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.


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.


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.

San Francisco BART’s Unpleasant Design

Introducing: The inverted guillotine

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.

London, UK. 10th June 2014. Anti-Homeless Spikes Protest outside Stock Photo: 70030582 - Alamy
Anti-homeless spikes

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.

These artists are tackling London's anti-homeless spikes head on
Activists in London combat the painful anti-homeless spikes

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.

Big Tobacco, Big Pharma, Big Vape

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.

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:




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)

Science and Politics of Glyphosate Workshop June 6, 2019

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.

For more information, registration, and to submit a paper to present at the conference, please visit our website, at the Dynamics of Inclusive Prosperity Initiative.

IARC and EFSA’s differing views on glyphosate

E-cigarette e-waste litter is an environmental health harm that can be stopped before it metastasizes

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.

This article was republished by the University of California, Salon, Phys.org, The Houston Chron, the Connecticut Post, The Fresh Toast, Business Insider, EcoWatch, The Chicago Tribune, and many other news sources.

Reuters also interviewed me for a piece titled “E-cigarette policy should consider environmental effects, expert says.”

For my other writing on e-waste, please see my interview with Eric Lundgren in Nautilus.


The Elon Musk of E-waste

My new article, “Is This Man the Elon Musk of E-Waste?” in my favorite popular science online magazine Nautilus, describes the Right to Repair movement, and the necessity to move from a linear manufacturing process built on planned and perceived obsolescence to a circular economy.

If we are to combat the 99 billion pounds of e-waste produced per year, ending up incinerated, in lakes and rivers, and trashing our communities and the lives of future generations, we’re going to need to mandate manufactures of electronics such as Apple, Samsung, Microsoft, IBM, Dell, and all the other major players, to engineer products that can DIY be taken apart, repaired, and built to last.

My interview with Eric Lundgren, his last before he was sent to prison for creating 28,000 Microsoft Windows restore CDs meant for refurbishing computers that otherwise would end up as e-waste, describes the necessity for financial mechanisms to incentivize companies and consumers to place e-waste back into an (dis)assembly line of reuse, reduce, recycle.

Screen Shot 2018-07-10 at 14.52.48.jpeg

Lundgren has championed the right for electronics to be repaired rather than tossed by staging high-profile recycling demonstrations including his Guinness Book of World Records farthest driving on a single charge electric car (999 miles with 90% recycled materials including recycled hybrid batteries) and his flagship solar-powered e-waste recycling factory.

I appreciate the comment on the article made by Ryan Shaw, who wrote:

Mr. Lundgren has done more with far less than what Musk started with so I don’t think the comparison does Lundgren justice (although I am a huge Musk fan). Maybe someday if Tesla starts a car rebuild program to re-use scrapped cars the title would be, “Elon Musk is the Eric Lundgren of car manufacturing.”