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.

New Publication: Financial Conflicts of Interest and Stance on Tobacco Harm Reduction: A Systematic Review

My colleagues Manali Vora, Jesse Elias, and Pam Ling and I at the Center for Tobacco Control Research and Education at the University of California, San Francisco just Financial Conflicts of Interest and Stance on Tobacco Harm Reduction: A Systematic Review. (Also available at PubMed).

Here are some sources that have blogged about the paper:

https://www.apha.org/news-and-media/news-releases/ajph-news-releases/2019/2019-july-issue

https://tobacco.ucsf.edu/scientific-articles-supporting-tobacco-harm-reduction-more-likely-be-industry-funded-and-lack-empirical-data

Abstract

Background. Tobacco companies have actively promoted the substitution of cigarettes with purportedly safer tobacco products (e.g., smokeless tobacco, e-cigarettes) as tobacco harm reduction (THR). Given the tobacco, e-cigarette, and pharmaceutical industries’ substantial financial interests, we quantified industry influence on support for THR.

Objectives. To analyze a comprehensive set of articles published in peer-reviewed journals assessing funding sources and support for or opposition to substitution of tobacco or nicotine products as harm reduction.

Search Methods. We searched PubMed, Embase, Web of Science, and PsycINFO with a comprehensive search string including all articles, comments, and editorials published between January 1, 1992 and July 26, 2016.

Selection Criteria. We included English-language publications published in peer-reviewed journals addressing THR in humans and excluded studies on modified cigarettes, on South Asian smokeless tobacco variants, on pregnant women, on animals, not mentioning a tobacco or nicotine product, on US Food and Drug Administration–approved nicotine replacement therapies, and on nicotine vaccines.

Data Collection and Analysis. We double-coded all articles for article type; primary product type (e.g., snus, e-cigarettes); themes for and against THR; stance on THR; THR concepts; funding or affiliation with tobacco, e-cigarette, pharmaceutical industry, or multiple industries; and each author’s country. We fit exact logistic regression models with stance on THR as the outcome (pro- vs anti-THR) and source of funding or industry affiliation as the predictor taking into account sparse data. Additional models included article type as the outcome (nonempirical or empirical) and industry funding or affiliation as predictor, and stratified analyses for empirical and nonempirical studies with stance on THR as outcome and funding source as predictor.

Main Results. Searches retrieved 826 articles, including nonempirical articles (21%), letters or commentaries (34%), editorials (5%), cross-sectional studies (15%), systematic reviews and meta-analyses (3%), and randomized controlled trials (2%). Overall, 23.9% disclosed support by industry; 49% of articles endorsed THR, 42% opposed it, and 9% took neutral or mixed positions. Support from the e-cigarette industry (odds ratio [OR] = 20.9; 95% confidence interval [CI] = 5.3, 180.7), tobacco industry (OR = 59.4; 95% CI = 10.1, +infinity), or pharmaceutical industry (OR = 2.18; 95% CI = 1.3, 3.7) was significantly associated with supportive stance on THR in analyses accounting for sparse data.

Authors’ Conclusions. Non–industry-funded articles were evenly divided in stance, while industry-funded articles favored THR. Because of their quantity, letters and comments may influence perceptions of THR when empirical studies lack consensus.

Public Health Implications. Public health practitioners and researchers need to account for industry funding when interpreting the evidence in THR debates. (Am J Public Health. Published online ahead of print May 16, 2019: e1–e8. doi:10.2105/AJPH.2019.305106)