Dr. Lesko's Toxic Conflicts
I was curious to hear that Dr. Samuel Lesko, a Lansford, Pa. native and medical director of Scranton’s Northeast Regional Cancer Institute, came to Hometown for the Jan. 18 meeting about the Pa. Department of Health's latest study of the local health crisis. The research was a response to public outcry after three people were diagnosed with the rare blood malignancy polycythemia vera on Ben Titus Road in the cancer-plagued Still Creek community, which lies near the McAdoo Associates Superfund site, Northeastern Power's waste-coal-fired co-generator and Air Products' industrial gas operation.
Lesko says he was invited to Hometown by Dr. Gene Weinberg, a state epidemiologist who conducted the DOH study. When residents criticized Weinberg's research for downplaying the connection between the area's pollution and their health problems, Lesko told attendees he might be willing to attempt his own study – "with adequate funding," of course. A spokesperson for state Sen. James Rhoades later told the Pottsville Republican that Rhoades "would likely approach U.S. Sens. Arlen Specter and Rick Santorum, both Republicans, and U.S. Rep. T. Timothy Holden, D-17, to tap money for a more extensive study."
I never heard of Lesko or NRCI before that meeting, so I did some checking. As it turns out, they have conflicts of interest that should automatically disqualify their involvement in Hometown.
One of NRCI's biggest funders is the U.S. Department of Energy, which is responsible for contamination at McAdoo Associates through National Beryllia of Haskell, N.J. A DOE contractor covered under the Energy Employees Occupational Illness Compensation Program, National Beryllia was among the companies sued by the U.S. Environmental Protection Agency to finance the site’s cleanup. Another conflict arises because Lesko's father (who's now deceased) worked for Air Products, which besides polluting Hometown's air also dumped waste at McAdoo Associates. Asking Lesko to study Hometown would put him in the position of possibly implicating or exonerating his father's former employer -- and his own employer’s major funder.
Unfortunately, Lesko did not disclose these potential conflicts at the Hometown meeting. In a recent interview, he said he did not know about DOE or Air Products involvement at McAdoo Associates until I told him about it.
"I don't even know where McAdoo Associates is," he said.
Lucky guy. Apparently he never had the bad luck to drive past it in the late 1970s when the chemical stench was so horrible you had to roll up the car windows to keep from retching. Today the site is still visible from Route 309, just up hill from the local drinking water reservoir, a chain-link fence marking the spot where some of America's biggest corporations -- and taxpayer-supported government contractors -- incinerated and dumped thousands of barrels of the most toxic chemicals known to science.
Following NRCI's Money
The DOE has been extremely generous to NRCI. Of the institute's total annual receipts of about $2.5 million, the DOE gave $640,000 in 2003, $1.4 million in 2002 and $529,000 in 2001, according to Internal Revenue Service paperwork available through Guidestar. In 1998, Congress appropriated a total of $10 million in DOE funds to NRCI "for innovative research that supports the Department's exploration of microbial genetics," according to House Report 105-271.
NRCI also has a close relationship with U.S. Sen. Rick Santorum (R-Pa.), who's currently pushing a plan to dredge the Delaware River and dump most of the resulting toxic waste in Pennsylvania. Schuylkill County would probably be targeted to get at least some of the dredge, since the material's already been dumped in coalmines in the nearby borough of Tamaqua over area residents' strenuous objections.
For at least the past two years, Santorum has presented checks of $100,000 in federal funds to NRCI for its work on colorectal cancer. He personally secured the money from the federal Centers for Disease Control and Prevention, and Lesko and NRCI President Robert Durkin have joined him at the presentation ceremonies.
Can we really expect an organization with such close financial ties to local polluters to take an unbiased look at the area's environmental health problems?
Not according to Dr. Samuel Epstein. Professor emeritus at the University of Illinois School of Public Health, Epstein is the author of more than 250 peer-reviewed articles and 11 books on environment and cancer, including The Politics of Cancer, winner of the American Library Association's Notable Book Award in 1979. (He published a follow-up, The Politics of Cancer, Revisited, in 1998.) Epstein currently chairs the Cancer Prevention Coalition, which unites leading independent public health experts and citizen activists to reduce growing cancer rates by promoting prevention. But unlike NRCI and many other cancer organizations, CPC's prevention message goes beyond personal matters such as smoking and diet to address environmental pollution.
Epstein cautioned Hometown-area residents against working with a DOE-funded organization. "I would be pretty suspicious of anything coming from the administration," he told me. "I don't believe they would be willing to find anything counter to their interests."
Even Lesko acknowledged he probably wouldn’t be the best person for the job. "I think we probably could do a scientifically valid study," he said. "A potential conflict of interest like you're suggesting should be disclosed. But the community perhaps wouldn't accept the study's scientific validity."
Perhaps it wouldn't, indeed. So why would local politicians want to waste taxpayers' money on expensive research when the outcome is guaranteed to be tainted by doubt?
NRCI's Lack of Experience
And then there's the troubling fact that Lesko and NRCI have absolutely no experience conducting the kind of studies being discussed for Hometown.
The NRCI was founded in 1991 by several Northeast Pennsylvania hospitals and serves Lackawanna, Luzerne, Pike, Wayne, Susquehanna, Wyoming, Columbia, Montour and Northumberland counties. It collects cancer statistics from member hospitals and publishes incidence maps comparing county cancer rates to state rates. It also educates health care providers about cancer and offers resources for cancer patients. This month's NRCI events address fear of recurrence, colon and skin cancer prevention, family risk, and genetic screening. The institute also distributes information on cervical cancer to low-income women through the federal Women, Infants and Children hunger relief program.
The NRCI's educational work focuses on cancers that can be prevented in large part by individual initiative such as diet and exercise, staying out of the sun, and avoiding unprotected sex. It has no experience studying communities harmed by environmental pollution -- a fact Lesko acknowledged.
"The institute has not done publishable work on environmental links to cancer," he told me.
Further, the organization shows little interest in environmental pollution's links to cancer. For example, NRCI's 125-page Cancer Resources Guide -- "a one-stop resource for newly diagnosed cancer patients, their families and caregivers" -- doesn't even include the word "pollution," and the only environmental toxin it mentions is tobacco.
Nor did Lesko show any professional interest in pollution’s health effects prior to his 2000 arrival at NRCI from Boston University. A search for his name in PubMed, the National Library of Medicine's online research database, turns up a body of work that includes research on diarrhea in American infants, sleep-disordered breathing symptoms in 5-year-olds, and bed sharing's relationship to breastfeeding -- but nothing on environmental pollution.
Lesko did have a suggestion for who might be a good alternative for conducting a study of Hometown: his former colleague, Dr. Richard Clapp. A professor of environmental health at Boston University, Clapp is also a member of the Prevent Cancer Coalition board.
But Hometown residents might want to consider whether an epidemiological study is something they want to press for at all. There are many problems associated with this kind of research for pollution-afflicted communities, according to Dr. Steven Wing, an epidemiologist at the University of North Carolina at Chapel Hill. Wing is the researcher who documented a connection between Pennsylvania's 1979 Three Mile Island nuclear disaster and increased cancer rates in the surrounding communities. In his work on TMI, Wing encountered deep biases on the part of DOH and other officials and wrote about his experience in a monograph titled "Objectivity and Ethics in Environmental Health Science" published in the journal Environmental Health Perspectives in 2003.
"The health and pollution issues in Hometown are frustrating for several reasons," Wing wrote in a recent e-mail to me. "Whatever pollution there is in the area should concern people who live with it regardless of their disease experience. It is disrespectful, dangerous and irresponsible for industries to avoid costs by dumping on people and leaving a mess that contaminates the environment. Unfortunately that happens in far too many places and tends to occur more in places where people have less wealth and political power.
"Clusters of the non-infectious diseases you write about are resistant to satisfactory investigation for several reasons," he continued. "First, these diseases are not named according to a necessary cause. Unlike tuberculosis, salmonellosis, the flu, or black lung, all of which are named according to a causal agent that is found in every case, cancers, thyroid and autoimmune diseases are named according to their site of occurrence in the body, changes in tissues, or effects on function. If there is an infectious disease outbreak, the infectious agent can be isolated from sick people and the investigation involves looking for the source of the germ, such as drinking water, food, a human carrier, or insect vectors. With cancer (for example), nothing isolated from a patient indicates what caused the cancer. Even strong carcinogens are not very effective in producing specific cancers -- most smokers do not get lung cancer -- and it is very hard to know what people have been exposed to via air, water, diet, and dermal absorption over the long time periods that are involved with most cancers.
"... In my experience it is hard to get much satisfaction from studies like those conducted by PDOH because these studies do not have the sensitivity to detect the causes of disease," Wing concluded. "But this doesn't mean that there is no causal connection between the environment and health, and it doesn't mean people shouldn't fight for clean up and environmental protection on principle, regardless of evidence about disease."
Hear, hear. Furthermore, we the people of Hometown don't need a multimillion-dollar, taxpayer-funded study to know our health is being damaged by the area's extraordinary levels of environmental pollution. But by pushing for such a health study, politicians appear to be doing something about the local health crisis while allowing it to continue. Meanwhile, what are are those politicians doing to clean up the mess in Hometown -- and to get us the medical help we need right now?
Lesko says he was invited to Hometown by Dr. Gene Weinberg, a state epidemiologist who conducted the DOH study. When residents criticized Weinberg's research for downplaying the connection between the area's pollution and their health problems, Lesko told attendees he might be willing to attempt his own study – "with adequate funding," of course. A spokesperson for state Sen. James Rhoades later told the Pottsville Republican that Rhoades "would likely approach U.S. Sens. Arlen Specter and Rick Santorum, both Republicans, and U.S. Rep. T. Timothy Holden, D-17, to tap money for a more extensive study."
I never heard of Lesko or NRCI before that meeting, so I did some checking. As it turns out, they have conflicts of interest that should automatically disqualify their involvement in Hometown.
One of NRCI's biggest funders is the U.S. Department of Energy, which is responsible for contamination at McAdoo Associates through National Beryllia of Haskell, N.J. A DOE contractor covered under the Energy Employees Occupational Illness Compensation Program, National Beryllia was among the companies sued by the U.S. Environmental Protection Agency to finance the site’s cleanup. Another conflict arises because Lesko's father (who's now deceased) worked for Air Products, which besides polluting Hometown's air also dumped waste at McAdoo Associates. Asking Lesko to study Hometown would put him in the position of possibly implicating or exonerating his father's former employer -- and his own employer’s major funder.
Unfortunately, Lesko did not disclose these potential conflicts at the Hometown meeting. In a recent interview, he said he did not know about DOE or Air Products involvement at McAdoo Associates until I told him about it.
"I don't even know where McAdoo Associates is," he said.
Lucky guy. Apparently he never had the bad luck to drive past it in the late 1970s when the chemical stench was so horrible you had to roll up the car windows to keep from retching. Today the site is still visible from Route 309, just up hill from the local drinking water reservoir, a chain-link fence marking the spot where some of America's biggest corporations -- and taxpayer-supported government contractors -- incinerated and dumped thousands of barrels of the most toxic chemicals known to science.
Following NRCI's Money
The DOE has been extremely generous to NRCI. Of the institute's total annual receipts of about $2.5 million, the DOE gave $640,000 in 2003, $1.4 million in 2002 and $529,000 in 2001, according to Internal Revenue Service paperwork available through Guidestar. In 1998, Congress appropriated a total of $10 million in DOE funds to NRCI "for innovative research that supports the Department's exploration of microbial genetics," according to House Report 105-271.
NRCI also has a close relationship with U.S. Sen. Rick Santorum (R-Pa.), who's currently pushing a plan to dredge the Delaware River and dump most of the resulting toxic waste in Pennsylvania. Schuylkill County would probably be targeted to get at least some of the dredge, since the material's already been dumped in coalmines in the nearby borough of Tamaqua over area residents' strenuous objections.
For at least the past two years, Santorum has presented checks of $100,000 in federal funds to NRCI for its work on colorectal cancer. He personally secured the money from the federal Centers for Disease Control and Prevention, and Lesko and NRCI President Robert Durkin have joined him at the presentation ceremonies.
Can we really expect an organization with such close financial ties to local polluters to take an unbiased look at the area's environmental health problems?
Not according to Dr. Samuel Epstein. Professor emeritus at the University of Illinois School of Public Health, Epstein is the author of more than 250 peer-reviewed articles and 11 books on environment and cancer, including The Politics of Cancer, winner of the American Library Association's Notable Book Award in 1979. (He published a follow-up, The Politics of Cancer, Revisited, in 1998.) Epstein currently chairs the Cancer Prevention Coalition, which unites leading independent public health experts and citizen activists to reduce growing cancer rates by promoting prevention. But unlike NRCI and many other cancer organizations, CPC's prevention message goes beyond personal matters such as smoking and diet to address environmental pollution.
Epstein cautioned Hometown-area residents against working with a DOE-funded organization. "I would be pretty suspicious of anything coming from the administration," he told me. "I don't believe they would be willing to find anything counter to their interests."
Even Lesko acknowledged he probably wouldn’t be the best person for the job. "I think we probably could do a scientifically valid study," he said. "A potential conflict of interest like you're suggesting should be disclosed. But the community perhaps wouldn't accept the study's scientific validity."
Perhaps it wouldn't, indeed. So why would local politicians want to waste taxpayers' money on expensive research when the outcome is guaranteed to be tainted by doubt?
NRCI's Lack of Experience
And then there's the troubling fact that Lesko and NRCI have absolutely no experience conducting the kind of studies being discussed for Hometown.
The NRCI was founded in 1991 by several Northeast Pennsylvania hospitals and serves Lackawanna, Luzerne, Pike, Wayne, Susquehanna, Wyoming, Columbia, Montour and Northumberland counties. It collects cancer statistics from member hospitals and publishes incidence maps comparing county cancer rates to state rates. It also educates health care providers about cancer and offers resources for cancer patients. This month's NRCI events address fear of recurrence, colon and skin cancer prevention, family risk, and genetic screening. The institute also distributes information on cervical cancer to low-income women through the federal Women, Infants and Children hunger relief program.
The NRCI's educational work focuses on cancers that can be prevented in large part by individual initiative such as diet and exercise, staying out of the sun, and avoiding unprotected sex. It has no experience studying communities harmed by environmental pollution -- a fact Lesko acknowledged.
"The institute has not done publishable work on environmental links to cancer," he told me.
Further, the organization shows little interest in environmental pollution's links to cancer. For example, NRCI's 125-page Cancer Resources Guide -- "a one-stop resource for newly diagnosed cancer patients, their families and caregivers" -- doesn't even include the word "pollution," and the only environmental toxin it mentions is tobacco.
Nor did Lesko show any professional interest in pollution’s health effects prior to his 2000 arrival at NRCI from Boston University. A search for his name in PubMed, the National Library of Medicine's online research database, turns up a body of work that includes research on diarrhea in American infants, sleep-disordered breathing symptoms in 5-year-olds, and bed sharing's relationship to breastfeeding -- but nothing on environmental pollution.
Lesko did have a suggestion for who might be a good alternative for conducting a study of Hometown: his former colleague, Dr. Richard Clapp. A professor of environmental health at Boston University, Clapp is also a member of the Prevent Cancer Coalition board.
But Hometown residents might want to consider whether an epidemiological study is something they want to press for at all. There are many problems associated with this kind of research for pollution-afflicted communities, according to Dr. Steven Wing, an epidemiologist at the University of North Carolina at Chapel Hill. Wing is the researcher who documented a connection between Pennsylvania's 1979 Three Mile Island nuclear disaster and increased cancer rates in the surrounding communities. In his work on TMI, Wing encountered deep biases on the part of DOH and other officials and wrote about his experience in a monograph titled "Objectivity and Ethics in Environmental Health Science" published in the journal Environmental Health Perspectives in 2003.
"The health and pollution issues in Hometown are frustrating for several reasons," Wing wrote in a recent e-mail to me. "Whatever pollution there is in the area should concern people who live with it regardless of their disease experience. It is disrespectful, dangerous and irresponsible for industries to avoid costs by dumping on people and leaving a mess that contaminates the environment. Unfortunately that happens in far too many places and tends to occur more in places where people have less wealth and political power.
"Clusters of the non-infectious diseases you write about are resistant to satisfactory investigation for several reasons," he continued. "First, these diseases are not named according to a necessary cause. Unlike tuberculosis, salmonellosis, the flu, or black lung, all of which are named according to a causal agent that is found in every case, cancers, thyroid and autoimmune diseases are named according to their site of occurrence in the body, changes in tissues, or effects on function. If there is an infectious disease outbreak, the infectious agent can be isolated from sick people and the investigation involves looking for the source of the germ, such as drinking water, food, a human carrier, or insect vectors. With cancer (for example), nothing isolated from a patient indicates what caused the cancer. Even strong carcinogens are not very effective in producing specific cancers -- most smokers do not get lung cancer -- and it is very hard to know what people have been exposed to via air, water, diet, and dermal absorption over the long time periods that are involved with most cancers.
"... In my experience it is hard to get much satisfaction from studies like those conducted by PDOH because these studies do not have the sensitivity to detect the causes of disease," Wing concluded. "But this doesn't mean that there is no causal connection between the environment and health, and it doesn't mean people shouldn't fight for clean up and environmental protection on principle, regardless of evidence about disease."
Hear, hear. Furthermore, we the people of Hometown don't need a multimillion-dollar, taxpayer-funded study to know our health is being damaged by the area's extraordinary levels of environmental pollution. But by pushing for such a health study, politicians appear to be doing something about the local health crisis while allowing it to continue. Meanwhile, what are are those politicians doing to clean up the mess in Hometown -- and to get us the medical help we need right now?
posted by Sue Sturgis at
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