[ RadSafe ] Busby's Fallujah paper -- a critique

[Steven Dapra]

Oct. 23, 2011

	In the preceding week or two, Chris Busby has delivered several 
exhortations that critics of his co-authored paper "Uranium and other 
contaminants in hair from the parents of children with congenital 
anomalies in Fallujah, Iraq" should "read the paper."

	I have read most of the paper, not all of it, and have done Busby 
one better.  I have read some of the source material he cited and am 
ready to present a critique of the paper.  According to Section 6 of 
the paper, Chris Busby drafted the manuscript, so I will refer to it 
as Busby's paper.  (Later, I will have more to say about 
authorship.)  This is not an exhaustive critique of Busby's paper, 
nor does it claim to be.  The "fn. x" references in my critique refer 
to the footnotes to Busby's Fallujah paper.

	Busby begins by saying there have been "reports of increased rates 
of cancer and congenital anomaly (CA) from Fallujah, Iraq."  He 
supports this claim (fn. 1) by quoting a paper he co-authored, and by 
quoting a paper (fn. 2) that reported on a study done on a cohort of 
four families.  He does not explain how these four families were 
chosen, nor are any data given about exposures to any toxins.  He 
invokes Agent Orange as a "war contaminant" having the "potential" to 
interfere with the development of the in utero child.  The study was 
funded by the Kuala Lumpur Foundation to Criminalize War.

	Busby writes that after the first Gulf war a research effort focused 
on DU as a "potential cause of increases in congenital anomaly (CA) 
and cancer rates."  In support of this, he cites a one page "News" 
article in the British Medical Journal (fn. 5).  This article 
includes a picture of a boy, perhaps ten years of age, with an 
"unknown" skin condition that was attributed to possible exposure to 
depleted uranium.  The BMJ received approximately eight letters 
commenting on this article.  Four of them pointed out that the boy 
suffered from a rare, inherited, (usually) autosomal recessive skin 
disorder, which the writers named.

	One of the writers noted that this photo had been used before in 
discussions of DU.  Another asked the question "How could one 
attribute an unknown condition to a specific cause?"  Eventually, 
Richard Smith, editor of the BMJ, published a letter apologizing for 
the article and the photograph.  Malcolm Aitken, author of the "News" 
article, published an apologetic and explanation for the article.  He 
invoked anecdotal evidence of alleged DU-related illnesses published 
in the Independent (by Robert Fisk), and in The Guardian (by Maggie 
O'Kane).  (I believe I have posted a link to RADSAFE to Fisk's 
article.)  Aitken also invoked Dan Fahey as a reliable source about DU.

	In fn. 9, Busby cites a study by Doyle et al. that "reported rates 
of congenital malformation" in a group of children of male and female 
UK veterans of the Gulf war.  This was a self-reported retrospective 
reproductive study with a comparison group.  When clinical diagnoses 
were obtained the associations with Gulf war service and 
malformations tended to "weaken".  On page 84 the authors discuss the 
problem of reporting bias, and on page 85 they say it is "important" 
to further investigate their findings and those of similar 
studies.  They also write, "However, there are severe limitations on 
what can be interpreted from data gathered retrospectively with 
little or no contemporaneous individual exposure information."

	Busby also uses fn. 10 in support of his claim of increased rates of 
congenital malformations.  This paper, published in Birth Defects 
Research, notes an increased rate of some deleterious conditions.  It 
then says (in the Abstract), "we did not have the ability to 
determine if the excess was caused by inherited or environmental 
factors, or was due to chance because of myriad reasons, including 
multiple comparisons."

	Let's skip ahead now to fn. 30, which Busby uses to support his 
claim that "Uranium may be considered theoretically to show enhanced 
levels of genomic damage" relative to exposure levels.  The paper 
cited (in Environmental Health Perspectives) reports on an in vitro 
study and says, "Microdosimetry studies demonstrate that few [amount 
given] cells are actually hit by alpha particles emitted from 
DU.  This argues for a negligible role for radiation effects from 
DU-UO2 2+ exposure."

	Another study (fn. 36) reports on the results of a study of a cohort 
of 16 volunteers that was funded by grants from the World Depleted 
Uranium Center in Berlin.  The authors note that the volunteers were 
exposed to more than DU.

	Busby's fn. 39 cites a study on uranium in hair conducted on a few 
monks in a monastery in northern Greece.  In their conclusions, the 
authors write, "From the results obtained in the present study, . . . 
it can be concluded that, from the radiochemical point of view, the 
monks were not exposed to uranium."

	In the last example I will give, Busby (fn. 44) cites a review paper 
in the British Medical Bulletin discussing the effects of 
environmental pollution on congenital anomalies.  This review paper 
mentions Iraq once, in connection with the methyl mercury poisoning 
there in 1971  1972.

	Now for some general comments about Busby's References.  His paper 
has 63 footnotes.  Eight of these (13%) are material written by 
Busby.  Three of them, and the Fallujah paper, were published in the 
International Journal of Environmental Research and Public 
Health.  He uses a paper by Han Kang.  He uses the Chernobyl article 
that was published by the NY Academy of Sciences, and was eventually 
disclaimed by the same Academy.  He ignores or is unaware of the 
letters in the BMJ about the boy with the "unknown" skin condition 
(fn. 5).  He quotes from some of the DU literature I debunked here in 
2006 when James Salsman and I had our battle over DU.  (Rita Hindin's 
paper, for instance.)

	To return to authorship, in Section 6 of the Fallujah paper, Busby 
says, "All authors read and approved the final manuscript[.]"  I 
wonder how carefully they read it?  Did they double-check any of the 
References?  Or did they merely give it a hurried once over and 
scribble "approved" on it?

Steven Dapra