[ RadSafe ] three questions

Wed Apr 11 20:54:09 CDT 2007

April 11

         My reply to James Salsman's message of April 10 follows.  He is 
JS, I am SD.  Portions of his message have been omitted.

SD

If you have some complaints about the HPS page, why not take them to the WHO?

JS
Is the WHO the right place to take them? Shouldn't I be contacting the 
American Conference of Governmental Industrial Hygienists' Executive 
Director and the Chair of the ACGIH Threshold Limit Values for Chemical 
Substances Committee?

SD

         I don't know.  Is it?  I don't know.  Should you?

         To remind you, you complained about the Health Physics Society's 
depleted uranium fact sheet.  You cleverly ignored the fact that the fact 
sheet is based on World Health Organization findings about DU.  Since the 
fact sheet is based on WHO findings, it is only natural -- isn't it? -- to 
take your complaints to the WHO.  As far as I know the ACGIH is not the 
World Health Organization, so taking your complaints to the former body 
would probably be a waste of time.

SD

         (JS had asked about "birth defect increases in Basrah".)

Assuming that by birth defects in Basrah you mean defects in Iraqi citizens 
I can think of two hypotheses. First, bad diet, specifically a lack of 
sufficient folic acid in women who were planning on becoming pregnant. 
Second bad diet in general, caused by the UN sanctions during the 1990s.

JS
There hasn't been an increase in birth defects in other places in Iraq, 
just Basra.

SD

         You appear to have claimed in the past that Iraqi birth defects 
are being caused by DU (and possibly by other agents).  If the defects are 
only occurring in or around Basra, that would mean DU was only used around 
Basra.  I find it hard to believe that DU was only used around Basra.  If 
it was used in other locations, why aren't there increases in birth defects 
in these areas as well?  Aren't your anti-DU fellow travelers claiming that 
wind-blown DU has spread all over Iraq?  If so, why aren't there birth 
defects all over Iraq?

SD

For US troops I don't think anyone has shown conclusively that there are 
increased in birth defects to US children....

JS
They have: Kang and Araneta both have the lower end of their confidence 
levels of the risk ratios well above unity.

SD

         Oops.  Well, maybe not oops.  In their summary Conclusion at the 
beginning of their paper, Kang et al. (2001) write, "The risk of veterans 
reporting birth defects among their children was significantly associated 
with veteran's military service in the Gulf War.  This observation needs to 
be confirmed by a review of medical records to rule out possible reporting 
bias."  (p. 504)  Remember, this was a self-reported study based on a 
mailed questionnaire, and on telephone follow-up.  There are some 
intricacies to the aspects of bias in self-reported studies, and Kang et 
al. discuss them, however those intricacies need not concern us here.

         Kang et al. also write that they were "unable to evaluate specific 
defects" and that this stemmed from "the dearth of documented information 
regarding specific exposures of particular veterans and the lack of 
knowledge on the human teratogenicity of most of the reported exposures . . 
. ."   They could not tell "which exposures might be associated with which 
outcomes."  (p. 509, col. 2)  Hence, even if these children did incur 
increased rates of birth defects, it is not possible to associate a 
specific defect with a specific agent.  Similar qualifiers will be found in 
Araneta et al. (2003).

SD

         There are other causes [of birth defects] too, such as exposure to 
poison gas, oil well fire smoke, and diseases and insects that are peculiar 
to the region.

JS
Those have been ruled out by the pentagon: The poison gasses used are not 
teratogenic (they are very carcinogenic though, and there's been no 
substantial increase in cancer.) The firefighters who were in the smoke 
don't have any of the GWI symptoms.

SD

         This is rich.  All of a sudden James Salsman believes the "pentagon."

         According to Kang et al. (2001) "Certainly, Gulf veterans were 
exposed to many chemical, biological, and physical agents suspected of 
being reproductive toxins."  (p. 509, col. 2)  For this, they give two 
citations:  the Presidential Advisory Committee on Gulf War Veterans' 
Illnesses, Final Report, 1996; and an Institute of Medicine report dated 
1996.  [see footnotes 1 and 22 in Kang et al. (2001)]

SD

You have never claimed increases in birth defects in UK soldiers.

JS
Yes, I have, Pat Doyle's study, I've cited it many times on RADSAFE.  And 
you have commented on it, too.  So, how about Canadians?  "higher 
prevalence of reported birth defects of babies of 
GWVs"  http://www.dnd.ca/site/Reports/Health/study1_e.asp

SD

         I know of two Doyle studies, and I am going to assume that you are 
referring to Doyle et al. (2006).  You could mean Doyle et al. (2004) 
though.  Let me quote what 2006 has to say about 2004, and about Kang et 
al. (2001):  "Both reported some evidence of a modest increase in risk of 
birth defect for male veterans' offspring born after the war, although 
cautious interpretations were offered because of concern about reporting 
bias."  (There's that word "modest" that you so like to complain about.)

Note the cautious interpretations, and the reporting bias.  Doyle et al. 
(2006) is a review paper.  Of Doyle et al. (2004), it says this was a 
"postal survey" (self-reported), with validation of two health 
conditions.  For male veterans it showed "no evidence of increased risk of 
most types of major congenital anomaly; some evidence of increased risk of 
anomaly of the genital and urinary system, but effect diminished when only 
validated defects [are] analysed".  For female veterans Doyle et al. (2004) 
showed "no evidence of increased risk of congenital anomaly."  (p. 573, 
Table 1)

         The Canadians are a clever red herring.  Your "higher prevalence" 
quote is from the Executive Summary.

         If you had bothered to read section 6.3.10 (Comparison of GWVs and 
Controls: Reproductive Outcomes), you would have found that "The 
proportional distribution of [congenital] anomaly births is similar for 
both GWVs and controls."  (GWV is, of course, Gulf War Veterans.)

         Concerning the rate of "reported birth defects," the Canadian 
report says, "Both of these rates are within expectation for the general 
population but the overall experience of GWVs is more than double the 
controls' experience . . . ."

         There is more, but perhaps I've made the point by now that the 
findings were inconclusive, or they reflected the general population.

         On March 6, you wrote, "So Dr. Kang goes back and reviews 700+ 
medical records, and finds that the number of birth defects has increased 
20%."  What is your source for this claim that Dr. Kang reviewed over 700 
medical records, and where did he publish these findings?  You are so good 
at asking questions, James.  Let's see you answer one for a change.

Steven Dapra
sjd at swcp.com

REFERENCES

Araneta, M. R. et al.  Prevalence of Birth Defects among Infants of Gulf 
War Veterans . . . .   Birth Defects Research.  (Part A) 67:246-260 (2003).

Doyle, P. et al.  Reproductive health of Gulf War Veterans.  Philosophical 
Transactions of the Royal Society B.  361:571-584; 2006.

Doyle P. et al.  Miscarriage, stillbirth and congenital malformation . . . 
.  International Journal of Epidemiology.  33:74-86; 2004.

Kang, H. et al.  Pregnancy Outcomes among U.S. Gulf War Veterans . . . 
.  Annals of Epidemiology, 11:504-511; 2001.