE should become more vocal on this issue and promote measures such as divestment from these industries.
There are three main reasons for taking this position: (i) The most important is that fossil fuel industries are major determinants of human disease and environmental deterioration; (ii) The second is that they knew! Like the tobacco industry, Big Oil knew for decades that their products could make the planet uninhabitable, and intentionally buried the evidence; (iii) The third reason is that like our stand against the tobacco industry that resulted to significant public health advances, we should take a categorical, effective and clear-cut position against the products and actions of these harmful industries. The science is more than adequate to warrant action. Unless we do this, we will not be able to effectively convince the lay public and our politicians of the urgency with which we must mobilise.
The proposed Symposium will illustrate major aspects of health consequences of fossil fuel combustion and the reactions of the industry trying to influence epidemiological research. We will discuss on the way epidemiologists should continue providing essential support to health policies avoiding corporate interests while encouraging industry and other stakeholder involvement as a part of the solution to the problem.

Lies in an Extra-Moral Sense

In doing some background research for my book, I remembered that I had read about a year ago of a US Congressman who was working to get rid of the imperative for US health insurers to take patients with preexisting conditions, who shortly thereafter was diagnosed with prostate cancer. The poetic justice was obvious, and I was ready to incorporate the story into mine, to demonstrate the hypocrisy of the political landscape around medical issues, and the demonizing of illness, making it into some Biblical or New Age Law of Attraction bullshit.

And then I noticed that as I went to retrieve this information, that the first hit that came up was from a notoriously provocative website, “The Daily KOS.” I read the article, but it seemed more lukewarm than I remembered in terms of evidence, so I went back and watched the original CNN interview with the supposed damning evidence of hypocrisy of the US Representative from Alabama, Republican Mo Brooks scorning those with preexisting conditions.

In fact, the Daily KOS had cherry-picked Brooks’ words out of context, completely mangling his meaning, which amounted to: those who have lived risk-prone lives should have to pay more than people who have done their best to take care of themselves, and many people are sick “through no fault of their own,” and “we must take care of them.” We can quibble with if we agree with that, but Brooks’ statement looked nothing like the fire and brimstone irony Daily KOS was insinuating.

Shoddy reporting helps no one, and making people whose political ideas you may not agree with into hyperbolic monsters reduces credibility, creates mutual antagonism, and is part of why America is divided. It’s time for journalistic ethics to make a comeback.