Today I gave a talk at the Stanford History of Science and Technology Workshop on Industrial Epidemics. It was a pleasure to discuss the ins and outs of public health, corporate malfeasance, and glyphosate in particular with the students and professorate of the History of Science and Technology Program. Especially rich were the insights of Robert Proctor, the coiner of the term agnotology, who has been a great inspiration for my own work.
Here’s the Abstract:
Noncommunicable diseases (NCDs) have turned out to be quite communicable; the disease vector isn’t some virus or pest, but instead the very bulwark of industrial civilization. While NCDs have always been with us as a species, their normalcy and multiplication is novel. The very system of corporate science, muscle, and capital that helped eradicate harrowing infectious diseases that threatened generations in the 20th century have left in their wake a new epidemic of chronic disease above and beyond background levels for the 21st century to clean up. The rise of chronic disease tracks directly with the rise in environmental exploitation and industrial pollutants. By virtue of epidemiology and randomized control trials, we know that certain classes of people (such as smokers, obese people, chemical manufacturing workers, farmers using pesticides) have inordinately more chronic disease than people without those exposures. Many people, especially as they age, incur multiple chronic diseases, causing them much suffering, and costing them and society extensive financial resources. Merrill Singer ( 2009, xiv) describes how syndemics represent “a set of enmeshed and mutually enhancing health problems that, working together in a context of noxious social and physical conditions, can significantly affect the overall disease burden and health status of a population.” Adopting the public health descriptor of epidemics associated with infectious disease for chronic disease conditions, framing the rise of chronic disease first in developed countries and now worldwide in terms of an epidemic caused by industrial processes, scrutinizes how corporate behavior socially determines the health of populations. This paper focuses on how these mechanisms have manifested in the agrochemical and petrochemical industries.
And my bio:
Yogi Hale Hendlin is an assistant professor in the Erasmus School of Philosophy and core faculty of the Dynamics of Inclusive Prosperity Initiative at Erasmus University Rotterdam in the Netherlands, as well as a research associate in the Environmental Health Initiative at UCSF. Yogi has been working at the intersection of public health and environmental political philosophy for 15 years and has published in journals such as MMWR, BMJ, Ambio, PLoS Medicine, The American Journal of Public Health, Tobacco Control, Environmental Philosophy, Environmental Ethics, and the Annals of Internal Medicine. Yogi’s work has been taken up in popular media outlets such as Time, National Geographic, The Guardian, BMJ, CNN, Fox, Salon, Reuters, Gizmodo, Bloomberg, Nautilus, The Revelator, and Science Daily. Yogi is currently writing a monograph titled Industrial Epidemics: Chronic Disease and the Corporate Determinants of Health.
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.
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.
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.
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.
Having lived for the better part of my life in the San Francisco Bay Area, I have put in my time on the Bay Area Rapid Transit (BART) system. From it’s loud, overcrowded, clunky, and infrequent trains, to the spate of BART police shootings of young men of color, this privatized (militarized?) operation has a monopoly on public transport, and unashamedly has its will with the region with little grace.
The latest offense is the instillation of “skull crusher” “inverted guillotine” pop-up spring-loaded barriers, that could hurt or maim (it’s just a lawsuit waiting to happen).
Instead of pouring money into education, or helping the homeless, the Bay Area has now apparently prioritized metal spikes shooting up from their BART turnstiles. Way to go, gentrification!
The fact that “fare jumping” is solved by violence is telling. Instead of maybe just making the BART – a public service – into a public company, free for all riders, payed by a corporate property tax (or some other public funding in the insanely overpriced Bay), as many other localities such as Tallinn in Estonia have done, doubling down on menacing design elements further marginalizes the marginalized. BART really doesn’t lose much money at all on fare jumpers. Their financial mismanagement is sui generis. Yet, like all administrative classes, the propensity to pay themselves more to harm the poor is too tempting; it exculpates their responsibility for mismanagement (and points to the need for the region to re-buy the service to run it correctly), and instead finger-wags at “scofflaws” for being bad people, when all they really are doing is what is necessary to get around their own town when they haven’t benefited from the Silicon Valley boom.
The book Unpleasant Design discusses the epidemic of public infrastructure that makes being in public an injurious experience for those worst off. From bus benches in shelters that slope so you can’t sleep on them (you’d fall off), to “anti-homeless spikes,” sonic warfare (projecting odious or repetitive noises, like that corporately-engineered “hit” “Baby Shark“), ordinances against “sitting” or lying in public spaces for too long — rich countries, especially English-speaking ones, have declared war on public space.
Unpleasant design takes what little of the commons are left – the nooks and the crannies – and puts money into destroying them to keep out “undesirables.” This racist and classiest action is often the result of gentrification; justified to keep the zoos of the rich free of those who can’t pay their entry fee.
The psychological warfare of guillotine turnstiles makes the entire experience of public transportation less comfortable for everyone. Instead of dealing with the 80-20 principle that 80% or 90% of riders will pay no problem, and that there will always be a remainder of the population that for what ever (often very legitimate) reason cannot or will not pay, BART has chosen to harm the public, pushing more people into their polluting cars.
I’m sure before long, people will be defacing these violent turnstiles. And it is likely that the accumulated rage against BART will reduce paying ridership (despite their monopoly), actually bringing them less money than they had before–the exact opposite result than they profess to so-desperately and so-forcefully want.
The public outrage on Twitter is already loud and clear against BART’s weaponization of its service. Such aggrandizement activities miss the point of their charge: they are in the business in providing a public service, and some people can pay more, some less, and not at all. Perhaps peg BART tickets to income. Then the rich might pay $100 per ride, the poor the normal $3.40 trip, and the very poor nothing. That would be a fair approach. Our society is far from that enlightened thinking, sadly, even in that hotbed of *potential* San Francisco, Oakland, Berkeley, and environs.
But let’s not deceive ourselves. There’s a reason why you can’t take the BART to Marin County: racism. Back in the 1950’s there was a plan in place to extend the San Francisco BART to Marin (North Bay), but because of vocal refusal by residents, it failed. And now, no easy public transportation (besides the ferries) go to Marin. The Bay Area is disconnected by design, an open gated community in a natural and cultural paradise predicated on class, race, and exclusion.
Have we not evolved as a city in 70 years? Are we still just as violent towards those less fortunate than us. San Francisco is a mess because of its wealth. But at least on this case of BART structural violence, the people are having their day of reckoning.
About a decade ago, the “American Vaping Association” railed against RJReynolds (later RAI, now part of British American Tobacco (BAT)) for attempting to persuade the FDA to “ban the sale of open-system e-cigarettes, including all component parts.” Now that pretty much all of the e-cigarette companies are tobacco companies, from Altria’s 35% stake in JUUL to RAI’s Vuse being #2 in the US, the question is moot. Big Tobacco won. Open systems are on the fringe, for people like Leonardo di Caprio.
Reynolds’ play to racism and prejudice by equating Chinese manufacture with poor quality is telling. Their own products are manufactured in China. But in order to try to dissuade the FDA from allowing open tank vape systems, it plays the China card. We need to educate people to stop doing this, as 99% of the time they are being hypocritical anyways (their own products are being made in China); and also, American manufacture now is mainly robot-run anyhow. Few quality American manufacturing jobs exist, compared to the 1970’s, for example.
What remains to be seen in the indefinite postponement of the E-cigarette regulations by the FDA is whether Big Tobacco got their way; or if public health will see their day.
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.
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.
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.
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.
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.
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
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)
My Erasmus University Rotterdam colleague Alessandra Arcuri and I are organizing a day-long workshop on the most used pesticide in the world: glyphosate. Glyphosate, the active ingredient in RoundUp, Monsanto’s flagship herbicide, has been linked with cancer by the International Agency for Research on Cancer (IARC) in 2015.
My op-ed in the American Journal of Public Health that appeared this week discusses the new tobacco waste stream of electronic cigarette waste. Electronic waste is already the fastest growing waste stream globally. Creating a new product that has no current responsible recycling infrastructure, and that may be littered widely, contributing to plastic sinks such as the Great Pacific Gyre (garbage patch) in the Pacific Ocean, is a mistake. This op-ed discusses the problem and some of the solutions that can be taken to avoid a possible environmental health and ecological disaster.
Photo of a dropped Juul vape on SF MUNI by Julia McQuoid, used with permission
Regarding this article and other research I am conducting, I also wrote a piece in the online academic blog/forum The Conversation on e-cigarettes as the Nespresso of tobacco products, environmentally speaking.