[ RadSafe ] Re: 2.2 odds/risk ratio

[Steven Dapra]

Feb. 28, 2007

On Feb. 2, James Salsman wrote," The fact remains that the number of birth 
defects in the children of combat-deployed male U.S. and U.K. 1991 Gulf War 
troops has been rising sharply, from 180% above the non-combat troops from 
the same era in 2000, to 220% in 2003."

I requested source material to support the claim of these large increases.

On Feb. 9, JS wrote, "I also apologize to Steve Dapra for claiming that a 
risk ratio of 1.8 or 2.2 is the same as a 180% or 220% increase; I should 
have said an 80% and 120% increase."

On Feb. 10, I again asked JS where he got the ratio of 2.2.

On Feb. 26, JS wrote, ""with medical records verification ... Dr. Kang and 
his colleagues concluded that the risk of birth defects in children of 
deployed male veterans was about 2.2 times that of non-deployed 
veterans."  -- Department of Veterans Affairs (2003) "Q's & A's -- New 
Information Regarding Birth Defects" Gulf War Review, vol. 12(1), page 10, 
fifth line from the end in: http://www1.va.gov/gulfwar/docs/GulfWarNov03.pdf

         I have read the Q's & A's (Q&A) in "Gulf War Review" (GWR) at this 
link, and a related article that is invoked in a footnote to the Q&A 
article, and have copies of each before me as I write.  (Keep in mind that 
this edition of GWR is dated November 2003.)

         In the third paragraph, the Q&A says, "It is not clear whether 
Gulf War military service and birth defects are linked.  But several 
studies are addressing this concern."  The Q&A then prints a lengthy reply 
by Dr. Mark A. Brown, Director of Environmental Agents Service (presumably 
a VA sub-agency), that Brown wrote in reply to an inquiry from a GWR reader.

         Brown presents a brief discussion of a study by Araneta et al. in 
Birth Defects Research, that found a few instances of increased rates of 
birth defects in children born to male and female Gulf War veterans.  He 
then says, "However, the overall rate of birth defects was not higher among 
Gulf War veterans."

         Brown further says, "Also, several previous similar large studies 
have shown no statistically significant increase in birth defects among 
children born to Gulf War veterans.

         "The [Araneta et al.] study does not provide solid proof that 
children of Gulf War veterans are at higher risk of birth defects because 
the results could easily have resulted from chance alone."

         In a footnote to the next paragraph, someone --- presumably a GWR 
editor --- mentions Dr. Han Kang's findings that are discussed in another 
article in the Nov. 2003 issue of GWR, saying:  "Preliminary results, 
announced by Dr. Kang, found that male Gulf War veterans reported having 
infants with likely birth defects at twice the rate of 
non-veterans.  Furthermore, female Gulf War veterans were almost three 
times more likely to report children with birth defects than their non-Gulf 
counterparts.  The numbers changed somewhat with medical records 
verification.  However, Dr. Kang and his colleagues concluded that the risk 
of birth defects in children of deployed male veterans still was about 2.2 
times that of non-deployed veterans. His research is currently undergoing 
peer review."

         The other article in the Nov. 2003 GWR describes two meetings of 
the Research Advisory Committee on Gulf War Veterans' Illnesses (RAC) that 
met in Washington, DC, in June, 2003; and Oct. 2003.  Of the Oct. meeting, 
the other article says, "During the first day of this meeting, VA 
researcher Han Kang presented information from the VA's National Health 
Survey of Gulf War Veterans and Their Families that shows an association 
between the children's birth defects and their parents' military service in 
the Gulf War.  . . .  [Kang's finding] has not yet been peer-reviewed or 
published in a scientific journal, steps required to gain acceptance [among 
scientists]."  In a parenthetical sentence, the article also notes that 
"Occasionally, scientific papers undergo extensive changes during this 
process as methodologies are carefully analyzed, assumptions challenged, 
and conclusions [are] modified."

         This other article in the Nov. 2003 GWR says nothing else about 
Kang's research.

         To recapitulate the key points, on Feb. 2 James Salsman claimed 
there had been a 220% increase in birth defects.  On Feb. 9, he admitted 
this was wrong, and that he should have said there was a 120% increase in 
birth defects.  On Feb. 9 he also said something about "a risk ratio of 1.8 
or 2.2".  On Feb. 10 I asked where he got the ratio of 2.2.  (I did not ask 
about the ratio of 1.8, because I thought, incorrectly, that it was a 
rounded off figure in another Kang paper, but even though Salsman hasn't 
explained the 1.8 let's leave it out of this.)  Finally on Feb. 26 Salsman 
came up with Kang's claim of the "2.2 times" risk --- a claim of Kang's 
that had NOT been subjected to peer review.

         Furthermore, the GWR Q&A article, and the Research Advisory 
Committee article --- EACH of them --- SPECIFICALLY STATE that Kang's 
research was either undergoing peer review (Q&A article) or that it had NOT 
been peer-reviewed or published (RAC article).

         And that is where matters stand as of November 2003.  Did Kang's 
2.2 ratio make it through peer review?  We don't know, however I'm certain 
that if it had James Salsman would be busy waving it around like a flaming 
torch.

Steven Dapra
sdjd at swcp.com