Sustained Outrage

On Monday and Tuesday evenings, the three-person C8 Science Panel will for the first time in its more than five years of activity hold public meetings to talk with the people of the Mid-Ohio Valley about its work.

Meetings are scheduled for Monday at Blennerhassett Middle School Auditorium in Parkersburg and Tuesday night at Meigs Local Middle School Auditorium in Pomeroy, Ohio. Both meetings start at 6 p.m.

We’ve written before here about how the C8 Science Panel’s periodic “Status Reports” are pretty bare bones, and don’t contain any data that would really allow anyone to critique the judgments being made by the panel.

And now, a series of new presentations — delivered by Science Panel members at an International Society for Environmental Epidemiology meeting last week in Barcelona, Spain — provides some interesting examples of how the panel’s Status Reports to the community differ from the data they report to other scientists in journals and at academic conferences. Here’s what I mean:

Back in July, the Science Panel issued a Status report called Serum PFOA and liver function markers in the blood of adults in the Mid-Ohio Valley that found an association between higher C8 levels and higher levels of one liver function marker, ALT. The panel also reported that neither of the other two markers examined, GGT or bilirubin, showed a clear relationship with C8, but provided no data to support that conclusion.

In a later interview with me, Science Panel member Tony Fletcher kind of hedged, though, when pressed about these findings … and now we know why.

As part of a presentation in Barcelona, Dr. Fletcher released some data results from this particular Science Panel study. I’ve posted a copy of this presentation here. This is what the new presentation — for the first time — says:

— There is some suggestion of an association between PFOA and GGT in linear regression models; however, these were not replicated in logistic regressions.

The relationship between PFOA and direct bilirubin is suggestive of an increase in bilirubin [with] increasing PFOA concentations up to 40 ng/ML, followed by a decrease in bilirubin after this peak.

— Negative associations observed in some occupational studies might be due [to] inclusion of subjects in the higher range of exposure missing the first part of the inverse U-shaped curve.

In a January 2011 Status Report called Association of perfluorinated compounds with Attention Deficit/Attention Deficit Hyperactivity Disorder and Learning Disorder among children aged 5 – 18 years with elevated community exposure to PFOA, reported that as levels of C8 in the blood increased, reports of ADD/ADHD decreased slightly. Basically, the Science Panel said it appears that higher levels of C8 appeared to be protecting against ADHD.

Six months later, when the panel’s work showed up in the peer-reviewed Environmental Health Perspectives journal, the results were reported somewhat differently:

There was an inverted J-shaped association between PFOA and ADHD, with a small increase in prevalence for the second quartile of exposure compared with the lowest, and a decrease for the highest versus lowest quartile. The prevalence of ADHD plus medication increased with perfluorohexane sulfonate (PFHxS) levels, with an adjusted odds ratio of 1.59 (95% confidence interval 1.21, 2.08) comparing the highest quartile of exposure to the lowest. There was a modest association between perfluorooctane sulfonate and ADHD with medication.

And now, in this presentation at the Barcelona conference, we learn of new results. If the data for children with 28.2 parts per billion and less of C8 in their blood are examined, they show what appears to be an increase in ADHD at levels similar to those in the general U.S. population. The panel says this is a “weak, imprecise positive association,” but worthy of further study.

Also in July 2011, the Science Panel released a Status Report called PFOA (C8) exposure and pregnancy outcome among participants in the C8 Health Project. It reported that “no associations were found” for stillbirths or birth defects, but provided no data on these matters.

But this presentation at the Barcelona conference includes data that seems to indicate a steadily increasing rate of stillbirths between the first and fourth C8 exposure groups., and then a drop in the highest exposure level. The panel, though, says the data provides “no support for association” with an increase in stillbirths.

Finally, in a Status Report also issued in July, the Science Panel reported on The mortality of DuPont workers in relation to exposure to PFOA (C8). Among other things, that Status Report said:

The only one which was significantly increased compared to the US population was mesothelioma, a rare cancer which is only caused by asbestos exposure, and is unlikely to be related to PFOA.

But now, in this presentation at Barcelona, the Science Panel says it found an “overall excess [of deaths] from mesothelioma” that “may be due to correlation of high exposure to both PFOA and asbestos for mechanics.”

Keep in mind now that these new findings were presented at a scientific conference in Spain — not at a public meeting or even a press conference in Parkersburg or Pomeroy. The Science Panel has chosen not to include detailed data in most of its Status Reports — perhaps at least in part because putting that data out there in the public domain would hurt their chances of getting their papers into the most prestigious journals.

I asked one of the Science Panel members, Dr. David Savitz of Brown University, about this, and he gave me this  explanation:

The decision about what to include the summaries provided for the Status Reports is another area in which we have to exercise some judgment. We focus on what we believe to be the bottom line message, and in doing so, inevitably fail to provide the full array of results.

Dr. Savitz also told me in an e-mail:

Also, by the timing, we prepare those before we have had peer review of the manuscript, and as in the case of the analysis of attention deficit disorder, the analyses done in response to suggestions can change the details though in no case has it changed the essential findings.

He also said:

For using the studies to make Probable Link assessments, of course we will use the full array of published data and then some, not restricting ourselves to the information summarized in the Status Reports. We instigated the mechanism for providing results in the form of Status Reports in the spirit of providing advance information to the Court and the affected community, but the full scientific report only comes with the publication, which we do make available upon request.

There is certainly no intent of presenting the summaries in a way that deviates from the more complete accounting that follows.

But would it really be so hard for the Science Panel to provide the same level of data detail to the people of the Parkersburg area — who after all are paying for the study — that they give to other scientists in places like Barcelona?